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Admission medecine

Daphne Lagrou, Rony Zachariah, Karen Bissell, Catherine Van Overloop, Masood Nasim, Hamsaya Nikyar Wagma, Shafiqa Kakar, Séverine Caluwaerts, Eva De Plecker, Renzo Fricke, Rafael Van den Bergh
Background: Provision of Emergency Obstetric and Neonatal Care (EmONC) reduces maternal mortality and should include three components: Basic Emergency Obstetric and Neonatal Care (BEmONC) offered at primary care level, Comprehensive EmONC (CEmONC) at secondary level and a good referral system in-between. In a conflict-affected province of Afghanistan (Khost), we assessed the performance of an Médecins Sans Frontières (MSF) run CEmONC hospital without a primary care and referral system...
2018: Conflict and Health
Mohammed Dalwai, Pola Valles, Michele Twomey, Yvonne Nzomukunda, Prince Jonjo, Manoj Sasikumar, Masood Nasim, Abdul Razaaq, Olivia Gayraud, Pierre Ronald Jecrois, Lee Wallis, Katie Tayler-Smith
OBJECTIVE: To assess the validity of the South African Triage Scale (SATS) in four Médecins Sans Frontières (MSF)-supported emergency departments (ED, two trauma-only sites, one mixed site (both medical and trauma cases) and one paediatric-only site) in Afghanistan, Haiti and Sierra Leone. METHODS: This was a retrospective cohort study conducted between June 2013 and June 2014. Validity was assessed by comparing patients' SATS ratings with their final ED outcome (ie, hospital admission, death or discharge)...
2017: BMJ Global Health
C Chan Chee, L-M Paget
BACKGROUND: Epidemiological surveillance of suicide attempts is essential for monitoring indicator trends in the evaluation of prevention actions. As part of this surveillance, analysis of data from hospitalization for suicide attempts is particularly useful. METHODS: For the first time, data from two national hospital discharge databases, the "Programme de médicalisation des systèmes d'information en médecine, chirurgie, obstétrique" (PMSI-MCO) and the " Recueil d'information médicalisé en psychiatrie" (RIM-P) have been analyzed jointly...
September 2017: Revue D'épidémiologie et de Santé Publique
Jacques Massaut, Pola Valles, Arnold Ghismonde, Claudinette Jn Jacques, Liseberth Pierre Louis, Abdulmutalib Zakir, Rafael Van den Bergh, Lunick Santiague, Rose Berly Massenat, Nathalie Edema
BACKGROUND: The South African Triage Scale (SATS) was developed to facilitate patient triage in emergency departments (EDs) and is used by Médecins Sans Frontières (MSF) in low-resource environments. The aim was to determine if SATS data, reason for admission, and patient age can be used to develop and validate a model predicting the in-hospital risk of death in emergency surgical centers and to compare the model's discriminative power with that of the four SATS categories alone. METHODS: We used data from a cohort hospitalized at the Nap Kenbe Surgical Hospital in Haiti from January 2013 to June 2015...
August 23, 2017: BMC Health Services Research
Georgios Theocharopoulos, Kostas Danis, Jane Greig, Alexandra Hoffmann, Henriette De Valk, Augustine Jimissa, Sumaila Tejan, Mohammed Sankoh, Karline Kleijer, Will Turner, Jay Achar, Jennifer Duncombe, Kamalini Lokuge, Ivan Gayton, Rob Broeder, Ronald Kremer, Grazia Caleo
Between August-December 2014, Ebola Virus Disease (EVD) patients from Tonkolili District were referred for care to two Médecins Sans Frontières (MSF) Ebola Management Centres (EMCs) outside the district (distant EMCs). In December 2014, MSF opened an EMC in Tonkolili District (district EMC). We examined the effect of opening a district-based EMC on time to admission and number of suspect cases dead on arrival (DOA), and identified factors associated with fatality in EVD patients, residents in Tonkolili District...
2017: PloS One
Johanna Thomson, Myrto Schaefer, Belen Caminoa, David Kahindi, Northan Hurtado
Neonatal deaths comprise a growing proportion of global under-five mortality. However, data from the highest-burden areas is sparse. This descriptive retrospective study analyses the outcomes of all infants exiting the Médecins sans Frontières-managed neonatal unit in Aweil Hospital, rural South Sudan from 2011 to 2014. A total of 4268 patients were treated over 4 years, with annual admissions increasing from 687 to 1494. Overall mortality was 13.5% (n = 576), declining from 18.7% to 11.1% (p for trend <0...
June 1, 2017: Journal of Tropical Pediatrics
Bérangère Gohy, Engy Ali, Rafael Van den Bergh, Erin Schillberg, Masood Nasim, Muhammad Mahmood Naimi, Sophia Cheréstal, Pauline Falipou, Eric Weerts, Peter Skelton, Catherine Van Overloop, Miguel Trelles
BACKGROUND: In Afghanistan, Médecins Sans Frontières provided specialised trauma care in Kunduz Trauma Centre (KTC), including physiotherapy. In this study, we describe the development of an adapted functional score for patient outcome monitoring, and document the rehabilitation care provided and patient outcomes in relation to this functional score. METHODS: A descriptive cohort study was done, including all patients admitted in the KTC inpatient department (IPD) between January and June 2015...
