乌干达医院医护人员对青蒿素类复方疗法疗效和疟疾诊断的体验。

Experiences of healthcare personnel on the efficacy of artemisinin-based combination therapy and malaria diagnosis in hospitals in Uganda.

机构信息

Department of Pharmacology & Therapeutics, College of Health Sciences, Makerere University, P. O. Box 7072, Kampala, Uganda.

Department of Health Policy, Planning and Management, College of Health Sciences, Makerere University, P. O. Box 7072, Kampala, Uganda.

出版信息

Malar J. 2023 Nov 27;22(1):362. doi: 10.1186/s12936-023-04800-2.

DOI:10.1186/s12936-023-04800-2

PMID:38012717

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10683277/

Abstract

BACKGROUND

The risk of widespread resistance to artemisinin-based combination therapy (ACT) remains high in Uganda following detection of Plasmodium falciparum parasites with delayed artemisinin clearance genotype and phenotype. Establishment of context specific interventions to mitigate emergence and spread of artemisinin resistance is thus key in the fight against malaria in the country. The aim of this study was to explore the experiences of healthcare personnel on malaria diagnosis and self-reported efficacy of ACT in the management of malaria symptomatic patients in hospitals in low and high malaria transmission settings in Uganda.

METHODS

This was a qualitative study in which data was collected from healthcare personnel in hospitals using key informant interviews. The key informant interview guide was developed, pre-tested prior to use and covered the following areas, (i) sociodemographic characteristics, (ii) malaria diagnosis (clinical and parasite based), (iii) quality-assured artemisinin-based combination therapy, (iv) malaria patient follow-up, (v) artemisinin resistance, (vi) anti-malarial self-medication. Data was entered in Atlas.ti ver 9.0 and analysis done following a framework criterion.

RESULTS

A total of 22 respondents were interviewed of which 16 (72.7%) were clinicians. Majority, 81.8% (18/22) of the respondents were male. The following themes were developed from the analysis, malaria diagnosis (procedures and challenges), use of malaria laboratory test results, malaria treatment in hospitals, use of quality assured ACT (QAACT) in malaria treatment, and efficacy of ACT in malaria treatment.

CONCLUSION

Most healthcare personnel-initiated malaria treatment after a positive laboratory test. Cases of malaria patients who report remaining symptomatic after prior use of ACT exist especially in high malaria transmission settings in Uganda. There is need for regular monitoring of artemisinin resistance emergence and spread in the country.

摘要

背景

在乌干达发现青蒿素清除基因型和表型延迟的恶性疟原虫寄生虫后，青蒿素为基础的联合疗法（ACT）广泛耐药的风险仍然很高。因此，在该国抗击疟疾的过程中，建立针对具体情况的干预措施以减轻青蒿素耐药性的出现和传播是关键。本研究旨在探讨医疗机构工作人员在疟疾诊断方面的经验，以及在低和高疟疾传播地区的医院中管理有症状疟疾患者时，对 ACT 的自我报告疗效。

方法

这是一项定性研究，通过关键知情人访谈在医院收集医疗机构工作人员的数据。知情人访谈指南是在使用前开发、预测试的，涵盖以下领域：（i）社会人口统计学特征，（ii）疟疾诊断（临床和寄生虫基础），（iii）有质量保证的青蒿素为基础的联合疗法，（iv）疟疾患者随访，（v）青蒿素耐药性，（vi）抗疟自我用药。数据输入 Atlas.ti ver 9.0，并按照框架标准进行分析。