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Nizeyimana F, Pendergrast J, Ntegerejuwampayee A, Lin Y, Kanyamuhunga A, Gashaija C, Masaisa F, Uzamukunda C, Mutuyimana G, Ndicunguye F, Gaseminari A, Mulindwa B, Muyombo T, Chargé S, Skelton T. Transfusion Camp Rwanda 2023: A train-the-trainer workshop establishing locally driven leadership in knowledge translation and sustainability in transfusion medicine education. Vox Sang 2024; 119:563-571. [PMID: 38425034 DOI: 10.1111/vox.13611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 01/15/2024] [Accepted: 02/16/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND AND OBJECTIVES Blood transfusion is performed daily in hospitals. Gaps exist between transfusion guidelines and day-to-day clinical care. These gaps are prevalent in resource-limited settings due to scarce continuing medical education. Transfusion Camp Rwanda aims to bridge this gap by (1) delivering context-appropriate up-to-date education, (2) teaching participants how to independently deliver a case-based curriculum and (3) identifying strategies to promote change in transfusion practice in Rwanda. MATERIALS AND METHODS In May 2023, a multidisciplinary team from Canada and Rwanda carried out a Transfusion Camp train-the-trainer workshop for clinicians from all five provinces in Rwanda. Participants attended in-person lectures, seminars and workshop group discussions on the implementation of the Rwanda National Directives on Rational Use of Blood and Blood Components. Course feedback was based on the Kirkpatrick Model of Training and Evaluation. RESULTS Fifty-one physicians and laboratory technicians participated in the course. Confidence in caring for patients based on transfusion guidelines was self-rated as 'excellent' by 23% of participants before and 77% after, while 84% reported they planned to teach Transfusion Camp to others and 100% responded that they will apply course content to clinical practice. Workshop groups recommended strategies to improve transfusion medicine practice in Rwanda in four domains: Communication, Institutional Approval, Practice Audits and Education. CONCLUSION Transfusion medicine education in Rwanda using a train-the-trainer approach was well-received by participants and allowed for a more detailed understanding of the local medical and educational environment. These observations can inform the further expansion of the Transfusion Camp Rwanda project.
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Affiliation(s)
- Francoise Nizeyimana
- Department of Anesthesia and Critical Care, University Teaching Hospital of Kigali, Kigali, Rwanda
- Department of Anesthesia and Critical Care, University of Rwanda, Kigali, Rwanda
| | - Jacob Pendergrast
- Laboratory Medicine Program, University Health Network, University of Toronto, Toronto, Ontario, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
- University of Toronto Quality in Utilization, Education and Safety in Transfusion Research Program, University of Toronto, Toronto, Ontario, Canada
| | - Angelique Ntegerejuwampayee
- Department of Anesthesia and Critical Care, University Teaching Hospital of Kigali, Kigali, Rwanda
- Department of Anesthesia and Critical Care, University of Rwanda, Kigali, Rwanda
| | - Yulia Lin
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
- University of Toronto Quality in Utilization, Education and Safety in Transfusion Research Program, University of Toronto, Toronto, Ontario, Canada
- Precision Diagnostics and Therapeutic Program, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Aimable Kanyamuhunga
- Department of Pediatrics, University Teaching Hospital of Kigali, University of Rwanda, Kigali, Rwanda
| | - Christopher Gashaija
- National Centre for Blood Transfusion, Rwanda Biomedical Centre, University of Rwanda, Kigali, Rwanda
| | - Florence Masaisa
- Department of Internal Medicine, University Teaching Hospital of Kigali, University of Rwanda, Kigali, Rwanda
| | - Claudine Uzamukunda
- Department of Anesthesia and Critical Care, University Teaching Hospital of Kigali, Kigali, Rwanda
- Department of Anesthesia and Critical Care, University of Rwanda, Kigali, Rwanda
| | - Grace Mutuyimana
- Department of Anesthesia and Critical Care, University Teaching Hospital of Kigali, Kigali, Rwanda
- Department of Anesthesia and Critical Care, University of Rwanda, Kigali, Rwanda
| | - Fabrice Ndicunguye
- National Centre for Blood Transfusion, Rwanda Biomedical Centre, University of Rwanda, Kigali, Rwanda
| | - Alexis Gaseminari
- National Centre for Blood Transfusion, Rwanda Biomedical Centre, University of Rwanda, Kigali, Rwanda
| | - Bruce Mulindwa
- National Centre for Blood Transfusion, Rwanda Biomedical Centre, University of Rwanda, Kigali, Rwanda
| | - Thomas Muyombo
- National Centre for Blood Transfusion, Rwanda Biomedical Centre, University of Rwanda, Kigali, Rwanda
| | - Sophie Chargé
- Medical Affairs and Innovation, Canadian Blood Services, Ottawa, Ontario, Canada
| | - Teresa Skelton
- Department of Anesthesiology, Pharmacology, and Therapeutics, BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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Bhattacharya S, Singh A. Revolutionizing healthcare: Navigating the trajectory of unmanned aerial vehicles from history to horizon. Med J Armed Forces India 2024; 80:252-256. [PMID: 38800002 PMCID: PMC11116996 DOI: 10.1016/j.mjafi.2023.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 11/19/2023] [Indexed: 05/29/2024] Open
Affiliation(s)
- Sudip Bhattacharya
- Assistant Professor (Community & Family Medicine), All India Institute of Medical Sciences, Deoghar, Jharkhand, India
| | - Amarjeet Singh
- Ex- Professor & Head (Community Medicine & School of Public Health), PGIMER, Chandigarh, India
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Hoek Spaans R, Drumond B, van Daalen KR, Rorato Vitor AC, Derbyshire A, Da Silva A, Lana RM, Vega MS, Carrasco-Escobar G, Sobral Escada MI, Codeço C, Lowe R. Ethical considerations related to drone use for environment and health research: A scoping review protocol. PLoS One 2024; 19:e0287270. [PMID: 38295017 PMCID: PMC10829986 DOI: 10.1371/journal.pone.0287270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 12/14/2023] [Indexed: 02/02/2024] Open
Abstract
INTRODUCTION The use of drones in environment and health research is a relatively new phenomenon. A principal research activity drones are used for is environmental monitoring, which can raise concerns in local communities. Existing ethical guidance for researchers is often not specific to drone technology and practices vary between research settings. Therefore, this scoping review aims to gather the evidence available on ethical considerations surrounding drone use as perceived by local communities, ethical considerations reported on by researchers implementing drone research, and published ethical guidance related to drone deployment. METHODS AND ANALYSIS This scoping review will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR) and the Joanna Briggs Institute (JBI) guidelines. The literature search will be conducted using academic databases and grey literature sources. After pilot testing the inclusion criteria and data extraction tool, two researchers will double-screen and then chart available evidence independently. A content analysis will be carried out to identify patterns of categories or terms used to describe ethical considerations related to drone usage for environmental monitoring in the literature using the R Package RQDA. Discrepancies in any phase of the project will be solved through consensus between the two reviewers. If consensus cannot be reached, a third arbitrator will be consulted. ETHICS AND DISSEMINATION Ethical approval is not required; only secondary data will be used. This protocol is registered on the Open Science Framework (osf.io/a78et). The results will be disseminated through publication in a scientific journal and will be used to inform drone field campaigns in the Wellcome Trust funded HARMONIZE project. HARMONIZE aims to develop cost-effective and reproducible digital infrastructure for stakeholders in climate change hotspots in Latin America & the Caribbean and will use drone technology to collect data on fine scale landscape changes.
