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https://www.readbyqxmd.com/read/28092934/visceral-leishmaniasis-treatment-outcome-and-its-determinants-in-northwest-ethiopia
#1
Berihun Assefa Dachew, Getachew Mebrahtu Welay, Kefyalew Addis Alene
Background: Poor treatment outcomes of visceral leishmaniasis (VL) are responsible for a high mortality rate in resource limited setting like Ethiopia. This study aimed at evaluating the magnitude and identifying determinants of poor VL treatment outcome in Kahsay Abera Hospital, Northwest Ethiopia. Methods: A hospital based retrospective follow up study was conducted among 595 VL patients who were admitted to Kahsay Abera Hospital, Northwest Ethiopia from October 2010 to April 2013...
December 28, 2016: Epidemiology and Health
https://www.readbyqxmd.com/read/28088757/challenges-in-neonatal-transport-in-jamaica-a-resource-limited-setting
#2
Salome Henry, Helen Trotman
AIM: This study aimed to determine challenges associated with neonatal transport in Jamaica, a resource-limited setting. METHODS: This was a prospective descriptive study of neonates transported to the University Hospital of the West Indies (UHWI) over a 15 month period. Data on the clinical status of the neonates before, during and at the end of transport, as well as on accompanying staff and equipment, were collected. Neonatal demographics, reason for transfer and outcome at 48 h and at discharge were also collected...
January 14, 2017: Journal of Tropical Pediatrics
https://www.readbyqxmd.com/read/28088186/concentration-of-fine-needle-aspirates-similar-to-molecular-method-improves-sensitivity-of-the-diagnosis-of-tuberculous-lymphadenitis-in-addis-ababa-ethiopia
#3
Olifan Zewdie, Tamrat Abebe, Adane Mihret, Eyob Hirpa, Gobena Ameni
BACKGROUND: Tuberculous lymphadenitis (TBLN) diagnosis has been a true challenge solely by clinical evidence in developing countries, due to limited the diagnostic facility on hand. However, the availability and affordability of available diagnostic tools in resource-limited settings like Ethiopia necessitates the quest for other techniques with added value over direct Z-N microscopy. Therefore, we aimed at to assess whether the concentration of lymph node aspirate similarly improves the detection rate of tuberculous lymphadenitis or not...
January 14, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28088027/an-alternative-strategy-to-western-blot-as-a-confirmatory-diagnostic-test-for-hiv-infection
#4
Xia Feng, Jibao Wang, Zhiyun Gao, Yu Tian, Ling Zhang, Huichao Chen, Tong Zhang, Lin Xiao, Jun Yao, Wenge Xing, Maofeng Qiu, Yan Jiang
BACKGROUND: In China, western blot (WB) is the recommended procedure for the diagnosis of HIV infection. However, this technique is time consuming and labor intensive, and its complexity restricts wide application in resource-limited regions. OBJECTIVE: The aim of this study was to evaluate the efficacy of a dry blood spots (DBS)-urine paired enzyme-linked immunosorbent assay (ELISA) test, instead of WB, for HIV antibody detection. STUDY DESIGN: Plasma, DBS, and urine samples were collected from 1213 subjects from different populations...
December 21, 2016: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
https://www.readbyqxmd.com/read/28086955/evaluation-of-the-xpert%C3%A2-mtb-rif-assay-and-microscopy-for-the-diagnosis-of-mycobacterium-tuberculosis-in-namibia
#5
Rooyen T Mavenyengwa, Emma Shaduka, Innocent Maposa
BACKGROUND: Tuberculosis (TB) kills approximately two million people and infects around nine million worldwide annually. Its proper management, especially in resource-limited settings, has been hindered by the lack of rapid and easy-to-use diagnostic tests. Sputum smear microscopy remains the cheapest, readily available diagnostic method but it only identifies less than half of the patients with a HIV/TB co-infection because the bacilli would have disseminated from the lungs to other areas of the body...
