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1.
Telemed J E Health ; 25(3): 221-229, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-29664328

RESUMO

BACKGROUND: Existing studies regarding e-health are mostly focused on information technology design and implementation, system architecture and infrastructure, and its importance in public health with ancillaries and barriers to mass adoption. However, not enough studies have been conducted to assess the end-users' reaction and acceptance behavior toward e-health, especially from the perspective of rural communities in developing countries. OBJECTIVE: The objective of this study is to explore the factors that influence rural end users' acceptance of e-health in Bangladesh. METHODS: Data were collected between June and July 2016 through a field survey with structured questionnaire form 292 randomly selected rural respondents from Bheramara subdistrict, Bangladesh. Technology Acceptance Model was adopted as the research framework. Logistic regression analysis was performed to test the theoretical model. RESULTS: The study found social reference as the most significantly influential variable (Coef. = 2.28, odds ratio [OR] = 9.73, p < 0.01) followed by advertisement (Coef. = 1.94, OR = 6.94, p < 0.01); attitude toward the system (Coef. = 1.52, OR = 4.56, p < 0.01); access to cellphone (Coef. = 1.37, OR = 3.92, p < 0.05), and perceived system effectiveness (Coef. = 0.74, OR = 2.10, p < 0.01). Among demographic variables, age, gender, and education were found significant while we did not find any significant impact of respondents' monthly family expenditure on their e-health acceptance behavior. The model explains 54.70% deviance (R2 = 0.5470) in the response variable with its constructs. The "Hosmer-Lemeshow" goodness-of-fit score (0.539) is also above the standard threshold (0.05), which indicates that the data fit well with the model. CONCLUSION: The study provides guidelines for the successful adoption of e-health among rural communities in developing countries. This also creates an opportunity for e-health technology developers and service providers to have a better understanding of their end users.


Assuntos
Países em Desenvolvimento/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , População Rural/estatística & dados numéricos , Telemedicina/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Bangladesh , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Reprodutibilidade dos Testes , Fatores Socioeconômicos , Inquéritos e Questionários
2.
Telemed J E Health ; 25(5): 391-398, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-29882727

RESUMO

Background:The electronic prescription system has emerged to reduce the ambiguity and misunderstanding associated with handwritten prescriptions. The opportunities and challenges of e-prescription system, its impact on reducing medication error, and improving patient's safety have been widely studied. However, not enough studies were conducted to explore and quantify the factors that affect rural patients' compliance with e-prescription, especially from the perspective of Asian developing countries where most of the world's population resides.Objective:The objective of this study is to explore and assess the factors that affect rural patients' primary compliance with e-prescription in Bangladesh.Methods:Data were collected from 95 randomly selected rural patients who received e-prescription through a field survey with a structured questionnaire from Bheramara subdistrict, Bangladesh, during June and July 2016. Logistic regression analysis was performed to test the research hypotheses.Results:The study found patients' gender as the most significantly influential factor (regression coefficient [Coef.] = 2.02, odds ratio [OR] = 7.51, p < 0.05) followed by visiting frequency (Coef. = 0.99, OR = 2.70, p < 0.05); education (Coef. = 0.92, OR = 2.51, p < 0.05); and distance to healthcare facility (Coef. = 0.82, OR = 2.26, p < 0.01). However, patients' age, monthly family expenditure, and use of cell phone were found insignificant. The model explains 59.40% deviance (R2 = 0.5940) in the response variable with its constructs. And the "Hosmer-Lemeshow" goodness-of-fit score (0.99) is also above the standard threshold (0.05), which indicates the data fit well with the model.Conclusions:The findings of this study are expected to be helpful for e-health service providers to gain a better understanding of the factors that influence their patients to comply with e-prescriptions.