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Affiliation(s)
- Remy Hoek Spaans
- Barcelona Supercomputing Center (BSC), Barcelona, Spain
- Liverpool School of Tropical Medicine (LSTM), Liverpool, United Kingdom
| | - Bruna Drumond
- Programa de Pós-Graduação em Saúde Pública, Escola Nacional de Saúde Pública Sergio Arouca (ENSP), Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro, Brazil
- Programa Institucional Territórios Sustentáveis e Saudáveis (PITSS), Vice-Presidência de Ambiente, Atenção e Promoção da Saúde (VPAAPS), Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro, Brazil
| | | | - Ana Claudia Rorato Vitor
- National Institute for Space Research (INPE), Laboratory for Investigation in Socio-Environmental Systems (LiSS), São José dos Campos, Brazil
| | - Alison Derbyshire
- Liverpool School of Tropical Medicine (LSTM), Liverpool, United Kingdom
| | - Adriano Da Silva
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde/Fiocruz (Icict/Fiocuz), Rio de Janeiro, Brazil
| | | | - Mauricio Santos Vega
- Grupo en Biologia Matematica y Computacional, Departamento de Ciencias Biologicas, Universidad de los Andes, Bogota, Colombia
| | - Gabriel Carrasco-Escobar
- Health Innovation Laboratory, Institute of Tropical Medicine “Alexander von Humboldt”, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Maria Isabel Sobral Escada
- National Institute for Space Research (INPE), Laboratory for Investigation in Socio-Environmental Systems (LiSS), São José dos Campos, Brazil
| | - Claudia Codeço
- Programa de Computação Científica, Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro, Brazil
| | - Rachel Lowe
- Barcelona Supercomputing Center (BSC), Barcelona, Spain
- Catalan Institution for Research and Advanced Studies (ICREA), Barcelona, Spain
- Centre on Climate Change & Planetary Health and Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
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Surman K, Lockey D. Unmanned aerial vehicles and pre-hospital emergency medicine. Scand J Trauma Resusc Emerg Med 2024; 32:9. [PMID: 38287437 PMCID: PMC10826110 DOI: 10.1186/s13049-024-01180-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 01/14/2024] [Indexed: 01/31/2024] Open
Abstract
Unmanned aerial vehicles (UAVs) are used in many industrial and commercial roles and have an increasing number of medical applications. This article reviews the characteristics of UAVs and their current applications in pre-hospital emergency medicine. The key roles are transport of equipment and medications and potentially passengers to or from a scene and the use of cameras to observe or communicate with remote scenes. The potential hazards of UAVs both deliberate or accidental are also discussed.
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Affiliation(s)
| | - David Lockey
- Bartshealth NHS Trust, London, UK.
- Blizard Institute, Queen Mary University, London, UK.
- London's Air Ambulance, Barts Health NHS Trust, London, UK.
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Kremer P, Leyzerovskaya A, DuBois S, Lipsitt J, Haruna F, Lebed O. Bringing underserved communities life-saving aid through aerial logistics. Sci Robot 2023; 8:eadm7020. [PMID: 38117867 DOI: 10.1126/scirobotics.adm7020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 11/28/2023] [Indexed: 12/22/2023]
Abstract
Autonomous drone delivery of medical supplies has improved access to health care for local communities in Africa.
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Affiliation(s)
- Pedro Kremer
- Zipline International, South San Francisco, CA 94080, USA
| | | | - Shelley DuBois
- Zipline International, South San Francisco, CA 94080, USA
| | - Jonah Lipsitt
- Zipline International, South San Francisco, CA 94080, USA
| | | | - Olga Lebed
- Zipline International, South San Francisco, CA 94080, USA
- University of Delaware, Newark, DE 19716, USA
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Skelton T, Nizeyimana F, Pendergrast J, Hagumimana J, Masaisa F, Kanyamuhunga A, Gashaija C, Callum J, Pavenski K, Khandelwal A, Lieberman L, Chargé S, Kapitany C, Morgan M, Meirovich H, Lin Y. Transfusion medicine education delivery in Rwanda: Adapting Transfusion Camp to a resource-limited setting. Transfusion 2023; 63:2159-2169. [PMID: 37688306 DOI: 10.1111/trf.17531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 08/01/2023] [Accepted: 08/14/2023] [Indexed: 09/10/2023]
Abstract
BACKGROUND Due to few teaching faculty, resource-limited settings may lack the education curricula providers need for safe practice. As safe surgery becomes an increasing priority worldwide, it is essential to improve access to critical education content including in transfusion medicine. Transfusion Camp is a longitudinal curriculum, shown to increase knowledge in postgraduate trainees. The objective was to develop a sustainable bilateral partnership between Rwanda and Canada, and to integrate Transfusion Camp into the existing curriculum of the School of Medicine and Pharmacy at University of Rwanda. METHODS A Transfusion Camp pilot course was initiated through collaboration of experts in Rwanda and Canada. Planning occurred over 6 months via online and in-person meetings. Canadian teaching faculty adapted course content via iterative discussion with Rwandan faculty. Final content was delivered through online pre-recorded lectures by Canadian Faculty, and in-person small-group seminars by Rwandan Faculty. Project feasibility was assessed through structured evaluation and informal debriefing. RESULTS Twenty-seven postgraduate trainees were present for the pilot course, of whom 21 (78%) submitted evaluation forms. While the structure and content of the adapted Transfusion Camp curriculum were well-received, the majority of respondents indicated a preference for in-person rather than pre-recorded lectures. Debriefing determined that future courses should focus on continuing education initiatives aimed at physicians entering or already in independent practice. CONCLUSION A partnership between universities and blood operators in high-resource and resource-limited countries results in a transfusion medicine curriculum that is locally applicable, multidisciplinary, and supportive of learning benefitting the learners and educators alike.