January 11, 2017: Infectious Diseases of Poverty
https://www.readbyqxmd.com/read/28086929/early-virological-failure-and-hiv-drug-resistance-in-ugandan-adults-co-infected-with-tuberculosis
#6
Amrei von Braun, Christine Sekaggya-Wiltshire, Alexandra U Scherrer, Brian Magambo, Andrew Kambugu, Jan Fehr, Barbara Castelnuovo
PURPOSE: This cross-sectional study took place in the integrated tuberculosis (TB) clinic of a large outpatient clinic for HIV-infected patients in Kampala, Uganda. The purpose of this study was to describe the proportion of TB/HIV co-infected adults with virological failure, type and frequency of HIV drug resistance-associated mutations, and the proportion of patients with suboptimal efavirenz levels. METHODS: HIV-1 plasma viral loads, CD4 cell count measurements, and efavirenz serum concentrations were done in TB/HIV co-infected adults...
January 5, 2017: AIDS Research and Therapy
https://www.readbyqxmd.com/read/28086771/naturalistic-study-of-guideline-implementation-tool-use-via-evaluation-of-website-access-and-physician-survey
#7
Melissa J Armstrong, Gary S Gronseth, Richard Dubinsky, Sonja Potrebic, Rebecca Penfold Murray, Thomas S D Getchius, Carol Rheaume, Anna R Gagliardi
BACKGROUND: Clinical guidelines support decision-making at the point-of-care but the onus is often on individual users such as physicians to implement them. Research shows that the inclusion of implementation tools in or with guidelines (GItools) is associated with guideline use. However, there is little research on which GItools best support implementation by individual physicians. The purpose of this study was to investigate naturalistic access and use of GItools produced by the American Academy of Neurology (AAN) to inform future tool development...
January 13, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28079593/improving-the-clinic-laboratory-interface-in-the-context-of-hiv-diagnosis-treatment-and-monitoring
#8
Timothy Johan Tucker, Peter Tsakani Manyike
PURPOSE OF REVIEW: Laboratory support is central to clinical medicine. The present review focuses on the health systems strengthening needs of the clinic-laboratory-interface (CLI) in developing countries within the context of HIV diagnosis, treatment, and monitoring. RECENT FINDINGS: Although significant improvements have been made in reducing error rates in the analytical phase of pathology services within laboratories, there remain substantial deficits in both the preanalytic and postanalytic phases of the entire value chain that require strengthening...
January 11, 2017: Current Opinion in HIV and AIDS
https://www.readbyqxmd.com/read/28079591/point-of-care-diagnostics-extending-the-laboratory-network-to-reach-the-last-mile
#9
Paul K Drain, Christine Rousseau
PURPOSE OF REVIEW: More point-of-care (POC) diagnostic tests are becoming available for HIV diagnosis and treatment in resource-limited settings. These novel technologies have the potential to foster decentralized HIV care and treatment for the benefit of clinical laboratories, HIV clinics, and HIV-infected patients. There continue to be many business, technological, and operational challenges that limit product development and regulatory approval, which limits products available for the required operational and cost-effectiveness studies and delays policy adoption and implementation...
January 11, 2017: Current Opinion in HIV and AIDS
https://www.readbyqxmd.com/read/28075337/implementation-of-point-of-care-diagnostics-in-rural-primary-healthcare-clinics-in-south-africa-perspectives-of-key-stakeholders
#10
Tivani P Mashamba-Thompson, Ngcwalisa A Jama, Benn Sartorius, Paul K Drain, Rowan M Thompson
INTRODUCTION: Key stakeholders' involvement is crucial to the sustainability of quality point-of-care (POC) diagnostics services in low-and-middle income countries. The aim of this study was to explore key stakeholder perceptions on the implementation of POC diagnostics in rural primary healthcare (PHC) clinics in South Africa. METHOD: We conducted a qualitative study encompassing in-depth interviews with multiple key stakeholders of POC diagnostic services for rural and resource-limited PHC clinics...
January 8, 2017: Diagnostics
https://www.readbyqxmd.com/read/28074419/deciphering-the-molecular-mechanisms-involved-in-hiv-associated-lipoatrophy-by-transcriptomics-a-pilot-study
#11
Patricia Pérez-Matute, María Iñiguez, Emma Recio-Fernández, José-Antonio Oteo
HIV-associated lipoatrophy (LA) has considerable implications for risk of metabolic diseases, quality of life, and adherence to treatments. Although it has decreased in high-income countries, it is still very common in resource-limited countries. Understanding the pathophysiological mechanisms of LA can open the possibility to explore new ways to treat or prevent this condition. To identify new markers for an accurate and quick diagnosis will be also of interest. Thus, we aimed to examine functional classes of genes implicated in LA and to identify potential new markers for an accurate/quick diagnosis of LA and future complications...
January 10, 2017: Journal of Physiology and Biochemistry
https://www.readbyqxmd.com/read/28073104/use-of-transcutaneous-bilirubin-to-determine-the-need-for-phototherapy-in-resource-limited-settings
#12
Bolajoko O Olusanya, Abieyuwa A Emokpae
BACKGROUND: Routine and timely determination of total serum bilirubin (TSB) remains a challenge in many resource-limited countries with substantial burden of severe neonatal hyperbilirubinemia. Limited evidence exists on the potential usefulness of transcutaneous bilirubin (TcB) to identify infants who may require phototherapy based on possible treatment criteria in such settings. OBJECTIVE: To compare the number of infants requiring phototherapy across different TSB criteria and determine the predictive performance of TcB under each criterion...
January 11, 2017: Neonatology
https://www.readbyqxmd.com/read/28070217/health-systems-context-s-for-integrating-mental-health-into-primary-health-care-in-six-emerald-countries-a-situation-analysis
#13
REVIEW
James Mugisha, Jibril Abdulmalik, Charlotte Hanlon, Inge Petersen, Crick Lund, Nawaraj Upadhaya, Shalini Ahuja, Rahul Shidhaye, Ntokozo Mntambo, Atalay Alem, Oye Gureje, Fred Kigozi
BACKGROUND: Mental, neurological and substance use disorders contribute to a significant proportion of the world's disease burden, including in low and middle income countries (LMICs). In this study, we focused on the health systems required to support integration of mental health into primary health care (PHC) in Ethiopia, India, Nepal, Nigeria, South Africa and Uganda. METHODS: A checklist guided by the World Health Organization Assessment Instrument for Mental Health Systems (WHO-AIMS) was developed and was used for data collection in each of the six countries participating in the Emerging mental health systems in low and middle-income countries (Emerald) research consortium...
2017: International Journal of Mental Health Systems
https://www.readbyqxmd.com/read/28069905/evaluation-of-the-threshold-value-for-the-modified-early-warning-score-mews-in-medical-septic-patients-a-secondary-analysis-of-an-italian-multicentric-prospective-cohort-snoopii-study
#14
Daniela Tirotta, Maurizia Gambacorta, La Regina Micaela, Tiziana Attardo, Lo Gullo Alberto, Filomena Panzone, Mazzone Antonino, Campanini Mauro, Francesco Dentali
BACKGROUND: Due to aging and resources limitation, septic patients are often admitted to medical wards (MWs). Early warning deterioration is a relevant issue in this setting. Unfortunately, a suitable prognostic score has not been identified, yet. AIM: To explore the ability of Modified Early Warning Score (MEWS) to predict the in-hospital mortality in septic patients admitted to MWs. DESIGN SECONDARY ANALYSIS OF A MULTICENTRIC PROSPECTIVE STUDY: Methods: Consecutive septic patients with positive blood culture admitted to 31 Italian MWs were included...
January 9, 2017: QJM: Monthly Journal of the Association of Physicians
https://www.readbyqxmd.com/read/28069782/delivering-patient-centred-care-in-rural-family-practice-using-the-patient-s-concept-of-health-to-guide-treatment
#15
Jennifer M Charlesworth, Evelyn McManus
Through an examination of the life of an 83-year-old patient diagnosed clinically with secondary progressive multiple sclerosis (MS), general practice specialists, consultants and junior doctors will see the importance of assessing their patient's concept of health and how to use this understanding to target healthcare options within their healthcare system. This article highlights, in a resource limited context of rural family practice, the utility of a strong physician-patient relationship, recalls the definition of patient-centred care, and the role of judicious inaction in certain contexts...
