scholarly journals The evidence and feasibility of using pulse oximetry for the management of childhood pneumonia in low- and middle-income countries: a clinical review

2021 ◽  
Vol 8 (2) ◽  
pp. 993
Author(s):  
Masahiro J. Morikawa ◽  
Prakash R. Ganesh
Keyword(s):  
Literature Review ◽  
Pulse Oximetry ◽  
Healthcare Workers ◽  
Randomized Trials ◽  
Clinical Signs ◽  
Middle Income ◽  
Childhood Pneumonia ◽  
Middle Income Countries ◽  
Pubmed Search ◽  
Device Use

The use of pulse oximetry (POx) for the diagnosis and management of childhood pneumonia has been of interest in recent years. In order to effectively employ POx to manage childhood pneumonia in LMICs, we aim to answer the following five questions through a literature review. These five questions are: 1) Which clinical signs are reliable to detect hypoxia? 2) What is the prevalence of hypoxia among those diagnosed with pneumonia? 3) Does the detection of hypoxia among clinical pneumonia patients improve survival? 4) How reliable are current POx devices in the field? and 5) What are the problems in introducing POx in the field?We searched three keywords-IMCI, childhood pneumonia and pulse oximetry, with the PubMed search engine and extracted 119 articles and book chapters. Each article was reviewed to answer above five questions. The literature review indicates that none of the clinical signs reliably detect hypoxia in children. The prevalence of hypoxia among pneumonia varied based on the study. 17-32% of patients without a diagnosis of pneumonia presented with hypoxia. There are currently no randomized trials available to demonstrate the benefit of pulse oximetry in childhood pneumonia survival. Various devices and probes are used in different studies and there are still technical and logistical issues related to POx device use in the field to manage childhood pneumonia in LMICs. There are numerous barriers to train healthcare workers in all levels. We need affordable, reliable, easy to use pulse oximetry for childhood pneumonia management.

scholarly journals Comparative evaluation of a novel solar powered low-cost ophthalmoscope (Arclight) by eye healthcare workers in Malawi

2018 ◽  
Vol 4 (2) ◽  
pp. 98-102 ◽  
Author(s):  
Rebecca Blundell ◽  
David Roberts ◽  
Evridiki Fioratou ◽  
Carl Abraham ◽  
Joseph Msosa ◽  
...  
Keyword(s):  
Low Income ◽  
Healthcare Workers ◽  
Screening Tool ◽  
Low Cost ◽  
Clinical Signs ◽  
Ease Of Use ◽  
Middle Income ◽  
Middle Income Countries ◽  
Eye Disorders ◽  
Solar Powered

This study compared a novel low-cost solar powered direct ophthalmoscope called the Arclight with a traditional direct ophthalmoscope (TDO). After appropriate training, 25 Malawian eye healthcare workers were asked to examine 12 retinal images placed in a teaching manikin head with both the Arclight ophthalmoscope and a traditional direct ophthalmoscope (Keeler Professional V.2.8). Participants were scored on their ability to identify clinical signs, to make a diagnosis and how long they took to make a diagnosis. They were also asked to score each ophthalmoscope for ‘ease of use’. Statistically significant differences were found in favour of the Arclight in the number of clinical signs identified, correct diagnoses made and ease of use. The ophthalmoscopes were equally effective as a screening tool for diabetic retinopathy, and there was no statistically difference in time to diagnosis. The authors conclude that the Arclight offers an easy to use, low cost alternative to the traditional direct ophthalmoscope to meet the demands for screening and diagnosis of visually impairing eye disorders in low-income and middle-income countries.

scholarly journals The impact of COVID-19 on the care of people living with noncommunicable diseases in low- and middle-income countries: an online survey of physicians and pharmacists in nine countries

2021 ◽  
Vol 22 ◽  
Author(s):  
Chris Bullen ◽  
Jessica McCormack ◽  
Amanda Calder ◽  
Varsha Parag ◽  
Kannan Subramaniam ◽  
...  
Keyword(s):  
Public Health ◽  
Healthcare Workers ◽  
Online Survey ◽  
World Health ◽  
Noncommunicable Diseases ◽  
Middle Income ◽  
Middle Income Countries ◽  
Health Measures ◽  
The Impact ◽  
Low And Middle Income