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Affiliation(s)
- Teresa Skelton
- Department of Anesthesiology, Pharmacology, and Therapeutics, BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - Francoise Nizeyimana
- Department of Anesthesia and Critical Care, Kigali University Teaching Hospital, Kigali, Rwanda
- Department of Anesthesia and Critical Care, University of Rwanda, Kigali, Rwanda
| | - Jacob Pendergrast
- Laboratory Medicine Program, University Health Network, University of Toronto, Toronto, Ontario, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
- University of Toronto Quality in Utilization, Education and Safety in Transfusion (QUEST) Research Program, Toronto, Ontario, Canada
| | - Justin Hagumimana
- Department of Anesthesia and Critical Care, University of Rwanda, Kigali, Rwanda
| | - Florence Masaisa
- Department of Internal Medicine, Kigali University Teaching Hospital, University of Rwanda, Kigali, Rwanda
| | - Aimable Kanyamuhunga
- Department of Pediatrics, Kigali University Teaching Hospital, University of Rwanda, Kigali, Rwanda
| | - Christopher Gashaija
- National Centre for Blood Transfusion, Rwanda Biomedical Centre, University of Rwanda, Kigali, Rwanda
| | - Jeannie Callum
- University of Toronto Quality in Utilization, Education and Safety in Transfusion (QUEST) Research Program, Toronto, Ontario, Canada
- Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ontario, Canada
| | - Katerina Pavenski
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
- University of Toronto Quality in Utilization, Education and Safety in Transfusion (QUEST) Research Program, Toronto, Ontario, Canada
- Department of Laboratory Medicine, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Aditi Khandelwal
- University of Toronto Quality in Utilization, Education and Safety in Transfusion (QUEST) Research Program, Toronto, Ontario, Canada
- Canadian Blood Services, Ottawa, Ontario, Canada
| | - Lani Lieberman
- Laboratory Medicine Program, University Health Network, University of Toronto, Toronto, Ontario, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
- University of Toronto Quality in Utilization, Education and Safety in Transfusion (QUEST) Research Program, Toronto, Ontario, Canada
| | - Sophie Chargé
- Medical Affairs and Innovation, Canadian Blood Services, Ottawa, Ontario, Canada
| | - Casey Kapitany
- Medical Affairs and Innovation, Canadian Blood Services, Ottawa, Ontario, Canada
| | - Mary Morgan
- Precision Diagnostics and Therapeutics Program, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Harley Meirovich
- University of Toronto Quality in Utilization, Education and Safety in Transfusion (QUEST) Research Program, Toronto, Ontario, Canada
| | - Yulia Lin
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
- University of Toronto Quality in Utilization, Education and Safety in Transfusion (QUEST) Research Program, Toronto, Ontario, Canada
- Precision Diagnostics and Therapeutics Program, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
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Inghels M, Mee P, Diallo OH, Cissé M, Nelson D, Tanser F, Asghar Z, Koita Y, Laborde-Balen G, Breton G. Improving early infant diagnosis for HIV-exposed infants using unmanned aerial vehicles for blood sample transportation in Conakry, Guinea: a comparative cost-effectiveness analysis. BMJ Glob Health 2023; 8:e012522. [PMID: 37984898 PMCID: PMC10660963 DOI: 10.1136/bmjgh-2023-012522] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 08/30/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND Early infant diagnosis (EID) for HIV-exposed infants is essential due to high mortality during the first months of their lives. In Conakry (Guinea), timely EID is difficult as traffic congestion prevents the rapid transport of blood samples to the central laboratory. We investigated the cost-effectiveness of transporting EID blood samples by unmanned aerial vehicles (UAV), also known as drones. METHODS AND FINDINGS Using Monte Carlo simulations, we conducted a cost-effectiveness comparative analysis between EID blood samples transportation by on-demand UAV transportation versus the baseline scenario (ie, van with irregular collection schedules) and compared with a hypothetic on-demand motorcycle transportation system. Incremental cost-effectiveness ratio (ICER) per life-year gained was computed. Simulation models included parameters such as consultation timing (eg, time of arrival), motorcycle and UAV characteristics, weather and traffic conditions. Over the 5-year period programme, the UAV and motorcycle strategies were able to save a cumulative additional 834.8 life-years (585.1-1084.5) and 794.7 life-years (550.3-1039.0), respectively, compared with the baseline scenario. The ICER per life-year gained found were US$535 for the UAV strategy versus baseline scenario, US$504 for the motorcycle strategy versus baseline scenario and US$1137 per additional life-year gained for the UAV versus motorcycle strategy. Respectively, those ICERs represented 44.8%, 42.2% and 95.2% of the national gross domestic product (GDP) per capita in Guinea-that is, US$1194. CONCLUSION Compared with the baseline strategy, both transportation of EID blood samples by UAVs or motorcycles had a cost per additional life-year gained below half of the national GDP per capita and could be seen as cost-effective in Conakry. A UAV strategy can save more lives than a motorcycle one although the cost needed per additional life-year gained might need to consider alongside budget impact and feasibility considerations.