Assuntos
Países em Desenvolvimento/estatística & dados numéricos , Prescrição Eletrônica/estatística & dados numéricos , Adesão à Medicação/estatística & dados numéricos , População Rural/estatística & dados numéricos , Adolescente , Adulto , Fatores Etários , Bangladesh , Criança , Registros Eletrônicos de Saúde , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Sexuais , Fatores Socioeconômicos , Meios de Transporte , Adulto Jovem
3.
J Med Internet Res ; 17(1): e2, 2015 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-25630348

RESUMO

BACKGROUND: The prevalence of non-communicable diseases is increasing throughout the world, including developing countries. OBJECTIVE: The intent was to conduct a study of a preventive medical service in a developing country, combining eHealth checkups and teleconsultation as well as assess stratification rules and the short-term effects of intervention. METHODS: We developed an eHealth system that comprises a set of sensor devices in an attaché case, a data transmission system linked to a mobile network, and a data management application. We provided eHealth checkups for the populations of five villages and the employees of five factories/offices in Bangladesh. Individual health condition was automatically categorized into four grades based on international diagnostic standards: green (healthy), yellow (caution), orange (affected), and red (emergent). We provided teleconsultation for orange- and red-grade subjects and we provided teleprescription for these subjects as required. RESULTS: The first checkup was provided to 16,741 subjects. After one year, 2361 subjects participated in the second checkup and the systolic blood pressure of these subjects was significantly decreased from an average of 121 mmHg to an average of 116 mmHg (P<.001). Based on these results, we propose a cost-effective method using a machine learning technique (random forest method) using the medical interview, subject profiles, and checkup results as predictor to avoid costly measurements of blood sugar, to ensure sustainability of the program in developing countries. CONCLUSIONS: The results of this study demonstrate the benefits of an eHealth checkup and teleconsultation program as an effective health care system in developing countries.


Assuntos
Doença Crônica/prevenção & controle , Países em Desenvolvimento , Medicina Preventiva/métodos , Consulta Remota , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Atenção à Saúde , Prescrição Eletrônica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Consulta Remota/instrumentação , Fatores de Risco , Telemedicina , Adulto Jovem
4.
PLoS One ; 19(2): e0289237, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38394176

RESUMO

Rich nature of social media data offers a great opportunity to examine social worlds of its users. Further to wide range of topics being discussed on social media, alcohol-related content is prevalent on social media and studies have found an association between this content and increased consumption of alcohol, cravings for alcohol and addiction. This study analyses social media data to examine social worlds of risky drinking in Victoria, Australia. This study conducted a scoping literature review and two online surveys, one with the general community and the other with health professionals, to determine key words to search for on social media sites. These keywords were used in a social media analytics tool called Talkwalker to generate quantitative and qualitative data on the social media users and their conversations. NVIVO was used for developing categories and themes in a sample of 172 posts. A total of 1,021 results were obtained from Twitter. The main demographic group found to be involved in conversations about drinking alcohol on Twitter was young fathers aged 25-34 years. The culture of alcohol consumption in Victoria for Twitter users is reflective of Australia's drinking culture within which risky drinking, and in particular binge drinking, is normalised.


Assuntos
Mídias Sociais , Humanos , Consumo de Bebidas Alcoólicas/epidemiologia , Comunicação , Fissura , Inquéritos e Questionários , Vitória
5.
Jpn J Nurs Sci ; 21(1): e12568, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37800657

RESUMO

AIM: Malnutrition and infectious diseases, such as helminthic infections, are widespread among primary school children, especially in low- and middle-income countries. However, there are limited studies on school health in Bangladesh, particularly in rural settings. This study aimed to explore the nutritional status and prevalence of helminthic infections in relation to associated health behavior, awareness, and knowledge regarding malnutrition and helminthic infections which were evaluated by school nurses among primary school children in Bangladesh. METHODS: This was a descriptive, cross-sectional survey study with a total duration of 1 month, from September to October, 2021. This study formed part of a school nurse project as a cluster non-randomized clinical trial in Bangladesh. Selected variables from that clinical trial were analyzed and reported in the results section. The study participants were primary school children from four schools in rural Bangladesh. RESULTS: In total, 604 children participated in the baseline survey and health checkups. Among them, 163 (27.0%) children were classified as malnourished according to the World Health Organization growth reference standard 2007. The prevalence of helminthic infections was 53 (8.8%). Approximately >50% of the children responded that they never/rarely practiced hygiene-related behaviors and had no awareness and knowledge regarding malnutrition and helminthic infections. However, differences between the variables were not statistically significant. CONCLUSION: Children's nutritional status and prevalence of helminthic infections with related deprived health behaviors, and minimal awareness and knowledge, reinforce the importance of implementing educational interventions in the future.


