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[PMID]:29462152
[Au] Autor:Treacy L; Bolkan HA; Sagbakken M
[Ad] Endereço:Department of Community Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway.
[Ti] Título:Distance, accessibility and costs. Decision-making during childbirth in rural Sierra Leone: A qualitative study.
[So] Source:PLoS One;13(2):e0188280, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Sierra Leone has one of the highest maternal mortality ratios in the world. Efforts to reduce maternal mortality have included initiatives to encourage more women to deliver at health facilities. Despite the introduction of the free health care initiative for pregnant women, many women still continue to deliver at home, with few having access to a skilled birth attendant. In addition, inequalities between rural and urban areas in accessing and utilising health facilities persist. Further insight into how and why women make decisions around childbirth will help guide future plans and initiatives in improving maternal health in Sierra Leone. The objective of this study was to explore the perceptions and decision-making processes of women and their communities during childbirth in rural Sierra Leone. METHODS AND FINDINGS: Data were collected through seven focus group discussions and 22 in-depth interviews with recently pregnant women and their community members in two rural villages. Data were analysed using systematic text condensation. Findings revealed that decision-making processes during childbirth are dynamic, intricate and need to be understood within the broader social context that they take place. Factors such as distance and lack of transport, perceived negative behaviour of hospital staff, direct and indirect financial obstacles, as well as the position of women in society all interact and influence how and what decisions are made. CONCLUSIONS: Pregnant women face multiple interacting vulnerabilities that influence their healthcare-seeking decisions during pregnancy and childbirth. Future initiatives to improve access and utilisation of safe healthcare services for pregnant women need to be based on adequate knowledge of structural constraints and health inequities that affect women in rural Sierra Leone.
[Mh] Termos MeSH primário: Tomada de Decisões
Custos de Cuidados de Saúde
Acesso aos Serviços de Saúde
População Rural
[Mh] Termos MeSH secundário: Feminino
Grupos Focais
Seres Humanos
Masculino
Gravidez
Pesquisa Qualitativa
Serra Leoa
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180221
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0188280


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[PMID]:29194680
[Au] Autor:Jenkins S; Ives J; Avery S; Draper H
[Ti] Título:Who gets the gametes? An argument for a points system for fertility patients.
[So] Source:Bioethics;32(1):16-26, 2018 01.
[Is] ISSN:1467-8519
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:This paper argues that the convention of allocating donated gametes on a 'first come, first served' basis should be replaced with an allocation system that takes into account more morally relevant criteria than waiting time. This conclusion was developed using an empirical bioethics methodology, which involved a study of the views of 18 staff members from seven U.K. fertility clinics, and 20 academics, policy-makers, representatives of patient groups, and other relevant professionals, on the allocation of donated sperm and eggs. Against these views, we consider some nuanced ways of including criteria in a points allocation system. We argue that such a system is more ethically robust than 'first come, first served', but we acknowledge that our results suggest that a points system will meet with resistance from those working in the field. We conclude that criteria such as a patient's age, potentially damaging substance use, and parental status should be used to allocate points and determine which patients receive treatment and in what order. These and other factors should be applied according to how they bear on considerations like child welfare, patient welfare, and the effectiveness of the proposed treatment.
[Mh] Termos MeSH primário: Temas Bioéticos
Doação Dirigida de Tecido/ética
Células Germinativas
Acesso aos Serviços de Saúde/ética
Infertilidade
Reprodução/ética
[Mh] Termos MeSH secundário: Adulto
Atitude do Pessoal de Saúde
Bioética
Dissidências e Disputas
Feminino
Fertilidade
Seres Humanos
Masculino
Pais
Discriminação Social
Participação dos Interessados
Reino Unido
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:E; IM
[Da] Data de entrada para processamento:171202
[St] Status:MEDLINE
[do] DOI:10.1111/bioe.12411


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[PMID]:28746168
[Au] Autor:Pittalis S; Orchi N; De Carli G; Navarra A; Chiaradia G; Puro V; Girardi E
[Ad] Endereço:*Clinical Epidemiology Unit, National Institute for Infectious Disease "L. Spallanzani"-IRCCS, Rome, Italy †Infectious Disease Epidemiology Unit, AIDS Reference Centre, National Institute for Infectious Disease "L. Spallanzani"-IRCCS, Rome, Italy.
