The complexities of simple technologies: re-imagining the role of rapid diagnostic tests in malaria control efforts.
The complexities of simple technologies: re-imagining the role of rapid diagnostic tests in malaria control efforts.
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DOI：
10.1186/s12936-016-1083-2
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发表时间：
2016-02-05
期刊：
影响因子：
3
通讯作者：
Chandler CI
中科院分区：
文献类型：
--
作者：
Beisel U;Umlauf R;Hutchinson E;Chandler CI
疟疾快速诊断测试被认为是一种易于使用的移动技术，有能力在各种临床环境中标准化疟疾的寄生虫学诊断。为了评估这些测试，重要的是要考虑这些假设在实践中，在诊所、保健中心、药店和社区卫生志愿者的日常环境中如何发挥作用。本文借鉴了过去九年对RDTs进行的定性研究。特别是，该研究报告了关于乌干达、坦桑尼亚和塞拉利昂使用rdt的四个定性案例研究，包括定性访谈、焦点小组讨论和参与者观察。结果表明，虽然RDTs作为独立的技术工具可能很容易使用，但要使其在各种经济压力大的卫生保健环境中有效发挥作用并非易事。这些研究表明，要有效地开展RDTs，很可能恰恰需要它们所要替代的基础设施：资金充足和运转良好的卫生系统的医疗专业知识、组织能力以及诊断和治疗选择。这些结果强调，成功的疟疾诊断和治疗需要对一般卫生基础设施的投资与对新技术的投资一样多。
Malaria rapid diagnostic tests (RDTs) are assumed to be simple-to-use and mobile technologies that have the capacity to standardize parasitological diagnosis for malaria across a variety of clinical settings. In order to evaluate these tests, it is important to consider how such assumptions play out in practice, in everyday settings of clinics, health centres, drug stores and for community health volunteers. This paper draws on qualitative research on RDTs conducted over the last nine years. In particular the study reports on four qualitative case studies on the use of RDTs from Uganda, Tanzania and Sierra Leone, including qualitative interviews, focus group discussions and participant observation. Results suggest that while RDTs may be simple to use as stand-alone technological tools, it is not trivial to make them work effectively in a variety of economically pressured health care settings. The studies show that to perform RDTs effectively might very well need exactly the infrastructure they were designed to substitute: the medical expertise, organizational capacity and diagnostic and treatment options of well-funded and functioning health systems. These results underline that successful malaria diagnosis and treatment requires as much investment in general health infrastructure as it does in new technologies.