Lack Of Healthcare Infrastructure Research Articles

Transforming mental health care: Telemedicine as a game-changer for low-income communities in the US and Africa

Telemedicine is transforming mental health care, particularly in low-income communities in the US and Africa, where access to traditional mental health services is limited. This review explores how telemedicine is revolutionizing mental health care delivery, addressing barriers to access, and improving health outcomes for underserved populations. In low-income communities, accessing mental health services can be challenging due to factors such as lack of healthcare infrastructure, stigma, and limited financial resources. Telemedicine, which involves providing healthcare services remotely using telecommunications technology, offers a solution to these challenges by enabling patients to receive mental health care from anywhere, including their homes. Telemedicine in mental health care is particularly impactful for low-income communities in the US and Africa, where access to mental health services is often limited. Through telemedicine, individuals can receive timely and convenient mental health care, leading to improved outcomes and reduced healthcare costs. This review highlights the benefits of telemedicine in mental health care, including increased access to care, improved convenience, and reduced stigma. It also discusses the challenges of implementing telemedicine in low-income communities, such as technological barriers and regulatory issues, and proposes strategies to address these challenges. Overall, telemedicine has the potential to revolutionize mental health care delivery in low-income communities in the US and Africa, improving access to care and health outcomes for underserved populations.

Social vulnerability and spatial inequality in access to healthcare facilities: The case of the Santiago Metropolitan Region (RMS), Chile

In Chile, the Metropolitan Region of Santiago (RMS) is exposed to several natural and anthropogenic hazards. This means that not only is there a constant need for healthcare, but also a significant increase whenever its inhabitants are affected by disasters. The RMS problem is not the lack of healthcare infrastructure; rather, the inequality in its spatial distribution, which does not consider the location of the most vulnerable population, who may have greater healthcare needs. In this paper, we have performed Pearson's correlation and multicollinearity analysis to select variables to include in the multiple regression analysis to identify the predictors of the number of healthcare facilities per commune in the RMS. Our research found that public healthcare facilities, average monthly income per person per commune, and population density predicts in a 74.1% the number of the total healthcare facilities per commune in the RMS. Network analysis allowed us to integrate distance-based and area-based approaches to spatially visualise the service area of the healthcare facilities in all the districts in the communes of the RMS according to three walking distances. Total coverage of service areas is observed only in 4% of the districts, while high and medium coverage is identified in 30%, low coverage is observed in 28% and 7% of districts are not covered at all. Those districts with low or non-coverage are mainly low-income and/or rural districts in the RMS communes.

Artificial Intelligence-Based Cervical Cancer Screening on Images Taken during Visual Inspection with Acetic Acid: A Systematic Review

Visual inspection with acetic acid (VIA) is one of the methods recommended by the World Health Organization for cervical cancer screening. VIA is simple and low-cost; it, however, presents high subjectivity. We conducted a systematic literature search in PubMed, Google Scholar and Scopus to identify automated algorithms for classifying images taken during VIA as negative (healthy/benign) or precancerous/cancerous. Of the 2608 studies identified, 11 met the inclusion criteria. The algorithm with the highest accuracy in each study was selected, and some of its key features were analyzed. Data analysis and comparison between the algorithms were conducted, in terms of sensitivity and specificity, ranging from 0.22 to 0.93 and 0.67 to 0.95, respectively. The quality and risk of each study were assessed following the QUADAS-2 guidelines. Artificial intelligence-based cervical cancer screening algorithms have the potential to become a key tool for supporting cervical cancer screening, especially in settings where there is a lack of healthcare infrastructure and trained personnel. The presented studies, however, assess their algorithms using small datasets of highly selected images, not reflecting whole screened populations. Large-scale testing in real conditions is required to assess the feasibility of integrating those algorithms in clinical settings.

COVID-19 Vaccine Equity: Codesigning Public Health Interventions with Community Partners.

COVID-19 Vaccine Equity: Codesigning Public Health Interventions with Community Partners.

Analysis of Multiple Factors Influencing COVID-19 Induced Mental Health

The pandemic has adversely affected human lives. People have lost their loved ones, their jobs and even their homes in some cases. People have suffered from anxiety, frequent frustration, distress and loneliness due to the pandemic. With many of us facing challenges and battles in our lives, it is natural to feel frustrated and distressed. The spread of rumours and misinformation has led to anger, disorder and stress among people. In a country like India, where the population has suffered immensely due to the lack of healthcare infrastructure, Mental Health conditions are also deteriorated considerably due to different factors, we can confirm this by looking at the rise in suicide cases not only in India but also all around the world. We surveyed a few people across India including the working class and students from various age groups as the Covid-19 pandemic situation has brought everyone into renewed focus. The result indicates the level of suffering and the factors that have influenced their recovery.

