Clinical features and outcomes of 84 COVID-Positive hemodialysis patients in a resource poor setting from India

BACKGROUND: Diagnostic challenge of malaria in Nigeria remarkably impedes the World Health Organization (WHO) recommendation of laboratory diagnosis before treatment. Rapid Diagnostic Test (RDT) is easier and cheaper to perform when compared with microscopy especially in resource-poor settings. However there are conflicting results on the accuracy of RDT versus microscopy from previous studies. AIM: To compare the overall accuracy of   microscopy and RDT in detecting peripheral malaria among   pregnant women with clinical features of malaria. MATERIALS & METHODS: This was a cross-sectional comparative studyin whichRDT, microscopy and polymerase chain reaction (PCR) were performed using the peripheral bloodof the eligible study participants at the Alex Ekwueme Federal University Teaching Hospital, Abakaliki between September 1, 2016 and March 31, 2017.The PCR was used as the gold standard in this study. Data was analyzed with the Statistical Package for Social Sciences version 18 (IBM SPSS, Chicago, USA). P value ≤ 0.05 was considered statistically significant. RESULTS: The actual prevalent rates of malaria based on RDT, microscopy and PCR results among the participants were 58.2%, 59.9% and 61.1% respectively. There was no statistical significant difference among RDT, microscopy and combined RDT and microscopy on overall accuracy. Malaria infestation was associated with self-employed and unemployed women, primigravidity, second trimester, rural residence, non-use of long lasting insecticide treated nets and intermittent preventive therapy for malaria. CONCLUSION: There was no difference in overall accuracy among RDT, microscopy and combined RDT and microscopy. This underscores the need to scale up RDT for every patient with clinical features of malaria before treatment in this environment.

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EVALUATION OF GLOMERULAR FUNCTIONS IN PATIENTS WITH SCA IN MAIDUGURI NORTH-EASTERN NIGERIA: A RECOMMENDATION FOR EARLY ASSESSMENT AND DETECTION OF DYSFUNCTION IN A RESOURCE-POOR SETTING.

Kanem Journal of Medical Sciences ◽

10.36020/kjms.2021.1505 ◽

2021 ◽

Vol 15 (1) ◽

pp. 1-10

Author(s):

Farouk AG ◽

◽

Yauba MS ◽

Yerima A ◽

Asheikh MM ◽

...

Keyword(s):

Blood Pressure ◽

Glomerular Filtration Rate ◽

Glomerular Filtration ◽

Clinical Features ◽

Filtration Rate ◽

Resource Poor Setting ◽

Healthy Children ◽

Early Assessment ◽

Resource Poor ◽

The Mean

Background: Sickle cell anaemia (SCA) is a disorder of Mendelian autosomal recessive inheritance, characterised by abnormal haemoglobin synthesis resulting in multi-systemic manifestations. The kidneys are largely affected by this disorder, but overt features of kidney disease mostly manifest after the second decade, even though insult and sub-clinical features may occur during childhood. Unfortunately, investigating these sub-clinical features is not routinely done in resource-scarce settings, partly due to the low socioeconomic status of most of our patients and the overwhelmed health care workers. Objectives: To investigate glomerular dysfunction in children with SCA in the context of the resource-poor setting. Methodology: This cross-sectional study was conducted at the University of Maiduguri Teaching Hospital (UMTH), over 6 months. One hundred and ten SCA (Hb SS) children aged 3 – 14 years in steady-state constituted the cases, while 110 non-SCA (Hb AA) age and sex-matched, apparently healthy children formed the control. Anthropometry, blood pressure, urinalysis and serum creatinine of the subjects was done. Glomerular filtration rate (GFR) was estimated using the Schwartz formula. Results: The mean systolic blood pressure (SBP) ± SD of the cases and controls were 96.8±9.34mmHg and 99.14±13.44mmHg respectively, (p = 0.13). The mean diastolic BP ± SD of the cases and controls were 60.18±6.85mmHg and 64.35±8.23mmHg respectively, (p = 0.0001). Glomerular filtration rate was significantly higher among the cases than the controls, 126±32ml/min/1.73m2 and 93±16ml/min/1.73m2 respectively (p <0.001). Proteinuria was higher among the cases (8.2%), with one (0.9%) having nephrotic range proteinuria. Conclusions: The proteinuria and hyperfiltration found in some of the children with SCA in this study suggest that renal function abnormalities can be detected early in this group of children when appropriately and timely investigated.

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EVALUATION OF GLOMERULAR FUNCTIONS IN PATIENTS WITH SCA IN MAIDUGURI NORTH-EASTERN NIGERIA: A RECOMMENDATION FOR EARLY ASSESSMENT AND DETECTION OF DYSFUNCTION IN A RESOURCE-POOR SETTING.

