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Early Care following Traumatic Spinal Cord Injury (TSCI) in a Rehabilitation Centre in Bangladesh - An Analysis

RAZZAK, A T M A
2013

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Purpose: The study aimed to explore the outcome of current practices in the treatment of persons with traumatic spinal cord injuries (TSCI) in Bangladesh, through the stages of rescue and first contact with physician, transportation to the tertiary hospital and intermediate admission.

 

Method: This observational study was conducted between June and August 2011, at the Centre for the Rehabilitation of the Paralysed (CRP), in Dhaka, Bangladesh. From the 113 persons with SCI admitted at CRP during this period, 56 persons with TSCI were selected. With the help of a questionnaire, data were collected from these persons or their attendants by trained staff, and also taken from hospital records. Data were processed and analysed by SPSS software version 16.

 

Results: The male-female ratio among the study participants was 5.25: 1, with a mean age of 33.02 years. 55.3% of them were paraplegic, while 44.7% were tetraplegic. About 70% of the injuries were complete according to ASIA impairment scale (AIS) during admission at CRP.

 

The most common causes of injury were falls (50%), followed by road traffic accidents (RTA) and carrying loads on the head. 74.8% of the injured persons had been rescued from the accident site by local people but only 16.1% had been transported by ambulance. The spine board had never been used. More than half of the injured received initial treatment only at a sub-district or district hospital where none of the requisite facilities were available.

 

While being transported from one hospital to the other, 10.7% experienced neurological deterioration of some sort. Significant statistical correlation was found between mode of transfer (P <0.03) and intermediate admission (P<0.001)with neurological deterioration.

 

Conclusions: There is an urgent need to implement pre-hospital trauma care in Bangladesh. Since resources and places for the rehabilitation of persons with TSCI are scarce, regional and national spinal injury centres should be established without delay.

 

Limitations: The study focussed only on a small sample of persons with TSCI undergoing treatment at a single centre.

Disability transitions and health expectancies among adults 45 years and older in Malawi : a cohort-based model

PAYNE, Colin F
MKANDAWIRE, James
KOHLER, Hnas-Peter
May 2013

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This article presents the results of study that investigated how poor physical health results in functional limitations that limit the day-to-day activities of individuals in domains relevant to this subsistence-agriculture context. Participants came from 2006, 2008, and 2010 waves of the Malawi Longitudinal Survey of Families and Health, a study of the rural population in Malawi. The study found that individuals in this population experience a lengthy struggle with disabling conditions in adulthood, with high probabilities of remitting and relapsing between states of functional limitation. Given the strong association of disabilities with work efforts and subjective well-being, this research suggests that current national health policies and international donor-funded health programs in SSA inadequately target the physical health of mature and older adults.

 

PLoS Med Vol 10, Issue 5

Strengthening communities to integrate persons with disabilities in the HIV and AIDS response in Rwanda

DELEU, Marijke
May 2013

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"This document aims to capture some of the key lessons learned from Handicap International’s New Partnership Initiative project in Rwanda, which started in 2008 with the objective to integrate persons with disabilities in HIV and Sexual Violence (SV) prevention efforts and service provision generally. It is the result of qualitative, multi-stakeholder study about how change occurred within the project and how the experience could be modelled for adaptation or replication in Rwanda or other contexts"
SD/LL 08

Towards preventing torture and ill-treatment in health-care settings

MENDEZ, Juan E
February 2013

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"The present report focuses on certain forms of abuses in health-care settings that may cross a threshold of mistreatment that is tantamount to torture or cruel, inhuman or degrading treatment or punishment. It identifies the policies that promote these practices and existing protection gaps. By illustrating some of these abusive practices in health-care settings, the report sheds light on often undetected forms of abusive practices that occur under the auspices of health-care policies, and emphasizes how certain treatments run afoul of the prohibition on torture and ill-treatment. It identifies the scope of State's obligations to regulate, control and supervise health-care practices with a view to preventing mistreatment under any pretext. The Special Rapporteur examines a number of the abusive practices commonly reported in health-care settings and describes how the torture and ill-treatment framework applies in this context. The examples of torture and ill-treatment in health settings discussed likely represent a small fraction of this global problem"
A/HRC/22/53

