Health Systems for Outcomes Publication | Using qualitative data from Rwanda, this study focuses on four institutional factors that affect health worker performance and career choice: incentives, monitoring arrangements, professional norms and health workers’ intrinsic motivation. It also provides... illustrations of three institutional innovations that work, at least in the context of Rwanda: performance pay, the establishment of community health workers and increased attention to the training of health workers.
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Rev Mex Patol Clin Med Lab 2020; 67 (2): 93-112: La tuberculosis (TB) es en la actualidad la patología de tipo infeccioso que causa mayor número de muertes alrededor del mundo cada año. La percepción acerca de esta entidad ha cambiado a lo largo del tiempo, ya que se consideraba que se relaciona...ba con la pobreza y las consecuencias de la misma como desnutrición, hacinamiento y promiscuidad; sin embargo, en los últimos 40 años con la aparición de la infección del virus de la inmunodeficiencia humana (VIH) los casos comenzaron a incrementarse, además de la aparición de nuevas sepas multirresistentes a la terapéutica convencional, lo que indudablemente ha provocado la reemergencia de esta entidad así como la potencialización en su letalidad.
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The objective of the study was the validation and implementation of GeneXpert MTB/RIF for routine use in the rapid detection of tuberculosis and sensitivity to rifampicin in clinical samples; for this, 1592 respiratory samples were collected and analyzed in the laboratory of Instituto Nacional de In...vestigación en Salud Pública Guayaquil. The analysis of the results of GeneXpert in comparison with smear microscopy showed an initial sensitivity of 99.8% and specificity of 93.2%; The analysis of discrepancies using the results of the culture as a reference method showed that the GeneXpert results considered false negatives turned out to be true negatives, the same happens with the false positives that correspond to true positives. Recalculated the sensitivity and specificity of the GeneXpert was 99.8% and 100% correspondingly. The comparison with the drugs susceptibility test showed a sensitivity of 91.4% and a specificity of 95.5% for the GeneXpert MTB/RIF system. It is concluded that the implementation of the GeneXpert system allows solution to certain problems associated with the application of conventional diagnostic methodologies, decreasing the waiting times, and increasing the sensitivity and specificity in the diagnosis of drug-resistant tuberculosis, thus generating a valuable opportunity for early diagnosis.
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Manual de Normas para el Diagnóstico y Tratamiento de Chagas Congénito