November 2016: International Health
François-André Allaert, Eric Benzenine, Catherine Quantin
Objective The study was designed to describe the hospital incidences and annual hospitalization rates for venous thromboembolic disease by age and sex in France and the United States on the closest possible methodological bases. Methods French statistics are from the PMSI MCO (Programme de médicalisation des système d'information de médecine, chirurgie et obstétrique (French national hospital discharge register)) national database. These are compiled for each calendar year by collating résumé de sortie anonymisé (RSA, anonymous discharge summary) files forwarded and validated by health establishments with admissions in medicine, surgery, obstetrics, and odontology...
August 2017: Phlebology
Tejshri Shah, Jane Greig, Linda Margaretha van der Plas, Jay Achar, Grazia Caleo, James Sylvester Squire, Alhaji Sayui Turay, Grace Joshy, Catherine D'Este, Emily Banks, Florian Vogt, Kamalini Lokuge
BACKGROUND: Médecins Sans Frontières (MSF) opened Ebola management centres (EMCs) in Sierra Leone in Kailahun in June, 2014, and Bo in September, 2014. Case fatality in the west African Ebola virus disease epidemic has been highest in children younger than 5 years. Clinical data on outcomes can provide important evidence to guide future management. However, such data on children are scarce and disaggregated clinical data across all ages in this epidemic have focussed on symptoms reported on arrival at treatment facilities, rather than symptoms and signs observed during admission...
July 2016: Lancet Global Health
Anna Crepet, Ernestina Repetto, Ahmad Al Rousan, Monica Sané Schepisi, Enrico Girardi, Tullio Prestileo, Luigi Codecasa, Silvia Garelli, Salvatore Corrao, Giuseppe Ippolito, Tom Decroo, Barbara Maccagno
BACKGROUND: Between June 2012 and December 2013 Médecins Sans Frontières launched a pilot project with the aim of testing a strategy for improving timely diagnosis of active pulmonary TB among migrants hosted in four centres of identification and expulsion (CIE) in Italy. METHODS: This is a descriptive study. For active TB case finding we used an active symptom screening approach among migrants at admission in four CIE's. Here we describe the feasibility and the yield of this programme...
September 2016: International Health
Kamalini Lokuge, Grazia Caleo, Jane Greig, Jennifer Duncombe, Nicholas McWilliam, James Squire, Manjo Lamin, Emily Veltus, Anja Wolz, Gary Kobinger, Marc-Antoine de la Vega, Osman Gbabai, Sao Nabieu, Mohammed Lamin, Ronald Kremer, Kostas Danis, Emily Banks, Kathryn Glass
INTRODUCTION: The scale and geographical distribution of the current outbreak in West Africa raised doubts as to the effectiveness of established methods of control. Ebola Virus Disease (EVD) was first detected in Sierra Leone in May 2014 in Kailahun district. Despite high case numbers elsewhere in the country, transmission was eliminated in the district by December 2014. We describe interventions underpinning successful EVD control in Kailahun and implications for EVD control in other areas...
March 2016: PLoS Neglected Tropical Diseases
Jessica F Davies, Annick Lenglet, Marten van Wijhe, Cono Ariti
BACKGROUND: The African continent has the greatest burden of surgical disability-adjusted life years, yet the least is known about operative care here. This analysis describes the surgical patients admitted to 7 hospitals supported by the Médécins Sans Frontières (MSF) over 3 years in 3 conflict-affected countries-Eastern Democratic Republic of Congo, Central African Republic, and South Sudan. METHODS: A standardized operative data collection tool was used for routine collection of operative inpatient data between 2011 and 2013 at 7 MSF surgical facilities...
May 2016: Surgery
Sheila Isanaka, Céline Langendorf, Fatou Berthé, Smaila Gnegne, Nan Li, Nassirou Ousmane, Souley Harouna, Hamidine Hassane, Myrto Schaefer, Eric Adehossi, Rebecca F Grais
BACKGROUND: High-quality evidence supporting a community-based treatment protocol for children with severe acute malnutrition, including routine antibiotic use at admission to a nutritional treatment program, remains limited. In view of the costs and consequences of emerging resistance associated with routine antibiotic use, more evidence is required to support this practice. METHODS: In a double-blind, placebo-controlled trial in Niger, we randomly assigned children who were 6 to 59 months of age and had uncomplicated severe acute malnutrition to receive amoxicillin or placebo for 7 days...
February 4, 2016: New England Journal of Medicine
Florian Vogt, Gabriel Fitzpatrick, Gabriela Patten, Rafael van den Bergh, Kathryn Stinson, Luigi Pandolfi, James Squire, Tom Decroo, Hilde Declerck, Michel Van Herp
Prevention of nosocomial Ebola virus (EBOV) infection among patients admitted to an Ebola management centre (EMC) is paramount. Current Médecins Sans Frontières (MSF) guidelines recommend classifying admitted patients at triage into suspect and highly-suspect categories pending laboratory confirmation. We investigated the performance of the MSF triage system to separate patients with subsequent EBOV-positive laboratory test (true-positive admissions) from patients who were initially admitted on clinical grounds but subsequently tested EBOV-negative (false-positive admissions)...
