Covid-19 PPE for LMIC

在低收入和中等收入国家(LMIC)，头颈部癌症的治疗存在许多障碍，特别是难以观察到解剖位置，缺乏受过充分培训的专业人员，以及需要专门的昂贵设备。头颈部癌症涉及口腔鼻腔、咽部和喉部，对全球健康构成重大负担，并对生活质量和日常生活活动(如说话和饮食)产生重大影响。在越南，许多省级和地区医院缺乏适当的培训和 对出现头颈部症状和主诉的患者进行充分检查的设备。为此，我们的学术和工业研究人员合作开发了一种低成本、可移动的柔性鼻咽镜(FNS)，用于检查和分选患者进行本地治疗或转诊至三级治疗中心的专家。 将越南作为其他资源匮乏的医疗体系的典范，拟议项目的目标是向当地医院和诊所的医疗提供者提供新的头颈癌诊断和治疗能力。此外，FNS的使用将改善对专门医疗中心的分流和利用。 这将通过减少不必要地在三级机构寻求普通护理的患者数量，在当地治疗早期癌症患者，并只转介那些需要专门护理的患者来实现。我们将通过以下具体目标实现这些目标：1)通过比较主要三级护理中心的护理标准来优化FNS；2)在FNS技术和检查方面对当地医疗保健提供者进行教育和培训；以及3)在实践研究网络中评估FNS的实施情况。我们将计划 通过建立一个由越南河内及其周边地区的30家医院组成的基于实践的研究网络来实现这些目标。数据将通过基于电子网络的调查在5年内从大约125,000名受试者中收集。 预期结果将改善越南当地医疗机构的头颈部护理，并为头颈癌患者提供及时的诊断、当地治疗或转诊。这些成果也将成为在世界其他低资源环境中扩大培训和使用低成本财务网络的基础。

There are many barriers to the care of head and neck cancers in low and middle income countries (LMICs), notably difficult-to-visualize anatomic locations, lack of adequately trained professionals, and the need for specialized, costly equipment. Head and neck cancers, which involve the oral-nasal cavities, pharynx and larynx, present a significant global health burden and have a significant impact on quality of life and daily living activities such as speaking and eating. In Vietnam, many provincial and district hospitals lack the proper training and equipment to adequately exam patients presenting with head and neck symptoms and complaints. To this end, our partnership of academic and industrial investigators has developed a low cost, mobile flexible nasolaryngoscope (FNS) for use to exam and triage patients for treatment locally or for referral to specialists in tertiary treatment centers. Using Vietnam as a model for other resource-poor healthcare systems, the goals of the proposed project are to deliver new diagnostic and treatment capacity for head and neck cancers to health providers at local hospitals and clinics. Furthermore, the use of FNS will improve triaging to and utilization of specialized medical centers. This will be achieved through decreasing the number of patients unnecessarily seeking general care at tertiary facilities, locally treating those with early cancers, and referring only those patients needing specialized care. We will accomplish these goals through the following specific aims:1) Optimize the FNS by comparison to standard of care scopes at the main tertiary care centers; 2) Educate and train local healthcare providers in FNS technique and examinations; and 3) Assess implementation of FNS within the practice research network. We will plan to achieve these aims through establishing a practice based research network of 30 hospitals sites in and around Hanoi Vietnam. Data will be collected from an estimated 125,000 subjects over 5 years via electronic web based survey. The expected outcomes will improve head and neck care by health providers at local facilities within Vietnam and provide timely diagnosis, local treatment or referral for head and neck cancer patients. These outcomes will also be the basis for expansion of training and use of the low cost FNS in other low resource settings worldwide.