Prevalence of cervical cancer in Ain Defla region (Algeria)

The high rate of cervical cancer in Algeria and the absence of organized screening programs are well shown in this study, which aims to determine the prevalence of cervical cancer and describe the risk factors associated with this alarming prevalence. This retrospective study is based on data collected from medical records and A questionnaire was developed to assess the risk factors (such as: parity, age at first marriage, smoking, oral contraceptive, and Hormonal status) of cervical cancer among the participants. Face to Face interview were conducted with the participants. The result obtained from this study revealed that cervical cancer occupies the fourth place of cancer in the Wilaya of Ain Defla (4,71 %); the results confirm the effect of several risk factors such as early marriage age (below 20 years: 46.66 %), multiparity (53.33%), menopause (66.66 %); taking contraception (53.33%) and smoking in the development of this pathology. The adoption of an early and annual screening program in our region would be very important to us. In addition, the interest of annual screening is to raise women's awareness of this pathology, particularly in isolated regions. (

The Quality of Medical RecordsManagementin Public Health Facilities inthe Jimma Zone, Oromia Regional state, Southwest Ethiopia

Background:Comprehensive medical records are the cornerstones forthe quality and efficiency of patient care, as they can provide a complete and accurate chronology of treatments, patient results, and plans for care. The study aimed to assess the quality of medical records in public health facilities in the Jimma Zone.Methods:A facility-based cross-sectional study design supplemented by a qualitative method was employed from May 30 -July 29, 2020. A total of 384 medical records were reviewed from 36 facilities using afacility inventory checklist. EPIData 3.1 software was used to enter the quantitative data, which wasthen analyzed using SPSS 23, and descriptive statistics were used to present the results. A thematic analysis approach was used for qualitative datawhich wasfinally triangulated with the quantitative data.Result:384medical records were reviewed from thirty-six public health facilities in the Jimma Zone with a 100% retrieval rate. Among the 36 health facilities, only one hada printer in the record room and three (8%) hadtracer cards. On completeness of the medical records, mode of arrival and date of birth were the least recoded data elements (17% and 5%), respectively.Conclusion:The majority of health facilities hada shortage of trained and qualified recording personnel in the medical record units. The majority of medical records had poor completeness in terms of administrative, clinical, financial, and legal data. The overall quality of medical records in public health facilities in the Jimma Zone was low as per the standard of health facility requirements. It was recommended to have qualified medical record unitpersonnel and to standardize the unitin order to improve the quality of medical records. [Ethiop. J. Health Dev. 2022;36(SI-1)]

Audit of medical records keeping at a Nigerian geriatric clinic

BACKGROUND: A medical record also known as health chart is the written health information about a patient or clients and is always opened whenever a patient or client visits a health facility. There are different types of medical records and it may be problem based or patient based; paper based or electronic. It enhances continuity of care; source of communication between healthcare professionals, as aides de memoire and it is a legal document. OBJECTIVE: To compare the medical records keeping with reference standards. METHOD: This is a prospective clinical audit, was conducted in a Nigerian Nursing Home for the elderly. The medical record keeping was compared with the generic standards of medicalrecordkeepingofthehealthinformatics Unitof the Royal College of Physicians. Two clinical audit cycles were performed. results: At the first clinical audit cycle only the third standard was 50%, others were zero. At the second clinical audit cycle there was improvement and 100% increase in standard 1, 3, 4 and 5, with 10% increase in standard 2. Paper based medical records are kept at the nursing home. Most of the residents do not know their age as their birth dates was not recorded. There were 30 residents at the nursing home when the clinical audit was conducted. CONCLUSION: Initially, the medical record keeping was below standard but with the clinical audit there was improvement. Clinical audit is important in medical practice in comparing the practice with standards

