Quality of Life of Epileptic Patients in Resource Limited Setting

Objective The present study reviews a series of patients who underwent thyroid surgery in Eldoret, Kenya, to demonstrate the feasibility of conducting long-term (>1 year) outcomes research in a resource-limited setting, impact on the quality of life of the recipient population, and inform future humanitarian collaborations. Study Design Case series with chart review. Setting Tertiary public referral hospital in Eldoret, Kenya. Subjects and Methods Twenty-one patients were enrolled during the study period. A retrospective chart review was performed for all adult patients who underwent thyroid surgery during humanitarian trips (2010-2015). Patients were contacted by mobile telephone. Medical history and physical examination, including laryngoscopy, were performed, and the SF-36 was administered (a quality-of-life questionnaire). Laboratory measurements of thyroid function and neck ultrasound were obtained. Results The mean follow-up was 33.6 ± 20.2 months after surgery: 37.5% of subtotal thyroidectomy patients and 15.4% of lobectomy patients were hypothyroid postoperatively according to serologic studies. There were no cases of goiter recurrence or malignancy. All patients reported postoperative symptomatic improvement and collectively showed positive pre- and postoperative score differences on the SF-36. Conclusion Although limited by a small sample size and the retrospective nature, our study demonstrates the feasibility of long-term surgical and quality-of-life outcomes research in a resource-limited setting. The low complication rates suggest minimal adverse effects of performing surgery in this context. Despite a considerable rate of postoperative hypothyroidism, it is in accordance with prior studies and emphasizes the need for individualized, longitudinal, and multidisciplinary care. Quality-of-life score improvements suggest benefit to the recipient population.

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Baseline Quality of Life among Patients with End Stage Kidney Disease in a Resource Limited Setting

10.26226/morressier.5c76c8b8e2ea5a7237612396 ◽

2019 ◽

Author(s):

Mhoira Leng

Keyword(s):

Quality Of Life ◽

Kidney Disease ◽

Resource Limited Setting ◽

End Stage Kidney Disease ◽

Resource Limited ◽

End Stage ◽

Limited Setting

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Determinants of quality of life among family caregivers of adult cancer patients in a resource-limited setting

Supportive Care in Cancer ◽

10.1007/s00520-019-04947-2 ◽

2019 ◽

Vol 28 (3) ◽

pp. 1295-1304 ◽

Cited By ~ 2

Author(s):

Irene Betty Kizza ◽

Joshua Kanaabi Muliira

Keyword(s):

Quality Of Life ◽

Cancer Patients ◽

Family Caregivers ◽

Resource Limited Setting ◽

Resource Limited ◽

Limited Setting

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Surgical debulking of podoconiosis nodules and its impact on quality of life in Ethiopia

PLoS Neglected Tropical Diseases ◽

10.1371/journal.pntd.0009053 ◽

2021 ◽

Vol 15 (1) ◽

pp. e0009053

Author(s):

Wendemagegn Enbiale ◽

Kristien Verdonck ◽

Melesse Gebeyehu ◽

Johan van Griensven ◽

Henry J. C. de Vries

Keyword(s):

Quality Of Life ◽

Standard Procedure ◽

Teaching Hospitals ◽

Secondary Intention ◽

Compression Bandaging ◽

Resource Limited ◽

Surgical Debulking ◽

One Year ◽

Limited Setting

Background In Ethiopia, severe lymphedema and acute dermato-lymphangio-adenitis (ADLA) of the legs as a consequence of podoconiosis affects approximately 1.5 million people. In some this condition may lead to woody-hard fibrotic nodules, which are resistant to conventional treatment. We present a series of patients who underwent surgical nodulectomy in a resource-limited setting and their outcome. Methods In two teaching hospitals, we offered surgical nodulectomies under local anaesthesia to patients with persisting significant fibrotic nodules due to podoconiosis. Excisions after nodulectomy were left to heal by secondary intention with compression bandaging. As outcome, we recorded time to re-epithelialization after surgery, change in number of ADLA episodes, change in quality of life measured with the Dermatology Quality of Live Index (DQLI) questionnaire, and recurrence rate one year after surgery. Results 37nodulectomy operations were performed on 21 patients. All wounds re-reepithelialised within 21 days (range 17–42). 4 patients developed clinically relevant wound infections. The DLQI values were significantly better six months after surgery than before surgery (P<0.0001). Also the number of ADLA episodes per three months was significantly lower six months after surgery than before surgery (P<0.0001). Conclusion Nodulectomy in podoconiosis patients leads to a significant improvement in the quality of life with no serious complications, and we recommend this to be a standard procedure in resource-poor settings.

