scholarly journals Using Telemedicine to Diagnose Surgical Site Infections in Low- and Middle-Income Countries: Systematic Review (Preprint)

2019 ◽  
Author(s):  
Charlotte E J Sandberg ◽  
Stephen R Knight ◽  
Ahmad Uzair Qureshi ◽  
Samir Pathak

BACKGROUND A high burden of preventable morbidity and mortality due to surgical site infections (SSIs) occurs in low- and middle-income countries (LMICs), and most of these SSIs occur following discharge. There is a high loss to follow-up due to a wide geographical spread of patients, and cost of travel can result in delayed and missed diagnoses. OBJECTIVE This review analyzes the literature surrounding the use of telemedicine and assesses the feasibility of using mobile phone technology to both diagnose SSIs remotely in LMICs and to overcome social barriers. METHODS A literature search was performed using Medline, Embase, CINAHL, PubMed, Web of Science, the Cochrane Central Register of Controlled Trials and Google Scholar. Included were English language papers reporting the use of telemedicine for detecting SSIs in comparison to the current practice of direct clinical diagnosis. Papers were excluded if infections were not due to surgical wounds, or if SSIs were not validated with in-person diagnosis. The primary outcome of this review was to review the feasibility of telemedicine for remote SSI detection. RESULTS A total of 404 articles were screened and three studies were identified that reported on 2082 patients across three countries. All studies assessed the accuracy of remote diagnosis of SSIs using predetermined telephone questionnaires. In total, 44 SSIs were accurately detected using telemedicine and an additional 14 were picked up on clinical follow-up. CONCLUSIONS The use of telemedicine has shown to be a feasible method in remote diagnosis of SSIs. Telemedicine is a useful adjunct for clinical practice in LMICs to decrease loss to postsurgical follow-up.

10.2196/13309 ◽  
2019 ◽  
Vol 7 (8) ◽  
pp. e13309 ◽  
Author(s):  
Charlotte E J Sandberg ◽  
Stephen R Knight ◽  
Ahmad Uzair Qureshi ◽  
Samir Pathak

Background A high burden of preventable morbidity and mortality due to surgical site infections (SSIs) occurs in low- and middle-income countries (LMICs), and most of these SSIs occur following discharge. There is a high loss to follow-up due to a wide geographical spread of patients, and cost of travel can result in delayed and missed diagnoses. Objective This review analyzes the literature surrounding the use of telemedicine and assesses the feasibility of using mobile phone technology to both diagnose SSIs remotely in LMICs and to overcome social barriers. Methods A literature search was performed using Medline, Embase, CINAHL, PubMed, Web of Science, the Cochrane Central Register of Controlled Trials and Google Scholar. Included were English language papers reporting the use of telemedicine for detecting SSIs in comparison to the current practice of direct clinical diagnosis. Papers were excluded if infections were not due to surgical wounds, or if SSIs were not validated with in-person diagnosis. The primary outcome of this review was to review the feasibility of telemedicine for remote SSI detection. Results A total of 404 articles were screened and three studies were identified that reported on 2082 patients across three countries. All studies assessed the accuracy of remote diagnosis of SSIs using predetermined telephone questionnaires. In total, 44 SSIs were accurately detected using telemedicine and an additional 14 were picked up on clinical follow-up. Conclusions The use of telemedicine has shown to be a feasible method in remote diagnosis of SSIs. Telemedicine is a useful adjunct for clinical practice in LMICs to decrease loss to postsurgical follow-up.


Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 1038
Author(s):  
Ana Carolina B. Leme ◽  
Sophia Hou ◽  
Regina Mara Fisberg ◽  
Mauro Fisberg ◽  
Jess Haines