[Ti] Título:HIV Self-Testing in Italy.
[So] Source:J Acquir Immune Defic Syndr;76(3):e84-e85, 2017 11 01.
[Is] ISSN:1944-7884
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Sorodiagnóstico da AIDS
Infecções por HIV/diagnóstico
Acesso aos Serviços de Saúde/estatística & dados numéricos
Kit de Reagentes para Diagnóstico/utilização
Autocuidado
[Mh] Termos MeSH secundário: Sorodiagnóstico da AIDS/utilização
Adulto
Aconselhamento Diretivo
Infecções por HIV/epidemiologia
Conhecimentos, Atitudes e Prática em Saúde
Promoção da Saúde
Homossexualidade Masculina
Seres Humanos
Itália/epidemiologia
Masculino
Estudos Prospectivos
Adulto Jovem
[Pt] Tipo de publicação:LETTER; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Reagent Kits, Diagnostic)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM; X
[Da] Data de entrada para processamento:170727
[St] Status:MEDLINE
[do] DOI:10.1097/QAI.0000000000001507


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[PMID]:28746166
[Au] Autor:Schaffer EM; Agot K; Thirumurthy H
[Ad] Endereço:*Department of Health Policy and Management, University of North Carolina at Chapel Hill, Chapel Hill, NC †Impact Research and Development Organization, Kisumu, Kenya ‡Carolina Population Center, Chapel Hill, NC.
[Ti] Título:The Association Between Intimate Partner Violence and Women's Distribution and Use of HIV Self-Tests With Male Partners: Evidence From a Cohort Study in Kenya.
[So] Source:J Acquir Immune Defic Syndr;76(3):e85-e87, 2017 11 01.
[Is] ISSN:1944-7884
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Sorodiagnóstico da AIDS/utilização
Infecções por HIV/diagnóstico
Violência por Parceiro Íntimo/estatística & dados numéricos
Programas de Rastreamento/métodos
Kit de Reagentes para Diagnóstico/utilização
Serviços de Saúde Reprodutiva
Parceiros Sexuais/psicologia
[Mh] Termos MeSH secundário: Adulto
Feminino
Infecções por HIV/psicologia
Acesso aos Serviços de Saúde
Seres Humanos
Quênia
Masculino
Programas de Rastreamento/psicologia
Ensaios Clínicos Controlados Aleatórios como Assunto
Estigma Social
Adulto Jovem
[Pt] Tipo de publicação:LETTER; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Reagent Kits, Diagnostic)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM; X
[Da] Data de entrada para processamento:170727
[St] Status:MEDLINE
[do] DOI:10.1097/QAI.0000000000001502


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[PMID]:28466547
[Au] Autor:Inch J; Notman F; Watson M; Green D; Baird R; Ferguson J; Hind C; McKinstry B; Strath A; Bond C; Telepharmacy Research Team
[Ad] Endereço:Centre of Academic Primary Care, University of Aberdeen, Aberdeen, UK.
[Ti] Título:Tele-pharmacy in rural Scotland: a proof of concept study.
[So] Source:Int J Pharm Pract;25(3):210-219, 2017 Jun.
