弥合"实践知识"差距,改善印度结核病的活跃病例发现:对国家结核病消除计划工作人员的观点进行定性探索
Hemant Deepak Shewade1, Prabhadevi Ravichandran1, S Kiran Pradeep1
1ICMR - National Institute of Epidemiology (ICMR-NIE), Chennai, India.
PloS one
|November 4, 2024
概括
改善印度结核病活体病例发现 (ACF) 需要解决提供者的观点. 关键的推动因素包括充足的预算和社区参与,而障碍则涉及缺乏理解和质量控制,需要能力建设和修订指导.
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
- 卫生系统研究 卫生系统研究
背景情况:
- 印度国家结核消除计划 (NTEP) 评估了2021年活跃病例查找 (ACF) 质量,发现其不理想.
- 在2022年委托进行国家评估,以告知结核病消除的基于证据的战略规划.
- 本研究从NTEP工作人员的角度研究了改善结核病ACF的推动因素,障碍和解决方案.
研究的目的:
- 确定使印度有效实施结核病ACF的因素和障碍.
- 收集项目经理和实施者的建议,以加强结核病ACF战略.
- 为改善结核病例检测提供ACF国家指南的修订信息.
主要方法:
- 描述性的定性研究设计.描述性的定性研究设计.
- 与八个州的34名故意选择的州,区和分区NTEP项目经理和实施者进行了关键信息员采访.
- 数据分析涉及两名独立调查人员手动描述性主题分析.
主要成果:
- 对ACF的感知推动因素包括充足的预算,激励措施,利益相关方参与,社区友好型方法,快速诊断和数字化.
- 发现的障碍是ACF质量低于最佳,对ACF概念的理解有限,"实践知识"差距,以及在一般人群中而不是高风险群体中不一致的实施.
- 激励缺乏强大的质量控制机制,Ni-kshay系统中的数据验证有限.
结论:
- 国家ACF指南需要修订,以强调能力建设和专注于高风险人群.
- 实施监测和与质量控制相关的激励措施对于提高ACF有效性至关重要.
- 修订后的策略应该提高覆盖范围,质量,并最终提高结核病ACF的结果.
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