January 9, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28069472/semi-quantitative-real-time-pcr-a-useful-approach-to-identify-persons-with-low-replicative-chronic-hepatitis-b
#16
Joany Castéra-Guy, Pierre-Alain Rubbo, Dramane Kania, Maud Lemoine, Philippe Van de Perre, Edouard Tuaillon
Antiviral therapy can be avoided during the low replicative phase of chronic Hepatitis B virus (HBV) infection which is characterized notably by HBV DNA concentration below 2000 IU/ml. Simplified diagnostic tests can improve access to HBV DNA monitoring in resource-limited settings. The capacity of a new semi-quantitative real-time PCR approach based on sample-to-standard relative detection of the target to discriminate samples with HBV DNA levels above or below the clinical threshold of 2000 IU/ml was compared to a quantitative assay (Roche CobasAmpliPrep/CobasTaqMan HBV Test v2...
January 6, 2017: Journal of Virological Methods
https://www.readbyqxmd.com/read/28069046/occurrence-of-emery-dreifuss-muscular-dystrophy-in-a-rural-setting-of-cameroon-a-case-report-and-review-of-the-literature
#17
Cyril Jabea Ekabe, Jules Kehbila, Carlson-Babila Sama, Benjamin Momo Kadia, Martin Hongieh Abanda, Gottlieb Lobe Monekosso
BACKGROUND: Emery-Dreifuss muscular dystrophy is a rare genetic muscular disease, presenting mainly with contractures, weakness and cardiac conduction abnormalities. Its clinical and laboratory similarities to other muscular dystrophies, and rarity poses diagnostic challenges, requiring a high index of suspicion in resource limited settings. CASE PRESENTATION: An 8 year old sub-Saharan male presented with rigidity and deformity of both elbows and ankles, and weakness of the upper limbs and lower limbs for duration of 4 months...
January 9, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28068424/scientific-evidence-and-potential-barriers-in-the-management-of-brazilian-protected-areas
#18
Eduardo L H Giehl, Marcela Moretti, Jessica C Walsh, Marco A Batalha, Carly N Cook
Protected areas are a crucial tool for halting the loss of biodiversity. Yet, the management of protected areas is under resourced, impacting the ability to achieve effective conservation actions. Effective management depends on the application of the best available knowledge, which can include both scientific evidence and the local knowledge of onsite managers. Despite the clear value of evidence-based conservation, there is still little known about how much scientific evidence is used to guide the management of protected areas...
2017: PloS One
https://www.readbyqxmd.com/read/28065392/mapping-the-process-of-emergency-care-at-a-teaching-hospital-in-ghana
#19
Emily Aaronson, Elizabeth Mort, Samara Soghoian
Emergency Department (ED) overcrowding has become a global concern as the number of countries with formalized emergency care systems has expanded, and the burden of trauma and non-communicable diseases in low and middle-income countries increased. In light of this, the international Emergency Medicine literature has outlined the need for operational projects in low and middle income countries which focus on the process of care. Despite this, there is limited published literature describing these types of projects...
January 3, 2017: Healthcare
https://www.readbyqxmd.com/read/28061898/metoclopramide-induced-acute-dystonic-reaction-a-case-report
#20
Frank-Leonel Tianyi, Valirie Ndip Agbor, Tsi Njim
BACKGROUND: Metoclopramide is a commonly used anti-emetic drug known to cause extrapyramidal symptoms as adverse effects, amongst which are dystonic reactions. These reactions are more frequent at high doses of metoclopramide, in female patients, children and adults less than 30 years of age. We hereby present the case of a 16 year old female who had dystonic reactions from metoclopramide, highlighting its unpredictable nature and the shortcomings of the management in resource-limited settings...
January 7, 2017: BMC Research Notes
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