[Is] ISSN:2042-7174
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Technology enables medical services to be provided to rural communities. This proof of concept study assessed the feasibility and acceptability of delivering community pharmacy services (CPS; including advice, sale of over-the-counter products and dispensing of prescriptions) by tele-technology (the Telepharmacy Robotic Supply Service (TPRSS)) to a rural population in Scotland. METHODS: Data collection included the following: postal surveys to local residents; focus groups/ interviews with pharmacists, other healthcare professionals (HCPs) and service users, at baseline and follow-up; TPRSS logs. Interviews/focus groups were audio-recorded, transcribed and thematically analysed. Descriptive statistics were reported for survey data. RESULTS: Qualitative results: Pre-installation: residents expressed satisfaction with current pharmacy access. HCPs believed the TPRSS would improve pharmacy access and reduce pressure on GPs. Concerns included costs, confidentiality, patient safety and 'fear' of technology. Post-installation: residents and pharmacy staff were positive, finding the service easy to use. Quantitative results: Pre-installation: almost half the respondents received regular prescription medicines and a third used an over-the-counter (OTC) medicine at least monthly. More than 80% (124/156) reported they would use the TPRSS. There was low awareness of the minor ailment service (MAS; 38%; 59/156). Post-installation: prescription ordering and OTC medicine purchase were used most frequently; the video link was used infrequently. Reasons for non-use were lack of need (36%; 40/112) and linkage to only one pharmacy (31%; 35/112). DISCUSSION: Community pharmacy services delivered remotely using tele-technology are feasible and acceptable. A larger study should be undertaken to confirm the potential of the TPRSS to reduce health inequalities in rural areas.
[Mh] Termos MeSH primário: Farmácia/tendências
Serviços de Saúde Rural/tendências
Telemedicina/tendências
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Serviços Comunitários de Farmácia
Prescrições de Medicamentos/estatística & dados numéricos
Estudos de Viabilidade
Feminino
Acesso aos Serviços de Saúde
Seres Humanos
Masculino
Meia-Idade
Medicamentos sem Prescrição
Farmacêuticos
População Rural
Escócia
Fatores Socioeconômicos
Inquéritos e Questionários
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Nonprescription Drugs)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170504
[St] Status:MEDLINE
[do] DOI:10.1111/ijpp.12376


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[PMID]:28459618
[Au] Autor:Celedón JC; Burchard EG; Schraufnagel D; Castillo-Salgado C; Schenker M; Balmes J; Neptune E; Cummings KJ; Holguin F; Riekert KA; Wisnivesky JP; Garcia JGN; Roman J; Kittles R; Ortega VE; Redline S; Mathias R; Thomas A; Samet J; Ford JG; American Thoracic Society and the National Heart, Lung, and Blood Institute
[Ti] Título:An American Thoracic Society/National Heart, Lung, and Blood Institute Workshop Report: Addressing Respiratory Health Equality in the United States.
[So] Source:Ann Am Thorac Soc;14(5):814-826, 2017 May.
[Is] ISSN:2325-6621
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Health disparities related to race, ethnicity, and socioeconomic status persist and are commonly encountered by practitioners of pediatric and adult pulmonary, critical care, and sleep medicine in the United States. To address such disparities and thus progress toward equality in respiratory health, the American Thoracic Society and the National Heart, Lung, and Blood Institute convened a workshop in May of 2015. The workshop participants addressed health disparities by focusing on six topics, each of which concluded with a panel discussion that proposed recommendations for research on racial, ethnic, and socioeconomic disparities in pulmonary, critical care, and sleep medicine. Such recommendations address best practices to advance research on respiratory health disparities (e.g., characterize broad ethnic groups into subgroups known to differ with regard to a disease of interest), risk factors for respiratory health disparities (e.g., study the impact of new tobacco or nicotine products on respiratory diseases in minority populations), addressing equity in access to healthcare and quality of care (e.g., conduct longitudinal studies of the impact of the Affordable Care Act on respiratory and sleep disorders), the impact of personalized medicine on disparities research (e.g., implement large studies of pharmacogenetics in minority populations), improving design and methodology for research studies in respiratory health disparities (e.g., use study designs that reduce participants' burden and foster trust by engaging participants as decision-makers), and achieving equity in the pulmonary, critical care, and sleep medicine workforce (e.g., develop and maintain robust mentoring programs for junior faculty, including local and external mentors). Addressing these research needs should advance efforts to reduce, and potentially eliminate, respiratory, sleep, and critical care disparities in the United States.
