scholarly journals Sensitivity and specificity of malaria rapid diagnostic test (mRDT CareStatTM) compared with microscopy amongst under five children attending a primary care clinic in southern Nigeria

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Oluwagbenga Ogunfowokan ◽  
Bamidele A. Ogunfowokan ◽  
Anthony I. Nwajei
Keyword(s):  
Primary Care ◽  
Diagnostic Accuracy ◽  
Sensitivity And Specificity ◽  
Parasite Density ◽  
Primary Care Clinic ◽  
Malaria Diagnosis ◽  
Malaria Prevalence ◽  
Cross Sectional ◽  
Care Clinic ◽  
Predictive Values

Background: Malaria diagnosis using microscopy is currently the gold standard. However, malaria rapid diagnostic tests (mRDTs) were developed to simplify the diagnosis in regions without access to functional microscopy.Aim: The objective of this study was to compare the diagnostic accuracy of mRDT CareStatTM with microscopy.Setting: This study was conducted in the paediatric primary care clinic of the Federal Medical Centre, Asaba, Nigeria.Methods: A cross-sectional study for diagnostic accuracy was conducted from May 2016 to October 2016. Ninety-eight participants were involved to obtain a precision of 5%, sensitivity of mRDT CareStatTM of 95% from published work and 95% level of confidence after adjusting for 20% non-response rate or missing data. Consecutive participants were tested using both microscopy and mRDT. The results were analysed using EPI Info Version 7.Results: A total of 98 children aged 3–59 months were enrolled. Malaria prevalence was found to be 53% (95% confidence interval [CI] = 46% – 60%), whilst sensitivity and specificity were 29% (95% CI = 20% – 38%) and 89% (95% CI = 83% – 95%), respectively. The positive and negative predictive values were 75% (95% CI = 66.4% – 83.6%) and 53% (95% CI = 46% – 60%), respectively.Conclusion: Agreement between malaria parasitaemia using microscopy and mRDT positivity increased with increase in the parasite density. The mRDT might be negative when malaria parasite density using microscopy is low.

scholarly journals Elderly Patients in Primary Care are Still at Risks of Receiving Potentially Inappropriate Medications

2021 ◽  
Vol 12 ◽  
pp. 215013272110350
Author(s):  
Pasitpon Vatcharavongvan ◽  
Viwat Puttawanchai
Keyword(s):  
Primary Care ◽  
Primary Care Clinic ◽  
Clinical Decision ◽  
Cross Sectional Study ◽  
Study Data ◽  
Patient Specific ◽  
Potentially Inappropriate Medications ◽  
Cross Sectional ◽  
Care Clinic ◽  
Inappropriate Medications

Background Most older adults with comorbidities in primary care clinics use multiple medications and are at risk of potentially inappropriate medications (PIMs) prescription. Objective This study examined the prevalence of polypharmacy and PIMs using Thai criteria for PIMs. Methods This study was a retrospective cross-sectional study. Data were collected from electronic medical records in a primary care clinic in 2018. Samples were patients aged ≥65 years old with at least 1 prescription. Variables included age, gender, comorbidities, and medications. The list of risk drugs for Thai elderly version 2 was the criteria for PIMs. The prevalence of polypharmacy and PIMs were calculated, and multiple logistic regression was conducted to examine associations between variables and PIMs. Results Of 2806 patients, 27.5% and 43.7% used ≥5 medications and PIMs, respectively. Of 10 290 prescriptions, 47% had at least 1 PIM. The top 3 PIMs were anticholinergics, proton-pump inhibitors, and nonsteroidal anti-inflammatory drugs (NSAIDs). Polypharmacy and dyspepsia were associated with PIM prescriptions (adjusted odds ratio 2.48 [95% confident interval or 95% CI 2.07-2.96] and 3.88 [95% CI 2.65-5.68], respectively). Conclusion Prescriptions with PIMs were high in the primary care clinic. Describing unnecessary medications is crucial to prevent negative health outcomes from PIMs. Computer-based clinical decision support, pharmacy-led interventions, and patient-specific drug recommendations are promising interventions to reduce PIMs in a primary care setting.