Abstract Background: The global COVID-19 pandemic has disrupted healthcare worldwide. In low- and middle-income countries (LMICs), where people may have limited access to affordable quality care, the COVID-19 pandemic has the potential to have a particularly adverse impact on the health and healthcare of individuals with noncommunicable diseases (NCDs). A World Health Organization survey found that disruption of delivery of healthcare for NCDs was more significant in LMICs than in high-income countries. However, the study did not elicit insights into the day-to-day impacts of COVID-19 on healthcare by front-line healthcare workers (FLHCWs). Aim: To gain insights directly from FLHCWs working in countries with a high NCD burden, and thereby identify opportunities to improve the provision of healthcare during the current pandemic and in future healthcare emergencies. Methods: We recruited selected frontline healthcare workers (general practitioners, pharmacists, and other medical specialists) from nine countries to complete an online survey (n = 1347). Survey questions focused on the impact of COVID-19 pandemic on clinical practice and NCDs; barriers to clinical care during the pandemic; and innovative responses to the many challenges presented by the pandemic. Findings: The majority of FLHCWs responding to our survey reported that their care of patients had been impacted both adversely and positively by the public health measures imposed. Most FLHCs (95%) reported a deterioration in the mental health of their patients. Conclusions: Continuity of care for NCDs as part of pandemic preparedness is needed so that chronic conditions are not exacerbated by public health measures and the direct impacts of the pandemic.

scholarly journals Global neurosurgery, Bangladesh and COVID-19 era

2020 ◽  
pp. 574-576
Author(s):  
Robert Ahmed Khan ◽  
Moshiur Rahman ◽  
Amit Agrawal ◽  
Ezequiel Garcia-Ballestas ◽  
Luis Rafael Moscote-Salazar
Keyword(s):  
Developing Countries ◽  
Healthcare Workers ◽  
Surgical Care ◽  
Medical Procedure ◽  
Surgical Service ◽  
Training Process ◽  
Middle Income ◽  
Middle Income Countries ◽  
Significant Obstacle ◽  
To Come

Background. COVID-19 has become an alarming pandemic for our earth. It has created panic not only in China but also in developing countries like Bangladesh. Bangladesh has adequate confinements to constrain the spread of the infection and in this circumstance, overall healthcare workers including neurosurgeons are confronting a ton of difficulties. The purpose of this paper is to depict the proficiency of Global neurosurgery in this COVID-19 time. Method. Global neurosurgery offers the chance of fusing the best proof-based guidelines of care. This paper demonstrated that, in low to middle-income countries, Global medical procedure has been received to address the issues of residents who lack critical surgical care. Results. Inappropriate and insufficient asset allotment has been a significant obstacle for the health system for decently giving security to the patients. The fundamental training process has been genuinely hampered in the current circumstance. Worldwide health activities have set to an alternate centre and Global neurosurgery as an assurance is slowed down. Conclusion. This paper recommended that Global neurosurgical activities need to come forward and increase the workforce to emphasize surgical service.

scholarly journals How primary healthcare workers obtain information during consultations to aid safe prescribing in low-income and lower middle-income countries: a systematic review

2020 ◽  
Vol 5 (4) ◽  
pp. e002094 ◽  
Author(s):  
Chris Smith ◽  
Michelle Helena van Velthoven ◽  
Nguyen Duc Truong ◽  
Nguyen Hai Nam ◽  
Vũ Phan Anh ◽  
...  
Keyword(s):  
Low Income ◽  
Primary Healthcare ◽  
Healthcare Workers ◽  
Health Workers ◽  
Internet Access ◽  
Sources Of Information ◽  
Quality Of Reporting ◽  
Middle Income ◽  
Middle Income Countries ◽  
Registration Number

BackgroundWe systematically reviewed the evidence on how primary healthcare workers obtain information during consultations to support decision-making for prescribing in low and lower middle-income countries.MethodsWe searched electronic databases, consulted the Healthcare Information For All network, hand searched reference lists, ran citation searches of included studies and emailed authors of identified papers. Two reviewers extracted data and appraised quality with relevant tools.ResultsOf 60 497 records found, 23 studies met our inclusion criteria. Fourteen studies were observational and nine were interventional. Frequently mentioned sources of information were books, leaflets, guidelines, aids and the internet. These sources were sometimes out of date and health workers reported being confused which to use. Internet access varied and even when it was available, use was limited by technical issues. Of the five electronic tools that were assessed, four had positive outcomes. Tools assisted prescribers with medicine selection and dosage calculations, which increased prescribing accuracy. The quality of reporting varied but was overall low.DiscussionStudies indicated a lack of up-to-date and relevant medicine information in low and lower middle-income settings. Internet-based sources appeared to be useful when it is possible to download content for offline use and to update when there is internet access. Electronic tools showed promise, but their accuracy needs to be validated and they should focus on giving actionable advice to guide prescribers.PROSPERO registration numberCRD42018091088.