Kanem Journal of Medical Sciences ◽

10.36020/kjms.2021.1501.005 ◽

2021 ◽

Vol 15 (1) ◽

pp. 35-44

Author(s):

Farouk AG ◽

◽

Yauba MS ◽

Yerima A ◽

Asheikh MM ◽

...

Keyword(s):

Blood Pressure ◽

Glomerular Filtration Rate ◽

Glomerular Filtration ◽

Clinical Features ◽

Filtration Rate ◽

Resource Poor Setting ◽

Healthy Children ◽

Early Assessment ◽

Resource Poor ◽

The Mean

Background: Sickle cell anaemia (SCA) is a disorder of Mendelian autosomal recessive inheritance, characterised by abnormal haemoglobin synthesis resulting in multi-systemic manifestations. The kidneys are largely affected by this disorder, but overt features of kidney disease mostly manifest after the second decade, even though insult and sub-clinical features may occur during childhood. Unfortunately, investigating these sub-clinical features is not routinely done in resource-scarce settings, partly due to the low socioeconomic status of most of our patients and the overwhelmed health care workers. Objectives: To investigate glomerular dysfunction in children with SCA in the context of the resource-poor setting. Methodology: This cross-sectional study was conducted at the University of Maiduguri Teaching Hospital (UMTH), over 6 months. One hundred and ten SCA (Hb SS) children aged 3 – 14 years in steady-state constituted the cases, while 110 non-SCA (Hb AA) age and sex-matched, apparently healthy children formed the control. Anthropometry, blood pressure, urinalysis and serum creatinine of the subjects was done. Glomerular filtration rate (GFR) was estimated using the Schwartz formula. Results: The mean systolic blood pressure (SBP) ± SD of the cases and controls were 96.8±9.34mmHg and 99.14±13.44mmHg respectively, (p = 0.13). The mean diastolic BP ± SD of the cases and controls were 60.18±6.85mmHg and 64.35±8.23mmHg respectively, (p = 0.0001). Glomerular filtration rate was significantly higher among the cases than the controls, 126±32ml/min/1.73m2 and 93±16ml/min/1.73m2 respectively (p <0.001). Proteinuria was higher among the cases (8.2%), with one (0.9%) having nephrotic range proteinuria. Conclusions: The proteinuria and hyperfiltration found in some of the children with SCA in this study suggest that renal function abnormalities can be detected early in this group of children when appropriately and timely investigated.

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Screening for Diabetes Mellitus and Gestational Diabetes in a Resource-Poor Setting—Implementing a Selective Protocol

Diabetes ◽

10.2337/db18-2371-pub ◽

2018 ◽

Vol 67 (Supplement 1) ◽

pp. 2371-PUB

Author(s):

KEVIN A. CABRERA ◽

ARIF PENDI ◽

NASSIM LASHKARI ◽

ERIC EL-TOBGY ◽

BEN B. LABROT

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Resource Poor Setting ◽

Resource Poor

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The importance of the autopsy in ascertaining the cause of death as an audit tool in a resource poor setting

10.26226/morressier.578f37fed462b8028d890706 ◽

2016 ◽

Author(s):

Michael Nweke

Keyword(s):

Cause Of Death ◽

Resource Poor Setting ◽

Audit Tool ◽

Resource Poor

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Faculty Opinions recommendation of Trichomoniasis: How do we diagnose in a resource poor setting?

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.718230854.793489425 ◽

2014 ◽

Author(s):

Phillip Hay ◽

Ellen Dwyer

Keyword(s):

Resource Poor Setting ◽

Resource Poor

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Developing a sustainable Digital Health Innovation Ecosystem in a rural and resource-poor region: A monitored networking approach (Preprint)

10.2196/preprints.19011 ◽

2020 ◽

Author(s):

Arunangsu Chatterjee ◽

Sebastian Stevens ◽

Sheena Asthana ◽

Ray B Jones

Keyword(s):

