( = 1431) .
Characteristic . | Health centre ( = 1431) . | Self-medicated at formal pharmacies ( = 328) . | Self-medicated at informal medicine vendors ( = 349) . | |||
---|---|---|---|---|---|---|
. | % . | . | % . | . | % . | |
Gender | ||||||
Female | 737 | 51.5 | 175 | 53.4 | 148 | 42.4 |
Male | 694 | 48.5 | 153 | 46.7 | 201 | 57.6 |
Age group, years | ||||||
0–4 | 622 | 43.5 | 21 | 6.4 | 15 | 4.3 |
5–17 | 253 | 17.7 | 43 | 13.1 | 21 | 6.0 |
18–49 | 366 | 25.6 | 206 | 62.8 | 267 | 76.5 |
≥50 | 190 | 13.3 | 58 | 17.7 | 46 | 13.2 |
Education level | ||||||
No education | 951 | 66.5 | 200 | 61.0 | 275 | 78.8 |
Primary school | 270 | 18.9 | 49 | 14.9 | 54 | 15.5 |
Secondary school | 194 | 13.6 | 70 | 21.3 | 19 | 5.4 |
University | 16 | 1.1 | 9 | 2.7 | 1 | 0.3 |
Care status | ||||||
Inpatients | 182 | 12.7 | 0 | 0.0 | 0 | 0.0 |
Outpatients | 1249 | 87.3 | 328 | 100.0 | 349 | 100.0 |
Fever | ||||||
Present | 1027 | 71.8 | 105 | 32.0 | 83 | 23.8 |
Absent | 404 | 28.2 | 223 | 68.0 | 266 | 76.2 |
Clinical presentation | ||||||
Malaria | 555 | 38.8 | 88 | 26.8 | 21 | 6.0 |
Rhinopharyngitis | 116 | 8.1 | 63 | 19.2 | 61 | 17.5 |
Bronchitis | 211 | 14.7 | 36 | 11.0 | 51 | 14.6 |
Pneumonia | 45 | 3.1 | 0 | 0.0 | 0 | 0.0 |
Enteric fever | 9 | 0.6 | 4 | 1.2 | 20 | 5.7 |
Undifferentiated fever | 87 | 6.1 | 0 | 0.0 | 0 | 0.0 |
Gastroenteritis | 128 | 8.9 | 7 | 2.1 | 48 | 13.8 |
Stomach ache | 70 | 4.9 | 32 | 9.8 | 28 | 8.0 |
Pain | 65 | 4.5 | 62 | 18.9 | 75 | 21.5 |
Dermatosis | 17 | 1.2 | 3 | 0.9 | 2 | 0.6 |
Wound | 37 | 2.6 | 12 | 3.7 | 18 | 5.2 |
Sexually transmitted/vaginal infection | 13 | 0.9 | 2 | 0.6 | 0 | 0.0 |
Urinary tract infection | 6 | 0.4 | 1 | 0.3 | 4 | 1.2 |
Sepsis | 5 | 0.4 | 0 | 0.0 | 0 | 0.0 |
Anorexia/asthenia | 20 | 1.4 | 2 | 0.6 | 3 | 0.9 |
Other | 47 | 3.3 | 16 | 4.9 | 18 | 5.2 |
Among 182 inpatients, 90.7% (95% CI 77.9%–96.4%, n = 165) used antibiotics, of which 59.4% (95% CI 16.1%–91.8%, n = 98) used more than one antibiotic. Among inpatients who used antibiotics, 64.2% (95% CI 8.13%–97.3%, n = 106) used Watch antibiotics (Table 2 ). Malaria, bronchitis and gastroenteritis were the most frequent clinical presentations, together accounting for 62.6% (114/182) of inpatients, 61.2% (111/165) of antibiotic use, and 54.7% (58/106) of Watch antibiotic use.
Number of inpatients who used antibiotics and Watch antibiotics according to clinical presentation
Clinical presentation . | Patients who received antibiotics . | Patients who received Watch antibiotics . | |||
---|---|---|---|---|---|
. | . | . | % (95% CI) . | . | % (95% CI) . |
Malaria | 52 | 40 | 76.9 (50.5–91.6) | 22 | 55.0 (44.7–97.0) |
Bronchitis | 36 | 35 | 97.2 (70.8–99.8) | 20 | 57.1 (0.4–99.8) |
Pneumonia | 11 | 11 | 100.0 | 10 | 90.9 (0.03–100) |
Enteric fever | 5 | 5 | 100.0 | 1 | 20.0 (0.04–99.3) |
Undifferentiated fever | 19 | 18 | 94.7 (20.7–99.9) | 15 | 83.3 (3.0–99.9) |
Gastroenteritis | 26 | 26 | 100.0 | 16 | 61.5 (10.4–95.7) |
Stomach ache | 9 | 8 | 88.9 (25.0–99.5) | 6 | 75.0 (4.16–99.5) |
Pain | 2 | 1 | 50.0 | 0 | 0.0 |
Wound | 3 | 3 | 100.0 | 1 | 33.3 (0.0–100.0) |
Urinary tract infection | 3 | 3 | 100.0 | 3 | 100.0 |
Sepsis | 5 | 5 | 100.0 | 5 | 100.0 |
Anorexia/asthenia | 1 | 0 | 0.0 | — | — |
Other | 10 | 10 | 100.0 | 7 | 70.0 (1.8–99.7) |
Total | 182 | 165 | 90.7 (77.9–96.4) | 106 | 64.2 (8.1–97.3) |
Clinical presentation . | Patients who received antibiotics . | Patients who received Watch antibiotics . | |||
---|---|---|---|---|---|
. | . | . | % (95% CI) . | . | % (95% CI) . |
Malaria | 52 | 40 | 76.9 (50.5–91.6) | 22 | 55.0 (44.7–97.0) |
Bronchitis | 36 | 35 | 97.2 (70.8–99.8) | 20 | 57.1 (0.4–99.8) |
Pneumonia | 11 | 11 | 100.0 | 10 | 90.9 (0.03–100) |
Enteric fever | 5 | 5 | 100.0 | 1 | 20.0 (0.04–99.3) |
Undifferentiated fever | 19 | 18 | 94.7 (20.7–99.9) | 15 | 83.3 (3.0–99.9) |
Gastroenteritis | 26 | 26 | 100.0 | 16 | 61.5 (10.4–95.7) |
Stomach ache | 9 | 8 | 88.9 (25.0–99.5) | 6 | 75.0 (4.16–99.5) |
Pain | 2 | 1 | 50.0 | 0 | 0.0 |
Wound | 3 | 3 | 100.0 | 1 | 33.3 (0.0–100.0) |
Urinary tract infection | 3 | 3 | 100.0 | 3 | 100.0 |
Sepsis | 5 | 5 | 100.0 | 5 | 100.0 |
Anorexia/asthenia | 1 | 0 | 0.0 | — | — |
Other | 10 | 10 | 100.0 | 7 | 70.0 (1.8–99.7) |
Total | 182 | 165 | 90.7 (77.9–96.4) | 106 | 64.2 (8.1–97.3) |
Antibiotic use was more frequent after consultation in health centres (54.8%, 95% CI 32.3%–75.5%, n = 685) than at formal pharmacies (26.2%, 95% CI 10.3%–52.4%, n = 86, P < 0.001) and informal medicine vendors (26.9%, n = 94, P < 0.001). Among these patients who used antibiotics, the percentage of those with Watch antibiotic use was higher at informal medicine vendors (50.0%, n = 47) than in health centres (16.5%, 95% CI 10.6%–24.8%, n = 113, P < 0.001) or at formal pharmacies (16.3%, 95% CI 15.0%–17.8%, n = 14, P < 0.001) (Table 3 ).
