Tropical medicine & international health : TM & IH
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Trop. Med. Int. Health · May 2015
ReviewUsing multi-country household surveys to understand who provides reproductive and maternal health services in low- and middle-income countries: a critical appraisal of the Demographic and Health Surveys.
The Demographic and Health Surveys (DHS) are a vital data resource for cross-country comparative analyses. This study is part of a set of analyses assessing the types of providers being used for reproductive and maternal health care across 57 countries. Here, we examine some of the challenges encountered using DHS data for this purpose, present the provider classification we used, and provide recommendations to enable more detailed and accurate cross-country comparisons of healthcare provision. ⋯ To improve clarity, we recommend addressing issues such as conflation of response options, data on public vs. private provider, inconsistent coding and obtaining metadata. More systematic and standardised collection of data would aid international comparisons of progress towards improved financial protection, and allow us to better characterise the incentives and commercial nature of different providers.
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Trop. Med. Int. Health · Apr 2015
Development of quality indicators to evaluate antibiotic treatment of patients with community-acquired pneumonia in Indonesia.
To develop an instrument for evaluating the quality of antibiotic management of patients with community-acquired pneumonia (CAP) applicable in a middle-income developing country. ⋯ Using the Delphi method, we defined a list of QIs for assessing the quality of care, in particular antibiotic treatment, for CAP in Indonesia. For further improvement, a modified Delphi method that includes discussion, a sound medical documentation system, improvement of microbiology laboratory services, and multi-center applicability tests are needed to develop a valid and applicable QI list for the Indonesian setting.
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Trop. Med. Int. Health · Apr 2015
Ebola outbreak in rural West Africa: epidemiology, clinical features and outcomes.
To describe Ebola cases in the district Ebola management centre of in Kailahun, a remote rural district of Sierra Leone, in terms of geographic origin, patient and hospitalisation characteristics, treatment outcomes and time from symptom onset to admission. ⋯ One in three admitted cases originated outside Kailahun district due to limited national access to Ebola management centres - complicating contact tracing, safe burial and disinfection measures. The comparatively high case fatality among health workers requires attention. The community infectivity time needs to be reduced to prevent continued transmission.
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Trop. Med. Int. Health · Feb 2015
The role of the private sector in the provision of antenatal care: a study of Demographic and Health Surveys from 46 low- and middle-income countries.
To examine the role of the private sector in the provision of antenatal care (ANC) across low- and middle-income countries. ⋯ The market for ANC varies considerably between regions. The two largest sectors - public and private commercial - perform similarly in terms of quality of care. Future research should examine the role of the private sector in other health service domains across multiple countries and test what policies and programmes can encourage private providers to contribute to increased coverage, quality and equity of maternal care.
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Trop. Med. Int. Health · Jan 2015
Changes in the clinical and epidemiological features of group A streptococcal bacteraemia in Australia's Northern Territory.
Invasive group A streptococcus (iGAS) disease is an important cause of mortality globally. The incidence of iGAS in Australia's tropical Northern Territory (NT) has been previously reported as 32.2/100 000 in Indigenous people for the period 1991-1996. We aimed to measure the incidence and severity of iGAS disease in the NT since this time. ⋯ The incidence and severity of iGAS are high and increasing in tropical northern Australia, and urgent attention is needed to improve surveillance and the social determinants of health in this population. This study adds to emerging data suggesting increasing importance of iGAS in low- and middle-income settings globally.