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Affiliation(s)
- Maxime Inghels
- Lincoln International Institute for Rural Health, University of Lincoln, Lincoln, UK
- Centre Population et Développement (UMR 196 Paris Descartes - IRD), SageSud (ERL INSERM 1244), Institut de Recherche pour le Développement, Paris, France
| | - Paul Mee
- Lincoln International Institute for Rural Health, University of Lincoln, Lincoln, UK
| | | | - Mohamed Cissé
- Service de Dermatologie, Centre de Traitement Ambulatoire, Laboratoire de Biologie Moléculaire, CHU Donka, Conakry, Guinea
| | - David Nelson
- Lincoln International Institute for Rural Health, University of Lincoln, Lincoln, UK
| | - Frank Tanser
- Centre for Epidemic Response and Innovation, School for Data Science and Computational Thinking, Stellenbosch University, Stellenbosch, South Africa
- Africa Health Research Institute, Durban, KwaZulu-Natal, South Africa
| | - Zahid Asghar
- School of Health and Social Care, University of Lincoln, Lincoln, UK
| | - Youssouf Koita
- Programme National de Lutte contre le VIH SIDA et les Hépatites (PNLSH), Conakry, Guinea
| | - Gabrièle Laborde-Balen
- TransVIHMI, University of Montpellier, INSERM, Institut de Recherche pour le Développement, Montpellier, France
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Jacobs JW, Stephens LD, Milner DA, Bloch EM, Goel R, Tobian AAR, Shibemba AL, Eichbaum Q. Survey of blood collection and transfusion practices among institutions in Africa. Transfusion 2023; 63:1849-1858. [PMID: 37646070 DOI: 10.1111/trf.17501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 07/01/2023] [Accepted: 07/07/2023] [Indexed: 09/01/2023]
Abstract
INTRODUCTION Dramatic improvements in blood transfusion have occurred during the last two decades. Transfusion medicine services and practices in Africa remain underexplored. METHODS A survey of blood bank/transfusion medicine (BBTM) practices, available blood products, blood product source(s), pre-transfusion testing, and blood donor infectious disease testing methodologies across Africa was performed using the American Society for Clinical Pathology (ASCP) listserv. Survey recipients included hospital-based laboratories/blood banks, national transfusion medicine services, and free-standing laboratories (collectively referred to as institutions). RESULTS Responses from a total of 81 institutions across 22 countries were analyzed. All 81 institutions provide at least one type of blood product-whole blood, red blood cells (RBCs), platelets, plasma, and cryoprecipitate, with whole blood (90.1%, 73 of 81) and RBCs (79.0%, 64 of 81) most common, while cryoprecipitate is least common (12.4%, 10 of 81). Only five countries had a responding institution that provides all types of products. Among institutions that collect blood onsite, the most common sources of blood products are patients' family members (94.1%, 48 of 51) and pre-screened on-demand volunteer donors (82.4%, 42 of 51). The most commonly screened infectious agents are HIV and hepatitis B virus (both 81.5%), while 70.4% (57 of 81) test for hepatitis C virus (HCV) and Treponema pallidum. DISCUSSION This study highlights significant variability and restrictions in blood product availability, pre-transfusion testing, and blood donor infectious disease testing across Africa. Further studies are needed to ascertain barriers to improving blood donor availability, blood product safety, and infectious disease testing.
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Affiliation(s)
- Jeremy W Jacobs
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Laura D Stephens
- Department of Pathology, University of California San Diego, La Jolla, California, USA
| | - Danny A Milner
- American Society for Clinical Pathology, Chicago, Illinois, USA
- Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Evan M Bloch
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Ruchika Goel
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Departments of Internal Medicine and Pediatrics, Simmons Cancer Institute at SIU School of Medicine, Springfield, Illinois, USA
| | - Aaron A R Tobian
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Aaron Lunda Shibemba
- Department of Pathology and Microbiology, University Teaching Hospital, Lusaka, Zambia
| | - Quentin Eichbaum
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Vanderbilt University School of Medicine, Nashville, Tennessee, USA
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Tih WN, Takang WA, Egbe TO. Preterm management of sickle cell crisis in a twin pregnancy with suboptimal antenatal care in a primary healthcare facility: A case report from Cameroon and literature review. Clin Case Rep 2023; 11:e7983. [PMID: 37808578 PMCID: PMC10551101 DOI: 10.1002/ccr3.7983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 09/05/2023] [Accepted: 09/15/2023] [Indexed: 10/10/2023] Open
Abstract
Key Clinical Message Twin pregnancies in homozygous sickle cell patients are not only uncommon in our setting but are most often associated with adverse maternal-fetal outcomes especially in primary healthcare facilities where most of these cases initially present due to financial constraints, though lacking the necessary technical platform (including blood banks) to properly manage them. Abstract We are reporting the case of the preterm management of sickle cell crises in a twin pregnancy with poor antenatal care uptake in a primary healthcare facility devoid of a blood bank in Cameroon. Ngungi Fely, a 21-year-old HbSS patient, of the Bakweri tribe G3P0020, blood group O rhesus positive, was admitted at our health facility at 33 3/7 weeks' gestation with twin pregnancy, clinical anemia (hemoglobin 3.3 g/dL), the pulse rate of 123 beats/min, the respiratory rate of 38 breaths per min, the temperature of 39.2°C, and altered state of consciousness. She has a history of two spontaneous abortions (16 and 18 weeks' gestation) and has attended three antenatal care (ANC) visits (18, 24, and 28 weeks' gestation) for the index pregnancy. She underwent cesarean delivery of two live-born babies at 35 4/7 weeks' gestation and received 9 units of compatible blood (before, during, and after the cesarean) partly with the help of the "Blood Track Program" (which uses text messages to seek blood donors). The babies were referred to a secondary healthcare facility and the mother and babies' outcomes were uneventful. Sickle cell disease (SCD) in pregnancy is difficult to manage in primary care settings in Cameroon because of a poor technical platform. A multidisciplinary approach to the management of SCD in pregnancy is the mainstay in secondary and tertiary healthcare centers. The "Blood Track Program" is a good initiative that should be extended nationwide in Cameroon to reduce the burden of acquiring blood for transfusion, particularly in primary care centers devoid of blood banks.