Differences in HIV knowledge and sexual practices of learners with intellectual disabilities and non-disabled learners in Nigeria

ADEEMI, Toyin
PILLAY, Basil
ESTERRHUIZEN, Tonya
February 2013

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"This study sought to compare the HIV knowledge and sexual practices of learners with mild/moderate intellectual disabilities and non-disabled learners (NDL) in Nigeria. Findings could help in the development of HIV interventions that are accessible to Nigerian learners with intellectual impairments"
Journal of the International AIDS Society, Vol 16

Why do women not use antenatal services in low- and middle-Income countries? a meta-synthesis of qualitative studies

FINLAYSON, Kenneth
DOWNE, Soo
January 2013

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This article aims to inform the development of future antenatal care programmes through a synthesis of findings in all relevant qualitative studies. The findings suggest that there may be a misalignment between current antenatal care provision and the social and cultural context of some women in low and middle income countries
PLoS Med, Vol 10, Issue 1

The global status report on road safety 2013 : supporting a decade of action

WORLD HEALTH ORGANIZATION (WHO)
2013

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"This report presents information on road safety from 182 countries, accounting for almost 99% of the world’s population. The report indicates that worldwide the total number of road traffic deaths remains unacceptably high at 1.24 million per year. Only 28 countries, covering 7% of the world’s population, have comprehensive road safety laws on five key risk factors: drinking and driving, speeding, and failing to use motorcycle helmets, seat-belts, and child restraints. This report serves as a baseline for the Decade of Action for Road Safety 2011-2020, declared by the UN General Assembly. This is the second in a Global status report series"

International perspectives on spinal cord injury

BICKENBACH, Jerome
et al
Eds
2013

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This report assembles and summarizes information on spinal cord injury, in particular the epidemiology, services, interventions and policies that are relevant, together with the lived experience of people with spinal cord injury. It also provides recommendations for actions based on this evidence that are consistent with the aspirations for people with disabilities as expressed in the Convention on the Rights of Persons with Disabilities

Creating a world as it should be : the power of disabled women activists

MOBILITY INTERNATIONAL USA (MIUSA)
December 2012

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Through interviews with women with disabilities, this video highlights the vision, determination, challenges and recommendations for including women and girls in international development programs. The video documents the power of women leaders with disabilities in their aim to be included in international development programs

Diabetes and cardiovascular disease policy brief

OLCHINI, Davide
PASQUIER, Estelle
GUIMET, Pauline
September 2012

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"This policy brief is an introduction to Handicap International’s 2012 policy paper on diabetes and other cardiovascular risk factors. It provides an overview of Handicap International's activities in this sector"
Policy brief 6

Mental health in post-crisis and development contexts

PÉGON, Guillaume
September 2012

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This brief provides an overview of Handicap International's activities in mental health in post-crisis and development contexts. Handicap International’s mental health projects specifically address the mental health of people with psychosocial and mental disabilities or with intellectual disabilities
PP brief No 3

Contingency planning guide

INTERNATIONAL FEDERATION OF RED CROSS AND RED CRESCENT SOCIETIES
2012

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This document provides an overview of the key elements of contingency planning. This guide is aimed at assisting National Society and IFRC staff responsible for developing contingency plans at the local, national, regional or global levels. It is essential to develop contingency plans in consultation and cooperation with those who will have to implement or approve them. This document provides guidelines, not strict rules; planning priorities will differ according to the context and scope of any given situation. This guide breaks contingency planning down into five main steps: prepare, analyse, develop, implement and review. Each step is covered by a separate chapter in this document

Inclusive and integrated HIV and AIDS programming : promoting universal access for all

MAC-SEING, Muriel
July 2012

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"This policy paper describes Handicap International’s mandate and values in operational terms as applied to the theme of inclusive and integrated HIV and AIDS programming. It presents the approaches and references for Handicap International’s actions, choices and commitments. It aims to ensure coherence in terms of practices whilst taking into account different contexts. Essentially this is a guidance document for programme staff which defines the topic and outlines the target populations, methods of intervention (expected results, activities) and indicators for monitoring and evaluation. This policy aims to ensure that all projects carried out by Handicap International programmes are consistent with the methods of intervention presented"
PP 07