Assessing the utilization of a child health monitoring tool

Objective: The study assessed the implementation of growth monitoring and promotion, immunisation, vitamin A supplementation, and deworming sections of the Road-to-Health Booklet. Caregivers and health care workers knowledge, attitudes and practices were investigated as well as health care workers perceptions of barriers undermining implementation.Methods: A cross-sectional descriptive study was conducted on a proportional sample of randomly selected Primary Health Care facilities across six health districts (35%; n=143) in the Western Cape Province. Health care workers involved in the implementation of the Road-to-Health Booklet, children (0-36 months) and CGs were included. Information was obtained through scrutiny of the Road-to-Health Booklet, observation of consultations and structured questionnaires.Results: A total of 2442 children, 2481 caregivers and 270 health care workers were recruited. Weight (94.7%) measurements were performed routinely. Less than half (40.2%) of caregivers reported that their child's growth was explained. Sixty-eight percent of health care workers correctly identified criteria for underweight, whereas only 55% and 39% could do so for stunting and wasting respectively. Road-to-Health Booklet sections were completed adequately for immunization (89.3%), vitamin A supplementation (94.6%) but not for deworming (48.8%). Most health care workers (94%) knew the correct regimes for vitamin A supplementation and deworming, but few caregivers knew when treatment was due for vitamin A supplementation (16.4%) and deworming (26.2%). Potential barriers identified related to inadequate training, staff shortages and limited time.Conclusion: Focussed effort and resources should be channelled towards health care workers training and monitoring regarding growth monitoring and promotion to optimize utilization of the Road-to-Health Booklet. Mobilisation of community health workers is needed to strengthen community awareness of preventative health interventions

Perceptions of undergraduate dental students at maker ere college of health sciences; Kampala; Uganda towards patient record keeping

Background. The creating; maintenance and storage of patients' medical records is an important competence for the professional training of a dental student. Objective. Owing to the unsatisfactory state of dental records at the students' clinic; the objective of this study was to obtain information from undergraduate dental students on the factors that affect this process and elicit recommendations for improvement. Methods. This qualitative cross-sectional study used focus group discussions with 4th- and 5th-year dental students for data collection. Data were captured through a written transcript and an audio recorder. The data were transcribed and analysed manually through developing themes; which were compared with the literature and interpreted. Results. Three themes emerged: (i) Poorly designed clerking forms. The clerking forms were deemed to have a poor design with inadequate space for clinical notes. It was recommended that they be redesigned. (ii) Inadequate storage space. Space for storing patient records was deemed inadequate and a referencing system for file retrieval was lacking. It was recommended that more space be allocated for storage; with a referencing system for easy file retrieval. (iii) Poor maintenance of records. Patients' records; especially radiographs; were not well labelled and stored. It was recommended that drug envelopes be utilised to store radiographs. An electronic system was deemed the ultimate solution to this problem. Conclusion. The general perception was that the current paper-based record system at the clinic was unsatisfactory. Therefore; there is a need to improve the maintenance and storage of records; and to change to a more efficient electronic system. The students' attitude towards record keeping was found to be questionable; with a need to be addressed as part of teaching and learning in the curriculum. Lecturers were deemed to have a bigger role to play in the record-keeping process

Awareness and Knowledge of Disease Surveillance and Notification by Health-Care Workers and Availability of Facility Records in Anambra State; Nigeria

Background: Disease surveillance and notification (DSN) is part of the Health Management Information System (HMIS) which comprises databases; personnel; and materials that are organized to collect data which are utilized for informed decision making. The knowledge about DSN is very important for the reporting of notifiable diseases. Objective: The aim of this study is to examine the awareness and knowledge of health-care workers about DSN; and availability of facility records in Anambra State; Nigeria. Materials and Methods: The study was a descriptive cross-sectional one in which relevant data were collected from health-care workers selected by a multistage sampling technique. Qualitative information was also elicited by key informant interviews; whereas an observational checklist; preceded by a desk review was used to examine the availability of facility records. Results: Although 89.8 of the health-care workers were aware of the DSN system; only 33.3; 31.1; and 33.7 of them knew the specific uses of forms IDSR 001; IDSR 002; and IDSR 003 (IDSR: Integrated Diseases Surveillance and Response); respectively. Knowledge of use of the various forms at the facility and local government area (LGA) levels were generally low; although the observational checklist revealed that IDSR 001 and IDSR 002 forms were predominantly found in primary health-care facilities. HMIS forms were less likely to be available in secondary health-care facilities (?[2]=7.67; P=0.005). Conclusions: Regular training and retraining of concerned health-care workers on DSN at the LGA level is recommended. This should run concurrently with adequate and regular provision of IDSR forms; copies of the standard case definitions; and other necessary logistics to the health-care facilities by the local and state governments

