scholarly journals Thermal Protection of Newborns: The World Health Organization Guidelines Need to Include Clear and Feasible Options for Low-Resource Settings

2021 ◽  
Vol 2 (6) ◽  
pp. 13-16
Author(s):  
Subhashchandra Daga
Keyword(s):  
Thermal Protection ◽  
World Health ◽  
Strong Recommendation ◽  
Low Resource ◽  
Moderate Quality ◽  
Resource Setting ◽  
Low Resource Setting ◽  
Health Organization ◽  
The Impact ◽  
Quality Evidence

Backgorund: Hypothermia in babies may increase mortality, directly or indirectly, by potentiating the effect of the other morbidities. Guidelines published by The World health organization (WHO) on newborn health (2015) may be inadequate to address the issue in a low-resource setting. To be relevant in such a context, they should be user-friendly for the trainers of health workers (HW) who may be responsible for interpreting the recommendations and training the HW. Text: According to earlier guidelines (2013), ‘No randomized or quasi-randomized trial that evaluated the impact of keeping infants warm after discharge (hospital births) or after 24 hours (home births) was identified’. However, kangaroo mother care (KMC), a strong recommendation with moderate-quality evidence, and thermal protection are inseparable, as the most crucial component of KMC is skin-to-skin contact, which keeps a baby warm. A HW may be surprised when the guidelines or the basis change and, the move comes at a time when the earlier guidelines (1993) are just finding roots in patient care practices. Current guidelines are based on the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology, where randomized trials assume more importance. The guidelines recommend the following methods to keep infants warm after birth: KMC (strong recommendation, moderate-quality evidence), intermittent KMC (strong recommendation, moderate-quality evidence), and radiant warmers or incubators (strong recommendation, very low-quality evidence). The divergence between the evidence and the recommendations may be difficult for the HW to comprehend. Conclusions: The guidelines for postnatal care need to be revisited and revised so that clear and feasible options for keeping infants warm in low-resource settings are offered. Besides KMC, warm rooms, heated mattresses, plastic wraps and Styrofoam boxes may be suggested. What is already known about this subject? •       In the absence of a randomized or quasi-randomized trial that evaluated the impact of keeping infants warm, there are fewer options in a low-resource setting. •       They include Kangaroo mother care and incubators/radiant warmers. What does this study add? •       Options that may not have been supported by randomized trials but have consistent results may be suggested. •       They include warm rooms, heated mattresses, plastic wraps and Styrofoam boxes. •       In future revisions, the level of evidence should be paired with the recommendations. How might this impact on clinical practice or future developments? The health worker may choose the most feasible option at home or at a facility.

scholarly journals Combination of Antibody based rapid diagnostic tests used in an algorithm may improve their performance in SARS CoV-2 diagnosis

2020 ◽  
Author(s):  
Grace Esther Kushemererwa ◽  
Ismail Kayongo ◽  
Patrick Semanda ◽  
Hellen Nansumba ◽  
Iga Tadeo ◽  
...  
Keyword(s):  
Diagnostic Methods ◽  
World Health ◽  
Microsoft Excel ◽  
Laboratory Equipment ◽  
Low Resource ◽  
Resource Setting ◽  
Low Resource Setting ◽  
Referral Hospitals ◽  
Health Organization ◽  
The Individual

