Author: cld220

Summer 2016: Finishing our GHTC paper!

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May 15, 2016 | Summer 2016

To further clarify our perceptions of Sierra Leonean health care and the local knowledge and treatment of diabetes, one of our group members visited a public hospital today with professors and World Hope employees. After speaking with the hospital’s Medical Superintendent, the head of the hospital, it was clear that the Medical Superintendent was very excited about Ukweli’s purpose and goals and sees a definite need for the project. The hospital currently uses ten parameter urinalysis test strips to diagnose diabetes because blood glucose test strips cost 15,000 Leones (about $2.50), which is too expensive for most to afford; our strips can save the hospitals and patients money, making diabetes screening more accessible and potentially allow more people with diabetes to eventually be diagnosed. This change would be extremely beneficial because most people are currently only diagnosed once they come to the hospital in a coma or with other life threatening diabetes-associated complications.

In addition, we compiled the information gathered yesterday in order to obtain more readily available data, which could be used in our future discussion course and in development of later study and article papers.

With the help of Professor Sarah Ritter, we focused on progressing and advancing on our Global Health Technology Conference (GHTC) papers. We also worked on redesigning our venture’s posters intending to be able to reprint colored posters by Sunday in order to receive feedback on them by Wednesday. These posters will later be hung in the hospitals so that it can catch the attention of patients, enabling them to know more information about diabetes screening. Our translator, Hassan, has a friend with diabetes. We plan to meet Hassan’s friend tomorrow in order to more clearly understand the daily life of an individual with diabetes. We also hope to visit a weekly diabetes association meeting that Hassan’s friend is a part of.

 

Summer 2016: First day in Field

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May 14, 2016 | Summer 2016

This morning, we met with Dr. Kamara, Bombali District Medical Officer (DMO), in Makeni to receive approval for our venture. We shared both the OEM and hand-stamped test strips with the DMO, and discussed the logistics regarding each of our scenarios for test strip distribution. Upon support of the DMO, we were introduced to Amara Baugali Sesay, the Bombali District Pharmacist. Amara explained the hierarchy of the healthcare system in Sierra Leone and pointed us to private hospitals, public hospitals, pharmacies, and public health units (PHUs) that we could contact in order to identify the diagnosis and treatment pathways for diabetes. Today, we visited one pharmacy and two private hospitals alongside Amara, who was very kind to travel with us and get us connected with each respective entity.

We first visited a pharmacist at MK Pharmacy located at a busy intersection in Makeni. The pharmacist provided valuable information regarding the number of individuals who walk in with diabetes, how individuals get diagnosed for diabetes, what kind of medication is used to treat diabetes, and how much such medication costs for the average consumer. The pharmacist also described the challenges surrounding diabetes screenings such as misinterpretation of tests, unsteady insulin supply, and short lifespan of insulin (i.e., it expires quickly, especially in hot and humid conditions).

After MK Pharmacy, we visited Dr. P. Turay, the medical coordinator at Holy Spirit Catholic Hospital. Dr. Turay described diabetes as a “silent killer” and commented that the frequency of diabetes in patients has been steadily increasing over the past few years. Five years ago, Dr. Turay saw 1 case of diabetes for every 10 patients. Now, Dr. Turay sees 2 to 3 cases of diabetes for every 10 patients. We also learned that the Holy Spirit Hospital hosts both a Diabetes Clinic and a Diabetes Association, which tells us there is a large need for diabetes screening and treatment in Sierra Leone. Dr. Turay was very welcoming and invited us to speak with members of the Diabetes Association in the upcoming weeks, which we can use to further investigate diabetes treatment pathways and identify the optimal way to distribute our test strips.

In our last trip for the day, we visited Dr. S. Turay, a general physician at Magbenteh Community Hospital. Dr. Turay remarked that diabetes is a serious and growing problem in Sierra Leone, but not given utmost priority. Dr. Turay also described challenges facing diabetes treatment in Sierra Leone, which included getting patients to visit clinics regularly, making medication affordable, and treating patients with Type I diabetes (which is especially difficult due to limited insulin supply). Dr. Turay was very open about diabetes being a large yet unsolved problem in Sierra Leone, and hosts weekly radio sessions, called “Talk to the Doctor,” in order to raise awareness for common health problems and encouraging individuals to visit clinics regularly. Dr. Turay was very helpful in describing the obstacles facing diabetes treatment pathways in Sierra Leone, and gave us valuable recommendations regarding the future designs of our test strips.

