RESUMEN
Socio-demographic inequities in health treatment and outcomes are not new. However, the COVID-19 pandemic presented new opportunities to examine and address biases. This article describes a scoping review of 170 papers published prior to the onset of global vaccinations and treatment (December 2021). We report differentiated COVID-19-related patient outcomes for people with various socio-demographic characteristics, including the need for intubation and ventilation, intensive care unit admission, discharge to hospice care, and mortality. Using the PROGRESS-Plus framework, we determined that the most researched socio-demographic factor was race/ethnicity/culture/language. Members of minoritized racial and ethnic groups tended to have worse COVID-19-related patient outcomes; more research is needed about other categories of social disadvantage, given the scarcity of literature on these factors at the time of the review. It is only by researching and addressing the causes of social disadvantage that we can avoid such injustice in future public health crises.
Asunto(s)
COVID-19 , Humanos , COVID-19/epidemiología , COVID-19/etnología , Factores Sociodemográficos , Factores Socioeconómicos , Inequidades en SaludRESUMEN
Ectopic pregnancy (EP) is a common diagnosis; frequently misdiagnosed early in its presentation and a leading cause of first trimester mortality. Ultrasound (US) is a key component of evidence-based diagnostic algorithms. We present a systematic review on the frequency of the use of US in the diagnosis of EP in Sub-Saharan Africa. Methods A librarian-assisted search of PUBMED; EMBASE; Cochrane; Web of Science; and POPLINE databases was performed. Inclusion criteria were original research studies that reported the proportion of patients receiving US as part of a workup for EP in a Sub-Saharan African country. Abstracts were reviewed and those potentially meeting criteria had a formal survey of the manuscript. Results: The initial search revealed 784 original publications. Manual review of abstracts narrowed this to 91 papers with potential relevance; and 12 studies were included in the final analysis. A total of 6055 patients diagnosed with EP were included. 8.7 received a pregnancy test. 92.3 were ruptured at the time of presentation. 42.9 were in shock and 75.8 received red blood cell transfusion. 73.7 were unaware of the pregnancy and 24.9 were seen by a healthcare worker prior to presentation; 1.1 of patients died. Overall; 12.6 received US to aid in the diagnosis.Conclusion :In this study; overall utilisation of US in the diagnosis of EP was found to be low. In this population; patients presented late and critically ill; obviating the need for US in many cases. However; studies in Sub-Saharan Africa in populations of patients with similar rates of late presentations have shown a substantial increase in the diagnosis of unruptured EP with the routine use of US