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Affiliation(s)
| | - William Ako Takang
- Department of Obstetrics and Gynaecology, Faculty of Health SciencesUniversity of BamendaCameroon
| | - Thomas Obinchemti Egbe
- Department of Obstetrics and Gynaecology, Faculty of Health SciencesUniversity of BueaCameroon
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Amirsahami A, Barzinpour F, Pishvaee MS. A hierarchical model for strategic and operational planning in blood transportation with drones. PLoS One 2023; 18:e0291352. [PMID: 37708186 PMCID: PMC10501658 DOI: 10.1371/journal.pone.0291352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 08/27/2023] [Indexed: 09/16/2023] Open
Abstract
Blood transportation is a critical aspect of the healthcare systems, ensuring whole blood and blood products are delivered to patients in a timely and efficient manner. However, transportation of blood and other medical supplies can be challenging, especially in urban areas with limited infrastructure and heavy traffic. Drones have become increasingly important in recent years as a means of delivering medical supplies, including blood, due to their ability to provide fast, reliable, and cost-effective transportation. This study proposes two mathematical programming models in the hierarchical structure to improve decision-making for strategic and operational planning in the blood supply chain network. The limited information available in strategic planning presents risks to the blood supply chain, making it imperative to address uncertainties. To tackle this challenge, a novel approach called Scenario-based Robust Bi-objective Optimization has been proposed. The first model employs this approach to efficiently handle demand uncertainty by simultaneously maximizing the covered demand and minimizing costs. The model is subsequently solved using the augmented ε-constraint method. The second model is a routing-scheduling operational model that aims to minimize the sum of operations time, taking into account time windows for blood collection centers and hospitals. The developed hierarchical model is implemented in a three-level supply chain of Tehran province under three crisis scenarios in different parts. The findings and analysis of this implementation suggest that it is beneficial to set up drone stations in cost-effective and central locations to avoid costly network design. Furthermore, utilizing the minimum number of feasible drones enhances operational time and results in cost savings and increased efficiency. Overall, this study highlights the potential of using drones for blood transportation in urban settings, which can have significant implications for improving the quality of healthcare delivery.
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Affiliation(s)
- Amirali Amirsahami
- School of Industrial Engineering, Iran University of Science and Technology, Tehran, Iran
| | - Farnaz Barzinpour
- School of Industrial Engineering, Iran University of Science and Technology, Tehran, Iran
| | - Mir Saman Pishvaee
- School of Industrial Engineering, Iran University of Science and Technology, Tehran, Iran
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11
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Datta SS, Sil S, Mandal S. Rare blood group registry in India-current challenges and future perspectives. Front Genet 2023; 14:1264853. [PMID: 37779913 PMCID: PMC10535088 DOI: 10.3389/fgene.2023.1264853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 09/01/2023] [Indexed: 10/03/2023] Open
Abstract
Patients who require blood from rare blood group donors present great challenges even to the most advanced healthcare delivery system. It is most challenging to supply blood for a patient with an antibody to an antigen of high prevalence. The blood donor lacking the corresponding antigen would have an occurrence rate of less than one in 1,000. The International Rare Donor Panel was established in 1965, but since then there has been gross underrepresentation of South Asian countries, including India. There are several challenges to starting a rare blood group donor program in India that include technical, logistical, and administrative limitations. But the main limiting factors are poor availability of trained resources, lack of awareness, absence of antibody screening, inadequate number of laboratories with blood group genotyping facilities, and the decentralized nature of blood transfusion services. Despite that, there were several rare blood groups identified by Indian immunohematologists in the recent past. Recently, a transfusion genomic group has been established in collaboration with the clinical transfusion medicine specialists in India under the GUaRDIAN (Genomics for Understanding Rare Disease in India Alliance Network) initiative to address the domain of rare blood group genomics. Similarly, the National Institute of Immunohematology, Mumbai under the directive of the ICMR (Indian Council of Medical Research) has taken a step to start the RDRI (Rare Donor Registry of India). In this context, we explore the current challenges of setting-up a rare blood group registry in India and future goals from a developing nation's perspective.
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Affiliation(s)
| | - Suhasini Sil
- Department of Transfusion Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Saikat Mandal
- Young Professional Council, International Society of Blood Transfusion, Amsterdam, Netherlands
- Medical Oncology, Hull York Medical School, Hull, United Kingdom
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12
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Griffith EF, Schurer JM, Mawindo B, Kwibuka R, Turibyarive T, Amuguni JH. The Use of Drones to Deliver Rift Valley Fever Vaccines in Rwanda: Perceptions and Recommendations. Vaccines (Basel) 2023; 11:vaccines11030605. [PMID: 36992189 DOI: 10.3390/vaccines11030605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 03/02/2023] [Accepted: 03/05/2023] [Indexed: 03/09/2023] Open
Abstract
Given the recent emergence of Rift Valley Fever (RVF) in Rwanda and its profound impact on livelihoods and health, improving RVF prevention and control strategies is crucial. Vaccinating livestock is one of the most sustainable strategies to mitigate the impact of RVF on health and livelihoods. However, vaccine supply chain constraints severely limit the effectiveness of vaccination programs. In the human health sector, unmanned aerial vehicles, i.e., drones, are increasingly used to improve supply chains and last-mile vaccine delivery. We investigated perceptions of whether delivering RVF vaccines by drone in Rwanda might help to overcome logistical constraints in the vaccine supply chain. We conducted semi-structured interviews with stakeholders in the animal health sector and Zipline employees in Nyagatare District in the Eastern Province of Rwanda. We used content analysis to identify key themes. We found that stakeholders in the animal health sector and Zipline employees believe that drones could improve RVF vaccination in Nyagatare. The primary benefits study participants identified included decreased transportation time, improved cold chain maintenance, and cost savings.
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Affiliation(s)
- Evan F Griffith
- Department of Infectious Disease and Global Health, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA 01536, USA
| | - Janna M Schurer
- Department of Infectious Disease and Global Health, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA 01536, USA
- Center for One Health, University of Global Health Equity, Kigali 6955, Rwanda
| | - Billy Mawindo
- London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
| | - Rita Kwibuka
- School of Veterinary Medicine, College of Agriculture, Animal Sciences, and Veterinary Medicine, The University of Rwanda, Nyagatare 4285, Rwanda
| | - Thierry Turibyarive
- School of Veterinary Medicine, College of Agriculture, Animal Sciences, and Veterinary Medicine, The University of Rwanda, Nyagatare 4285, Rwanda
| | - Janetrix Hellen Amuguni
- Department of Infectious Disease and Global Health, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA 01536, USA
- Center for One Health, University of Global Health Equity, Kigali 6955, Rwanda
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13
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Sheng T, Jin R, Yang C, Qiu K, Wang M, Shi J, Zhang J, Gao Y, Wu Q, Zhou X, Wang H, Zhang J, Fang Q, Pan N, Xue Y, Wang Y, Xiong R, Gao F, Zhang Y, Lu H, Yu J, Gu Z. Unmanned Aerial Vehicle Mediated Drug Delivery for First Aid. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2023; 35:e2208648. [PMID: 36563167 DOI: 10.1002/adma.202208648] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 10/31/2022] [Indexed: 06/17/2023]
Abstract
Timely administration of key medications toward patients with sudden diseases is critical to saving lives. However, slow transport of first-aid therapeutics and the potential absence of trained people for drug usage can lead to severe injuries or even death. Herein, an unmanned aerial vehicle (UAV)-mediated first-aid system for targeted delivery (uFAST) is developed. It allows unattended administration of emergency therapeutics-loaded transdermal microneedle (MN) patches toward patients to relieve symptoms by a contact-triggered microneedle applicator (CTMA). The implementability and safety of the uFAST for first aid is demonstrated in a severe hypoglycemic pig model by automatically delivering a glucagon patch with immediate and bioresponsive dual release modes. This platform technique may facilitate the development of UAV-mediated first-aid treatments for other sudden diseases.
