Covid-19 PPE for LMIC

适用于中低收入国家的 Covid-19 个人防护装备

• 批准号: 10295570
• 负责人: WALTER Tsong LEE
• 金额: $ 4.58万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-08-19 至 2022-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10295570
• 关键词: Activities of Daily Living; Adoption; Anatomy; Asia; Breathing; COVID-19; Caring; Clinical; Clinical effectiveness; Clinics and Hospitals; Country; Data; Databases; Detection; Devices; Diagnosis; Disease; Distant; District Hospitals; Eating; Effectiveness; Equipment; Evaluation; Feedback; Goals; Head and Neck Cancer; Head and neck structure; Health Personnel; Healthcare; Healthcare Systems; High Prevalence; Hospitals; Image; Incidence; Industrialization; Infrastructure; Larynx; Lighting; Local Therapy; Location; Malignant Neoplasms; Medical center; Modeling; Nasal cavity; Online Systems; Oral; Otolaryngology; Outcome; Pain; Patient Outcomes Assessments; Patient Triage; Patients; Pharyngeal structure; Physicians; Prognosis; Quality of life; Research; Research Personnel; Resources; Safety; Site; Southeastern Asia; Specialist; Stress; Surveys; Symptoms; Techniques; Time; Training; Training and Education; Triage; Tumor stage; Vietnam; barrier to care; cancer care; clinical outcome measures; cost; design; effectiveness implementation study; flexibility; global health; head and neck cancer patient; implementation outcomes; improved; low and middle-income countries; mortality; novel; novel diagnostics; parent project; practice-based research network; public health relevance; standard of care; tertiary care; treatment center

There are many barriers to the care of head and neck cancers in low and middle income countries (LMICs), notably difficult-to-visualize anatomic locations, lack of adequately trained professionals, and the need for specialized, costly equipment. Head and neck cancers, which involve the oral-nasal cavities, pharynx and larynx, present a significant global health burden and have a significant impact on quality of life and daily living activities such as speaking and eating. In Vietnam, many provincial and district hospitals lack the proper training and equipment to adequately exam patients presenting with head and neck symptoms and complaints. To this end, our partnership of academic and industrial investigators has developed a low cost, mobile flexible nasolaryngoscope (FNS) for use to exam and triage patients for treatment locally or for referral to specialists in tertiary treatment centers. Using Vietnam as a model for other resource-poor healthcare systems, the goals of the proposed project are to deliver new diagnostic and treatment capacity for head and neck cancers to health providers at local hospitals and clinics. Furthermore, the use of FNS will improve triaging to and utilization of specialized medical centers. This will be achieved through decreasing the number of patients unnecessarily seeking general care at tertiary facilities, locally treating those with early cancers, and referring only those patients needing specialized care. We will accomplish these goals through the following specific aims:1) Optimize the FNS by comparison to standard of care scopes at the main tertiary care centers; 2) Educate and train local healthcare providers in FNS technique and examinations; and 3) Assess implementation of FNS within the practice research network. We will plan to achieve these aims through establishing a practice based research network of 30 hospitals sites in and around Hanoi Vietnam. Data will be collected from an estimated 125,000 subjects over 5 years via electronic web based survey. The expected outcomes will improve head and neck care by health providers at local facilities within Vietnam and provide timely diagnosis, local treatment or referral for head and neck cancer patients. These outcomes will also be the basis for expansion of training and use of the low cost FNS in other low resource settings worldwide.

低收入和中等收入国家 (LMIC) 的头颈癌护理存在许多障碍，特别是解剖位置难以可视化、缺乏经过充分培训的专业人员以及需要专门且昂贵的设备。头颈癌涉及口鼻腔、咽部和喉部，对全球健康造成重大负担，并对生活质量和说话和饮食等日常生活活动产生重大影响。在越南，许多省级和县级医院缺乏适当的培训和培训 对出现头颈部症状和主诉的患者进行充分检查的设备。为此，我们的学术和工业研究人员合作开发了一种低成本、移动式柔性鼻喉镜 (FNS)，用于检查和分类患者进行本地治疗或转诊给三级治疗中心的专家。 以越南作为其他资源匮乏的医疗保健系统的典范，拟议项目的目标是为当地医院和诊所的医疗服务提供者提供新的头颈癌诊断和治疗能力。此外，FNS 的使用将改善专业医疗中心的分类和利用率。 这将通过减少不必要地在三级机构寻求普通护理的患者数量、在当地治疗早期癌症患者以及仅转诊那些需要专门护理的患者来实现。我们将通过以下具体目标来实现这些目标：1）与主要三级护理中心的护理范围标准进行比较，优化 FNS； 2) 对当地医疗保健提供者进行 FNS 技术和检查方面的教育和培训； 3) 评估实践研究网络中 FNS 的实施情况。我们将计划 通过建立一个由越南河内及周边地区 30 家医院组成的基于实践的研究网络来实现这些目标。数据将通过电子网络调查在 5 年内从估计 125,000 名受试者中收集。 预期成果将改善越南当地医疗机构的头颈护理，并为头颈癌症患者提供及时诊断、局部治疗或转诊。这些成果也将成为在全球其他资源匮乏地区扩大低成本 FNS 培训和使用的基础。