scholarly journals A clinical algorithm for triaging patients with significant lymphadenopathy in primary health care settings in Sudan

2013 ◽  
Vol 5 (1) ◽  
Author(s):  
Eltahir A.G. Khalil ◽  
Imad A. El Hag ◽  
Kamal E. Elsiddig ◽  
Mohamed E.M.O. Elsafi ◽  
Mona E.E. Elfaki ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Lymph Node ◽  
Sensitivity And Specificity ◽  
Predictor Variables ◽  
Reduced Model ◽  
Node Number ◽  
Major Health Problem ◽  
Clinical Algorithm ◽  
Primary Health

Background: Tuberculosis is a major health problem in developing countries. The distinction between tuberculous lymphadenitis, non-specific lymphadenitis and malignant lymph node enlargement has to be made at primary health care levels using easy, simple and cheap methods.Objective: To develop a reliable clinical algorithm for primary care settings to triage cases ofnon-specific, tuberculous and malignant lymphadenopathies.Methods: Calculation of the odd ratios (OR) of the chosen predictor variables was carried out using logistic regression. The numerical score values of the predictor variables were weighed against their respective OR. The performance of the score was evaluated by the ROC (ReceiverOperator Characteristic) curve.Results: Four predictor variables; Mantoux reading, erythrocytes sedimentation rate (ESR),nocturnal fever and discharging sinuses correlated significantly with TB diagnosis and were included in the reduced model to establish score A. For score B, the reduced model included Mantoux reading, ESR, lymph-node size and lymph-node number as predictor variables for malignant lymph nodes. Score A ranged 0 to 12 and a cut-off point of 6 gave a best sensitivity and specificity of 91% and 90% respectively, whilst score B ranged -3 to 8 and a cut-off point of3 gave a best sensitivity and specificity of 83% and 76% respectively. The calculated area underthe ROC curve was 0.964 (95% CI, 0.949 – 0.980) and -0.856 (95% CI, 0.787 ‑ 0.925) for scores Aand B respectively, indicating good performance.Conclusion: The developed algorithm can efficiently triage cases with tuberculous andmalignant lymphadenopathies for treatment or referral to specialised centres for furtherwork-up.

scholarly journals Early diagnosis of neonatal sepsis in primary health care unit

2015 ◽  
Vol 14 (2) ◽  
pp. 169-172 ◽  
Author(s):  
Aditya Prasad Sarkar ◽  
Goutam Dhar ◽  
Munmun Das Sarkar ◽  
Tapan Kumar Ghosh ◽  
Sulekha Ghosh
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Sensitivity And Specificity ◽  
Neutrophil Count ◽  
Neonatal Sepsis ◽  
Comparison Group ◽  
Medical Science ◽  
Standard Test ◽  
Haematological Parameters ◽  
Primary Health

Aim: The aim of the study is to find out the role of common haematological parameters along with micro-ESR, I/T ratio in diagnosis of neonatal sepsis for initiating early management.Methods: This is a descriptive study consisting of 35 neonates admitted at a sophisticated institute with clinical suspicion of septicaemia along with 40 neonates as the comparison group. The neonatal haematological parameters including total leucocytes count, absolute neutrophil count, immature neutrophil count, I/T ratio, platelet count were measured in all the neonates. Micro-ESR was measured as a bed side test. CRP was also measured using slide agglutination method and the results were compared with turbidimetric method. Blood culture was done as a gold standard test for sepsis. Micro-ESR more than age of the patient in days +3 mm in 1st hour was considered significant for sepsis. I/T ratio more than or equal to 0.2 was considered positive for sepsis.Results: The study revealed that micro-ESR and I/T ratio were significantly higher (p<0.001) in suspected cases of septicaemia as compared to the neonates in the comparison group. Sensitivity and specificity of micro-ESR were 87.09% and 75.0% respectively. Sensitivity and specificity of I/T ratio were 93.54% and 95% respectively.Conclusion: Micro-ESR and I/T ratio can be used effectively as cheap and simple tests to screen for septicaemia in neonate which is possible even in a primary health care centre.Bangladesh Journal of Medical Science Vol.14(2) 2015 p.169-172

scholarly journals Prediabetes Screening with American Diabetes Association (ADA) Scoring in the Primary Health Care Yogyakarta (Development And Validation Of Scoring Systems)

2020 ◽  
Vol 3 (2) ◽  
pp. 22
Author(s):  
Yaltafit Abror Jeem ◽  
Hari Koesnanto ◽  
Muhammad Robikhul Ikhsan
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Sensitivity And Specificity ◽  
American Diabetes Association ◽  
Scoring Systems ◽  
Tolerance Test ◽  
Screening Methods ◽  
Oral Glucose ◽  
Scoring Method ◽  
Primary Health

Background: Numerous studies have shown  the increasing of prediabetes incidence from the time being. Some of the prediabetes screening methods that can be performed at primary health care were American Diabetes Association (ADA) scoring for prediabetes. However, there was no data that describes the validity and applicability of the ADA scoring on prediabetes patients in Indonesia. Objective: To discribe prediabetes screening and to find out the applicability of the ADA scoring method in Yogyakarta primary health care. Method: The diagnostic test by scoring system of the ADA questionnaire was compared with OGTT (oral glucose tolerance test) as the gold standard. The subjects were patients of primary health care in Yogyakarta who fulfill the inclusion and exclusion criteria. Result: The subjects were 279 respondents with 227 female  (81.4%) and 52 male patients (18.6%). The mean age of the study subjects was 50.4 years (SD 12.81). The sensitivity and specificity of the scoring method of ADA was 61% and 71%. This could be influenced by the difference in BMI standard as one of the scoring items. Conclusion: Prediabetes prevalence was 11.1% in the study population. The sensitivity and specificity of the scoring method of ADA is 61% and 71%. The scoring method of ADA could not be used in primary health care.

Non-Fatal Deliberate Self-Harm in Three Remote Indigenous Communities in Far North Queensland, Australia

Crisis ◽  
2019 ◽  
Vol 40 (6) ◽  
pp. 422-428 ◽  
Author(s):  
Chris Rouen ◽  
Alan R. Clough ◽  
Caryn West
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Care Center ◽  
Indigenous Communities ◽  
Indigenous Australians ◽  
Deliberate Self Harm ◽  
Health Care Center ◽  
Far North ◽  
Primary Health ◽  
Self Harm

Abstract. Background: Indigenous Australians experience a suicide rate over twice that of the general population. With nonfatal deliberate self-harm (DSH) being the single most important risk factor for suicide, characterizing the incidence and repetition of DSH in this population is essential. Aims: To investigate the incidence and repetition of DSH in three remote Indigenous communities in Far North Queensland, Australia. Method: DSH presentation data at a primary health-care center in each community were analyzed over a 6-year period from January 1, 2006 to December 31, 2011. Results: A DSH presentation rate of 1,638 per 100,000 population was found within the communities. Rates were higher in age groups 15–24 and 25–34, varied between communities, and were not significantly different between genders; 60% of DSH repetitions occurred within 6 months of an earlier episode. Of the 227 DSH presentations, 32% involved hanging. Limitations: This study was based on a subset of a larger dataset not specifically designed for DSH data collection and assesses the subset of the communities that presented to the primary health-care centers. Conclusion: A dedicated DSH monitoring study is required to provide a better understanding of DSH in these communities and to inform early intervention strategies.

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