印度中央邦曼德拉、巴尔加尔和丁多里三个毗邻地区社区一线卫生工作者在疟疾诊断和治疗方面的知识和实践的比较评估。

A comparative assessment of the community frontline health workers for their knowledge and practices of malaria diagnosis and treatment in three contiguous districts Mandla, Balaghat, and Dindori of Madhya Pradesh, India.

机构信息

Malaria Elimination Demonstration Project, Mandla, Madhya Pradesh, India.

Asia Pacific Leaders Malaria Alliance (APLMA), Singapore, Singapore.

出版信息

Malar J. 2023 Feb 21;22(1):62. doi: 10.1186/s12936-023-04492-8.

DOI:10.1186/s12936-023-04492-8

PMID:36810077

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9942041/

Abstract

BACKGROUND

Global malaria cases rose by 14 million, and deaths by 69,000, in 2020. In India, a 46% decline has been reported between 2020 and 2019. In 2017, the Malaria Elimination Demonstration Project conducted a needs-assessment of the Accredited Social Health Activists (ASHAs) of Mandla district. This survey revealed the inadequate level of knowledge in malaria diagnosis and treatment. Subsequently, a training programme was launched for enhancing malaria-related knowledge of ASHAs. The present study was conducted in 2021 to evaluate the impact of training on malaria-related knowledge and practices of ASHAs in Mandla. This assessment was also done in two adjoining districts: Balaghat and Dindori.

METHODS

A cross-sectional survey using a structured questionnaire was administered to ASHAs to measure their knowledge and practices related to malaria etiology, prevention, diagnosis, and treatment. A comparison of information collected from these three districts was performed using simple descriptive statistics, comparison of means and multivariate logistic regression analysis.

RESULTS

Significant improvement was noted amongst ASHAs of district Mandla between 2017 (baseline) and 2021 (endline) in knowledge related to malaria transmission, preventive measures, adherence to the national drug policy, diagnosis using rapid diagnostic tests, and identification of age group-specific, colour-coded artemisinin combination therapy blister packs (p < 0.05). The multivariate logistic regression analysis revealed that odds of Mandla baseline was 0.39, 0.48, 0.34, and 0.07 times lower for malaria-related knowledge on disease etiology, prevention, diagnosis, and treatment, respectively (p < 0.001). Further, participants in districts Balaghat and Dindori showed significantly lower odds for knowledge (p < 0.001) and treatment practices (p < 0.01) compared to Mandla endline. Education, attended training, having a malaria learner's guide, and minimum 10 years' work experience were potential predictors for good treatment practices.

CONCLUSION

The findings of the study unequivocally establishes significant improvement in overall malaria-related knowledge and practices of ASHAs in Mandla as a result of periodic training and capacity building efforts. The study suggests that learnings from Mandla district could be helpful in improving level of knowledge and practices among frontline health workers.

摘要

背景

2020 年，全球疟疾病例增加了 1400 万例，死亡人数增加了 6.9 万例。据报道，2020 年至 2019 年，印度的疟疾病例下降了 46%。2017 年，疟疾消除示范项目对 Mandla 区的认证社会卫生活动家（ASHAs）进行了需求评估。这项调查显示，疟疾诊断和治疗方面的知识水平不足。随后，为提高 ASHAs 与疟疾相关的知识，启动了一项培训计划。本研究于 2021 年进行，以评估培训对 Mandla 区 ASHAs 与疟疾相关知识和实践的影响。这项评估还在两个毗邻的地区：Balaghat 和 Dindori 进行。

方法

使用结构化问卷对 ASHAs 进行横断面调查，以衡量他们与疟疾病因、预防、诊断和治疗相关的知识和实践。使用简单描述性统计、均值比较和多变量逻辑回归分析比较这三个地区收集的信息。

结果

在 Mandla 区，与 2017 年（基线）相比，2021 年（终线），疟疾传播、预防措施、遵守国家药物政策、使用快速诊断测试进行诊断以及识别年龄组特定、彩色编码的青蒿素联合治疗泡罩包方面的知识显著提高（p<0.05）。多变量逻辑回归分析显示，Mandla 区基线时与疟疾相关的病因、预防、诊断和治疗知识的几率分别为 0.39、0.48、0.34 和 0.07 倍（p<0.001）。此外，与 Mandla 区终线相比，Balaghat 和 Dindori 区的参与者在知识（p<0.001）和治疗实践（p<0.01）方面的几率明显较低。教育程度、参加培训、有疟疾学习者指南和至少 10 年工作经验是良好治疗实践的潜在预测因素。