Task shifting for point of care ultrasound in primary healthcare in low- and middle-income countries-a systematic review.
| Autor: | Abrokwa SK; Institute of Tropical Medicine and International Health, Charité-Universitätsmedizin Berlin, Germany., Ruby LC; Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany., Heuvelings CC; Currently has no affiliation., Bélard S; Institute of Tropical Medicine and International Health, Charité-Universitätsmedizin Berlin, Germany.; Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.; Berlin Institute of Health, Berlin, Germany. |
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| Jazyk: | angličtina |
| Zdroj: | EClinicalMedicine [EClinicalMedicine] 2022 Mar 06; Vol. 45, pp. 101333. Date of Electronic Publication: 2022 Mar 06 (Print Publication: 2022). |
| DOI: | 10.1016/j.eclinm.2022.101333 |
| Abstrakt: | Low-and middle-income countries (LMIC) are faced with healthcare challenges including lack of specialized healthcare workforce and limited diagnostic infrastructure. Task shifting for point-of-care ultrasound (POCUS) can overcome both shortcomings. This review aimed at identifying benefits and challenges of task shifting for POCUS in primary healthcare settings in LMIC. Medline and Embase were searched up to November 22nd, 2021. Publications reporting original data on POCUS performed by local ultrasound naïve healthcare providers in any medical field at primary healthcare were included. Data were analyzed descriptively. PROSPERO registration number CRD42021223302. Overall, 36 publications were included, most ( n = 35) were prospective observational studies. Medical fields of POCUS application included obstetrics, gynecology, emergency medicine, infectious diseases, and cardiac, abdominal, and pulmonary conditions. POCUS was performed by midwives, nurses, clinical officers, physicians, technicians, and community health workers following varying periods of short-term training and using different ultrasound devices. Benefits of POCUS were yields of diagnostic images with adequate interpretation impacting patient management and outcome. High cost of face-to-face training, poor internet connectivity hindering telemedicine components, and unstable electrici'ty were among reported drawbacks for successful implementation of task shifting POCUS. At the primary care level in resource-limited settings task shifting for POCUS has the potential to expand diagnostic imaging capacity and impact patient management leading to meaningful health outcomes. Competing Interests: Sabine Bélard is a board member (unpaid) for the Deutsche Gesellschaft für Tropenmedizin, Reisemedizin und Globale Gesundheit e.V. Lisa C. Ruby report a Medizinernachwuchs.de travel grant and a Charité SEED grant for travel support for a research project in India. The other authors have nothing to declare. (© 2022 Published by Elsevier Ltd.) |
| Databáze: | MEDLINE |
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