ABSTRACT
OBJECTIVES: Social determinants of health (SDH) are the prevalent enablers of health among populations, and integrating them in medical education will advance clinical care by integrating social and economic risk data into medical diagnosis and treatment. Despite the numerous publications on SDH and medical education, the publication trends are not known. The study aims to analyse publication trends in integrating SDH into medical education and the corresponding thematic areas. STUDY DESIGN: This was a bibliometric analysis study. METHODS: Bibliometric was used. Data from Scopus databases from January 2006 to June 2023 were retrieved with no language restriction. VOSviewer software was used for analysis. Bibliographic coupling was used to identify the clusters of published literature on the integration of SDH into medical education, followed by the analysis of annual distribution and growth trends, authors and co-author relationships and collaborations. RESULTS: A total of 1047 articles were retrieved. The annual research publication exhibited a swift surge in the studies conducted during the reviewed period. Five clusters of information were derived: relating to curriculum development, community engagement and service-learning, stakeholder collaborations, development of assessment methods and tools for SDH, and the impact of integrating SDH into medical education. CONCLUSION: Bibliometric analysis has revealed a growing trend in the field of integrating SDH into medical education, and the study has highlighted the research impact through bibliographic coupling by identifying the five thematic areas. This study lays a foundation for advancing knowledge on what has been published and possible areas for improvement in the integration of SDH into medical education.
ABSTRACT
BACKGROUND: Despite WHO guidelines for testing all suspected cases of malaria before initiating treatment, presumptive malaria treatment remains common practice among some clinicians and in certain low-resource settings the capacity for microscopic testing is limited. This can lead to misdiagnosis, resulting in increased morbidity due to lack of treatment for undetected conditions, increased healthcare costs, and potential for drug resistance. This is particularly an issue as multiple conditions share the similar etiologies to malaria, including brucellosis, a rare, under-detected zoonosis. Linking rapid diagnostic tests (RDTs) and digital test readers for the detection of febrile illnesses can mitigate this risk and improve case management of febrile illness. METHODS: This technical advance study examines Connected Diagnostics, an approach that combines the use of point-of-care RDTs for malaria and brucellosis, digitally interpreted by a rapid diagnostic test reader (Deki Reader) and connected to mobile payment mechanisms to facilitate the diagnosis and treatment of febrile illness in nomadic populations in Samburu County, Kenya. Consenting febrile patients were tested with RDTs and patient diagnosis and risk information were uploaded to a cloud database via the Deki Reader. Patients with positive diagnoses were provided digital vouchers for transportation to the clinic and treatment via their health wallet on their mobile phones. RESULTS: In total, 288 patients were tested during outreach visits, with 9% testing positive for brucellosis and 0.6% testing positive for malaria. All patients, regardless of diagnosis were provided with a mobile health wallet on their cellular phones to facilitate their transport to the clinic, and for patients testing positive for brucellosis or malaria, the wallet funded their treatment. The use of the Deki Reader in addition to quality diagnostics at point of care also facilitated geographic mapping of patient diagnoses in relation to key risk areas for brucellosis transmission. CONCLUSIONS: This study demonstrates that the Connected Dx approach can be effective even when addressing a remote, nomadic population and a rare disease, indicating that this approach to diagnosing, treatment, and payment for healthcare costs is feasible and can be scaled to address more prevalent diseases and conditions in more populous contexts.
