背景:被忽视的热带病(NTD)的负担,艾滋病毒/艾滋病,结核病,和疟疾对埃塞俄比亚的公共卫生构成重大挑战。本研究旨在探索埃塞俄比亚医疗机构治疗结核病(TB)的NTD护理服务的可用性和准备情况,艾滋病毒/艾滋病,和/或疟疾。
方法:本研究利用了来自埃塞俄比亚服务提供评估2021-22调查的次要数据。服务的可获得性以艾滋病毒/艾滋病的百分比计算,结核病,或提供NTD服务的疟疾设施。设施被认为是高度准备管理任何类型的NTD,如果他们得分至少一半(>50%)的示踪剂项目列出的三个领域(员工培训和指南,设备,和基本药物)。采用描述性统计和逻辑回归模型来呈现研究结果并分析影响设施就绪的因素,分别。
结果:在全国提供NTD护理的403个医疗机构中,179、183和197也提供TB,艾滋病毒/艾滋病,和疟疾服务,分别。大部分结核病(90.1%),艾滋病毒/艾滋病(89.6%),疟疾(90.9%)设施提供土壤传播蠕虫服务,其次是沙眼(范围87-90%)。上述设施中至少有一名受过培训的工作人员从事任何类型的NTD的百分比为87.2%,88.4%,82.1%,分别。具有任何类型NTD指南的设施百分比相对较低(范围为3.7-4.1%)。甲苯咪唑是最广泛使用的基本药物,从69%到70%。总体准备情况分析表明,所包括的设施(结核病=11.9%;艾滋病毒/艾滋病=11.6%;疟疾=10.6%)都没有准备好提供NTD护理。具体来说,仅在这些设施的药物领域观察到较高的准备水平。与健康中心和诊所相比,医院更愿意提供NTD护理。此外,在设施就绪性和设施类型等因素之间观察到显著的关联,区域,出席例行管理会议,提供的NTD服务的类型,以及服务的固定成本。
结论:埃塞俄比亚医疗机构治疗结核病,艾滋病毒/艾滋病,疟疾的总体服务可用性不令人满意,并且缺乏提供NTD护理的准备。鉴于结核病的流行病学风险和高负担,艾滋病毒/艾滋病,疟疾,和埃塞俄比亚的NTD,迫切需要考虑制定和实施一项合作传染病护理计划,以将NTD服务整合到这些设施中。
BACKGROUND: The burden of neglected tropical diseases (NTDs), HIV/AIDS, tuberculosis, and malaria pose significant public health challenges in Ethiopia. This study aimed to the explore
service availability and readiness for NTD care among Ethiopian health facilities treating tuberculosis (TB), HIV/AIDS, and/or malaria.
METHODS: This study utilized secondary data from the Ethiopian
Service Provision Assessment 2021-22 survey. The availability of services was calculated as the percentage of HIV/AIDS, tuberculosis, or malaria facilities providing NTD services. Facilities were considered highly prepared to manage any type of NTD if they scored at least half (> 50%) of the tracer items listed in each of the three domains (staff training and guidelines, equipment, and essential medicines). Descriptive statistics and logistic regression models were employed to present the study findings and analyze factors influencing facility readiness, respectively.
RESULTS: Out of 403 health facilities providing NTD care nationally, 179, 183, and 197 also offer TB, HIV/AIDS, and malaria services, respectively. The majority of TB (90.1%), HIV/AIDS (89.6%), and malaria (90.9%) facilities offer soil-transmitted helminth services, followed by trachoma (range 87-90%). The percentages of the aforementioned facilities with at least one trained staff member for any type of NTD were 87.2%, 88.4%, and 82.1%, respectively. The percentage of facilities with guidelines for any type of NTD was relatively low (range 3.7-4.1%). Mebendazole was the most widely available essential medicine, ranging from 69 to 70%. The overall readiness analysis indicated that none of the included facilities (TB = 11.9%; HIV/AIDS = 11.6%; and malaria = 10.6%) were ready to offer NTD care. Specifically, a higher level of readiness was observed only in the domain of medicines across these facilities. Hospitals had better readiness to offer NTD care than did health centers and clinics. Furthermore, a significant associations were observed between facility readiness and factors such as facility type, region, presence of routine management meetings, types of NTD services provided, and fixed costs for services.
CONCLUSIONS: Ethiopian health facilities treating TB, HIV/AIDS, and malaria had an unsatisfactory overall
service availability and a lack of readiness to provide NTD care. Given the existing epidemiological risks and high burden of TB, HIV/AIDS, malaria, and NTDs in Ethiopia, there is an urgent need to consider preparing and implementing a collaborative infectious disease care plan to integrate NTD services in these facilities.