Research comparing the adherence to food-based dietary guidelines (FBDGs) across countries with different socio-economic status is lacking, which may be a concern for developing nutrition policies. The aim was to report on the adherence to FBDGs in high-income (HIC) and low-and-middle-income countries (LMIC). A systematic review with searches in six databases was performed up to June 2020. English language articles were included if they investigated a population of healthy children and adults (7–65 years), using an observational or experimental design evaluating adherence to national FBDGs. Findings indicate that almost 40% of populations in both HIC and LMIC do not adhere to their national FBDGs. Fruit and vegetables (FV) were most adhered to and the prevalence of adhering FV guidelines was between 7% to 67.3%. HIC have higher consumption of discretionary foods, while results were mixed for LMIC. Grains and dairy were consumed below recommendations in both HIC and LMIC. Consumption of animal proteins (>30%), particularly red meat, exceeded the recommendations. Individuals from HIC and LMIC may be falling short of at least one dietary recommendation from their country’s guidelines. Future health policies, behavioral-change strategies, and dietary guidelines may consider these results in their development.


2021 ◽  
Vol 33 (S1) ◽  
pp. 33-33
Author(s):  
Clarissa Giebel ◽  
Bwire Ivan ◽  
Maria Isabel Zuluaga ◽  
Suresh Kumar ◽  
Mark Gabbay ◽  
...  

Background:The pandemic has put a huge strain on people’s mental health, with varying restrictions affecting people’s lives. Little is known how the pandemic affects older adults’ mental health, particularly those living in low- and middle-income countries (LMICs) where restrictions are affecting people’s access to basic necessities. Thus, the aim of this 3-country study was to understand the long- term impacts of the pandemic on the mental well-being of older adults with and without dementia in LMICs.Methods:We are collecting 30 baseline and 15 follow-up interviews with older adults (aged 60+), people with dementia, and family carers in Colombia, India, and Uganda, as well as a baseline and follow-up focus group with health and social are professionals in each country. Interviews are conducted remotely over the phone due to pandemic restrictions, with data collection taking place between March and July 2021. Transcripts are translated into English before being analysed using thematic analysis.Results:To date, we have completed close to 90 baseline interviews and 3 focus groups with health and social care professionals. Analysis is ongoing, but findings are capturing the detrimental second wave in India and follow-up interviews will capture the longitudinal impacts on mental health.Conclusions:Whilst vaccines are starting to be rolled out in LMICs, albeit at different rates, the virus will likely take much longer to be somewhat managed in LMICs. This leaves more room for people’s physical as well as mental health to be impacted by the restrictions, and with often limited mental health service coverage, it is all the more important o understand the impact of the pandemic on older people’s mental health.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
I Fitzpatrick ◽  
D Byrne ◽  
J Cranwell ◽  
A Gilmore

Abstract Background There is clear evidence that exposure to tobacco is linked to smoking uptake. The economic and social burden of diseases associated with smoking is particularly high in low-and middle-income countries, where smoking uptake is high and exposure to tobacco use and branded content is widespread. Streamed content exhibits consistently higher levels of tobacco content than broadcast media and these levels have increased. The prevalence of smoking and tobacco content in video-on-demand (VOD) services is troubling given their popularity with youth audiences and the ease with which content can be accessed by children. This is because barriers to youth consumption that exist for film or broadcast media, including content gatekeepers, are absent. Methods The most popular VOD series from 10 low- and middle-income countries (Bangladesh, Brazil, China, India, Indonesia, Mexico, Pakistan, Philippines, Ukraine and Vietnam) were identified based on demand expressions and coded for individual depictions of tobacco. 18 series were analysed, representing a mix of international content in several languages. 111 episodes, totalling 81.4 hours of coded content, were analysed for tobacco depictions and characterisation of smoking characters. Results Tobacco content was prevalent and particularly prominent in non-English language series, where readily identifiable “stars” frequently partook in smoking. Cigarettes dominated tobacco imagery, with other forms (pipes and electronic nicotine delivery systems) rarely appearing. Notably, there were several incidents featuring well-known brands. Given that access to VOD services is difficult to moderate, youth audiences can easily access programming featuring high levels of tobacco use by identifiable characters, played by well-known actors. A lack of control regarding consumption of streamed content means that it is extremely important for content producers like Netflix and Amazon to ensure VOD content is suitable for youth audiences. Key messages Tobacco content in video-on demand services is increasing. Tobacco exposure is linked to smoking uptake.