Number of outpatients prescribed antibiotics and Watch antibiotics by type of healthcare provider according to clinical presentation
Clinical presentation . | Patients who visited health centre ( = 1249) . | Self-medicated at formal pharmacies ( = 328) . | Self-medicated at informal medicine vendors ( = 349) . | ||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Number of patients per clinical presentation . | Patients who received antibiotics . | Patients who received Watch antibiotics . | Number of patients per clinical presentation . | Patients who received antibiotics . | Patients who received Watch antibiotics . | Number of patients per clinical presentation . | Patients who received antibiotics . | Patients who received Watch antibiotics . | |||||||
. | . | . | % (95% CI) . | . | % (95% CI) . | . | . | % (95% CI) . | . | % (95% CI) . | . | . | / (%) . | . | / (%) . |
Malaria | 503 | 170 | 33.8 (15.5–58.8) | 27 | 15.9 (6.9–32.6) | 88 | 2 | 2.3 (0.0–82.6) | 0 | 0.0 | 21 | 0 | 0.0 | — | — |
Rhinopharyngitis | 116 | 74 | 63.8 (34.2–85.6) | 6 | 8.1 (5.3–12.1) | 63 | 13 | 20.6 (3.6–64.7) | 1 | 7.7 (1.0–40.9) | 61 | 10 | 16.4 | 1 | 10.0 |
Bronchitis | 175 | 161 | 92.0 (64.9–98.6) | 6 | 3.7 (1.3–10.4) | 36 | 31 | 86.1 (0.0–100.0) | 1 | 3.2 (0.0–92.6) | 51 | 11 | 21.6 | 3 | 27.3 |
Pneumonia | 34 | 31 | 91.2 (7.65–99.9) | 1 | 3.2 (0.1–56.4) | 0 | — | — | — | — | 0 | — | — | — | — |
Enteric fever | 4 | 3 | 75.0 (0.0–100.0) | 3 | 100.0 | 4 | 4 | 100.0 | 1 | 25.0 (0.0–99.9) | 20 | 6 | 30.0 | 3 | 50.0 |
Undifferentiated fever | 68 | 49 | 72.1 (42.5–90.0) | 15 | 30.6 (10.4–62.7) | 0 | — | — | — | — | 0 | — | — | — | — |
Gastroenteritis | 102 | 87 | 85.3(42.8–97.8) | 12 | 13.8(1.9–56.5) | 7 | 6 | 85.7 | 3 | 50.0 | 48 | 20 | 41.7 | 13 | 65.0 |
Stomach ache | 61 | 29 | 47.5 (24.7–71.5) | 9 | 31.0 (15.7–52.2) | 32 | 12 | 37.5 (20.5–58.3) | 4 | 33.3 (0.1–99.7) | 28 | 19 | 67.9 | 14 | 73.7 |
Pain | 63 | 7 | 11.1 (3.7–29.0) | 2 | 28.6 (0.8–95.4) | 62 | 3 | 4.8 | 2 | 66.7 | 75 | 2 | 2.7 | 2 | 100.0 |
Dermatosis | 17 | 15 | 88.2 (6.0–99.9) | 12 | 80.0 (57.7–92.1) | 3 | 2 | 66.7 | 2 | 100.0 | 2 | 2 | 100.0 | 2 | 100.0 |
Wound | 34 | 29 | 85.3 (14.9–99.5) | 6 | 20.7 (6.0–51.6) | 12 | 11 | 91.7 | 0 | 0.0 | 18 | 18 | 100.0 | 4 | 22.2 |
Sexually transmitted/vaginal infection | 13 | 9 | 69.2 (12.7–97.2) | 7 | 77.8 (17.3–98.3) | 2 | 0 | 0.0 | — | — | 0 | — | — | — | — |
Urinary tract infection | 3 | 2 | 66.7 (0.0–100.0) | 1 | 50.0 (0.0–100.0) | 1 | 1 | 100.0 | 0 | 0.0 | 4 | 4 | 100.0 | 4 | 100.0 |
Anorexia/asthenia | 19 | 0 | 0.0 | — | — | 2 | 0 | 0.0 | — | — | 3 | 0 | 0.0 | — | — |
Other | 37 | 19 | 51.4 (36.4–66.1) | 6 | 31.6 (16.5–51.9) | 16 | 1 | 6.3 | 0 | 0.0 | 18 | 2 | 11.1 | 1 | 50.0 |
Total | 1249 | 685 | 54.8 (32.3–75.5) | 113 | 16.5 (10.6–24.8) | 328 | 86 | 26.2 (10.3–52.4) | 14 | 16.3 (15.0–17.7) | 349 | 94 | 26.9 | 47 | 50.0 |
Clinical presentation . | Patients who visited health centre ( = 1249) . | Self-medicated at formal pharmacies ( = 328) . | Self-medicated at informal medicine vendors ( = 349) . | ||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Number of patients per clinical presentation . | Patients who received antibiotics . | Patients who received Watch antibiotics . | Number of patients per clinical presentation . | Patients who received antibiotics . | Patients who received Watch antibiotics . | Number of patients per clinical presentation . | Patients who received antibiotics . | Patients who received Watch antibiotics . | |||||||
. | . | . | % (95% CI) . | . | % (95% CI) . | . | . | % (95% CI) . | . | % (95% CI) . | . | . | / (%) . | . | / (%) . |
Malaria | 503 | 170 | 33.8 (15.5–58.8) | 27 | 15.9 (6.9–32.6) | 88 | 2 | 2.3 (0.0–82.6) | 0 | 0.0 | 21 | 0 | 0.0 | — | — |
Rhinopharyngitis | 116 | 74 | 63.8 (34.2–85.6) | 6 | 8.1 (5.3–12.1) | 63 | 13 | 20.6 (3.6–64.7) | 1 | 7.7 (1.0–40.9) | 61 | 10 | 16.4 | 1 | 10.0 |
Bronchitis | 175 | 161 | 92.0 (64.9–98.6) | 6 | 3.7 (1.3–10.4) | 36 | 31 | 86.1 (0.0–100.0) | 1 | 3.2 (0.0–92.6) | 51 | 11 | 21.6 | 3 | 27.3 |
Pneumonia | 34 | 31 | 91.2 (7.65–99.9) | 1 | 3.2 (0.1–56.4) | 0 | — | — | — | — | 0 | — | — | — | — |
Enteric fever | 4 | 3 | 75.0 (0.0–100.0) | 3 | 100.0 | 4 | 4 | 100.0 | 1 | 25.0 (0.0–99.9) | 20 | 6 | 30.0 | 3 | 50.0 |
Undifferentiated fever | 68 | 49 | 72.1 (42.5–90.0) | 15 | 30.6 (10.4–62.7) | 0 | — | — | — | — | 0 | — | — | — | — |
Gastroenteritis | 102 | 87 | 85.3(42.8–97.8) | 12 | 13.8(1.9–56.5) | 7 | 6 | 85.7 | 3 | 50.0 | 48 | 20 | 41.7 | 13 | 65.0 |
