Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
Department of Infection, St Thomas' Hospital, London, UK.
Clin Med (Lond). 2019 Mar;19(2):145-148. doi: 10.7861/clinmedicine.19-2-145.
Implementation science uses methods to promote the scaling up and use of evidence-based practices by health systems to improve quality and outcomes. Its use is vital to maximise the efficiency of limited resources for health care in tropical settings. HIV and tuberculosis (TB) are two of the major causes of morbidity and mortality in sub-Saharan Africa, and globally. Although effective treatments are widely available, lack of diagnosis remains a large barrier to accessing treatment, particularly in resource-limited settings. We explore HIV and TB diagnostics that can be used at point-of-care in any settings, and outline some important principles and applications of implementation science to aid their application and use. Despite robust evidence of diagnostic accuracy and efficacy in improving patient-centred outcomes, such interventions cannot be fully utilised without addressing operational barriers and knowledge gaps.
实施科学利用方法来促进卫生系统扩大和采用基于证据的实践，以提高质量和结果。在热带环境中，最大限度地提高医疗保健资源的效率，实施科学的应用至关重要。艾滋病毒和结核病（TB）是撒哈拉以南非洲和全球发病率和死亡率的主要原因之一。尽管有广泛可用的有效治疗方法，但诊断的缺乏仍然是获得治疗的一个主要障碍，特别是在资源有限的环境中。我们探讨了可以在任何环境中在护理点使用的艾滋病毒和结核病诊断方法，并概述了实施科学的一些重要原则和应用，以帮助其应用和使用。尽管有大量证据表明诊断准确性和疗效可改善以患者为中心的结果，但如果不解决运营障碍和知识差距，这些干预措施就无法充分利用。
