社区对在低收入和中等收入国家发现结核病例的看法:定性证据综合
Melissa Taylor1, Nancy Medley2, Susanna S van Wyk3
1Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK.
The Cochrane database of systematic reviews
|March 21, 2024
概括
结核病的活跃病例发现 (ACF) 改善了弱势群体的诊断机会,但在保留和卫生系统支持方面面临挑战. 社区的经验凸显了对耻辱和基础设施不足的恐惧,需要改善和加强卫生系统,以有效控制结核病.
科学领域:
- 公共卫生 公共卫生
- 传染病流行病学 传染病流行病学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 活跃病例发现 (ACF) 系统地识别社区的结核病例,旨在改善贫困人口的诊断和治疗机会,并减少传播.
- 虽然ACF提供了潜在的好处,但了解社区经验对于设计有效的结核病控制计划至关重要.
研究的目的:
- 在低收入和中等收入国家综合社区对结核病活跃病例发现 (ACF) 计划的看法和经验.
主要方法:
- 一个系统的审查和定性和混合方法研究的主题综合,探索社区对结核病ACF计划的看法.
- 搜索了多个数据库,直到2023年6月,包括参考检查和引文搜索.
- 采用了感应编码和主题综合,使用GRADE-CERQual.来评估对发现的信心.
主要成果:
- ACF改善了许多人的诊断机会,特别是那些资源较少的人,但努力接触到边缘化群体并应对更广泛的社会经济挑战.
- 社区成员表达了对结核病诊断的恐惧,原因是潜在的耻辱,歧视和治疗负担,导致不愿参与.
- 卫生基础设施薄弱,资源有限,信息共享不足破坏了ACF的有效性,并可能导致患者和医疗保健工作人员的负面体验.
- 卫生工作者对于ACF的成功至关重要,提供关键的人际联系,但经常面临资源不足和个人健康风险.
- 当地领导对于社区参与至关重要,但单独是不够的;平衡专业权威与当地知识是ACF计划成功的关键.
结论:
- 结核病ACF和接触者追踪增强了对难以接触的人群的诊断服务提供.
- 有效的结核病控制需要强有力的卫生系统加强,以确保护理的连续性,并解决复杂的治疗级联.
- 受到污名,基础设施和支持系统的影响,社区的看法和经验对ACF计划的参与有重大影响.
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