scholarly journals Multicentre pilot study evaluation of lung ultrasound for the management of paediatric pneumonia in low-resource settings: a study protocol

2018 ◽  
Vol 5 (1) ◽  
pp. e000340 ◽  
Author(s):  
Jennifer L Lenahan ◽  
Giovanni Volpicelli ◽  
Alessandro Lamorte ◽  
Fyezah Jehan ◽  
Quique Bassat ◽  
...  
Keyword(s):  
Lung Ultrasound ◽  
Integrated Management ◽  
Healthcare Providers ◽  
World Health ◽  
Phone Call ◽  
Low Resource Settings ◽  
Childhood Pneumonia ◽  
Low Resource ◽  
Study Results ◽  
Health Organization

IntroductionPneumonia is the leading infectious cause of death among children under 5 years of age worldwide. However, pneumonia is challenging to diagnose. Lung ultrasound (LUS) is a promising diagnostic technology. Further evidence is needed to better understand the role of LUS as a tool for the diagnosis of childhood pneumonia in low-resource settings.Methods and analysisThis study aims to pilot LUS in Mozambique and Pakistan and to generate evidence regarding the use of LUS as a diagnostic tool for childhood pneumonia. Children with cough <14 days with chest indrawing (n=230) and without chest indrawing (n=40) are enrolled. World Health Organization Integrated Management of Childhood Illness assessment is performed at enrolment, along with a chest radiograph and LUS examination. Respiratory and blood specimens are collected for viral and bacterial testing and biomarker assessment. Enrolled children are followed for 14 days (in person) and 30 days (phone call) post-enrolment with LUS examinations performed on Days 2, 6 and 14. Qualitative and quantitative data are also collected to assess feasibility, usability and acceptability of LUS among healthcare providers and caregivers. The primary outcome is LUS findings at enrolment with secondary outcomes including patient outcomes, repeat LUS findings, viral and bacterial test results, and patient status after 14 and 30 days of follow-up.Ethics and disseminationThis trial was approved by the Western Institutional Review Board as well as local ethics review committees at each site. We plan to disseminate study results in peer-reviewed journals and international conferences.Trial registration numberNCT03187067.

scholarly journals Detecting tuberculosis: rapid tools but slow progress

2019 ◽  
Vol 9 (3) ◽  
pp. 80-83
Author(s):  
K. England ◽  
T. Masini ◽  
E. Fajardo
Keyword(s):  
Point Of Care ◽  
Scale Up ◽  
Critical Issue ◽  
World Health ◽  
High Turnover ◽  
Low Resource Settings ◽  
Laboratory Staff ◽  
Low Resource ◽  
Point Of Care Test ◽  
Health Organization

The World Health Organization (WHO) currently recommends Xpert® MTB/RIF as the initial test for all people with presumptive tuberculosis (TB). A number of challenges have been reported, however, in using this technology, particularly in low-resource settings. Here we examine these challenges, and provide our perspective of the barriers to Xpert scale-up as assessed through a survey in 16 TB burden countries in which the Médecins Sans Frontières is present. We observed that the key barriers to scale-up include a lack of policy adoption and implementation of WHO recommendations for the use of Xpert, resulting from high costs, poor sensitisation of clinical staff and a high turnover of trained laboratory staff; insufficient service and maintenance provision provided by the manufacturer; and inadequate resources for sustainability and expansion. Funding is a critical issue as countries begin to transition out of support from the Global Fund. While it is clear that there is still an urgent need for research into and development of a rapid, affordable point-of-care test for TB that is truly adapted for use in low-resource settings, countries in the meantime need to develop functional and sustainable Xpert networks in order to close the existing diagnostic gap.

scholarly journals Lung ultrasound patterns in pediatric pneumonia in Mozambique and Pakistan

2020 ◽  
pp. 00518-2020
Author(s):  
Amy Sarah Ginsburg ◽  
Pio Vitorino ◽  
Zunera Qasim ◽  
Jennifer L. Lenahan ◽  
Jun Hwang ◽  
...  
Keyword(s):  
Interrater Reliability ◽  
Lung Ultrasound ◽  
Point Of Care ◽  
Integrated Management ◽  
Secondary Analysis ◽  
World Health ◽  
P Value ◽  
Pediatric Pneumonia ◽  
District Hospitals ◽  
Health Organization

