Implementation of Fingerprint Technology for Unique Patient Matching and Identification in Kenya: This cross-sectional study was conducted at a HIV care and treatment facility in Western Kenya. An open-source fingerprint application was integrated within an implementation of the Open Medical Records System (OpenMRS) which is currently in use at the study setting (Preprint)

2021 ◽  
Author(s):  
Noah Jaafa ◽  
Benard Mokaya, ◽  
Simon Muhindi Savai, ◽  
Ada Yeung ◽  
Martin Were ◽  
...  

BACKGROUND Unique patient identification remains a challenge in many healthcare settings within low- and middle-income countries (LMICs). Without national-level unique identifiers for whole populations, countries rely on deterministic and probabilistic patient matching approaches that have proven suboptimal in LMICs. Affordable bio-metric-based approaches, implemented with consideration of contextual ethical, legal and social implications (ELSI), have a potential to address patient identification challenges and to improve care quality, patient safety and reporting accuracy. However, limited studies exist to evaluate actual performance of biometric approaches and perceptions towards these systems within LMIC contexts. OBJECTIVE To evaluate performance and acceptability of fingerprint technology (FPT) for unique patient matching and identification in the LMIC setting of Kenya METHODS This cross-sectional study was conducted at a HIV care and treatment facility in Western Kenya. An open-source fingerprint application was integrated within an implementation of the Open Medical Records System (OpenMRS) which is an open source electronic medical records system (EMR) and currently in use at the study setting. OpenMRS is nationally-endorsed and deployed for HIV care in Kenya and in over 40 countries, hence potential for ease of translating findings across multiple countries. Adult participants over 18 years of age were conveniently sampled and enrolled into the study. Participants’ left thumbprints were captured, stored and used to retrieve and match patient records. FPT performance was evaluated using standard measures namely: Sensitivity, False Acceptance Rate (FAR), False Rejection Rate (FRR), and Failure to Enroll Rate (FER). Wald test was used to compare the accuracy of the FPT to the EMRs’ probabilistic matching technique. Time to retrieval and matching of records was compared using the independent samples t-test. A survey was administered to evaluate patient acceptance and satisfaction with use of the FPT. RESULTS 300 participants were enrolled, mean age was 36.3 years (SD 12.2) and 174/300 (58%) were female. FPT per-formed as follows: sensitivity 89.3%, FAR 0%, FRR 11%, and FER 2.3%. FPT mean record retrieval speed was 3.2s (SD 1.1) vs. 9.5s (SD 1.9) with demographic-based record retrieval in the EMR (p<.001). Survey results revealed participants’ comfort (96.3%) and willingness (90.3%) to use the FPT. CONCLUSIONS Fingerprint Technology (FPT) performed very well in identifying adult patients within a LMIC setting. Patients reported a high level of satisfaction and acceptance of the technology. Serious considerations need to be given to use of FPT for patient identification in LMICs, but this has to be done with strong consideration on ELSI and security issues.

BMJ ◽  
2007 ◽  
Vol 335 (7629) ◽  
pp. 1085 ◽  
Author(s):  
Ira B Wilson ◽  
Bruce E Landon ◽  
Peter V Marsden ◽  
Lisa R Hirschhorn ◽  
Keith McInnes ◽  
...  

Objective To determine whether a selected set of indicators can represent a single overall quality construct. Design Cross sectional study of data abstracted during an evaluation of an initiative to improve quality of care for people with HIV. Setting 69 sites in 30 states. Data sources Medical records of 9020 patients. Main outcome measures Adjusted performance rates at site level for eight measures of quality of care specific to HIV and a site level summary performance score (the number of measures for which the site was in the top quarter of the distribution). Results Of 28 site level correlations between measures, two were greater than 0.40, two were between 0.30 and 0.39, four were between 0.20 and 0.29, and the 20 remaining were all less than 0.20. One site was in the top quarter for seven measures, but no sites were in the top quarter for six or eight of the measures. Across the eight quality measures, sites were in the top quarter no more often than predicted by a chance (binomial) distribution. Conclusions The quality suggested by one measured indicator cannot necessarily be generalised to unmeasured indicators, even if this might be expected for clinical or other reasons.


2021 ◽  
pp. 095646242097594
Author(s):  
Guilherme B Shimocomaqui ◽  
Craig S Meyer ◽  
Maria L Ikeda ◽  
Elson Romeu Farias ◽  
Tonantzin R Gonçalves ◽  
...  

