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Abstract：
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.
RESULTS: 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.
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.
RESULTS: 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.
摘要：
背景：血吸虫病和土壤传播的蠕虫病（STH）是布隆迪的地方病。STH控制已纳入全国各地的卫生设施（HF），但是血吸虫病的控制却没有。本研究旨在评估HF将肠道血吸虫病病例管理纳入其常规活动的能力。此外,评估了基于HF的STH病例管理的当前能力。
方法：2014年7月对曼氏血吸虫和STH流行区的65例HF进行了随机整群调查。通过半定量问卷收集数据。采访了HF具有不同职能的工作人员(经理，护理提供者，实验室和药房负责人以及数据文员)。有关肠道血吸虫病和STH症状知识的数据，收集了人力和物力资源以及诊断测试和治疗的可用性和成本。
结果：65名护理提供者中只有不到一半提到了肠血吸虫病的一种或多种主要症状（腹痛43.1％，血性腹泻13.9%和血便7.7%)。很少有工作人员(15.7%)接受过高等教育,不到10％的人接受了肠道血吸虫病病例管理的在职培训。在1/3的HF患者中，有用于肠道血吸虫病诊断和治疗的临床指南和实验室方案。仅通过直接涂片进行诊断。吡喹酮在任何HF中均不可用。STH的结果相似，除了主要症状更为已知和引用（腹痛69.2％和腹泻60％）。临床指南可用于61.5%的HF，阿苯达唑或甲苯咪唑在所有HF中均可用。
结论：目前HF对肠血吸虫病和STH的检测和管理能力不足。血吸虫病治疗不可用。需要解决这些问题，为成功将肠道血吸虫病和STH病例管理纳入布隆迪HF常规活动创造有利环境，以更好地控制这些疾病。
方法：2014年7月对曼氏血吸虫和STH流行区的65例HF进行了随机整群调查。通过半定量问卷收集数据。采访了HF具有不同职能的工作人员(经理，护理提供者，实验室和药房负责人以及数据文员)。有关肠道血吸虫病和STH症状知识的数据，收集了人力和物力资源以及诊断测试和治疗的可用性和成本。
结果：65名护理提供者中只有不到一半提到了肠血吸虫病的一种或多种主要症状（腹痛43.1％，血性腹泻13.9%和血便7.7%)。很少有工作人员(15.7%)接受过高等教育,不到10％的人接受了肠道血吸虫病病例管理的在职培训。在1/3的HF患者中，有用于肠道血吸虫病诊断和治疗的临床指南和实验室方案。仅通过直接涂片进行诊断。吡喹酮在任何HF中均不可用。STH的结果相似，除了主要症状更为已知和引用（腹痛69.2％和腹泻60％）。临床指南可用于61.5%的HF，阿苯达唑或甲苯咪唑在所有HF中均可用。
结论：目前HF对肠血吸虫病和STH的检测和管理能力不足。血吸虫病治疗不可用。需要解决这些问题，为成功将肠道血吸虫病和STH病例管理纳入布隆迪HF常规活动创造有利环境，以更好地控制这些疾病。