AbstractBackgroundGlobally response to the SARS-CoV-2 pandemic is highly limited by diagnostic methods. Currently, World Health Organization (WHO) recommends the use of molecular assays for confirmation of SARS-CoV-2 infection which are highly expensive and require specialized laboratory equipment. This is a limitation in mass testing and in low resource settings. SARS CoV-2 IgG/IgM antibody tests have had poor diagnostic performance that do not guarantee their use in diagnostics. In this study we demonstrate a concept of using a combination of RDTs in an algorithm to improve their performance for diagnostics.MethodEighty six (86) EDTA whole blood samples were collected from SARS-CoV-2 positive cases admitted at Masaka and Mbarara Regional Referral Hospitals in Uganda. These were categorized from day when confirmed positive as follows; category A (0-3 days, 10 samples), category B (4-7 days, 20 samples), Category C (8-17 days, 11 samples) and Category D (18-28 days, 20 samples). Plasma was prepared, transported to the testing laboratory and stored at −200C prior to testing. A total of 13 RDTS were tested following manufacturer’s instructions. Data was entered in Microsoft Excel exported to STATA for computation of sensitivity and specificity. We computed for all possible combinations of 2 of the 13 RDTS (13C2) that were evaluated in parallel algorithm.ResultsThe individual sensitives of the RDTs ranged between 74% and 18% and there was a general increasing trend across the categories with days since PCR confirmation. A total of 78 possible combinations of the RDTs to be used in parallel was computated. The combinations of the 2 RDTS improved the sensitivities to 90%.DiscussionWe demonstrate that use of RDTs in combinations can improve their overall sensitivity. This approach when used on a wider range of combination of RDTs may yield combinations that can give sensitivities that are of diagnostics relevance in mass testing and low resource setting.

scholarly journals The impact of pre-hospital antibiotics on blood culture yields in a low resource setting

2016 ◽  
Vol 45 ◽  
pp. 72-73 ◽  
Author(s):  
I. Sarr ◽  
S. Jarju ◽  
N. kebbeh ◽  
G. Sey ◽  
M. Saidykhan ◽  
...  
Keyword(s):  
Blood Culture ◽  
Low Resource ◽  
Resource Setting ◽  
Low Resource Setting ◽  
The Impact

scholarly journals Convalescent Plasma a Potential Therapy in Covid-19 Patients in Low Resource Setting: Rapid Review

2020 ◽  
pp. 20-31
Author(s):  
Abdelrahman H. Abdelmoneim ◽  
Mujahed I. Mustafa ◽  
Raghda Hatim Abdalhaleem Adlan ◽  
Noun Eltayeb Ahmed Abdulgader ◽  
Hiba Awadelkareem Osman Fadl ◽  
...  
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
World Health ◽  
Rapid Review ◽  
Virus Infections ◽  
Plasma Therapy ◽  
Genetic Sequencing ◽  
Published Evidence ◽  
Resource Setting ◽  
Low Resource Setting ◽  
Health Organization

Background: The COVID-19 pandemic is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). At the time of writing, neither a cure nor a vaccine has been approved by the World health organization (WHO)  for this disease. Given the fact that the severe acute respiratory syndrome coronavirus  (SARS) and Middle East Respiratory Syndrome (MERS) viruses have a genetic sequencing similar to SARS-CoV-2, and since the use of convalescent plasma therapy (CP) has proved its efficacy in SARS and MERS virus infections, researchers are starting to focus more on it as a possible therapy for the COVID-19 disease. The main objective of this rapid review is to report and summarize the published evidence on the role of convalescent plasma therapy in the current COVID-19 pandemic. Method: The PICO method was used to establish the review question. Moreover, papers were gathered from PubMed and Google scholar, critically appraised for the best evidence. Piersons 5-component scheme was used to check the quality of the review papers. Results: After website screening: 10 papers in PubMed and 6 papers from Google scholars were retrieved. There were encouraging reports regarding the uses of CP in the previous viral outbreaks likes SARS and Ebola, yet there is still a doubt on the efficacy of this mode of therapy in the current COVID-19 pandemic. Conclusion: CP is a very promising treatment approach for COVID-19 patients; however, more clinical trials are required to validate the effectiveness of this therapy. Keywords: COVID-19, convalescent plasma therapy, SARS-CoV-2, therapy.

scholarly journals Development and evaluation of a Point-of-Care Test (POCT) in a low resource setting with high rates of Chlamydia trachomatis urogenital infections in Fiji

2021 ◽  
Author(s):  
Deborah Dean ◽  
Sumeetha Swaminathan ◽  
Mike Kama ◽  
Sophie Goemans ◽  
Daniel Faktaufon ◽  
...  
Keyword(s):  
Chlamydia Trachomatis ◽  
Trichomonas Vaginalis ◽  
Point Of Care ◽  
World Health ◽  
Sexually Transmitted ◽  
Point Of Care Test ◽  
Urogenital Infections ◽  
Resource Setting ◽  
Low Resource Setting ◽  
Health Organization

