eHealth as a facilitator of equitable access to primary healthcare: the case of caring for non-communicable diseases in rural and refugee settings in Lebanon

Saleh, Shadi; Alameddine, Mohamad; Farah, Angie; Arnaout, Nour El; Dimassi, Hani; Muntaner, Carles; Morr, Christo El

doi:10.1007/s00038-018-1092-8

Cited by 37 publications

(47 citation statements)

References 28 publications

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“…These isolates could have been acquired while people were visiting other countries where CL is endemic and then imported foreign strains of L. tropica after they return as previously suggested [15]. Isolates LT1, LT2 and Kubba collected from Lebanon and Syria, respectively, clustered together under population IV consistent with either a transfer event associated with human displacement of refugees [61][62][63][64][65] crossing the Syrian-Lebanon border or movements of the sandfly vector.…”

Section: Plos Neglected Tropical Diseasesmentioning

confidence: 68%

Expanded genome-wide comparisons give novel insights into population structure and genetic heterogeneity of Leishmania tropica complex

et al. 2020

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Leishmania tropica is one of the main causative agents of cutaneous leishmaniasis (CL). Population structures of L. tropica appear to be genetically highly diverse. However, the relationship between L. tropica strains genomic diversity, protein coding gene evolution and biogeography are still poorly understood. In this study, we sequenced the genomes of three new clinical L. tropica isolates, two derived from a recent outbreak of CL in camps hosting Syrian refugees in Lebanon and one historical isolate from Azerbaijan to further refine comparative genome analyses. In silico multilocus microsatellite typing (MLMT) was performed to integrate the current diversity of genome sequence data in the wider available MLMT genetic population framework. Single nucleotide polymorphism (SNPs), gene copy number variations (CNVs) and chromosome ploidy were investigated across the available 18 L. tropica genomes with a main focus on protein coding genes. MLMT divided the strains in three populations that broadly correlated with their geographical distribution but not populations defined by SNPs. Unique SNPs profiles divided the 18 strains into five populations based on principal component analysis. Gene ontology enrichment analysis of the protein coding genes with population specific SNPs profiles revealed various biological processes, including iron acquisition, sterols synthesis and drug resistance. This study further highlights the complex links between L. tropica important genomic heterogeneity and the parasite broad geographic distribution. Unique sequence features in protein coding genes identified in distinct populations reveal potential novel markers that could be exploited for the development of more accurate typing schemes to further improve our knowledge of the evolution and epidemiology of the parasite as well as highlighting protein variants of potential functional importance underlying L. tropica specific biology.

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Section: Plos Neglected Tropical Diseasesmentioning

confidence: 68%

Expanded genome-wide comparisons give novel insights into population structure and genetic heterogeneity of Leishmania tropica complex

et al. 2020

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“…Telemedicine could be a promising strategy [39]. It was found that e-health might be a facilitator in gaining access to health care as well as to overcoming transport barriers [40,41]. It was also recommended that strengthening continuity of care for refugees could be achieved through patient-held personal health records [42].…”

Section: Discussionmentioning

confidence: 99%

Equity in Health Care: A Qualitative Study with Refugees, Health Care Professionals, and Administrators in One Region in Germany

Hahn

Steinhäuser

Goetz

2020

BioMed Research International

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Introduction. Equity in health is an essential issue and it would appear that it is not guaranteed for all human beings, especially refugee groups. The aim of this qualitative descriptive study was to explore the experiences of refugees, health care professionals, and administrators of refugee health care in a host country. Methods. The study used qualitative methods which consisted of a convenience sample of stakeholders directly and indirectly involved in care for refugees and refugees themselves. The study participants were located in a rural area in the federal state of Schleswig-Holstein, Germany. Focus groups and interviews were conducted with 25 participants. A semistructured interview guideline was used for the focus groups and interviews. The data were evaluated using qualitative content analysis. Results. Four main categories were identified which are important for equity in health care: legal aspects, sociocultural aspects, environmental aspects, and communication aspects. Legal frameworks and language barriers were perceived as strong barriers for accessing health care. Conclusions. The findings suggest that the host countries should address the specific needs of this population group at a systemic and individual level. Based on the views of the participants interviewed it can be concluded that the refugee population group is particularly affected by limited access to health care services. Bureaucratic barriers, unfamiliarity with a new health system, and language issues all contribute to limiting access to health care services.

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“…This study was part of a larger study that employed a community mapping approach where adults residing in several rural areas of Lebanon were screened for chronic disease(s) and consequently referred to primary healthcare centers [11,12].…”

Section: Methodsmentioning

confidence: 99%

Trusting the Pharmacist in Delivering Medication Information: A Community-Based Perspective

Dimassi

Makhoul

Khabsa

et al. 2019

Int J Pharm Pharm Sci

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Objective: Optimal disease management is influenced by a solid patient-health provider relationship; which includes trust in the provider. The study compares respondents’ trust in pharmacists and physicians for the delivery of drug information. Methods: Residents of 3 rural communities in Lebanon, aged 40 and above, were invited to participate in the study, 760 accepted. Participants were asked who they trust the most with information about their medication: their physician or their pharmacist. Results: Of the total sample, 154 chose the pharmacist as their most trusted source of medication information (20%). Characteristics associated with choosing the pharmacist were: being a male (29.3% vs 16.2% p<.001), of younger age (31.5% among<50 y, 18.8% among 50-64 y, and 14.6% among 65+years p<.001), single (31.6% vs 21.9% married and 9.3 others, p=0.023), working (39.2% vs15.7% p<.001), and insured (2.3% vs 16.4% p=0.048). The multivariate logistic regression model revealed that having a family member with hypertension (OR=1.86 95% 1.23-2.82), or cardiovascular (OR=3.39 95%CI 1.55-7.45) increased the likelihood of trusting pharmacists over medical doctor. On the other hand, a self-report of cardiovascular disease (OR=0.34 95% CI 0.12-0.95) and taking medication (OR=0.41 95% CI 0.25-0.67) were associated with a decrease in the trust in the pharmacist in favor of the physician. Conclusion: Although pharmacists are the drug specialists, the majority of the Lebanese rural community residents reported higher trust in their physicians with information about their medication(s).

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eHealth as a facilitator of equitable access to primary healthcare: the case of caring for non-communicable diseases in rural and refugee settings in Lebanon

Abstract: Low-cost eHealth netbook application was deemed effective in identifying new cases of NCDs and establishing appropriate referrals in underserved communities.

Cited by 37 publications

References 28 publications

Expanded genome-wide comparisons give novel insights into population structure and genetic heterogeneity of Leishmania tropica complex

Expanded genome-wide comparisons give novel insights into population structure and genetic heterogeneity of Leishmania tropica complex

Equity in Health Care: A Qualitative Study with Refugees, Health Care Professionals, and Administrators in One Region in Germany

Trusting the Pharmacist in Delivering Medication Information: A Community-Based Perspective

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