Ultrasensitive point-of-care immunoassay for secreted glycoprotein detects Ebola infection earlier than PCR.

Ebola virus (EBOV) hemorrhagic fever outbreaks have been challenging to deter due to the lack of health care infrastructure in disease-endemic countries and a corresponding inability to diagnose and contain the disease at an early stage. EBOV vaccines and therapies have improved disease outcomes, but the advent of an affordable, easily accessed, mass-produced rapid diagnostic test (RDT) that matches the performance of more resource-intensive polymerase chain reaction (PCR) assays would be invaluable in containing future outbreaks. Here, we developed and demonstrated the performance of a new ultrasensitive point-of-care immunoassay, the EBOV D4 assay, which targets the secreted glycoprotein of EBOV. The EBOV D4 assay is 1000-fold more sensitive than the U.S. Food and Drug Administration-approved RDTs and detected EBOV infection earlier than PCR in a standard nonhuman primate model. The EBOV D4 assay is suitable for low-resource settings and may facilitate earlier detection, containment, and treatment during outbreaks of the disease.

Healthcare-related factors affecting the management of HIV infected patients: a systematic review of qualitative evidence.

Human immunodeficiency virus (HIV) infection is a major health concern that is associated with high mortality and socioeconomic burden on both patients and healthcare authorities. This systematic review aimed to qualitatively explore the healthcare-related factors influencing the management of HIV in adult patients. Seven online databases (PubMed, Embase, Google Scholar, CINAHL, PsycInfo, PsycExtra, and International Pharmaceutical Abstract) were searched. Articles published in English language between September 2000 and September 2018 were eligible for inclusion. Quality assessment tool developed by the EPPI-Centre was used to assess the quality of the included studies. A cross-case thematic analysis was conducted using NVivo 10. A total of 30 studies were included in the review. The qualitative analysis identified four major themes influencing the management of HIV: awareness of healthcare professionals (HCPs), attitudes of HCPs, lack of healthcare infrastructure, and stigma associated with HIV. The findings of this review suggest that people living with HIV are at an increased risk of experiencing poor disease management due to various healthcare-related factors. HCPs and policy makers should acknowledge the presence of these factors with the aim of providing quality care to people living with HIV.

Role of Human Pappillomavirus and Cervical Cancer in Developing Countries: A Current Trend in Africa

Cervical cancer is a relatively rare disease in countries that have instituted and maintained national screening programs, with call and recall of women at various intervals and built-in quality control with appropriate monitoring and evaluation. Unfortunately, this process has failed in most areas of the world where more than 80% of new cases of cervical cancer are diagnosed. Cervical cancer is the fourth most common cancer affecting women, with worldwide annual incidence and mortality rates of 528,000 and 266,000, respectively. It is well established that cervical cancer is predominantly caused by a persistent human papillomavirus (HPV) infection of cervical cells. Increasing numbers of studies have investigated HPV and cervical cancer, contributing greatly to the global knowledge and unraveling some of the critical questions regarding HPV transmission, infection, and prevention. Treatment of cervical cancer in Africa is hampered by the lack of diagnostic and treatment facilities, lack of healthcare infrastructure and poor pathology services. Furthermore, there is a significant brain drain of trained healthcare workers in Africa that exacerbates the problem. Cancer is becoming an increasingly important public health problem as more people live longer. It is time to develop programs for the prevention, early detection, treatment, and palliation of cancer sufferers in Africa. Therefore, this review describes the current status of HPV in developing countries, presenting some of the existing challenges in implementing cervical screening and HPV vaccination programs.

Neonatal Mortality in a Haitian Hospital

Introduction A report by UNICEF found that in 2012, there were 264,887 live births in Haiti, and a neonatal mortality rate of 25.4 per 1,000 live births, placing the country in the bottom tier for infant mortality rate.1 These reports often cite the general lack of healthcare infrastructure as the primary cause. However, few, if any studies have looked at specific causes of death and factors affecting mortality in neonates within the healthcare setting. Assessing the causes of mortality as well as risk factors that contribute to a higher risk of infant …

