Knowledge and Skills for Management of Sexually Transmitted Infections by Rural Medical Practitioners in Bangladesh

Alam, Nazmul; Mridha, Malay K; Kristensen, Sibylle; Vermund, Sten H.

doi:10.4236/ojpm.2015.54018

Cited by 3 publications

(2 citation statements)

References 17 publications

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“…4,5 There is a severe shortage of specialists and primary care physicians (PCPs) trained in diagnosing and managing genital diseases, and even those PCPs who are trained tend not to see these patients regularly and are hesitant to discuss sexual health. 6,7 The number of dermatologists, who frequently encounter such cases, is very low -3.2 per 100,000 in the US and 0.49 per 100,000 in India. 8 In contrast, the number of registered physicians is much higher, about 0.9 per 1000 in India.…”

Section: Introductionmentioning

confidence: 99%

“…For example, patients delay getting treatment for STIs, leading to transmission to other people, and delay getting treatment for NVGD, like lichen sclerosus, which can result in severe complications 4,5 . There is a severe shortage of specialists and primary care physicians (PCPs) trained in diagnosing and managing genital diseases, and even those PCPs who are trained tend not to see these patients regularly and are hesitant to discuss sexual health 6,7 . The number of dermatologists, who frequently encounter such cases, is very low – 3.2 per 100,000 in the US and 0.49 per 100,000 in India 8 .…”

Section: Introductionmentioning

confidence: 99%

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The performance of an artificial intelligence‐based computer vision mobile application for the image diagnosis of genital dermatoses: a prospective cross‐sectional study

Mehta,

Khan,

Choudhary

et al. 2024

Int J Dermatology

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BackgroundThere is a huge demand–supply gap between the incidence of genital dermatoses (including sexually transmitted infections and non‐venereal genital dermatoses) and physicians trained to manage them.ObjectivesTo find out the performance of an artificial intelligence (AI)‐based mobile application in the image diagnosis of genital dermatoses, and to compare it with primary care physicians (PCPs) and dermatologists.MethodsPhotos of the genital diseases of consecutive patients presenting to the STD and genital diseases clinic were included. The gold standard diagnosis was established by the consensus of two certified dermatologists after examination and one positive investigation. Image diagnoses by the DermaAId application, two PCPs, and two dermatologists were recorded and compared to the gold standard diagnosis and to each other.ResultsA total of 257 genital disease images, including 95 (37.0%) anogenital warts, 60 (22.2%) lichen sclerosus, 20 (7.8%) anogenital herpes, 15 (5.8%) tinea cruris, 14 (5.4%) molluscum contagiosum, 9 (3.5%) candidiasis, 8 (3.1%) scabies, 6 (2.3%) squamous cell carcinomas, were included. The top‐1 correct diagnosis rate of the application was 68.9%, compared to the 50.4% of the PCPs and 73.2% of the dermatologists. The application significantly outperformed PCPs with regard to the correlation with the gold standard diagnosis (P < 0.0001), and matched that of the dermatologists.ConclusionsAI‐based image diagnosis platforms can potentially be a low‐cost rapid decision support tool for PCPs, integrated with syndromic management programs and direct‐to‐consumer services, and address healthcare inequities in managing genital dermatoses.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The performance of an artificial intelligence‐based computer vision mobile application for the image diagnosis of genital dermatoses: a prospective cross‐sectional study

Mehta,

Khan,

Choudhary

et al. 2024

Int J Dermatology

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Village doctors: a national telephone survey of Bangladesh’s lay medical practitioners

