scholarly journals Performance of colposcopic scoring by modified International Federation of Cervical Pathology and Colposcopy terminology for diagnosing cervical intraepithelial neoplasia in a low-resource setting

2019 ◽  
Vol 08 (04) ◽  
pp. 218-220 ◽  
Author(s):  
Prabhakaran Nair Rema ◽  
Aleyamma Mathew ◽  
Shaji Thomas
Keyword(s):  
Cervical Intraepithelial Neoplasia ◽  
Scoring Systems ◽  
Intraepithelial Neoplasia ◽  
International Federation ◽  
Screening Tests ◽  
Substantial Agreement ◽  
Low Resource ◽  
Resource Setting ◽  
Low Resource Setting

Abstract Introduction: Colposcopy is a tool to evaluate women with cervical pre-cancer and cancer. To interpret the colposcopic findings, various scoring systems are used but with inter observer variations. To improve the quality of colposcopy, International Federation of Cervical Pathology and Colposcopy (IFCPC) has introduced a colposcopic nomenclature in 2011. Colposcopic scoring helps to select patients who need treatment for cervical intraepithelial neoplasia. Aim of the Study: The study aimed to evaluate the agreement between colposcopic diagnosis with the modified IFCPC terminology and cervical pathology in patients with abnormal screening tests and to assess the utility of this colposcopic scoring system in low resource settings. Methodology: Patients with abnormal screening tests who underwent colposcopic assessment in the department of Gynaecological oncology were included in the study. Colposcopic scoring was done by the modified IFCPC nomenclature. The results were compared with cytology and the final histopathology. Results: 56 patients were included in the study. The colposcopic scoring when compared to histopathology showed agreement in 65.7% which indicated the agreement was substantial and was statistically significant (P = 0.0001). With cytology the colposcopic score showed agreement in 35.6% indicating a fair agreement and this was also statistically significant (P = 0.001). Conclusion: Colposcopic scoring by modified IFCPC 2011 criteria showed substantial agreement with cervical histopathology. Compared to traditional methods, 2011 international terminology of colposcopy could improve colposcopic accuracy.

scholarly journals “There is no time for knowing each other”: Quality of care during childbirth in a low resource setting

Midwifery ◽  
2019 ◽  
Vol 75 ◽  
pp. 33-40 ◽  
Author(s):  
Florence Mgawadere ◽  
Helen Smith ◽  
Atnafu Asfaw ◽  
Jaki Lambert ◽  
Nynke van den Broek
Keyword(s):  
Quality Of Care ◽  
Low Resource ◽  
Resource Setting ◽  
Low Resource Setting

scholarly journals Triage of Women Testing Positive With the careHPV Test on Self-Collected Vaginal Samples for Cervical Cancer Screening in a Low-Resource Setting

2018 ◽  
pp. 1-7 ◽  
Author(s):  
Usha Rani Poli ◽  
Swarnalata Gowrishankar ◽  
Meenakshi Swain ◽  
Jose Jeronimo
Keyword(s):  
Cervical Cancer ◽  
Cervical Intraepithelial Neoplasia ◽  
Intraepithelial Neoplasia ◽  
Screening Tests ◽  
Low Resource Settings ◽  
Screening Programs ◽  
Low Resource ◽  
Incidence And Mortality ◽  
Hpv Test

Purpose Human papillomavirus (HPV) DNA screening reduces cervical cancer incidence and mortality in low-resource settings. Self-collected vaginal samples tested with affordable HPV tests such as careHPV can increase the rate of screening in resource-constrained settings. We report the role of visual inspection with acetic acid (VIA) as a triage test for women testing positive with the careHPV test on self-collected vaginal samples. Methods As part of a multicountry demonstration study, 5,207 women 30 to 49 years of age were recruited from urban slums to undergo four cervical screening tests using the careHPV test on self-collected vaginal samples, provider-collected cervical samples, the Papanicolaou test, and VIA. All women who tested positive for any of the screening tests were evaluated with colposcopy and guided biopsies, followed by treatment if any cervical lesions were detected. The data from the 377 women who tested positive for HPV in the self-collected vaginal samples were also analyzed to assess the performance of VIA, conventional cytology, and colposcopy, as triage tests in the detection of cervical cancer and precancerous lesions. Results Nineteen percent of women who tested positive for vaginal HPV (V-HPV) also tested positive with the VIA test; cervical intraepithelial neoplasia 2+ lesions were detected in 58% of these women. In the 30 % of the women who tested positive for V-HPV with cytology triage, cervical intraepithelial neoplasia 2+ lesions were detected in 80% of these women. The colposcopy referrals for women who tested positive for V-HPV were reduced from 7.6% to 1.5% by VIA triage, and to 2.3% by cytology triage. Although the sensitivity was reduced, the positive predictive value improved after triage with VIA and cytology. Conclusion This study reflects the optimal role of VIA triaging for treatment selection of lesions among those who test positive for V-HPV in screen and treat screening programs that use an HPV test in low-resource settings.