Our visit to the pharmacist and two doctors provided valuable information on the current state of diabetes diagnosis and treatment pathways in Sierra Leone. Both the private hospitals we visited appear to be strong candidates for our study, which involves studying the outcomes and responses of community members getting screened using our test strips. In particular, the Holy Spirit Catholic Hospital provides diabetes screening for free, while the Magbenteh Community Hospital does not provide diabetes screening for free. As a result, both hospitals provide an excellent foundation to conduct paid and unpaid scenarios of study. We would like to give much thanks to Amara for connecting us with several pharmacists and doctors in Makeni, in addition to Dr. P. Turay and Dr. S. Turay for their time and consideration in answering each of our questions. Moving forward, our game plan is to visit a couple of public hospitals and PHUs over the next few days, where we hope to connect with Community Health Workers (CHWs) and further expand our venture into the different communities of Sierra Leone.

 

Summer 2016: Arriving in Sierra Leone

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May 12, 2016 | Summer 2016 Penn State Team

Before arrival, many important preparations were taken care of in order to aid in our research on the ground. Once the chemical protocol for our strips was finalized, we stamped 500 of our own test strips and taped filter paper to popsicle sticks. We will use this as a supplemental experiment to testing the community response to the introduction of test strips. Furthermore, we have ten parameter test strips that will be used as an additional supplemental study to gather data for future work. For our primary study we have 10,000 OEM test strip. We created and brought material for our trainings and experimentation and prepared 3 binders with a set of each.

Today we met at World Hope International Headquarters in Makeni, in the Bombali District. We waited for more information on future meetings and assignments for where our experiments will take place and who will help us complete them. We had the opportunity to talk to Hassan, the Supervisor of Social Mobilization. He explained his background, which included overseeing the national burial team needed to combat the Ebola crisis. He did this by educating different members of Sierra Leonean communities, including the leaders of “secret societies” –closed groups within the communities– so that they could use their influence to re-guide traditional burial practices and ultimately reduce the spread of Ebola. Hassan will be helping us identify places that we can begin our venture as well as providing us a more in depth understanding of Sierra Leonean cultures, traditions, and social structure.

Aside from the happenings of our venture, our personal day involved waking up around 7:30 and having a breakfast of mango, eggs, sausage, and really yummy bread at 8:00. Next, we loaded up in the back of a World Hope International van and headed to the headquarters of World Hope International. We waited and then had the opportunity to speak with Hassan, then, around 6, headed off to a restaurant for dinner.

 

Summer 2015 in Zambia

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Conclusion of time in Zambia:

Forty percent of pregnant women will contract a UTI at some point during their nine-month term. In rural areas, a significant percentage of this number will simply never make the trip to a doctor, and without a local and readily available diagnostic or screening tool these women will leave their condition untreated, leading to further serious complications. If a UTI is detected and treated in a timely manner, it is relatively harmless. However, women are suffering from kidney failure, stillborns, and even death because of the lack of knowledge of the infection and the inaccessibility of UTI diagnostic and treatment tools. UTIs are a serious problem in the rural communities that needs to be addressed. By creating a targeted approach that addresses every point on the patient landscape, utilizes CHWs, increases awareness, and creates tools that are affordable, accessible, and specific to the infection, UTIs will no longer prove to be a prevalent issue in rural communities.

Summer 2015 Lab Work

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Conclusions:

1. Teslin paper is not a good choice. Regular printer paper gives a good color change but

is flimsy and must be attached to a stick so it doesn’t tear. Watercolor paper gives a good color change and is durable and does not require a stick.

Next step: Test to see if color changes in the pH strip are influenced by the

acidity of the paper.

2. Printing is not a good method due to printer failures. Clogged ink heads are the most

common failure and can be cleaned by disassembling the printer and flushing with vinegar. This will most likely not be viable in Kenya because it happens so often. Printers are designed only for original manufactured ink. Each printer is disassembled differently but the most recent model is take apart like this: https://www.youtube.com/watch?v=E0kDN0ccBZg

3. Alternative methods that have been tested are stamps and Fantastix pens. Stamps are

large and do not transfer a solid area to the paper so are less reliable. Fantastix pens work well but may look sloppy if the person manufacturing the strips is not careful.

4. Manufacturing is the best option. Details of the best manufacturers can be found in the

corresponding Excel file. The best deal I’ve found so far is for pH strips priced at 3.2 cents/strip. Alibaba.com is a great resource for finding manufacturers.

5. The N-(1-naphthyl)-ethylenediamine dihydrochloride solution, used in the Nitrite test, is

only stable for one month

pH Testing Picture: