PDF(Pubmed)
Abstract：
BACKGROUND: The last 3 years have witnessed global health challenges, ranging from the pandemics of COVID-19 and mpox (monkeypox) to the Ebola epidemic in Uganda. Public health surveillance is critical for preventing these outbreaks, yet surveillance systems in resource-constrained contexts struggle to provide timely disease reporting. Although community health workers (CHWs) support health systems in low-income and middle-income countries (LMICs), very little has been written about their role in supporting public health surveillance. This review identified the roles, impacts and challenges CHWs face in public health surveillance in 25 LMICs.
METHODS: We conducted a scoping review guided by Arksey and O\'Malley\'s framework. We exported 1,156 peer-reviewed records from Embase, Global Health and PubMed databases. After multiple screenings, 29 articles were included in the final review.
RESULTS: CHWs significantly contribute to public health surveillance in LMICs including through contact tracing and patient visitation to control major infectious diseases such as HIV/AIDS, malaria, tuberculosis, Ebola, neglected tropical diseases and COVID-19. Their public health surveillance roles typically fall into four main categories including community engagement; data gathering; screening, testing and treating; and health education and promotion. The use of CHWs in public health surveillance in LMICs has been impactful and often involves incorporation of various technologies leading to improved epidemic control and disease reporting. Nonetheless, use of CHWs can come with four main challenges including lack of education and training, lack of financial and other resources, logistical and infrastructural challenges as well as community engagement challenges.
CONCLUSIONS: CHWs are important stakeholders in surveillance because they are closer to communities than other healthcare workers. Further integration and training of CHWs in public health surveillance would improve public health surveillance because CHWs can provide health data on \'hard-to-reach\' populations. CHWs\' work in public health surveillance would also be greatly enhanced by infrastructural investments.
METHODS: We conducted a scoping review guided by Arksey and O\'Malley\'s framework. We exported 1,156 peer-reviewed records from Embase, Global Health and PubMed databases. After multiple screenings, 29 articles were included in the final review.
RESULTS: CHWs significantly contribute to public health surveillance in LMICs including through contact tracing and patient visitation to control major infectious diseases such as HIV/AIDS, malaria, tuberculosis, Ebola, neglected tropical diseases and COVID-19. Their public health surveillance roles typically fall into four main categories including community engagement; data gathering; screening, testing and treating; and health education and promotion. The use of CHWs in public health surveillance in LMICs has been impactful and often involves incorporation of various technologies leading to improved epidemic control and disease reporting. Nonetheless, use of CHWs can come with four main challenges including lack of education and training, lack of financial and other resources, logistical and infrastructural challenges as well as community engagement challenges.
CONCLUSIONS: CHWs are important stakeholders in surveillance because they are closer to communities than other healthcare workers. Further integration and training of CHWs in public health surveillance would improve public health surveillance because CHWs can provide health data on \'hard-to-reach\' populations. CHWs\' work in public health surveillance would also be greatly enhanced by infrastructural investments.
摘要：
背景：过去三年见证了全球卫生挑战，从COVID-19和猴痘（monkeypox）的大流行到乌干达的埃博拉疫情。公共卫生监测对于预防这些疫情至关重要，然而，在资源有限的情况下，监测系统难以提供及时的疾病报告。尽管社区卫生工作者（CHW）支持低收入和中等收入国家（LMICs）的卫生系统，关于他们在支持公共卫生监测中的作用的文章很少。这次审查确定了角色，CHW在25个低收入国家的公共卫生监测中面临的影响和挑战。
方法：我们在Arksey和O\'Malley的框架指导下进行了范围审查。我们从Embase导出了1156条同行评审记录,全球卫生和PubMed数据库。经过多次筛查,最终审查包括29篇文章。
结果：CHWs对低收入和中等收入国家的公共卫生监测做出了重大贡献，包括通过接触者追踪和患者探访来控制主要传染病，如艾滋病毒/艾滋病，疟疾,结核病,埃博拉病毒,被忽视的热带病和COVID-19。他们的公共卫生监督角色通常分为四个主要类别，包括社区参与;数据收集;筛选，检测和治疗；以及健康教育和推广。在低收入国家的公共卫生监测中使用CHWs具有影响力，通常涉及各种技术的结合，从而改善了流行病控制和疾病报告。尽管如此，CHW的使用可能带来四个主要挑战，包括缺乏教育和培训，缺乏财政和其他资源，后勤和基础设施挑战以及社区参与挑战。
结论：CHW是监测的重要利益相关者，因为它们比其他医护人员更接近社区。CHW在公共卫生监测中的进一步整合和培训将改善公共卫生监测，因为CHW可以提供“难以接触”人群的健康数据。基础设施投资也将大大加强CHWs在公共卫生监测方面的工作。
方法：我们在Arksey和O\'Malley的框架指导下进行了范围审查。我们从Embase导出了1156条同行评审记录,全球卫生和PubMed数据库。经过多次筛查,最终审查包括29篇文章。
结果：CHWs对低收入和中等收入国家的公共卫生监测做出了重大贡献，包括通过接触者追踪和患者探访来控制主要传染病，如艾滋病毒/艾滋病，疟疾,结核病,埃博拉病毒,被忽视的热带病和COVID-19。他们的公共卫生监督角色通常分为四个主要类别，包括社区参与;数据收集;筛选，检测和治疗；以及健康教育和推广。在低收入国家的公共卫生监测中使用CHWs具有影响力，通常涉及各种技术的结合，从而改善了流行病控制和疾病报告。尽管如此，CHW的使用可能带来四个主要挑战，包括缺乏教育和培训，缺乏财政和其他资源，后勤和基础设施挑战以及社区参与挑战。
结论：CHW是监测的重要利益相关者，因为它们比其他医护人员更接近社区。CHW在公共卫生监测中的进一步整合和培训将改善公共卫生监测，因为CHW可以提供“难以接触”人群的健康数据。基础设施投资也将大大加强CHWs在公共卫生监测方面的工作。
