Ibrahim Bayan E, El-Amin Rahba Osman, Abdulla Safia Tarig Adam
Faculty of Medicine, University of Khartoum, Khartoum, Sudan.
Open Access Emerg Med. 2023 Oct 18;15:373-382. doi: 10.2147/OAEM.S433240. eCollection 2023.
The inevitable coronavirus disease 2019 global pandemic has severely affected Sudan's fragile healthcare system. The authors share the experience of COVID-19 triage in the emergency departments of five public hospitals in Khartoum state, Sudan.
A clinical audit was conducted in December 2020 using the Centers for Disease Control and Prevention Checklist and Monitoring Tool for Triage of Suspected COVID-19 Cases. The tool was categorised into 5 domains and 38 indicators.
Only three hospitals had hand hygiene stations in their triage areas: Ibrahim Malik, Omdurman, and Al-Nau. Omdurman Teaching Hospital was the sole hospital with a designated respiratory waiting area. At Al-Nau and Omdurman Hospitals, all respiratory symptomatic patients wore a facemask or alternative. Ibrahim Malik and Bahri Teaching Hospitals had 60% and 50% compliance, respectively, while none at El-Tamayouz Hospital did. No posters or job aids were present in donning and doffing areas. Heavy duty gloves were worn only at Ibrahim Malik (50%) and Omdurman (20%). 100% of staff wore closed-toe footwear at Ibrahim Malik and Omdurman, 75% at El-Tamayouz, 63% at Bahri, and none at Al-Nau.
The healthcare facilities displayed significant shortcomings in preparedness and response to COVID-19, with variations across hospitals in infrastructure, human resources, and procedures. To better combat future outbreaks, systemic improvements and a focused approach on consistent staff training, standard triage algorithms, and adequate PPE availability are imperative.
2019年冠状病毒病不可避免的全球大流行严重影响了苏丹脆弱的医疗体系。作者分享了在苏丹喀土穆州五家公立医院急诊科进行新型冠状病毒肺炎分诊的经验。
2020年12月，使用美国疾病控制与预防中心的新型冠状病毒肺炎疑似病例分诊清单和监测工具进行了一项临床审计。该工具分为5个领域和38项指标。
只有三家医院在其分诊区域设有手部卫生设施：易卜拉欣·马利克医院、恩图曼医院和纳乌医院。恩图曼教学医院是唯一设有指定呼吸道候诊区的医院。在纳乌医院和恩图曼医院，所有有呼吸道症状的患者都佩戴了口罩或其他替代品。易卜拉欣·马利克教学医院和巴赫里教学医院的合规率分别为60%和50%，而塔迈尤兹医院则无人合规。穿脱区域没有张贴海报或提供操作指南。只有易卜拉欣·马利克医院（50%）和恩图曼医院（20%）的工作人员佩戴了重型手套。在易卜拉欣·马利克医院和恩图曼医院，100%的工作人员穿着不露趾鞋，在塔迈尤兹医院为75%，在巴赫里医院为63%，在纳乌医院则无人穿着。
医疗机构在新型冠状病毒肺炎的防控准备和应对方面存在重大缺陷，不同医院在基础设施、人力资源和程序方面存在差异。为了更好地应对未来的疫情爆发，必须进行系统性改进，并采取针对性方法，持续开展工作人员培训、采用标准分诊算法并确保充足的个人防护装备供应。