Assuntos
Helmintíase , Desnutrição , Criança , Humanos , Estado Nutricional , Estudos Transversais , Prevalência , Bangladesh/epidemiologia , Helmintíase/epidemiologia , Desnutrição/epidemiologia , Instituições Acadêmicas
6.
Stud Health Technol Inform ; 310: 309-313, 2024 Jan 25.
Artigo em Inglês | MEDLINE | ID: mdl-38269815

RESUMO

Portable medical sensors play an important role in healthcare services, especially in rural communities. Many telehealth systems use these devices for providing patients' vital information from a distance to remote doctors. Erroneous data will not only mislead the remote doctor for correct diagnosis but it will cause health threats to these unreached community people. Therefore, it is very important to identify good sensors with an acceptable level of accuracy but within the affordable price of the available sensors in the market. This study aims to identify quality portable cholesterol sensors with high accuracy with the reference of the Japanese clinical pathology laboratory as a gold standard. We have considered cholesterol sensors that measure total cholesterol for this study that are commonly used in the developing countries of Asia. We found that out of four, three of them were very much erroneous and cannot be recommended even for primary healthcare.


Assuntos
Serviços de Laboratório Clínico , Telemedicina , Humanos , Ásia , Colesterol , Laboratórios
7.
J Family Med Prim Care ; 13(3): 1024-1036, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38736776

RESUMO

Background: Malnutrition is a major health concern among children especially in low and middle-income countries. However, there are limited studies on school health in Bangladesh. This study aimed to reduce malnutrition among primary school children in Bangladesh by increasing awareness and knowledge through school nurse-led health education. Methods and Materials: A prospective, open-label, parallel-group (1:1), cluster nonrandomized controlled trial on primary school children conducted in rural Bangladesh. The study lasted 13 months between September 2021 and September 2022. Four schools were selected and assigned to the intervention and control groups (CGs). Next, school nurses provided evidence-based health education to the children in the intervention group (IG) for 9 months to improve awareness and knowledge of malnutrition. Data were collected at baseline, midline, and endline. Results: Overall, 604 children were enrolled at the baseline; among them, 455 (CG, n = 220; IG, n = 235) completed the study. Changes in the malnutrition rate-the primary outcome-were not significant (P = 0.225). However, after adjusting the endline data with baseline and sociodemographic data, the children's body mass index improved significantly in the IG than in the CG (P < 0.05). Changes in eating behavior, and awareness and knowledge of malnutrition-the secondary outcomes-significantly differed between the groups (P < 0.001). Conclusion: The school nurse-led health education program significantly improved primary school children's awareness and knowledge of malnutrition. This study revealed the effectiveness of school nurses in reducing malnutrition among children, which may decrease future morbidity and mortality rates in children.

