Publications by authors named "Ewan Wilkinson"

This study evaluated the effectiveness of an electronic system for managing individuals with drug-sensitive pulmonary tuberculosis in the Kyrgyz Republic. This cohort study used programmatic data. The study included people registered on the paper-based system in 2019 and 302 people registered on both the electronic and the paper-based systems between June 2021 and May 2022.

View Article and Find Full Text PDF

Background: Mental, neurological, and substance-use disorders cause medium to long term disability in all countries. They are amenable to treatment but often treatment is only available in hospitals, as few staff feel competent to give treatment. The WHO developed the "Mental Health GAP" (mhGAP) course to train non-specialist clinical staff in basic diagnosis and treatment.

View Article and Find Full Text PDF

Water quality surveillance can help to reduce waterborne diseases. Despite better access to safe drinking water in Sierra Leone, about a third of the population (3 million people) drink water from unimproved sources. In this cross-sectional study, we collected water samples from 15 standpipes and 5 wells and measured the physicochemical and bacteriological water quality, and the antimicrobial sensitivity of Escherichia coli (E.

View Article and Find Full Text PDF

Healthcare-associated infections (HAIs) result in millions of avoidable deaths or prolonged lengths of stay in hospitals and cause huge economic loss to health systems and communities. Primarily, HAIs spread through the hands of healthcare workers, so improving hand hygiene can reduce their spread. We evaluated hand hygiene practices and promotion across 13 public health hospitals (six secondary and seven tertiary hospitals) in the Western Area of Sierra Leone in a cross-sectional study using the WHO hand hygiene self-Assessment framework in May 2021.

View Article and Find Full Text PDF

Objectives: Sexual violence can have a destructive impact on the lives of people. It is more common in unstable conditions such as during displacement or migration of people. On the Greek island of Lesvos, Médecins Sans Frontières provided medical care to survivors of sexual violence among the population of asylum seekers.

View Article and Find Full Text PDF

Background: Despite the increasing recognition globally of the importance of mental health for sustainable development, significant barriers remain to developing mental health services in low- and middle-income countries. This study explored the particular barriers and opportunities for developing mental health services in Cambodia and how these compared with those described in other low- and middle-income countries.

Methods: For this qualitative study, 18 experienced mental health professionals from different disciplines were selected using purposive sampling.

View Article and Find Full Text PDF

Mental health services in Cambodia required rebuilding in their entirety after their destruction during conflict in the 1970s. During the late 1990s there was rapid growth and development of professional mental health training and education. Currently, basic mental healthcare is available primarily in urban areas and is provided by a mixture of government, non-government and private services.

View Article and Find Full Text PDF

Safe waste management protects hospital staff, the public, and the local environment. The handling of hospital waste in Bwindi Community Hospital did not appear to conform to the hospital waste management plan, exhibiting poor waste segregation, transportation, storage, and disposal which could lead to environmental and occupational risks. We undertook a mixed-methods study.

View Article and Find Full Text PDF

Objectives: India contributes approximately 25% of the 'missing' cases of tuberculosis (TB) globally. Even though ~50% of patients with TB are diagnosed and treated within India's private sector, few are notified to the public healthcare system. India's TB notification policy mandates that all patients with TB are notified through Nikshay (TB notification portal).

View Article and Find Full Text PDF

Low-cost community-based interventions to improve infant health potentially offer an exciting means of progressing toward the Sustainable Development Goals (SDGs). However, the feasibility of such interventions in low-income settings remains unclear. Bwindi Community Hospital (BCH), Uganda implemented a 3-year nurse-led community project to address child-health issues.

View Article and Find Full Text PDF

Out-of-pocket fees to pay for health care prevent poor people from accessing health care and drives millions into poverty every year. This obstructs progress toward the World Health Organization goal of universal health care. Community-based health insurance (CBHI) improves access to health care primarily by reducing the financial risk.

View Article and Find Full Text PDF

The harmful use of alcohol is a growing global public health concern, with Sub-Saharan Africa at particular risk. A large proportion of adults in Uganda consume alcohol and the country has a high prevalence of alcohol use disorders (AUD), almost double that for the African region as a whole. Bwindi Community Hospital, in rural western Uganda, recently introduced a program of screening, diagnosis and management of AUD and we assessed how this worked.