2017 ◽  
Vol 3 (2_suppl) ◽  
pp. 18s-18s
Author(s):  
Vanessa J. Eaton ◽  
Megan K. Kremzier ◽  
Doug Pyle

Abstract 28 Background: The global burden of cancer is growing in low- and middle-income countries where availability of specialists to treat cancer is acutely low. To detect cancer earlier, patients must be educated about their risk for cancer and be screened when appropriate. In response to a growing need for cancer education in primary health care, ASCO International created the Cancer Control in Primary Care course, which was piloted in 2015. The purpose of the program is to increase the knowledge of primary health workers so as to recognize signs and symptoms of cancer, increase their ability to talk with patients about their risk, and to know how and when to refer patients for additional screening or diagnostic testing. Methods: ASCO collects data from participants in two stages: an on-site evaluation and a follow-up survey 12 months after the workshop. The survey instruments include questions about practice changes, learning objectives, and demographic information. Results: Follow-up surveys have been conducted for four courses. Ninety-three percent of respondents have reported that they made practice changes after the course. In addition, 90% reported that communication with patients about their risk for cancer had increased, 76% reported that they are screening patients for cancer more than before, and 74% reported that they have worked with specialists to plan treatment for their patients with cancer. Conclusion: Results of the Cancer Control in Primary Care course are positive, and ASCO will continue to collaborate with society and institutional partners to train primary health workers around the world to raise awareness of cancer. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST No COIs from the authors.


AIDS ◽  
2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Elise M. Frijters ◽  
Lucas E. Hermans ◽  
Annemarie M.J. Wensing ◽  
Walter L.J.M. Devillé ◽  
Hugo A. Tempelman ◽  
...  

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Christina Daskalopoulou ◽  
Yu-Tzu Wu ◽  
William Pan ◽  
Iago Giné Vázquez ◽  
Martin Prince ◽  
...  

AbstractSarcopenia and sarcopenic obesity research in low- and middle- income countries (LMICs) is limited. We investigated sarcopenia and sarcopenic obesity prevalence and sociodemographic, bio-clinical and lifestyle factors in LMICs settings. For the purposes of this study, the 10/66 Dementia Research Group follow-up wave information from individuals aged 65 and over in Cuba, Dominican Republic, Peru, Mexico, Puerto Rico, China, was employed and analysed (n = 8.694). Based on indirect population formulas, we calculated body fat percentage (%BF) and skeletal muscle mass index (SMI). Sarcopenia prevalence ranged from 12.4% (Dominican Republic) to 24.6% (rural Peru); sarcopenic obesity prevalence ranged from 3.0% (rural China) to 10.2% (rural Peru). Odds ratios (OR) with 95% confidence intervals (CI) for sarcopenia were higher for men 2.82 (2.22–3.57) and those with higher %BF 1.08 (1.07–1.09), whereas higher number of assets was associated with a decreased likelihood 0.93 (0.87–1.00). OR of sarcopenic obesity were higher for men 2.17 (1.70–2.76), those reporting moderate alcohol drinking 1.76 (1.21–2.57), and those with increased number of limiting impairments 1.54 (1.11–2.14). We observed heterogeneity in the prevalence of sarcopenia and sarcopenic obesity in the 10/66 settings. We also found a variety of factors to be associated with those. Our results reveal the need for more research among the older population of LMICs.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ashwini Kamath Mulki ◽  
Mellissa Withers

