Date de publication: / Author: Kenya Mugisha, Nathan - Lunaris - Découvrez les données de recherche canadiennes Résultats de recherche

<6m Observation - Pulse Oximetry (dataset) ~ Smart Discharges

Borealis

Kumbakumba, Elias; Kabakyenga, Jerome; Wiens, Matthew; Lavoie, Pascal; Businge, Stephen; Tagoola, Abner; Kenya Mugisha, Nathan; Ansermino, J Mark; Kissoon, Niranjan (Tex) — 2021-03-30

<6m Observation - Clinical 1 (dataset) ~ Smart Discharges

Borealis

Kumbakumba, Elias; Kabakyenga, Jerome; Wiens, Matthew; Lavoie, Pascal; Businge, Stephen; Tagoola, Abner; Kenya Mugisha, Nathan; Ansermino, J Mark; Kissoon, Niranjan (Tex) — 2021-04-20

Smart Discharges to improve pediatric post-discharge survival

Borealis

Wiens, Matthew O; Tagoola, Abner; Kissoon, Niranjan; Ansermino, J Mark; Oyella Sherine, Sheila; Byaruhanga, Emmanuel; Ssemwanga, Edwards; Zhang, Cherri; Nguyen, Vuong; Bone, Jeffery N; Kenya Mugisha, Nathan; Kumbakumba, Elias; Kabakyenga, Jerome — 2024-07-22 Background: In Sub-Saharan Africa, pediatric post-discharge death is increasingly recognized as an important contributor to mortality. Current studies evaluating interventional approaches for post-discharge mortality focus on pharmacologic therapy, though only malaria prophylaxis post-discharge appears effective. Approaches to reduce vulnerability through health system strengthening approaches may further help to improve outcomes. This study aimed to evaluate the impact of a risk-differentiated approach to improved peri-discharge care on post-discharge mortality among children under 60 months. Methods: We conducted a prospective parallel cluster crossover trial at 6 hospitals in Uganda. Children <60 months admitted due to suspected infectious illness were eligible for enrollment. Phase 1 was a comparative control. During phase 2, enrolled children were screened for post-discharge mortality risk at admission using a multivariable risk algorithm. All children received counselling on post-discharge care practices during admission and at discharge. High-risk children received referrals and automated SMS engagement at 2, 7 and 14 days at a clinic of their choice, or by a community health worker. Survival analysis, adjusting for age, sex, site, period time and predicted risk of mortality was used to estimate the effect of the intervention on 6-month all-cause post-discharge mortality. Findings: 13,050 patients were enrolled (phase 1: n=6954; phase 2: n=6096) and had complete 6-month follow-up. Baseline characteristics were similar between groups. The median age was 0.8 months (IQR: 0.2-1.7), with 56% of participants male. The multivariable risk algorithm gave a mean predicted risk of post-discharge mortality of 6.1% in phase 1 and 5.9% in phase 2. The rate of post-discharge mortality was 6.0% during phase 1 and 4.9% during phase 2, with an adjusted hazard ratio of 0.77 (95% CI – 0.90), favoring the intervention. Additional sensitivity analysis using different sets of covariates in the model showed similar results. Ethics Declaration: These studies were approved by the Mbarara University of Science and Technology (No. 15/10-16), the Uganda National Council for Science and Technology (HS 2207), and the University of British Columbia (H16-02679). NOTE for restricted files: If you are not yet a CoLab member, please complete our <a href = "https://rc.bcchr.ca/redcap/surveys/?s=EDCYL7AC79">membership application survey</a> to gain access to restricted files within 2 business days. Some files may remain restricted to CoLab members. These files are deemed more sensitive by the file owner and are meant to be shared on a case-by-case basis. Please contact the CoLab coordinator at <a href = mailto:sepsiscolab@bccchr.ca>sepsiscolab@bcchr.ca</a> or visit our <a href = "https://wfpiccs.org/pediatric-sepsis-colab/">website</a>.

