Mbwele B, Slot A, De Mast Q, Kweka P, Msuya M, Hulscher M
Kilimanjaro Christian Medical Center, Kilimanjaro Clinical Research Institute, Zanzibar, Tanzania; Programme Manager - Reproductive Maternal Newborn Child Health, Nutrition and WASH, Save the Children, Zanzibar, Tanzania.
Nijmegen Institute for International Health (NIIH, UMC Nijmegen), Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
Ann Med Health Sci Res. 2016 Mar-Apr;6(2):100-8. doi: 10.4103/2141-9248.181845.
Evaluations of the guidelines for the management of Lower Respiratory Tract Infections (LRTI) Sub-Saharan Africa, particularly in Tanzania is scant.
The aim of the study was to assess the usefulness of the current Tanzanian treatment guideline for the management lower respiratory tract infection.
A descriptive cross sectional study in 11 hospitals of different levels in the Kilimanjaro region Data were collected from May 2012 to July 2012 by semi-structured interview for clinicians using 2 dummy cases for practical assessment. Data were analyzed by STATA v11 (StataCorp, TX, USA). Qualitative narratives from the interviews were translated, transcribed then coded by colors into meaningful themes.
A variety of principles for diagnosing and managing LRTI were demonstrated by 53 clinicians of Kilimanjaro. For the awareness, 67.9% (36/53) clinicians knew their responsibility to use Standard Treatment Guideline for managing LRTI. The content derived from Standard Treatment Guideline could be cited by 11.3% of clinicians (6/53) however they all showed concern of gaps in the guideline. Previous training in the management of patients with LRTI was reported by 25.9% (14/53), majority were pulmonary TB related. Correct microorganisms causing different forms of LRTI were mentioned by 11.3% (6/53). Exact cause of Atypical pneumonia and Q fever as an example was stated by 13.0% (7/53) from whom the need of developing the guideline for LRTI was explicitly elaborated.
The current guidelines have not been used effectively for the management of LRTI in Tanzania. There is a need to review its content for the current practical use.
撒哈拉以南非洲地区,尤其是坦桑尼亚,对下呼吸道感染(LRTI)管理指南的评估较少。
本研究旨在评估坦桑尼亚现行的下呼吸道感染治疗指南的实用性。
在乞力马扎罗地区的11家不同级别的医院开展描述性横断面研究。于2012年5月至2012年7月,通过半结构化访谈,使用2个虚拟病例对临床医生进行实际评估来收集数据。数据采用STATA v11(美国德克萨斯州的StataCorp公司)进行分析。访谈中的定性叙述被翻译、转录,然后按颜色编码为有意义的主题。
乞力马扎罗地区的53名临床医生展示了多种诊断和管理下呼吸道感染的原则。在认知方面,67.9%(36/53)的临床医生知道他们有责任使用标准治疗指南来管理下呼吸道感染。11.3%的临床医生(6/53)能够引用标准治疗指南的内容,不过他们都对指南中的差距表示担忧。25.9%(14/53)的临床医生报告曾接受过下呼吸道感染患者管理方面的培训,其中大多数与肺结核相关。11.3%(6/53)的临床医生提到了导致不同类型下呼吸道感染的正确微生物。例如,13.0%(7/53)的临床医生指出了非典型肺炎和Q热的确切病因,并明确阐述了制定下呼吸道感染指南的必要性。
坦桑尼亚目前的指南在管理下呼吸道感染方面未得到有效应用。有必要针对当前的实际应用情况对其内容进行审查。