Prevalence and Profile of Injuries in Khorixas District Hospital; Namibia

The aims of this study were to identify the demographic characteristics of injury victims and the types of injury cases seen and admitted for treatment in Khorixas District Hospital; Namibia. A descriptive retrospective survey of all injuries attended to and admitted in the hospital from January 2001 to December 2004 was done using document review of patients' medical records. A total of 331 injury cases (6.8 of all admissions) were admitted. The age group 20-29 years was the most commonly affected; with 18 injured. Injury was common among the males (76). The unemployed constituted 36 of all the injuries; followed by children/infants (19). Over two-thirds (68) of the injuries were unintentional. Cuts and stabs were the most common (24) type of injury among the injury cases admitted. Motor vehicle accidents accounted for 21 of all injuries admitted. Over a third (36) of all the injuries were alcohol related. Farmers (11) constitute the most affected group among the employed. Type of injury and occupation were significantly associated (?2=107.879; p 0.001). Mass propagation of anti-violence education is needed to reduce the high rate of intentional injuries among the injuries such as cuts/stabs; assaults; human bite and gunshot injuries

Doctors' Use of Laboratory Tests in the Diagnosis and Treatment of Patients

Abstract:The provincial health budgets in South Africa are under enormous pressure and; annually; budgets are exceeded by most hospitals and clinics. Laboratory tests requested by clinicians are contributing to the problem of over-expenditure. The aim of this study was to determine from patients' files whether doctors were using laboratory tests prudently during their treatment of patients in the outpatient department (OPD) of the National District Hospital in Bloemfontein. A descriptive study was carried out using all the files of patients who visited the OPD in a three-month period (1 July to 30 September 2005) for whom laboratory tests were requested by the attending physician. The majority (31.3) of patients for whom laboratory tests were requested presented to the OPD with cardiovascular complaints or diagnoses; followed by endocrine (27.8) and musculoskeletal (16.3) complaints or diagnoses. Between one and three tests were requested for most patients; i.e. 33 and 15; respectively. The most frequently requested tests were erythrocyte sedimentation rate (8.1); urea and electrolytes (7.7); urine microscopy; culture and sensitivity (6.4); cholesterol (6.1); full blood count (5.7) and thyroid profile (TSH 4.6; T4 2.6 and thyroid functions 2.3). In 70.4 of cases; results were documented and; in 59.1; the physician's management plans indicated the incorporation of laboratory test results into the patient's treatment regimen. Our findings indicated inappropriate documentation and application of test results. Interventions to improve physician behaviour include education; guidelines; feedback; leadership and redesign of requisition forms

Paediatric solid tumours in Nigerian children: a changing pattern?

Background: Childhood cancer is fast becoming an important paediatric problem in Nigeria and several parts of Africa; with the progressive decline of infectious and nutritional diseases. The following study was a 5-year retrospective review of paediatric solid tumours as seen at the Jos University Teaching Hospital; Nigeria. Objective: To determine the relative frequencies of childhood solid malignant tumours in Jos; Central Nigeria and compare with reports of previous studies both locally and abroad. Materials and Methods: Cancer registers and medical records of patients were used to extract demographic data; specimen number and/or codes. Archival materials were retrieved from the histopathology laboratory and sections were made from paraffin embedded blocks of these specimens. Slides of these histological sections were reviewed and reclassified where necessary. The relative frequencies were then determined. Results: One hundred and eighty one solid tumours of children were diagnosed within the study period. Ninety-four (51) were benign and 87 (49) malignant. Male: Female ratio was 1.3:1. The commonest malignant tumour diagnosed was rhabdomyosarcoma which accounted for 27 (31); comprising of 15 (55.6); 11 (40.7) and 1 (3.7) embryonal; alveolar and pleomorphic rhabdomyosarcomas; respectively. Non Hodgkin lymphoma and Burkitt lymphoma accounted for 17 (19.5) and 12 (13.8); respectively. Conclusion: Based on the result of our study; we conclude that the commonest solid malignancy of childhood in Jos; Nigeria is rhabdomyosarcoma. This has implications for diagnosis; management and prognosis of theses soft tissue sarcomas in our paediatric population

Poor Quality of Data and Care Cast Doubts on Reported Success of Uganda's TB Programme: a Study of the Unit Tuberculosis Registers of Three Ugandan hospitals