Stomach ache | 61 | 29 | 47.5 (24.7–71.5) | 9 | 31.0 (15.7–52.2) | 32 | 12 | 37.5 (20.5–58.3) | 4 | 33.3 (0.1–99.7) | 28 | 19 | 67.9 | 14 | 73.7 |
Pain | 63 | 7 | 11.1 (3.7–29.0) | 2 | 28.6 (0.8–95.4) | 62 | 3 | 4.8 | 2 | 66.7 | 75 | 2 | 2.7 | 2 | 100.0 |
Dermatosis | 17 | 15 | 88.2 (6.0–99.9) | 12 | 80.0 (57.7–92.1) | 3 | 2 | 66.7 | 2 | 100.0 | 2 | 2 | 100.0 | 2 | 100.0 |
Wound | 34 | 29 | 85.3 (14.9–99.5) | 6 | 20.7 (6.0–51.6) | 12 | 11 | 91.7 | 0 | 0.0 | 18 | 18 | 100.0 | 4 | 22.2 |
Sexually transmitted/vaginal infection | 13 | 9 | 69.2 (12.7–97.2) | 7 | 77.8 (17.3–98.3) | 2 | 0 | 0.0 | — | — | 0 | — | — | — | — |
Urinary tract infection | 3 | 2 | 66.7 (0.0–100.0) | 1 | 50.0 (0.0–100.0) | 1 | 1 | 100.0 | 0 | 0.0 | 4 | 4 | 100.0 | 4 | 100.0 |
Anorexia/asthenia | 19 | 0 | 0.0 | — | — | 2 | 0 | 0.0 | — | — | 3 | 0 | 0.0 | — | — |
Other | 37 | 19 | 51.4 (36.4–66.1) | 6 | 31.6 (16.5–51.9) | 16 | 1 | 6.3 | 0 | 0.0 | 18 | 2 | 11.1 | 1 | 50.0 |
Total | 1249 | 685 | 54.8 (32.3–75.5) | 113 | 16.5 (10.6–24.8) | 328 | 86 | 26.2 (10.3–52.4) | 14 | 16.3 (15.0–17.7) | 349 | 94 | 26.9 | 47 | 50.0 |
Among all antibiotics used in inpatients, 60.3% (95% CI 32.2%–82.9%, n = 176) were Access, 39.7% (95% CI 17.1%–67.8%, n = 116) were Watch; and none Reserve (Figure 1 ). By clinical presentations, malaria, bronchitis, undifferentiated fever, gastroenteritis and wounds accounted together for 70.7% ( n = 82) of all inpatient Watch antibiotics used. Ceftriaxone was the most used Watch antibiotic among inpatients.
Distribution of AWaRe groups among all antibiotics used per type of visit. This figure appears in colour in the online version of JAC and in black and white in the print version of JAC .
Among all antibiotics prescribed for outpatients at health centres, 85.2% (95% CI 80.9%–88.7%, n = 675) were Access and 14.8% (95% CI 11.3%–19.1%, n = 117) were Watch. Clinical presentations such as malaria, rhinopharyngitis, bronchitis, undifferentiated fever, gastroenteritis, pain, dermatosis and wounds for which antibiotics were not recommended (apart from dermatosis where Access group antibiotics were adequate) accounted together for 68.4% ( n = 80) of all Watch antibiotics used, which could have been avoided. Ciprofloxacin was the most frequently dispensed Watch antibiotic in health centres (35.0%, n = 41), followed by erythromycin (32.5%, n = 38) and ceftriaxone (22.2%, n = 26).
Among all antibiotics received after formal pharmacy visits, 84.6% ( n = 77) were Access and 15.4% ( n = 14) were Watch. Clinical presentations such as rhinopharyngitis, bronchitis, gastroenteritis, dermatosis and pain accounted for 64.3% ( n = 9) of all Watch antibiotics used, which could have been avoided. Ciprofloxacin was the most frequently used Watch antibiotic by self-medication in formal pharmacies (71.4%, n = 10) followed by erythromycin (28.6%, n = 4).
Among all antibiotics used after informal medicine vendors’ visits, 52.5% ( n = 53) were Access and 47.5% ( n = 48) were Watch. Clinical presentations such as rhinopharyngitis, bronchitis, gastroenteritis, pain and wounds for which antibiotics were avoidable, accounted for 50.0% ( n = 24) of all Watch antibiotics used. Oxytetracycline was the most used Watch antibiotic following informal medicine vendors’ visits (45.8%, n = 22), followed by norfloxacin (27.1%, n = 13), ciprofloxacin (25.0%, n = 12) and erythromycin (2.1%, n = 1).
Third-generation cephalosporins were the most frequently used antibiotic class in inpatients (35.6% 95% CI 10.3%–72.8%, n = 104) while penicillins were the most frequently used class by outpatients who consulted health centres (40.3% 95% CI 27.7%–53.3%, n = 319) or self-medicated in formal pharmacies (49.5% 95% CI 16.6%–82.8%, n = 45) or at informal medicine vendors (31.7%, n = 32) (Figure 2 ).
Distribution of antibiotic classes among all antibiotics used, by clinical presentation and by type of visit. This figure appears in colour in the online version of JAC and in black and white in the print version of JAC .
Injectable antibiotics accounted for 68.2% (95% CI 8.2%–98.1%, n = 199) of antibiotics used by inpatients and 6.9% (95% CI 2.7%–16.5%, n = 54) of antibiotics used by outpatients who visited health centres. None of the antibiotics used by self-medicated was injectable.
The median duration of treatment was 5 days (IQR 4–7) among health centre outpatients, 5 days (IQR 5–7) in formal pharmacies and 3 days (IQR 2–3) at informal medicine vendors.