Cervical Cancer Screening in Post-Conflict Underdeveloped Areas

Cervical cancer is a huge health concern. It is the second most common female tumor worldwide. It is consider a professionalchallenge for gynecologist. 90% of newly diagnosed cases are in the countries with a low socio-economic growth. Lack of health care infrastructure, accessibility, low level of education, lack of hygienic habits are all the factors contributing to this figure. Cervical cancer occurs mainly in low-resource, underserved regions as part of a complex of diseases linked to poverty, race/ethnicity, and/or other health disparities. It has been shown that only 5% of women living in under developed countries, are having regular yearly screening. Under given circumstances regular cervical cancer screening using cervical cytology (Papanicolaou [Pap] smears) is the best cost-effective option gynecologist have.The goal of this scientific paper is to present the results of screening test done in Clinical Center Pristina Gracanica Kosovo, Serbia.Screening was done retrospectively in the period of 2011-2015. The total number of screened women was 2871. Pap smear test and colposcopy were performed. In 6.3% of the cases Pap test was positive, including 96% Papa III, and 12 cases of cervical cancer were diagnosed.

Displaced children with cancer in Lebanon: A sustained response to an unprecedented crisis.

The unrest in Syria has resulted in an escalating refugee crisis. The postwar lack of health care infrastructure in Iraq has also resulted in Iraqis seeking health care in neighboring countries. Pediatric cancer is largely curable, although its treatment is expensive and complex. Strategies to implement pediatric cancer care with curative intent in these vulnerable populations are lacking. To assess the feasibility of a collaborative approach for the provision of care to displaced children with cancer, this study reviewed the experience of the authors over the past 6 years in Lebanon, the country with the highest number of refugees per capita in the world. The American University of Beirut Medical Center and the Children's Cancer Center of Lebanon Foundation, in partnership with St. Jude Children's Research Hospital and the American Lebanese Syrian Associated Charities, established 3 successive funding programs to treat displaced children with cancer along with a continuous assessment of resource utilization. Between 2011 and 2017, 575 non-Lebanese children suspected to have cancer were evaluated. Of those, 311 received direct medical support, with 107 receiving full-treatment coverage and 204 receiving limited-workup/specialty services; the remaining 264 patients received medical consultations. In addition to providing lifesaving humanitarian support, the coordination of care delivery, including the establishment of guidelines for prioritization, can help direct future efforts. Many patients continue to be in dire need of support, and this should be addressed via collaboration among governmental, nongovernmental, and health care organizations. Cancer 2018;124:1464-72. © 2018 American Cancer Society.

Knowledge, Attitude and Behavior Related to Antibiotic Use in Community Dwellings

Background: Irrational antibiotic use is the major reason for insidence of antibiotic resistance. Antibiotic misuse in community is influenced by environmental and behavioral factors. Environment included community preference for purchasing antibiotics, lack of health care infrastructure, lack of general practitioner and policy in regulating antibiotic use. Behavior is influenced by lack of information in antibiotic use and unawareness of antibiotic resistancy. The aim of the study was to assess the level of knowledge, attitude and behavior regarding antibiotic use in community dwellings. Methods: A cross sectional descriptive study was carried out to 96 respondents who were selected by a rapid survey sampling method in Cileles village Jatinangor, Sumedang, West Java, Indonesia in August 2013. Data were collected using questionnaires. The data was analyzed in the form of frequency and percentage. Results: Out of 96 respondents, only 40.6% had good knowledge regarding antibiotic use, 12.5% of respondents were prescribed antibiotics, but in the last course did not purchased all the antibiotics prescribed by the clinician and 55.2% of respondents did not complete their treatment course. Conclusions: Most of the community still have poor knowledge regarding antibiotic use and its consequences such as allergy, and resistancy based on the knowledge questions has a total score ≤6. Their attitude and behavior regarding antibiotic use are still poor which is also based on incompletion of the antibiotic treatment and irregular use. DOI: 10.15850/amj.v4n2.1082

Colorectal cancer screening: An updated review of the available options.

Colorectal cancer (CRC) is a significant cause of morbidity and mortality worldwide. However, colon cancer incidence and mortality is declining over the past decade owing to adoption of effective screening programs. Nevertheless, in some parts of the world, CRC incidence and mortality remain on the rise, likely due to factors including “westernized” diet, lifestyle, and lack of health-care infrastructure and resources. Participation and adherence to different national screening programs remain obstacles limiting the achievement of screening goals. Different modalities are available ranging from stool based tests to radiology and endoscopy with varying sensitivity and specificity. However, the availability of these tests is limited to areas with high economic resources. Recently, FDA approved a blood-based test (Epi procolon®) for CRC screening. This blood based test may serve to increase the participation and adherence rates. Hence, leading to increase in colon cancer detection and prevention. This article will discuss various CRC screening tests with a particular focus on the data regarding the new approved blood test. Finally, we will propose an algorithm for a simple cost-effective CRC screening program.

