Connor, Barbara

Dannan, Tom

Friedman, Daniel

Manyok, Gabriel

Reed, David

Reed, William

English

AJOL - African Journals Online

South Sudan Medical Journal                                                                             Vol 6. No 3. August 2013     67SHorT ITEMSA seasonal variation of the three Leading diagnoses over fifty months at the Duk Lost Boys Clinic, South Sudan   reed, williama, Dannan, Tomb, Friedman Danielc, MD, Manyok gabrield, Connor Barbarae, MD, reed Davidf, MD   IntroductionThe Duk Lost Boys Clinic, a Primary Health Care Clinic in Duk Payuel, is the only Duk County clinic in continuous operation during the study period, serving an estimated 70,000 to 100,000 South Sudanese in Jonglei State. (Figure 1) Maternal Child Health capabilities include prenatal care, immunizations and transfusion capability, HIV/TB/Le i shman i a s i s testing and treatment, nutrition, ultrasound, and midwife attended delivery. Obstacles to clinic access include lack of  roads and commercial transportation, political insecurity, and heavy flooding during the wet season, typically April-November. The objective of  this study was to describe seasonal variation of  monthly patient visits, and totals of  the leading three primary diagnoses over the first fifty months of  operation. MethodsMonthly Clinic Activity Reports were analyzed for number of  total patients, and number of  patients with diagnoses of  malaria, diarrheal disease, and respiratory illness--the three leading primary diagnoses at the clinic. These data were analyzed for correlation with wet and dry season. A t-test (p<0.05) was used to determine correlation between the incidence of  the three leading diagnoses and wet versus dry season. a Cornell University;  b Syracuse University;  c Department of  Internal Medicine, Massachusetts General Hospital;  d Duk Lost Boys Clinic, Data Manager;  e Duk Lost Boys Clinic, Medical Director;  f  Department of  Emergency Medicine, SUNY Upstate Medical      UniversityCorrespondence: David Reed reedd@upstate.eduFigure 1. The Duk Lost Boys ClinicFigure 2:  The percentage of  all patients who presented with either Respiratory Illness, Diarrhea, or Malaria (Yellow lines = Dry season)South Sudan Medical Journal                                                                             Vol 6. No 3. August 2013     68SHorT ITEMSresultsTotal patient visits: 59,915; monthly mean: 1198 (range 471-2457). Respiratory Illness mean: 173 (range 6-393); Malaria mean: 114 (range 12-332). Diarrheal Illness mean: 230 (range 46-644).DiscussionIt is very likely that patients’ inability to travel and access the clinic due to flooding, political instability, as well as potentially, cultural stigmas are major factors influencing how many patients present to the clinic when, and with what disease symptoms. However, these preliminary results offer insight into complexities of  planning for surge-capacity, staffing, and medication requirements during seasonal variations. Conclusion  Monthly data reports do not demonstrate a statistically significant seasonal difference between wet and dry season incidence of  total visits or the three leading primary diagnoses at the clinic during the study period.LimitationsInaccurate or incomplete data in several monthly reports required estimation and averaging to complete the data set for analysis. Varied interpretation of  final primary diagnosis associated with staff  turnover was also a potential confounderacknowledgementsSpecial thanks to the many who have supported the John Dau Foundation in its quest to help develop sustainable health care at the Duk Lost Boys Clinic. Above all, thanks to the staff  at the clinic who work tirelessly towards this goal.Figure 3. Children playing in Duk villageResearch Beyond GoogleThis resource at http://oedb.org/library/college-basics/research-beyond-google provides research tools beyond searching in Google. Google, the largest search database, currently has around 50 billion web pages indexed. But Google can only index the visible web, or searchable web. The invisible web, or deep web, is estimated to be 500 times biggerand includes databases and results of  specialty search engines that the popular search engines simply are not able to index. This link includes: Deep Web Search Engines, Books Online, and Medical and Health. Under Medical and Health it lists the following free sites:PubMed — A service of  the U.S. National Library of  Medicine that includes over 16 million citations from MEDLINE and other life science journals for biomedical articles back to the 1950s. Includes links to full-text articles and related resources.National Institutes of  Health — A searchable encyclopedia of  health topics.U.S. Global Health Policy — A data bank of  world health information, sortable by country, disease, condition, program, or demographic.Centers for Disease Control Data & Statistics — A data bank of  statistical health information compiled by the CDC.ClinicalTrials.gov — Search nearly 150,000 clinical studies from 182 countries around the world.Thanks to Daniel Strauss danielstrauss1988@gmail.com for providing this item.

A seasonal variation of the three Leading diagnoses over fifty months at the Duk Lost Boys Clinic, South Sudan

https://www.ajol.info/index.php/ssmj/article/download/132606/122204

A seasonal variation of the three Leading diagnoses over fifty months at the Duk Lost Boys Clinic, South Sudan

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