2015: Euro Surveillance: Bulletin Européen sur les Maladies Transmissibles, European Communicable Disease Bulletin
S Burza, R Mahajan, E Marino, T Sunyoto, C Shandilya, M Tabrez, K Kumar, A Jha, P Mathew, N Salse, C Casademont, N K Mishra
BACKGROUND/OBJECTIVES: Children aged 6 months to 5 years completing treatment for severe acute malnutrition (SAM) in a Médecins Sans Frontières Community Management of Acute Malnutrition (CMAM) program in Bihar, India, showed high cure rates; however, the program suffered default rates of 38%. This report describes the nutritional status of 1956 children followed up between 3 and 18 months after exiting the program. SUBJECTS/METHODS: All children aged 6-59 months discharged as cured with mid-upper arm circumference (MUAC) ⩾120 mm or who defaulted from the program with MUAC <115 mm were traced at 3, 6, 9, 12 and 18 months (±10 days) before three exit reference dates: first at the end of the food insecure period, second after the 2-month food security and third after the 4-month food security...
April 2016: European Journal of Clinical Nutrition
Caris E Grimes, Michael L Billingsley, Anna J Dare, Nigel Day, Imogen Mabey, Sara Naraghi, Peter M George, Michael Murowa, Thaim B Kamara, Nyengo C Mkandawire, Andy Leather, Christopher B D Lavy
BACKGROUND: Awareness is growing of both the importance of surgical disease as a major cause of death and disability in low-income and middle-income countries (LMICs) and the cost-effectiveness of fairly simple surgical interventions. We hypothesised that surgical disease predominantly affects young adults and is therefore significant in both the macroeconomic effect of untreated disease and the microeconomic effects on patients and families in low-resource settings. METHODS: We retrospectively reviewed all admission data from two rural government district hospitals, Bo District Hospital in Sierra Leone and Thyolo District Hospital in Malawi...
April 27, 2015: Lancet
Gabriel Fitzpatrick, Florian Vogt, Osman B Moi Gbabai, Tom Decroo, Marian Keane, Hilde De Clerck, Allen Grolla, Raphael Brechard, Kathryn Stinson, Michel Van Herp
This paper describes patient characteristics, including Ebola viral load, associated with mortality in a Médecins Sans Frontières Ebola case management centre (CMC).Out of 780 admissions between June and October 2014, 525 (67%) were positive for Ebola with a known outcome. The crude mortality rate was 51% (270/525). Ebola viral load (whole-blood sample) data were available on 76% (397/525) of patients. Univariate analysis indicated viral load at admission, age, symptom duration prior to admission, and distance traveled to the CMC were associated with mortality (P < ...
December 1, 2015: Journal of Infectious Diseases
Sakib Burza, Raman Mahajan, Elisa Marino, Temmy Sunyoto, Chandra Shandilya, Mohammad Tabrez, Kabita Kumari, Prince Mathew, Amar Jha, Nuria Salse, Kripa Nath Mishra
BACKGROUND: An estimated one-third of the world's children who are wasted live in India. In Bihar state, of children <5 y old, 27.1% are wasted and 8.3% have severe acute malnutrition (SAM). In 2009, Médecins Sans Frontières (MSF) initiated a community-based management of acute malnutrition (CMAM) program for children aged 6-59 mo with SAM. OBJECTIVE: In this report, we describe the characteristics and outcomes of 8274 children treated between February 2009 and September 2011...
April 2015: American Journal of Clinical Nutrition
B Branger, V Rouger, I Berlie, A Beucher, C Flamant, S N'guyen The Tich, J Garcia, J-P Brossier, Y Montcho, M Hanf, J-C Roze
INTRODUCTION: Vulnerable children are at-risk newborns including premature infants and some children with pathologies presented by fear anomalies and deficiencies, most particularly neurological. Monitoring is based on the detection of these abnormalities and their early management. The organization of this monitoring system is based on a network of doctors, mostly pediatricians, trained regularly. The objective of this review was to assess the resources, means, and results of 10 years of follow-up...
February 2015: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
Agnes Sobry, Walter Kizito, Rafael Van den Bergh, Katie Tayler-Smith, Petros Isaakidis, Erastus Cheti, Rose J Kosgei, Alexandra Vandenbulcke, Zacharia Ndegwa, Tony Reid
OBJECTIVE: In three primary health care clinics run by Médecins Sans Frontières in the informal settlement of Kibera, Nairobi, Kenya, we describe the caseload, management and treatment outcomes of patients with hypertension (HT) and/or diabetes mellitus (DM) receiving care from January 2010 to June 2012. METHOD: Descriptive study using prospectively collected routine programme data. RESULTS: Overall, 1465 patients were registered in three clinics during the study period, of whom 87% were hypertensive only and 13% had DM with or without HT...
January 2014: Tropical Medicine & International Health: TM & IH
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