In adult outpatients, 60.7% (95% CI 28.7%–85.5%, n / N = 74/122) of antibiotics prescribed in health centres and 69.1% ( n / N = 67/97) of antibiotics used by self-medicators, including 59.1% (95% CI 0.2%–99.9%) in formal pharmacies and 90.3% ( n / N = 28/31) in informal medicine vendors were taken suboptimally.
The mean DDD per antibiotic treatment course among adult outpatients was higher in health centres (5.9 DDD, 95% CI 3.9–8.0) and formal pharmacies (4.7 DDD, 95% CI 2.6–6.8) than at informal medicine vendors (1.8 DDD).
The rate of healthcare utilization was 1.46 visits per 1000 inhabitants per day (655 healthcare visits among 4984 adult household members in the past 3 months/90 days): 0.97 to health centres ( n = 434), 0.36 to informal medicine vendors ( n = 162) and 0.13 to private community pharmacies ( n = 59).
The community-wide rate of antibiotic use was 2.9 DID (95% CI 1.9–3.9 DID), consisting of 2.6 DID (95% CI 1.7–3.5 DID) from health centres, 0.14 (95% CI 0.08–0.2 DID) from community pharmacies and 0.15 DID from informal medicine vendors. This gap is explained by differences in healthcare utilization, as well as the prevalence of antibiotic use per type of provider visited.
Community-wide antibiotic use in rural Burkina Faso in 2021–22 (2.9 DID) was lower than the median estimate of lower middle-income countries in 2015 (10.8 DID), yet comparable to estimates from Democratic Republic of Congo in 2019–20 (1.75 to 10.2 DID in rural and periurban populations, respectively). 6 , 19 The 54.8% prevalence of antibiotic use during health-centre visits was within the prediction interval of 44%–60% antibiotic use during primary care-centre visits in a systematic review in 27 LMICs. 17 The percentage of outpatients with Watch antibiotic use after health-centre visits (16.5%) was lower than that observed in most studies globally (range 7.5%–90.3%) yet comparable to that in other west or central African settings (range 10.0%–23.6%). 6 , 17 Nevertheless, nearly 70% of Watch antibiotic use in PHCs could have been avoided treatment guidance in the 2022 WHO AWaRe Antibiotic Book had been adhered to.
The high proportion of inpatients dispensed (Watch) antibiotics may be related to prescription being guided by perceived disease severity, as in other LMICs. 20 Likewise, the high proportion of outpatients diagnosed with conditions very unlikely to be of bacterial origin such as rhinopharyngitis, bronchitis, gastroenteritis (watery diarrhoea), who were nevertheless prescribed (Watch) antibiotics when attending health centres, confirms that there also, antibiotics are not only prescribed when recommended, as observed in other LMICs. 21–23 Similarly, inadequate use of antibiotic classes, such as imidazoles and sulphonamide/trimethoprim combinations for pneumonia were observed. In the same way, the single-dose administration of injectable ceftriaxone in some outpatients with mild to moderate clinical presentations without an antibiotic indication, as well as a high proportion of antibiotics dispensed suboptimally, are worrisome. These practices by healthcare workers could be related to limited diagnostic resources in health centres, inducing concerns of missing a potential bacterial coinfection, which resulted in an (over)prescription of wide-spectrum antibiotics. Lack of knowledge on the rational choice and use of antibiotics according to patients’ clinical presentations and the implications of incorrect use could have further perpetuated or exacerbated such practices. Interventions to improve quality of care and reduce AMR in health centres should be multifaceted, combining different strategies including dedicated education and awareness on AMR for healthcare workers, improved diagnostic tools to differentiate bacterial from non-bacterial infections, patient management algorithms that take into account age, based on the latest WHO recommendations for antibiotic prescription. 12 , 24–28
Although most antibiotics used in the community came from health centres and a large quantity were inappropriate, implying a need for more intensified interventions there, a significant amount were also dispensed over-the-counter, suggesting more involvement of the national pharmaceutical regulatory agency is needed in combating AMR. At district level, this involvement could be more responsibilities allocated to the district management team (well trained on AMR), allowing them to include all private pharmacies in the district areas into their regular monitoring programme with PHCs, instead of spot inspections, as currently allowed. 14 Watch antibiotics should be included in the list of medicines to be dispensed following medical prescription only and should be one of the key components of this monitoring. This could also be an opportunity for ongoing AMR awareness activities for pharmacy workers. 29 At national level, more commitment could help limit uncontrolled access to medicines of potentially poor quality, hence reducing the availability of over-the-counter antibiotics at informal medicine vendors. For this group, AMR awareness programmes should stress the harm of the misuse of Watch antibiotics (wrong indications and suboptimal regimen) for their entire community and urge them not to sell these medicines.
At community level, health literacy, including awareness of risk behaviours leading to emergence and spread of resistant microorganisms in the community, could significantly reduce self-medication with antibiotics. 30 Such activities should be combined with interventions facilitating and promoting access to healthcare facilities, e.g. through universal health insurance and patient-centred care including reducing patients’ waiting time. 31–34
Interventions to optimize antibiotic dispensing should be provider-type tailored: at formal pharmacies, strengthening regulation on antibiotic sales, associated with regular AMR awareness activities and monitoring, should mitigate over-the-counter dispensing of Watch antibiotics; at informal medicine vendors, AMR awareness programmes should help self-restriction of Watch antibiotic sales; and in health centres, while access should be promoted and facilitated, interventions should include healthcare professionals’ education and awareness on AMR, which is a key component for the success of a multiplex intervention including improving diagnostic tools and using appropriate algorithms to reduce (over)prescription.
The findings of this study were the subject of a poster presentation (P2720) at the ESCMID Global congress held in Barcelona on 27–30 April 2024.
We acknowledge all healthcare providers and all study participants for their willingness to participate in this study. We are also thankful to all the staff of the Clinical Research Unit of Nanoro for being part of the success of this study.
The study was funded by the European Joint Programme Initiative on AMR (grant JPIAMR2021-053), the Belgian Development Cooperation through ITM-CRUN Framework Agreement 5, and the InBev-Baillet-Latour Fund. The Conseil de l’Action Internationale de l’Université Catholique de Louvain partially funded D.V. through a PhD scholarship.
The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. All authors have no conflicts of interest to declare.
Table S1 is available as Supplementary data at JAC Online.
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Oropouche virus belongs to the Simbu serogroup of the viral genus Orthobunyavirus in the Peribunyaviridae family. The virus was first detected in 1955 in a febrile forest worker in a village in Trinidad and Tobago called Vega de Oropouche, near the Oropouche River. Oropouche virus is endemic to the Amazon basin.
