Kurumop Serah F, Pulford Justin, Mueller Ivo, Siba Peter M, Hetzel Manuel W
P N G Med J. 2014 Mar-Dec;57(1-4):59-67.
Papua New Guinea (PNG) introduced a revised national malaria treatment protocol (NMTP) in late 2011. Successful implementation of the revised protocol requires all health facilities in PNG to have reliable access to microscopy or malaria rapid diagnostic kits as well as a reliable supply of all recommended first-line medications. This paper presents findings from a study that sought to assess the availability of microscopy, malaria rapid diagnostic kits and recommended first-line antimalarial medication in Papua New Guinean health facilities across the country before the introduction of the revised treatment protocol.
A country-wide cross-sectional survey of 79 randomly selected health centres, health subcentres and aid posts. Data were collected via an interviewer-administered questionnaire completed with the officer in charge of participating health facilities.
Overall, 15% of surveyed health facilities had unexpired rapid diagnostic test (RDT) in stock or working microscopy available. A recommended first-line antimalarial for uncomplicated malaria was available in 85% of health facilities. The preferred first-line antimalarial combination for treating severe malaria was present in 42% of health facilities, although 68% had the capacity to provide either the preferred or recommended substitute first-line medication for severe malaria. The total number of health workers employed in the 79 surveyed health facilities was 443, only 3 of whom were medical doctors.
Our findings indicate that diagnostic capacity was low in Papua New Guinean health facilities before the introduction of the new NMTP and that access to recommended first-line antimalarial medication was variable. Substantial improvements in diagnostic capacity and antimalarial procurement and distribution will need to be made if the revised protocol is to be adhered to.
巴布亚新几内亚（PNG）于2011年末引入了修订后的国家疟疾治疗方案（NMTP）。要成功实施该修订方案，巴布亚新几内亚的所有卫生设施都需要能够可靠地使用显微镜或疟疾快速诊断试剂盒，以及可靠供应所有推荐的一线药物。本文介绍了一项研究的结果，该研究旨在评估在修订后的治疗方案引入之前，巴布亚新几内亚全国卫生设施中显微镜、疟疾快速诊断试剂盒和推荐的一线抗疟药物的可获得性。
对79个随机选择的健康中心、健康分中心和援助站进行全国性横断面调查。通过与参与卫生设施的负责人共同完成的访谈式问卷收集数据。
总体而言，15%的被调查卫生设施库存有未过期的快速诊断检测（RDT）或具备可用的显微镜。85%的卫生设施有用于治疗非复杂性疟疾的推荐一线抗疟药物。42%的卫生设施有治疗重症疟疾的首选一线抗疟药物组合，不过68%的卫生设施有能力提供重症疟疾的首选或推荐替代一线药物。79个被调查卫生设施雇佣的卫生工作者总数为443人，其中只有3名是医生。
我们的研究结果表明，在新的国家疟疾治疗方案引入之前，巴布亚新几内亚卫生设施的诊断能力较低，且获取推荐一线抗疟药物的情况各不相同。如果要遵守修订后的方案，就需要在诊断能力以及抗疟药物采购和分发方面做出大幅改进。
