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首页> 外文期刊>The American Journal of Tropical Medicine and Hygiene >Does the availability of blood slide microscopy for malaria at health centers improve the management of persons with fever in Zambia?
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Does the availability of blood slide microscopy for malaria at health centers improve the management of persons with fever in Zambia?

机译：卫生中心提供的用于疟疾的载玻片显微镜是否可以改善赞比亚发烧患者的管理？

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Some Ministries of Health in Africa plan to make blood slide microscopy available in peripheral health centers to improve malaria diagnosis over the current practice, which relies solely on clinical findings. To assess whether microscopy improves the management of febrile persons in health centers, we prospectively reviewed medical records of all outpatients visiting six health centers with laboratories in Zambia during a 2-3-day period. Staff interviews and a blinded review of a series of blood slides from each facility by two expert microscopists were also conducted. Of 1,442 outpatients, 655 (45%) reported fevers or had a temperature > or = 37.5 degrees C. Blood slide microscopy was ordered in 28-93% of patients with fever (mean = 46%). Eighty-eight (35%) patients without parasitemia were prescribed an antimalarial drug. Antimalarial drugs were prescribed with equal frequency to those who were referred for a blood slide (56%) and those not referred (58%). The sensitivity of microscopy was 88% and the specificity was 91%. Use of malaria microscopy varied widely, indicating that clinicians are not using standard criteria for ordering this test. Although diagnosis by microscopy was generally accurate, it appeared to have had little impact on the treatment of persons with fever. Guidelines for using blood slide microscopy are needed and prescription of antimalarial drugs should be discouraged when slide results are negative.
机译：非洲一些卫生部计划在外围医疗中心提供血液切片镜检查，以改善目前仅依靠临床发现的疟疾诊断方法。为了评估显微镜检查是否能改善卫生中心中发热人士的管理，我们前瞻性地回顾了在2-3天的时间内访问赞比亚设有实验室的六个卫生中心的所有门诊病人的病历。还进行了工作人员访谈，并由两名专业显微镜专家对每个工厂的一系列血片进行了盲目检查。在1,442名门诊患者中，有655名（45％）报告发烧或温度>或= 37.5摄氏度。在28-93％的发烧患者中要求进行血片显微镜检查（平均= 46％）。八十八（35％）例无寄生虫的患者被处方抗疟药。开具抗疟药的频率与被推荐进行血常规检查的人（56％）和未被推荐进行血液检查的人（58％）相同。显微镜的灵敏度为88％，特异性为91％。疟疾显微镜的使用变化很大，表明临床医生没有使用标准标准订购该测试。尽管通过显微镜诊断通常是准确的，但似乎对发烧患者的治疗影响很小。需要使用玻片显微镜的指南，当玻片结果为阴性时，不建议使用抗疟药。

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