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初级卫生保健工作者对急性风湿热和风湿性心脏病的认知:乌干达西南部公共卫生设施的一项研究

Primary Healthcare Workers' Awareness of Acute Rheumatic Fever & Rheumatic Heart Disease: A Study in Public Health Facilities in South Western Uganda.

作者信息

Ochora Moses, Kyasimire Lydia, Lutasingwa Dan, Namata Tamara, Ahmed Muna, Favina Alain, Kumbakumba Elias, Nampijja Dorah

机构信息

Department of Paediatrics and Child Health, Mbarara University of Science and Technology, Mbarara City, Uganda.

Department of Community Health, Mbarara University of Science and Technology, Mbarara City, Uganda.

出版信息

Pediatric Health Med Ther. 2024 Jun 4;15:223-229. doi: 10.2147/PHMT.S461168. eCollection 2024.

Abstract

INTRODUCTION

Timely identification and treatment of a streptococcal throat infection prevents acute rheumatic fever (ARF) and its progression to Rheumatic Heart Disease (RHD). However, children in developing countries still present with established RHD, due to either missed, untreated or sub-optimally treated sore throats and ARF. We aimed to determine the level of knowledge, skills, and practices of primary health workers in South Western Uganda in providing care such children.

METHODS

We conducted a comparative quantitative cross-sectional study to assess knowledge, practices, and skills regarding the care of a child with a sore throat, ARF, and RHD. The responses were scored against a structured guide. The Fisher's exact test and the chi-squared test with level of significance set at 0.05 were utilized to compare differences in knowledge, skills, and practices among health workers in private and public health facilities about ARF and RHD.

RESULTS

Eighty health workers from health facilities were interviewed in Mbarara district with a median age of 29.5 years (IQR 27.34) and median duration in practice of 5 years (IQR: 2, 10). On average, there were at least 3 children with sore throats weekly. At least 95% (CI: 87.25%-98.80%) of the health worker had awareness about ARF and RHD. Only 43.75% (95% CI: 33.18%-54.91%) had good knowledge about ARF and RHD. Majority, 61.25% (95% CI: 50.03%-71.39%) did not know the proper prophylaxis and investigations for a child with ARF. There were no statistically significant differences but a clinically meaningful differentials in the level of knowledge among health workers in public and private facilities.

CONCLUSION

The knowledge and skill level of health workers in primary healthcare facilities about ARF and RHD in South Western Uganda remains low, with no difference between practitioners in public and private facilities.

摘要

引言

及时识别并治疗链球菌性咽喉感染可预防急性风湿热(ARF)及其进展为风湿性心脏病(RHD)。然而,由于咽喉痛、ARF未得到诊治或治疗不充分,发展中国家的儿童仍会出现确诊的RHD。我们旨在确定乌干达西南部初级卫生工作者在为这类儿童提供护理方面的知识、技能和实践水平。

方法

我们开展了一项比较性定量横断面研究,以评估有关咽喉痛、ARF和RHD患儿护理的知识、实践和技能。根据一份结构化指南对回答进行评分。采用费舍尔精确检验和设定显著性水平为0.05的卡方检验,比较私立和公立卫生机构的卫生工作者在ARF和RHD知识、技能和实践方面的差异。

结果

在姆巴拉拉区,对来自卫生机构的80名卫生工作者进行了访谈,他们的中位年龄为29.5岁(四分位距27.34),中位从业年限为5年(四分位距:2, 10)。平均每周至少有3名儿童出现咽喉痛。至少95%(可信区间:87.25%-98.80%)的卫生工作者了解ARF和RHD。只有43.75%(95%可信区间:33.18%-54.91%)对ARF和RHD有充分的了解。大多数人,即61.25%(95%可信区间:50.03%-71.39%)不知道ARF患儿的正确预防措施和检查方法。公立和私立机构卫生工作者的知识水平虽无统计学显著差异,但存在具有临床意义的差别。

结论

乌干达西南部初级卫生保健机构的卫生工作者对ARF和RHD的知识和技能水平仍然较低,公立和私立机构的从业者之间没有差异。

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