ABSTRACT
For several decades Cameroon's healthcare system has faced a multitude of challenges. These challenges are associated with observed shifts in the country's demographic profile, epidemiology, lifestyle, technological advances, and environment change. Health outcomes are among the poorest in the world. Cameroon's medical infrastructure and available human resources fail to meet the demand for care. Public financing accounts for only 3% of the national budget, thus Cameroonians spend large shares of their household budget on healthcare. Cameroon has benefited from national and international financial support for healthcare. This has helped establish 31 healthcare financing programmes (HFP) in Cameroon. This chapter reviews the practice of economic and efficiency evaluations of HFP in Cameroon. It also presents the main challenges faced when conducting these assessments. The chapter stresses the need for continuous monitoring and evaluation of Cameroon's healthcare sector financing, both in the current COVID-19 pandemic as well as in the post-pandemic period. Such critical appraisal of current HFP is necessary to achieve optimal, effective, efficient and sustainable investment that can promote healthcare for the Cameroonian population over the long term. © Oxford University Press 2022. All rights reserved.
ABSTRACT
Context: Throughout the current COVID-19 pandemic, tremendous effort has been made to implement innovative practices to address social isolation and loneliness (SIL) in long-term care facilities (LTCFs), disproportionally affected by COVID-19. These interventions have not yet been synthesized. This review intended to gather the current promising best practices (PBPs) implemented in LTCFs to alleviate SIL in older persons during the COVID-19 pandemic as well as during the SARS and H1N1 pandemics, using an intersectional lens. Methods: An extensive search was done in nine electronic databases. Arksey and O'Malley's framework was used to format the scoping review. Two independent reviewers screened citations for inclusion, blindly. The selection of articles was conducted blindly by two coauthors. Finally, 16 studies were analyzed out of 9,077 records. Results: Two main themes of findings arose from this review. They comprised proximal PBPs directly addressing SIL in LTCF residents such as pseudo-contact interventions (e.g., chat from balcony or behind transparent barriers/glasses), remote communication tools (e.g., phone or video chat, voice mail/text messaging), and humanoid robots. Distal PBPs included measures implemented to prevent or mitigate the development of COVID-19, including COVID-19 screening approaches, outbreak preparedness, quarantining approaches for both residents and staff. Conclusion: This scoping review found varied PBP implemented during the multiple waves of the COVID-19 pandemic as well as evidence supporting their effectiveness. The contribution of this study is significant as most of the PBP investigated should be prioritized by public policymakers or institutions to provide more satisfactory services to the elderly and their families. © 2022 The Author(s).
ABSTRACT
Purpose: We aim to highlight a case of COVID-19 associated acute macular neuroretinopathy (AMN), an outer retinopathy known to occur following febrile and flu-like illnesses. Method(s): Case report. Result(s): A 23-year-old Caucasian female presented with a 10-day history of sudden onset bilateral paracentral scotomata which developed following confirmed SARSCoV- 2 infection. The patient's medical history was significant for polycystic ovary syndrome and use of the combined oral contraceptive pill (OCP). Fundoscopic examination revealed multiple reddish-brown, wedge shaped lesions in both eyes perifoveally. Optical coherence tomography of these lesions demonstrated areas of ellipsoid zone disruption associated with overlying hyperreflectivity of outer retinal layers. The lesions were hyporeflective on infrared imaging. The location of lesions at the macula correlated nearly identically with Amsler grid recordings as illustrated by the patient. As a result, the patient was diagnosed with AMN. Other inflammatory, infective and hypercoaguable causes of outer retinopathy were excluded. While OCP use is a risk factor for AMN, the aetiology was determined to be associated with COVID-19, given the onset of visual symptoms closely following the onset of acute febrile illness. Conclusion(s): We report a rare case of AMN occurring in the context of recently diagnosed COVID-19, on the background of OCP use. More broadly, this case report aims to contribute to the broader literature regarding COVID- 19 associated ocular sequelae. Clinicians should consider asking about recent COVID-19 infection when encountering patients presenting with symptoms of AMN.
ABSTRACT
Nosocomial or healthcare-associated infections (HCAIs) are associated with a financial burden that affects both patients and healthcare institutions worldwide. The clinical best care practices (CBPs) of hand hygiene, hygiene and sanitation, screening, and basic and additional precautions aim to reduce this burden. The COVID-19 pandemic has confirmed these four CBPs are critically important prevention practices that limit the spread of HCAIs. This paper conducted a systematic review of economic evaluations related to these four CBPs using a discounting approach. We searched for articles published between 2000 and 2019. We included economic evaluations of infection prevention and control of Clostridioides difficile-associated diarrhoea, meticillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, and carbapenem-resistant Gram-negative bacilli. Results were analysed with cost-minimization, cost-effectiveness, cost-utility, cost-benefit and cost-consequence analyses. Articles were assessed for quality. A total of 11,898 articles were screened and seven were included. Most studies (4/7) were of overall moderate quality. All studies demonstrated cost effectiveness of CBPs. The average yearly net cost savings from the CBPs ranged from $252,847 (2019 Canadian dollars) to $1,691,823, depending on the rate of discount (3% and 8%). The average incremental benefit cost ratio of CBPs varied from 2.48 to 7.66. In order to make efficient use of resources and maximize health benefits, ongoing research in the economic evaluation of infection control should be carried out to support evidence-based healthcare policy decisions.