Background:Schistosomiasis and soil-transmitted helminthiasis(STH)are endemic diseases in Burundi.STH control is integrated into health facilities(HF)across the country,but schistosomiasis control is not.The present s...Background:Schistosomiasis and soil-transmitted helminthiasis(STH)are endemic diseases in Burundi.STH control is integrated into health facilities(HF)across the country,but schistosomiasis control is not.The present study aimed to assess the capacity of HF for integrating intestinal schistosomiasis case management into their routine activities.In addition,the current capacity for HF-based STH case management was evaluated.Methods:A random cluster survey was carried out in July 2014,in 65 HF located in Schistosoma mansoni and STH endemic areas.Data were collected by semi-quantitative questionnaires.Staff with different functions at the HF were interviewed(managers,care providers,heads of laboratory and pharmacy and data clerks).Data pertaining to knowledge of intestinal schistosomiasis and STH symptoms,human and material resources and availability and costs of diagnostic tests and treatment were collected.Findings:Less than half of the 65 care providers mentioned one or more major symptoms of intestinal schistosomiasis(abdominal pain 43.1%,bloody diarrhoea 13.9%and bloody stool 7.7%).Few staff members(15.7%)received higher education,and less than 10%were trained in-job on intestinal schistosomiasis case management.Clinical guidelines and laboratory protocols for intestinal schistosomiasis diagnosis and treatment were available in one third of the HF.Diagnosis was performed by direct smear only.Praziquantel was not available in any of the HF.The results for STH were similar,except that major symptoms were more known and cited(abdominal pain 69.2%and diarrhoea 60%).Clinical guidelines were available in 61.5%of HF,and albendazole or mebendazole was available in all HF.Conclusions:The current capacity of HF for intestinal schistosomiasis and STH detection and management is inadequate.Treatment was not available for schistosomiasis.These issues need to be addressed to create an enabling environment for successful integration of intestinal schistosomiasis and STH case management into HF routine activities in Burundi for better control of these diseases.展开更多
Background:Remarkable progress has been made in the fight against neglected tropical diseases,but new challenges have emerged.Innovative diagnostics,better drugs and new insecticides are often identified as the priori...Background:Remarkable progress has been made in the fight against neglected tropical diseases,but new challenges have emerged.Innovative diagnostics,better drugs and new insecticides are often identified as the priority;however,access to these new tools may not be sufficient to achieve and sustain disease elimination,if certain challenges and priorities are not considered.Main body:The authors summarise key operational challenges,and based on these,identify two major priorities:strengthening the capacity of the primary health care health system in correctly diagnosing and managing neglected tropical diseases;and establishing an effective disease surveillance process.Five steps are proposed as concrete actions to build an effective primary health care service for neglected tropical diseases,and a health management information system capable of accurately reporting these diseases.Community engagement and formalization of community health workers role are proposed as essential components of these steps.Shift of financial support from disease oriented programmes to disease integrated interventions,improved access to international guidelines for primary health care staff,and availability of donated drugs in health care structures are also suggested as key elements of the proposed process.Conclusion:The authors conclude that failure to address these priorities now may lead to further challenges on the long path towards neglected tropical disease elimination and beyond.展开更多
基金The Schistosomiasis Control Initiative(SCI)/Imperial College and VLIR-UOS funded this study。
文摘Background:Schistosomiasis and soil-transmitted helminthiasis(STH)are endemic diseases in Burundi.STH control is integrated into health facilities(HF)across the country,but schistosomiasis control is not.The present study aimed to assess the capacity of HF for integrating intestinal schistosomiasis case management into their routine activities.In addition,the current capacity for HF-based STH case management was evaluated.Methods:A random cluster survey was carried out in July 2014,in 65 HF located in Schistosoma mansoni and STH endemic areas.Data were collected by semi-quantitative questionnaires.Staff with different functions at the HF were interviewed(managers,care providers,heads of laboratory and pharmacy and data clerks).Data pertaining to knowledge of intestinal schistosomiasis and STH symptoms,human and material resources and availability and costs of diagnostic tests and treatment were collected.Findings:Less than half of the 65 care providers mentioned one or more major symptoms of intestinal schistosomiasis(abdominal pain 43.1%,bloody diarrhoea 13.9%and bloody stool 7.7%).Few staff members(15.7%)received higher education,and less than 10%were trained in-job on intestinal schistosomiasis case management.Clinical guidelines and laboratory protocols for intestinal schistosomiasis diagnosis and treatment were available in one third of the HF.Diagnosis was performed by direct smear only.Praziquantel was not available in any of the HF.The results for STH were similar,except that major symptoms were more known and cited(abdominal pain 69.2%and diarrhoea 60%).Clinical guidelines were available in 61.5%of HF,and albendazole or mebendazole was available in all HF.Conclusions:The current capacity of HF for intestinal schistosomiasis and STH detection and management is inadequate.Treatment was not available for schistosomiasis.These issues need to be addressed to create an enabling environment for successful integration of intestinal schistosomiasis and STH case management into HF routine activities in Burundi for better control of these diseases.
基金This work was supported by a UK Department for International Development Programme Partnership Arrangements grant。
文摘Background:Remarkable progress has been made in the fight against neglected tropical diseases,but new challenges have emerged.Innovative diagnostics,better drugs and new insecticides are often identified as the priority;however,access to these new tools may not be sufficient to achieve and sustain disease elimination,if certain challenges and priorities are not considered.Main body:The authors summarise key operational challenges,and based on these,identify two major priorities:strengthening the capacity of the primary health care health system in correctly diagnosing and managing neglected tropical diseases;and establishing an effective disease surveillance process.Five steps are proposed as concrete actions to build an effective primary health care service for neglected tropical diseases,and a health management information system capable of accurately reporting these diseases.Community engagement and formalization of community health workers role are proposed as essential components of these steps.Shift of financial support from disease oriented programmes to disease integrated interventions,improved access to international guidelines for primary health care staff,and availability of donated drugs in health care structures are also suggested as key elements of the proposed process.Conclusion:The authors conclude that failure to address these priorities now may lead to further challenges on the long path towards neglected tropical disease elimination and beyond.