With the global resurgence of TB as a public health threat especially in association with HIV-coinfection; accompanied by mismanagement which has led to the emergence of multi-drug resistant TB disease; it is important that care for patients and record-keeping be enhanced. The objective of this study was to analyze the recording of TB cases in Unit Tuberculosis Registers of three Ugandan hospitals in order to identify and quantify the deficiencies in the data registered; for improvement. The design was a retrospective study of the Unit Tuberculosis Registers; with interviews of the staff responsible for entering the data. The setting was three hospitals in the South-Eastern zone of the National Tuberculosis and Leprosy Programme of Uganda - St Francis Buluba Hospital in Mayuge District; Jinja Regional Referral Hospital in Jinja District and Iganga Hospital in Iganga District. All the patients records of cases of tuberculosis entered in the Unit Tuberculosis Registers during 2002 were analysed for the standard TB programme indicators. The Main outcome measures were errors; misclassifications and missing data for each patient registered. The study identified areas for intervention to improve data accuracy. Many so-called cases were diagnosed clinically and never confirmed by laboratory sputum smear examination. Most cases had pulmonary TB. Despite a highly-rated national TB programme; these key field sites showed a cure rate of only 13; a treatment completion rate of 26and a treatment-defaulter rate of 29. These findings are much worse than the reported national figures at the time and suggest a need for the national level to strengthen lower levels further; in order to improve case management; follow-up and reporting

An Audit of Anaesthetic Record Charts in the Orthopaedic Theatre of a Nigerian Teaching Hospital

Objective: The anaesthetic record is an essential part of a patient's record; providing useful information for the management of the patient. It is of medico-legal importance and can be used for quality assurance and researchpurposes. An analysis of anaesthetic record charts from a satellite operating theatre of the University of Port-Harcourt Teaching Hospital (UPTH) was undertaken to determine their legibility; correctness and completeness. Method: A retrospective analysis of the anaesthetic record charts from March 2003 to February 2004 of the orthopaedic theatre of the UPTH was undertaken. Results : A total of 232 anaesthetic record charts were analyzed. All entries were manually-written. Of these; 141 (60.9) were filled by anaesthetic registrars; the rest were filled by senior registrars 85 (36.5) and consultants 6 (2.6). One hundred and twenty-one charts (52.2) were legible; completely and correctly filled; but 47.8were incompletely filled; and 47.7had at least an illegible parameter. Conclusion: It is concluded from this analysis that the standard of anaesthetic record-keeping needs to be improved and consideration given to the use of computer-generated records which will eliminate the problems of illegible records

Improving the use of patient-held records in the Emtshezi Subdistrict

"Background The aim of this interventional study was to assess; document and improve the Patient-held Record (PHR) System in the Emtshezi Subdistrict. The study began in 1998 and was conducted using a Quality Assurance (QA) Cycle; which focuses on systems and processes and encourages a team approach to problem solving and quality improvement. The keeping of good; accurate health records; as well as the communication of this clinical information between health practitioners; is essential for good quality practice in primary care. In Emtshezi; many patients eceive care from different health facilities and practitioners. Historically; the health services in the Subdistrict; as in much of KwaZulu-Natal; were fragmented. Clinics; hospitals and private practitioners in the Subdistrict used a variety of different health records systems; which did not integrate with each other. There was very little communication between these health providers; ossibly because no overall plan for health records was worked out for the Subdistrict or the Province at that stage. The Emtshezi Subdistrict forms part of the uThukela Health District of KwaZulu-Natal and lies 120 km northwest of Pietermaritzburg. The population is mostly rural. The major towns are Estcourt; Weenen and Winterton. In the Subdistrict; there is one district hospital of 300 beds; 10 residential clinics and four mobile clinics. There are more than 20 private practitioners; the majority of whom practice in Estcourt. The term ""ambulatory records"" refers to records that are used by outpatients as opposed to records used for admission to a hospital ward. Two basic types of ambulatory medical records are used throughout KwaZulu-Natal - the A4-sized Facilityheld Record (FHR) and the small PHR (see Photograph 1). They are both called ""Outpatient Record"". The FHRs are used only at that facility and are filed at the facility. The PHR is kept by the patient nd can thus be used at any health facility. Method The method used for this study was the Quality Assurance Cycle. Focus group discussions were the main research tool utilised. This research was conducted with ethical approval as the dissertation towards an MFamMed degree at MEDUNSA. Results The following problems were identified: poor communication of clinical information between health facilities. There were problems with the records system in the hospital; poor design of ambulatory records and the use of multiple PHRs by patients. The following solutions were proposed: A single; common PHR to be the definitive ambulatory health record for every patient at district level. The design of the PHR has been improved and meets the legal requirements for a health record.Conclusions PHRs have a valuable role to play within the District Health System in South Africa. They are especially useful in improving the standard of health care; as well as the continuity of care between the district hospital and the clinics and community health centres that the hospital supports. PHRs form a vital link; not only between facilities; but as a link through time: patients need a definitive personal health record for themselves; a record that is problem-orientated and tracks their health and illnesses throughout life. We need to move away from episodic care. Hospital doctors need to be more seriouslycommitted to communicating with the PHC clinics and private practitioners who refer to that hospital. Senior managers and policy planners need to be more aware of the potential of PHRs as a means of transformation towards a better district health system."