Social Network ◽

Network Analysis ◽

Data Collection ◽

Digital Health ◽

Resource Poor Setting ◽

Quadruple Helix ◽

Innovation Ecosystem ◽

Resource Poor ◽

Quadruple Helix Model ◽

Over Time

BACKGROUND Digital health (DH) innovation ecosystems (IE) are key to the development of new e-health products and services. Within an IE, third parties can help promote innovation by acting as knowledge brokers and the conduits for developing inter-organisational and interpersonal relations, particularly for smaller organisations. Kolehmainen’s quadruple helix model suggests who the critical IE actors are, and their roles. Within an affluent and largely urban setting, such ecosystems evolve and thrive organically with minimal intervention due to favourable economic and geographical conditions. Facilitating and sustaining a thriving DH IE within a resource-poor setting can be far more challenging even though far more important for such peripheral economics and the health and well-being of those communities. OBJECTIVE Taking a rural and remote region in the UK, as an instance of an IE in a peripheral economy, we adapt the quadruple helix model of innovation, apply a monitored social networking approach using McKinsey’s Three Horizons of growth to explore: • What patterns of connectivity between stakeholders develop within an emerging digital health IE? • How do networks develop over time in the DH IE? • In what ways could such networks be nurtured in order to build the capacity, capability and sustainability of the DH IE? METHODS Using an exploratory single case study design for a developing digital health IE, this study adopts a longitudinal social network analysis approach, enabling the authors to observe the development of the innovation ecosystem over time and evaluate the impact of targeted networking interventions on connectivity between stakeholders. Data collection was by an online survey and by a novel method, connection cards. RESULTS Self-reported connections between IE organisations increased between the two waves of data collection, with Small and Medium-sized Enterprises (SMEs) and academic institutions the most connected stakeholder groups. Patients involvement improved over time but still remains rather peripheral to the DH IE network. Connection cards as a monitoring tool worked really well during large events but required significant administrative overheads. Monitored networking information categorised using McKinsey’s Three Horizons proved to be an effective way to organise networking interventions ensuring sustained engagement. CONCLUSIONS The study reinforces the difficulty of developing and sustaining a DH IE in a resource-poor setting. It demonstrates the effective monitored networking approach supported by Social Network Analysis allows to map the networks and provide valuable information to plan future networking interventions (e.g. involving patients or service users). McKinsey’s Three Horizons of growth-based categorisation of the networking assets help ensure continued engagement in the DH IE contributing towards its long-term sustainability. Collecting ongoing data using survey or connection card method will become more labour intensive and ubiquitous ethically driven data collection methods can be used in future to make the process more agile and responsive.

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Strategies for diagnosis of bacterial vaginosis in a resource-poor setting

International Journal of STD & AIDS ◽

10.1258/0956462052932601 ◽

2005 ◽

Vol 16 (1) ◽

pp. 52-55 ◽

Cited By ~ 8

Author(s):

S F Posner ◽

J Kerimova ◽

F Aliyeva ◽

A Duerr

Keyword(s):

Bacterial Vaginosis ◽

Resource Poor Setting ◽

Resource Poor

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Clinical Features of Maintenance Hemodialysis Patients with 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China

Clinical Journal of the American Society of Nephrology ◽

10.2215/cjn.04160320 ◽

2020 ◽

Vol 15 (8) ◽

pp. 1139-1145 ◽

Cited By ~ 21

Author(s):

Jun Wu ◽

Jushuang Li ◽

Geli Zhu ◽

Yanxia Zhang ◽

Zhimin Bi ◽

...

Keyword(s):

Clinical Features ◽

Troponin I ◽

Clinical Laboratory ◽

Cardiac Injury ◽

Hemodialysis Patients ◽

Hospitalized Patients ◽

Maintenance Hemodialysis ◽

Computed Tomographic ◽

Risk Of Death ◽

Novel Coronavirus

Background and objectivesPrevious reports on the outbreak of coronavirus disease 2019 were on the basis of data from the general population. Our study aimed to investigate the clinical features of patients on maintenance hemodialysis.Design, setting, participants, & measurements In this retrospective, single-center study, we included 49 hospitalized patients on maintenance hemodialysis and 52 hospitalized patients without kidney failure (controls) with confirmed coronavirus disease 2019 at Tongren Hospital of Wuhan University from January 30, 2020 to March 10, 2020. Demographic, clinical, laboratory, and radiologic characteristics and treatment and outcomes data were analyzed. The final date of follow-up was March 19, 2020.ResultsThe median age of 101 patients was 62 years (interquartile range, 49–72). All patients were local residents of Wuhan. In terms of common symptoms, there were differences between patients on hemodialysis and controls (fatigue [59% versus 83%], dry cough [49% versus 71%], and fever [47% versus 90%]). Lymphocyte counts were decreased (0.8×109/L [patients on hemodialysis] versus 0.9×109/L [controls], P=0.02). Comparing patients on hemodialysis with controls, creatine kinase–muscle and brain type, myoglobin, hypersensitive troponin I, B-type natriuretic peptide, and procalcitonin were increased, and the percentage of abnormalities in bilateral lung was higher in computed tomographic scan (82% versus 69%, P=0.15) and unilateral lung was lower (10% versus 27%, P=0.03). Common complications including shock, acute respiratory distress syndrome, arrhythmia, and acute cardiac injury in patients on hemodialysis were significantly higher. Compared with controls, more patients on hemodialysis received noninvasive ventilation (25% versus 6%, P=0.008). As of March 19, 2020, three patients on hemodialysis (6%) were transferred to the intensive care unit and received invasive ventilation. Seven patients on hemodialysis (14%) had died.ConclusionsThe main symptoms of coronavirus disease 2019 pneumonia, including fever and cough, were less common in patients on hemodialysis. Patients on hemodialysis with coronavirus disease 2019 were at higher risk of death.

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