Prior to 2000, outbreaks of Oropouche virus were reported in Brazil, Panama, and Peru. Evidence of animals being infected was also noted in Colombia and Trinidad during this time. In the last 25 years, cases of Oropouche have been identified in many countries in the Amazon region, including Bolivia, Brazil, Colombia, Ecuador, French Guiana, Panama, and Peru. One child was found to be infected in Haiti in 2014.
In late 2023, Oropouche virus was identified as causing large outbreaks in endemic areas and new areas in South America. In June 2024, Cuba reported its first confirmed Oropouche case. Currently, there is no evidence of local transmission in the United States.
The incubation period for Oropouche virus disease is 3–10 days. Typically, disease starts with the abrupt onset of fever (38-40°C) with headache (often severe), chills, myalgia, and arthralgia.
Other signs and symptoms include photophobia, dizziness, retroorbital or eye pain, nausea and vomiting, or maculopapular rash that starts on the trunk and goes to the extremities. Less common symptoms can include conjunctival injection, diarrhea, severe abdominal pain, and hemorrhagic symptoms (e.g., epistaxis, gingival bleeding, melena, menorrhagia, and petechiae).
Symptoms typically last less than a week (2–7 days). However, in up to 60% of patients, symptoms can reoccur a few days or even weeks later. Similar symptoms are reported on relapse.
The symptoms of Oropouche virus disease can be similar to symptoms of dengue, chikungunya, or Zika viruses, or malaria.
Abnormal laboratory findings have been documented in some patients with Oropouche virus disease including lymphopenia and leukopenia, elevated CRP (C-reactive protein), and mildly elevated liver enzymes. Thrombocytopenia also has been reported in a few cases.
Oropouche virus can cause neuroinvasive disease (e.g., meningitis and encephalitis). It is estimated that up to 4% of patients will develop neurologic symptoms after their initial febrile illness. Symptoms reported for patients with neuroinvasive disease include intense occipital pain, dizziness, confusion, lethargy, photophobia, nausea, vomiting, nuchal rigidity, and nystagmus. Laboratory abnormalities noted in cerebrospinal fluid (CSF) for patients with neuroinvasive disease include pleocytosis and elevated protein.
Persistence of weakness and malaise has been noted in some patients for up to one month following symptom onset. Patients might require hospitalization for more severe signs and symptoms. Patients typically recover without long-term sequalae, including in severe cases. There have been very few deaths reported among people infected with Oropouche virus.
Causality of Oropouche virus disease and negative pregnancy outcomes has not been established. Viruses in the Simbu serogroup (e.g., Akabane virus) have been associated with fetal losses and deformities in cattle and sheep.
On July 17, 2024, the Pan American Health Organization (PAHO) issued an epidemiological alert about possible cases of pregnant mother-to-child transmission of Oropouche virus with adverse pregnancy outcomes in Brazil. These cases are under investigation. CDC is working with PAHO and other international partners to learn more about the potential risks of Oropouche during pregnancy.
Preliminary diagnosis of Oropouche virus disease is based on the patient's clinical symptoms, location where infection likely occurred (including places and dates of travel), and activities leading to risk of possible exposure.
Evidence of the virus can be detected in serum samples during the first week of infection. The virus is readily cultured during the first few days of the infection and is usually not detected beyond day 5. However, viral RNA can be detected for several more days after the virus is no longer present. Toward the end of the first week of illness, IgM antibodies form, followed by IgG antibodies.
In patients with neuroinvasive disease, viral RNA can be detected but is often not present in CSF. Therefore, serologic testing is the preferred method to look for evidence of infection in the CSF. Viral RNA has been detected in saliva and urine of a patient 5 days into the illness. However, testing of these sample types is not currently validated or available in the United States.
Currently, CDC can perform plaque reduction neutralization tests (PRNTs) to detect virus-specific neutralizing antibodies in serum and CSF. To confirm a recent infection using serologic testing, both acute and convalescent samples are needed to document a 4-fold or greater change in antibody titers.
Contact your state or local health department if you have a patient with an acute illness and epidemiologic risk factors that might be compatible with Oropouche virus disease. They can assist you with determining if samples should be sent to the CDC Arbovirus Diagnostic Laboratory for further testing. Specimens should be submitted to CDC through state health departments. All results will be sent from CDC to the appropriate state health department.
There are no medicines to treat Oropouche virus disease. Supportive care is recommended for clinical management of patients. Treatment for symptoms can include rest, fluids, and use of analgesics and antipyretics. Patients who develop more severe symptoms should be hospitalized for close observation and supportive treatment.
All patients with clinically suspected dengue should receive appropriate management without waiting for diagnostic test results. Patients should be advised to avoid aspirin containing drugs or other nonsteroidal anti-inflammatory drugs until dengue can be ruled out to reduce the risk of bleeding.
The best way people can protect themselves from Oropouche is to prevent bites from biting midges and mosquitoes. There are no vaccines to prevent Oropouche virus disease. Additionally, there are no efficient, or economically or ecologically feasible, vector control measures for the primary vector, Culicoides paranesis .
Oropouche virus is spread primarily by midges. Learn about areas at risk, the illness it causes, and ways to prevent becoming infected.
Health care providers.
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Malnutrition is a prevalent condition in chronic diseases, significantly impacting morbidity and mortality. Point-of-care ultrasound (POCUS) is increasingly utilized in clinical practice as a rapid and accessible tool for evaluating muscle mass. Here, we present two cases of females with chronic diseases who presented with acute exacerbations of their conditions accompanied by fluid overload. Suspected of experiencing nutritional alterations, they underwent ultrasound evaluation to confirm muscle mass loss. These cases highlight the potential of ultrasound in guiding effective muscle mass assessment, particularly in pathologies prone to fluid overload, such as chronic kidney disease and heart failure.
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The project adheres to Resolution 8430 of October 4, 1993, of Colombia and had the verbal and written consent of the patient for publication as well as approval from the Fundación Cardio Infantil Ethics Committee.
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Department of Internal Medicine. Universidad Del Norte, Barranquilla, Colombia
Santiago Gómez-Jordan
Department of Nephrology. Fundación Cardio Infantil - Instituto de Cardiología, Bogotá, Colombia
Juan Camilo Castellanos-de la Hoz, Sandra Saumett, Alejandra Molano & Eduardo Zúñiga-Rodríguez
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All authors contributed to the study conception and design. Data collection and analysis were performed by S.G.J., S.S. and, J.C. The first draft of the manuscript was written by S.G.J. and S.S. Review and editing was made by E. Z., J.C., A.M. and, S.G.J. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
Correspondence to Santiago Gómez-Jordan .