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Affiliation(s)
- Tao Sheng
- Key Laboratory of Advanced Drug Delivery Systems of Zhejiang Province, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, 310058, China
| | - Rui Jin
- State Key Laboratory of Industrial Control and Technology, Zhejiang University, Hangzhou, 310027, China
- Institute of Cyber-Systems and Control, the Department of Control Science and Engineering, Zhejiang University, Hangzhou, 310027, China
- Huzhou Institute of Zhejiang University, Huzhou, 313000, China
| | - Changwei Yang
- Key Laboratory of Advanced Drug Delivery Systems of Zhejiang Province, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, 310058, China
| | - Ke Qiu
- State Key Laboratory of Industrial Control and Technology, Zhejiang University, Hangzhou, 310027, China
- Institute of Cyber-Systems and Control, the Department of Control Science and Engineering, Zhejiang University, Hangzhou, 310027, China
| | - Mingyang Wang
- State Key Laboratory of Industrial Control and Technology, Zhejiang University, Hangzhou, 310027, China
- Institute of Cyber-Systems and Control, the Department of Control Science and Engineering, Zhejiang University, Hangzhou, 310027, China
- Huzhou Institute of Zhejiang University, Huzhou, 313000, China
| | - Jiaqi Shi
- Key Laboratory of Advanced Drug Delivery Systems of Zhejiang Province, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, 310058, China
| | - Jingyu Zhang
- State Key Laboratory of Industrial Control and Technology, Zhejiang University, Hangzhou, 310027, China
- Institute of Cyber-Systems and Control, the Department of Control Science and Engineering, Zhejiang University, Hangzhou, 310027, China
| | - Yuman Gao
- State Key Laboratory of Industrial Control and Technology, Zhejiang University, Hangzhou, 310027, China
- Institute of Cyber-Systems and Control, the Department of Control Science and Engineering, Zhejiang University, Hangzhou, 310027, China
- Huzhou Institute of Zhejiang University, Huzhou, 313000, China
| | - Qing Wu
- Key Laboratory of Advanced Drug Delivery Systems of Zhejiang Province, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, 310058, China
| | - Xin Zhou
- State Key Laboratory of Industrial Control and Technology, Zhejiang University, Hangzhou, 310027, China
- Institute of Cyber-Systems and Control, the Department of Control Science and Engineering, Zhejiang University, Hangzhou, 310027, China
- Huzhou Institute of Zhejiang University, Huzhou, 313000, China
| | - Hao Wang
- Key Laboratory of Advanced Drug Delivery Systems of Zhejiang Province, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, 310058, China
| | - Juan Zhang
- Key Laboratory of Advanced Drug Delivery Systems of Zhejiang Province, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, 310058, China
| | - Qin Fang
- State Key Laboratory of Industrial Control and Technology, Zhejiang University, Hangzhou, 310027, China
- Institute of Cyber-Systems and Control, the Department of Control Science and Engineering, Zhejiang University, Hangzhou, 310027, China
| | - Neng Pan
- State Key Laboratory of Industrial Control and Technology, Zhejiang University, Hangzhou, 310027, China
- Institute of Cyber-Systems and Control, the Department of Control Science and Engineering, Zhejiang University, Hangzhou, 310027, China
- Huzhou Institute of Zhejiang University, Huzhou, 313000, China
| | - Yanan Xue
- State Key Laboratory of Industrial Control and Technology, Zhejiang University, Hangzhou, 310027, China
- Institute of Cyber-Systems and Control, the Department of Control Science and Engineering, Zhejiang University, Hangzhou, 310027, China
| | - Yue Wang
- State Key Laboratory of Industrial Control and Technology, Zhejiang University, Hangzhou, 310027, China
- Institute of Cyber-Systems and Control, the Department of Control Science and Engineering, Zhejiang University, Hangzhou, 310027, China
| | - Rong Xiong
- State Key Laboratory of Industrial Control and Technology, Zhejiang University, Hangzhou, 310027, China
- Institute of Cyber-Systems and Control, the Department of Control Science and Engineering, Zhejiang University, Hangzhou, 310027, China
| | - Fei Gao
- State Key Laboratory of Industrial Control and Technology, Zhejiang University, Hangzhou, 310027, China
- Institute of Cyber-Systems and Control, the Department of Control Science and Engineering, Zhejiang University, Hangzhou, 310027, China
- Huzhou Institute of Zhejiang University, Huzhou, 313000, China
| | - Yuqi Zhang
- Key Laboratory of Advanced Drug Delivery Systems of Zhejiang Province, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, 310058, China
- Department of Burns and Wound Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, China
| | - Haojian Lu
- State Key Laboratory of Industrial Control and Technology, Zhejiang University, Hangzhou, 310027, China
- Institute of Cyber-Systems and Control, the Department of Control Science and Engineering, Zhejiang University, Hangzhou, 310027, China
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Reach Center for Oral Diease of Zhejiang Province, Key Laboratory of Oral Biomedical Reach of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006, China
| | - Jicheng Yu
- Key Laboratory of Advanced Drug Delivery Systems of Zhejiang Province, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, 310058, China
- Liangzhu Laboratory, Zhejiang University Medical Center, Hangzhou, 311121, China
- Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, 310016, China
- Jinhua Institute of Zhejiang University, Jinhua, 321299, China
| | - Zhen Gu
- Key Laboratory of Advanced Drug Delivery Systems of Zhejiang Province, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, 310058, China
- Liangzhu Laboratory, Zhejiang University Medical Center, Hangzhou, 311121, China
- Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, 310016, China
- Jinhua Institute of Zhejiang University, Jinhua, 321299, China
- MOE Key Laboratory of Macromolecular Synthesis and Functionalization, Department of Polymer Science, Zhejiang University, Hangzhou, 310027, China
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14
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Roberts NB, Ager E, Leith T, Lott I, Mason-Maready M, Nix T, Gottula A, Hunt N, Brent C. Current summary of the evidence in drone-based emergency medical services care. Resusc Plus 2023; 13:100347. [PMID: 36654723 PMCID: PMC9841214 DOI: 10.1016/j.resplu.2022.100347] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 12/09/2022] [Accepted: 12/12/2022] [Indexed: 01/07/2023] Open