ObjectiveImproved pneumonia diagnostics are needed, particularly in resource-constrained settings. Lung ultrasound (LUS) is a promising point-of-care imaging technology for diagnosing pneumonia. The objective was to explore LUS patterns associated with pediatric pneumonia.MethodsWe conducted a prospective, observational study among children aged 2 through 23 months with World Health Organization Integrated Management of Childhood Illness chest-indrawing pneumonia and among children without fast breathing, chest indrawing or fever (no pneumonia cohort) at two district hospitals in Mozambique and Pakistan. We assessed LUS and chest radiograph (CXR) examinations, and viral and bacterial nasopharyngeal carriage, and performed a secondary analysis of LUS patterns.ResultsLUS demonstrated a range of distinctive patterns that differed between children with and without pneumonia and between children in Mozambique versus Pakistan. The presence of LUS consolidation or interstitial patterns was more common in children with chest-indrawing pneumonia than in those without pneumonia. Consolidations were also more common among those with only bacterial but no viral carriage detected (50.0%) than among those with both (13.0%) and those with only virus detected (8.3%;p-value 0.03). LUS showed high interrater reliability among expert LUS interpreters for overall determination of pneumonia (κ=0.915), consolidation (κ=0.915), and interstitial patterns (κ=0.901), but interrater reliability between LUS and CXR for detecting consolidations was poor (κ=0.159, Pakistan) to fair (κ=0.453, Mozambique).DiscussionPattern recognition was discordant between LUS and CXR imaging modalities. Further research is needed to define and standardise LUS patterns associated with pediatric pneumonia and to evaluate the potential value of LUS as a reference standard.

scholarly journals Investigating the Effective Factors on Implementation of World Health Organization Package of Essential Non communicable Disease Interventions for Primary Health Care in Low Resource Settings: A Scoping review

2020 ◽  
Author(s):  
Mina Aminpour ◽  
Aidin Aryankhesal ◽  
Nasrin Seyfori
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Scoping Review ◽  
World Health ◽  
Factors Affecting ◽  
Effective Factors ◽  
Low Resource Settings ◽  
Low Resource ◽  
Primary Health ◽  
Health Organization

Abstract Background/objective: Due to the widespread prevalence of non-communicable diseases, the World Health Organization has designed a package of essential interventions for non-communicable diseases for primary health care in low-resource settings. This study aimed to investigate the factors affecting the implementation of the WHO PEN for primary health care in low-resource settings. Materials and Methods This research was conducted through a five-step process of scoping review. We first searched for the keywords Noncommunicable Diseases, NCD, WHO PEN, PEN and other synonyms for these words to find the suitable analytical studies in databases including PubMed / MEDLINE, Scopus Cochrane Library, Web of Science, Google Scholar. The articles were then selected based on the PRISMA 2009 Flow Diagram. Finally, to analyze the content from the results section of the selected articles, we used the framework analysis method to extract the study implementation outcome and the factors affecting it. Results A total of 26 articles were included. Most articles are from 2016 to 2018. Most of the articles were cross-sectional and most studies evaluated the outcomes of Appropriateness and Feasibility. Identified effective factors include target population coverage, staff training, patient motivation, patient follow-up, and observance of PEN protocols. Conclusion Using this study, policymakers and managers of the health system will be able to implement this package (WHO PEN) more successfully.

scholarly journals Serial lung ultrasounds in pediatric pneumonia in Mozambique and Pakistan

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Amy Sarah Ginsburg ◽  
Imran Nisar ◽  
Lola Madrid ◽  
Jennifer L. Lenahan ◽  
Benazir Balouch ◽  
...  
Keyword(s):  
Prospective Observational Study ◽  
Lung Ultrasound ◽  
Point Of Care ◽  
Integrated Management ◽  
Secondary Analysis ◽  
World Health ◽  
Pediatric Pneumonia ◽  
District Hospitals ◽  
Health Organization