In 2018, Rio Grande do Sul (RS) had some of the highest HIV/AIDS rates in Brazil, and we did not find any studies about the HIV care and treatment cascade (HCTC) related to this state. We aimed to estimate the indicators of HCTC of RS, Brazil, and associated factors. A cross-sectional study with all people living with HIV (PLWH) in RS between 1 January 2014 and 31 December 2017 was conducted using a national database which registers all HIV notifications, CD4 and viral load laboratory data and antiretroviral therapy (ART) usage in the public health system. We considered sex, age, education, race, year of HIV diagnosis, and health region as predictor factors, and defined linkage to care, retention to care, being on ART, and having undetectable viral load as the HCTC indicators. Descriptive analysis and multivariable logistic regression were performed using Stata 15.2. A total of 116,121 PLWH were diagnosed, 79,959 were linked to care, 72,117 retained in care, 69,219 on ART, and 54,857 had undetectable viral load from 2014 to 2017. We observed greatest attrition for younger age, non-white, and lower education in all HCTC indicators. Women are more likely to have undetectable viral load (OR = 1.04, 95% CI: 1.01–1.07), even though they are less likely to be retained to care (OR = 0.92; 95% CI: 0.89–0.96) and on ART (OR = 0.82; 95% CI: 0.78–0.86). Although all HCTC indicators have increased over the period and the “test and treat” policy indicates improvements in ART and in undetectable viral load outcomes, evidence suggests specific attrition and disparities such as those related to HIV healthcare facilities should be addressed. These findings may be used by researchers, health professionals, and policymakers in order to investigate and implement interventions to better engage PLWH across the HCTC.


BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e040238
Author(s):  
Belayneh Kefale ◽  
Amien Ewunetei ◽  
Mulugeta Molla ◽  
Gobezie Temesgen Tegegne ◽  
Amsalu Degu

ObjectivesThis study aimed to assess the clinical pattern and predictors of stroke treatment outcomes among hospitalised patients in Felege Hiwot comprehensive specialised hospital (FHCSH) in northwest Ethiopia.DesignA retrospective cross-sectional study.SettingThe study was conducted medical ward of FHCSH.ParticipantsThe medical records of 597 adult patients who had a stroke were included in the study. All adult (≥18 years) patients who had a stroke had been admitted to the medical ward of FHSCH during 2015–2019 were included in the study. However, patients with incomplete medical records (ie, incomplete treatment regimen and the status of the patients after treatment) were excluded in the study.ResultsIn the present study, 317 (53.1%) were males, and the mean age of the study participants was 61.08±13.76 years. About two-thirds of patients (392, 65.7%) were diagnosed with ischaemic stroke. Regarding clinical pattern, about 203 (34.0%) of patients complained of right-side body weakness and the major comorbid condition identified was hypertension (216, 64.9%). Overall, 276 (46.2%) of them had poor treatment outcomes, and 101 (16.9%) of them died. Patients who cannot read and write (AOR=42.89, 95% CI 13.23 to 111.28, p<0.001), attend primary school (AOR=22.11, 95% CI 6.98 to 55.99, p<0.001) and secondary school (AOR=4.20, 95% CI 1.42 to 12.51, p<0.001), diagnosed with haemorrhagic stroke (AOR=2.68, 95% CI 1.62 to 4.43, p<0.001) and delayed hospital arrival more than 24 hours (AOR=2.92, 95% CI 1.83 to 4.66, p=0.001) were the independent predictors of poor treatment outcome.ConclusionsApproximately half of the patients who had a stroke had poor treatment outcomes. Ischaemic stroke was the most predominantly diagnosed stroke type. Education status, types of stroke and the median time from onset of symptoms to hospitalisation were the predictors of treatment outcome. Health education should be given to patients regarding clinical symptoms of stroke. In addition, local healthcare providers need to consider the above risk factors while managing stroke.


Author(s):  
Muliana Edi ◽  
Yit Chin ◽  
Fui Woon ◽  
Geeta Appannah ◽  
Poh Lim ◽  
...  

Despite the advancement of the healthcare system, low birth weight (LBW) remains as one of the leading causes of under-five mortality. This cross-sectional study aimed to determine the prevalence of LBW and its associated factors among 483 third trimester pregnant women recruited from six selected public health clinics in the Federal Territory of Kuala Lumpur and the state of Selangor, Malaysia. Pregnant women were interviewed for information on socio-demographic characteristics, smoking behaviour, and second-hand smoke (SHS) exposure at home and in the workplace. Information on the obstetrical history and prenatal care visits history were retrieved from the maternal medical records, while infant’s birth outcomes were retrieved from infant medical records. The prevalence of LBW (<2.5 kg) in infants was 10.4%, with a mean birth weight of 3.0 [standard deviation (SD) 0.4] kg. Results from the multivariable logistic regression model showed that inadequate weight gained during pregnancy [odds ratio (OR) = 2.41, 95% confidence interval (CI) = 1.18–4.90] and exposure to SHS at home (OR = 1.92, 95% CI = 1.03–3.55) were significantly associated with LBW. In conclusion, pregnant women should monitor their rate of weight gain throughout pregnancy and avoid SHS exposure at home to reduce the risk of delivering LBW infants.


2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Addisu Tadesse Sahile ◽  
Mieraf Shiferaw Beyene

Objectives. This study was aimed at assessing the magnitude of induced abortion and associated factors among students in Hawassa University, southern region, Ethiopia, 2019. Methods. An institutional-based cross-sectional study was conducted among a total of 422 students selected on the bases of a probability simple random sampling method. A pretested structured questionnaire was used to collect data. Analysis was made with SPSS 20. Descriptive summary and inferential statistics (binary logistic regression) were used with a 95% CI and P value of less than 5% as a level of significance. Findings were presented in tables, figure, and texts. Confidentiality of information was also secured. Results. The prevalence of induced abortion in the study setting was 68.7% (95% CI: 64.15%-73.2%). Participants who used emergency contraceptives had 12 times higher odds of undergoing abortion than those who did not use emergency contraceptives at AOR: 11.95, 95% CI: 5.615-25.326, P<001. Conclusions. A higher prevalence of induced abortion was observed in the study setting. Contraceptive use was the predictor of induced abortion identified. Concerned bodies were recommended to work on the identified determinant of induced abortion in the study setting.


2021 ◽  
pp. 112067212110026
Author(s):  
Edward Barayev ◽  
Ofri Vorobichik Berar ◽  
Gad Dotan ◽  
Alon Skaat ◽  
Orly Gal-Or ◽  
...  

Purpose: To estimate the extent of WhatsApp utilization using text and media messages for inter-physician consultations among ophthalmologists (residents and specialists) at various clinical settings and its perceived benefits for ophthalmologists and their patients. We also aimed to detect obstacles that concern ophthalmologists when using WhatsApp as a consultation platform. Methods: This was a cross-sectional study using a self-administered survey through Google Forms, which was sent to 660 practicing ophthalmologists during April to May 2020. Results: One hundred and ninety-two ophthalmologists completed the questionnaire, 151 of which (78.6%) were specialists and 41 (21.4%) were residents. Most ophthalmologists reported using WhatsApp at least once a day for both personal and professional use. Residents reported lower rates of contacting patients using WhatsApp than specialists (1.51 ± 0.98 vs 2.72 ± 1.32, p < 0.001). Respondents reported WhatsApp consultations frequently replaced referrals of patients to other physicians, with a median of once a week. 97.8% of residents and 91.4% of specialists reported the ability to share media is a major advantage of WhatsApp over other medias, followed by rapid responses for consultations. Conclusion: Many ophthalmologists already use WhatsApp as a tool for professional consultations with other providers, mainly thanks to its simplicity and wide availability. Residents use it more frequently than specialists, and ranked it higher when asked how much WhatsApp has improved the clinical setting. Policy makers should address concerns brought up by physicians, such as documentation in medical records and proper compensation for consulting ophthalmologists during and after work hours.


2021 ◽  
Vol 28 (05) ◽  
pp. 702-706
Author(s):  
Niaz Hussain Keerio ◽  
Nasrullah Aamir ◽  
Nuresh Kumar ◽  
Masood Ahmad Qureshi ◽  
Hassan Amir us Saqlain ◽  
...  