scholarly journals Evaluation of a two-minute strep A direct swab test (SADST) on patients with pharyngitis at a primary care clinic

1986 ◽  
Vol 97 (1) ◽  
pp. 133-138 ◽  
Author(s):  
G. F. Araj ◽  
H. A. Majeed
Keyword(s):  
Primary Care ◽  
Primary Care Clinic ◽  
Culture Method ◽  
Care Clinic ◽  
Predictive Values ◽  
Primary Care Clinics ◽  
Clinical Laboratories ◽  
Standard Culture ◽  
Group A ◽  
Lancefield Group

SUMMARYA two-minute strep A direct swab test (SADST) was used to detect the presence of Lancefield group A streptococci (GAS) from the throats of 207 patients with pharyngitis at a primary-care clinic. The results were compared with a standard culture method. Fifty-one specimens were positive and 156 specimens were negative for GAS by culture. The SADST had a sensitivity of 96% (49 of 51) and specificity of 98·7% (154 of 156). The predictive values of a positive and negative SADST, for GAS, were 96% and 98·7 % respectively. The SADST showed negative reactions with five specimens containing beta-haemotytic streptococci other than GAS and 34 known stock cultures other than GAS. Our results indicate that SADST is a rapid, simple, convenient and reliable test to use for diagnosis of GAS pharyngitis at primary care clinics, physicians' offices and clinical laboratories.

scholarly journals Prevalence, perceptions and practices associated with non-adherence to diabetes medications in primary care setting: A cross sectional study in urban Bangalore

2016 ◽  
Vol 7 (6) ◽  
pp. 106-109
Author(s):  
Leeberk Raja Inbaraj ◽  
Carolin Elizabeth Georg ◽  
Nan Lin Kham ◽  
Gift Norman
Keyword(s):  
Primary Care ◽  
Primary Care Clinic ◽  
Cross Sectional Study ◽  
Blood Glucose Monitoring ◽  
Adherence Rate ◽  
Sectional Study ◽  
Cross Sectional ◽  
Care Clinic ◽  
Adherence To Diet ◽  
Multiple Doses

Background: Adherence to diet and drugs, blood glucose monitoring, foot care, exercise and early recognition of the complications, are the crucial elements for tertiary prevention of Diabetes Mellitus. Non compliance can lead to poor glycemic control which can eventually aggravate complications and lead to disability and mortality. This study aimed  at estimating prevalence of non-adherence and identify perceptions and practices associated with non-adherence.Materials and Methods: A cross sectional study was conducted in a primary care clinic in a disadvantaged community Hundred patients with Diabetes were recruited and interviewed using a semi-structured questionnaire.Results: Non adherence rate was 30%. Those who are unable to remember multiple doses (37.5%) were 2.77 (95% CI: 0.94-8.15) times more likely to non-adhere to the treatment than those who are able to remember multiple doses (16.7%).Similarly Patients who often discontinued medications and switched over to alternative system medicines tended to be non- adherent 8.5 (95% CI:1.6- 45.0) times more than those who continued treatment without interruption. Non adherence was not associated with age, gender, education level, and cost of medication and duration of diabetes. People who were illiterate and elderly did not know the consequences of missing doses and stopped medications when they felt better as well as resorted to traditional medicinesConclusions: Counselling sessions should focus on perceptions and ideas about diabetes. Innovative health education modalities have to be developed for illiterate and elderly people.Asian Journal of Medical Sciences Vol.7(5) 2016 106-109

scholarly journals Disclosure of Traditional and Complementary Medicine Use and Its Associated Factors to Medical Doctor in Primary Care Clinics in Kuching Division, Sarawak, Malaysia

2017 ◽  
Vol 2017 ◽  
pp. 1-10 ◽  
Author(s):  
Anak Kelak Johny ◽  
Whye Lian Cheah ◽  
Safii Razitasham
Keyword(s):  
Primary Care ◽  
Complementary Medicine ◽  
Associated Factors ◽  
Primary Care Clinic ◽  
Healthcare Providers ◽  
Cross Sectional Study ◽  
Medical Doctor ◽  
Open Communication ◽  
Cross Sectional ◽  
Care Clinic

