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Objective: To discover and summarize the problems and useful practices in the current primary-level application of Rapid Diagnostic Test (RDT) of malariain the eradicationphase,and explore the feasibility of overall introduction of RDT in primary-level medical institutions. There in after, empirical evidence and policy suggestions are provided for the improvement of primary-level malaria diagnosis systerato better meet the working requirements in the malaria eradication phase. Methods : We selected four districts as theresearch sites from which 36 respondents were invited from city, county and township level. All of the respondents invited to receive face-to-face semi-structural key informants' interviews included hospital physicians, hospital lab professionals, CDC malaria prevention and control professionals, and previous malaria patients. The interviewing system was focused on group interviews. Results :In the current stage,the primary-level malaria control professionals cautiously welcomed the RDT technology application. The lack of complete and specific training system and unclear RDT technological orientation were the two main reasons for the confusions and challenges faced by the above-mentioned professionals in the practical work at the primary-level. The primary-level hospital physicians' attitude towards malaria diagnosis and treatment,and their awareness of related technologies highly depended on their actual experience of receiving malaria cases and the number of residents coming back from their foreign working places (especially Sub-Sahaxan Africa) within their hospitals' service areas as well,which also differs across different regions. Conclusions : From the actual need of healthcare professionals and malaria patients,it is necessary and feasible to introduce RDT in primary-level medical institutions,but on the condition that further strengthening of the training on malaria prevention and control,and essential education on the existing knowledge are provided.
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To analyze the situation of malaria elimination, identify the current main challenges and difficulties of maintaining the achievements of malaria elimination, and find out feasible solutions in Jiangsu Province.Through randomized grouping, the subject discussion and questionnaires were conducted by malaria control staffs from centers for diseases control and prevention of 13 cities of Jiangsu Province and Jiangsu Institute of Parasitic Diseases. The basic characteristics of participants and the effect of the discussion were analyzed through questionnaires.Twenty-seven professional participants were randomly divided into 3 groups. Totally 27 questionnaires were released and 24 valid questionnaires were retrieved. Among the 24 participants, 79.1% (19/24) of them were with mid-level and senior professional titles, and 66.7% (16/24) of them had worked for more than 10 years. Before the group discussion, only 16.7% (4/24) of the participants were aware of the current main challenges and difficulties in Jiangsu Province. After the discussion, 87.5% (21/24) of them thought the discussion increased their understanding of the challenges and difficulties. Through the subject discussion, the expert group summarized the current challenges and difficulties as well as the solutions in malaria prevention in Jiangsu Province in 4 aspects, namely the management guarantee of prevention work, diagnosis and treatment of the cases, field epidemiological investigation and others. Finally, a framework about these discussion results was established.During the post-stage of malaria elimination, Jiangsu Province still faced many challenges and difficulties, such as management guarantee, case diagnosis and treatment, epidemiology survey and focus disposals, and malaria surveillance sustainability. The feasible solutions of these challenges may provide examples for other provinces and regions which are undergoing malaria elimination or in post-stage of malaria elimination.
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To evaluate the implementation effect of the optimization strategy for the use and management of malaria rapid diagnostic testing (RDT) technology in Jiangsu Province, so as to provide the empirical evidence and suggestions for promoting the standardized use of RDT technology.Questionnaire surveys of primary-level health professionals’ RDT-related knowledge, attitude, and practice (KAP) and work satisfaction were conducted in 4 pilot cities in Jiangsu Province before and after the intervention.After the implementation of the intervention, 13.9% of surveyed laboratory technicians, 21.9% of surveyed clinicians and 4.1% of surveyed staff of the centers for disease control and prevention (CDCs) had significant improvements in RDT-related knowledge. About 10.9% of the surveyed laboratory technicians and 25.6% of the surveyed CDC staff improved their attitudes toward RDT technology. About 38.4% of the surveyed laboratory technicians and 10.0% of the surveyed clinicians improved the standardized use of RDT technology. All types of primary-level health professionals had high evaluation in the satisfaction and effectiveness of the optimization strategy. However, the evaluation of the surveyed clinicians was slightly lower than that of the laboratory technicians and CDC staff.The optimization strategy in this project can effectively improve the knowledge, attitude and behavior of all types of primary-level health professionals and help to promote the standardized use of RDT technology.
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To investigate the malaria rapid diagnostic testing (RDT) - related knowledge, attitude, practice (KAP) of primary healthcare professionals in Jiangsu Province and analyze the corresponding influencing factors.Four cities in Jiangsu Province were selected as the study sites by the typical sampling method to conduct a survey for the RDT related KAP and work satisfaction of primary healthcare professionals, and the multiple logistic regression model was used to explore the relevant influencing factors.Totally 1 150 questionnaires were issued and 949 valid questionnaires were collected with the recovery rate of 82.52%. The valid questionnaires included 453 questionnaires from laboratory technicians, 466 from clinicians, and 30 from malaria prevention and control workers. Totally 83.98% of the surveyed professionals had a low mastering level of essential RDT-related knowledge. A total of 52.17% of the surveyed laboratory technicians recognized that the application of RDT technology could effectively improve the current primary-level microscopy work, and the degree of recognition of RDT technological advantage in the laboratory technicians was higher than that in the clinicians. Totally 79.25% of the surveyed laboratory technicians regarded themselves to be capable of conducting the standardized RDT operation, and 84.55% of the surveyed clinicians regarded themselves to be capable of conducting the qualified malaria clinical diagnostic practice. The key influencing factors of RDT-related KAP of primary healthcare professionals included the laboratory technicians’ gender, educational level, employer’s institutional level, professional title, and working years, and the employer’s institutional level of clinicians.The primary healthcare professionals in Jiangsu Province exhibita good acceptability towards RDT technology. However, their essential knowledge on RDT remains to be improved. Therefore, it is necessary to establish a specific training and educational system for primary healthcare professionals to better guarantee the advantageous impact of RDT technology on the consolidation of the malaria elimination work achievements.
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Objective:To study the satisfaction of patients and medical personnel after the new health care re-form.Methods:Using questionnaire survey method, we interviewed patients and medical personnel in 4 comprehen-sive hospitals and 8 community hospitals.The number of questionnaire is 1001,the number of patient questionnaire is 499,the number of medical personnel questionnaire is 502.Results:The overall satisfaction of patients and medical personnel are good.The patient's overall satisfaction score was 3.95, the average satisfaction score of administrative supervision,hospital environment,service attitude and service ability is more than 4 points,the average satisfaction score of the knowledge publicity,drug supply,medical expenses,medical care system and medical processes is less than 4 points.The satisfaction degree of return of work of medical personnel is lowest,The satisfaction degree of work-ing environment is highest.Community hospital medical staff and patient satisfaction is generally better than general hospital.Conclusion:The overall satisfaction of medical personnel and patients is good in the Shanghai area.In the fu-ture,more should be done on knowledge publicity,strengthening diagnosis and treatment process optimizing,medical expense controlling,and the improvement of the social practice environment and working conditions.