Evaluation of the introduction of a novel device in the management of hypertension and shock in pregnancy in low-resource settings

在资源匮乏地区引入新型设备治疗妊娠期高血压和休克的评估

• 批准号: MR/N006240/1
• 负责人: Andrew Shennan
• 金额: $ 114.53万
• 依托单位: King's College London
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2015
• 资助国家: 英国
• 起止时间: 2015 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=MR%2FN006240%2F1
• 关键词: Evaluation; introduction; novel; device; management

Every day, approximately 800 women die in pregnancy or childbirth. 99% of all of these deaths occur in the developing world, with women in rural communities, with limited access to healthcare, at the greatest risk. The leading causes of death in these women include severe bleeding, overwhelming infections, and blood pressure problems. It is widely recognised that many women die in pregnancy because the problem is recognised too late. In all of these instances, simply monitoring women's blood pressure and pulse could be lifesaving. A woman would be recognised as being unwell and appropriately treated before serious, irreversible complications set in. In the developing world many healthcare providers do not have access to working blood pressure devices. Many devices that are available are often inaccurate in pregnancy, particularly in women with BP problems. This means that unwell women go unrecognised and treatment is either delayed or not given, which can result in serious illness and even death.We have developed a simple, accurate, handheld device to measure blood pressure and pulse. This device has some special features that make it ideal for use in the developing world. It does not require medically training and anyone can use the device with minimal skill. This makes it ideal for use in communities, particularly rural settings, where untrained health workers commonly visit women and their babies. Another special feature is the 'traffic light' system; the device tells the user if the blood pressure and pulse measurements are normal (green), worrying (amber) or severely abnormal (red). This enables the device to signpost women who are unwell, or becoming unwell, to untrained observers. This will enable more appropriate and early referral to higher-level care. The device has been tested extensively and is shown to be accurate in pregnant women, even those with blood pressure problems. The device can be charged through a regular mobile phone charger, has a long power life and a large easy-to-read screen. The device is cheap at less than 20 euros.Through our previous work in rural community settings in Africa, we know that there is a need for access to blood pressure devices; many clinics have no access to working, accurate machines. This project will improve access for women to have accurate measurements of their blood pressure and pulse (a fundamental part of care for women in pregnancy). Our project intends to put these simple devices into communities with the aim of improving detection of pulse and blood pressure problems. By highlighting those who are unwell, we hope use of the device will lead to more women receiving the best, most appropriate care and fewer women dying or becoming seriously unwell from these devastating diseases.

每天大约有800名妇女死于怀孕或分娩。所有这些死亡中的99%发生在发展中国家，农村社区的妇女获得医疗保健的机会有限，面临的风险最大。这些妇女的主要死亡原因包括严重出血、严重感染和血压问题。人们普遍认为，许多女性在怀孕期间死亡，是因为认识到这个问题太晚了。在所有这些情况下，仅仅监测女性的血压和脉搏就可以挽救生命。在出现严重的、不可逆转的并发症之前，女性将被认为身体不适并得到适当的治疗。在发展中国家，许多医疗保健提供者无法获得正常工作的血压设备。许多可用的设备在怀孕期间往往不准确，特别是在患有BP问题的女性身上。这意味着身体不适的女性不被发现，治疗要么被推迟，要么得不到治疗，这可能会导致严重的疾病甚至死亡。我们开发了一种简单、准确的手持设备来测量血压和脉搏。这种设备有一些特殊的特点，使其非常适合在发展中国家使用。它不需要医学培训，任何人都可以使用该设备，只需最低限度的技能。这使得它非常适合在社区使用，特别是在农村环境中，在那里未经培训的卫生工作者通常会探望妇女及其婴儿。另一个特殊功能是“红绿灯”系统；该设备告诉用户血压和脉搏的测量结果是正常的(绿色)、令人担忧的(琥珀色)还是严重异常(红色)。这使得该设备能够将身体不适或身体不适的女性指示给未受过训练的观察员。这将使患者能够更适当和更早地转诊到更高级别的护理。该设备已经过广泛的测试，并被证明在孕妇身上是准确的，即使是那些有血压问题的女性。该设备可以通过普通手机充电器充电，续航时间长，屏幕大，便于阅读。这种仪器的价格不到20欧元。通过我们之前在非洲农村社区的工作，我们知道有必要使用血压设备；许多诊所无法获得工作的、准确的机器。该项目将改善妇女获得准确测量其血压和脉搏的机会(这是孕期妇女护理的一个基本部分)。我们的项目打算将这些简单的设备投入社区，目的是改善对脉搏和血压问题的检测。通过强调那些身体不适的人，我们希望该设备的使用将导致更多的妇女得到最好、最适当的护理，并减少因这些毁灭性疾病而死亡或严重不适的妇女。

项目成果

'A prospective case control study to evaluate shock index for identifying patients at risk of clinically important malaria in refugee settings'.

“一项前瞻性案例控制研究，以评估识别难民环境中临床上重要疟疾风险的患者的冲击指数”。

• DOI: 10.1177/00494755221134975
• 发表时间: 2023-04
• 期刊: TROPICAL DOCTOR
• 影响因子: 0.6
• 作者: Kuhrt, Katy;Seed, Paul T.;Shennan, Andrew H.
• 通讯作者: Shennan, Andrew H.

Planned early delivery for late preterm pre-eclampsia in a low- and middle-income setting: a feasibility study.

• DOI: 10.1186/s12978-021-01159-y
• 发表时间: 2021-06-02
• 期刊: Reproductive health
• 影响因子: 3.4
• 作者: Beardmore-Gray A;Vousden N;Silverio SA;Charantimath U;Katageri G;Bellad M;Chinkoyo S;Vwalika B;Goudar S;Sandall J;Chappell LC;Shennan AH
• 通讯作者: Shennan AH

'A Prospective Case Control Study to Evaluate The CRADLE Vital Signs Alert Device For Detection of Patients With Clinically Important Malaria in Refugee Settings'.

“一项前瞻性病例对照研究，旨在评估用于检测难民环境中患有临床重要疟疾的 CRADLE 生命体征警报装置的患者”。

• DOI: 10.21203/rs.3.rs-205157/v1
• 发表时间: 2021
• 作者: Kuhrt K

A Prospective Case Control Study To Evaluate The CRADLE Vital Signs Alert Device For Detection Of Patients With Clinically Important Malaria In Refugee Settings

一项前瞻性病例对照研究，旨在评估用于检测难民环境中患有临床重要疟疾的 CRADLE 生命体征警报装置的患者

• DOI: 10.21203/rs.3.rs-47471/v1
• 发表时间: 2020
• 作者: Kuhrt K

Planned early delivery versus expectant management to reduce adverse pregnancy outcomes in pre-eclampsia in a low- and middle-income setting: study protocol for a randomised controlled trial (CRADLE-4 Trial).

• DOI: 10.1186/s13063-020-04888-w
• 发表时间: 2020-11-23
• 期刊: Trials
• 影响因子: 2.5
• 作者: Beardmore-Gray A;Vousden N;Charantimath U;Katageri G;Bellad M;Kapembwa K;Chinkoyo S;Vwalika B;Clark M;Hunter R;Seed P;Goudar S;Chappell LC;Shennan A
• 通讯作者: Shennan A