Rapid and precise detection of Chlamydia trachomatis—the leading global cause of sexually transmitted infections (STI)—at the point-of-care (POC) is required for treatment decisions to prevent transmission and sequelae including pelvic inflammatory disease, ectopic pregnancy, tubal-factor infertility and preterm birth. We developed a rapid POC test (POCT), termed LH-POCT, which uses Loop-mediated AMPlification (LAMP) of nucleic acids, and performed a head-to-head comparison with the Cepheid Xpert® CT/NG assay using clinician-collected de-identified paired vaginal samples from a parent study that consecutively enrolled symptomatic and asymptomatic females over age 18 years from the Ministry of Health and Medical Services Health Centers in Fiji. Samples were processed by the Xpert® CT/NG assay and LH-POCT, blinded to the comparator. Discrepant samples were resolved by qPCR. De-identified clinical data and tests for Trichomonas vaginalis, Candida and bacterial vaginosis (BV) were provided. There were a total of 353 samples from 327 females. C. trachomatis positivity was 16.7% (59/353) while the prevalence was 16.82% (55/327) after discrepant resolution. Seven discrepant samples resolved to: four false negatives, two false positives and one true positive for the LH-POCT. The sensitivity of the LH-POCT was 93.65% (95% CI: 84.53% to 98.24%) and specificity 99.31% (95% CI: 97.53% to 99.92%). Discrepant samples clustered among women with vaginal discharge and/or BV. The prototype LH-POCT workflow has excellent performance, meeting many World Health Organization ASSURED criteria for POC tests, including a sample-to-result time of 35 minutes. Our LH-POCT holds promise for improving clinical practice to prevent and control C. trachomatis STIs in diverse health care settings globally.

scholarly journals Adapting and pre-testing the World Health Organization’s Caregiver Skills Training programme for autism and other developmental disorders in a very low-resource setting: Findings from Ethiopia

Autism ◽  
2019 ◽  
Vol 24 (1) ◽  
pp. 51-63 ◽  
Author(s):  
Bethlehem Tekola ◽  
Fikirte Girma ◽  
Mersha Kinfe ◽  
Rehana Abdurahman ◽  
Markos Tesfaye ◽  
...  
Keyword(s):  
Developmental Disorders ◽  
Qualitative Interviews ◽  
Skills Training ◽  
Training Programme ◽  
World Health ◽  
Low Resource ◽  
Resource Setting ◽  
Training Materials ◽  
Low Resource Setting ◽  
The World

The World Health Organization’s Caregiver Skills Training programme for children with developmental disorders or delays teaches caregivers strategies to help them support their child’s development. Ethiopia has a severe lack of services for children with developmental disorders or delays. This study explored the perspectives of Ethiopian caregivers, professionals and other stakeholders to inform adaptation and implementation of the World Health Organization’s Caregiver Skills Training in Ethiopia. Data collection included (1) a consultation and review, comprising stakeholder meetings, review of draft Caregiver Skills Training materials and feedback from Ethiopian Master Trainees and (2) a pre-pilot including quantitative feasibility and acceptability measures and qualitative interviews with caregivers (n = 9) and programme facilitators/observers (n = 5). The consultation participants indicated that the Caregiver Skills Training addresses an urgent need and is relevant to the Ethiopian context. Several adaptations were proposed, including more emphasis on psycho-education, stigma, parental feelings of guilt and expectations of a cure. The adapted Caregiver Skills Training was pre-piloted with excellent participation (100%) and retention (90%) rates. Four themes were developed from the qualitative data: (1) Programme acceptability and relevance, (2) Perceived programme benefits, (3) Challenges and barriers and (4) Suggestions for improvement. The World Health Organization’s Caregiver Skills Training addresses a local need and, with careful adaptations, is feasible and acceptable to be implemented in Ethiopia. These findings may have relevance to low-resource settings worldwide.

