Infectious Diseases

Chronic hepatitis B virus (HBV) infection is the leading cause of liver disease and liver cancer and a major source of health-related discrimination in China. To better target HBV detection and prevention programs, it is necessary to assess existing HBV knowledge, educational resources, reporting, and preventive practices, particularly among those health professionals who would be responsible for implementing such programs. [from abstract]

Information on health expenditure suggests that most poor countries have a large and growing private medical sector. Surveys indicate that the private sector is an important source of care, even for poor people and even where public services are widely available. Experts believe that private practitioners manage a large proportion of the unreported majority of tuberculosis cases. [adapted from author]

In this study, we aimed to determine the cost and cost-effectiveness of involving health extension workers in tuberculosis treatment in Southern Ethiopia. This paper presents an ancillary cost-effectiveness analysis of data from a randomized control trial. [adapted from introduction]

This study presents evaluation findings of two different programs targeting private medicine retailers for malaria control in Kenya. Key components of this evaluation were measurement of program performance, including coverage, knowledge, practices, and utilization based on spatial analysis. [from abstract]

Documentation of test results for latent tuberculosis infection is important for health care workers and students before they begin work. A negative result provides a baseline for comparison with future tests. A positive result affords a potential opportunity for treatment of latent infection when appropriate. This study sought to evaluate the yield of the referral process for positive baseline tuberculin tests, among persons beginning health care work or studies. [from abstract]

This handbook provides background information on the current workforce situation in the health sector and summarizes the issues and challenges; introduces the HRH Action Framework and the Stop TB (tuberculosis) Strategy; applies the Framework to human resource development (HRD) for comprehensive TB control; describes how to prepare a strategic plan for HRD in support of comprehensive TB control; and gives a step-by-step guide on how to develop HRD plans based on the structures and processes described. [adapted from introduction]

The objective of this study was to assess the skills of community health volunteers in diagnosing active trachoma, the world’s leading cause of preventable blindness, and distributing azithromycin treatment in the Northern Region of Ghana. [adapted from author]

This article describes a systematic process to develop and implement two strategic action plans focussing on competence development based on specific job descriptions. The approach was a change from only focussing on training, to a broader, long term approach to human resource development for comprehensive TB control. [adapted from abstract]

The Integrated Management of Childhood Illness strategy can improve the quality of care for pneumonia and other common illnesses in developing countries, but adherence to these guidelines could be improved. We evaluated an intervention in Benin to support health worker adherence to the guidelines after training, focusing on pneumonia case management. [from abstract]

We conducted a survey among nurses and midwives working at district level in Sudan and Zambia to determine their roles and functions in polio eradication and measles elimination programs. [from abstract]

This article reports on the obstacles to care and the outcome of treatment for patients presenting with tuberculosis to four hospitals in the rural South African region of Sekhukhuneland. [adapted from article]

This study involves the development and evaluation of training materials for provider-initiated HIV counseling and testing, HIV prevention and integrated primary HIV care and support for use by health care workers involved in the care of patients with TB at the primary health care clinic level in the Democratic Republic of Congo. [adapted from abstract]

The study assessed knowledge and practice of health care providers on current concepts on malaria prophylaxis in pregnancy. [from abstract]

There is a general consensus that another influenza pandemic is inevitable. Although health care workers (HCWs) are essential to the health system response, there are few studies exploring HCW attitudes to pandemic influenza. The aim of this study was to explore HCWs knowledge, attitudes and intended behaviour towards pandemic influenza. [from abstract]

The UK healthcare system's ability to cope during an influenza pandemic will largely depend on the number of healthcare workers (HCWs) who are able and willing to work through the crisis. This paper includes the results of a qualitative study exploring the views of UK HCWs on working during an influenza pandemic in order to identify factors that might influence their willingness and ability to work. [from abstract]

Increased immunization coverage is an important step towards fulfilling the Millennium Development Goal of reducing childhood mortality. Recent cross-sectional and cross-national research has indicated that physician, nurse and midwife densities may positively influence immunization coverage. However, little is known about relationships between densities of HRH and vaccination coverage within developing countries and over time. This study examines HRH densities and coverage of the Expanded Program on Immunization (EPI) in Turkey from 2000 to 2006. [from abstract]

The purpose of this survey was to identify nurses' perceived challenges in implementing a community-based TB program in the Omaheke region of Namibia. The HIV pandemic has increased the number of TB patients and increased nurses' workloads, aggravating the burden of TB as a resurgent disease in this region. In order to implement a successful community-based TB program, the patient-related, access-related and knowledge-related challenges, perceived by the nurses, need to be addressed effectively. [from abstract]

The current global tuberculosis (TB) epidemic has pressured health care managers, particularly in developing countries, to seek for alternative, innovative ways of delivering effective treatment to the large number of TB patients diagnosed annually. One strategy employed is direct observation of treatment for all patients. In high-burden settings innovation with this strategy has resulted into the use of lay community members to supervise TB patients during the duration of anti-TB treatment.