Informativite du carnet de sante de la mere et de l'enfant en usage en Cote d'Ivoire

OBJECTIF: Notre etude avait pour objectif d'apprecier l'informativite du carnet de sante de l'enfant. METHODOLOGIE: Il s'agit d'une etude transversale; prospective et retrospective a visee descriptive qui s'est deroulee du la fevrier au 30 avril 2004 dans les services de pediatrie de trois formations sanitaires : Marcory; Koumassi et Port-Bouet. Elle a porte sur 400 enfants ages de 1 a 5 ans consultants; leurs parents et leurs carnets de sante. Les informations ont ete recueillies a partir de l'observation; des interviews et des mensurations. RESULTATS: Nous avons note les resultats suivants: -Age : 82;5pour cent des enfants etaient ages de 1 a 2 ans ; -Sexe : feminin : 49;5pour cent; masculin : 50;5pour cent ; -Nationalite : ivoirienne : 69pour cent; etrangere : 31pour cent ; -Score d'Apgar inscrit: 95pour cent ; -Notification du developpement psychomoteur: station assise: 1pour cent; marche acquise : nulle (0pour cent) ; -Mesures anthropometriques : poids: 23;5pour cent; taille: 18;8pour cent; PB: 18;5pour cent; PC: 19pour cent ; -Courbe de croissance : 2;3pour cent ; -Absence d'enregistrement des consultations: nourrissons: 4;2pour cent; enfants: ; 2;9pour cent ; -Enregistrement du numero de lot : 97;5pour cent ; -Enfants malnutris : 34;8pour cent. CONCLUSION: Il existe de nombreux manquements dans les informations fournies par le carnet de sante. Une etude devrait etre menee aupres du personnel de sante pour connaitre les raisons pour lesquels ils ne remplissent pas correctement les carnets de sante

Evaluation de la tenue du dossier medical du patient hospitalise pour pneumopathie aigue d'allure bacterienne : audit clinique de 89 dossiers medicaux colliges au PPH du CHU de Cocody