 Objective: To determine how frequent NSAIDs are used for osteoarthritic patients because OA is common old age patients and NSAIDs can cause divesting complications on their health. In our study we tried to identify the main reasons and suggest a best possible solution. Study Design: Community Based Cross-sectional study. Setting: Mohammad Medical College and Hospital Mirpurkhas Pakistan. Period:  June 2018 to August 2018. Material & Methods: In this study, we included more than 300 prescriptions written for Osteoarthritis, a degenerative joint disease. Prescriptions collected from hospital pharmacy (80%) and from other pharmacies (20%). Data was collected on preformed proforma and was analyzed in SPSS version 25. Results: Osteoarthritis mainly affects elderly population. NSAIDs are used for pain relief but can cause acute renal failure and GIT bleeding ulcers. In our study 69% patients were prescribed double NSAIDs. Traditional NSAIDs were used 95% of the time and only 5% percent of the time selective cox 2 were used. Along with these NSAIDS only 20% patient were given prophylactically gastroprotective agents like PPI and other medications. Conclusion: Prescription osteoarthritis include multiple NSAID without any protocol and over dosage was observed commonly.


2018 ◽  
Vol 31 (9) ◽  
pp. 1343-1353 ◽  
Author(s):  
Juliana Onofre de Lira ◽  
Thaís Soares Cianciarullo Minett ◽  
Paulo Henrique Ferreira Bertolucci ◽  
Karin Zazo Ortiz

ABSTRACTIntroduction:Alzheimer’s disease (AD) is a degenerative syndrome that impairs cognitive functioning, including speech and language. Discourse can be used to analyze language processing, which is organized into microlinguistic and macrolinguistic dimensions.Objectives:To identify the occurrence of changes in the macrolinguistic dimension of oral discourse in AD patients. Design: This was developed as a cross-sectional study. Setting: Outpatient clinic of the Behavioural Neurology Division of São Paulo Federal University.Participants:121 elderly patients, with ≥ 4 years of education, divided into AD and comparison groups.Measurements:The subjects were asked to create a narrative based on seven figures that made up a story. The macrolinguistic aspects of the narratives were analyzed.Results:The performance of the AD group was inferior to that of the comparison group on content-related, no-content-related complete and incomplete propositions as well as macropropositions, main information units, appropriated local and global coherence, cohesive devices and all subtypes, cohesive errors and some of their subtypes. Global coherence, macropropositions and ellipsis subtype of cohesive devices were the variables that best differentiated the groups.Conclusions:Changes were observed in most aspects of the macrolinguistic dimension of oral discourse in patients with AD.


2012 ◽  
Vol 52 (6) ◽  
pp. 341
Author(s):  
Leny Zabidi ◽  
Gatot Irawan Sarosa ◽  
Farah Prabowo

Background Congenital gastrointestinal anomalies may manifestsigns or symptoms in the first few days of life, most commonly inthe fonn of obstructions. Radiologic imaging plays an importantrole in diagnosis confirmation and surgical correction plans. Mostcases may be diagnosed by plain radiographs alone, but cr scansand MRI may be needed to make accurate diagnoses, especiallyin difficult cases.Objective To report radiologic imaging findings in infants Mthcongenital gastrointestinal anomalies.Methods For this retrospective, cross􀁊sectional study we tooksecondary data from medical records of infants 'With congenitalgastrointestinal anomalies in Dr. Kariadi Hospital, Semarang,Indonesia from January 2010 - June 2011. Diagnosis of congenitalanomalies was confirmed by clinical manifestation and radiologicimaging. Radiologic findings were reviewed by a single radiologiston duty at that time. Data is presented in the form of frequencydistribution.Results Subjects consisted of 50 males and 23 females. The mostcormnon complaints were vorrritingin 14 subjects (19%), alxlominaldistension in 31 subjects (43%), and fecal passage dysfunction in28 subjects (38%). Radiologic imaging of subjects with congenitalgastrointestinal anomalies revealed the folloMng conditions: analatresia in 28 subjects (38%), congenital megacolon in 21 subjects(29%), esophageal atresia in 14 subjects (19%), duodenal atresia in9 subjects (12%), and pyloric atresia in 1 subject (2%).Conclusion Using radiologic imaging of infants with congenitalgastrointestinal anomalies, the most to least common conditionsfound were anal atresia, congenital megacolon, esophagealatresia, duodenal atresia, and pyloric atresia. [Paediatr Indones.2012;52:341-5].


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