Abstract
An 8-year-old previously healthy female presented with a 3 weeks history of headache, neck stiffness, deafness, fever and vomiting and was diagnosed with cryptococcal meningitis. She had documented hearing loss and was referred to tertiary-level care after treatment with fluconazole did not improve her neurological signs and symptoms. Her symptoms slowly resolved over two months. This case report illustrates the occurrence of cryptococcal meningitis in a non-immunocompromised patient, as well as the challenges of providing effective care in resource-limited settings.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 330-331 |
| Number of pages | 2 |
| Journal | Malawi Medical Journal |
| Volume | 29 |
| Issue number | 4 |
| DOIs | |
| State | Published - Dec 2017 |
Bibliographical note
Funding Information:Reasons for failing to integrate mobile solutions of iCCM can be attributed to a mixture of technical, financial, regulatory and local political factors (often hindered by lack of a country-level HIS). This may involve lengthy and complicated negotiations with multiple stakeholders, which may be at odds with external organizations with specific agendas of satisfying funding objectives. In the authors’ case, proving end-to-end functionality with sufficient confidence and in time for standalone evaluation in a clinical trial was not possible. Interoperability of mobile solutions of iCCM with district and national HIS, needs to be prioritized. Whilst use of both mobile and paper iCCM in the diagnostic work-up of children has been viewed as acceptable to CHWs in previous research13, the practical and financial sustainability of this approach, should be carefully considered. If the standalone potential of these types of interventions is to be truly determined, and a compelling case made for government and investor “buy-in”, establishing whether interoperability is achievable needs to be part of programmatic research agendas and supported by local leadership. Exploration of the compatibility and readiness of country-level HIS to support connected systems also warrants investigation. Finally, open architecture more conducive to interoperability is worthy of consideration for leveraging connectedness between programs that are siloed from each other, as well as health systems23. Acknowledgements This study received funding from the European Union’s Seventh Framework Programme for research, technological development and demonstration under grant agreement no 305292. References
Publisher Copyright:
© 2017 The College of Medicine and the Medical Association of Malawi.