Enfermedad Diarreica Aguda en el Departamento de Nariño

El presente trabajo se encuentra enfocado en analizar la situación sobre la enfermedad con mayor incidencia en el Departamento de Nariño, teniendo en cuenta su historia natural, datos estadistas sobre su comportamiento en los últimos 10 años, además de identificar y describir los programas y estrategias implementadas por las instituciones implicadas para su control. La enfermedad con mayor incidencia es la Enfermedad Diarreica Aguda EDA, la cual es un problema de salud pública más común en niños, y es la segunda causa de morbilidad y mortalidad a escala mundial, además se presenta en lugares en donde las condiciones higiénicas no son muy buenas y se presenta en las zonas más desprotegidas.The present work is focused on analyzing the situation on the disease with greater incidence in the Department of Nariño, taking into account its natural history, statistical data on its behavior in the last 10 years, as well as identifying and describing the programs and strategies implemented by the institutions involved for its control. The disease with greater incidence is the Acute Diarrheic Disease EDA, which is a public health problem more common in children, and is the second cause of morbidity and mortality worldwide, also occurs in places where hygienic conditions are not very good and is presented in the most unprotected areas

Impact of hospital characteristics on implementation of a Pediatric Early Warning System in resource-limited cancer hospitals

BackgroundPediatric Early Warning Systems (PEWS) aid in identification of deterioration in hospitalized children with cancer but are underutilized in resource-limited settings. Proyecto EVAT is a multicenter quality improvement (QI) collaborative in Latin America to implement PEWS. This study investigates the relationship between hospital characteristics and time required for PEWS implementation.MethodsThis convergent mixed-methods study included 23 Proyecto EVAT childhood cancer centers; 5 hospitals representing quick and slow implementers were selected for qualitative analysis. Semi-structured interviews were conducted with 71 stakeholders involved in PEWS implementation. Interviews were recorded, transcribed and translated to English, then coded using a priori and novel codes. Thematic content analysis explored the impact of hospital characteristics and QI experience on time required for PEWS implementation and was supplemented by quantitative analysis exploring the relationship between hospital characteristics and implementation time.ResultsIn both quantitative and qualitative analysis, material and human resources to support PEWS significantly impacted time to implementation. Lack of resources produced various obstacles that extended time necessary for centers to achieve successful implementation. Hospital characteristics, such as funding structure and type, influenced PEWS implementation time by determining their resource-availability. Prior hospital or implementation leader experience with QI, however, helped facilitate implementation by assisting implementers predict and overcome resource-related challenges.ConclusionsHospital characteristics impact time required to implement PEWS in resource-limited childhood cancer centers; however, prior QI experience helps anticipate and adapt to resource challenges and more quickly implement PEWS. QI training should be a component of strategies to scale-up use of evidence-based interventions like PEWS in resource-limited settings