Community Awareness - A Key to the Early Detection of Head and Neck Cancer

INTRODUCTION
 Mortality and morbidity associated with head and neck cancers have decreased to a great extent in many developed countries of the world due to early diagnosis and treatment with advances in surgical techniques and better availability of radiotherapist and oncologists. But the situation in developing countries like India is quite different.
 AIMS AND OBJECTIVES
 This study was conducted amongst the patients attending the Otolaryngology department of a teaching hospital in Kolkata to find the incidence of various types and sites of head and neck cancer, to assess time delay from the date of onset of symptom to the final disease confirmation in relation to patients’ demographic profile, to assess time delay in histopathological diagnosis after reaching a tertiary care setup and also to correlate tobacco consumption and alcohol intake as risk factors for head and neck cancer and to note the reasons for late presentation, as described by the patient.
 MATERIALS AND METHODS
 The descriptive study was conducted at a tertiary level teaching hospital, in the Department of Otorhinolaryngology for a period from August 2013 to August 2015 with a study population of 133. 
 OBSERVATIONS 
 An average time lag from the onset of symptom to final diagnosis as malignancy was found to be 6 months to one year in nearly 72% of cases. Most of the patients were uneducated males of more than 50 years of age, hailing from rural areas. Cancer larynx was found to be the commonest of all head and neck cancers (31.6%). More than 65% of the patients were addicted to tobacco chewing or smoking or consumption of alcohol. 
 DISCUSSION 
 Poverty, lack of education, poor communication, lack of health care infrastructure in rural areas, community awareness about various risk factors, lack of effective health policy to achieve early diagnosis of head neck cancer were common factors related to delay in diagnosis. 
 CONCLUSION 
 Tobacco use and alcohol intake are the modifiable risk factors of head and neck cancer. Educating the field workers about the danger signs of head and neck cancer may promote early referral of the suspected cases to tertiary health care setup for early detection of cancer.

New era of colorectal cancer screening.

Colorectal cancer (CRC) is the 2(nd) most common cancer in women and 3(rd) most common cancer in men worldwide. Most CRCs develop from adenomatous polyps arising from glandular epithelium. Tumor growth is initiated by mutation of the tumor suppressor gene APC and involves other genetic mutations in a stepwise process over years. Both hereditary and environmental factors contribute to the development of CRC. Screening has been proven to reduce the incidence of CRC. Screening has also contributed to the decrease in CRC mortality in the United States. However, CRC incidence and/or mortality remain on the rise in some parts of the world (Eastern Europe, Asia, and South America), likely due to factors including westernized diet, lifestyle, and lack of healthcare infrastructure. Multiple screening options are available, ranging from direct radiologic or endoscopic visualization tests that primarily detect premalignant or malignant lesions such as flexible sigmoidoscopy, optical colonoscopy, colon capsule endoscopy, computed tomographic colonography, and double contrast barium enema - to stool based tests which primarily detect cancers, including fecal DNA, fecal immunochemical test, and fecal occult blood test. The availability of some of these tests is limited to areas with high economic resources. This article will discuss CRC epidemiology, pathogenesis, risk factors, and screening modalities with a particular focus on new technologies.

Elevated prevalence of malnutrition and malaria among school-aged children and adolescents in war-ravaged South Sudan

Emerging as a sovereign state from decades of civil war, the Republic of South Sudan now faces poverty, a lack of health care infrastructure, a high burden of infectious diseases and a widespread food insecurity. School-aged children and youth, in particular, represent a high-risk demographic for malnutrition and infectious diseases. We screened 109 school-aged children and youth for nutritional status and malaria antigenaemia in Akuak Rak, South Sudan, and found a large proportion of underweight (77/109 = 73%) and prevalent malaria (44/109 = 40%). There was no significant association between malnutrition and malaria. This study represents one of the few published reports on child and youth nutritional status and malaria prevalence in South Sudan since its independence. The implementation of nutrition and malaria screening combined with evidence-based interventions in schools could help target this high burden vulnerable group.

