Mulwafu Wakisa, Nyirenda Thomas Elliot, Fagan Johannes J, Bem Chris, Mlumbe Kumvana, Chitule Jean
ENT Surgeon and Head of Unit, College of Medicine, University of Malawi, Malawi.
South-South Networking and Capacity Development Manager, European and Developing Countries Clinical Trials Partnership, Medical Research Council, Cape Town, South Africa
Trop Doct. 2014 Jul;44(3):135-9. doi: 10.1177/0049475514524393. Epub 2014 Feb 25.
Sub-Saharan Africa countries like Malawi have a paucity of ear, nose and throat (ENT) data, services and training opportunities.
To reflect on new Malawian ENT experience and to propose guidelines to poorly resourced countries.
Analysis of data predating and following establishment of ENT services in Malawi.
In 2008 the first and only Malawian ENT specialist established ENT services with external funding. Fifteen clinical officers have been trained and a nurse placed at each outreach hospital. In 2012, 15,284 consultations were recorded: 543 (3.6%) from outreach clinics. Forty-nine percent needed medical treatment, while 45% needed medical advice. Surgery was performed on 2.7% of patients; 21% for foreign bodies in the nose and throat and 18% for foreign bodies and biopsies of ears.
To establish accessible and sustainable specialist ENT services in a poor country requires building on an established local health delivery system, careful planning and investment in personnel, infrastructure, training and data collection.
像马拉维这样的撒哈拉以南非洲国家缺乏耳鼻喉（ENT）方面的数据、服务和培训机会。
反思马拉维在耳鼻喉方面的新经验，并为资源匮乏的国家提出指导方针。
对马拉维建立耳鼻喉服务之前和之后的数据进行分析。
2008年，第一位也是唯一一位马拉维耳鼻喉科专家在外部资金支持下建立了耳鼻喉服务。15名临床干事接受了培训，每家外展医院都配备了一名护士。2012年，记录了15284次会诊：其中543次（3.6%）来自外展诊所。49%的患者需要药物治疗，45%的患者需要医疗建议。2.7%的患者接受了手术；21%是针对鼻腔和咽喉异物，18%是针对耳部异物和活检。
在贫穷国家建立可及且可持续的专科耳鼻喉服务需要依托已有的当地卫生服务体系，进行精心规划并在人员、基础设施、培训和数据收集方面进行投入。
