Knowledge evaluation of clinical case management in IMNCI among trained and untrained accredited social health activists in two districts of Uttar Pradesh, India

IMNCI was launched in Uttar Pradesh, India in 2005 for integrated management of under 5 children. Success of IMNCI depends to a large scale on the performance of ASHAs. The performance of ASHAs will in turn depend on their knowledge and skills. There is a paucity of research describing and comparing the knowledge of ASHAs who are trained in IMNCI to those who are not trained. The present study was done to compare and describe the knowledge of non-trainees and the follow up knowledge of the trainees regarding clinical case management of IMNCI in two districts of Uttar Pradesh of India. This study indirectly assessed the effects of IMNCI training in the improvement of knowledge of health care personnel. It was a Cross-sectional comparative study conducted in two districts Kanpur & Kannauj of Uttar Pradesh and specifically Shivrajpur and Jalalabad blocks of Kanpur and Kannauj respectively over a duration of one year from March 2019 to February 2020. hivrajpur block of Kanpur had 122 ASHAs and none of them had received 10 days IMNCI/CCSP training. Jalalabad block of Kannauj had 153 ASHAs and all of them had received 10 days IMNCI/CCSP training(as per NRHM UP data). 108 ASHAs from Kanpur and 94 ASHAs from Kannauj participated in the study. CHI-Square test was done to test whether the finding that knowledge difference between the ASHAs of Kanpur Nagar and Kannauj was real or merely a chance finding. The results were pooled form the two districts against each of the 26 variables. The proportion of trained in IMNCI module and untrained was calculated. Results show that clinical case management of IMNCI training status had an association with knowledge score. This study testified much higher knowledge score among trained personnel than their counterparts.

ECMO-Supported Ablation and Percutaneous Repair of Severe Valvulopathy: A Winning Combination in a Complex Clinical Case

In this case report, we describe a complex case of a 67-year-old patient who was suffering from acute heart failure with electrical storm. Clinical case management was based on an integrated approach comprising two different procedures that were complementary and synergistic, and that allowed the patient to reach acute stabilization and to demonstrate mid-term clinical improvement. Complex clinical settings, such as electrical and hemodynamic instability, require complex solutions. The use of an integrated approach that allows physiopathological mechanisms to work together may be beneficial for these patients.

Comparison of capillary and venous blood for malaria detection using two PCR-based assays in febrile patients in Sierra Leone

Background Rapid and sensitive diagnostics are critical tools for clinical case management and public health control efforts. Both capillary and venous blood are currently used for malaria detection and while diagnostic technologies may not be equally sensitive with both materials, the published data on this subject are scarce and not conclusive. Methods Paired clinical samples of venous and capillary blood from 141 febrile individuals in Bo, Sierra Leone, were obtained between January and May 2019 and tested for the presence of Plasmodium parasites using two multiplexed PCR assays: the FilmArray-based Global Fever Panel (GFP) and the TaqMan-based Malaria Multiplex Sample Ready (MMSR) assay. Results No significant differences in Plasmodium parasite detection between capillary and venous blood for both assays were observed. The GFP assay was more sensitive than MMSR for all markers that could be compared (Plasmodium spp. and Plasmodium falciparum) in both venous and capillary blood. Conclusions No difference was found in malaria detection between venous and capillary blood using two different PCR-based detection assays. This data gives support for use of capillary blood, a material which can be obtained easier by less invasive methods, for PCR-based malaria diagnostics, independent of the platform.

Comparison of capillary and venous blood for malaria detection using two PCR based assays in febrile patients in Sierra Leone.

Background. Rapid and sensitive diagnostics are critical tools for clinical case management and public health control efforts. Both capillary and venous blood are currently used for malaria detection and while diagnostic technologies may not be equally sensitive with both materials, the published data on this subject are scarce and not conclusive.Methods. Paired clinical samples of venous and capillary blood from 141 febrile individuals in Bo, Sierra Leone, were obtained between January and May 2019 and tested for the presence of Plasmodium parasites using two multiplexed PCR assays: the FilmArray-based Global Fever Panel (GFP) and the TaqMan-based Malaria Multiplex Sample Ready (MMSR) assay.Results. We observed no significant differences in Plasmodium parasite detection between capillary and venous blood for both assays. The GFP assay was more sensitive than MMSR for all markers that could be compared (Plasmodium spp. and P. falciparum) in both venous and capillary blood.Conclusions. No difference was found in malaria detection between venous and capillary blood using two different PCR-based detection assays. This data gives support for use of capillary blood, a material which can be obtained easier by less invasive methods, for PCR-based malaria diagnostics, independent of the platform.

Comparison of capillary and venous blood for malaria detection using two PCR based assays in febrile patients in Sierra Leone.

Background. Malaria parasites infect over 200 million people and cause more than 400,000 deaths each year. Rapid and sensitive diagnostics are critical tools for clinical case management and public health control efforts. Both capillary and venous blood are currently used for malaria detection and while diagnostic technologies may not be equally sensitive with both materials, the published data on this subject are scarce and not conclusive.Methods. Paired clinical samples of venous and capillary blood from 141 febrile individuals in Bo, Sierra Leone, were obtained between January and May 2019 and tested for the presence of Plasmodium parasites using two multiplexed PCR assays: the FilmArray-based Global Fever Panel (GFP) and the TaqMan-based Malaria Multiplex Sample Ready (MMSR) assay.Results. We observed no significant differences in Plasmodium parasite detection between capillary and venous blood for both assays. The GFP assay was more sensitive than MMSR for all markers that could be compared (Plasmodium spp. and P. falciparum) in both venous and capillary blood.Conclusions. No difference was found in malaria detection between venous and capillary blood using two different PCR-based detection assays. This data gives support for use of capillary blood, a material which can be obtained easier by less invasive methods, for PCR-based malaria diagnostics, independent of the platform.

Leveraging investments in Ebola preparedness for COVID-19 in Sub-Saharan Africa

The emergence of SARS-CoV-2 in China and transmission to more than 80 territories worldwide, including nine countries in Africa, presents a delicate situation for low-resource settings. Countries in Eastern and Central Africa have been on high alert since mid-2018 in anticipation of regional spread of the Ebola virus from the Democratic Republic of Congo. Significant investment has been made to support enhanced surveillance at point of entry and hospitals, infection control practices, clinical case management, and clinical research. With a new threat on the horizon, African countries have an opportunity to leverage the existing capacities for Ebola preparedness to brace for the imminent threat.