Symptom clusters on primary care medical service trips in five regions in Latin America

Abstract

Short-term primary care medical service trips organized by the North American non-governmental organizations (NGOs) serve many communities in Latin America that are poorly served by the national health system. This descriptive study contributes to the understanding of the epidemiology of patients seen on such low-resource trips. An analysis was conducted on epidemiologic data collected from anonymized electronic medical records on patients seen during 34 short-term medical service trips in five regions in Ecuador, Guatemala, and the Dominican Republic between April 2013 and April 2014. A total of 22,977 patients were assessed by North American clinicians (physicians, nurse practitioners, physician assistants) on primary care, low-resource medical service trips. The majority of patients were female (67.1%), and their average age was 36. The most common presenting symptoms in all regions were general pain, upper respiratory tract symptoms, skin disorders, eye irritation, dyspepsia, and nonspecific abdominal complaints; 71-78% of primary care complaints were easily aggregated into well-defined symptom clusters. The results suggest that guideline development for clinicians involved in these types of medical service trips should focus on management of the high-yield symptom clusters described by these data.

A case-series of patients with musculoskeletal conditions in an underserved community in Moca, Dominican Republic

“…In a previous study conducted in the Monti Cristi region of the Dominican Republic, 18.6% of individuals reported experiencing general pain (back pain, nonspecific headaches, general pain, non-specific muscle strain and osteoarthritis). In addition, general pain was the most frequently reported symptom [37]. The current study is similar to this larger study in which the majority of individuals reported experiencing musculoskeletal complaints.…”

“…The current study is similar to this larger study in which the majority of individuals reported experiencing musculoskeletal complaints. The findings from these two prior studies [36,37] combined with ours are helpful to generate hypotheses of the association between musculoskeletal conditions and disability in low-and middle-income countries. It is important for clinicians and researchers to understand the associations between these conditions to ensure that appropriate educational, patient referral networks and management strategies can be implemented at the WSC clinic.…”

An Internet based Questionnaire to Identify Drug Seeking Behavior in a Patient in the ED and Office

“…Of course, pain is the presenting symptom of the majority of the problems a physician sees. In one study, on 22,977 primary care patients, seen in "lowresource" communities, the most common presenting symptoms were general pain, upper respiratory tract symptoms, skin disorders, eye irritation, dyspepsia, and nonspecific abdominal complaints [1]. With increasing frequency, the Emergency Department is being used to replace the primary care physicians [2].…”

A narrative review of dermatologic protocols for primary care medical service trips in Latin America and the Caribbean

“…3,4 Skin disorders such as scabies, fungal infections, and pyoderma are examples of disease processes that are commonly encountered during MSTs but less frequently seen by volunteer clinicians in their home settings. 5,6 In one epidemiological study, superficial mycosis accounted for 1.4-4.2% of patient diagnoses on five MSTs located in Ecuador, Guatemala, and Dominican Republic, 7 and studies based on mycological examinations indicate a prevalence of 7-33% in children in Africa. [8][9][10][11][12][13][14] Likewise, the prevalence of pyoderma (i.e., impetigo, cellulitis, abscesses) is approximately 5-10% in tropical regions, according to the World Health Organization (WHO).…”