Introduction There is a substantial burden of respiratory disease in infants in the sub-Saharan Africa region. Many health care providers (HCPs) that initially receive infants with respiratory distress may not be adequately skilled to differentiate between mild, moderate and severe respiratory symptoms, which may contribute to poor management and outcome. Therefore, respiratory severity scores have the potential to contributing to address this gap. Objectives to field-test the use of two existing standardized bronchiolitis severity scores (LIBSS and ReSViNET) in a population of Rwandan infants (1–12 months) presenting with respiratory illnesses to urban, tertiary, pediatric hospitals and to assess the severity of respiratory distress in these infants and the treatments used. Methods A cross-sectional, validation study, was conducted in four tertiary hospitals in Rwanda. Infants presenting with difficulty in breathing were included. The LIBSS and ReSViNET scores were independently employed by nurses and residents to assess the severity of disease in each infant. Results 100 infants were recruited with a mean age of seven months. Infants presented with pneumonia (n = 51), bronchiolitis (n = 36) and other infectious respiratory illnesses (n = 13). Thirty-three infants had severe disease and survival was 94% using nurse applied LIBSS. Regarding inter-rater reliability, the intra-class correlation coefficient (ICC) for LIBSS and ReSViNET between nurses and residents was 0.985 (95% CI: 0.98–0.99) and 0.980 (0.97–0.99). The convergent validity (Pearson’s correlation) between LIBSS and ReSViNET for nurses and residents was R = 0.836 (p<0.001) and R = 0.815 (p<0.001). The area under the Receiver Operator Curve (aROC) for admission to PICU or HDU was 0.956 (CI: 0.92–0.99, p<0.001) and 0.880 (CI: 0.80–0.96, p<0.001) for nurse completed LIBSS and ReSViNET respectively. Conclusion LIBSS and ReSViNET were designed for infants with bronchiolitis in resource-rich settings. Both LIBSS and ReSViNET demonstrated good reliability and validity results, in this cohort of patients presenting to tertiary level hospitals. This early data demonstrate that these two scores have the potential to be used in conjunction with clinical reasoning to identify infants at increased risk of clinical deterioration and allow timely admission, treatment escalation and therefore support resource allocation in Rwanda.
Abstract:Oral diseases and orodental trauma are major public health problems worldwide and poor oral health has a profound effect on general health and quality of life. This retrospective study was conducted on dental visits at Rwandan Level 2 hospital Bria in Central African Republic from August 2015 to November 2016. Dental and periodontal diseases have been documented; demographic and analytical data were reviewed and analyzed. A total of 540 dental visits aged from 22 to 59 years; mean age of 37.57 ± 8.15 years. Male sex ratio of 9.6: 1. Dental caries, gingivitis and periodontitis were more prevalent with 33.13%, 16.98% and 13.87% respectively. Scaling and root planning, permanent filling and extractions were the most treatment in 34%, 32.4% and 19.92% respectively. The teeth 16, 26, 36 and 46 were found to be more diseased with 23%, 25.52%, 30.17% and 27.15% respectively. Gingivitis and periodontitis showed a protection association with age of less than 37.57 years p=0.013, OR=0.55, 95% CI (0.34 -0.88) and p< 0.001, OR=0.38, 95% CI (0.22 -0.64) respectively. Dental caries, Operculitis, fractured crown and teeth extractions showed strong statistical significance and risks with particular teeth. Dental and periodontal diseases are prevalent at Rwanda Level 2 hospital Bria. The different diseases and management have been documented. As per our hypothesis, dental caries were found to be the most common disease in this population. Particular statistical association of some diseased teeth has been shown.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.