AbstractLung ultrasound (LUS) is a promising point-of-care imaging technology for diagnosing and managing pneumonia. We sought to explore serial LUS examinations in children with chest-indrawing pneumonia in resource-constrained settings and compare their clinical and LUS imaging courses longitudinally. We conducted a prospective, observational study among children aged 2 through 23 months with World Health Organization Integrated Management of Childhood Illness chest-indrawing pneumonia and among children without fast breathing, chest indrawing or fever (no pneumonia cohort) at 2 district hospitals in Mozambique and Pakistan. We assessed serial LUS at enrollment, 2, 6, and 14 days, and performed a secondary analysis of enrolled children’s longitudinal clinical and imaging courses. By Day 14, the majority of children with chest-indrawing pneumonia and consolidation on enrollment LUS showed improvement on follow-up LUS (100% in Mozambique, 85.4% in Pakistan) and were clinically cured (100% in Mozambique, 78.0% in Pakistan). In our cohort of children with chest-indrawing pneumonia, LUS imaging often reflected the clinical course; however, it is unclear how serial LUS would inform the routine management of non-severe chest-indrawing pneumonia.

scholarly journals Role of Visual Inspection of Cervix with Acetic Acid (VIA) in Detecting Precancerous Lesions of Cervix

2014 ◽  
Vol 4 (1) ◽  
pp. 39-44 ◽  
Author(s):  
Kamrun Nessa ◽  
Khadija Nazneen ◽  
Najmin Munni ◽  
Runa Laila ◽  
Farhana Islam ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Acetic Acid ◽  
Mortality Rate ◽  
Visual Inspection ◽  
Precancerous Lesions ◽  
World Health ◽  
Inflammatory Lesions ◽  
Low Resource Settings ◽  
Low Resource ◽  
Study Results

Background: Carcinoma of cervix is the most common malignancy in female and a major public health problem worldwide. It is the leading cause of death from cancer among women in low resource settings. In Bangladesh, mortality rate is high as most of the cases with cervical cancer are diagnosed in advanced stage. World Health Organization considers cervical cancer as a preventable disease as it can be identified in preinvasive stage. Considerable efforts have been given in detection and treatment of the condition all over the world. A number of cervical cancer screening tests are available. Among them, visual inspection of cervix with acetic acid is rational and can be competently performed by physicians with proper training. Objective: To find out the feasibility of the visual inspection of cervix with acetic acid for the detection of the precancerous lesions of the cervix in our country. Materials and Methods: This cross sectional, analytical study was carried out among the patients attending the outpatient department of Bangabandhu Sheikh Mujib Medical University (BSMMU) who were VIA positive and sent for colposcopy in the colposcopy clinic in the department of Obstetrics and Gynecology in BSMMU from June to December 2004. Two hundred samples were considered for this study. Results: Out of 200 cases, colposcopically 85% had CIN and invasive lesions, 4% had inflammatory lesions while 11% had normal findings. Colposcopy directed punch biopsy revealed positive lesions in 81%, 4% had inflammatory lesions while 15% had normal findings. Conclusion: The study concluded that VIA and colposcopy are the important methods in the evaluation of cervical premalignancy. VIA may be an important tool for screening of cervical cancer in low resource settings as it is simple, easy to perform and cost-effective. After screening, VIA positive cases must be referred for colposcopic evaluation. We can screen cervical cancer by VIA all over the country and thus reduce morbidity and mortality rate. DOI: http://dx.doi.org/10.3329/jemc.v4i1.18068 J Enam Med Col 2014; 4(1): 39-44

scholarly journals mPneumonia: Development of an Innovative mHealth Application for Diagnosing and Treating Childhood Pneumonia and Other Childhood Illnesses in Low-Resource Settings

