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The ‘Practical Approach to Lung Health' in sub-Saharan Africa: a systematic review

Banda, H, Robinson, R, Thomson, Rachael, Squire, Bertie ORCID: https://orcid.org/0000-0001-7173-9038 and Mortimer, Kevin ORCID: https://orcid.org/0000-0002-8118-8871 (2016) 'The ‘Practical Approach to Lung Health' in sub-Saharan Africa: a systematic review'. International Journal of Tuberculosis and Lung Disease, Vol 20, Issue 4, pp. 552-559.

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Abstract

SETTING: There is a high burden of respiratory disease in sub-Saharan Africa. To address this problem, the World Health Organization launched the ‘Practical approach to Lung Health' (PAL), i.e., locally applicable integrated syndromic algorithms, to improve primary care management of these diseases.

OBJECTIVE: To examine the evidence for the impact of PAL on the diagnosis and management of tuberculosis (TB) and other common respiratory problems in sub-Saharan Africa.

DESIGN: A systematic review of MEDLINE (1998–2015), EMBASE (1998–2015) and CINAHL (1998–2015) was conducted to find trials evaluating PAL implementation in sub-Saharan Africa.

RESULTS: Five studies were found, evaluating three PAL variations: PAL in South Africa (PALSA), PALSA with integrated human immunodeficiency virus treatment (PALSA PLUS) and PAL in Malawi using lay health workers (PALM/LHW). PALSA increased TB diagnosis (OR 1.72, 95%CI 1.04–2.85), as did PALSA PLUS (OR 1.25, 95%CI 1.01–1.55). Cure or completion rates in retreatment cases in PALSA and PALSA PLUS were significantly improved (OR 1.78, 95%CI 1.13–2.76). PALM/LHW, which examined TB treatment success, found no significant improvement (P = 0.578).

CONCLUSION: The limited research performed shows that PAL can be effective in TB diagnosis and partial treatment success; however, more evidence is needed to assess its effects on other respiratory diseases, especially in wider sub-Saharan Africa.

Item Type: Article
Subjects: WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries
WA Public Health > Health Administration and Organization > WA 540 National and state health administration
WF Respiratory System > Tuberculosis > WF 200 Tuberculosis (General)
WF Respiratory System > Lungs > WF 600 Lungs
Faculty: Department: Biological Sciences > Department of Tropical Disease Biology
Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI): https://doi.org/10.5588/ijtld.15.0613
Depositing User: Jessica Jones
Date Deposited: 04 Apr 2016 13:17
Last Modified: 12 Jul 2018 15:32
URI: https://archive.lstmed.ac.uk/id/eprint/5833

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