Notre travail est une etude retrospective portant sur 89 dossiers de patients hospitalises pour pneumopathie aigue d'allure bacterienne durant la periode du 01janvier 2002 au 31 decembre 2002 dans le service de PPH du CHU de Cocody. L'objectif general de cette recherche est d'evaluer la tenue du dossier medical de ces patients. Les resultats obtenus sont les suivants: AU PLAN DE L'ARCHIVAGE DES DOSSIERS MEDICAUX : *3 dossiers medicaux soit 3;04pour cent n'ont pas ete retrouves. *Il n'existe ni procedure ecrite sur le secret medical ni procedure ecrite de validation des dossiers avant l'archivage. *Les conditions d'archivage des dossiers presentent de nombreuses insuffisances. AU PLAN DE L'ETAT DES DOSSIERS APRES L'ARCHIVAGE : *Les dossiers medicaux apres leur archivage sont degrades. *40;45pour cent des dossiers avaient des examens para cliniques manquants. AU PLAN DES ELEMENTS DE LA STRUCTURE DU DOSSIER : *Le dossier du patient est bien identifiable dans 100pour cent des cas. *Les parametres de l'admission sont toujours precises. *Le mode de debut est indique dans 48;31pour cent des cas tandis que le delai d'evolution de la maladie et la chronologie des signes fonctionnels sont mentionnes dans plus de 80pour cent des dossiers. *Le resume de l'observation a ete ecrit dans 92;13pour cent des dossiers. *Plus de 66pour cent des dossiers indiquent la nature; le rythme et le mode d'administration de l'antibiotherapie. *Le resume du dossier a ete redige dans 98;88pour cent des cas. *Alors qu' un antecedent de PAB et d'affection ORL n'a ete rapporte que respectivement dans 16;85pour cent et 6;74pour cent des cas. *Les modalites d'administration du traitement sont precises seulement dans 3;37pour cent des dossiers. *L'existence ou non des effets secondaires des medicaments n'a pas ete mentionnee. *Seuls 11;24pour cent des dossiers ont une observation medicale conforme. *Le suivi post-hospitalier n'a ete assure que pour 29;1pour cent des patients. Compte tenu des nombreuses insuffisances ainsi revelees; cette etude suggere la realisation d'une etude comparee entre la qualite de la tenue du dossier medical et la qualite des soins administres au patient hospitalise pour pneumopathie aigue bacterienne

Evaluation de la tenue du dossier medical en pneumologie : audit clinique de 511 dossiers medicaux colliges au PPH de cocody

Notre etude s'est deroulee du 1er janvier au 31 decembre 1999. Il s'agissait d'une etude retrospective portant sur 511 dossiers medicaux archives au PPH de Cocody. L'objectif general etait d'apprecier la qualite de la tenue du dossier medical en pneumologie. Au terme de cette etude; les principaux resultats sont : 1) Au plan de l'etat des dossiers : 4;7 pour cent des dossiers n'ont pas ete retrouves. 2) Au plan des elements de structure du dossier : -Dans 99;8 pour cent des cas; le service et le numero de service sont precises; -La qualite du redacteur; precisee dans 34;6 pour cent; -Les elements d'identification du patient sont precises dans plus de 90 pour cent; -Les donnees d'admission sont precisees dans plus de 98 pour cent; -les antecedents pulmonaires sont precises dans plus de 71;4 pour cent et la notion alcoolo-tabagique a pres de 81 pour cent; -Les elements de l'examen general sont precises dans plus de 53 pour cent; la taille precisee dans 2;3 pour cent; -Les elements de l'examen pleuro-pulmonaire sont precises dans 80 pour cent des cas; -Le syndrome est precise 49;5 pour cent des cas; -Dans 87;3 pour cent; le resume de l'observation medicale est precis; -Les hypotheses diagnostiques sont precisees dans 39;7 pour cent des cas; -La radiographie pulmonaire est demandee dans 86;1 pour cent des cas contre l'IDR dans 8;4 pour cent; -Dans 80 pour cent des cas; les resultats des examens demandes sont parvenus; sauf la lecture de I'IDR qui est fait dans 23;3 pour cent des cas; -Le diagnostic de sortie est precise dans 90;8 pour cent des cas; -Les elements ayant contribue a poser le diagnostic sont precises dans 81;6 pour cent; -Les elements du traitement medical sont precises dans plus de 87 pour cent; -Le debut traitement precise dans 86;5 pour cent; -Les effets secondaires precises dans 0;8 pour cent; -Les elements de surveillance clinique et la fiche de temperature sont retrouves dans plus de 86 pour cent et l'evolution dans 82;4 pour cent; -Le traitement de sortie est precise dans 57;9 pour cent et le mode de sortie est precise dans 52;3 pour cent; -Dans 100 pour cent des cas; les elements para cliniques sont identifies au nom du patient; -Dans 57;8 pour cent des cas; les elements contenus dans le dossier sont bien agrafes; -Le plan d'observation est respecte dans 37;8 pour cent des cas. 3) Au plan des conditions d'archivages des dossiers : -Salle des archives bien tenue; sous la responsabilite d'un archiviste; -Les dossiers; ranges par annee et par numero d'ordre. De notre etude se degage l'interet de la realisation d'autres audits cliniques etendus aux autres services du CHU en vue d'en apprecier la qualite de la tenue du dossier medical. Aussi; l'interet de la vulgarisation de l'outil d'audit medical