8.
Cureus ; 16(1): e52157, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38344509

RESUMO

BACKGROUND: Menstruation is a normal physiological process for women during their reproductive cycle, typically beginning during adolescence. During this stage, lack of knowledge, social taboos, and shyness act as barriers to proper menstrual hygiene management, rendering adolescent girls more vulnerable. This issue is highly prevalent in low- and middle-income countries. In rural areas of Bangladesh, there is a deficiency in menstrual hygiene management due to inadequate information and knowledge among adolescent girls. Therefore, this study aims to assess the effect of mHealth education on the knowledge and practices of menstrual hygiene management among school-going adolescent girls in rural Bangladesh. METHODS: This is a quasi-experimental study conducted from early June to December 2023 at a secondary high school in Chandpur, Bangladesh. Participants' data will be collected through face-to-face interviews using a structured questionnaire covering socioeconomics, knowledge of menstrual hygiene management, and practices. Pre-test data will be collected at baseline, followed by a 6-month mHealth education intervention. Afterward, post-test data will be collected using the same questionnaire. The data will be analyzed as frequency and percentage for descriptive statistics, and a paired t-test will be used to compare the pre-and post-test data. RESULTS: In the study, 172 participants were enrolled at baseline. Among them, 69.8% were aged 10-14 years. The outcome of this study will be published in a peer-reviewed journal. The findings will provide evidence-based information for the government, researchers, and policymakers on menstrual hygiene management using mobile health technology. CONCLUSION: mHealth education can be posited as a significant tool for increasing knowledge and practices related to menstrual hygiene management in rural regions of Bangladesh.

9.
J Family Med Prim Care ; 12(11): 2569-2575, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-38186809

RESUMO

Adolescent girls are highly vulnerable to developing anemia due to reproductive immaturity, poor personal hygiene, and lack of nutritional intake and health education in rural Bangladesh. Digital health technology is a promising tool to overcome barriers and provide appropriate health guidelines. We aim to evaluate eHealth education's impact and changes in adolescent girls' knowledge, attitude, and practice regarding anemia. A 1:1 parallel randomized control trial was conducted among school-going adolescent girls in rural Bangladesh. A total of 138 anemic (mild and moderate) participants were enrolled. We randomized schools to reduce the health education bias through a simple coin toss technique, then allocated participants to the intervention group (n = 69) and control group (n = 69) by stratified random sampling technique. The intervention group received two online counseling sessions and 8-month eHealth education through mobile phone calls and short message service regarding anemia. The control group received the usual care. The primary endpoint changes the anemic level through changing knowledge, healthy lifestyle behavior, and an iron-rich food dietary plan. Per-protocol analysis will utilize to compare the control and intervention groups using SPSS software. Descriptive statistics (frequencies, percentages, mean, SD) will be employed, and continuous variables will be compared using the t-test/Mann-Whitney test. Two-way analysis of variance will assess outcome variables at baseline, 4 months, and 8 months. The 8-month intervention is designed from May 2022 to February 2023. Participants' age range of 10-14 years was 60.9% in the intervention group and 56.5% in the control group. Among the participants, 89.9% and 88.4% were mild anemic; 11.11 (SD ± 0.80) and 11.06 (SD ± 0.96) were mean hemoglobin in the intervention and control groups, respectively. eHealth education is expected to be an effective way to increase knowledge and healthy behavioral change, which can reduce the anemia burden among adolescent girls.

10.
Artigo em Inglês | MEDLINE | ID: mdl-35692954

RESUMO

Background: A developing country like Bangladesh suffers very much from the sudden appearance of the COVID-19 pandemic due to the shortage of medical facilities for testing and follow-up treatment. The Portable Health Clinic (PHC) system has developed the COVID-19 module with a triage system for the detection of COVID-19 suspects and the follow-up of the home quarantined COVID-19 patients to reduce the workload of the limited medical facilities. Methods: The PHC COVID-19 system maintains a questionnaire-based triage function using the experience of the Japanese practice of diseases management for early detection of suspected COVID-19 patients who may need a confirmation test. Then only the highly suspected patients go for testing preventing the unnecessary crowd from the confirmation PCR test centers and hospitals. Like the basic PHC system, it also has the features for patients' treatment and follow-up for the home quarantined COVID-19 positive and suspect patients using a telemedicine system. This COVID-19 system service box contains 4 self-checking medical sensors, namely, (1) thermometer, (2) pulse oximeter, (3) blood pressure machine, and (4) glucometer for patient's health monitoring including a tablet PC installed with COVID-19 system application for communication between patient and doctor for tele-consultancy. Results: This study conducted a COVID-19 triage among 300 villagers and identified 220 green, 45 light-yellow, 2 yellow, 30 orange, and 3 red patients. Besides the 3 red patients, the call center doctors also referred another 13 patients out of the 30 orange patients to health facilities for PCR tests as suspect COVID-19 positive, and to go under their follow-up. Out of these (3 + 13 =) 16 patients, only 4 went for PCR test and 3 of them had been tested positive. The remaining orange, yellow and light-yellow patients were advised home quarantine under the follow-up of the PHC health workers and got cured in 1-2 weeks. Conclusions: This system can contribute to the community healthcare system by ensuring quality service to the suspected and 80% or more tested COVID-19 positive patients who are usually in the moderate or mild state and do not need to be hospitalized. The PHC COVID-19 system provides services maintaining social distance for preventing infection and ensuring clinical safety for both the patients and the health workers.