[Mh] Termos MeSH primário: Grupos Étnicos/estatística & dados numéricos
Acesso aos Serviços de Saúde/estatística & dados numéricos
Disparidades nos Níveis de Saúde
Disparidades em Assistência à Saúde
Grupos Minoritários/estatística & dados numéricos
Doenças Respiratórias/epidemiologia
[Mh] Termos MeSH secundário: Política de Saúde
Seres Humanos
National Heart, Lung, and Blood Institute (U.S.)
Pneumologia
Classe Social
Sociedades Médicas
Estados Unidos
[Pt] Tipo de publicação:CONSENSUS DEVELOPMENT CONFERENCE, NIH; JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170502
[St] Status:MEDLINE
[do] DOI:10.1513/AnnalsATS.201702-167WS


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[PMID]:28465277
[Au] Autor:Gammon D; Strand M; Eng LS; Børøsund E; Varsi C; Ruland C
[Ad] Endereço:Center for Shared Decision-Making and Collaborative Care Research, Oslo University Hospital, Oslo, Norway.
[Ti] Título:Shifting Practices Toward Recovery-Oriented Care Through an E-Recovery Portal in Community Mental Health Care: A Mixed-Methods Exploratory Study.
[So] Source:J Med Internet Res;19(5):e145, 2017 May 02.
[Is] ISSN:1438-8871
[Cp] País de publicação:Canada
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Mental health care is shifting from a primary focus on symptom reduction toward personal recovery-oriented care, especially for persons with long-term mental health care needs. Web-based portals may facilitate this shift, but little is known about how such tools are used or the role they may play in personal recovery. OBJECTIVE: The aim was to illustrate uses and experiences with the secure e-recovery portal "ReConnect" as an adjunct to ongoing community mental health care and explore its potential role in shifting practices toward recovery. METHODS: ReConnect was introduced into two Norwegian mental health care communities and used for 6 months. The aim was to support personal recovery and collaboration between service users and health care providers. Among inclusion criteria for participation were long-term care needs and at least one provider willing to interact with service users through ReConnect. The portal was designed to support ongoing collaboration as each service user-provider dyad/team found appropriate and consisted of (1) a toolbox of resources for articulating and working with recovery processes, such as status/goals/activities relative to life domains (eg, employment, social network, health), medications, network map, and exercises (eg, sleep hygiene, mindfulness); (2) messaging with providers who had partial access to toolbox content; and (3) a peer support forum. Quantitative data (ie, system log, questionnaires) were analyzed using descriptive statistics. Qualitative data (eg, focus groups, forum postings) are presented relative to four recovery-oriented practice domains: personally defined recovery, promoting citizenship, working relationships, and organizational commitment. RESULTS: Fifty-six participants (29 service users and 27 providers) made up 29 service user-provider dyads. Service users reported having 11 different mental health diagnoses, with a median 2 (range 1-7) diagnoses each. The 27 providers represented nine different professional backgrounds. The forum was the most frequently used module with 1870 visits and 542 postings. Service users' control over toolbox resources (eg, defining and working toward personal goals), coupled with peer support, activated service users in their personal recovery processes and in community engagement. Some providers (30%, 8/27) did not interact with service users through ReConnect. Dyads that used the portal resources did so in highly diverse ways, and participants reported needing more than 6 months to discover and adapt optimal uses relative to their individual and collaborative needs. CONCLUSIONS: Regardless of providers' portal use, service users' control over toolbox resources, coupled with peer support, offered an empowering common frame of reference that represented a shift toward recovery-oriented practices within communities. Although service users' autonomous use of the portal can eventually influence providers in the direction of recovery practices, a fundamental shift is unlikely without broader organizational commitments aligned with recovery principles (eg, quantified goals for service user involvement in care plans).