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Gómez-Jordan, S., Castellanos-de la Hoz, J.C., Saumett, S. et al. Nutritional ultrasound: above body mass index, two cases presentation. Eur J Clin Nutr (2024). https://doi.org/10.1038/s41430-024-01459-z
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Plague still poses a significant threat to human health and as a reemerging infection is unfamiliar to the majority of the modern medical doctors. In this chapter, the plague is described according to Dr. Nikiforov's experiences in the diagnosis and treatment of patients, and also a review of the relevant literature on this subject is provided. The main modern methods and criteria for laboratory diagnosis of plague are briefly described. The clinical presentations include the bubonic and pneumonic form, septicemia, rarely pharyngitis, and meningitis. Early diagnosis and the prompt initiation of treatment reduce the mortality rate associated with bubonic plague and septicemic plague to 5-50 %; although a delay of more than 24 h in the administration of antibiotics and antishock treatment can be fatal for plague patients. Most human cases can successfully be treated with antibiotics.
Keywords: Bubonic plague; Plague symptoms; Plague treatment; Pneumonic plague; Septicemic plague.
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Transforming the understanding and treatment of mental illnesses.
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What is asd.
Autism spectrum disorder (ASD) is a neurological and developmental disorder that affects how people interact with others, communicate, learn, and behave. Although autism can be diagnosed at any age, it is described as a “developmental disorder” because symptoms generally appear in the first 2 years of life.
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) , a guide created by the American Psychiatric Association that health care providers use to diagnose mental disorders, people with ASD often have:
Autism is known as a “spectrum” disorder because there is wide variation in the type and severity of symptoms people experience.
People of all genders, races, ethnicities, and economic backgrounds can be diagnosed with ASD. Although ASD can be a lifelong disorder, treatments and services can improve a person’s symptoms and daily functioning. The American Academy of Pediatrics recommends that all children receive screening for autism. Caregivers should talk to their child’s health care provider about ASD screening or evaluation.
The list below gives some examples of common types of behaviors in people diagnosed with ASD. Not all people with ASD will have all behaviors, but most will have several of the behaviors listed below.
People with ASD may also experience sleep problems and irritability.
People on the autism spectrum also may have many strengths, including:
Researchers don’t know the primary causes of ASD, but studies suggest that a person’s genes can act together with aspects of their environment to affect development in ways that lead to ASD. Some factors that are associated with an increased likelihood of developing ASD include:
Health care providers diagnose ASD by evaluating a person’s behavior and development. ASD can usually be reliably diagnosed by age 2. It is important to seek an evaluation as soon as possible. The earlier ASD is diagnosed, the sooner treatments and services can begin.
Diagnosis in young children is often a two-stage process.
Every child should receive well-child check-ups with a pediatrician or an early childhood health care provider. The American Academy of Pediatrics recommends that all children receive screening for developmental delays at their 9-, 18-, and 24- or 30-month well-child visits, with specific autism screenings at their 18- and 24-month well-child visits. A child may receive additional screening if they have a higher likelihood of ASD or developmental problems. Children with a higher likelihood of ASD include those who have a family member with ASD, show some behaviors that are typical of ASD, have older parents, have certain genetic conditions, or who had a very low birth weight.
Considering caregivers’ experiences and concerns is an important part of the screening process for young children. The health care provider may ask questions about the child’s behaviors and evaluate those answers in combination with information from ASD screening tools and clinical observations of the child. Read more about screening instruments on the Centers for Disease Control and Prevention (CDC) website.
If a child shows developmental differences in behavior or functioning during this screening process, the health care provider may refer the child for additional evaluation.
It is important to accurately detect and diagnose children with ASD as early as possible, as this will shed light on their unique strengths and challenges. Early detection also can help caregivers determine which services, educational programs, and behavioral therapies are most likely to be helpful for their child.
A team of health care providers who have experience diagnosing ASD will conduct the diagnostic evaluation. This team may include child neurologists, developmental pediatricians, speech-language pathologists, child psychologists and psychiatrists, educational specialists, and occupational therapists.
The diagnostic evaluation is likely to include:
Because ASD is a complex disorder that sometimes occurs with other illnesses or learning disorders, the comprehensive evaluation may include:
The evaluation may lead to a formal diagnosis and recommendations for treatment.
Caregivers and teachers are often the first to recognize ASD symptoms in older children and adolescents who attend school. The school’s special education team may perform an initial evaluation and then recommend that a child undergo additional evaluation with their primary health care provider or a health care provider who specialize in ASD.
A child’s caregivers may talk with these health care providers about their child’s social difficulties, including problems with subtle communication. For example, some children may have problems understanding tone of voice, facial expressions, or body language. Older children and adolescents may have trouble understanding figures of speech, humor, or sarcasm. They also may have trouble forming friendships with peers.
Diagnosing ASD in adults is often more difficult than diagnosing ASD in children. In adults, some ASD symptoms can overlap with symptoms of other mental health disorders, such as anxiety disorder or attention-deficit/hyperactivity disorder (ADHD).
Adults who notice signs of ASD should talk with a health care provider and ask for a referral for an ASD evaluation. Although evaluation for ASD in adults is still being refined, adults may be referred to a neuropsychologist, psychologist, or psychiatrist who has experience with ASD. The expert will ask about:
The evaluation also may include a conversation with caregivers or other family members to learn about the person’s early developmental history, which can help ensure an accurate diagnosis.
Receiving a correct diagnosis of ASD as an adult can help a person understand past challenges, identify personal strengths, and find the right kind of help. Studies are underway to determine the types of services and supports that are most helpful for improving the functioning and community integration of autistic transition-age youth and adults.
Treatment for ASD should begin as soon as possible after diagnosis. Early treatment for ASD is important as proper care and services can reduce individuals’ difficulties while helping them build on their strengths and learn new skills.
People with ASD may face a wide range of issues, which means that there is no single best treatment for ASD. Working closely with a health care provider is an important part of finding the right combination of treatment and services.
A health care provider may prescribe medication to treat specific symptoms. With medication, a person with ASD may have fewer problems with:
Read more about the latest medication warnings, patient medication guides, and information on newly approved medications at the Food and Drug Administration (FDA) website .
People with ASD may be referred to a health care provider who specializes in providing behavioral, psychological, educational, or skill-building interventions. These programs are often highly structured and intensive, and they may involve caregivers, siblings, and other family members. These programs may help people with ASD:
Many services, programs, and other resources are available to help people with ASD. Here are some tips for finding these additional services:
Clinical trials are research studies that look at new ways to prevent, detect, or treat diseases and conditions. The goal of clinical trials is to determine if a new test or treatment works and is safe. Although individuals may benefit from being part of a clinical trial, participants should be aware that the primary purpose of a clinical trial is to gain new scientific knowledge so that others may be better helped in the future.
Researchers at NIMH and around the country conduct many studies with patients and healthy volunteers. We have new and better treatment options today because of what clinical trials uncovered years ago. Be part of tomorrow’s medical breakthroughs. Talk to your health care provider about clinical trials, their benefits and risks, and whether one is right for you.