11.
PLoS One ; 17(5): e0266141, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35560141

RESUMO

The coronavirus disease (COVID-19) pandemic has widely spread worldwide since 2020. Several countries have imposed lockdown or stay-at-home policies to prevent the infection. Bangladesh experienced a lockdown from March 2020 to May 2020, and internal travel was restricted. Such long and strict confinement may impact women's health. Herein, we aimed to assess the impact of the COVID-19 pandemic on women's health by comparing their health status before and during the pandemic. We conducted a prospective longitudinal study in two zones in the Chhaygaon union, rural district Shariatpur, Bangladesh. The study population comprised non-pregnant women aged 15-49 years. We visited the household of all eligible women and invited them for health checkups. The survey staff examined their health status at the checkup camps and conducted questionnaire interviews. In total, 121 non-pregnant women received health checkups both from June 2019 to July 2019 and in October 2020, before and during the COVID-19 pandemic, respectively. Compared with those during the 2019 health checkup, the medians of body mass index, systolic blood pressure, and diastolic blood pressure were significantly higher (22.7 kg/m2 to 23.6 kg/m2; 110.0 mmHg to 111.0 mmHg; and 73.0 mmHg to 75.0 mmHg, respectively, p<0.05) during the 2020 health checkup. In contrast, urine glucose levels were significantly lower (10.1% to 3.4%, p = 0.021). The lack of physical activity and other inconvenience accumulation caused by the prolonged confinement might have affected their health status. This necessitates local health workers to promote physical activity to prevent health deterioration during the pandemic.


Assuntos
COVID-19 , Pandemias , Bangladesh/epidemiologia , COVID-19/epidemiologia , Controle de Doenças Transmissíveis , Feminino , Nível de Saúde , Humanos , Estudos Longitudinais , Estudos Prospectivos , Saúde da Mulher
12.
Stud Health Technol Inform ; 290: 163-167, 2022 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-35672992

RESUMO

A personal health record (PHR) is not only a collection of personal health data but also a personal healthcare and disease management tool for individual patients. Recently, PHRs have been considered indispensable tools for patient engagement in the area of noncommunicable diseases (NCDs) and have gained a special importance. Unfortunately, similar to several other developing countries, Bangladesh remains far behind in establishing a standard PHR system for the country despite the fact that the growth of NCDs is extremely high and accounts for approximately 70% of the total diseases experienced in the country. The Portable Health Clinic system, which has a PHR feature, was established in Bangladesh in 2010. This PHR system requires standardization for each country. The objective of this research is to standardize this PHR system with reference to the PHR system proposed by the Japanese Clinical Societies, which is a pioneer of work in this field in Asia.


