Simoes E A, McGrath E J
Department of Pediatrics, University of Colorado Health Sciences Center, Denver 80262.
Lancet. 1992;340(8834-8835):1502-3. doi: 10.1016/0140-6736(92)92757-7.
In developing countries primary health care workers are being trained to manage and treat acute respiratory infections with a protocol developed by the WHO. We tested the ability of nurses and nursing assistants in Swaziland to recognise the signs and symptoms of pneumonia; with the results of a paediatrician's examination as "gold standard", sensitivities and specificities were calculated. Danger signs of stridor and abnormal sleepiness were poorly recognised (sensitivity 0-50%) by the health care workers, as was audible wheeze. Severe undernutrition, tachypnoea, and chest wall indrawing were well recognised. Overall, the recognition of pneumonia was good (sensitivity 71-83%, specificity 84-85%). These findings highlight topics for emphasis in training.
在发展中国家，初级卫生保健工作者正在接受培训，以便按照世界卫生组织制定的方案来管理和治疗急性呼吸道感染。我们测试了斯威士兰护士和护理助理识别肺炎体征和症状的能力；以儿科医生的检查结果作为“金标准”，计算了敏感度和特异度。卫生保健工作者对喘鸣和异常嗜睡等危险体征的识别较差（敏感度为0 - 50%），对可闻及的哮鸣音的识别情况也是如此。严重营养不良、呼吸急促和胸壁凹陷则得到了较好的识别。总体而言，对肺炎的识别情况良好（敏感度为71 - 83%，特异度为84 - 85%）。这些研究结果突出了培训中需要重点强调的内容。