PLoS ONE ◽  
2015 ◽  
Vol 10 (10) ◽  
pp. e0139625 ◽  
Author(s):  
Amy Sarah Ginsburg ◽  
Jaclyn Delarosa ◽  
Waylon Brunette ◽  
Shahar Levari ◽  
Mitch Sundt ◽  
...  
Keyword(s):  
Low Resource Settings ◽  
Childhood Pneumonia ◽  
Low Resource ◽  
Childhood Illnesses

scholarly journals The health effects of quarantine during the COVID-19 pandemic

Work ◽  
2020 ◽  
Vol 67 (3) ◽  
pp. 523-527
Author(s):  
Maryam Feiz Arefi ◽  
Amin Babaei-Pouya ◽  
Mohsen Poursadeqiyan
Keyword(s):  
Health Effects ◽  
World Health ◽  
Economic Activities ◽  
Negative Effects ◽  
Social Hygiene ◽  
Social Communications ◽  
Study Results ◽  
Control And Prevention ◽  
Health Organization ◽  
Made In

BACKGROUND: Quarantine is considered as an effective solution in the early stages of an epidemic. In the case of the coronavirus epidemic, quarantine was also recommended and implemented as a significant guideline to prevent the disease. However, despite the benefits of quarantine, there are also complications and problems. OBJECTIVE: The present study aimed to investigate the health effects of quarantine during the COVID-19 pandemic. METHODS: This study was conducted as a literature review through searching the databases Google Scholar, PubMed, and Science Direct for papers published before July 2020. The research was conducted based on the keywords “Coronavirus,” “COVID-19,” and “quarantine.” The references of the papers were also reviewed to find the ones not found in the databases. The guidelines published by reputable organizations such as the World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC) were used in this study. RESULTS: Although quarantine is applied as an important and primary solution in the outbreak of epidemics, in cases of pandemics, it may not be free of negative effects on individuals and public health. However, because of the need to reopen and restart social and economic activities, some changes should be made in lifestyles and work activities. Using cyberspace and telework can be helpful. As the findings showed, COVID-19 bubbles can be used to restore social communications. CONCLUSION: Using masks, avoiding unnecessary gatherings, complying with personal and social hygiene, and respecting social distancing can be valuable solutions that, if implemented properly, can decrease the rate of the disease significantly. It is also emphasized that quarantine is still necessary and important as the best solution for sick people and individuals who are suspected carriers of the disease.

scholarly journals Coronavirus Pandemic: Coping with the Psychological Outcomes, Mental Changes, and the “New Normal” During and After COVID-19

2020 ◽  
pp. 07-19
Author(s):  
Hiba Takieddine ◽  
Samaa AL Tabbah
Keyword(s):  
Healthcare Providers ◽  
Well Being ◽  
World Health ◽  
Vulnerable Groups ◽  
Public Health Response ◽  
New Normal ◽  
The World ◽  
Health Organization ◽  
The Impact

Coronavirus disease 2019 (COVID-19) is a highly infectious disease that has rapidly swept across the world, inducing a considerable degree of fear, worry and concern in the population at large and among certain groups in particular, such as older adults, healthcare providers and people with underlying health conditions. Authorities around the world tried to prevent the virus spread by imposing social distancing measures, quarantining citizens and isolating infected persons. Apart from its physical impact, COVID-19 pandemic has brought numerous changes to people’s lives. It changed daily routines, caused worldwide economic crisis, increased unemployment, and placed people under emotional and financial pressures. It affected people psychologically and mentally especially in terms of emotions and cognition. During the acute crisis, everyone to varying degrees experienced fear of infection, somatic concerns, worries about the pandemic’s consequences, loneliness, depression, stress, as well as increased alcohol and drug use. As part of its public health response, the World Health Organization (WHO) has worked with partners to develop a set of new guidelines and messages that can be used to prevent, manage, and support mental and psychological well-being in different vulnerable target groups during the outbreak. Whether people like it or not, the psychological sequela of this pandemic will emerge and persist for months and years to come leading to long-term consequences. New lifestyles and “New Normals” will surely emerge. The main purpose of this review is to summarize the impact of coronavirus pandemic on the psychological and mental health of people around the world especially vulnerable groups. It also presents the relevant intervention actions and recommendations to cope efficiently and effectively with the psychological short-term and long-term outcomes, mental changes, and the “New Normal” during and after COVID-19. Keywords: COVID-19; Coronavirus, Psychological; Mental; New Normal

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