Centro Nacional de Medicina Tropical, Instituto de Salud Carlos III, Madrid, Spain.
Servicio de Medicina Preventiva, Hospital Virgen de la Salud, Toledo, Spain.
Malar J. 2021 Jan 7;20(1):21. doi: 10.1186/s12936-020-03528-7.
In 2018, an estimated 228 million cases of malaria occurred worldwide. Countries are far from having achieved reasonable levels of national protocol compliance among health workers. Lack of awareness of treatment protocols and treatment resistance by prescribers threatens to undermine progress when it comes to reducing the prevalence of this disease. This study sought to evaluate the degree of knowledge and practices regarding malaria diagnosis and treatment amongst prescribers working at the public health facilities of Bata, Equatorial Guinea.
A cross-sectional survey was conducted in October-December 2017 amongst all public health professionals who attended patients under the age of 15 years, with suspected malaria in the Bata District of Equatorial Guinea. Practitioners were asked about their practices and knowledge of malaria and the National Malaria Treatment Guidelines. A bivariate analysis and a logistic regression model were used to determine factors associated with their knowledge.
Among the 44 practitioners interviewed, 59.1% worked at a Health Centre and 40.9% at the District Hospital of Bata. Important differences in knowledge and practices between hospital and health centre workers were found. Clinical diagnosis was more frequently by practitioners at the health centres (p = 0.059), while microscopy confirmation was more frequent at regional hospital (100%). Intramuscular artemether was the anti-malarial most administrated at the health centres (50.0%), while artemether-lumefantrine was the treatment most used at the regional hospital (66.7%). Most practitioners working at public health facilities (63.6%) have a low level of knowledge regarding the National Malaria Treatment Guidelines. While knowledge regarding malaria, the National Malaria Treatment Guidelines and treatment resistances is low, it was higher amongst hospital workers than amongst practitioners at health centres.
It is essential to reinforce practitioners' knowledge, treatment and diagnosis practices and use of the National Malaria Treatment Guidelines in order to improve malaria case management and disease control in the region. A specific malaria training programme ensuring ongoing updates training is necessary in order to ensure that greater experience does not entail obsolete knowledge and, consequently, inadequate diagnosis and treatment practices.
2018 年，全球估计有 2.28 亿例疟疾病例。各国远远没有实现卫生工作者遵守国家方案的合理水平。由于开处方者对治疗方案缺乏认识以及治疗耐药性，这有可能破坏在减少这种疾病的流行方面取得的进展。本研究旨在评估赤道几内亚巴塔公共卫生设施工作的开处方者在疟疾诊断和治疗方面的知识和实践程度。
2017 年 10 月至 12 月，在赤道几内亚巴塔地区，对所有 15 岁以下疑似疟疾的公共卫生专业人员进行了横断面调查。从业者被问及他们对疟疾和国家疟疾治疗指南的实践和知识。采用双变量分析和逻辑回归模型来确定与他们的知识相关的因素。
在所采访的 44 名从业者中，59.1%在卫生中心工作，40.9%在巴塔区医院工作。在医院和卫生中心工作人员之间发现了知识和实践方面的重要差异。在卫生中心，从业者更常进行临床诊断（p=0.059），而在区域医院，显微镜确认更为常见（100%）。在卫生中心，肌肉内青蒿琥酯是最常用的抗疟药（50.0%），而在区域医院，青蒿琥酯-甲氟喹是最常用的治疗方法（66.7%）。在公共卫生设施工作的大多数从业者（63.6%）对国家疟疾治疗指南的了解程度较低。虽然疟疾、国家疟疾治疗指南和治疗耐药性的知识较低，但在医院工作者中高于在卫生中心工作者。
为了改善该地区的疟疾病例管理和疾病控制，必须加强从业者对国家疟疾治疗指南的知识、治疗和诊断实践的掌握。有必要开展专门的疟疾培训方案，确保不断进行最新的培训，以确保更多的经验不会导致过时的知识，从而导致诊断和治疗实践不足。
