scholarly journals Tuberculosis Diagnosis Delaying Treatment of Cancer: Experience From a New Oncology Unit in Blantyre, Malawi

2016 ◽  
Vol 2 (1) ◽  
pp. 26-29 ◽  
Author(s):  
Leo Peter Lockie Masamba ◽  
Yankho Jere ◽  
Ewan Russell Stewart Brown ◽  
Dermot Robert Gorman
Keyword(s):  
Low Income ◽  
Descriptive Analysis ◽  
Clinical Problem ◽  
Neck Mass ◽  
Sub Saharan Africa ◽  
Tuberculosis Treatment ◽  
Central Hospital ◽  
Low Income Country ◽  
Oncology Unit ◽  
Queen Elizabeth Central Hospital

Purpose Malawi is a low-income country in sub-Saharan Africa with limited health care infrastructure and high prevalance of HIV and tuberculosis. This study aims to determine the characteristics of patients presenting to Queen Elizabeth Central Hospital Oncology Unit, Blantyre, Malawi, who had been treated for tuberculosis before they were diagnosed with cancer. Methods Clinical data on all patients presenting to the oncology unit at Queen Elizabeth Central Hospital from 2010 to 2014 after a prior diagnosis of tuberculosis were prospectively recorded, and a descriptive analysis was undertaken. Results Thirty-four patients who had been treated for tuberculosis before being diagnosed with cancer were identified between 2010 and 2014, which represents approximately 1% of new referrals to the oncology unit. Forty-one percent of patients were HIV positive. Mean duration of tuberculosis treatment before presentation to the oncology unit was 3.6 months. The most common clinical presentation was a neck mass or generalized lymphadenopathy. Lymphoma was the most common malignancy that was subsequently diagnosed in 23 patients. Conclusion Misdiagnosis of cancer as tuberculosis is a significant clinical problem in Malawi. This study underlines the importance of closely monitoring the response to tuberculosis treatment, being aware of the possibility of a cancer diagnosis, and seeking a biopsy early if cancer is suspected.

scholarly journals A descriptive analysis of depression and pain complaints among patients with cancer in a low income country

PLoS ONE ◽  
2018 ◽  
Vol 13 (3) ◽  
pp. e0193713 ◽  
Author(s):  
Melkam Alemayehu ◽  
Negussie Deyessa ◽  
Girmay Medihin ◽  
Abebaw Fekadu
Keyword(s):  
Low Income ◽  
Descriptive Analysis ◽  
Income Country ◽  
Low Income Country ◽  
Patients With Cancer

scholarly journals Setting up a nurse-led model of care for management of Hypertension and Diabetes Mellitus in a high HIV prevalence context in rural Zimbabwe: a descriptive study

2019 ◽  
Author(s):  
Marthe Marie Frieden ◽  
Blessing Zamba ◽  
Nisbert Mukumbi ◽  
Patron Titsha Mafaune ◽  
Brian Makumbe ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Low Income ◽  
Descriptive Study ◽  
Communicable Diseases ◽  
Hiv Prevalence ◽  
Sub Saharan Africa ◽  
Income Country ◽  
Model Of Care ◽  
Non Communicable Diseases ◽  
Low Income Country

Abstract Background In light of the increasing burden of non-communicable diseases on health systems in low- and middle-income countries, particularly in Sub-Saharan Africa, context adapted cost effective service delivery models are now required as a matter of urgency. Multiple models have thus been trialled across Africa with varying degrees of success. Zimbabwe is a low-income country with unique socio-economic challenges but similar dual disease burden of infectious chronic diseases such as HIV and non-communicable diseases. We aim to describe the experience of setting up and organising a nurse-led Diabetes Mellitus (DM) and Hypertension (HTN) model of care in a rural context of a low-income country from July 2016 to June 2019.Methods A descriptive study based on a conceptual framework successfully applied in the roll-out of antiretroviral therapy in Manicaland Province, Zimbabwe. Attempting to mirror the HIV experience, we describe the key enablers in the design and implementation of the model: decentralization of services, integration of care, simplification of management guidelines, mentoring and task-sharing, provision of affordable medicines, quality assured laboratory support, patient empowerment, a dedicated monitoring and evaluation system, and a robust referral system.Results 11 out of 51 health facilities were selected in Chipinge district, of which nine were primary health care (PHC) clinics and two were hospitals. DM/HTN services were set up and integrated into the general out-patient department or pre-existing HIV clinics. In one hospital, an integrated chronic care clinic was established. Through structured intensive mentoring, including simplified protocols, nurses in seven PHC facilities and one hospital developed sufficient knowledge and skills to diagnose, initiate treatment and monitor DM/HTN patients. Overall, more than 3000 patients were registered in a dedicated recording system and offered education. Free medication with differentiated periodic refills and regular monitoring of blood pressure and/or blood glucose with the use of glycosylated haemoglobin were provided.Conclusion Our experience shows that it is feasible to implement nurse-led decentralized integrated DM/HTN care in a high HIV prevalence rural, low-income context. Developing a context-adapted efficient model of care is a dynamic process.

scholarly journals Cost of Illness Study of Regular Out Patient Department Diabetic in a Low Income Country: A Cross Sectional Study

2019 ◽  
Vol 3 (1) ◽  
pp. 16-25
Author(s):  
V. Kattel ◽  
M. Subedi ◽  
Y. Agrawal ◽  
Z.S. Pall ◽  
S. Rani ◽  
...  
Keyword(s):  
Direct Cost ◽  
Cost Of Illness ◽  
Low Income ◽  
Financial Burden ◽  
Quality Care ◽  
Cross Sectional Study ◽  
Sub Saharan Africa ◽  
Sectional Study ◽  
Cross Sectional ◽  
Low Income Country

