Eke R A, Enwereji E E
Department of Community Medicine & Public Health Care, College of Medicine Abia State University, Aba, Nigeria.
East Afr J Public Health. 2009 Apr;6(1):15-6. doi: 10.4314/eajph.v6i1.45736.
The introduction of primary health care made Nigeria, a developing country, train and retrain community health workers to work all over the country especially in the rural communities where there is dearth of doctors. Despite their training and experience many people are skeptical of their competence to diagnose accurately what more treating endemic disease like malaria. The need to find out the diagnostic competence of the health workers in malaria control programme now in Nigeria necessitated this study.
A rural primary health centre, the sentinel site for malarial control programme investigation in Imo State of Nigeria was selected. The community health technician (CHT) was the health worker in charge. Those who were diagnosed as malaria patients by CHT were examined by a medical laboratory scientist (who was engaged specifically for this job) for malaria parasitaemia. The laboratory examination was Giamsa - stained thick blood from fingerprint. Those with positive parasite density count at 1000/microL and above were regarded as malaria patients. The study was from March - October 2007.
The number diagnosed as malaria patients on clinical grounds by CHT was 2512 while the number diagnosed by both clinical and laboratory basis was 2490. The number of patients with wrong diagnosis of malaria by CHT was 22 (0.875%).
The CHT is useful in the diagnosis and by extension in the control of such endemic disease as malaria where there is no laboratory facilities. Both the employers and populace should repose confidence in their services and in the area where they have been trained and acquired experience
初级卫生保健的引入促使发展中国家尼日利亚对社区卫生工作者进行培训和再培训，使其能在全国范围内工作，特别是在医生匮乏的农村社区。尽管他们接受过培训且有经验，但许多人对他们准确诊断疾病的能力表示怀疑，更不用说治疗疟疾等地方病了。鉴于有必要了解尼日利亚目前疟疾控制项目中卫生工作者的诊断能力，开展了本研究。
选择尼日利亚伊莫州一个农村初级卫生中心作为疟疾控制项目调查的哨点。负责的卫生工作者是社区卫生技术员（CHT）。被CHT诊断为疟疾患者的人由一名医学检验科学家（专门为此工作聘请）检查是否存在疟原虫血症。实验室检查采用吉姆萨染色的指纹厚血涂片。寄生虫密度计数在1000/微升及以上的为疟疾患者。研究时间为2007年3月至10月。
CHT根据临床诊断为疟疾患者的有2512例，而经临床和实验室双重诊断的有2490例。CHT误诊为疟疾的患者有22例（0.875%）。
在没有实验室设施的情况下，CHT在疟疾等地方病的诊断及推广控制方面很有用。雇主和民众都应该对他们的服务以及他们接受培训和积累经验的领域给予信任。
