scholarly journals A Lung Ultrasound Scanning Technique for Children and Adults in Low-Resource Settings: Preliminary Experiences in Sub-Saharan Africa

2021 ◽  
Author(s):  
Matthew Fentress ◽  
Phillip Ezibon ◽  
Akuot Bulabek ◽  
Carla Schwanfelder ◽  
David Schrift ◽  
...  
Keyword(s):  
Lung Ultrasound ◽  
Sub Saharan Africa ◽  
Ultrasound Scanning ◽  
Resource Limited Settings ◽  
Scanning Technique ◽  
Resource Limited ◽  
Adults And Children ◽  
Chest X Ray ◽  
Sub Saharan ◽  
Limited Setting

Lung ultrasound is increasingly used as a diagnostic tool for pulmonary pathologies by nonspecialist clinicians in resource-limited settings where chest X-ray may not be readily available. However, the optimal technique for lung ultrasound in these settings is not yet clearly defined. We describe here our experience of implementing a standardized, focused six-zone, 12-view lung ultrasound scanning technique with a high-frequency probe in both adults and children in a resource-limited setting in sub-Saharan Africa. Our experience suggests that this may be a feasible technique to rapidly introduce lung ultrasound to new learners that can be adapted to emergency or outbreak settings. However, research is needed to determine how this technique compares with clinical examination and other available tests for the diagnosis of pathology commonly encountered in resource-limited settings.

scholarly journals International Radiotherapy Referrals From Rural Rwanda: Implementation Processes and Early Clinical Outcomes

2018 ◽  
pp. 1-12
Author(s):  
Maud Hanappe ◽  
Lowell T. Nicholson ◽  
Shekinah N.C. Elmore ◽  
Alexandra E. Fehr ◽  
Jean Bosco Bigirimana ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Head And Neck ◽  
Low Income ◽  
Cancer Care ◽  
Sub Saharan Africa ◽  
Resource Limited Settings ◽  
Cancer Centre ◽  
Resource Limited ◽  
Centre Of Excellence ◽  
Sub Saharan

Purpose Low- and middle-income countries disproportionately comprise 65% of cancer deaths. Cancer care delivery in resource-limited settings, especially low-income countries in sub-Saharan Africa, is exceedingly complex, requiring multiple modalities of diagnosis and treatment. Given the vast human, technical, and financial resources required, access to radiotherapy remains limited in sub-Saharan Africa. Through 2017, Rwanda has not had in-country radiotherapy services. The aim of this study was to describe the implementation and early outcomes of the radiotherapy referral program at the Butaro Cancer Centre of Excellence and to identify both successful pathways and barriers to care. Methods Butaro District Hospital is located in a rural area of the Northern Province and is home to the Butaro Cancer Centre of Excellence. We performed a retrospective study from routinely collected data of all patients with a diagnosis of cervical, head and neck, or rectal cancer between July 2012 and June 2015. Results Between 2012 and 2015, 580 patients were identified with these diagnoses and were potential candidates for radiation. Two hundred eight (36%) were referred for radiotherapy treatment in Uganda. Of those referred, 160 (77%) had cervical cancer, 31 (15%) had head and neck cancer, and 17 (8%) had rectal cancer. At the time of data collection, 101 radiotherapy patients (49%) were alive and had completed treatment with no evidence of recurrence, 11 (5%) were alive and continuing treatment, and 12 (6%) were alive and had completed treatment with evidence of recurrence. Conclusion This study demonstrates the feasibility of a rural cancer facility to successfully conduct out-of-country radiotherapy referrals with promising early outcomes. The results of this study also highlight the many challenges and lessons learned in providing comprehensive cancer care in resource-limited settings.

Diagnosis and management of antiretroviral-therapy failure in resource-limited settings in sub-Saharan Africa: challenges and perspectives

2010 ◽  
Vol 10 (1) ◽  
pp. 60-65 ◽  
Author(s):  
Anthony D Harries ◽  
Rony Zachariah ◽  
Joep J van Oosterhout ◽  
Steven D Reid ◽  
Mina C Hosseinipour ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Sub Saharan Africa ◽  
Therapy Failure ◽  
Resource Limited Settings ◽  
Diagnosis And Management ◽  
Resource Limited ◽  
Sub Saharan

scholarly journals EDITORIAL: COVID-19: Rebooting pharmacy education in resource-limited settings

2021 ◽  
pp. 67-70
Author(s):  
Jennie Lates ◽  
Dan Kibuule
Keyword(s):  
Health Systems ◽  
World Health Organisation ◽  
Pharmacy Education ◽  
Sub Saharan Africa ◽  
World Health ◽  
Resource Limited Settings ◽  
Non Communicable Diseases ◽  
High Burden ◽  
Resource Limited ◽  
Sub Saharan

Globally, the COVID-19 pandemic has aggravated inequalities in access to quality pharmacy education, particularly in resource-limited settings in Africa (Engle, 2020; Fuller et al., 2020). This is a serious concern for Africa especially, given that sub-Saharan Africa ranks lowest on the global pharmaceutical workforce index and has a disproportionately high burden of infectious and non-communicable diseases, combined with weak health systems (World Health Organisation [WHO], 2013; Bates et al., 2018).

scholarly journals Lung Ultrasound for Initial Diagnosis and Subsequent Monitoring of Aspiration Pneumonia in Elderly in Home Medical Care Setting

2019 ◽  
Vol 5 ◽  
pp. 233372141985844
Author(s):  
Hirofumi Namiki ◽  
Tadashi Kobayashi
Keyword(s):  
Aspiration Pneumonia ◽  
Care Setting ◽  
Lung Ultrasound ◽  
Initial Diagnosis ◽  
Resource Limited Settings ◽  
X Ray ◽  
Resource Limited ◽  
X Ray Imaging ◽  
Chest X Ray ◽  
B Lines

The number of aspiration pneumonia cases has increased in recent times. A definitive diagnosis of aspiration pneumonia is difficult in resource-limited settings where radiological equipment is unavailable. We report the initial diagnosis and subsequent monitoring of aspiration pneumonia in a home medical care setting. An 88-year-old Japanese male presented an acute onset of dyspnea, fever, and productive cough. At home, lung ultrasound displayed pleural effusion along with B-lines and subpleural consolidations. Upon admission, tests revealed increased total leucocyte counts with left-shifted neutrophils, elevated C-reactive protein levels, and positive sputum Gram stain. Chest X-ray imaging and computed tomography (CT) showed bibasilar infiltrates and wall thickening in the left S10 bronchi. The patient was diagnosed with aspiration pneumonia and treated with an antibiotic. After a 10-day hospitalization, lung ultrasound showed some remaining B-lines and disappearance of pleural effusion and subpleural consolidation. Chest X-ray image was normal, and CT revealed pleural abnormality and disappearance of bibasilar infiltrates, consistent with the ultrasound findings. Aspiration pneumonia develops with various clinical signs. However, diagnosis using chest X-ray imaging or CT in resource-limited settings is difficult. Ultrasound might allow physicians to make more accurate judgments, particularly while monitoring aspiration pneumonia following initial diagnosis in resource-limited settings.

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