Utilizing three years of epidemiological data from medical missions in Cambodia to shape the mobile medical clinic formulary
DOI:
https://doi.org/10.15566/cjgh.v4i1.156Keywords:
Epidemiological data, Cambodia, Medical missions, Common diseases, Common medications, Mobile clinic formularyAbstract
Objective: The purpose of this project was to gather epidemiological data on common diseases and medications dispensed during medical mission teams to Cambodia to shape the mobile medical clinic formulary.
Methods: Data for patients seen during week-long, mobile, medical clinics was collected in Cambodia during Septembers 2012 to 2014. Patient’s gender, age, weight, blood pressure, glucose, pertinent laboratory values, diagnoses, and medications dispensed were collected. Blood pressure and glucose were measured in patients 18 years and above. Data collected onto paper intake forms were transferred onto spreadsheets without patient identifying information and analyzed for aggregate means, common diseases, and most dispensed medications. This project received institutional review board approval.
Results: A total of 1,015 patients were seen over three years. Women made up 61.4% and the mean age was 41.8 years. The most common diagnosis was gastrointestinal disorders (22.9%), which included gastroesophageal reflux disease and intestinal parasites. Next, 20.1% of patients had hypertension (BP>140/90), 18.0% had presbyopia, 15.4% had back and joint pain, followed by 8.8% with headache, including migraines. Approximately 8.4% of patients had hyperglycemia (RPG >140 mg/dl). Top five medications dispensed were acetaminophen, omeprazole, multivitamin, ibuprofen and metformin. For hypertension, amlodipine and lisinopril were dispensed.
Conclusion: Cambodia lacks systematic public health collection of epidemiological data for prevalence of diseases. Hence, investigators collected and analyzed information from week-long mobile medical clinics over three years. Proton-pump inhibitors and H. pylori lab tests are recommended for gastrointestinal disorders. Acetaminophen and ibuprofen are recommended for pain. Angiotensin-converting-enzyme inhibitors and dihydropyridine calcium channel blockers are recommended over diuretics since patients are already dehydrated. Metformin is recommended for diabetes. Vitamins and supplements are recommended for malnourished patients. Hemoglobin machine and urine test strips are suggested. This information should help future teams decide what medications and laboratory tests are most beneficial on medical teams in Cambodia.
References
National Institute of Statistics, Directorate General for Health, and ICF Macro, 2011. Cambodia Demographic and Health Survey 2010. Phnom Penh, Cambodia and Calverton, Maryland, USA: National Institute of Statistics, Directorate General for Health, and ICF Macro.
https://dhsprogram.com/pubs/pdf/FR249/FR249.pdf. Accessed on January 12, 2016.
Centers for Disease Control and Prevention. Global Health – Cambodia. http://www.cdc.gov/globalhealth/countries/cambodia/. Accessed on January 12, 2016.
The World Factbook. East & Southeast Asia: Cambodia. https://www.cia.gov/library/publications/the-world-factbook/geos/cb.html. Accessed on January 12, 2016.
World Bank (2014). World Bank Databank. http://databank.worldbank.org/. Accessed on January 12, 2016
Department of Planning and Health Information. Annex 1 Situation Analysis. Accessed at http://www.who.int/health_financing/documents/cam_frmwrk-annex_1.pdf. Accessed on January 12, 2015
Meessen B, Van Damme W, Por I, Van Leemput L, Hardeman W. 2002. The New Deal in Cambodia: the second year. Phnom Penh: MSF Cambodia. http://www.unicef.org/evaldatabase/files/Cambodia_New_Deal_rec_347894.pdf
Accessed on January 12, 2016.
James PA, Oparil S, Carter BL, et al. 2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults: Report From the Panel Members Appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2014;311(5):507-520. doi:10.1001/jama.2013.284427.
World Health Organization. Cambodia. http://www.who.int/nmh/countries/khm_en.pdf?ua=1. Accessed September 29, 2015.
Country statistics and global health estimates by WHO and UN partners (http://www.who.int/gho/en/) Last updated: January 2015. Accessed January 26, 2016.
Global Burden of Diseases (GBD) Profile: Cambodia. http://www.healthdata.org/sites/default/files/files/country_profiles/GBD/ihme_gbd_country_report_cambodia.pdf. Accessed January 19, 2016.
King H, Lim K, Seng S, Khun T, Roglic G, Pinget M. Diabetes and associated disorders in Cambodia; two epidemiological surveys. Lancet 2005; 366: 1633–1639. DOI: 10.1016/S0140-6736(05)67662-3
Nwankwo T, Yoon SS, Burt V, Gu Q. Hypertension among adults in the United States: National Health and Nutrition Examination Survey, 2011–2012. NCHS data brief, no 133. Hyattsville, MD: National Center for Health Statistics. 2013.
The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. NIH Publication No. 04-5230 August 2004.
International Diabetes Federation. Cambodia 2015. http://www.idf.org/membership/wp/cambodia. Accessed June 8, 2016.
National Institute of Statistics, Directorate General for Health, and ICF Macro, 2011. 2010 Cambodia Demographic and Health Survey: Key Findings. Phnom Penh, Cambodia and Calverton, Maryland, USA: National Institute of Statistics, Directorate General for Health, and ICF Macro. http://dhsprogram.com/pubs/pdf/SR185/SR185.pdf/. Accessed September 29, 2015.
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