Muurlink,

Uzzaman,

Boorman

et al. 2023

BMC Health Serv Res

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Background Bangladesh outperforms its Least Developed Country (LDC) status on a range of health measures including life expectancy. Its frontline medical practitioners, however, are not formally trained medical professionals, but instead lightly-trained ‘village doctors’ able to prescribe modern pharmaceuticals. This current study represents the most complete national survey of these practitioners and their informal ‘clinics’. Methods The study is based on a national Computer Assisted Telephone Interviewing (CATI) of 1,000 informal practitioners. Participants were sampled from all eight divisions and all 64 districts of Bangladesh, including 682 participants chosen from the purposively recruited Refresher Training program conducted by the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), supplemented with 318 additional participants recruited through snowball sampling. Primary and secondary outcome measures In addition to demographics, village doctors were asked about the characteristics of their ‘clinics’ including their equipment, their training, income and referral practices. Results Three quarters of the wholly male sample had not completed an undergraduate program, and none of the sample had received any bachelor-level university training in medicine. Medical training was confined to a range of short-course offerings. Village doctor ‘clinics’ are highly dependent on the sale of pharmaceuticals, with few charging a consultation fee. Income was not related to degree of short-course uptake but was related positively to degree of formal education. Finally, practitioners showed a strong tendency to refer patients to the professional medical care system. Conclusions Bangladesh’s village doctor sector provides an important pathway to professional, trained medical care, and provides some level of care to those who cannot afford or otherwise access the nation’s established healthcare system. However, the degree to which relatively untrained paramedical practitioners are prescribing conventional medicines has concerning health implications.

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Evaluations of training programs to improve human resource capacity for HIV, malaria, and TB control: a systematic scoping review of methods applied and outcomes assessed

Roychowdhury

Khan

2017

Trop Med Health

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BackgroundOwing to the global health workforce crisis, more funding has been invested in strengthening human resources for health, particularly for HIV, tuberculosis, and malaria control; however, little is known about how these investments in training are evaluated. This paper examines how frequently HIV, malaria, and TB healthcare provider training programs have been scientifically evaluated, synthesizes information on the methods and outcome indicators used, and identifies evidence gaps for future evaluations to address.MethodsWe conducted a systematic scoping review of publications evaluating postgraduate training programs, including in-service training programs, for HIV, tuberculosis, and malaria healthcare providers between 2000 and 2016. Using broad inclusion criteria, we searched three electronic databases and additional gray literature sources. After independent screening by two authors, data about the year, location, methodology, and outcomes assessed was extracted from eligible training program evaluation studies. Training outcomes evaluated were categorized into four levels (reaction, learning, behavior, and results) based on the Kirkpatrick model.FindingsOf 1473 unique publications identified, 87 were eligible for inclusion in the analysis. The number of published articles increased after 2006, with most (n = 57, 66%) conducted in African countries. The majority of training evaluations (n = 44, 51%) were based on HIV with fewer studies focused on malaria (n = 28, 32%) and TB (n = 23, 26%) related training. We found that quantitative survey of trainees was the most commonly used evaluation method (n = 29, 33%) and the most commonly assessed outcomes were knowledge acquisition (learning) of trainees (n = 44, 51%) and organizational impacts of the training programs (38, 44%). Behavior change and trainees’ reaction to the training were evaluated less frequently and using less robust methods; costs of training were also rarely assessed.ConclusionsOur study found that a limited number of robust evaluations had been conducted since 2000, even though the number of training programs has increased over this period to address the human resource shortage for HIV, malaria, and TB control. Specifically, we identified a lack evaluation studies on TB- and malaria-related healthcare provider training and very few studies assessing behavior change of trainees or costs of training. Developing frameworks and standardized evaluation methods may facilitate strengthening of the evidence base to inform policies on and investments in training programs.

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Knowledge and Skills for Management of Sexually Transmitted Infections by Rural Medical Practitioners in Bangladesh

Cited by 3 publications

References 17 publications

The performance of an artificial intelligence‐based computer vision mobile application for the image diagnosis of genital dermatoses: a prospective cross‐sectional study

The performance of an artificial intelligence‐based computer vision mobile application for the image diagnosis of genital dermatoses: a prospective cross‐sectional study

Village doctors: a national telephone survey of Bangladesh’s lay medical practitioners

Evaluations of training programs to improve human resource capacity for HIV, malaria, and TB control: a systematic scoping review of methods applied and outcomes assessed

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