Irrational drug use is contributed by many factors including care providers giving wrong drug information to patients. Dispensing staff in private pharmacy shops play a significant role in pharmaceutical management and provision of relevant information to clinicians and patients, enhancing the improvement of rational medicine use. This report offers an evaluation/staff assessment of pharmacist knowledge in a situation where they function as health workers in dispensing and prescribing medications. [adapted from introduction]

Increased interest in parasite-based malaria diagnosis has led to increased use of rapid diagnostic tests (RDTs), particularly in rural settings. The scarcity of health facilities and trained personnel in many sub-Saharan African countries means that limiting RDT use to such facilities would exclude a significant proportion of febrile cases. Use of RDTs by volunteer community health workers (CHWs) is one alternative, but most sub-Saharan African countries prohibit CHWs from handling blood, and little is known about CHW ability to use RDTs safely and effectively. [adapted from introduction]

This article compares the quality, quantity and distribution of tuberculosis physicians, laboratory staff, community health workers and nurses in Nigeria and Kyrgyzstan, and highlights implications for (re)training tuberculosis workers in developing countries. [from abstract]

Improving the capacity of developing countries to respond to emerging diseases and especially influenza pandemics is essential to reduce both transmission around the globe and the human toll of outbreaks in the developing world. Investing in this capacity in developing countries is thus increasingly seen as a shared concern within the global community. [from introduction]

Healthcare workers (HCWs) will be key players in any response to pandemic influenza, and will be in the front line of exposure to infection. This study is designed to determine the range of factors associated with their responses to the prospect of working through pandemic influenza. The findings will be used to estimate of the likely proportion of HCWs affected by each factor, and how likely it is that they would be willing and/or able to continue to work during an influenza pandemic. [adapted from abstract]

Early detection of smear positive tuberculosis (TB) cases by smear microscopy requires a high level of suspicion of TB among primary care physicians. The objective of this study is to measure TB suspicion and knowledge among private and public sector general practitioners using clinical vignette-based survey and structured questionnaire. [from abstract]

Malaria over-diagnosis in Africa is widespread and costly both financially and in terms of morbidity and mortality from missed diagnoses. An understanding of the reasons behind malaria over-diagnosis is urgently needed to inform strategies for better targeting of antimalarials. [from abstract]

Throughout Africa, the private retail sector has been recognised as an important source of antimalarial treatment, complementing formal health services. However, the quality of advice and treatment at private outlets is a widespread concern, especially with the introduction of artemisinin-based combination therapies (ACTs). This research aimed at assessing the performance of the retail sector in rural Tanzania. Such information is urgently required to improve and broaden delivery channels for life-saving drugs. [from abstract]

Infectious diseases kill more than 10 million people worldwide every year. It is therefore vital that doctors receive a good education in this field. Online learning is one way in which doctors can learn new knowledge and skills. We conducted this study to determine whether the infectious diseases interactive online learning packages enabled primary care professionals to increase their knowledge and skills in the area of infectious diseases. [from abstract]

The objective of this study was to assess whether traditional birth attendants, drug-shop vendors, community reproductive-health workers, or adolescent peer mobilizers could administer intermittent preventive treatment (IPTp) for malaria with sulfadoxine-pyrimethamine to pregnant women. The study concludes that the use of the guideline with adequate training significantly improved correctness of malaria treatment with chloroquine at home. Adoption of this mode of intervention is recommended to improve compliance with drug use at home. The applicability for deploying artemisinin-based combination therapy at the community level needs to be investigated.

Many Nigerian children with malaria are treated at home. Treatments are mostly incorrect, due to caregivers’ poor knowledge of appropriate and correct dose of drugs. A comparative study was carried out in two rural health districts in southwest Nigeria to determine the effectiveness of a guideline targeted at caregivers, in the treatment of febrile children using chloroquine. [from abstract]

In the rural areas of sub-Saharan Africa, the majority of young children affected by malaria have no access to formal health services. Home treatment through mothers of febrile children supported by mother groups and local health workers has the potential to reduce malaria morbidity and mortality. [from author]