Division of Global Health, Department of Public Health Sciences, Karolinska Institutet, Nobels väg 9, 171 77, Stockholm, Sweden.
BMC Int Health Hum Rights. 2012 Sep 25;12:19. doi: 10.1186/1472-698X-12-19.
Diarrhoea is the second leading cause of death in children under five accounting for 1.8 million deaths yearly. Despite global efforts to reduce diarrhoea mortality through promotion of proper case management, there is still room for ample improvement. In order to seek options for such improvements this study explored the knowledge and practices of diarrhoea case management among health care providers at health centres and drug shops in Uganda.
Records were reviewed for case management and structured interviews concerning knowledge and practices were conducted with the staff at all health centres and at all identified drug shops in the rural district of Namutumba, Uganda.
There was a significant gap between knowledge and documented practices among staff. Antibiotics, antimalarials and antipyretics were prescribed or recommended as frequently as Oral Rehydration Solution (ORS). In almost a third of the health facilities, ORS was out of stock. 81% of staff in health centres and 87% of staff in drug shops stated that they prescribed antibiotics for common diarrhoea. Zinc was not prescribed or recommended in any case.
The findings indicate that many children presenting with diarrhoea are inadequately treated. As a result they may not get the rehydration they need and are at risk of potential side effects from unjustified usage of antibiotics. Practices must be improved at health centres and drug shops in order to reduce childhood mortality due to diarrhoeal diseases.
腹泻是导致五岁以下儿童死亡的第二大原因,每年导致 180 万人死亡。尽管全球努力通过促进适当的病例管理来降低腹泻死亡率,但仍有很大的改进空间。为了寻求改进的方法,本研究探讨了乌干达卫生中心和药店卫生保健提供者在腹泻病例管理方面的知识和实践。
对病例管理记录进行了审查,并对所有卫生中心和乌干达纳穆通巴农村地区所有确定的药店的工作人员进行了有关知识和实践的结构化访谈。
工作人员的知识和记录的实践之间存在显著差距。抗生素、抗疟药和退烧药的处方或推荐频率与口服补液盐 (ORS) 一样高。在近三分之一的卫生设施中,ORS 缺货。81%的卫生中心工作人员和 87%的药店工作人员表示,他们会为常见腹泻开抗生素。在任何情况下都没有开锌。
研究结果表明,许多患有腹泻的儿童治疗不充分。因此,他们可能无法获得所需的补液,并且有因不合理使用抗生素而产生潜在副作用的风险。为了降低因腹泻病导致的儿童死亡率,必须改进卫生中心和药店的实践。