Ross Andrew B, DeStigter Kristen K, Coutinho Anastasia, Souza Sonia, Mwatha Anthony, Matovu Alphonsus, Kawooya Michael Grace, Renny Ssembatya
Department of Radiology, University of Vermont Medical Center, 111 Colchester Rd., Burlington, Vermont, 05401, USA.
University of Vermont College of Medicine, 89 Beaumont Ave., Burlington, Vermont, 05405, USA.
BMC Pregnancy Childbirth. 2014 Dec 19;14:424. doi: 10.1186/s12884-014-0424-9.
In June of 2010, an antenatal ultrasound program was introduced to perform basic screening examinations at a health care clinic in rural Uganda. The impact of the program on the existing antenatal care infrastructure including the proportion and number of women receiving recommended antenatal care at clinic visits was unknown. The aim of this study was to investigate the relationship between the advent of the ultrasound program and the proportion of women receiving recommended antenatal interventions at their clinic visits. Change in the absolute numbers of antenatal services provided was also assessed.
Records at the Nawanyago clinic were reviewed to determine the total numbers of women receiving specific interventions before and after the advent of the ultrasound program including HIV testing, intermittent preventive therapy for malaria, presumptive anti-parasitic treatment, and provision of iron and folate for anemia. The rate at which these interventions were provided (number of interventions per clinic visit) was also assessed. The differences in absolute numbers of antenatal interventions before and after the introduction of the ultrasound program were assessed using the Wilcoxon rank-sum test. Differences in intervention rate were assessed using negative binomial regression modeling.
The mean monthly numbers of women receiving each of these interventions increased significantly with the greatest increase seen in numbers of women receiving anemia and deworming treatments at +113% and +102% respectively (p < 0.001). The intervention rate increased for anemia treatment, deworming treatment, and 2nd dose of intermittent preventive therapy for malaria. A slight decrease in intervention rate was observed for 1st dose of malaria treatment with a rate ratio of 0.88 (0.79 - 0.98, 95% CI). Intervention rate for HIV testing was not significantly changed.
The introduction of a low-cost antenatal ultrasound program at a health care clinic in rural Uganda was associated with increases in the number of women receiving specific recommended antenatal care interventions. Effect on intervention rates was mixed but showed an overall increase. The use of ultrasound in this context may provide a benefit to the maternal and neonatal health of the community.
2010年6月，乌干达农村地区的一家医疗诊所引入了一项产前超声检查项目，用于进行基本筛查。该项目对现有产前保健基础设施的影响，包括在诊所就诊时接受推荐产前保健的妇女比例和数量，尚不清楚。本研究的目的是调查超声检查项目的引入与在诊所就诊时接受推荐产前干预的妇女比例之间的关系。同时还评估了所提供产前服务绝对数量的变化。
对纳万亚戈诊所的记录进行回顾，以确定超声检查项目引入前后接受特定干预措施的妇女总数，这些干预措施包括艾滋病毒检测、疟疾间歇预防性治疗、推定抗寄生虫治疗以及提供治疗贫血的铁剂和叶酸。还评估了这些干预措施的提供率（每次诊所就诊的干预措施数量）。使用Wilcoxon秩和检验评估超声检查项目引入前后产前干预绝对数量的差异。使用负二项回归模型评估干预率的差异。
接受每项干预措施的妇女平均每月数量显著增加，接受贫血治疗和驱虫治疗的妇女数量增加最多，分别增加了113%和102%（p < 0.001）。贫血治疗、驱虫治疗以及疟疾间歇预防性治疗第二剂的干预率有所提高。观察到疟疾治疗第一剂的干预率略有下降，率比为0.88（0.79 - 0.98，95%置信区间）。艾滋病毒检测的干预率没有显著变化。
在乌干达农村地区的一家医疗诊所引入低成本的产前超声检查项目，与接受特定推荐产前保健干预措施的妇女数量增加有关。对干预率的影响喜忧参半，但总体呈上升趋势。在这种情况下使用超声检查可能对社区的孕产妇和新生儿健康有益。
