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加纳社区成员和医护人员对蛇咬伤中毒控制与预防的优先事项。

Community members and healthcare workers' priorities for the control and prevention of snakebite envenoming in Ghana.

作者信息

Aglanu Leslie Mawuli, Amuasi John Humphrey, Prokesh Evie, Beyuo Alexis, Dari Chrisantus Danaah, Ravensbergen Sofanne J, Agbogbatey Melvin Katey, Adobasom-Anane Austin Gideon, Abass Kabiru Mohammed, Lalloo David G, Blessmann Jörg, Kreuels Benno, Stienstra Ymkje

机构信息

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

Global Health and Infectious Diseases Research Group, Kumasi Centre for Collaborative Research in Tropical Medicine, Kumasi, Ghana.

出版信息

PLoS Negl Trop Dis. 2023 Jul 21;17(7):e0011504. doi: 10.1371/journal.pntd.0011504. eCollection 2023 Jul.

Abstract

INTRODUCTION

Snakebite is one of the most neglected tropical diseases. In Ghana, there has been a limited interest in snakebite envenoming research despite evidence of high human-snake conflicts. In an effort to meet the World Health Organisation's (WHO) 2030 snakebite targets, the need for research evidence to guide policy interventions is evident. However, in setting the research agenda, community and healthcare workers' priorities are rarely considered.

METHODS

Three categories of focus groups were formed in the Ashanti and Upper West regions of Ghana, comprising of community members with and without a history of snakebite and healthcare workers who manage snakebite patients. Two separate focus group discussions were conducted with each group in each region. Using the thematic content analysis approach, the framework method was adopted for the data analysis. A predefined 15-item list of potential snakebite-associated difficulties and the WHO's 2030 snakebite strategic key activities were ranked in order of priority based on the participants' individual assessment.

RESULTS

Both acute and chronic effects of snakebite such as bite site management, rehabilitation and mental health were prioritised by the community members. Health system challenges including training, local standard treatment protocols and clinical investigations on the efficacy of available antivenoms were identified as priorities by the healthcare workers. Notably, all the participant groups highlighted the need for research into the efficacy of traditional medicines and how to promote collaborative strategies between traditional and allopathic treatment practices.

CONCLUSION

The prioritisation of chronic snakebite envenoming challenges by community members and how to live and cope with such conditions accentuate the lack of post-hospital treatment follow-ups for both mental and physical rehabilitation. To improve the quality of life of patients, it is essential to involve grassroots stakeholders in the process of developing and prioritising future research agenda.

摘要

引言

蛇咬伤是最被忽视的热带疾病之一。在加纳,尽管有证据表明人与蛇的冲突频繁,但对蛇咬伤中毒研究的关注有限。为了实现世界卫生组织(WHO)2030年的蛇咬伤防治目标,显然需要研究证据来指导政策干预。然而,在制定研究议程时,很少考虑社区和医护人员的优先事项。

方法

在加纳的阿散蒂和上西部地区组建了三类焦点小组,包括有和没有蛇咬伤史的社区成员以及治疗蛇咬伤患者的医护人员。在每个地区,对每个小组分别进行了两次单独的焦点小组讨论。采用主题内容分析法,运用框架法进行数据分析。根据参与者的个人评估,对预先定义的15项潜在蛇咬伤相关困难清单和WHO 2030年蛇咬伤战略关键活动按优先顺序进行排序。

结果

社区成员将蛇咬伤的急性和慢性影响,如咬伤部位处理、康复和心理健康列为优先事项。医护人员将卫生系统面临的挑战,包括培训、当地标准治疗方案以及现有抗蛇毒血清疗效的临床研究确定为优先事项。值得注意的是,所有参与小组都强调了对传统药物疗效进行研究以及如何促进传统与对抗疗法之间合作策略的必要性。

结论

社区成员将慢性蛇咬伤中毒挑战列为优先事项,以及如何应对这些情况,凸显了在心理和身体康复方面缺乏院后治疗随访。为了提高患者的生活质量,让基层利益相关者参与制定未来研究议程并确定其优先顺序至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ee31/10395900/e017c03dc4a8/pntd.0011504.g001.jpg

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