Evaluation of a New Protocol of Insulin Dose Adjustment in a Low-Resource Setting

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 93-LB
Author(s):  
EDDY JEAN BAPTISTE ◽  
PHILIPPE LARCO ◽  
MARIE-NANCY CHARLES LARCO ◽  
JULIA E. VON OETTINGEN ◽  
EDDLYS DUBOIS ◽  
...  
Keyword(s):  
Dose Adjustment ◽  
Insulin Dose ◽  
Low Resource ◽  
Resource Setting ◽  
Low Resource Setting

Novel Coronavirus 2019 Outbreak: A Global Epidemic

2020 ◽  
Vol 17 (12) ◽  
pp. 1458-1464
Author(s):  
Sweta Kamboj ◽  
Rohit Kamboj ◽  
Shikha Kamboj ◽  
Kumar Guarve ◽  
Rohit Dutt
Keyword(s):  
World Health ◽  
Upper Respiratory Tract ◽  
Global Epidemic ◽  
The Public ◽  
The Government ◽  
Tract Disease ◽  
The 1960S ◽  
Novel Coronavirus ◽  
Health Organization ◽  
The Impact

Background: In the 1960s, the human coronavirus was designated, which is responsible for the upper respiratory tract disease in children. Back in 2003, mainly 5 new coronaviruses were recognized. This study directly pursues to govern knowledge, attitude and practice of viral and droplet infection isolation safeguard among the researchers during the outbreak of the COVID-19. Introduction: Coronavirus is a proteinaceous and infectious pathogen. It is an etiological agent of severe acute respiratory syndrome (SARS) and the Middle East respiratory syndrome (MERS). Coronavirus, appeared in China from the seafood and poultry market last year, which has spread in various countries, and has caused several deaths. Methods: The literature data has been taken from different search platforms like PubMed, Science Direct, Embase, Web of Science, who.int portal and complied. Results: Corona virology study will be more advanced and outstanding in recent years. COVID-19 epidemic is a threatening reminder not solely for one country but all over the universe. Conclusion: In this review article, we encapsulated the pathogenesis, geographical spread of coronavirus worldwide, also discussed the perspective of diagnosis, effective treatment, and primary recommendations by the World Health Organization, and guidelines of the government to slow down the impact of the virus are also optimistic, efficacious and obliging for the public health. However, it will take a prolonged time in the future to overcome this epidemic.

Characterizing the effectiveness of COVID-19 mitigation measures: A data-centric approach (Preprint)

2020 ◽  
Author(s):  
Lukman Olagoke ◽  
Ahmet E. Topcu
Keyword(s):  
Control Measure ◽  
Control Measures ◽  
World Health ◽  
Mitigation Measures ◽  
Effective Control ◽  
The World ◽  
Decision Making Processes ◽  
And Performance ◽  
Health Organization ◽  
The Impact

BACKGROUND COVID-19 represents a serious threat to both national health and economic systems. To curb this pandemic, the World Health Organization (WHO) issued a series of COVID-19 public safety guidelines. Different countries around the world initiated different measures in line with the WHO guidelines to mitigate and investigate the spread of COVID-19 in their territories. OBJECTIVE The aim of this paper is to quantitatively evaluate the effectiveness of these control measures using a data-centric approach. METHODS We begin with a simple text analysis of coronavirus-related articles and show that reports on similar outbreaks in the past strongly proposed similar control measures. This reaffirms the fact that these control measures are in order. Subsequently, we propose a simple performance statistic that quantifies general performance and performance under the different measures that were initiated. A density based clustering of based on performance statistic was carried out to group countries based on performance. RESULTS The performance statistic helps evaluate quantitatively the impact of COVID-19 control measures. Countries tend show variability in performance under different control measures. The performance statistic has negative correlation with cases of death which is a useful characteristics for COVID-19 control measure performance analysis. A web-based time-line visualization that enables comparison of performances and cases across continents and subregions is presented. CONCLUSIONS The performance metric is relevant for the analysis of the impact of COVID-19 control measures. This can help caregivers and policymakers identify effective control measures and reduce cases of death due to COVID-19. The interactive web visualizer provides easily digested and quick feedback to augment decision-making processes in the COVID-19 response measures evaluation. CLINICALTRIAL Not Applicable

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