clove and Wounds-and-Injuries

Marine microorganisms such as

Topics: Adult; Amoxicillin; Animals; Anti-Bacterial Agents; Female; Gram-Negative Bacterial Infections; Humans; Madagascar; Meningoencephalitis; Seawater; Sepsis; Shewanella; Swimming; Travel; Treatment Outcome; Wound Infection; Wounds and Injuries

An Auckland paediatric nurse finds caring for children on a hospital ship in Madagascar to be satisfying on many levels.

Topics: Bandages; Humans; Madagascar; New Zealand; Nurses, Pediatric; Ships; Wounds and Injuries

Efforts to develop effective and regionally-appropriate emergency care systems in sub-Saharan Africa are hindered by a lack of data on both the burden of disease in the region and on the state of existing care delivery mechanisms. This study describes the burden of acute disease presenting to an emergency unit in Mahajanga, Madagascar.. Handwritten patient registries on all emergency department patients presenting between 1 January 2011 and 30 September 2012 were reviewed and data entered into a database. Data included age, sex, diagnosis, and disposition. We classified diagnoses into Clinical Classifications Software (CCS) multi-level categories. The population was 53.5% male, with a median age of 31 years. The five most common presenting conditions were 1) Superficial injury; contusion, 2) Open wounds of head; neck; and trunk, 3) Open wounds of extremities, 4) Intracranial injury, and 5) Unspecified injury and poisoning. Trauma accounted for 48%, Infectious Disease for 15%, Mental Health 6.1%, Noncommunicable 29%, and Neoplasms 1.2%. The acuity seen was high, with an admission rate of 43%. Trauma was the most common reason for admission, representing 19% of admitted patients.. This study describes the burden of acute disease at a large referral center in northern Madagascar. The Centre Hôpitalier Universitaire de Mahajanga sees a high volume of acutely ill and injured patients. Similar to other reports from the region, trauma is the most common pathology observed, though infectious disease was responsible for the majority of adult mortality. Typhoid fever other intestinal infections were the most lethal CCS-coded pathologies. By utilizing a widely understood classification system, we are able to highlight contrasts between Mahajanga's acute and overall disease burden as well as make comparisons between this region and the rest of the globe. We hope this study will serve to guide the development of context-appropriate emergency medicine systems in the region.

Topics: Acute Disease; Adolescent; Adult; Child; Child, Preschool; Emergency Medical Services; Female; Humans; Infections; Madagascar; Male; Mental Health; Referral and Consultation; Wounds and Injuries; Young Adult

Prehospital care in developing countries is severely lacking. Few countries can afford the relatively expensive formalised Western model of a prehospital emergency medical system. The WHO has highlighted the development of layperson first responder programmes as the most basic step in the development of a functioning prehospital system.. To describe the first training programme of its kind, run in Mahajanga, Madagascar. The faculty was invited by Mahajanga Medical School.. Local input was taken into account in developing the curriculum. 26 taxi drivers were invited to attend in cooperation with the local municipality. The faculty consisted of five instructors from the Division of Emergency Medicine and EMSSA, plus local doctors from University Hospital Mahajanga. The 1-day course included workshops on prehospital scene management, bleeding and broken bones, immobilisation and patient movement, and labour and delivery. The workshops made use of commonly available items only including packets, string and towels; French and Malagasy translators were available throughout.. Both faculty and candidates deemed the course a success and plans for formal evaluation of knowledge and skill retention are underway. Future plans are to continue the training using local instructors and in rural districts.

Topics: Automobile Driving; Delivery, Obstetric; Emergency Medical Services; Emergency Treatment; First Aid; Health Education; Hemorrhage; Humans; Immobilization; Madagascar; Moving and Lifting Patients; Wounds and Injuries