Geographic accessibility to public health facilities providing tuberculosis testing services at point-of-care in the upper east region, Ghana

Kuupiel, Desmond; Adu, Kwame Manu; Apiribu, Felix; Bawontuo, Vitalis; Adogboba, Duncan A.; Ali, Kwasi T.; Mashamba-Thompson, Tivani P.

doi:10.1186/s12889-019-7052-2

Cited by 38 publications

(54 citation statements)

References 13 publications

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“…An optimal combination of both on-site placement and the use of POC hubs can reduce the cost per test by 6-35% by reducing transport costs and increasing instrument utilization. Kuupiel 12…”

Section: Geospatial Cost Model For Point Of Care Instrument Placementmentioning

confidence: 99%

Geospatial Hotspots Need Point-of-Care Strategies to Stop Highly Infectious Outbreaks

Kost

2020

Archives of Pathology &Amp; Laboratory Medicine

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Context. Point-of-care testing (POCT), diagnostic testing at or near the site of patient care, is inherently spatial, that is, performed at points of need, and also intrinsically temporal, because it produces fast actionable results. Outbreaks generate geospatial “hotspots.” POC strategies help control hotspots, detect spread, and speed treatment of highly infectious diseases. Objectives. To stop outbreaks, accelerate detection, facilitate emergency response for epidemics, mobilize public health practitioners, enhance community resilience, and improve crisis standards of care. Data Sources. PubMed, WWW, newsprint, others were searched until COVID-19 was declared a pandemic, the US, a national emergency, and Europe, the epicenter. Coverage comprised interviews in Asia, email to/from Wuhan, papers, articles, chapters, documents, maps, flowcharts, schematics, and geospatial-associated concepts. EndNote X9.1 (Clarivate Analytics) consolidated literature as abstracts, ULRs, and PDFs, recovering 136 hotspot articles. More than 500 geospatial science articles were assessed for relevance to point-of-care testing. Conclusions POCT can interrupt spirals of dysfunction and delay by enhancing disease detection, decision making, contagion containment, and safe spacing, thereby softening outbreak surges and diminishing risk before human, economic, and cultural losses mount. Point-of-care tests results identify where infected individuals spread COVID-19, when delays cause death, and how to deploy resources. Results in national cloud databases help optimize outbreak control, mitigation, emergency response, and community resilience. The COVID-19 pandemic demonstrates unequivocally that governments must support POCT and multidisciplinary healthcare personnel must learn its principles, then adopt POC geospatial strategies, so that onsite diagnostic testing can ramp up to meet needs in times of crisis.

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Section: Geospatial Cost Model For Point Of Care Instrument Placementmentioning

confidence: 99%

Geospatial Hotspots Need Point-of-Care Strategies to Stop Highly Infectious Outbreaks

Kost

2020

Archives of Pathology &Amp; Laboratory Medicine

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“…Although we found no study reporting on the geographical access to POC testing for G6PD deficiency either in Ghana or elsewhere, previous studies that assessed the geographical access to health facilities for comprehensive ANC service, and tuberculosis POC testing in UER reported similarly poor accessibility with district variation as well as random spatial distribution of the health facilities providing the services [32,34,39]. The poor geographical accessibility to POC testing for G6PD deficiency evidenced by this current study has potential implications on Ghana's malaria control program, screening of pregnant women prior to SP administration, and screening of newborns for G6PD deficiency as recommended by the WHO.…”

Section: Discussionmentioning

confidence: 68%

“…We used an assumed speed of 20 km per hour of the most available and generally utilized public transport in the region known as "motor king" (a motorized tricycle) to estimate the travel time from all areas. The model and technique used to guesstimate the travel time from all locations in UER to the closest health facilities providing G6PD deficiency screening test in this current study are published in our previous studies [32,34]. The estimated distances and travel times for each of the Districts to the nearest health facility providing G6PD deficiency testing services from PHC clinics and all locations in the UER were exported to Stata V 14.0 software for analysis and the mean and standard deviation calculated and reported.…”

Section: Data Analysis and Mappingmentioning

confidence: 99%

Geographical Accessibility to Glucose-6-Phosphate Dioxygenase Deficiency Point-of-Care Testing for Antenatal Care in Ghana