View Article and Find Full Text PDF

Road traffic accidents (RTAs) are a major cause of death and injury globally. There was little information on the burden and causes of RTAs in Bhutan. The study estimates the burden and characteristics of RTAs and describes the victims of RTAs in Bhutan.

View Article and Find Full Text PDF

Objective: To calculate the yield and cost per diagnosed tuberculosis (TB) case for three World Health Organization screening algorithms and one using the Chinese National TB program (NTP) TB suspect definitions, using data from a TB prevalence survey of people aged 65 years and over in China, 2013.

Methods: This was an analytic study using data from the above survey. Risk groups were defined and the prevalence of new TB cases in each group calculated.

View Article and Find Full Text PDF

Background: National drug policies are formulated to encourage rational use of drugs and to reduce drug resistance. This study assessed physicians' compliance with the National Drug Policy on Malaria at a tertiary care hospital in north India.

Methods: This mixed method study extracted data from adult malaria inpatient records of the hospital from 2010-2015, and assessed drug supply at pharmacies.

View Article and Find Full Text PDF

Introduction: Community health volunteers (CHVs) play an integral role in primary healthcare. Several countries rely on CHV programs as a major element in improving access to care and attaining universal health coverage. However, their performance has been heterogeneous and at times context-specific, and influenced by multiple factors.

View Article and Find Full Text PDF

Background: In sub-Saharan Africa there is an increasing need to leverage available health care workers to provide care for non-communicable diseases (NCDs). This study was conducted to evaluate adherence to Médecins Sans Frontières clinical protocols when the care of five stable NCDs (hypertension, diabetes mellitus type 2, epilepsy, asthma, and sickle cell) was shifted from clinical officers to nurses.

Methods: Descriptive, retrospective review of routinely collected clinic data from two integrated primary health care facilities within an urban informal settlement, Kibera, Nairobi, Kenya (May to August 2014).

View Article and Find Full Text PDF

While scientific understanding of environmental issues develops through careful observation, experiment and modelling, the application of such advances in the day to day world is much less clean and tidy. Merseyside in northwest England has an industrial heritage from the earliest days of the industrial revolution. Indeed, the chemical industry was borne here.

View Article and Find Full Text PDF

Objectives: To assess the care of hypertension, diabetes mellitus and/or HIV patients enrolled into Medication Adherence Clubs (MACs).

Methods: Retrospective descriptive study was carried out using routinely collected programme data from a primary healthcare clinic at informal settlement in Nairobi, Kenya. All patients enrolled into MACs were selected for the study.

View Article and Find Full Text PDF
Oral zinc for arterial and venous leg ulcers.

Cochrane Database Syst Rev

September 2014

Background: Leg ulcers affect up to one percent of people at some time in their life. Leg ulceration is chronic in nature and ulcers may be present for months or even years without healing. After healing there is a high risk of recurrence.

View Article and Find Full Text PDF

Background: Leg ulcers affect up to one percent of people at some time in their life. Leg ulceration is chronic in nature with ulcers being present for months and in some cases years without healing, and with a high risk of recurrence. Management approaches include dressings and the treatment of underlying medical problems such as malnutrition, lack of minerals and vitamins, poor blood supply or infection.

View Article and Find Full Text PDF

Objectives: To explore the views of clinicians and lay people about the minimum benefit needed to justify drug treatment to prevent heart attacks, and to explore the rationale behind treatment decisions.

Design: Qualitative study using semi-structured interviews.

Participants: 4 general practitioners, 4 practice nurses, and 18 lay people.

View Article and Find Full Text PDF

Objective: To compare measurements of thyroid and adrenal function between survivors and non-survivors in critical illness.

Design And Setting: Prospective, observational study at the medical/surgical intensive care unit (ICU) at Royal Infirmary of Edinburgh, Scotland.

Patients: 163 patients admitted to the intensive care unit over a 4-month period.

View Article and Find Full Text PDF