The decision by the patients to disclose traditional and complementary medicine (TCM) use to their doctor is an important area to be explored. This study aimed to determine the disclosure of TCM use and its associated factors to medical doctor among primary care clinic attendees in Kuching Division, Sarawak. It was a cross-sectional study using questionnaire, interviewer administered questionnaire. A total of 1130 patients were screened with 80.2% reporting using TCM. Logistic regression analysis revealed that being female (AOR = 3.219, 95% CI: 1.385, 7.481), perceived benefits that TCM can prevent complication of illness (AOR = 3.999, 95% CI: 1.850, 8.644) and that TCM is more gentle and safer (AOR = 4.537, 95% CI: 2.332, 8.828), perceived barriers of not having enough knowledge about TCM (AOR = 0.530, 95% CI: 0.309, 0.910), patient dissatisfaction towards healthcare providers being too business-like and impersonal (AOR = 0.365, 95% CI: 0.199, 0.669) and paying more for healthcare than one can afford (AOR = 0.413, 95% CI: 0.250, 0.680), and accessibility of doctors (AOR = 3.971, 95% CI: 2.245, 7.023) are the predictors of disclosure of TCM use. An open communication between patients and doctor is important to ensure safe implementation and integration of both TCM and medical treatment.

scholarly journals Intention to Seek Medical Consultation for Symptoms of Upper Respiratory Tract Infection– A Cross-Sectional Survey

2020 ◽  
Vol 14 (2) ◽  
Author(s):  
Tan CE ◽  
Mohd Roozi AH ◽  
Wong WHR ◽  
Sabaruddin SAH ◽  
Ghani NI ◽  
...  
Keyword(s):  
Primary Care ◽  
Common Cold ◽  
Tertiary Education ◽  
Primary Care Clinic ◽  
Medical Consultation ◽  
Upper Respiratory Tract ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Care Clinic ◽  
The Common

Introduction: The common cold is the commonest reason for primary care encounters worldwide. This paper aims to describe the reasons that influence patients to seek medical consultation for the common cold. Methods: This was a cross-sectional survey conducted among adult patients of an urban teaching primary care clinic. An adapted bilingual survey form was administered by the researchers to obtain data regarding their decision to seek medical consultation for a cold and the reasons for their decision. Quantitative analyses were done to describe the close-ended responses. Open-ended responses were analysed using a qualitative approach and the frequencies of the themes were reported. Results: A total of 320 respondents participated in this study, with a response rate of 91.4%. They were predominantly females (59.4%), Malay (70.9%), and had tertiary education (65.9%). More than half of the patients (52.5%) said they would seek consultation for cold symptoms. Fever was the commonest symptom (57-61%) which compelled them to seek consultation. The commonest reason for seeking consultation was to get medications (41.7%), whereas the commonest reason not to seek consultation was the practice of self-medication (44.2%). Ethnicity was found to be significantly associated with the decision to seek doctor’s consultation. Conclusion: Colds are usually self-limiting and do not result in complications. Empowering patients by providing appropriate self-care knowledge can help to reduce the burden of primary care services. Patients should be taught about red flag symptoms as well as drug safety for medications commonly taken for colds.

scholarly journals Mentorship on malaria microscopy diagnostic service in Ethiopia: Baseline competency of microscopists and performance of health facilities

2021 ◽  
Author(s):  
Bokretsion Gidey ◽  
Desalegn Nega ◽  
Adugna Abera ◽  
Abnet Abebe ◽  
Sindew Mekasha ◽  
...  
Keyword(s):  
Sensitivity And Specificity ◽  
Predictive Value ◽  
False Negative ◽  
Malaria Diagnosis ◽  
Health Facilities ◽  
Malaria Parasites ◽  
Cross Sectional ◽  
Predictive Values ◽  
Microscopic Diagnosis ◽  
Malaria Microscopy

