Kihumuro Raymond Bernard, Atimango Lorna, Kintu Timothy Mwanje, Makai Conrad, Kanyike Andrew Marvin, Bazira Joel
Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda.
Department of Internal Medicine, Mulago National Referral Hospital, Kampala, Uganda.
Trans R Soc Trop Med Hyg. 2024 Dec 3;118(12):781-789. doi: 10.1093/trstmh/trae043.
Neglected tropical diseases (NTDs), including soil-transmitted helminths (STHs) and schistosomiasis, continue to impose a heavy burden, especially in sub-Saharan Africa and Uganda, despite being preventable. Integration of NTD management into primary healthcare has been inadequate. While researchers have explored community perspectives, there is a notable gap in understanding the viewpoints of healthcare workers (HCW), which is crucial for effective NTD control strategies. This study explores HCW' perspectives in Eastern Uganda, highlighting challenges in schistosomiasis and STH prevention and management.
In this qualitative descriptive study, we conducted semistructured interviews with 10 key informants who were HCW in Eastern Uganda with experience in managing STHs and schistosomiasis. Participants were selected purposively and interviewed through Zoom guided by a comprehensive interview guide. The data were transcribed, coded and analyzed thematically.
We identified five key themes regarding the impact and management of NTDs: (i) the burden of NTDs, where schistosomiasis and STHs were notably prevalent among children and communities adjacent to water bodies; (ii) transmission of NTDs, emphasizing water bodies and poor sanitation as primary routes of disease spread; (iii) clinical manifestations of NTDs, detailing the symptomatic presentations that complicate diagnosis and management; (iv) challenges in managing and diagnosing NTDs, highlighting the shortages of essential medications and diagnostic tools, along with the under-prioritization of NTDs within healthcare systems; and (v) fatalities and complications arising from NTDs, reporting on the severe outcomes and under-reporting of deaths associated with NTDs due to misdiagnosis, delayed treatment and traditional healing preferences.
The interviewed Ugandan HCW demonstrated sufficient knowledge of schistosomiasis and STHs, but faced challenges due to inadequate diagnostic tools and medication shortages. The study underscores the need for NTD prioritization with direct funding and government involvement, alongside strategies that integrate continuous medical training, effective community outreach and an enhanced healthcare system response to reduce the burden of NTDs.
被忽视的热带病(NTDs),包括土壤传播的蠕虫病(STHs)和血吸虫病,尽管是可预防的,但仍继续造成沉重负担,特别是在撒哈拉以南非洲和乌干达。将NTD管理纳入初级卫生保健的工作一直不够充分。虽然研究人员已经探讨了社区的观点,但在了解医护人员(HCW)的观点方面存在明显差距,而这对于有效的NTD控制策略至关重要。本研究探讨了乌干达东部医护人员的观点,突出了血吸虫病和土壤传播的蠕虫病预防与管理中的挑战。
在这项定性描述性研究中,我们对10名关键信息提供者进行了半结构化访谈,他们是乌干达东部有管理土壤传播的蠕虫病和血吸虫病经验的医护人员。通过有目的的选择,在一份全面的访谈指南的指导下,通过Zoom对参与者进行访谈。对数据进行转录、编码并进行主题分析。
我们确定了关于NTDs的影响和管理的五个关键主题:(i)NTDs的负担,其中血吸虫病和土壤传播的蠕虫病在儿童和水体附近的社区中尤为普遍;(ii)NTDs的传播,强调水体和卫生条件差是疾病传播的主要途径;(iii)NTDs的临床表现,详细说明了使诊断和管理复杂化的症状表现;(iv)NTDs管理和诊断中的挑战,突出了基本药物和诊断工具的短缺,以及医疗系统中NTDs的优先级较低;(v)NTDs引起的死亡和并发症,报告了由于误诊、治疗延迟和传统治疗偏好导致的与NTDs相关的严重后果和死亡报告不足。
接受采访的乌干达医护人员对血吸虫病和土壤传播的蠕虫病有足够的了解,但由于诊断工具不足和药物短缺而面临挑战。该研究强调需要通过直接资助和政府参与对NTDs进行优先排序,同时采取整合持续医学培训、有效的社区宣传和加强医疗系统应对措施的策略,以减轻NTDs的负担。