Browsing by Autor "Anna Volz"

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Could clinical audit improve the diagnosis of pulmonary tuberculosis in Cuba, Peru and Bolivia?
(Wiley, 2008) Kamran Siddiqi; Anna Volz; Luisa Armas; Larissa Otero; R Ugaz; Edilberto González Ochoa; Eduardo Gotuzzo; Faustino Torrico; James Newell; John Walley
Clinical audit may drive improvements in the quality of clinical care in resource-poor settings. It is likely to be more effective if integrated within and supported by the local TB programmes. We recommend developing and evaluating an integrated model of quality improvement including clinical audit.
Covid-19, una mirada desde la pediatría
(2020) Giuseppe Grandy; Carlos G. Terán; Alejandro Martínez; Anna Volz
El COVID-19 fue predominantemente más prevalente entre adultos mayores de 15 años en las primeras etapas del brote y la proporción de casos confirmados entre niños fue relativamente menor. Sin embargo, debido a la creciente propagación mundial del SARS-CoV-2, tenemos nuevos desafíos para la prevención y el control de la epidemia de COVID-19 entre los niños. Ya que en los más pequeños no se pueden emplear medidas de prevención (barbijos), la clínica inespecífica que presentan, las dificultades para el diagnóstico, la deficiente comunicación entre médico-paciente y familiar que han contribuido al desafío de desarrollar medidas para proteger a esta población, al igual que al personal de salud que manejan casos pediátricos. Al mismo tiempo, los niños con comorbilidades, s on vulnerables a la infección por SARS-CoV-2. La presente revisión intenta mostrar esta enfermedad desde el punto de vista pediátrico, para orientar en su diagnóstico y manejo.
Delays to treatment and out-of-pocket medical expenditure for tuberculosis patients, in an urban area of South America
(Maney Publishing, 2005) Michel Lambert; R Delgado; Geneviève Michaux; Anna Volz; Niko Speybroeck; Patrick Van der Stuyft
Short delays to treatment are important for the control of tuberculosis (TB). National Tuberculosis Programmes provide free diagnosis and treatment for smear-positive patients, so that the patients' out-of-pocket medical expenditure could be almost nil. The factors associated with delays in starting treatment, and the pre-treatment out-of-pocket medical expenditure for TB patients, have now been investigated in the Bolivian city of Cochabamba. Bolivia is the Latin American country with the highest incidence of TB. It is covered by a national TB programme that provides free diagnosis and free treatment for smear-positive patients. Structured interviews with 144 smear-positive patients enrolled in this programme revealed median patient, provider and total delays of 3.6, 6.2 and 12.9 weeks, respectively. The total delays were longer for the female patients than for the male, and for patients who consulted private doctors than for the other patients. When the first healthcare provider was a doctor, the median provider delay was 4.9 weeks in the public sector but 7.2 weeks in the private. The median out-of-pocket medical expenditure per patient, which was U.S.$13.2 overall, was much higher for those who consulted a private doctor than for those who did not (U.S.$21.9 v. U.S.$5.4, respectively; P<0.001). It appears that interventions targeting doctors (in both the private and public sectors) are likely to have a larger impact on the shortening of delays in TB treatment than interventions targeting patients. They could also reduce unnecessary out-of-pocket expenditure.