[Mh] Termos MeSH primário: Serviços Comunitários de Saúde Mental/organização & administração
Aconselhamento/métodos
Acesso aos Serviços de Saúde
Transtornos Mentais/terapia
Avaliação de Resultados (Cuidados de Saúde)
Consulta Remota/utilização
[Mh] Termos MeSH secundário: Adulto
Feminino
Grupos Focais
Seres Humanos
Entrevistas como Assunto
Masculino
Meia-Idade
Noruega
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170504
[St] Status:MEDLINE
[do] DOI:10.2196/jmir.7524


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[PMID]:28453720
[Au] Autor:Chavehpour Y; Rashidian A; Raghfar H; Emamgholipour Sefiddashti S; Maroofi A
[Ad] Endereço:Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
[Ti] Título:'Seeking affluent neighbourhoods?' a time-trend analysis of geographical distribution of hospitals in the Megacity of Tehran.
[So] Source:Health Policy Plan;32(5):669-675, 2017 Jun 01.
[Is] ISSN:1460-2237
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Objective: Access to hospitals in megacities in low and middle income countries might be hampered by travel barriers and distance. We assessed the 'inverse care law' hypothesis: whether hospitals tended to be built in the relatively better-off areas through the time. Methods: A longitudinal time-series study (1966 to 2011) in Tehran to measure inequality in the distribution of hospital beds. We assessed correlations between the district socioeconomic status and availability of hospital beds via regression analyses, estimated correlation, Gini and concentration indices, and used GIS models to map hospital distributions through time. Finding: We found a clear relationship between socioeconomic status and number of hospital beds per capita ( P -values <0.05). Gini coefficients were about 0.6 and 0.8 for public and private beds, respectively. A third of the variations in hospital bed distribution was explained by the welfare status of the district. For every extra residential room per capita, 130 to 280 extra beds were observed per ten thousand population at the district level. In 2011, out of 162 hospitals, 110 were located in six districts around the centre and northern part of the city. During the time period only two private hospitals were built in relatively disadvantaged districts. Conclusion: Over a period of about fifty years new hospitals had been established in the relatively affluent areas of the city and the relationship between socioeconomic status of district with total, private and public beds were direct and intensive. Results indicate the problem of inequality may remain over time and be resistant to policy initiatives and major political changes.
[Mh] Termos MeSH primário: Acesso aos Serviços de Saúde
Número de Leitos em Hospital/estatística & dados numéricos
Hospitais Urbanos/estatística & dados numéricos
Fatores Socioeconômicos
[Mh] Termos MeSH secundário: Geografia
Irã (Geográfico)
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:H
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1093/heapol/czw172


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[PMID]:28453714
[Au] Autor:Lorenzetti LMJ; Leatherman S; Flax VL
[Ad] Endereço:Department of Health Policy & Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, NC, USA.
[Ti] Título:Evaluating the effect of integrated microfinance and health interventions: an updated review of the evidence.
[So] Source:Health Policy Plan;32(5):732-756, 2017 Jun 01.
[Is] ISSN:1460-2237
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Background: Solutions delivered within firm sectoral boundaries are inadequate in achieving income security and better health for poor populations. Integrated microfinance and health interventions leverage networks of women to promote financial inclusion, build livelihoods, and safeguard against high cost illnesses. Our understanding of the effect of integrated interventions has been limited by variability in intervention, outcome, design, and methodological rigour. This systematic review synthesises the literature through 2015 to understand the effect of integrated microfinance and health programs. Methods: We searched PubMed, Scopus, Embase, EconLit, and Global Health databases and sourced bibliographies, identifying 964 articles exclusive of duplicates. Title, abstract, and full text review yielded 35 articles. Articles evaluated the effect of intentionally integrated microfinance and health programs on client outcomes. We rated the quality of evidence for each article. Results: Most interventions combined microfinance with health education, which demonstrated positive effects on health knowledge and behaviours, though not health status. Among programs that integrated microfinance with other health components ( i.e. health micro-insurance, linkages to health providers, and access to health products), results were generally positive but mixed due to the smaller number and quality of studies. Interventions combining multiple health components in a given study demonstrated positive effects, though it was unclear which component was driving the effect. Most articles (57%) were moderate in quality. Discussion: Integrated microfinance and health education programs were effective, though longer intervention periods are necessary to measure more complex pathways to health status. The effect of microfinance combined with other health components was less clear. Stronger randomized research designs with multiple study arms are required to improve evidence and disentangle the effects of multiple component microfinance and health interventions. Few studies attempted to understand changes in economic outcomes, limiting our understanding of the relationship between health and income effects.
