PubMed · 8952424
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1996-11-08. Expanded programme on immunization (EPI).. https://pubmed.ncbi.nlm.nih.gov/8952424/
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BACKGROUND: Quantitative and qualitative shortage of both human and material resources in the diagnosis of sexually transmitted diseases (STD's) remains one of the difficulties in dealing with these diseases in developing countries. The aim of this study was to determine the capability of health and medical laboratories personnel to diagnose STD's prevailing in Ouagadougou. METHOD: The study has been conducted in all the health centres and the medical laboratories of the town. The personnel ensuring out-patient clinics and the director of each medical laboratory have been interviewed. The interview as well as the assessment of the consulting room and the medical laboratories technical equipment were carried out. RESULTS: The range of STD's that the staff was able to point out was limited only to classical diseases. One member of the staff out of five mentioned two probable diagnoses of STD's in a case of a genito-urinary symptom. Errors in the diagnosis of vaginal discharge were significantly more frequent in the paramedical staff than in the medical one (p < 0.01), likewise the number of erroneous diagnoses of urethral discharge was more significant among the health agents in the private sector than those in the public sector (p = 0.04). The number of medical laboratories and the range of medical tests conducted in the town were lacking. Moreover, the results of these tests were not taken into account while prescribing the treatment for STD's. CONCLUSIONS: The above observations indicate a limited capability of the urban health services in establishing diagnoses of STD's on a rational basis. The transformation of current laboratory activities to a centralized specialized laboratory capable of a) identifying microorganisms circulating in the town and determine their magnitude and sensitivity to the main antimicrobials available, b) maintain regular surveillance of microorganism susceptibilities, and c) ensure quality control of laboratory tests conducted at a lower geographical level would contribute to the information and training of health care personnel and better acceptability of diagnosis and treatment strategies by this personnel.
OBJECTIVE: To evaluate the attitude of pregnant women towards HIV testing in two cities of West Africa: Abidjan, Côte d'Ivoire and Bobo-Dioulasso, Burkina Faso. METHODS: In the context of a clinical trial to prevent HIV vertical transmission, HIV counselling and testing was offered systematically to women attending antenatal clinics. Informed consent was obtained and test results were given anonymously. Multiple logistic regression was performed to identify factors associated with refusal for testing and failure to return for test results. RESULTS: A total of 9724 pregnant women were interviewed from January 1995 to September 1996. In Abidjan (n=5766) and Bobo-Dioulasso (n=3958), 78 and 92.4% of the women consented to HIV testing, respectively, and 58.4 and 81.8% of them returned for the test results disclosure, respectively. In the two sites, the counsellors themselves and high educational level of the women appeared to be related to refusal of the test, whereas last trimester gestation was associated with failure to return for test results. In Abidjan, foreigners and employees were more likely to refuse testing, and HIV-infected women were three times less likely to return for results than uninfected women. CONCLUSION: Future implementation of interventions to reduce vertical transmission of HIV that require antenatal HIV testing and counselling will have to solve issue of acceptability of HIV testing by pregnant women.
After implementation of a nation-wide essential drug programme in Burkina Faso a prospective study was undertaken consisting of non-participant observation in the health centre and in the village pharmacy, and of household interviews with the patients. The study covered all general consultations in nine health centres in three districts over a two-week period as well as all client-vendor contacts in the corresponding village pharmacies; comprising 313 patients in consultations and 498 clients in eight village pharmacies with 12 vendors involved in dispensing 908 drugs. Additionally patients were interviewed in their households. Performance and utilization of the village pharmacy: 82.0% of the drugs prescribed in the health centres were actually dispensed at the village pharmacy, 5.9% of the drugs were not available at the village pharmacy. Wrong drugs were dispensed in 2.1% of cases. 41.3% of the drugs dispensed in the village pharmacy were bought without a prescription. Differences are seen between the district and are put in relation to different onset of the essential drug programme. Patient compliance: Patients could recall the correct dosage for 68.3% of the drugs. Drug taking compliance was 63.1%, derived from the pills remaining in the households. 11.5% of the drugs had obviously been taken incorrectly to such an extent that the occurrence of undesired drug effects was likely. The study demonstrates the success of the essential drug programme not only in performance but also in acceptability and utilization by the population.