Barss P, Brabec J, Gregotski G
P N G Med J. 1985 Dec;28(4):251-6.
Many rural health centres in developing countries continue to treat patients without the help of any laboratory tests. The result is often inaccurate diagnosis, wasteful use of multiple drugs, and increasing drug resistance of pathogens. It is unlikely that there will ever be sufficient funds to employ a full-time laboratory worker at each of the many small remote health centres in Papua New Guinea. It is also doubtful whether staff and health extension officers who run such centres have the appropriate knowledge to adequately utilize full-time laboratory personnel. It is feasible, however, to train selected health workers in courses of three to four months' duration to perform a few simple laboratory tests part-time, in addition to their clinical duties. Suitable tests are those where the result does not require skilled interpretation. For most such tests, the result is the diagnosis. After the clinical staff have received the laboratory diagnosis, they are free to decide whether it fits the clinical picture. If so, they can then find the appropriate treatment to prescribe in standard treatment books. The present paper describes the experience in setting up and operating laboratory training for health centre staff in Milne Bay Province, Papua New Guinea. Costs and initial results of the program are discussed.
发展中国家的许多农村医疗中心在没有任何实验室检测帮助的情况下继续为患者治疗。结果往往是诊断不准确、多种药物的浪费性使用以及病原体耐药性的增加。在巴布亚新几内亚众多偏远的小型医疗中心，要为每个中心配备一名全职实验室工作人员，资金往往是不够的。此外，运营这些中心的工作人员和卫生推广官员是否具备充分利用全职实验室人员的适当知识也值得怀疑。然而，对选定的卫生工作者进行为期三到四个月的培训，让他们在履行临床职责之余兼职进行一些简单的实验室检测是可行的。合适的检测是那些结果不需要专业解读的检测。对于大多数此类检测，结果就是诊断。临床工作人员收到实验室诊断结果后，可以自行判断该结果是否符合临床表现。如果符合，他们就可以在标准治疗手册中找到合适的治疗方法并开出处方。本文描述了在巴布亚新几内亚米尔恩湾省为医疗中心工作人员开展实验室培训并进行运营的经验。还讨论了该项目的成本和初步成果。