To learn more or find a study, visit:
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This Preventive Medicine Grand Rounds session is scheduled for: Wednesday, July 6, 2022, 1:30 – 3:00 p.m. ET
Public Health Grand Rounds (PHGR) will continue to promote Preventive Medicine Grand Rounds (PMGR) while our monthly PHGR sessions are on hold. We welcome your questions. Please email us at [email protected]
In this presentation, Dr. Didi Ebert will explain that social determinants of health (SDOH) are conditions in the environments where people are born, live, learn, work, play, worship, and age that affect a wide range of health risks and outcomes. Attendees will learn how SDOH present in clinical care settings and the role they play in driving health outcomes and health disparities. Dr. Ebert will describe strategies to address SDOH, including those to align primary care with public health through clinical services and education in the healthcare profession. Multiple policies now influence healthcare organizations to address SDOH in clinical care. By leveraging these policies, clinicians and healthcare organizations can supplement individualized disease state interventions with social services interventions that impact population-level outcomes beyond individual factors.
Didi Ebert, DO, MPH, MS, FAAFP Associate Professor of Family Medicine University of North Texas Health Science Center, Texas College of Osteopathic Medicine
These Grand Rounds presentations are provided as a courtesy of CDC’s Preventive Medicine Residency and Fellowship (PMR/F) program with the goal of sharing systems-based approaches and leadership practices to address population health issues and public health emergencies.
Continuing education (CE) is available and there is no cost for this activity. For more details, go to https://www.cdc.gov/prevmed/pmgr/upcoming-lectures.html .
For More Information Please contact the PMR/F program at [email protected] or visit the Preventive Medicine Grand Rounds web page.
Empowering emergency nurses throughout the patient journey.
By Kathryn Spears, Critical Care Clinical Stream Manager, South Western Sydney Local Health District
30 Jul 2024 Reading time approximately
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The Emergency Care Assessment and Treatment program is going live across NSW emergency departments, transforming care for patients and emergency nurses.
On 7 December 2017, a call to arms was issued for clinical nurse consultants and nursing leaders in NSW emergency departments (EDs) to be involved in a project to standardise nurse-initiated care across NSW. The phrase ‘It won’t be a huge amount of work’ sits with me now.
Six subcommittees were established to focus on different aspects of the program, involving more than 180 members from across the state. I joined the Clinical Subcommittee and was involved in reviewing the initial drafts of the protocols and providing clinical expertise.
Almost seven years, a worldwide pandemic and a few grey hairs later, we now have 73 statewide protocols under the Emergency Care Assessment and Treatment (ECAT) program being rolled out across all EDs in NSW.
Nurse-initiated care protocols are not new to EDs; however, they varied across the state prior to ECAT. Those we used in South Western Sydney Local Health District (SWSLHD) had evolved over the past 20 years. Our protocols were generally used by nurses with at least 3-4 years of experience and training in the ED, although all of our ED nurses could use them in theory. This worked well for conditions like a laceration or fracture, but not as well in common emergency presentations such as abdominal or chest pain, for a variety of reasons.
The new ECAT protocols leverage existing models of care across rural and metropolitan EDs, and the latest evidence-based practice in emergency care. They are available online, making them accessible anywhere, anytime, via the Agency for Clinical Innovation (ACI) ECAT website .
Supported by a policy directive, a robust education pathway and governance, ECAT provides a standardised approach to nurse-initiated care for the most common presentations by children and adults in our EDs.
The initial statewide conversations when developing ECAT were tough, as well-established processes were challenged and we were focused on our differences – rural versus metropolitan; big vs small. However, once we pivoted to focus on our patients and staff, we started to make real collaborative progress.
ECAT is providing whole-of-system reform for EDs. It has been led by emergency nurses, with a focus on developing and enhancing their capability to support the patient’s journey. I don’t know of a project that has achieved the same breadth of consultation and engagement, from colleges, supporting service providers and associated clinical experts.
Where we identified a barrier, we overcame it through the strength of our combined clinical experience, advocacy for our emergency nursing profession, and the support of our advocates from the ACI, the College of Emergency Nursing, Australasian College for Emergency Medicine, Clinical Excellence Commission, Health Educational and Training Institute and the Nursing and Midwifery Office, Ministry of Health.
Who else but emergency nurses could have legislation changed to improve access to care for our patients?
SWSLHD was the first to go live as a whole district with ECAT on 21 May, with onsite support provided by the ACI team, along with our in-house digital health, clinical support and nursing informatic teams, working with more than 50 champions and site leads.
My role as ECAT lead has been to work collaboratively across the district and state. I enabled and supported my facility and LHD leads to drive education and implementation and worked with the supporting services to deliver the project. I advocated for SWSLHD staff and patients with the project team, and worked with other district leads to achieve this shared vision. We used novel education methods, engaged through our digital platforms, collaborated, compromised, lost sleep, but most importantly we watched our clinical leaders grow and develop to enable this project to succeed.
Since then, more than 24,000 protocols have been commenced for our patients, and more than 10,000 medications or fluids initiated under ECAT protocols. Our less experienced and developing ED nurses are supported to deliver independent nurse-initiated care within a structured protocol; and our more experienced nurses can access and deliver medications based on their capability to meet the patient’s need.
We are still realising the benefits of the ECAT program in SWSLHD. But what we do know is that we have just begun a major change in our system that will build nurses’ capability and confidence to deliver high quality, standardised patient care.
We will continue to:
Our workforce is adaptable and open to change, despite the pressures of our overwhelmed EDs. ECAT means emergency nurses are beginning to treat patients more quickly and reducing wait times, which is making a real difference to our patients’ journey and their outcome.
Kathryn is passionate about staff development, patient safety and high quality nursing care. She has been an Emergency Clinical Nurse Educator and Clinical Nurse Consultant for more than 10 years. She holds a Graduate Certificate in Emergency Nursing and a Masters in Clinical Leadership.
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Presenting patient cases is a key part of everyday clinical practice. A well delivered presentation has the potential to facilitate patient care and improve efficiency on ward rounds, as well as a means of teaching and assessing clinical competence. 1 The purpose of a case presentation is to communicate your diagnostic reasoning to the listener, so that he or she has a clear picture of the ...
The ability to deliver oral case presentations is a core skill for any physician. Effective oral case presentations help facilitate information transfer among physicians and are essential to delivering quality patient care. Oral case presentations are also a key component of how medical students and residents are assessed during their training.
Presenting a patient is an essential skill that is rarely taught Clinical presenting is the language that doctors use to communicate with each other every day of their working lives. Effective communication between doctors is crucial, considering the collaborative nature of medicine. As a medical student and later as a doctor you will be expected to present cases to peers and senior colleagues ...