[Mh] Termos MeSH primário: Apoio Financeiro
Promoção da Saúde/métodos
Pobreza
[Mh] Termos MeSH secundário: Redes Comunitárias/economia
Conhecimentos, Atitudes e Prática em Saúde
Acesso aos Serviços de Saúde/economia
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1711
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:H
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1093/heapol/czw170


  10 / 62479 MEDLINE  
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[PMID]:27777282
[Au] Autor:Meka AO; Chukwu JN; Nwafor CC; Oshi DC; Madichie NO; Ekeke N; Anyim MC; Alphonsus C; Mbah O; Uzoukwa GC; Njoku M; Ntana K; Ukwaja KN
[Ad] Endereço:Medical Department, German Leprosy and TB Relief Association, Enugu State, Nigeria.
[Ti] Título:Diagnosis delay and duration of hospitalisation of patients with Buruli ulcer in Nigeria.
[So] Source:Trans R Soc Trop Med Hyg;110(9):502-509, 2016 09.
[Is] ISSN:1878-3503
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Delayed diagnosis of Buruli ulcer can worsen clinical presentation of the disease, prolong duration of management, and impose avoidable additional costs on patients and health providers. We investigated the profile, delays in diagnosis, duration of hospitalisation, and associated factors among patients with Buruli ulcer in Nigeria. METHODS: This was a prospective cohort study of patients with Buruli ulcer who were identified from a community-based survey. Data on the patients' clinical profile, delays in diagnosis and duration of hospitalisation were prospectively collected. RESULTS: Of 145 patients notified, 125 (86.2%) were confirmed by one or more laboratory tests (81.4% by PCR). The median age of the patients was 20 years, 88 (60.7%) were >15years old and 85 (58.6%) were females. In addition, 137 (94.5%) were new cases, 119 (82.1%) presented with ulcers and 110 (75.9%) had lower limb lesions. The mean time delay to diagnosis was 50.6 (±101.9) weeks. The mean duration of hospitalisation was 108 (±60) days. Determinants of time delay to diagnosis were higher disease category (p=0.001) and laboratory confirmation of disease (p=0.02). Determinants of longer hospitalisation were; multiple lesions (p=0.035), and having functional limitation at diagnosis and undertaking surgery (p=0.003). CONCLUSIONS: Patients with Buruli ulcer have very long time delays to diagnosis and long hospitalisation during treatment. This calls for early case-finding and improved access to Buruli ulcer services in Nigeria.
[Mh] Termos MeSH primário: Úlcera de Buruli/diagnóstico
Diagnóstico Tardio
Acesso aos Serviços de Saúde/normas
Hospitalização/estatística & dados numéricos
Tempo de Internação/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Úlcera de Buruli/economia
Úlcera de Buruli/microbiologia
Úlcera de Buruli/terapia
Criança
Diagnóstico Tardio/efeitos adversos
Diagnóstico Tardio/economia
Feminino
Custos de Cuidados de Saúde
Gastos em Saúde
Conhecimentos, Atitudes e Prática em Saúde
Hospitalização/economia
Seres Humanos
Tempo de Internação/economia
Masculino
Mycobacterium ulcerans/isolamento & purificação
Nigéria/epidemiologia
Reação em Cadeia da Polimerase/economia
Estudos Prospectivos
População Rural
Inquéritos e Questionários
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180307
[Lr] Data última revisão:
180307
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161030
[St] Status:MEDLINE



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BIREME/OPAS/OMS - Centro Latino-Americano e do Caribe de Informação em Ciências da Saúde