通过复杂性镜头评估撒哈拉以南非洲地区抗微生物管理计划的实施决定因素. 在CFIR指导下进行系统审查
Thandizo Kapatsa1,2, Akim Nelson Bwanali1, Leonard Naphazi Kambewa1
1Education and Research, Clinical Research Education and Management Services (CREAMS), Lilongwe, Malawi.
Frontiers in microbiology
|December 5, 2025
概括
撒哈拉以南非洲的抗菌素耐药性 (AMR) 由于卫生系统疲软而恶化. 抗菌药物管理 (AMS) 计划面临资金不足和培训不足等障碍,阻碍了他们的成功.
科学领域:
- 全球健康 全球健康
- 传染性疾病 传染性疾病
- 卫生系统研究 卫生系统研究
背景情况:
- 抗菌素耐药性 (AMR) 是撒哈拉以南非洲 (SSA) 的一个关键威胁,由脆弱的卫生系统加剧.
- 抗菌药物管理 (AMS) 计划对于优化抗菌药物使用和打击AMR至关重要.
- 在SSA中有限成功的AMS实施需要了解其决定因素.
研究的目的:
- 系统地审查和评估SSA中的AMS计划的实施决定因素.
- 通过实施研究综合框架 (CFIR) 确定影响AMS计划成功的障碍和促进因素.
主要方法:
- 按照PRISMA指南对PubMed和谷歌学者 (2018-2024) 进行了系统的搜索.
- 包括31项研究,报告了影响在SSA实施AMS的因素.
- 将数据提取并映射到CFIR框架的五个领域.
主要成果:
- 主要障碍包括资金不足的卫生系统,诊断不足,缺乏特定背景的指导方针,治理薄弱和培训不足.
- 促进者包括领导力支持,利益相关者参与和全球指南 (例如,WHO AWaRe).
- 观察到不良融入国家卫生重点和有限的监测数据,特别是在初级保健水平.
结论:
- 在SSA中实施AMS受到系统,基础设施和教育方面的挑战的阻碍.
- 加强领导力,监督,培训和制定特定背景的协议至关重要.
- 量身定制的战略,强有力的治理和可持续的资金对于有效的AMS实施至关重要.
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