Here's how to create an effective and engaging medical presentation — without wasting hours on PowerPoint! Simple is better. Be wise with your color choice. Don't overcrowd slides with text. Give your audience time to process.
Request a consultant's advice on a clinical problem: the presentation will be focused on the clinical question being posed to the consultant. ... For ongoing care, have the information available to respond to questions. Past Surgical History. Provide names of procedures, approximate dates, indications, any relevant findings or complications ...
Visit pointofcaremedicine.com to see the templates, pearls, literature, and other resources discussed in this episode. At Point of Care Medicine, our mission is to create accessible and easy-to-use digital resources that help healthcare professionals tackle common clinical presentations at the point of care, without getting bogged down by ...
Case presentation format and clinical reasoning: a strategy for teaching medical students. Medical Teacher 1987;9:285-292. doi: 10.3109/01421598709034790. Goldberg C. A practical guide to clinical medicine: overview and general information about oral presentation. 2009. University of California, San Diego.
Whether your presentation relates to the latest National Institute for Health and Clinical Excellence (NICE) guidelines for your specialty or a business plan in response to a proposed polyclinic, this structure will help keep your audience engaged and your presentation within the time limit. Indeed, timing is crucial when giving a presentation.
1. Free Healthcare Infographic Presentation. This multi-purpose template for PowerPoint and Keynote comes with more than 100 slides and dark and light versions. However, there is a free sample version that features 6 high-quality slides available to download and edit. Free Version: 6 slides.
As a healthcare professional, good presentation skills can make or break your career, but speaking to a crowded conference room can be petrifying. Scott C. Litin, MD gives 16 tips and tools for giving a memorable presentation. ... Addressing and Preventing Sexual Harassment in Healthcare. Sexual harassment in health care can have lasting ...
Download the Antimicrobial Resistance Case Report presentation for PowerPoint or Google Slides. A clinical case is more than just a set of symptoms and a diagnosis. It is a unique story of a patient, their experiences, and their journey towards healing. Each case is an opportunity for healthcare professionals to...
3. Medical Practitioner. Introducing our Medical Practitioner presentation template, a powerful resource designed to enhance your medical and healthcare-related presentations. This template features a confident and dedicated doctor at the forefront, symbolizing expertise and trust in the field of medicine.
Advocate for Health With a Free Medical Slide Template. ... To make a medical presentation, first consider two things: 1) what medical information or message you want your audience to receive and 2) what you want them to do. Next, choose the best medical template for the job. Finally, prepare for your presentation by practicing your talking points.
Medical PowerPoint Template. This beautifully designed free healthcare PowerPoint template has all the tools you might need for a medical presentation. It has slides you can use to showcase different procedure options or different service tiers. It has several text slides so you can easily add any messages you find convenient.
Water and community health. When to Call 911. Women's Health. Work Injury Management. Working environment and community health. Worksite Wellness. Xenobiotics. Yoga in health and disease. Hope this list of healthcare and medical presentation topics will help you prepare stunning presentations for school, college and other power-point ...
Here are a handful of the best premium medical and health PowerPoint templates. These are trending on Envato Elements in 2023: 1. Dheral - Medical PowerPoint Presentation Template. Click here to see more of the Dheral medicine and medical school PowerPoint slides. The Dheral medical PowerPoint template is designed for modern 2023 presentations.
This comprehensive slide deck of ADA's 2023 Standards of Care contains content created, reviewed, and approved by the American Diabetes Association. You are free to use the slides in presentations without further permission as long as the slide content is not altered in any way and appropriate attribution is made to the American Diabetes Association (the Association name and logo on the slides ...
Generally, payers or health-care funding bodies restrict reimbursement to treatments that have been demonstrated to provide clinical benefit in well-conducted trials that produced definitive results.
Health Presentation templates ... Download the Adult Day Care Center presentation for PowerPoint or Google Slides. Hospitals, private clinics, specific wards, you know where to go when in need of medical attention. ... Clinical Case 06-2023 Slidesgo is back with a new free medical template, perfect for a presentation about a clinical case. The ...
We assigned clinical presentations to presumed diagnoses reported by the healthcare provider, or—if none reported—to a combination of reported symptoms (Table S1, available as Supplementary data at JAC Online) following the symptoms reported for each disease in the WHO AWaRe antibiotic book. 12 In the case of a patient reporting only one ...
Abstract. Background: Clinical conferences are generally defined as scheduled events at which practicing physicians themselves present to their colleagues interesting clinical cases, share their new experiences and learn about the latest achievements of medical science and practice. The value of a clinical conference is thought to be in direct ...
Clinical presentation is commonly mistaken for other arboviruses such as dengue, chikungunya, and Zika viruses, and malaria. ... Health Care Providers: Clinical Care of Dengue. Prevention. The best way people can protect themselves from Oropouche is to prevent bites from biting midges and mosquitoes. There are no vaccines to prevent Oropouche ...
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The clinical presentations include the bubonic and pneumonic form, septicemia, rarely pharyngitis, and meningitis. Early diagnosis and the prompt initiation of treatment reduce the mortality rate associated with bubonic plague and septicemic plague to 5-50 %; although a delay of more than 24 h in the administration of antibiotics and antishock ...
Health care providers diagnose ASD by evaluating a person's behavior and development. ASD can usually be reliably diagnosed by age 2. It is important to seek an evaluation as soon as possible. ... Talk to your health care provider about clinical trials, their benefits and risks, and whether one is right for you. To learn more or find a study ...
Division of healthcare organization analyzes management of medical care in institutions of Moscow Healthcare Department and proposes how it can be improved and ... briefs from scientific conferences and advanced clinical know-how. ... TEDTalk-style presentations, etc.) and for a wide audience (educational animated videos on popular ...
In this presentation, Dr. Didi Ebert will explain that social determinants of health (SDOH) are conditions in the environments where people are born, live, learn, work, play, worship, and age that affect a wide range of health risks and outcomes. Attendees will learn how SDOH present in clinical care settings and the role they play in driving ...
We read with great interest the study by Travis Zack and colleagues1 in The Lancet Digital Health on the potential of GPT-4 to perpetuate racial and gender biases in health care. Zack and colleagues argue that large language models (LLM), such as GPT-4, show inherent biases in the portrayal of patients in clinical vignettes generated for case-based learning. The study shows that the ...
Findings suggest that children with mental health conditions during COVID-19 pandemic's early days have increased frequency of forgone health care, lower FCC, lower SDM, less open communication and decreased satisfaction compared to children with physical conditions. Children's perspective in pediatric care should be prioritized
Kathryn is the Clinical Stream Manager for Critical Care in South Western Sydney Local Health District, as well as district ECAT Lead and a member of the ECAT development Clinical Subcommittee. She is a registered nurse with 20 years of experience across emergency departments, adult and neonatal intensive care, paediatrics, retrieval and ...