Dataset Information

Severe malaria management: current situation, challenges and lessons learned from Gezira State, Sudan.

ABSTRACT:

Background

The present study aimed to evaluate the management of severe malaria at Gezira State hospitals in Sudan by assessing hospital readiness, health care provider knowledge and the care received by severe malaria patients.

Methods

A cross-sectional descriptive study was performed to assess the severe malaria management practices at hospitals level in Gezira State. The study population included hospitals, health care providers and patients. Data was collected using checklists and structured questionnaires.

Results

A total of 20 hospitals, 158 health care providers and 370 patients were included in the study. Out of the total hospitals, 95% (19/20) were providing 24 h outpatient services, 65% (13/20) had ICU units, while triage system was found in only 35% (7/20) of hospitals. From all hospitals evaluated, 90% (18/20) were suffering from shortage of staff, especially doctors. About half of the health care providers (46.7%) did not receive severe malaria management training. The average knowledge score among health care providers was 55.4%. Microscopy was available in all hospitals (100%), while rapid diagnostic test, complete blood count and renal function test were available in 15 hospitals (75%). Fever was the most presenting symptom (97.8%) followed by repeated vomiting (51.4%), convulsion in children (24.3%) and prostration in adult (57.9%). Correctly diagnosed patients were 68.9%. Essential tests were done for only 11.1% of patients. Majority of patients (91.7%) were treated with quinine, 5.9% received artemether, while 2.4% were treated with artemether-lumefantrine. Those who received both the correct dose and dosing regimen were 53.8%. The overall compliance to guidelines was 2.2%.

Conclusion

This study highlights the fact that management of severe malaria at hospital level was suboptimal with serious shortcomings in the different aspects of care particularly in specialized hospitals. Technical staff was inadequate, hospitals were anguish from defective emergency services, and most patients were not treated according to the national guidelines.

SUBMITTER: Elnour FA

PROVIDER: S-EPMC6515598 | biostudies-literature | 2019 May

REPOSITORIES: biostudies-literature

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Publications

Severe malaria management: current situation, challenges and lessons learned from Gezira State, Sudan.

Elnour Fahad A FA Alagib Mohammed E A MEA Bansal Devendra D Farag Elmoubasher Abu Baker Abd EABA Malik Elfatih M EM

Malaria journal 20190514 1

<h4>Background</h4>The present study aimed to evaluate the management of severe malaria at Gezira State hospitals in Sudan by assessing hospital readiness, health care provider knowledge and the care received by severe malaria patients.<h4>Methods</h4>A cross-sectional descriptive study was performed to assess the severe malaria management practices at hospitals level in Gezira State. The study population included hospitals, health care providers and patients. Data was collected using checklists ...[more]

PMID: 31088466

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Project description:Background:Rift Valley fever (RVF) is a zoonotic viral vector-borne disease that affects both animals and humans and leads to severe economic consequences. RVF outbreaks are triggered by a favorable environment and flooding, which enable mosquitoes to proliferate and spread the virus further. RVF is endemic to Africa and has spread to Saudi Arabia and Yemen. There is great concern that RVF may spread to previously unaffected geographic regions due to climate change. We aimed to better understand the spatiotemporal pattern of the 2007 RVF outbreak at the human-animal-environment interface and to determine environmental factors that may have effects on RVF occurrence in Gezira state, Sudan. Materials and methods:We compiled epidemiological, environmental, and spatiotemporal data across time and space using remote sensing and a geographical information system (GIS). The epidemiological data included 430 RVF human cases as well as human and animal population demographic data for each locality. The cases were collected from 41 locations in Gezira state. The environmental data represent classified land cover during 2007, the year of the RVF outbreak, and the average of the Normalized Difference Vegetation Index (NDVI) for 6 months of 2007 is compared with those of 2010 and 2014, when there was no RVF outbreak. To determine the effect of the environmental factors such as NDVI, soil type, and RVF case's location on the Blue Nile riverbank on RVF incidence in Gezira state, a multilevel logistic regression model was carried out. Results:We found that the outbreak in Gezira state occurred as a result of interaction among animals, humans, and the environment. The multilevel logistic regression model (F?=?43,858, df?=?3, p?=?0.000) explained 23% of the variance in RVF incidence due to the explanatory variables. Notably, soil type (??=?0.613, t?=?11.284, p?=?0.000) and NDVI (??=?-?0.165, t?=?-?3.254, p?=?0.001) were the explanatory environmental factors that had significant effects on RVF incidence in 2007 in Gezira state, Sudan. Conclusions:Precise remote sensing and the GIS technique, which rely on environmental indices such as NDVI and soil type that are satellite-derived, can contribute to establishing an early warning system for RVF in Sudan.Future preparedness and strengthening the capacity of regional laboratories are necessary for early notification of outbreaks in animals and humans.

Project description:BACKGROUND:Historical changes in the nature of sedentary activities have been observed in other countries, but it is not clear if similar trends exist in Canada. It is also unclear how changes in the measurement of sedentary behaviour affects national estimates. Our objective is to document all sources and measures of sedentary behaviour from Canadian, nationally representative surveys, and report on selected estimates of time spent in sedentary activities. Lessons learned can benefit the wider international surveillance community. METHODS:We describe and document all data sources of sedentary behaviour at the national level in Canada, and report on selected prevalence data from repeated cross-sectional surveys. We summarize amounts of total device-assessed sedentary time and self-reported sedentary activities (e.g., passive travel, leisure television, computer, video games, screen, and reading) by age group over time. RESULTS:Nineteen national surveys were identified. Changes in questions and/or response categories precluded direct assessment of trends over time for some measures; however, certain trends were observed. Accelerometer-measured sedentary time, leisure reading (among those <?50?years) and television/video viewing in younger age groups have remained relatively stable (with a possible slight decline in television/video viewing). Time spent in passive travel and leisure computer and electronic device use appears to have increased. Television and video viewing appears to have increased in older adults while their leisure reading appears to have fallen. CONCLUSIONS:Changes in measurement of sedentary behaviour can affect estimates and reduce comparability over time. Total leisure screen use appears to have increased over time, reflecting the ways in which Canadians spend their free time and technological advances. The main public health message is the need for continued efforts to reduce leisure screen use, especially among youth and older adults.

Dataset Information

Severe malaria management: current situation, challenges and lessons learned from Gezira State, Sudan.

Background

Methods

Results

Conclusion

Publications

Severe malaria management: current situation, challenges and lessons learned from Gezira State, Sudan.

Similar Datasets

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