Women victims of sexual violence in armed conflicts in the Democratic Republic of Congo

Summary Context The conflict in the East of the Democratic Republic of the Congo (DRC) is one of the most deadly conflicts that there has been since the Second World War. The main author has been working in South Kivu for ten years now. During the course of her numerous assignments, she has been confronted with particular situations of women who are victims of sexual violence and the consequences of rape. The current gaps in the provision of care for victims include a lack of healthcare infrastructure, an insufficient number of psychotherapists, and challenges associated with socio-economic reintegration. Method This study is based on sexual health counselling and on a survey done on women who are victims of rape in rural environments and who are being cared for in the Panzi hospitals of reference in South Kivu. Results The article presents the situation as a whole, a study of three illustrative cases and recommendations for an improvement in care. Sexual health and reproduction form an integral part of the improvement of life in general and are possible only if human rights are respected.

How do you circumcise a nation? The Rwandan case study.

Voluntary medical male circumcision has been conclusively demonstrated to reduce the lifetime risk of male acquisition of HIV. The strategy has been adopted as a component of a comprehensive strategy towards achieving an AIDS-free generation. A number of countries in which prevalence of HIV is high and circumcision is low have been identified as a priority, where innovative approaches to scale-up are currently being explored. Rwanda, as one of the priority countries, has faced a number of challenges to successful scale-up. We discuss here how simplifications in the procedure, addressing a lack of healthcare infrastructure and mobilizing resources, and engaging communities of both men and women have permitted Rwanda to move forward with more optimism in its scale-up tactics. Examples from Rwanda are used to highlight how these barriers can and should be addressed.

Health care social media: expectations of users in a developing country.

BackgroundAffordability, acceptability, accommodation, availability, and accessibility are the five most important dimensions of access to health services. Seventy two percent of the Indian population lives in semi-urban and rural areas. The strong mismatched ratio of hospitals to patients, rising costs of health care, rapidly changing demographics, increasing population, and heightened demands in pricing for technological health care usage in emerging economies necessitate a unique health delivery solution model using social media. A greater disease burden lies in the health care delivery in developing country like India. This is due to the lack of health care infrastructure in the majority of semi-urban and rural regions. New techniques need to be introduced in these regions to overcome these issues. In the present scenario, people use social media from business, automobiles, arts, book marking, cooking, entertainment, and general networking. Developed and advanced countries like the United States have developed their communication system for many years now. They have already established social media in a number of domains including health care. Similar practice incidences can be used to provide a new dimension to health care in the semi-urban regions of India.ObjectiveThis paper describes an extended study of a previous empirical study on the expectations of social media users for health care. The paper discusses what the users of social media expect from a health care social media site.MethodsMultiple regression analysis was used to determine the significance of the affect of four factors (privacy, immediacy, usability, and communication) on the usage of health care social media. Privacy, immediacy, usability, and communication were the independent variables and health care social media was the dependant variable.ResultsThere were 103 respondents who used the online questionnaire tool to generate their responses. The results from the multiple regression analysis using SPSS 20 showed that the model is acceptable, with P=.011, which is statistically significant on a P<.05 level. The observed F value (2.082) in ANOVA was less than the given value in the F table (2.61), which allowed us to accept the hypothesis that the independent variables influence the dependant variable. The users of social media in India expect that they can best utilize social media through emergency service information. They want to be able to learn the operations of the social media site quickly and expect to know about health camps and insurance collaborations. However, people like to become friends with people with similar interests based on their interests identified.ConclusionsHealth care social media requires intelligent implementation in developing economies. It needs to cater to the expectations of the users. The people in India, especially those in urban and semi-urban regions, are very interested in accepting the system.

Cervical Cancer in Africa

Cervical cancer is a relatively rare disease in countries that have instituted and maintained national screening programs, with call and recall of women at various intervals and built-in quality control with appropriate monitoring and evaluation. Unfortunately, this process has failed in most areas of the world where more than 80% of new cases of cervical cancer are diagnosed. Cervical cancer affects women in the prime of their lives causing premature and needless suffering and death in a critically important segment of the world's population, despite being one of the few cancers that can be prevented with simple testing. In the past 15 years innovative approaches to both primary and secondary prevention of cervical cancer have been subjected to a number of large scale, scientifically valid and applicable studies that have opened the way for new approaches. Treatment of cervical cancer in Africa is hampered by the lack of diagnostic and treatment facilities, lack of healthcare infrastructure and poor pathology services. Further, there is a significant brain drain of trained healthcare workers in Africa that exacerbates the problem. Cancer is becoming an increasingly important public health problem as more people live longer. It is time to develop programs for the prevention, early detection, treatment, and palliation of cancer sufferers in Africa.