RESUMEN
BACKGROUND: It is unclear whether algorithms with evidence-based interventions are used in a setting where the work load is high and qualified staff is scarce to identify neonates with life-threatening conditions. METHODS: The nurse-midwives' knowledge and opinion about the World Health Organization (WHO) guide on postpartum newborn care were assessed in a hospital in Tanzania before and after training. Their adherence to this guide was evaluated by analysing 100 neonatal records. RESULTS: Before training, 44% of the nurse-midwives were familiar with the WHO guide. All nurse-midwives supported the implementation of the guide. In all, 21% of the postpartum record forms were fully completed. Risk factors for illness were missed in 27%. CONCLUSION: Nurse-midwives' expertise in the WHO guide on postpartum newborn care cannot be taken for granted. The complexity of this guide demands expertise and makes its use time-consuming and thus its practicability disputable in a setting with limited resources.
Asunto(s)
Adhesión a Directriz , Conocimientos, Actitudes y Práctica en Salud , Capacitación en Servicio/métodos , Enfermeras Obstetrices/educación , Guías de Práctica Clínica como Asunto , Pautas de la Práctica en Enfermería , Adulto , Algoritmos , Atención a la Salud/métodos , Evaluación Educacional , Femenino , Humanos , Recién Nacido , Periodo Posparto , Estudios Prospectivos , Calidad de la Atención de Salud , Población Rural , Encuestas y Cuestionarios , Tanzanía , Organización Mundial de la SaludAsunto(s)
Misiones Religiosas , Recolección de Datos , Investigación sobre Servicios de Salud , Humanos , Misioneros , Objetivos Organizacionales , Ejecutivos Médicos/organización & administración , Ejecutivos Médicos/psicología , Misiones Religiosas/organización & administración , Misiones Religiosas/psicología , TanzaníaRESUMEN
OBJECTIVE: We sought to evaluate the relationship between onchocerciasis prevalence and that of epilepsy using available data collected at community level. DESIGN: We conducted a systematic review and meta-regression of available data. DATA SOURCES: Electronic and paper records on subject area ever produced up to February 2008. REVIEW METHODS: We searched for population-based studies reporting on the prevalence of epilepsy in communities for which onchocerciasis prevalence was available or could be estimated. Two authors independently assessed eligibility and study quality and extracted data. The estimation of point prevalence of onchocerciasis was standardized across studies using appropriate correction factors. Variation in epilepsy prevalence was then analyzed as a function of onchocerciasis endemicity using random-effect logistic models. RESULTS: Eight studies from west (Benin and Nigeria), central (Cameroon and Central African Republic) and east Africa (Uganda, Tanzania and Burundi) met the criteria for inclusion and analysis. Ninety-one communities with a total population of 79,270 individuals screened for epilepsy were included in the analysis. The prevalence of epilepsy ranged from 0 to 8.7% whereas that of onchocerciasis ranged from 5.2 to 100%. Variation in epilepsy prevalence was consistent with a logistic function of onchocerciasis prevalence, with epilepsy prevalence being increased, on average, by 0.4% for each 10% increase in onchocerciasis prevalence. CONCLUSION: These results give further evidence that onchocerciasis is associated with epilepsy and that the disease burden of onchocerciasis might have to be re-estimated by taking into account this relationship.