Assuntos
Registros de Saúde Pessoal , Instituições de Assistência Ambulatorial , Registros Eletrônicos de Saúde , Programas Governamentais , Humanos , Participação do Paciente , Padrões de Referência
13.
Sci Rep ; 12(1): 3601, 2022 03 04.
Artigo em Inglês | MEDLINE | ID: mdl-35246576

RESUMO

Doctors in developing countries are too busy to write digital prescriptions. Ninety-seven percent of Bangladeshi doctors write handwritten prescriptions, the majority of which lack legibility. Prescriptions are harder to read as they contain multiple languages. This paper proposes a machine learning approach to recognize doctors' handwriting to create digital prescriptions. A 'Handwritten Medical Term Corpus' dataset is developed containing 17,431 samples of 480 medical terms. In order to improve the recognition efficiency, this paper introduces a data augmentation technique to widen the variety and increase the sample size. A sequence of line data is extracted from the augmented images of 1,591,100 samples and fed to a Bidirectional Long Short-Term Memory (LSTM) network. Data augmentation includes pattern Rotating, Shifting, and Stretching (RSS). Eight different combinations are applied to evaluate the strength of the proposed method. The result shows 93.0% average accuracy (max: 94.5%, min: 92.1%) using Bidirectional LSTM and RSS data augmentation. This accuracy is 19.6% higher than the recognition result with no data expansion. The proposed handwritten recognition technology can be installed in a smartpen for busy doctors which will recognize the writings and digitize them in real-time. It is expected that the smartpen will contribute to reduce medical errors, save medical costs and ensure healthy living in developing countries.


Assuntos
Países em Desenvolvimento , Médicos , Atenção à Saúde , Escrita Manual , Humanos , Leitura
14.
Stud Health Technol Inform ; 295: 213-216, 2022 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-35773846

RESUMO

Rural women in developing countries do not have any option but to visit the distant city to see the obstetricians and gynecologists in case of any maternal and child health issues. However, it becomes more difficult to travel during the COVID-19 pandemic situation. Thus, the telehealth service using the Portable Health Clinic can be very effective for maternal and child health care services. Since the PHC system provides home delivery services through the local health workers, the rural women can avail regular continuum of care services. This study found a 300% increase in participation in the continuum of care. This is not because they receive the service at home but also because they can receive consultancy from urban specialist doctors without travel during the pandemic situation.


Assuntos
COVID-19 , Serviços de Saúde da Criança , Serviços de Saúde Materna , Instituições de Assistência Ambulatorial , COVID-19/epidemiologia , Criança , Saúde da Criança , Feminino , Humanos , Pandemias , Gravidez
15.
JMIR Res Protoc ; 11(12): e41586, 2022 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-36520523

RESUMO

BACKGROUND: Ensuring an appropriate continuum of care in maternal, newborn, and child health, as well as providing nutrition care, is challenging in remote areas. To make care accessible for mothers and infants, we developed a telehealth care system called Portable Health Clinic for Maternal, Newborn, and Child Health. OBJECTIVE: Our study will examine the telehealth care system's effectiveness in improving women's and infants' care uptake and detecting their health problems. METHODS: A quasi-experimental study will be conducted in rural Bangladesh. Villages will be allocated to the intervention and control areas. Pregnant women (≥16 gestational weeks) will participate together with their infants and will be followed up 1 year after delivery or birth. The intervention will include regular health checkups via the Portable Health Clinic telehealth care system, which is equipped with a series of sensors and an information system that can triage participants' health levels based on the results of their checkups. Women and infants will receive care 4 times during the antenatal period, thrice during the postnatal period, and twice during the motherhood and childhood periods. The outcomes will be participants' health checkup coverage, gestational and neonatal complication rates, complementary feeding rates, and health-seeking behaviors. We will use a multilevel logistic regression and a generalized estimating equation to evaluate the intervention's effectiveness. RESULTS: Recruitment began in June 2020. As of June 2022, we have consented 295 mothers in the study. Data collection is expected to conclude in June 2024. CONCLUSIONS: Our new trial will show the effectiveness and extent of using a telehealth care system to ensure an appropriate continuum of care in maternal, newborn, and child health (from the antenatal period to the motherhood and childhood periods) and improve women's and infants' health status. TRIAL REGISTRATION: ISRCTN Registry ISRCTN44966621; https://www.isrctn.com/ISRCTN44966621. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/41586.