Abstract Background Screening for HPV has led to significant reductions in cervical cancer deaths in high-income countries. However, the same results have not been achieved in low- and middle-income countries (LMICs). HPV self-sampling is a novel approach that could improve screening rates. Methods This study’s objective is to summarize the recent literature on HPV self-sampling in LMICs, focusing on sensitivity/specificity, and feasibility/acceptability of self-sampling compared to traditional screening methods. We conducted a PubMed search for articles published in English within the last 10 years on self-sampling in LMICs. Results Fifty eligible articles from 26 countries were included, 19 of which came from sub-Saharan Africa and 18 from Latin America/Caribbean. Seven studies examined sensitivity, with five reporting rates higher than 91%. Six reported on specificity, which was also very high at 86–97.8%. Six studies examined self-sampling concordance with provider-collected sampling, with concordance rates ranging from 87 to 97.5%. A total of 38 studies examined the feasibility/acceptability of HPV self-sampling. Participation rates were very high in all studies, even when self-sampling was done at participants’ homes (over 89% participation). Overall, participants reported that HPV self-sampling was easy to perform (75–97%, 18 studies), painless (60–90%, nine studies), and preferred over provider-collected sampling (57–100%, 14 studies). Eight studies reported follow-up rates for participants who completed self-sampling; however, these rates varied widely-from 13.7 to 90%. The major benefits of self-sampling include convenience of screening from home, less embarrassment, and less travel. Improved education and awareness of self-sampling, combined with support from community health workers, could reduce perceptions of self-sampling being inferior to provider-collected sampling. Improving follow-up of abnormal results and improving linkages to treatment are also essential. Conclusion Our literature review highlights HPV self-sampling is a well-performing test that shows promise in terms of expanding screening efforts for the prevention of cervical cancer-related deaths in LMICs.


PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243464
Author(s):  
Anna Tupetz ◽  
Kaitlyn Friedman ◽  
Duan Zhao ◽  
Huipeng Liao ◽  
Megan Von Isenburg ◽  
...  

Injuries are a leading cause of death and disability among children. Numerous injury prevention strategies have been successful in high-income countries, but the majority of unintentional injuries happen to children living in low- and middle-income countries (LMICs). This project aims to delineate the childhood injury prevention initiatives in LMICs. For inclusion, peer-reviewed articles needed to address unintentional injury, include children <18, assess a prevention-related intervention, contain a control group, and be published after 1988. Two pairs of reviewers evaluated articles independently to determine study eligibility. 74 articles were included. 30 studies addressed road traffic injuries, 11 drowning, 8 burns, 3 falls, 8 poisonings, and 21 an unspecified injury type. The findings show positive effects on injury outcome measures following educational interventions, the need for longer follow-up periods after the intervention, the need for effectiveness trials for behavior change, and the need for an increase in injury prevention services in LMICs. This is the first systematic review to summarize the prevention initiatives for all types of childhood unintentional injuries in LMICs. Increased attention and funding are required to go beyond educational initiatives with self-reported measures and little follow-up time to robust interventions that will reduce the global burden of unintentional injuries among children.


2014 ◽  
Vol 13 (1) ◽  
pp. 12-23
Author(s):  
Shanta Kumar Shrestha ◽  
Joanne Travaglia ◽  
Chandni Joshi

Background: Good quality antenatal care is one of the recommended strategies to reduce maternal and neonatal mortality and improve health outcomes of the mother and her child. The utilization and quality of antenatal care in low and middle income countries is not well documented and hence deserves further study. This is a literature review of antenatal care in low and middle income countries on its utilization, the barriers and facilitators, and the available evidence of effectiveness and quality of antenatal careMethod: A systematic review of the published literature was conducted which also included published systematic reviews. Studies published between 2002 and 2012 were identified by searching Medline, EMBASE and CINAHL. This was supplemented by papers provided by international advisors from grey literature and snowballing search of reference list of all included papers. Only English language studies in low and middle income countries on antenatal care were includedResults: Twenty-three papers met the inclusion criteria. Health-facility based studies reported near universal access to antenatal care, which was not the case for community based studies. Women received at least one antenatal visit but fewer women had the recommended number of visits. Socioeconomic status and women’s education were the most frequent and the strongest predictors of antenatal care use. Antenatal care promoted the use of skilled birth attendant at delivery, but did not contribute to reductions in maternal mortality and stillbirths. The quality of care was reported as unsatisfactory; major issues being poor client-provider relationship and inferior quality of counselling.Conclusion: In order to increase the utilization of antenatal care, in the short term, less educated women from socioeconomically disadvantaged households require targeting. Long-term improvements require a focus on improving female education. Further research is needed to explore the quality of antenatal care in order to validate its effect on maternal and child health.DOI: http://dx.doi.org/10.3126/hprospect.v13i1.11341 Health Prospect Vol.13(1) 2014: 12-23


Sign in / Sign up

Export Citation Format

Share Document