Using mHealth technology to identify and refer surgical site infections in Rwanda

在卢旺达使用移动医疗技术识别和转诊手术部位感染

基本信息

  • 批准号:
    9339665
  • 负责人:
  • 金额:
    $ 17.83万
  • 依托单位:
  • 依托单位国家:
    美国
  • 项目类别:
  • 财政年份:
    2016
  • 资助国家:
    美国
  • 起止时间:
    2016-09-01 至 2019-06-30
  • 项目状态:
    已结题

项目摘要

 DESCRIPTION (provided by applicant): Surgical site infections (SSI) are a significant cause of morbidity and mortality worldwide, and particularly in low- and middle-income countries, where geographic and infrastructural barriers often delay or prevent post- operative patients from returning to care. In these settings, rates of SSI can reach 30%. In Rwanda, the site of the proposed research, the current standard of care does not include follow-up of post-operative surgical patients. There, a network of community health workers (CHWs) are employed to provide care and follow-up for pregnant and post-partum women as well as children under five years of age. However, the limited education and existing work load of these workers preclude them from supporting the follow-up of other specialized conditions, such as post-operative patients. The interventions evaluated in this proposed research seeks to address these gaps. The first aim of this study is to optimize a screening protocol to identify SSI in patients receivig surgery at Kirehe District Hospital (KDH) 10 days post-operation. This initial phase of research will involve screening 450 patients first by a general practitioner and then by a surgical CHW (sCHW) using a six question protocol. The protocol will undergo an optimization procedure and the final sensitivity and specificity reported. The second aim is to evaluate the impact of SSI screening protocol, delivered by sCHWs equipped with mHealth support, on the rate of return to care for patients with SSI 10 days post-operation. Two CHW-mHealth interventions will be evaluated. In the first, a sCHW will visit post-operative study participants in their homes to administer the screening protocol prompted by the mobile phone. In the second, a sCHW will call the patient and administer the same screening protocol over the phone. In this phase of the research, 400 patients will be assigned to each of these delivery arms, and the rates of appropriate return to care will be compared to that of 400 patients in a control arm receiving the standard of care (i.e. no follow-up). Process indicators also will be reported to describe the feasibility of CHW-mHealth interventions. We believe that the SSI screening protocol administered via CHW-mHealth interventions can support accurate diagnosis of SSI and refer patients back to the hospital for appropriate follow-up care. The research team's close collaboration with colleagues at the Rwanda Ministry of Health will facilitate the scale-up of the intervention, should it prove efficacious. Results of this study will also inform the development o similar mHealth interventions across other disease areas, allowing CHWs to expand services to other specialized patients in rural African settings.
 描述(由申请方提供):手术部位感染(SSI)是全球发病率和死亡率的重要原因,特别是在低收入和中等收入国家,地理和基础设施障碍通常会延迟或阻止术后患者返回护理。在这些情况下,SSI的发生率可达30%。在拟议研究的地点卢旺达,目前的护理标准不包括手术后手术患者的随访。在那里,雇用了一个社区保健工作者网络,为孕妇和产后妇女以及5岁以下儿童提供护理和跟踪服务。然而,这些工作人员受教育程度有限,现有工作量很大,无法支持对其他特殊情况,如手术后病人的后续工作。在这项拟议的研究中评估的干预措施旨在解决这些差距。本研究的第一个目的是优化筛选方案,以确定手术后10天在Kirehe地区医院(KDH)接受手术的患者中的SSI。该研究的初始阶段将涉及筛选450名患者,首先由全科医生,然后由外科CHW(sCHW)使用六个问题的协议。该方案将进行优化程序,并报告最终灵敏度和特异性。第二个目的是评估SSI筛查方案的影响,该方案由配备mHealth支持的sCHW提供,对手术后10天SSI患者的恢复率有影响。将对两项CHW-mHealth干预措施进行评估。首先,sCHW将访问术后研究参与者的家中,以管理移动的电话提示的筛查方案。在第二种情况下,sCHW将致电患者并通过电话执行相同的筛查方案。在研究的这一阶段,400名患者将被分配到每个治疗组,并将适当恢复治疗的比率与接受标准治疗(即无随访)的对照组400名患者的比率进行比较。还将报告过程指标,以描述CHW-mHealth干预措施的可行性。我们相信,通过CHW-mHealth干预措施管理的SSI筛查方案可以支持SSI的准确诊断,并将患者转诊回医院进行适当的后续护理。研究小组与卢旺达卫生部同事的密切合作将有助于扩大干预措施的规模,如果它被证明是有效的。这项研究的结果还将为其他疾病领域类似的移动健康干预措施的发展提供信息,使CHW能够将服务扩展到非洲农村地区的其他专业患者。