Abstract
Interventions for many medical emergencies including cardiac arrests, strokes, drug overdoses, seizures, and trauma, are critically time-dependent, with faster intervention leading to improved patient outcomes. Consequently, a major focus of emergency medical services (EMS) systems and prehospital medicine has been improving the time until medical intervention in these time-sensitive emergencies, often by reducing the time required to deliver critical medical supplies to the scene of the emergency. Medical indications for using unmanned aerial vehicles, or drones, are rapidly expanding, including the delivery of time-sensitive medical supplies. To date, the drone-based delivery of a variety of time-critical medical supplies has been evaluated, generating promising data suggesting that drones can improve the time interval to intervention through the rapid delivery of automatic external defibrillators (AEDs), naloxone, antiepileptics, and blood products. Furthermore, the improvement in the time until intervention offered by drones in out-of-hospital emergencies is likely to improve patient outcomes in time-dependent medical emergencies. However, barriers and knowledge gaps remain that must be addressed. Further research demonstrating functionality in real-world scenarios, as well as research that integrates drones into the existing EMS structure will be necessary before drones can reach their full potential. The primary aim of this review is to summarize the current evidence in drone-based Emergency Medical Services Care to help identify future research directions.
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Affiliation(s)
- Nathan B. Roberts
- University of Michigan Department of Emergency Medicine, University of Michigan Medical School, 1500 E Medical Center Dr, Ann Arbor, MI 48109-5305, USA
- Corresponding authors at: Medical School, University of Michigan Department of Emergency Medicine, University of Michigan Medical School, 1500 E Medical Center Dr, Ann Arbor, MI 48109-5305, USA.
| | - Emily Ager
- University of Michigan Department of Emergency Medicine, University of Michigan Medical School, 1500 E Medical Center Dr, Ann Arbor, MI 48109-5305, USA
- Corresponding authors at: Medical School, University of Michigan Department of Emergency Medicine, University of Michigan Medical School, 1500 E Medical Center Dr, Ann Arbor, MI 48109-5305, USA.
| | - Thomas Leith
- University of Michigan Medical School, 7300 Medical Science Building I—A Wing, 1301 Catherine St, Ann Arbor, MI 48109, USA
| | - Isabel Lott
- University of Michigan Medical School, 7300 Medical Science Building I—A Wing, 1301 Catherine St, Ann Arbor, MI 48109, USA
| | - Marlee Mason-Maready
- Oakland University William Beaumont School of Medicine, 586 Pioneer Dr, Rochester, MI 48309, USA
| | - Tyler Nix
- University of Michigan, Taubman Health Sciences Library, University of Michigan, Ann Arbor, MI 48109, USA
| | - Adam Gottula
- University of Michigan Department of Emergency Medicine, University of Michigan Medical School, 1500 E Medical Center Dr, Ann Arbor, MI 48109-5305, USA
- The University of Michigan, Department of Anesthesiology , University of Michigan Medical School, 1500 East Medical Center Dr. Ann Arbor, MI 48109, USA
| | - Nathaniel Hunt
- University of Michigan Department of Emergency Medicine, University of Michigan Medical School, 1500 E Medical Center Dr, Ann Arbor, MI 48109-5305, USA
| | - Christine Brent
- University of Michigan Department of Emergency Medicine, University of Michigan Medical School, 1500 E Medical Center Dr, Ann Arbor, MI 48109-5305, USA
- Corresponding authors at: Medical School, University of Michigan Department of Emergency Medicine, University of Michigan Medical School, 1500 E Medical Center Dr, Ann Arbor, MI 48109-5305, USA.
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15
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Sage AT, Cypel M, Cardinal M, Qiu J, Humar A, Keshavjee S. Testing the delivery of human organ transportation with drones in the real world. Sci Robot 2022; 7:eadf5798. [PMID: 36542685 DOI: 10.1126/scirobotics.adf5798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Last-mile transportation of human donor lungs in a densely populated urban environment has been made possible with drones.
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Affiliation(s)
- Andrew T Sage
- Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada.,Toronto Lung Transplant Program, Ajmera Transplant Centre, University Health Network, Toronto, ON, Canada
| | - Marcelo Cypel
- Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada.,Toronto Lung Transplant Program, Ajmera Transplant Centre, University Health Network, Toronto, ON, Canada.,Division of Thoracic Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | | | - Jimmy Qiu
- Techna, University Health Network, Toronto, ON, Canada
| | - Atul Humar
- Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada.,Toronto Lung Transplant Program, Ajmera Transplant Centre, University Health Network, Toronto, ON, Canada
| | - Shaf Keshavjee
- Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada.,Toronto Lung Transplant Program, Ajmera Transplant Centre, University Health Network, Toronto, ON, Canada.,Division of Thoracic Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada
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16
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Faria I, Thivalapill N, Makin J, Puyana JC, Raykar N. Bleeding, Hemorrhagic Shock, and the Global Blood Supply. Crit Care Clin 2022; 38:775-793. [PMID: 36162910 DOI: 10.1016/j.ccc.2022.06.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Hemorrhage is responsible for at least 40% of deaths after trauma and 27% of maternal deaths worldwide. Patients with hemorrhagic shock require attentive critical care and transfusion of blood products. Access to a safe and affordable blood supply is critical to providing safe surgical care. Traumatic injury, obstetric hemorrhage, and upper gastrointestinal bleed are the main causes of severe bleeding requiring transfusion. This article discusses the presentation and management of these causes across the world and provides a brief overview of the current challenges in maintaining a global blood supply.
