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为实现共同目标而团结:传统治疗师与对抗疗法医护人员合作以改善农村蛇咬伤救治情况。

Uniting behind a common goal: Collaboration between traditional healers and allopathic health care workers to improve rural snakebite care.

作者信息

Steinhorst Jonathan, Tianyi Frank-Leonel, Habib Abdulrazaq Garba, Oluoch George O, Lalloo David G, Stienstra Ymkje

机构信息

University of Groningen, Department of Internal Medicine/Infectious Diseases, University Medical Centre Groningen, Groningen, the Netherlands.

Centre for Snakebite Research and Interventions, Liverpool School of Tropical Medicine, Liverpool, United Kingdom.

出版信息

Toxicon X. 2022 Oct 28;16:100140. doi: 10.1016/j.toxcx.2022.100140. eCollection 2022 Dec.

Abstract

Snakebite envenoming is an acute medical emergency which affects hundreds of thousands of people worldwide, primarily in remote rural areas of low-and middle income countries in the Global South. A considerable proportion of snakebite patients turn to traditional healers (THs) for help, driven by a number of push and pull factors. These include socio-cultural factors, geographical proximity, and the absence or inaccessibility of overstretched and often costly allopathic healthcare services. Although traditional healers and allopathic healthcare staff share a common focus -the recovery and well-being of their patients- both systems operate largely in parallel to each other with collaborations being an exception rather than the rule. This is to the detriment of snakebite patients, who frequently find themselves being caught-up in the dualism between the two separate systems. Given the right circumstances, snakebite patients could benefit from elements of care from both modalities. Here, we have reviewed the role of THs in snakebite care and explored how their integration into the formal healthcare system could improve the implementation and outcome of care. The effective recruitment of THs to aid in disease control and treatment efforts in diseases other than snakebite underscores the potential benefits of this strategy. Carefully devised proof of concept studies are needed to test our hypothesis that collaborations between the formal healthcare sector and THs are feasible and improve outcomes in snakebite care.

摘要

蛇咬伤中毒是一种急性医疗紧急情况,全球有数十万人受其影响,主要集中在全球南方低收入和中等收入国家的偏远农村地区。由于多种推动因素和拉动因素,相当一部分蛇咬伤患者会向传统治疗师寻求帮助。这些因素包括社会文化因素、地理位置接近,以及现代医学医疗服务过度紧张且往往费用高昂,导致无法获得或难以获得此类服务。尽管传统治疗师和现代医学医护人员都有一个共同的关注点——患者的康复和福祉,但这两种体系在很大程度上是并行运作的,合作只是例外而非惯例。这对蛇咬伤患者不利,他们常常发现自己陷入了这两个独立体系的二元对立之中。在合适的情况下,蛇咬伤患者可以从这两种治疗方式的护理要素中受益。在此,我们回顾了传统治疗师在蛇咬伤护理中的作用,并探讨了将他们纳入正规医疗体系如何能够改善护理的实施和效果。有效招募传统治疗师以协助控制和治疗除蛇咬伤之外的其他疾病,凸显了这一策略的潜在益处。需要精心设计概念验证研究,以检验我们的假设,即正规医疗部门与传统治疗师之间的合作是可行的,并且能够改善蛇咬伤护理的效果。

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