scholarly journals No time for change? Impact of contextual factors on the effect of training primary care healthcare workers in Kyrgyzstan and Vietnam on how to manage asthma in children - A FRESH AIR implementation study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Jesper Kjærgaard ◽  
◽  
Thomas Nørrelykke Nissen ◽  
Elvira Isaeva ◽  
Nguyen Nhat Quynh ◽  
...  
Keyword(s):  
Primary Care ◽  
Healthcare Workers ◽  
Health Workers ◽  
Clinical Performance ◽  
Contextual Factors ◽  
Middle Income ◽  
Middle Income Countries ◽  
Primary Care Health ◽  
Care Health ◽  
Asthma In Children

Abstract Background Training is a common and cost-effective way of trying to improve quality of care in low- and middle-income countries but studies of contextual factors for the successful translation of increased knowledge into clinical change are lacking, especially in primary care. The purpose of this study was to assess the impact of contextual factors on the effect of training rural healthcare workers in Kyrgyzstan and Vietnam on their knowledge and clinical performance in managing pediatric patients with respiratory symptoms. Methods Primary care health workers in Kyrgyzstan and Vietnam underwent a one-day training session on asthma in children under five. The effect of training was measured on knowledge and clinical performance using a validated questionnaire, and by direct clinical observations. Results Eighty-one healthcare workers participated in the training. Their knowledge increased by 1.1 Cohen’s d (CI: 0.7 to 1.4) in Kyrgyzstan where baseline performance was lower and 1.5 Cohen’s d (CI: 0.5 to 2.5) in Vietnam. Consultations were performed by different types of health care workers in Kyrgyzstan and there was a 79.1% (CI 73.9 to 84.3%) increase in consultations where at least one core symptom of respiratory illness was asked. Only medical doctors participated in Vietnam, where the increase was 25.0% (CI 15.1 to 34.9%). Clinical examination improved significantly after training in Kyrgyzstan. In Vietnam, the number of actions performed generally declined. The most pronounced difference in contextual factors was consultation time, which was median 15 min in Kyrgyzstan and 2 min in Vietnam. Discussion and conclusion The effects on knowledge of training primary care health workers in lower middle-income countries in diagnosis and management of asthma in children under five only translated into changes in clinical performance where consultation time allowed for changes to clinical practice, emphasizing the importance of considering contextual factors in order to succeed in behavioral change after training.

Congenital Syphilis in Honiara, Solomon Islands

2020 ◽  
Vol 66 (6) ◽  
pp. 583-588
Author(s):  
Maxson Lifigao ◽  
Titus Nasi ◽  
Carol Titiulu ◽  
Steven Lumasa ◽  
Trevor Duke
Keyword(s):  
Congenital Syphilis ◽  
Solomon Islands ◽  
Venereal Disease ◽  
Treponema Pallidum ◽  
Clinical Signs ◽  
Syphilis Infection ◽  
Middle Income ◽  
Middle Income Countries ◽  
Neurodevelopmental Problems

Abstract Introduction Congenital syphilis remains a significant cause of newborn mortality and long-term neurodevelopmental problems in some low- and middle-income countries. This study was done in Honiara, Solomon Islands to determine the incidence of babies born to mothers with a positive venereal disease research laboratory (VDRL) test and a positive Treponema pallidum haemagglutination assay (TPHA); to determine the VDRL status of newborns and features of congenital syphilis; and to estimate the proportion of stillbirths associated with syphilis. Methodology All neonates born to VDRL-positive mothers, including stillbirths were included between April and July 2019. Neonates were examined, investigated and treated. Results Among 1534 consecutive births, 1469 were live births and 65 (4.2%) were stillbirths. One hundred and forty-three neonates were born to VDRL-positive mothers: 130 (90.1%) were live infants and 13 (8.9%) stillbirths. Of the 130 VDRL-exposed live-born infants, 72 (55%) had reactive VDRL and a positive TPHA and 7 (9.7%) had clinical signs of congenital syphilis. Five of the infants with clinical signs of syphilis infection had a 4-fold higher VDRL titre than their mother. Four infants of VDRL-positive mothers died during admission, all of whom had clinical signs of syphilis. Ninety percent of affected infants were born to mothers who were not treated or only partially treated during pregnancy. Conclusions In this study, 1:210 live-born babies had clinical and serological evidence of congenital syphilis, and evidence of Treponema infection was found disproportionately in stillbirths. In a setting where Treponema infections are common, an empirical approach to prevention may be needed.

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