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Clients’ Perception of Quality of Multidrug-Resistant Tuberculosis Treatment and Care in Resource-Limited Setting: Experience from Nigeria

Mycobacterium - Research and Development ◽

10.5772/intechopen.76001 ◽

2018 ◽

Author(s):

Olanrewaju Oladimeji ◽

Daniel Adedayo Adeyinka ◽

Lehlogonolo Makola ◽

Kabwebwe Honoré Mitonga ◽

Ekerette Emmanuel Udoh ◽

...

Keyword(s):

Multidrug Resistant ◽

Resource Limited Setting ◽

Tuberculosis Treatment ◽

Resistant Tuberculosis ◽

Multidrug Resistant Tuberculosis ◽

Resource Limited ◽

Perception Of Quality ◽

Limited Setting

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Randomized controlled trial (RCT) of a patient navigation (PN) intervention to increase early access to supportive care (SC) for patients with metastatic cancer in a resource-limited setting.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.15_suppl.11505 ◽

2019 ◽

Vol 37 (15_suppl) ◽

pp. 11505-11505

Author(s):

Enrique Soto Perez De Celis ◽

Yanin Chavarri Guerra ◽

Wendy Alicia Ramos-Lopez ◽

Alfredo Covarrubias-Gómez ◽

Africa Navarro-Lara ◽

...

Keyword(s):

Metastatic Cancer ◽

Controlled Trial ◽

Resource Limited Setting ◽

Early Integration ◽

Early Access ◽

Resource Limited ◽

Lost To Follow Up ◽

And Control ◽

Limited Setting

11505 Background: Early integration of SC to the treatment of advanced cancer can improve outcomes, but this may be challenging in developing countries due to a lack of resources and knowledge. In this RCT, we examined whether PN could improve early access to SC among Mexican patients with metastatic solid tumors as recommended by ASCO guidelines. Methods: Adult patients with newly-diagnosed metastatic cancer were randomly assigned to PN or standard oncologic care. At baseline, a navigator assessed the patients’ SC needs (depression, anxiety, fatigue, pain, caregiver burden) using validated questionnaires administered with an electronic tablet. For those in the PN arm, a personalized SC plan was created and implemented by a multidisciplinary team (palliative care, physical therapy, geriatrics, psychology, psychiatry). The primary outcome was access to SC, defined as receipt of SC interventions in the first 3 months (mo) after diagnosis. Secondary outcomes included advanced directive (AD) completion (for patients with expected survival ≤6 mo in accordance to Mexican law), changes in SC needs, and changes in quality of life (assessed using FACT-G). Results: 133 patients (median age 60, range 23-93; 52% male) were randomized (66 PN, 67 control). 61% of patients had gastrointestinal tumors. 94% of patients in the PN arm completed baseline assessments and received recommendations from the navigator. At 3 mo, 37 patients died or were lost to follow-up (16 PN, 21 control; p = 0.45), and 96 completed assessments. SC interventions were provided to 73% of patients in the PN arm and 24% of controls (p < 0.01). In the PN arm, 48% of 29 eligible patients completed AD, compared to 0% of eligible controls (p < 0.01). At 3 mo, patients in the PN arm were significantly less likely to report moderate/severe pain than controls (10 vs 33%, p = 0.006). There were no significant differences in other symptoms or in FACT-G scores (76 vs 76.3, p = 0.46) between PN and control arms at 3 mo. Conclusions: PN can lead to significant improvements in early access to SC, AD completion, and pain control among patients with metastatic cancer treated in a resource-limited setting. Clinical trial information: NCT03293849.

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