疟疾诊断进修培训方案对医学实验室专业人员疟疾诊断能力和技能的影响：来自加纳 2015-2019 年的证据。
Impact of malaria diagnostic refresher training programme on competencies and skills in malaria diagnosis among medical laboratory professionals: evidence from Ghana 2015-2019.
机构信息
Department of Health Policy, Planning and Management, School of Public Health, University of Ghana, Legon, Accra, Ghana.
Ghana Health Service, District Hospital, Begoro, Ghana.
出版信息
Malar J. 2021 Jun 8;20(1):255. doi: 10.1186/s12936-021-03796-x.
BACKGROUND
The quality of malaria test results is crucial for optimal patient treatment and care. The Ghana Health Service is successfully shifting from presumptive clinical diagnosis and treatment of malaria to the Test, Treat and Track (T3) initiative. In line with the initiative, the National Malaria Control Programme (NMCP) set out to improve the capacity of medical laboratory professionals in Ghana through a five-day Malaria Diagnostic Refresher Training (MDRT) to build competencies and skills in malaria diagnosis, especially in the three components of microscopy: parasite detection, species identification and parasite quantification. This study evaluates the impact of the training on malaria microscopy.
METHODS
The training which was based on the World Health Organization basic malaria microscopy training guide employed presentations and practical approaches to malaria diagnosis. A total number of 765 medical laboratory professionals from various health facilities across the country were trained every other year from 2015 to 2019 and were included in this evaluation. Evaluation of this training was done using pre-test and post-test microscopy scores. The Negative Binomial fixed effect model was used in determining the overall effect of the training in improving the competencies of the participants on malaria microscopy.
RESULTS
The ability of the medical laboratory professionals to correctly detect malaria parasites increased significantly from a median score of 64% prior to the training to 87% after the training (p < 0.001). The competencies of the medical laboratory scientists to correctly identify malaria parasite species and quantify the number of malaria parasites increased significantly from a median score of 17% and 20% pre-test to 78% and 50% post-test, respectively (p < 0.001). The results showed that participants' competency level and skill to perform malaria microscopy (species identification, parasite quantification and detection of malaria parasites) increased by approximately two folds after the training compared to the no-training scenario (adjusted rate ratio = 2.07, 95% CI 2.01-2.13, p < 0.001).
CONCLUSION
The MDRT programme significantly improved participants' performance of malaria microscopy over a short period of time.
背景
疟疾检测结果的质量对患者的治疗和护理至关重要。加纳卫生服务部门正成功地从疟疾的临床诊断和经验性治疗向 Test, Treat and Track（T3）倡议转变。根据该倡议，国家疟疾控制计划（NMCP）着手通过为期五天的疟疾诊断复习培训（MDRT）来提高加纳医学实验室专业人员的能力，以建立疟疾诊断方面的能力和技能，特别是在显微镜检查的三个方面：寄生虫检测、物种鉴定和寄生虫定量。本研究评估了该培训对疟疾显微镜检查的影响。
方法
该培训以世界卫生组织基本疟疾显微镜培训指南为基础，采用演示和实践方法进行疟疾诊断。2015 年至 2019 年，每年对来自全国各地不同卫生机构的 765 名医学实验室专业人员进行培训，并将其纳入本评估。使用培训前后的显微镜检查评分来评估该培训。使用负二项固定效应模型来确定培训对提高参与者疟疾显微镜检查能力的总体效果。
结果
医学实验室专业人员正确检测疟原虫的能力从培训前的中位数 64%显著提高到培训后的 87%（p<0.001）。医学实验室科学家正确识别疟原虫物种和定量疟原虫数量的能力也从培训前的中位数 17%和 20%显著提高到培训后的 78%和 50%（p<0.001）。结果表明，与无培训相比，培训后参与者进行疟疾显微镜检查的能力水平和技能（物种鉴定、寄生虫定量和疟原虫检测）提高了约两倍（调整后的比率比为 2.07，95%置信区间为 2.01-2.13，p<0.001）。
结论
MDRT 计划在短时间内显著提高了参与者的疟疾显微镜检查表现。
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