Sanders J E, Chakare T, Mapota-Masoabi L, Ranyali M, Ramokhele M M, Rozario A M, McCollum E D
Jhpiego Lesotho, Maseru, Lesotho.
Ministry of Health, Maseru, Government of Lesotho.
Public Health Action. 2021 Dec 21;11(4):180-185. doi: 10.5588/pha.21.0067.
Sub-Saharan African country, Lesotho, during the SARS-CoV-2 COVID-19 pandemic.
To evaluate COVID-19 hospital capacity in Lesotho.
We conducted a pragmatic assessment of all public hospitals in Lesotho using a WHO COVID-19 hospital assessment tool during July 2020 (baseline), with targeted follow-up in December 2020. We adapted the WHO tool into a questionnaire with a focus on hospital services and included oxygen ecosystem elements (pulse oximeters, oxygen, and advanced respiratory care). We converted qualitative questionnaire answers into quantitative ordinal variables and used standard statistics for analysis.
At baseline, we found all 12 questionnaire domains demonstrate both hospital preparedness and weakness in infection prevention and control. Key baseline gaps were lack of a dedicated team, and insufficient personal protective equipment and space for donning and doffing. Substantial limitations were noted in hypoxemia diagnosis and treatment; information management and care coordination pathways were also suboptimal. Targeted follow-up after 5 months revealed improvement in the availability of pulse oximetry, oxygen capacity, and heated high-flow nasal cannula devices.
Our baseline findings may reflect uneven early pandemic care quality; targeted follow-up suggests strengthening of the oxygen ecosystem.
在严重急性呼吸综合征冠状病毒2型（SARS-CoV-2）引发的2019冠状病毒病（COVID-19）大流行期间的撒哈拉以南非洲国家莱索托。
评估莱索托的COVID-19医院收治能力。
2020年7月（基线期），我们使用世界卫生组织（WHO）的COVID-19医院评估工具对莱索托所有公立医院进行了务实评估，并于2020年12月进行了针对性随访。我们将WHO工具改编成一份侧重于医院服务的问卷，并纳入了氧气生态系统要素（脉搏血氧仪、氧气和高级呼吸护理）。我们将定性问卷答案转换为定量有序变量，并使用标准统计方法进行分析。
在基线期，我们发现12个问卷领域均显示出医院在感染预防与控制方面既有准备又存在不足。关键的基线差距在于缺乏专门团队，以及个人防护装备和穿脱空间不足。在低氧血症的诊断与治疗方面存在重大局限；信息管理和护理协调途径也不尽人意。5个月后的针对性随访显示，脉搏血氧测定、氧气供应能力和高流量加温鼻导管设备的可用性有所改善。
我们的基线期研究结果可能反映出大流行早期护理质量参差不齐；针对性随访表明需加强氧气生态系统建设。
