Screening and triage at health-care facilities in Timor-Leste during the COVID-19 pandemic

Howitt, Rosemary; Jesus, Gustodio A de; Araujo, F. R.; Francis, Joshua; Marr, Ian; McVean, Melanie; MacMorran, Eleanor; Rollinson, Victoria; Chung, Antonieta; Yip, Teem Wing

doi:10.1016/s2213-2600(20)30183-1

Cited by 9 publications

(6 citation statements)

References 1 publication

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“…Further, this study shows that the dengue cases reported by each municipality in Timor-Leste had a significant association with the presented COVID-19 cumulative case number. However, in consideration of this result, we assumed the existence of an uncertain diagnosis among these two disorders due to Timor-Leste's fragile healthcare system ( 48 ), particularly a lack of clinical laboratory systems. Furthermore, the coronavirus disease 2019 (COVID-19) has non-specific clinical and laboratory characteristics ( 49 ), which might be similar to other viral infections, including dengue.…”

Section: Discussionmentioning

confidence: 99%

Dengue in Timor-Leste during the COVID-19 phenomenon

da Cruz,

Araujo,

Ribas

et al. 2023

Front. Public Health

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Dengue is a significant public health problem in mostly tropical countries, including Timor-Leste. Dengue continues to draw attention from the health sector during the COVID-19 phenomenon. Therefore, the goal of this study is to evaluate the dengue incidence rate in comparison with the COVID-19 cumulative number and associated dengue risk factors, including the fatality rate of dengue infection in each municipality during the COVID-19 phenomenon in Timor-Leste, by applying the data processing program in Geographic Information Systems (GIS). A descriptive study using GIS was performed to provide a spatial-temporal mapping of dengue cases. Secondary data, which were sourced from the Department of Health Statistics Information under the Ministry of Health Timor-Leste, were collected for the period during the COVID-19 outbreak in 2020–2021. These data were grounded at the municipal (province) level. Quantum GIS and Microsoft Excel were used to analyze the data. During the COVID-19 outbreak (2020–2021), dengue spread nationwide. It was found that there was an increase in municipalities with high dengue cases and cumulative COVID-19 numbers. The high number of dengue cases associated with the COVID-19 cumulative number found in municipalities with an urban characteristic and in terms of severity, dengue fever (DF) is most commonly reported with a total of 1,556 cases and is followed by dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). Most cases were reported in the months of the monsoon season, such as December, January, and March. Dengue GIS mapping helps understand the disease's presence and dynamic nature over time.

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Section: Discussionmentioning

confidence: 99%

Dengue in Timor-Leste during the COVID-19 phenomenon

da Cruz,

Araujo,

Ribas

et al. 2023

Front. Public Health

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“…Of the tools proposed for use in LMICs, 51–31 for screening, 5 for triage, and 15 for severity scoring were deemed feasible in LRS. The most notable of these was the integrated screening and triage process used by Howitt et al 28 in Timor-Leste. The algorithm was adapted from Ayebare et al 29 (Uganda) with the removal of laboratory testing for COVID-19.…”

Section: Discussionmentioning

confidence: 99%

Potential solutions for screening, triage, and severity scoring of suspected COVID-19 positive patients in low-resource settings: a scoping review

et al. 2021

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ObjectivesPurposefully designed and validated screening, triage, and severity scoring tools are needed to reduce mortality of COVID-19 in low-resource settings (LRS). This review aimed to identify currently proposed and/or implemented methods of screening, triaging, and severity scoring of patients with suspected COVID-19 on initial presentation to the healthcare system and to evaluate the utility of these tools in LRS.DesignA scoping review was conducted to identify studies describing acute screening, triage, and severity scoring of patients with suspected COVID-19 published between 12 December 2019 and 1 April 2021. Extracted information included clinical features, use of laboratory and imaging studies, and relevant tool validation data.ParticipantThe initial search strategy yielded 15 232 articles; 124 met inclusion criteria.ResultsMost studies were from China (n=41, 33.1%) or the United States (n=23, 18.5%). In total, 57 screening, 23 triage, and 54 severity scoring tools were described. A total of 51 tools−31 screening, 5 triage, and 15 severity scoring—were identified as feasible for use in LRS. A total of 37 studies provided validation data: 4 prospective and 33 retrospective, with none from low-income and lower middle-income countries.ConclusionsThis study identified a number of screening, triage, and severity scoring tools implemented and proposed for patients with suspected COVID-19. No tools were specifically designed and validated in LRS. Tools specific to resource limited contexts is crucial to reducing mortality in the current pandemic.

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“…A plan was made for patients to be given structured appointment times, and only one patient to be in the facility at a pre‐set time. A pre‐designed standardised questionnaire screening for COVID‐19 symptoms was utilised 9 . ETHF had regularly shipped containers of personal protective equipment and hand sanitiser to Timor‐Leste throughout the pandemic, enabling their availability at the clinic.…”

Section: Methodsmentioning

confidence: 99%

“…A pre-designed standardised questionnaire screening for COVID-19 symptoms was utilised. 9 ETHF had regularly shipped containers of personal protective equipment and hand sanitiser to Timor-Leste throughout the pandemic, enabling their availability at the clinic.…”

Section: Clinic Designmentioning

confidence: 99%

Telemedicine to Timor‐Leste: implementing an international cardiac telehealth service during population dislocation, floods and COVID‐19

Paratz

Mock²,

Marques³

et al. 2022

Internal Medicine Journal

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Background The East Timor Hearts Fund (ETHF) has provided cardiac services in Timor‐Leste since 2010, conducting three clinics yearly. With international border closures due to the COVID‐19 pandemic, development of collaborative telehealth services was required. Methods Scoping discussions identified major challenges (structural, patient‐related and medical system‐related). At two pilot clinics, patient history, investigation and management were collated. Clinic metrics were compared to an index face‐to‐face clinic in February 2019. Post‐clinic discussions identified areas of success and shortfall in the conduct of the telehealth clinics. Results 23 patients were reviewed at the online telehealth clinics held onsite at Timorese medical facilities. Compared to an index 2019 clinic,there were markedly lower numbers of new referrals (2 vs 190 patients, 8.7% vs 59.4%). Patients seen at the online clinic were predominantly female (17/23, 73.9%) and Dili‐based (18/23, 78.3%) with a mean age of 25.9 ± 7.2 years old. The majority (12/23, 52.2%) had isolated rheumatic mitral valve disease. Investigations including electrocardiography, pathology, echocardiography and 6‐minute walk tests were conducted in select patients. Medication advice was provided for 10 (43.5%) patients. 11 patients (47.8%) were deemed to require urgent intervention. Post‐clinic discussions indicated general satisfaction with telehealth clinics, although frustration at current inability to provide interventional services was highlighted. Conclusion Our pilot telehealth clinics indicate that capacity‐building telemedicine can be rapidly implemented in an emergency setting internationally. Clinic design benefits from careful identification and resolution of challenges to optimise flow. Cardiac patients in Timor‐Leste have a significant burden of disease amenable to intervention. This article is protected by copyright. All rights reserved.

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Screening and triage at health-care facilities in Timor-Leste during the COVID-19 pandemic

Cited by 9 publications

References 1 publication

Dengue in Timor-Leste during the COVID-19 phenomenon

Dengue in Timor-Leste during the COVID-19 phenomenon

Potential solutions for screening, triage, and severity scoring of suspected COVID-19 positive patients in low-resource settings: a scoping review

Telemedicine to Timor‐Leste: implementing an international cardiac telehealth service during population dislocation, floods and COVID‐19

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