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Affiliation(s)
- Isabella Faria
- Program in Global Surgery and Social Change, Harvard Medical School, 641 Hungtington Avenue, Boston, MA 02115, USA; Faculdade de Medicina da Universidade Federal de Minas Gerais, 190 Avenida Professor Alfredo Balena, Belo Horizonte, MG 31130450, Brazil
| | - Neil Thivalapill
- Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, 420 East Superior Street, Chicago IL 60611, USA
| | - Jennifer Makin
- Department of Obstetrics, Gynecology and Reproductive Science, The University of Pittsburgh Medical Center Magee - Women's Hospital, 300 Halket Street, Pittsburgh, PA 15213, USA
| | - Juan Carlos Puyana
- Critical Care Medicine, and Clinical Translational Science, Pittsburgh, PA 15213, USA; University of Pittsburgh, UPMC Presbyterian, F1263, 200 Lothrop Street, Pittsburgh, PA 15213, USA
| | - Nakul Raykar
- Program in Global Surgery and Social Change, Harvard Medical School, 641 Hungtington Avenue, Boston, MA 02115, USA; Division of Trauma & Emergency Surgery, Center for Surgery and Public Health, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02215, USA.
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17
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Blood delivery by drone: a faltering step in a promising direction. Lancet Glob Health 2022; 10:e1098. [DOI: 10.1016/s2214-109x(22)00272-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 06/07/2022] [Accepted: 06/07/2022] [Indexed: 11/20/2022]
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18
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Quality Analysis of Tuberculosis Specimens Transported by Drones versus Ground Transportation. DRONES 2022. [DOI: 10.3390/drones6070155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
There are many challenges that impact the current referral network for Tuberculosis (TB) sputum specimens in Mozambique. In some cases, health facilities are remote and the road infrastructure is poor and at times impassable, leading to delays in laboratory specimen transportation and long turn-around times for results. Drone transportation is a promising solution to reduce transportation time and improve access to laboratory diagnostics if the sample quality is not compromised during transport. This study evaluated the impact of drone transportation on the quality of TB sputum specimens with suspected Mycobacterium tuberculosis. 156 specimens were collected at five (5) health centers and sent to the Instituto Nacional de Saúde (INS) National TB Reference Laboratory. Specimens were then equally divided into two aliquots; one to be transported on land and the other by air using a drone. Control and study group specimens were processed using the NALC-NaOH method. Agreement between sample and control specimens was acceptable, indicating that drone transportation did not affect the quality of TB specimens. The authors recommend additional studies to validate drone transportation of TB specimens over a longer period of time to give further confidence in the adoption of drone delivery in Mozambique.
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Ameh CA, Meka RJ, West F, Dickinson F, Allott H, Godia P. A synthesis of clinical and health system bottlenecks to implementing new WHO postpartum hemorrhage recommendations: Secondary data analysis of the Kenya Confidential Enquiry into Maternal Deaths 2014-2017. Int J Gynaecol Obstet 2022; 158 Suppl 1:14-22. [PMID: 35762810 PMCID: PMC9544179 DOI: 10.1002/ijgo.14270] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Objective To describe maternal deaths from postpartum hemorrhage (PPH) in Kenya by secondary analysis of the Kenya Confidential Enquiry into Maternal Deaths (CEMD) database and clinical audit of a sample of those deaths, and to identify the perceived challenges to implementing country‐specific PPH guidelines. Methods A retrospective descriptive study using the Kenyan CEMD database and anonymized maternal death records from 2014–2017. Eight standards from the Kenya National Guidelines for Quality Obstetric and Perinatal Care were selected to perform clinical audit. The process of supporting eight Sub‐Saharan African countries to develop country‐specific PPH guidelines was described and perceived challenges implementing these were identified. Results In total, 725 women died from PPH. Most women attended at least one antenatal care visit (67.2%) and most did not receive iron and folate supplementation (35.7%). Only 39.0% of women received prophylactic uterotonics in the third stage of labor. Factors significantly associated with receiving prophylactic uterotonics were place of delivery (χ2 = 43.666, df = 4; P < 0.001), being reviewed by a medical doctor (χ2 = 16.905, df = 1; P < 0.001), and being reviewed by a specialist (χ2 = 49.244, df = 1; P < 0.001). Only three of eight standards had a greater percentage of met cases in comparison to unmet cases. Key concerns about implementation of the new WHO PPH guidance included use of misoprostol by unskilled health personnel, availability of misoprostol and tranexamic acid (TXA) at primary healthcare level, lack of availability of heat‐stable carbetocin (HSC) due to cost, lack of awareness and education about HSC and TXA, and lack of systems to ensure quality oxytocin is available at point of care. Conclusion There is a need for improved quality of care for women to minimize the risk of mortality from PPH, by implementing updated clinical guidelines combined with focused health system interventions. Improving quality of care for women with postpartum hemorrhage requires use of up‐to‐date clinical guidelines combined with focused health system interventions.
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Affiliation(s)
- Charles A Ameh
- Emergency Obstetric Care and Quality of Care Unit, WHO collaborating Centre for Research and Training in Maternal and Newborn Health, International Public Health Department, Liverpool School of Tropical Medicine, Liverpool, UK.,Department of Obstetrics and Gynecology, Kenya
| | - Ramya Jyothi Meka
- Emergency Obstetric Care and Quality of Care Unit, WHO collaborating Centre for Research and Training in Maternal and Newborn Health, International Public Health Department, Liverpool School of Tropical Medicine, Liverpool, UK
| | | | - Fiona Dickinson
- Emergency Obstetric Care and Quality of Care Unit, WHO collaborating Centre for Research and Training in Maternal and Newborn Health, International Public Health Department, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Helen Allott
- Emergency Obstetric Care and Quality of Care Unit, WHO collaborating Centre for Research and Training in Maternal and Newborn Health, International Public Health Department, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Pamela Godia
- Emergency Obstetric Care and Quality of Care Unit, WHO collaborating Centre for Research and Training in Maternal and Newborn Health, International Public Health Department, Liverpool School of Tropical Medicine, Liverpool, UK.,School of Public Health, University of Nairobi, Nairobi, Kenya.,Liverpool School of Tropical Medicine, Nairobi, Kenya
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20
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Amukele T. Using drones to deliver blood products in Rwanda. THE LANCET GLOBAL HEALTH 2022; 10:e463-e464. [DOI: 10.1016/s2214-109x(22)00095-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 03/02/2022] [Indexed: 10/18/2022] Open
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