ABSTRACT
Objectives: To determine if compliance with daily iron-folic acid (IFA) supplementation to prevent anemia and daily IFA and calcium supplementation to prevent anemia and pre-eclampsia can be improved with counseling and by using reminder cards and cell phone messages to ensure daily intake. Methods: Implementation research conducted in Eastern region and Nyanza region of Kenya over six months with 120 pregnant women. Initial qualitative research determined women's perceptions about anemia and pre-eclampsia and experiences with taking IFA/calcium and was used to develop counseling messages. All women received standard antenatal care (ANC), counseling, and reminder cards. Women were randomized into one of four groups: those receiving only IFA and no text messages; those receiving only IFA with text messages; those receiving IFA and calcium with no text messages; and those receiving IFA and calcium with text messages. Supplement compliance and barriers to compliance was assessed monthly during ANC or home visits and measured by self-reporting by women, reporting by a family member who observed intake, and by counting remaining pills. Husbands, mothers-in-law, health workers and community leaders were interviewed for insights about how they can influence compliance. Results: Initial findings in Kenya suggest that less than 5% of women are taking 90+IFA supplements during pregnancy due to inadequate supplies, lack of counseling or compliance with IFA supplementation. Conclusions: This study will help inform future programming on the existing IFA supplementation policy and as the country introduces calcium supplementation.
Subject(s)
Humans , Colitis, Ulcerative/diagnosis , Crohn Disease/diagnosis , Colitis, Ulcerative/complications , Crohn Disease/complications , Crohn Disease/drug therapy , Crohn Disease/surgery , Diagnosis, Differential , Inflammatory Bowel Diseases/complications , Inflammatory Bowel Diseases/diagnosis , Inflammatory Bowel Diseases/etiology , Pregnancy ComplicationsSubject(s)
Humans , Colonic Diseases/classification , Colon/physiology , Hirschsprung Disease/diagnosis , Anus Neoplasms/classification , Anus, Imperforate/diagnosis , Appendicitis/diagnosis , Bacterial Infections/diagnosis , Colonic Diseases, Functional/diagnosis , Diverticulitis, Colonic/diagnosis , Enterocolitis, Necrotizing/diagnosis , Rectal Fistula/physiopathology , Herpesviridae Infections/physiopathology , Postoperative Complications , Tuberculosis, Gastrointestinal/diagnosisABSTRACT
Se efectuó un estudio retrospectivo para validar nuestra observación que los pacientes que requieren altas dosis de Diazepam como premedicación para endoscopía digestiva alta tienen en general, menos hallazgos patológicos, que aquellos que requieren dosis menores. Se analizaron 150 casos y se comprobó que setenta por ciento (70%) de los pacientes con hallazgos endoscópicos significativos requirieron 20 mg de diazepam o menos. Esto en contraste con los pacientes que requieron más de 20 miligramos quienes tuvieron cambios endoscópicos en 26.7% de los casos