Oum Sophal, Chandramohan Daniel, Cairncross Sandy
Ministry of Health, Phnom Penh, Cambodia.
Trop Med Int Health. 2005 Jul;10(7):689-97. doi: 10.1111/j.1365-3156.2005.01445.x.
This study seeks to assess the performance of a community-based surveillance system (CBSS), developed and implemented in seven rural communes in Cambodia from 2000 to 2002 to provide timely and representative information on major health problems and life events, and so permit rapid and effective control of outbreaks and communicable diseases in general.
Lay people were trained as Village Health Volunteers (VHVs) to report suspected outbreaks, important infectious diseases, and vital events occurring in their communities to local health staff who analysed the data and gave feedback to the volunteers during their monthly meetings.
Over 2 years of its implementation, the system was able to detect outbreaks early, regularly monitor communicable disease trends, and to provide continuously updated information on pregnancies, births and deaths in the rural areas. In addition, the system triggered effective responses from both health staff and VHVs for disease control and prevention and in outbreaks.
A CBSS can successfully fill the gaps of the current health facility-based disease surveillance system in the rapid detection of outbreaks, in the effective monitoring of communicable diseases, and in the notification of vital events in rural Cambodia. Its replication or adaptation for use in other rural areas in Cambodia and in other developing countries is likely to be beneficial and cost-effective.
本研究旨在评估一个基于社区的监测系统(CBSS)的运行情况。该系统于2000年至2002年在柬埔寨的七个农村公社开发并实施,目的是提供有关主要健康问题和生活事件的及时且具有代表性的信息,从而总体上实现对疫情和传染病的快速有效控制。
将非专业人员培训为乡村卫生志愿者(VHV),由他们向当地卫生工作人员报告其社区中发生的疑似疫情、重要传染病和重大事件,当地卫生工作人员对数据进行分析,并在每月会议上向志愿者反馈。
在实施的两年多时间里,该系统能够早期发现疫情,定期监测传染病趋势,并持续提供农村地区怀孕、出生和死亡的最新信息。此外,该系统促使卫生工作人员和乡村卫生志愿者针对疾病控制与预防以及疫情做出了有效反应。
在柬埔寨农村地区,基于社区的监测系统能够成功填补当前基于医疗机构的疾病监测系统在快速发现疫情、有效监测传染病以及通报重大事件方面的空白。将其复制或加以调整用于柬埔寨其他农村地区以及其他发展中国家可能会带来益处且具有成本效益。