Smart Discharges Program for children with sepsis in Uganda: a qualitative program evaluation

Borealis

Wiens, Matthew O.; Jacob, Shevin T.; Kabajaasi, Olive; Kenya Mugisha, Nathan — 2024-07-22 NOTE for restricted files: If you are not yet a CoLab member, please complete our <a href = "https://rc.bcchr.ca/redcap/surveys/?s=EDCYL7AC79">membership application survey</a> to gain access to restricted files within 2 business days. Some files may remain restricted to CoLab members. These files are deemed more sensitive by the file owner and are meant to be shared on a case-by-case basis. Please contact the CoLab coordinator at <a href = mailto:sepsiscolab@bccchr.ca>sepsiscolab@bcchr.ca</a> or visit our <a href = "https://wfpiccs.org/pediatric-sepsis-colab/">website</a>. Background: Pediatric sepsis continues to be a significant burden in low- and middle-income countries. Studies have shown that in-hospital mortality is equal to, and sometimes exceeds, mortality during the post-discharge period. These facts call for a concerted action to improve childhood survival following discharge from sepsis. The Smart Discharges Program uses a mobile health platform for risk stratification of children admitted with sepsis to target at-risk children and their caregivers for educational counseling at discharge and referrals and follow-up care during the vulnerable post-discharge period. Since 2017, this program has been enrolling children at four hospitals in Uganda (Mbarara, Masaka and Jinja Regional Referral Hospitals and Holy Innocents Children’s Hospital). However, the perceptions of the caregivers with regard to the SD Program are poorly understood. Objectives: The purpose of the study is to explore the parents’/caregivers’ perceptions of the Smart Discharges Program in regard to its contribution to improved care post-discharge of children who have suffered from severe infections. Specific objectives include i) to describe parents'/caregivers' experiences receiving and using Smart Discharges care package; ii) to explore parents'/caregivers' perception of the barriers to access the care provided by Smart Discharges; and iii) to document the lessons learned and opportunities for improvement of Smart Discharges Program to improve discharge care for children who have suffered from sepsis. Methods: A qualitative design using different approaches and methods will be adopted. We will enrol 64 parents/caregivers of children who have received care through the Smart Discharges Program and 8 implementation nurses involved in providing the care in this program at the four program sites. Seventy-two participants (64 parents/caregivers and 8 nurses) will take part in the study. Eight Focus Group Discussions (8 participants per FGD), and 8 interviews with program implementation nurses will be conducted. Audio files will be transcribed verbatim, translated into English and analyzed using Nvivo. Findings will contribute to improvement of post-discharge care in Uganda. Ethics Declaration: We will obtain ethics approval from the University of British Columbia Children’s & Women’s Research Ethics Board in Canada as well as the relevant institutional review boards in Uganda. Administrative clearance will also be obtained from the respective hospitals.

Limiter à la zone sur la carte

Instructions pour la recherche cartographique

1.Activez le filtre cartographique en cliquant sur le bouton « Limiter à la zone sur la carte ».

2.Déplacez la carte pour afficher la zone qui vous intéresse. Maintenez la touche Maj enfoncée et cliquez pour encadrer une zone spécifique à agrandir sur la carte. Les résultats de la recherche changeront à mesure que vous déplacerez la carte.

3.Pour voir les détails d’un emplacement, vous pouvez cliquer soit sur un élément dans les résultats de recherche, soit sur l’épingle d’un emplacement sur la carte et sur le lien associé au titre.

Remarque : Les groupes servent à donner un aperçu visuel de l’emplacement des données. Puisqu’un maximum de 50 emplacements peut s’afficher sur la carte, il est possible que vous n’obteniez pas un portrait exact du nombre total de résultats de recherche.

Recherche

Résultats de recherche

Instructions pour la recherche cartographique

Détails de la recherche

Limiter par :

Dépôt source

Date de publication

Auteur(s) Effacer