Abstract Background: In Ethiopia, malaria cases are declining as a result of proven interventions and in 2017, the country launched a malaria elimination strategy in targeted settings. Accurate malaria diagnosis and prompt treatment are the key components of the strategy to prevent morbidity and stop the continuation of transmission. However, the quality of microscopic diagnosis in general is deteriorating as malaria burden declines. Therefore, this study was carried out to evaluate the competency of microscopists and the performance of health facilities on malaria microscopic diagnosis.Methods: A cross-sectional study was conducted from August 1st to September 30th, 2019 in nine regional states and one city administration. A standard checklist was used for on-site evaluation, archived patient slides were re-checked, and proficiency of microscopists was tested using WHO certified slides from the national slide bank at the Ethiopian Public Health Institute (EPHI). The strength of agreement, the sensitivity, the specificity, and the positive and negative predictive values were calculated.Results: In this study, 102 health facilities (84 health centers and 18 hospitals) were included; from which, 202 laboratory professionals participated. In slide re-checking, moderate agreement (Agreement: 76.0%; Kappa: 0.41) was observed between experts and microscopists on malaria detection in all health facilities. The sensitivity and specificity of routine slide reading and the re-checking results were 78.1% and 80.7%, respectively. Likewise, positive predictive value of 65.1% and negative predictive value of 88.8% were scored in the routine diagnosis. By panel testing, a substantial overall agreement (A: 91.8%; K: 0.79) was observed between microscopists and experts in detecting malaria parasites. The sensitivity and specificity in the detection of malaria parasites was 92.7% and 89.1%, respectively. Furthermore, in identifying species, a slight agreement (A: 57%; K: 0.18) was observed between microscopists and experts. Conclusion: The study found significant false positive and false negative results in routine microscopy on slide re-checking of Plasmodium parasites. Moreover, reduced grade in parasite species identification was reported on the panel tests. Therefore, implementing comprehensive malaria microscopy mentorship, in-service training, and supportive supervision are the key strategies to improve the overall performance of health facilities in malaria microscopy.

scholarly journals Three Questions to Screen your Patients for Chemical, Food, and Drug Intolerances the Brief Environmental Exposure and Sensitivity Inventory (BREESI)

2020 ◽  
Author(s):  
Raymond F Palmer ◽  
Carlos Roberto Jaén ◽  
Roger B. Perales ◽  
Rodolfo Rincon ◽  
Jacqueline Viramontes ◽  
...  
Keyword(s):  
Primary Care ◽  
Positive Predictive Value ◽  
Environmental Exposure ◽  
Health Care Professionals ◽  
Predictive Value ◽  
Primary Care Clinic ◽  
Diagnostic Tools ◽  
Care Clinic ◽  
Predictive Values ◽  
Chemical Intolerance

Abstract Background: The 50-item Quick Environmental Exposure and Sensitivity Inventory (QEESI) is a validated questionnaire used worldwide to assess intolerances to chemicals, foods, and/or drugs and has become the gold standard for assessing chemical intolerance (CI). Despite a reported prevalence of 8-33%, CI often goes undiagnosed in epidemiological studies and routine primary care. To enhance the QEESI’s utility, we developed the Brief Environmental Exposure and Sensitivity Inventory (BREESI) as a 3-item CI screening instrument. We tested the BREESI’s potential to predict whether an individual is likely to respond adversely to structurally unrelated chemicals, foods, and drugs. Methods: We recruited 286 adult participants from a university-based primary care clinic and through online participation. The positive and negative predictive values of the BREESI items were calculated against the full QEESI scores. Results: 90% of participants answering “yes” to all three items on the BREESI were classified as very suggestive of CI based upon the QEESI chemical intolerance and symptom scores both ≥ 40 (positive predictive value = 90%). For participants endorsing two items, 92% were classified as either very suggestive (39%) or Suggestive (53%) of CI (positive predictive value = 87%). Of those endorsing only one item, only 13% were found to be very suggestive of CI. However, 70% were classified as Suggestive. Of those answering “No” to all of the BREESI items, 99% were classified as not suggestive of CI (i.e., negative predictive value = 99%). Conclusions: The BREESI is a versatile screening tool for rapidly determining potential CI, with clinical and epidemiological applications. Together, the validated BREESI and QEESI provide much needed diagnostic tools that will help inform treatment protocols and teach health care professionals about Toxicant Induced Loss of Tolerance – the mechanism driving CI.

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