Abstract：
Human African trypanosomiasis (HAT) is a neglected tropical disease that has not received much attention in Zambia and most of the countries in which it occurs. In this study, we assessed the adequacy of the healthcare delivery system in diagnosis and management of rHAT cases, the environmental factors associated with transmission, the population at risk and the geographical location of rHAT cases. Structured questionnaires, focus group discussions and key informant interviews were conducted among the affected communities and health workers. The study identified 64 cases of rHAT, of which 26 were identified through active surveillance and 38 through passive surveillance. We identified a significant association between knowledge of the vector for rHAT and knowledge of rHAT transmission (p < 0.028). In all four districts, late or poor diagnosis occurred due to a lack of qualified laboratory technicians and diagnostic equipment. This study reveals that the current Zambian healthcare system is not able to adequately handle rHAT cases. Targeted policies to improve staff training in rHAT disease detection and management are needed to ensure that sustainable elimination of this public health problem is achieved in line with global targets.
摘要：
人类非洲锥虫病（HAT）是一种被忽视的热带病，在赞比亚和发生这种疾病的大多数国家都没有受到太多关注。在这项研究中,我们评估了医疗服务系统在诊断和管理rHAT病例方面的充分性，与传播相关的环境因素，高危人群和rHAT病例的地理位置。结构化问卷，在受影响社区和卫生工作者中进行了焦点小组讨论和关键线人访谈。该研究确定了64例rHAT，其中26个是通过主动监测确定的，38个是通过被动监测确定的。我们确定了rHAT矢量知识与rHAT传播知识之间的显着关联（p＆lt;0.028）。在所有四个区，由于缺乏合格的实验室技术人员和诊断设备，导致诊断延迟或不良。这项研究表明，当前的赞比亚医疗保健系统无法充分处理rHAT病例。需要有针对性的政策来改善工作人员在rHAT疾病检测和管理方面的培训，以确保按照全球目标可持续地消除这一公共卫生问题。