Use of mobile phone technology to improve the quality of point-of-care testing in a low-resource setting

AIDS ◽  
2016 ◽  
Vol 30 (1) ◽  
pp. 159-161 ◽  
Author(s):  
Ilesh V. Jani ◽  
Jorge I. Quevedo ◽  
Ocean Tobaiwa ◽  
Timothy Bollinger ◽  
Nadia E. Sitoe ◽  
...  
Keyword(s):  
Mobile Phone ◽  
Point Of Care ◽  
Point Of Care Testing ◽  
Mobile Phone Technology ◽  
Low Resource ◽  
Resource Setting ◽  
Low Resource Setting

scholarly journals Quality of eyeglass prescriptions from a low-cost wavefront autorefractor evaluated in rural India: results of a 708-participant field study

2018 ◽  
Author(s):  
Nicholas J. Durr ◽  
Shivang R. Dave ◽  
Daryl Lim ◽  
Sanil Joseph ◽  
Thulasiraj D Ravilla ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Form Factor ◽  
Standard Deviation ◽  
Low Cost ◽  
Rural India ◽  
Low Resource ◽  
Resource Setting ◽  
Low Resource Setting ◽  
Significant Difference

ABSTACTAimTo assess the quality of eyeglass prescriptions provided by an affordable wavefront autorefractor operated by a minimally-trained technician in a low-resource setting.Methods708 participants were recruited from consecutive patients registered for routine eye examinations at Aravind Eye Hospital in Madurai, India, or an affiliated rural satellite vision centre. Visual acuity (VA) and patient preference were compared for eyeglasses prescribed from a novel wavefront autorefractor versus eyeglasses prescribed from subjective refraction by an experienced refractionist.ResultsMean ± standard deviation VA was 0.30 ± 0.37, −0.02 ± 0.14, and −0.04 ± 0.11 LogMAR units before correction, with autorefractor correction, and with subjective refraction correction, respectively (all differences P < 0.01). Overall, 25% of participants had no preference, 33% preferred eyeglasses from autorefractor prescriptions, and 42% preferred eyeglasses from subjective refraction prescriptions (P < 0.01). Of the 438 patients 40 years old and younger, 96 had no preference and the remainder had no statistically-significant difference in preference for subjective refraction prescriptions (51%) versus autorefractor prescriptions (49%) (P = 0.52).ConclusionsAverage VAs from autorefractor-prescribed eyeglasses were one letter worse than those from subjective refraction. More than half of all participants either had no preference or preferred eyeglasses prescribed by the autorefractor. This marginal difference in quality may warrant autorefractor-based prescriptions, given the portable form-factor, short measurement time, low-cost, and minimal training required to use the autorefractor evaluated here.SYNOPSISEyeglass prescriptions can be accurately measured by a minimally-trained technician using a low-cost wavefront autorefractor in rural India. Objective refraction may be a feasible approach to increasing eyeglass accessibility in low-resource settings.

Outcome of infants with 10 min Apgar scores of 0–1 in a low-resource setting

2021 ◽  
pp. fetalneonatal-2021-322545
Author(s):  
Thorkild Tylleskär ◽  
Francesco Cavallin ◽  
Susanna Myrnerts Höök ◽  
Nicolas J Pejovic ◽  
Clare Lubulwa ◽  
...  
Keyword(s):  
Delivery Room ◽  
Apgar Scores ◽  
Low Resource Settings ◽  
Low Resource ◽  
High Resource ◽  
Resource Setting ◽  
Low Resource Setting ◽  
Mulago National Referral Hospital ◽  
Term Newborns

BackgroundIn high-resource settings, postponing the interruption of cardiopulmonary resuscitation from 10 to 20 min after birth has been recently suggested, but data from low-resource settings are lacking. We investigated the outcome of newborns with Apgar scores of 0–1 at 10 min of resuscitative efforts in a low-resource setting.MethodsThis observational substudy from the NeoSupra trial included all 49 late preterm/full-term newborns with Apgar scores of 0–1 at 10 min of resuscitation. The study was carried out at Mulago National Referral Hospital (Kampala, Uganda) between May 2018 and August 2019. Outcome measures were mortality and hypoxic-ischaemic encephalopathy in the first week of life. All resuscitations were video recorded and daily reviewed by trial researchers.ResultsMedian duration of resuscitation was 32 min (IQR 17–37). Advanced resuscitation was provided to 21/49 neonates (43%). Overall, 48 neonates (98%) died within 2 days of life (44 in the delivery room, three on the first day and one on the second day) and one survived at 1 week with severe hypoxic-ischaemic encephalopathy.ConclusionOur study adds information from a low-resource setting to the recent evidence from high-resource settings about prolonging the resuscitation in infants with Apgar scores of 0–1 at 10 min. The vast majority died in the delivery room despite prolonged resuscitative efforts. We confirm that duration of resuscitation should be tailored to the setting, while the focus in low-resource settings should be improving the quality of antenatal and immediately after birth care.

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
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