Background: The burden of Diabetes in South Asia is alarming as the prevalence is higher compared to other region, living cost is low after Sub Saharan Africa and health care system are in state of expanding to be more accessible and adequate.   Objectives: The objective of the study was to assess the direct cost of illness among diabetic patient regularly visiting at outpatient department (OPD) in BPKIHS. Methods: This was a cross sectional study done in year 2018.  142 patients with at least nine visit per year were enrolled. The direct cost were calculated from the pattern of prescription of medications and laboratory investigations carried out over a year of the individual patient. The data were tabulated and analyzed. Results: Among the 142 patients on 37.5% were in mono-therapy and 62.5% were in poly-therapy. The direct cost of illness was USD 103 per annum that includes drug and investigation cost expensed at OPD visit. The average indirect cost was USD 102 per annum including travel and food. Among 142 patient the cost of illness on inpatient due to DM was USD 85.47 per event. Conclusion: The financial burden of being a diabetic in Nepal is high. Comprehensive quality care by expansion of health system and service with nominal charges to patient seems to be one of the challenges in Nepal.

scholarly journals Outcome of Tuberculosis Treatment: A Comparison between Alberta and Nicaragua

2000 ◽  
Vol 11 (2) ◽  
pp. 85-88 ◽  
Author(s):  
Narmin Kassam ◽  
Anne Fanning ◽  
Jose Ramon Cruz ◽  
Alejandro Tardencilla
Keyword(s):  
Low Income ◽  
High Income ◽  
Tuberculosis Treatment ◽  
Sputum Smear ◽  
Low Income Country ◽  
National Tuberculosis Program ◽  
Significant Difference ◽  
National Tuberculosis ◽  
Low Incidence ◽  
Cure Rates

OBJECTIVE: To measure the outcome of tuberculosis treatment in a low incidence, high income region, Alberta, and compare with an intermediate incidence, low income country with a model national tuberculosis program, Nicaragua.DESIGN: All 1992 sputum smear-positive pulmonary cases from both regions were included. Treatment outcome was assigned retrospectively to Alberta cases according to the International Union Against Tuberculosis and Lung Diseases' (IUATLD) criteria of cure, failure, transfer, absconder and death.SETTING: Alberta laboratories are required to report allMycobacterium tuberculosiscultures to Alberta provincial tuberculosis services. Nicaragua cases are reported centrally to the Programa de control de tuberculosis in Managua using the IUATLD criteria.MAIN RESULTS: In Alberta, 222 tuberculosis cases were identified, of which 61 were smear positive. Nicaragua had 1552 smear positive cases of 2885 tuberculosis cases. Alberta's outcomes were 82% cured, no failed treatment, 5% absconded, 2% transferred and 11% died; Nicaragua's outcomes were 77% cured, 2% failed, 13% absconded, 5% transferred and 4% died. There was no significant difference in cure rates between Alberta and Nicaragua, P=0.33.CONCLUSIONS: Treatment outcomes can be measured effectively and reported in high income, low incidence settings. Alberta is achieving comparable cure rates with the Nicaraguan national tuberculosis program.

scholarly journals Patterns of Mortality Occurrence in a Cardiology Unit of a Low-Income Country: A Critical Analysis at the Yaoundé Central Hospital

2021 ◽  
Vol 11 (02) ◽  
pp. 126-134
Author(s):  
Liliane Mfeukeu Kuaté ◽  
Mazou Ngou Temgoua ◽  
Hamadou Ba ◽  
Chris Nadège Nganou ◽  
Doriane Mbono ◽  
...  
Keyword(s):  
Low Income ◽  
Critical Analysis ◽  
Income Country ◽  
Central Hospital ◽  
Low Income Country

scholarly journals Associations of day of week and time of day of ICU admission with hospital mortality in Malawi

2020 ◽  
Vol 50 (4) ◽  
pp. 303-311
Author(s):  
Meghan Prin ◽  
Ruoyu Ji ◽  
Clement Kadyaudzu ◽  
Guohua Li ◽  
Anthony Charles
Keyword(s):  
Intensive Care Unit ◽  
Hospital Mortality ◽  
Low Income ◽  
Primary Outcome ◽  
Time Of Day ◽  
Sub Saharan Africa ◽  
Low Income Country ◽  
Sub Saharan ◽  
Night And Day ◽  
Time Of Admission

This prospective cohort study evaluated the associations of day and time of admission to the Intensive Care Unit (ICU) with hospital mortality at a referral hospital in Malawi, a low-income country in sub-Saharan Africa. Patients admitted to the ICU during the day (08:00–16:00) were compared to those admitted at night (16:01–07:59); patients admitted on weekdays (Monday–Friday) were compared to admissions on weekends/holidays. The primary outcome was hospital mortality. Most patients were admitted during daytime (56%) and on weekdays (72%). There was no difference in mortality between night and day admissions (58% vs. 56%, P = 0.8828; hazard ratio [HR] = 1.09, 95% confidence interval [CI = 0.82–1.44, P = 0.5614) or weekend/holiday versus weekday admissions (56% vs. 57%, P = 0.9011; HR = 0.87, 95% CI = 0.62–1.21, P = 0.4133). No interaction between time and day was found. These results may be affected by high overall hospital mortality.

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