Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia; Research Institute for Tropical Medicine, Department of Health, Philippines.
Discipline of Public Health, School of Health Sciences, Flinders University, Adelaide, Australia.
Int J Infect Dis. 2018 Jan;66:14-21. doi: 10.1016/j.ijid.2017.10.023. Epub 2017 Nov 8.
Schistosomiasis control is centred on preventive chemotherapy through mass drug administration (MDA). However, endemic countries continue to struggle to attain target coverage rates and patient compliance. In the Philippines, barangay health workers (BHWs) play a vital role in the coordination of MDA, acting as advocates, implementers, and educators. The aim of this study was to determine whether BHW knowledge and attitudes towards schistosomiasis and MDA is sufficient and correlated with resident knowledge and drug compliance.
A cross-sectional survey was conducted in 2015 among 2186 residents and 224 BHWs in the province of Northern Samar, the Philippines using a structured survey questionnaire.
BHWs showed good familiarity on how schistosomiasis is acquired and diagnosed. Nevertheless, both BHWs and residents had poor awareness of the signs and symptoms of schistosomiasis, disease prevention, and treatment options. There was no correlation between the knowledge scores of the BHWs and the residents (r=0.080, p=0.722). Kruskal-Wallis analysis revealed significant differences in BHW knowledge scores between the low (3.29, 95% confidence interval 3.16-3.36), moderate (3.61, 95% confidence interval 3.49-3.69), and high (4.05, 95% confidence interval 3.77-4.13) compliance village groups (p=0.002), with the high compliance areas having the highest mean knowledge scores.
This study highlights the importance of community health workers in obtaining the World Health Organization drug coverage rate of 75% and improving compliance with MDA in the community. Investing in the education of community health workers with appropriate disease-specific training is crucial if disease elimination is ultimately to be achieved.
血吸虫病防治工作以群体化疗的大规模药物治疗（MDA）为中心。然而，流行国家仍在努力实现目标覆盖率和患者依从性。在菲律宾，乡村保健员（BHW）在 MDA 的协调中发挥着至关重要的作用，充当倡导者、执行者和教育者。本研究旨在确定乡村保健员对血吸虫病和 MDA 的知识和态度是否足够，以及是否与居民的知识和药物依从性相关。
2015 年，在菲律宾北萨马省，采用结构问卷调查对 2186 名居民和 224 名乡村保健员进行了横断面调查。
乡村保健员对血吸虫病的获得和诊断方式非常熟悉。尽管如此，乡村保健员和居民对血吸虫病的症状和体征、疾病预防以及治疗选择的认识都很差。乡村保健员的知识得分与居民之间没有相关性（r=0.080，p=0.722）。Kruskal-Wallis 分析显示，低（3.29，95%置信区间 3.16-3.36）、中（3.61，95%置信区间 3.49-3.69）和高（4.05，95%置信区间 3.77-4.13）依从性村组之间的乡村保健员知识得分存在显著差异（p=0.002），高依从性地区的平均知识得分最高。
本研究强调了社区卫生工作者在获得世界卫生组织 75%的药物覆盖率和提高社区 MDA 依从性方面的重要性。如果要最终实现消除疾病，就必须对社区卫生工作者进行适当的疾病特异性培训的教育投资。