16.
J Family Med Prim Care ; 11(6): 2613-2619, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-36119341

RESUMO

Context: Telepathology is a promising tool for remote communities to receive pathology services where professional diagnosis services are inadequate. Aims: We aimed to clarify how effective telepathology was when compared with conventional pathology service among rural communities of Bangladesh. Methods and Materials: We conducted a cross-sectional study in suburban and rural areas of Bangladesh between June and August 2020. We enrolled 117 participants who received both telepathology services from Thakurgaon Eye Hospital and conventional pathology service experience. The participant's satisfaction with the accessibility and perceptions were statistically compared. In addition, we summarized descriptive statistics using the frequencies and percentages of participants' responses. Statistical Analysis Used: Wilcoxon's Signed-rank test using SPSS statistic software version 25.00. Results: Among the study participants, service cost, travel cost, travel time, waiting time, and travel distance were significantly higher for conventional pathology than telepathology (P < 0.001). The majority of participants (94%) were satisfied with the telepathology experience; however, one out of 117 participants was dissatisfied with this service when their travel distance was far away (≥50 km). Among the participants, 91.5% thought that telepathology service was effective for their treatment, and 98.3% wanted to continue this service in their community. On an average, participants saved 58% (95% CI, 53.4-61.5) of cost using telepathology rather than conventional pathology service. Conclusions: Remote under-resourced communities received professional pathology services with less time-consuming and significantly lower costs using the telepathology approach. Where pathology services are absent/insufficient, telepathology is efficacious for primary diagnosis, screening, and referral through professional pathologists for the satisfactory treatment of unreached communities.

17.
Stud Health Technol Inform ; 284: 130-134, 2021 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-34920489

RESUMO

The number of deaths of a mother and child caused by maternal and child healthcare (MCH) issues has been greatly decreased recently, but still, the number is extremely high especially in developing countries. Although the governments have been given a priority in this issue, the lack of financial and human resources brings a limit. Thus, the use of low-cost but appropriate technology is required. Portable Health Clinic (PHC), a telemedicine system developed for providing primary healthcare, is such a technology. This study aimed to address this MCH issue with the aid of a low-cost PHC service involving a continuum-of-care protocol to the rural communities of Bangladesh. Moreover, this study introduces a triage protocol to distinguish high-risk patients from the early stage of the continuum of care who need special care and refer to specialized physicians to prevent unwanted deaths.


Assuntos
Atenção à Saúde , Triagem , Instituições de Assistência Ambulatorial , Família , Programas Governamentais , Humanos
18.
Comput Methods Programs Biomed ; 207: 106156, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34038864

RESUMO

BACKGROUND AND OBJECTIVE: Regular health checkups are important for mothers and newborns to detect health problems at an early stage; however, this is often difficult in resource-limited settings. Therefore, the portable health clinic (PHC) for maternal and child health (MCH), a telemedicine health checkup system, was introduced as an intervention study in a rural area in Bangladesh. The aim of this research project was to report findings that we had observed at a mid-point of the intervention period. METHODS: This was an intervention study conducted in Shariatpur, Bangladesh. The study population included pregnant/parturient women aged 15-49 years and their newborns. With the help of the newly created PHC for MCH, health workers, with a set of sensor devices in an attaché case, visited mothers and newborns at home to examine their health status. Their health status was triaged into four categories using a data management application, and in cases of affected or emergent health status, they were placed on remote video consultation with a doctor. RESULTS: In total, 94 women were included in the PHC for MCH intervention. The rate of participants who received antenatal care at least four times or postnatal care at least once increased (from 29% to 51%, and from 27% to 78%, respectively) compared with before introducing PHC for MCH. Using the PHC for MCH, we detected health problems in pregnant/parturient women; a relatively high percentage had anemia (45-54%) and/or abnormal pulse rate (20-40%). Moreover, after introducing the PHC for MCH, more than 40% of women who received multiple antenatal care or postnatal care checkups improved their health status. CONCLUSIONS: The PHC for MCH could be an effective system to improve the health of mothers and newborns by increasing the availability of care. In the future, this system is expected to be used as a primary resource for maternity healthcare, not only in rural areas but also in other social environments.