项目成果

期刊论文数量(7)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
Long travel times from health center to hospital reduce caesarean section access: a study from Kirehe District, Rwanda.
The Effect and Feasibility of mHealth-Supported Surgical Site Infection Diagnosis by Community Health Workers After Cesarean Section in Rural Rwanda: Randomized Controlled Trial.
  • DOI:
    10.2196/35155
  • 发表时间:
    2022-06-08
  • 期刊:
  • 影响因子:
    5
  • 作者:
    Kateera, Fredrick;Riviello, Robert;Goodman, Andrea;Nkurunziza, Theoneste;Cherian, Teena;Bikorimana, Laban;Nkurunziza, Jonathan;Nahimana, Evrard;Habiyakare, Caste;Ntakiyiruta, Georges;Matousek, Alexi;Gaju, Erick;Gruendl, Magdalena;Powell, Brittany;Sonderman, Kristin;Koch, Rachel;Hedt-Gauthier, Bethany
  • 通讯作者:
    Hedt-Gauthier, Bethany
Variability of water, sanitation, and hygiene conditions and the potential infection risk following cesarean delivery in rural Rwanda.
卢旺达农村地区水、环境卫生和个人卫生条件的变化以及剖腹产后的潜在感染风险。
  • DOI:
    10.2166/wh.2020.220
  • 发表时间:
    2020
  • 期刊:
  • 影响因子:
    2.3
  • 作者:
    Robb,KatharineAnn;Habiyakare,Caste;Kateera,Fredrick;Nkurunziza,Theoneste;Dusabe,Leila;Kubwimana,Marthe;Powell,Brittany;Koch,Rachel;Gruendl,Magdalena;Ngamije,Patient;Riviello,Robert;Hedt-Gauthier,Bethany
  • 通讯作者:
    Hedt-Gauthier,Bethany
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Bethany Hedt-Gauthier其他文献

Bethany Hedt-Gauthier的其他文献

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{{ truncateString('Bethany Hedt-Gauthier', 18)}}的其他基金

mHealth-Community Health Worker tool for comprehensive post-cesarean follow-up in rural Rwanda
用于卢旺达农村地区剖腹产后全面随访的移动医疗社区卫生工作者工具
  • 批准号:
    10477365
  • 财政年份:
    2021
  • 资助金额:
    $ 17.83万
  • 项目类别:
mHealth-Community Health Worker tool for comprehensive post-cesarean follow-up in rural Rwanda
用于卢旺达农村地区剖腹产后全面随访的移动医疗社区卫生工作者工具
  • 批准号:
    10913655
  • 财政年份:
    2021
  • 资助金额:
    $ 17.83万
  • 项目类别:
mHealth-Community Health Worker tool for comprehensive post-cesarean follow-up in rural Rwanda
用于卢旺达农村地区剖腹产后全面随访的移动医疗社区卫生工作者工具
  • 批准号:
    10268606
  • 财政年份:
    2021
  • 资助金额:
    $ 17.83万
  • 项目类别:
Telemedicine to improve the diagnosis of surgical site infections post-cesarean delivery in rural Rwanda
远程医疗可改善卢旺达农村地区剖腹产后手术部位感染的诊断
  • 批准号:
    9895899
  • 财政年份:
    2019
  • 资助金额:
    $ 17.83万
  • 项目类别:
Telemedicine to improve the diagnosis of surgical site infections post-cesarean delivery in rural Rwanda
远程医疗可改善卢旺达农村地区剖腹产后手术部位感染的诊断
  • 批准号:
    10019000
  • 财政年份:
    2018
  • 资助金额:
    $ 17.83万
  • 项目类别:

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