新型結核醫療服務可顯著降低死亡率

2015/09/01 瀏覽次數:16 收藏
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  9月1日VOA聽力:新型結核醫療辦事可明顯下降滅亡率


  A new study shows that redesigning medical servicesfor tuberculosis can dramatically reduce the deathrate. The research was conducted in a local healthdistrict in the West African nation of Togo.

  TB is blamed for two million deaths every year. Mostof them are in developing countries. It’s also thesecond leading cause of death among infectious diseases.

  Over the years, TB and HIV have been closely linked because TB easily infects those withweakened immune systems. Also, new drug resistant strains of TB have arisen, often makingtreatment difficult and painful and sometimes ineffective.

  But a study in Togo reports a 10 percent drop in TB deaths following changes in services in theLacs Health District. It’s located in the country’s southern Maritime Region.

  Dr. Kossivi Afanvi works for Togo’s Ministry of Health. He was health director of the LacsDistrict from 2008 to 2015. He said when he arrived there was much room for improvement inthe treatment of TB.

  “The treatment rate of tuberculosis was very, very low at 80 percent. And the death rate wasvery, very high at 13 percent.”

  Afanvi is the lead author of the Togo study appearing in BMJ Quality Improvement Reports. Hehad received training from the Boston-based Institute for Healthcare Improvement, a non-profitorganization. In 2012, Afanvi implemented – what’s called -- a System Quality ImprovementModel in Lacs.

  “So, we decided to increase the treatment success rate to at least 85 percent and to reduce themortality rate to five percent,”

  Two years later, the program exceeded its goals. The mortality rate quickly fell from 13 tothree percent. And by the time he took a new job early this year, he said there were no TBdeaths in Lacs District.

  There’s a hospital and more than 30 health clinics in Lacs. The model called for increasing TBscreening in every location where there was a registered nurse. If a test is positive, it’s followedby intensive treatment.

  What’s more, screening was also done for HIV. Treating those infected with the AIDS virus canstrengthen their immune systems and in turn make them better able to defend against TB.

  Dr. Afanvi is now in charge of the neighboring Vo Health District, where he’s also implementedthe System Quality Improvement Model.

  “In my new district, I decided to use the model to manage other programs. I came here inFebruary and according to the immunization program the rate was at 75 [percent].But actuallywe are at 91 [percent] for vaccinating or immunizing children,”

  And the TB death rate has also dropped sharply in Vo.

  Afanvi has recommended to Togo’s Ministry of Health that the model be applied to the entirecountry.

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