Assuntos
Serviços de Saúde Materna , Mães , Bangladesh , Criança , Gerenciamento de Dados , Atenção à Saúde , Feminino , Humanos , Recém-Nascido , Gravidez , População Rural
19.
Artigo em Inglês | MEDLINE | ID: mdl-32164344

RESUMO

The advancement of ICT and affordability of medical sensors enable healthcare data to be obtained remotely. Remote healthcare data is erroneous in nature. Detection of errors for remote healthcare data has not been significantly studied. This research aims to design and develop a software system to detect and reduce such healthcare data errors. Enormous research efforts produced error detection algorithms, however, the detection is done at the server side after a substantial amount of data is archived. Errors can be efficiently reduced if the suspicious data can be detected at the source. We took the approach to predict acceptable range of anthropometric data of each patient. We analyzed 40,391 records to monitor the growth patterns. We plotted the anthropometric items e.g., Height, Weight, BMI, Waist and Hip size for males and females. The plots show some patterns based on different age groups. This paper reports one parameter, height of males. We found three groups that can be classified with similar growth patterns: Age group 20-49, no significant change; Age group 50-64, slightly decremented pattern; and Age group 65-100, a drastic height loss. The acceptable range can change over time. The system estimates the updated trend from new health records.


Assuntos
Antropometria , Estatura , Modelos Teóricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Antropometria/métodos , Bangladesh , Índice de Massa Corporal , Peso Corporal , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
20.
JMIR Med Inform ; 8(10): e18331, 2020 Oct 08.
Artigo em Inglês | MEDLINE | ID: mdl-33030442

RESUMO

BACKGROUND: Uric acid is associated with noncommunicable diseases such as cardiovascular diseases, chronic kidney disease, coronary artery disease, stroke, diabetes, metabolic syndrome, vascular dementia, and hypertension. Therefore, uric acid is considered to be a risk factor for the development of noncommunicable diseases. Most studies on uric acid have been performed in developed countries, and the application of machine-learning approaches in uric acid prediction in developing countries is rare. Different machine-learning algorithms will work differently on different types of data in various diseases; therefore, a different investigation is needed for different types of data to identify the most accurate algorithms. Specifically, no study has yet focused on the urban corporate population in Bangladesh, despite the high risk of developing noncommunicable diseases for this population. OBJECTIVE: The aim of this study was to develop a model for predicting blood uric acid values based on basic health checkup test results, dietary information, and sociodemographic characteristics using machine-learning algorithms. The prediction of health checkup test measurements can be very helpful to reduce health management costs. METHODS: Various machine-learning approaches were used in this study because clinical input data are not completely independent and exhibit complex interactions. Conventional statistical models have limitations to consider these complex interactions, whereas machine learning can consider all possible interactions among input data. We used boosted decision tree regression, decision forest regression, Bayesian linear regression, and linear regression to predict personalized blood uric acid based on basic health checkup test results, dietary information, and sociodemographic characteristics. We evaluated the performance of these five widely used machine-learning models using data collected from 271 employees in the Grameen Bank complex of Dhaka, Bangladesh. RESULTS: The mean uric acid level was 6.63 mg/dL, indicating a borderline result for the majority of the sample (normal range <7.0 mg/dL). Therefore, these individuals should be monitoring their uric acid regularly. The boosted decision tree regression model showed the best performance among the models tested based on the root mean squared error of 0.03, which is also better than that of any previously reported model. CONCLUSIONS: A uric acid prediction model was developed based on personal characteristics, dietary information, and some basic health checkup measurements. This model will be useful for improving awareness among high-risk individuals and populations, which can help to save medical costs. A future study could include additional features (eg, work stress, daily physical activity, alcohol intake, eating red meat) in improving prediction.

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