Diabetes and other cardiovascular risk factors

GUIMET, Pauline
PASQUIER, Estelle
OLCHINI, Davide
July 2012

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"This document is an operational guideline produced specifically for Handicap International’s programmes. It is intended to provide them with guidance and a framework for each stage of the project cycle (project development, implementation, monitoring and evaluation) for projects tackling the theme of diabetes and other cardiovascular risk factors (CVRF)"
Policy paper 6

IDDC policy briefing on HIV and AIDS and disability

INTERNATIONAL DISABILITY AND DEVELOPMENT CONSORTIUM HIV AND AIDS AND DISABILITY TASK GROUP
June 2012

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This policy brief presents information highlighting that persons with disabilities are at equal or higher risk of HIV infection than the rest of the community for the following reasons: poor access to information on sexual and reproductive health and HIV&AIDS; poor access to health care, including HIV&AIDS services; poverty and marginalisation; and high rates of sexual abuse and exploitation. Recommended actions are provided to increase the participation of persons with disabilities in the HIV response and ensure they have access to HIV services

Tackling NCDs : a different approach is needed

DE MAESENEER, Jan
et al
May 2012

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"The NCD Alliance aims to put non-communicable diseases (NCDs) on the global agenda to address the NCD-crisis. Improving outcomes in morbidity and mortality by 2015 will clearly depend to a large extent on tackling the burden of NCDs, especially in developing countries"
To access this article, users need to register (free) online
The Lancet, Vol 379, Issue 9829

Inclusive and integrated HIV and AIDS programming

MAC-SEING, Muriel
March 2012

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"This policy brief is an introduction to Handicap International’s 2012 Policy Paper "Inclusive and integrated HIV and AIDS programming". Handicap International promotes an inclusive approach to improving quality of life and access to services for persons with disabilities. This means that basic health care and socioeconomic services are developed according to the principle of Universal Access, where all people with impairments (whether physical, sensory, intellectual or mental), have equal access and opportunities for participation. This inclusive approach also ensures that gender considerations and disparities are acknowledged as a cross-cutting issue"
Policy brief No 7

A Low-intensity Approach for Early Intervention and Detection of Childhood Disability in Central Java: Long-term Findings and Implications for “Inclusive Development”

KUIPERS, P
MARATMO, J
2012

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Purpose: This paper describes a qualitative follow-up study, conducted eight years after completion of a low-intensity early intervention and detection of childhood disability project in Central Java, Indonesia. The original project sought to increase the level of skills and engagement of existing community health volunteers, for the support of children with disabilities. This follow- up study explored long-term outcomes and implications for the inclusive development approach.

 

Method: Semi-structured interviews were conducted with 18 of the original volunteers. Interview notes were translated and thematically categorised.

 

Results: While the study was qualitative and descriptive, results indicate that despite the low intensity of the project, some early detection and prevention activities were still going on eight years later.

 

Conclusions: The study suggests that a low-intensity initiative such as this, which is closely aligned with the goals of a government department, may indeed achieve some ongoing change by extending the focus of the department towardsdisability-related concerns.

 

Implications: Implications are drawn for the emerging area of “inclusive development”, which similarly seeks to promote change in mainstream services for the benefit of people with disabilities.

Helmet use among motorcyclists in Cambodia : a survey of use, knowledge, attitudes, and practices

BACHANI, Abdulgafoor M
et al
2012

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"Road traffic injuries (RTIs) are a leading cause of disability and fatality globally. Motorcycle-related injuries, mainly head injuries, and related deaths and disabilities are a significant contributor to the burden of disease in low- and middle-income countries (LMICs). Helmets have been proven to be an effective way to reduce the risk of head injury. As motorcycle use continually increases in Cambodia, head injuries and related deaths and disabilities are expected to rise. This article aims to assess the current status of helmet use in Cambodia, as well as the knowledge, attitudes, and practices among motorcyclists, in order to assist with better planning and implementation of injury prevention strategies"
Traffic Injury Prevention, Vol 13, Supplement 1

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