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Tehrani JM, Vos IA, Kisabacak R, Topper MK, Steinhorst J, Phillips RO, Abass KM, Osei-Mireku S, Anokye CO, Adu Poku JK, Stienstra Y, Amoako YA. Traditional healers' perception on scabies causation and management in Ghana. Trop Med Int Health 2024. [PMID: 38599337 DOI: 10.1111/tmi.13989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2024]
Abstract
INTRODUCTION Scabies is an underdiagnosed skin infestation caused by the Sarcoptes scabiei mite. The infection causes severe itching and a skin rash but can be effectively treated using topical or systemic drugs. Scabies outbreaks are commonly reported in resource-poor countries, including Ghana. Traditional healers play an important role in primary care in rural areas. The role of these traditional healers in the management of scabies has so far not been explored. The aim of this study was therefore to investigate the perceptions of traditional healers regarding the causation and management of scabies. METHODS A phenomenological qualitative approach was employed. Traditional healers in the Asante Akim North and Central districts in Ghana were approached with an interview request. Using a semi-structured interview protocol, 15 traditional healers were interviewed. The results were coded and analysed, after which seven themes were extrapolated. RESULTS Scabies infections were frequently reported by traditional healers. Itching and skin rash were unanimously regarded as the major symptoms of scabies. The majority acknowledged the infectious nature of scabies, but no participant reported the causative organism. A dichotomous disease classification was noted, consisting of 'natural' and 'spiritual' variants each with a unique disease profile and management requirements, as reported by the traditional healers. All but two traditional healers reported to treat scabies using almost exclusively herbs and spiritual rituals. CONCLUSION The majority of traditional healers were open to collaboration with allopathic healthcare providers. Collaboration could broaden the primary care network in rural areas, but mistrust and lack of transparency form potential barriers to collaboration. We, therefore, emphasise the need for additional efforts to investigate strategies for future collaboration.
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Affiliation(s)
- Jian M Tehrani
- Department of Internal Medicine/Infectious Diseases, University Medical Centre Groningen, Groningen, The Netherlands
| | - Ingmar A Vos
- Department of Internal Medicine/Infectious Diseases, University Medical Centre Groningen, Groningen, The Netherlands
| | - Robin Kisabacak
- Department of Internal Medicine/Infectious Diseases, University Medical Centre Groningen, Groningen, The Netherlands
| | - Marten K Topper
- Department of Internal Medicine/Infectious Diseases, University Medical Centre Groningen, Groningen, The Netherlands
| | - Jonathan Steinhorst
- Department of Internal Medicine/Infectious Diseases, University Medical Centre Groningen, Groningen, The Netherlands
| | - Richard Odame Phillips
- Kumasi Centre for Collaborative Research, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - Samuel Osei-Mireku
- Agogo Presbyterian Hospital, Agogo, Ghana
- The Trust Hospital, Accra, Ghana
| | | | | | - Ymkje Stienstra
- Department of Internal Medicine/Infectious Diseases, University Medical Centre Groningen, Groningen, The Netherlands
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Yaw Ampem Amoako
- Department of Internal Medicine/Infectious Diseases, University Medical Centre Groningen, Groningen, The Netherlands
- Kumasi Centre for Collaborative Research, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Vos IA, Deuring E, Kwant M, Bens BWJ, Dercksen B, Postma R, Jorna EMF, Struys MMRF, Ter Maaten JC, Singer B, Ter Avest E. What is the potential benefit of pre-hospital extracorporeal cardiopulmonary resuscitation for patients with an out-of-hospital cardiac arrest? A predictive modelling study. Resuscitation 2023:109825. [PMID: 37178899 DOI: 10.1016/j.resuscitation.2023.109825] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 05/03/2023] [Accepted: 05/04/2023] [Indexed: 05/15/2023]
Abstract
AIM In this predictive modelling study we aimed to investigate how many patients with an out-of-hospital cardiac arrest (OHCA) would benefit from pre-hospital as opposed to in-hospital initiation of extracorporeal cardiopulmonary resuscitation (ECPR). METHODS A temporal spatial analysis of Utstein data was performed for all adult patients with a non-traumatic OHCA attended by three emergency medical services (EMS) covering the north of the Netherlands during a one-year period. Patients were considered potentially eligible for ECPR if they had a witnessed arrest with immediate bystander CPR, an initial shockable rhythm (or signs of life during resuscitation) and could be presented in an ECPR-centre within 45 minutes of the arrest. Endpoint of interest was defined as the hypothetical number of ECPR eligible patients after 10, 15 and 20 minutes of conventional CPR and upon (hypothetical) arrival in an ECPR-centre as a fraction of the total number of OHCA patients attended by EMS. RESULTS During the study period 622 OHCA patients were attended, of which 200 (32%) met ECPR eligibility criteria upon EMS arrival. The optimal transition point between conventional CPR and ECPR was found to be after 15 minutes. Hypothetical intra-arrest transport of all patients in whom no return of spontaneous circulation (ROSC) was obtained after that point (n=84) would have yielded 16/622 (2.5%) patients being potentially ECPR eligible upon hospital arrival (average low-flow time 52 minutes), whereas on-scene initiation of ECPR would have resulted in 84/622 (13.5%) potential candidates (average estimated low-flow time 24 minutes before cannulation). CONCLUSION Even in healthcare systems with relatively short transport distances to hospital, consideration should be given to pre-hospital initiation of ECPR for OHCA as it shortens low-flow time and increases the number of potentially eligible patients.
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Affiliation(s)
- I A Vos
- Department of Emergency Medicine, University Medical Centre Groningen, University of Groningen
| | - E Deuring
- Department of Emergency Medicine, University Medical Centre Groningen, University of Groningen
| | - M Kwant
- Department of Emergency Medicine, Medical Centre Leeuwarden
| | - B W J Bens
- Department of Emergency Medicine, University Medical Centre Groningen, University of Groningen
| | - B Dercksen
- Department of Anesthesiology, University Medical Centre Groningen, University of Groningen; UMCG Ambulancezorg
| | - R Postma
- Department of Anesthesiology, University Medical Centre Groningen, University of Groningen; Ambulancezorg Groningen
| | | | - M M R F Struys
- Department of Anesthesiology, University Medical Centre Groningen, University of Groningen
| | - J C Ter Maaten
- Department of Internal Medicine, University Medical Centre Groningen, University of Groningen
| | - B Singer
- St Bartholomew's Hospital and Barts Heart Centre, Barts Health NHS Trust, London, United Kingdom; London's Air Ambulance
| | - E Ter Avest
- Department of Emergency Medicine, University Medical Centre Groningen, University of Groningen; Air Ambulance Kent, Surrey and Sussex, Redhill, Surrey, United Kingdom.
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