방글라데시에서 지역사회 보건인력 훈련과 결핵 사례의 관계 연구

방글라데시에서 지역사회 보건인력 훈련과 결핵 사례의 관계 연구

Training of community healthcare providers and TB case detection in Bangladesh

Shayla Islam a,*, Anthony D. Harries b,c, Sumit Malhotra d, K. Zamane, Ashaque Husain f, Akramul Islama and Faruque Ahmeda

배경 : 지난 몇 년간 BRAC(Bangladesh Rural Advancement Committee)은 방글라데시의 국가적 결핵 관리(control) 노력을 지원해왔으며, 특히 지역사회의 보건의료 인력의 훈련에 집중해왔다. 이 연구는 지역사회 기반 결핵 훈련 프로그램과 같은 지역에서의 결핵 사례간 상관관계를 보고자 하였다.

방법 : 이 연구는 후향적 단면 연구(cross-sectional retrospective study)로서 객담(가래) 등록자(registers)와 BRAC의 훈련보고서를 바탕으로 하였다.

결과 : 2005년과 2010년 사이에 536회의 훈련 과정을 통해 9037명의 사람들을 훈련시켰다. 검사를 받는 환자의 숫자는 훈련 전 8211명(2004년)에서 훈련 시작시점에서 10961명(2005년)으로 증가하였고, 동시에 도말검사에서 결핵 양성으로 나온 사람도 7.1%에서 11.2%로 증가하였다. 그 후에 결핵으로 의심되거나 진단된 사람의 숫자든 2010년까지도 비슷하게 유지되었다. 환자를 의뢰해온 가장 중요한 소스는 지역사회 건강 자원봉사자와 자기보고 환자들이었고 이들의 전체 환자의 58%를 차지하였다.

결론 : 이 operational research에서 결핵 사례는 초반에 증가하나가, 나중에는 포화(plateau)상태에 이르렀다. 이러한 현상을 설명하기 위한 추가의 연구가 필요해 보인다.

---

Training of community healthcare providers and TB case detection in Bangladesh

1. Shayla Islama,*, 
2. Anthony D. Harriesb,c, 
3. Sumit Malhotrad, 
4. K. Zamane,
5. Ashaque Husainf, 
6. Akramul Islama and 
7. Faruque Ahmeda

+Author Affiliations

1. ^aBRAC Health Programme, Dhaka, Bangladesh
2. ^bInternational Union Against Tuberculosis and Lung Disease (The Union), Paris, France
3. ^cDepartment of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
4. ^dAll India Institute of Medical Sciences, New Delhi, India
5. ^eInternational Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
6. ^fMinistry of Health, Bangladesh

1. ↵*Corresponding author: Present address: BRAC Health Programme, BRAC Centre, 16th floor, 75 Mohakhali, Dhaka-1212, Bangladesh; E-mail: shayla.i@brac.net

• Received January 29, 2013.
• Revision received April 3, 2013.
• Accepted April 15, 2013.

 

Next Section

Abstract

Background For several years, BRAC (previously known as the Bangladesh Rural Advancement Committee) has been assisting with national TB control efforts in Bangladesh and has especially focused on training of community healthcare personnel. This study attempts to determine whether there is any association between a community-based TB training programme in peri-urban Dhaka and TB case finding within the same catchment area.

Methods This was a cross-sectional retrospective study using laboratory sputum registers and annual BRAC training reports.

Results Between 2005 and 2010, there were 536 training activities for community healthcare providers with 9037 people trained. Numbers of patients attending laboratories with suspected TB increased from 8211 in 2004 (before training) to 10 961 in 2005 (start of training) with the proportion diagnosed with smear-positive TB increasing from 7.1% to 11.2%. Thereafter, the numbers with suspected and diagnosed TB remained similar up to 2010. The most important sources of referral of patients for investigation were community health volunteers and self-referring patients accounting for 58% of all patients.

Conclusion In this operational research study in peri-urban Dhaka, there was an initial increase in TB case finding with numbers then reaching a plateau despite continued training activities. Further prospective evaluation is required to understand these phenomena.

Key words

• Training
 
• Health care providers
 
• Tuberculosis case finding
 
• Bangladesh

Previous SectionNext Section