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印度拉贾斯坦邦焦特布尔市社区卫生官员能力建设以优化口腔癌筛查与早期诊断

Capacity building of community health officers for optimizing the screening and early diagnosis of oral cancer in Jodhpur, Rajasthan, India.

作者信息

Gautam Janesh Kumar, Anand Praveen Kumar, Chouhan Mahendra, Babu Bontha V

机构信息

Indian Council of Medical Research-National Institute for Implementation Research on Non-Communicable Diseases, Jodhpur, Rajasthan, India.

Department of ENT, Dr. S.N. Medical College, Jodhpur, Rajasthan, India.

出版信息

Sci Rep. 2025 May 8;15(1):16027. doi: 10.1038/s41598-025-00225-w.

Abstract

Oral Cancer screening through the detection of Oral Potentially Malignant Disorders (OPMDs) reduces Oral Cancer mortality and the overall burden of Oral Cancer. However, the high cost and the low accessibility are the major barriers associated with Oral Cancer screening. The present study aims to optimize the screening and early diagnosis of Oral Cancer through the capacity building of Community Health Officers (CHOs) posted in Ayushman Arogya Mandir (erstwhile Health and Wellness Centers) in Jodhpur, Rajasthan, India. A quasi-experimental interventional study was conducted among CHOs of the Jodhpur district of Rajasthan, India. A total of 46 CHOs underwent one day of training on Oral Cancer screening through Oral Visual Examination (OVE). CHOs' knowledge was assessed pre-training, post-training, and at a two-month follow-up. CHOs conducted screenings over eight months, and ENT specialists remotely validated their findings. This study evaluated the effectiveness of training CHOs in Oral Cancer screening and assessed their screening performance and diagnostic accuracy. The training on Oral Cancer screening resulted in significant and sustained knowledge gains among CHOs. CHOs with higher educational qualifications, previous job experience, and previous knowledge of Oral Cancer screening performed significantly better than others. The overall sensitivity and specificity of CHO screenings were 83.87% and 98.31%, respectively, with an overall diagnostic accuracy of 96.17%. Training CHOs in Oral Cancer screening significantly improved their knowledge and screening performance. CHO findings showed high diagnostic accuracy. The results of the study support the potential role of trained CHOs in community-based Oral Cancer screening programs. This can be a sustainable and effective implementation strategy to enhance Oral Cancer screening in resource-limited settings.

摘要

通过检测口腔潜在恶性疾病(OPMDs)进行口腔癌筛查可降低口腔癌死亡率和口腔癌的总体负担。然而,高成本和低可及性是与口腔癌筛查相关的主要障碍。本研究旨在通过对印度拉贾斯坦邦焦特布尔市阿育吠陀健康中心(原健康与 wellness 中心)的社区卫生官员(CHOs)进行能力建设,优化口腔癌的筛查和早期诊断。在印度拉贾斯坦邦焦特布尔地区的社区卫生官员中开展了一项准实验性干预研究。共有46名社区卫生官员接受了为期一天的通过口腔视诊(OVE)进行口腔癌筛查的培训。在培训前、培训后以及两个月的随访中评估社区卫生官员的知识水平。社区卫生官员在八个月内进行筛查,耳鼻喉科专家远程验证他们的检查结果。本研究评估了培训社区卫生官员进行口腔癌筛查的有效性,并评估了他们的筛查表现和诊断准确性。口腔癌筛查培训使社区卫生官员的知识有了显著且持续的增长。受过高等教育、有先前工作经验以及对口腔癌筛查有先前了解的社区卫生官员表现明显优于其他人。社区卫生官员筛查的总体敏感性和特异性分别为83.87%和98.31%,总体诊断准确性为96.17%。培训社区卫生官员进行口腔癌筛查显著提高了他们的知识水平和筛查表现。社区卫生官员的检查结果显示出较高的诊断准确性。该研究结果支持了经过培训的社区卫生官员在基于社区的口腔癌筛查项目中的潜在作用。这可以成为在资源有限环境中加强口腔癌筛查的一种可持续且有效的实施策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8b4a/12062443/5d322d060321/41598_2025_225_Fig1_HTML.jpg

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