Objective:Myanmar has been trying to improve the disease management of malaria through public health services. The involvement of private general practitioners(GPs) is recognized as one of the key contributory issues ...Objective:Myanmar has been trying to improve the disease management of malaria through public health services. The involvement of private general practitioners(GPs) is recognized as one of the key contributory issues in malaria control,but no one has yet made an attempt to study the efficiency of their role.This study aimed to assess the participation of GPs in improvement of disease management.Methods:The study was conducted with all 32 GPs practicing at three randomly selected townships with high malaria load situated in Upper Myanmar from June 2006 to March 2007 using a pretest-posttest design to assess their knowledge of the disease management prior to and after intervention.The intervention package consisted of a one-day workshop on diagnosis and treatment of malaria and the supply of facilities for microscopy.Questionnaires filled in before and after tests were compared to assess the change of knowledge after the intervention.Diagnosis and treatment practice during the study period was analysed by review of registers kept by GPs,together with a follow-up survey of their patients for the reliability of data.Results:An overall improvement of knowledge was observed and significant changes were apparent for three variables:the criteria for referral of severe malaria,the effect of incomplete treatment and recommended treatment of Plasmodium vivax.Pre-test results showed that only 65.6%of GPs perceived microscopy or Rapid Diagnostic Test kits(RDTs) for confirmation of malaria necessary,while only 15.6%and 40.6%of the GPs knew the recommended treatments of falciparum and vivax malaria,respectively. However,after intervention 92%of the patients were diagnosed as malaria by RDTs and 3%by microscopy throughout the study.The GPs prescribed artemisinin-based combination therapy(ACTs) to 95%of confirmed falciparum cases and treated 82.4%of RDT confirmed falciparum negatives with chloroquine and primaquine.Concurrent with our study,an international NGO,Population Service International,supplied GPs with RDTs and ACTs at subsidized rate which was helpful.Conclusion:The study suggests that participation of GPs may help improve the disease management of malaria and thus assist in the country’s effort to control ma- laria.展开更多
背景以家庭医生签约服务为载体的健康管理服务是我国农村老年人实现健康老龄化的必要途径,而该项服务在实践中受到多种因素影响。目的对影响我国农村家庭医生签约服务老年人健康管理实践的因素进行范围综述,为提高该项服务的可及性和有...背景以家庭医生签约服务为载体的健康管理服务是我国农村老年人实现健康老龄化的必要途径,而该项服务在实践中受到多种因素影响。目的对影响我国农村家庭医生签约服务老年人健康管理实践的因素进行范围综述,为提高该项服务的可及性和有效性提供参考依据。方法于2023年1—4月,遵循范围综述报告规范清单,于Web of Science、PubMed、Embase、Medline、CINAHL、中国知网、万方数据知识服务平台、维普网和中国生物医学文献数据库检索有关家庭医生签约服务老年人健康管理的文献,检索时限为建库至2022-12-31。根据纳入和排除标准,基于社会生态学模型审查、总结和分析影响农村家庭医生签约服务老年人健康管理实践的因素。结果共纳入27篇文献,提取了与农村家庭医生签约服务老年人健康管理相关的个人、人际、组织、社区及政策5个层面的影响因素。结论农村家庭医生签约服务老年人健康管理实践受到多层面、多因素影响,推动农村地区签约服务老年人健康管理发展需综合考虑其影响因素,明确各责任部门、主体的权利和义务,合力促进以家庭医生签约服务为载体的健康管理服务提质增效。展开更多
基金financially supported by WHO TDR Small Giant Programme.
文摘Objective:Myanmar has been trying to improve the disease management of malaria through public health services. The involvement of private general practitioners(GPs) is recognized as one of the key contributory issues in malaria control,but no one has yet made an attempt to study the efficiency of their role.This study aimed to assess the participation of GPs in improvement of disease management.Methods:The study was conducted with all 32 GPs practicing at three randomly selected townships with high malaria load situated in Upper Myanmar from June 2006 to March 2007 using a pretest-posttest design to assess their knowledge of the disease management prior to and after intervention.The intervention package consisted of a one-day workshop on diagnosis and treatment of malaria and the supply of facilities for microscopy.Questionnaires filled in before and after tests were compared to assess the change of knowledge after the intervention.Diagnosis and treatment practice during the study period was analysed by review of registers kept by GPs,together with a follow-up survey of their patients for the reliability of data.Results:An overall improvement of knowledge was observed and significant changes were apparent for three variables:the criteria for referral of severe malaria,the effect of incomplete treatment and recommended treatment of Plasmodium vivax.Pre-test results showed that only 65.6%of GPs perceived microscopy or Rapid Diagnostic Test kits(RDTs) for confirmation of malaria necessary,while only 15.6%and 40.6%of the GPs knew the recommended treatments of falciparum and vivax malaria,respectively. However,after intervention 92%of the patients were diagnosed as malaria by RDTs and 3%by microscopy throughout the study.The GPs prescribed artemisinin-based combination therapy(ACTs) to 95%of confirmed falciparum cases and treated 82.4%of RDT confirmed falciparum negatives with chloroquine and primaquine.Concurrent with our study,an international NGO,Population Service International,supplied GPs with RDTs and ACTs at subsidized rate which was helpful.Conclusion:The study suggests that participation of GPs may help improve the disease management of malaria and thus assist in the country’s effort to control ma- laria.
文摘背景以家庭医生签约服务为载体的健康管理服务是我国农村老年人实现健康老龄化的必要途径,而该项服务在实践中受到多种因素影响。目的对影响我国农村家庭医生签约服务老年人健康管理实践的因素进行范围综述,为提高该项服务的可及性和有效性提供参考依据。方法于2023年1—4月,遵循范围综述报告规范清单,于Web of Science、PubMed、Embase、Medline、CINAHL、中国知网、万方数据知识服务平台、维普网和中国生物医学文献数据库检索有关家庭医生签约服务老年人健康管理的文献,检索时限为建库至2022-12-31。根据纳入和排除标准,基于社会生态学模型审查、总结和分析影响农村家庭医生签约服务老年人健康管理实践的因素。结果共纳入27篇文献,提取了与农村家庭医生签约服务老年人健康管理相关的个人、人际、组织、社区及政策5个层面的影响因素。结论农村家庭医生签约服务老年人健康管理实践受到多层面、多因素影响,推动农村地区签约服务老年人健康管理发展需综合考虑其影响因素,明确各责任部门、主体的权利和义务,合力促进以家庭医生签约服务为载体的健康管理服务提质增效。
