Survey of Otolaryngology Services in Central America: Need for a Comprehensive Intervention

Abstract

In the developing world, there exists a scarcity of services and training in otolaryngology, audiology, and speech therapy, which is reflected by the gap between health care delivery in high-income countries and low-income countries. We surveyed, by questionnaire, the countries of Central America, except for Belize, because of the lack of otolaryngology services, on the following issues: availability of otolaryngology, audiology, and speech therapy services and equipment; otolaryngologist, audiologist, and speech therapist training; and availability of services in rural areas. Surveys were distributed via email and by hand at the 2011 Central American Congress of Otolaryngology, in San Salvador, El Salvador, to otolaryngologists, audiologists, and speech therapists. Not to our surprise, there is a shortfall in services and training in all three professions. The data collected and presented in this commentary will provide a basis by which change might take place.

<p>Juvenile-Onset Recurrent Respiratory Papillomatosis Diagnosis and Management – A Developing Country Review</p>

“…30,32 Patients are often misdiagnosed as having asthma, laryngotracheobronchitis, foreign body aspiration or laryngomalacia. 3 In developing countries, as a result of the poor availability of healthcare services in general and ENT services in particular, [42][43][44] patients frequently present with upper airway obstruction and a history of hoarseness for many years. 3,4,30,40,41,[45][46][47][48][49][50][51] In a South African study, all patients diagnosed in the private sector had only hoarseness on initial presentation, while 70.1% of patients diagnosed in the public sector also presented with stridor, with 51.9% being in respiratory distress.…”

“…75,92 While formal voice evaluation and therapy may be of value in the management of patients, 56 these services are often not available in developing countries. [42][43][44]…”

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“…[6][7][8][9] This situation of ENT diseases gets further complexed by the fact that, as there are only a few population-based epidemiological studies on ENT psycho-social assessments among adults. 10,11 Although many studies have explored the physical needs of ENT patients from pediatric age group to elderly in Primary health care to tertiary health care set ups across the world. [6][7][8][9][10][11][12][13][14][15][16] Such kind of studies have also shown that, they can help in effective treatment prioritization of ear, nose, throat disorders with an added advantage in planning and resource allocation, which is relevant in Indian context due to the presence of higher prevalence of otorhinolaryngological morbidities and scarce resources.…”

“…10,11 Although many studies have explored the physical needs of ENT patients from pediatric age group to elderly in Primary health care to tertiary health care set ups across the world. [6][7][8][9][10][11][12][13][14][15][16] Such kind of studies have also shown that, they can help in effective treatment prioritization of ear, nose, throat disorders with an added advantage in planning and resource allocation, which is relevant in Indian context due to the presence of higher prevalence of otorhinolaryngological morbidities and scarce resources. [6][7][8][9][10][11][12][13][14][15][16][17] It has also been seen from studies that even the most common ENT disorders presenting to the emergency department can be tackled at the level of primary health care level.…”

“…[6][7][8][9][10][11][12][13][14][15][16] Such kind of studies have also shown that, they can help in effective treatment prioritization of ear, nose, throat disorders with an added advantage in planning and resource allocation, which is relevant in Indian context due to the presence of higher prevalence of otorhinolaryngological morbidities and scarce resources. [6][7][8][9][10][11][12][13][14][15][16][17] It has also been seen from studies that even the most common ENT disorders presenting to the emergency department can be tackled at the level of primary health care level. 4,[16][17][18][19] However important areas such health education, socioeconomic status and primary health facilities services as a community oriented otorhino laryngological care has been an ignored agenda, despite its potential to reduce the prevalence of ENT diseases as evident from studies.…”