et al. 2020

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Background: Glucose-6-Phosphate Dehydrogenase (G6PD) deficiency screening test is essential for malaria treatment, control, and elimination programs. G6PD deficient individuals are at high risk of severe hemolysis when given anti-malarial drugs such as primaquine, quinine, other sulphonamide-containing medicines, and chloroquine, which has recently been shown to be potent for the treatment of coronavirus disease . We evaluated the geographical accessibility to POC testing for G6PD deficiency in Ghana, a malaria-endemic country. Methods: We obtained the geographic information of 100 randomly sampled clinics previously included in a cross-sectional survey. We also obtained the geolocated data of all public hospitals providing G6PD deficiency testing services in the region. Using ArcGIS 10.5, we quantified geographical access to G6PD deficiency screening test and identified clinics as well as visualize locations with poor access for targeted improvement. The travel time was estimated using an assumed speed of 20 km per hour. Findings: Of the 100 clinics, 58% were Community-based Health Planning and Services facilities, and 42% were sub-district health centers. The majority (92%) were Ghana Health Service facilities, and the remaining 8% were Christian Health Association of Ghana facilities. Access to G6PD deficiency screening test was varied across the districts, and G6PD deficiency screening test was available in all eight public hospitals. This implies that the health facility-to-population ratio for G6PD deficiency testing service was approximately 1: 159,210 (8/1,273,677) population. The spatial analysis quantified the current mean distance to a G6PD deficiency testing service from all locations in the region to be 34 ± 14 km, and travel time (68 ± 27 min). The estimated mean distance from a clinic to a district hospital for G6PD deficiency testing services was 15 ± 11 km, and travel time (46 ± 33 min). Conclusion: Access to POC testing for G6PD deficiency in Ghana was poor. Given the challenges associated with G6PD deficiency, it would be essential to improve access to G6PD deficiency POC testing to facilitate administration of sulphadoxine-pyrimethamine to pregnant women, full implementation of the malaria control program in Ghana, and treatment of COVID-19 patients with chloroquine in malaria-endemic countries. To enable the World Health Organization include appropriate G6PD POC diagnostic tests in its list of essential in-vitro diagnostics for use in resource-limited settings, we recommend a wider evaluation of available POC diagnostic tests for G6PD deficiency, particularly in malaria-endemic countries.

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“…Community health strategies are underway in most rural areas of Sub-Saharan Africa, where health infrastructure is sparse and the majority of travel is on foot [10]. Distance and travel time to primary health centers (PHC) in these areas are known drivers of care utilization, showing consistent negative impacts on the use of prenatal, perinatal and obstetric care for women [4,[11][12][13][14][15]; child vaccination coverage and pediatric health utilization [16][17][18][19]; voluntary enrolment in health insurances [2]; and rates of diagnosis or treatment for tuberculosis, malaria, and HIV [20][21][22][23][24]. In fact, the use of primary care tends to fall exponentially as distance from facility rises, a phenomenon known as "distance decay" [16,23,[25][26][27].…”

Section: Introductionmentioning

confidence: 99%

Improving geographical accessibility modeling for operational use by local health actors

Ihantamalala¹,

Herbreteau

Révillion³

et al. 2020

Preprint

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Background Geographical accessibility to health facilities remains one of the main barriers to access care in rural areas of the developing world. Although methods and tools exist to model geographic accessibility, the lack of basic geographic information prevents their widespread use at the local level for targeted program implementation. The aim of this study was to develop very precise, context-specific estimates of geographic accessibility to care in a rural district of Madagascar to help with the design and implementation of interventions that improve access for remote populations. Methods We used a participatory approach to map all the paths, residential areas, buildings and rice fields on OpenStreetMap (OSM). We estimated shortest route from every household in the District to the nearest primary health care center (PHC) and community health site (CHS) with the Open Source Routing Machine (OSMR) tool. Then, we used remote sensing methods to obtain a high resolution land cover map, a digital elevation model and rainfall data to model travel speed. Travel speed models were calibrated with field data obtained by GPS tracking in a sample of 168 walking routes. Model results were used to predict travel time to seek care at PHCs and CHSs for all the shortest route estimated earlier. Finally, we integrated geographical accessibility results into an e-health platform developed with R Shiny. Results We mapped over 100,000 buildings, 23,000 km of footpaths, and 4,925 residential areas throughout Ifanadiana district; this data is freely available on OSM. We found that over three quarters of the population lived more than one hour away from a PHC, and 10-15% lived more than one hour away from a CHS. Moreover, we identified areas in the North and East of the district where the nearest PHC was further than 5 hours away, and vulnerable populations across the district with poor geographical access (>1 hour) to both PHCs and CHSs. Conclusion Our study demonstrates how to improve geographical accessibility modeling so that results can be context-specific and operationally actionable by local health actors. The importance of such approaches is paramount for achieving universal health coverage in rural areas throughout world.

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Geographic accessibility to public health facilities providing tuberculosis testing services at point-of-care in the upper east region, Ghana

Cited by 38 publications

References 13 publications

Geospatial Hotspots Need Point-of-Care Strategies to Stop Highly Infectious Outbreaks

Geospatial Hotspots Need Point-of-Care Strategies to Stop Highly Infectious Outbreaks

Geographical Accessibility to Glucose-6-Phosphate Dioxygenase Deficiency Point-of-Care Testing for Antenatal Care in Ghana

Improving geographical accessibility modeling for operational use by local health actors

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