Das Vidya Nand Ravi, Pandey Ravindra Nath, Kumar Vijay, Pandey Krishna, Siddiqui Niyamat Ali, Verma Rakesh Bihari, Matlashewski Greg, Das Pradeep
a Rajendra Memorial Research Institute of Medical Sciences (ICMR) , Patna , India.
b Department of Microbiology and Immunology , McGill University , Montreal , Canada.
Pathog Glob Health. 2016;110(1):33-5. doi: 10.1080/20477724.2016.1156902.
Accredited Social Health Activists (ASHAs) are incentive-based, female health workers responsible for a village of 1000 population and living in the same community and render valuable services towards maternal and child health care, polio elimination program and other health care-related activities including visceral leishmaniasis (VL). One of the major health concerns is that cases remain in the endemic villages for weeks without treatment causing increased likelihood to treatment failure and disease transmission in the community. To address this problem, we have begun a training program for ASHAs to enhance early detection of potential VL cases and referring them to their local Primary Health Centers (PHCs) for diagnosis and treatment. The result of this training showed increased referral rate to PHCs for diagnosis and treatment. Encouraged with the results from a single training session, we determined in the present study whether repeated training of ASHAs resulted in an a further increase in VL case referral to the local PHCs. After two training sessions, VL referrals by ASHAs increased to 46% as compared to 28% after a single training session in this cohort and a baseline of 7% before training. ASHA training is an effective way to conduct active case detection of VL cases and should be repeated once a year.
经认可的社会健康活动家（ASHAs）是基于激励机制的女性卫生工作者，负责服务一个有1000人口的村庄，她们生活在同一社区，为孕产妇和儿童保健、消灭脊髓灰质炎计划以及包括内脏利什曼病（VL）在内的其他与医疗保健相关的活动提供了宝贵服务。一个主要的健康问题是，在流行村庄中，病例在数周内得不到治疗，导致治疗失败和疾病在社区传播的可能性增加。为了解决这个问题，我们已经开始为ASHAs开展一项培训计划，以加强对潜在VL病例的早期发现，并将他们转诊到当地的初级卫生保健中心（PHCs）进行诊断和治疗。这次培训的结果显示，转诊到PHCs进行诊断和治疗的比率有所提高。受到单次培训结果的鼓舞，我们在本研究中确定，对ASHAs进行重复培训是否会进一步提高向当地PHCs转诊VL病例的数量。经过两次培训后，ASHAs转诊的VL病例增加到了46%，而在这个队列中，单次培训后的转诊率为28%，培训前的基线转诊率为7%。对ASHAs的培训是对VL病例进行主动病例检测的有效方法，应该每年重复一次。
