Pedro Galván

Epidemiological Surveillance Using Information Technologies in Paraguay

This article presents the early work on a project in Paraguay for epidemiological surveillance using information technologies. This project is a response of our university to a governmental request to establish links of cooperation and development between academic public sectors of Spain and Paraguay. The overall project objective is the promotion ofa healthy citizenry through the application of information and communication technologies to the monitoring of populations vulnerable to febrile syndromes (FS). The goal of this project is to create the infrastructure that will allow the population of the country to easily communicate with health centers and provide information on cases of FS. The telephone network will be the main physical support for this communication. The project was formally initiated in January 2009 with the implementation of the prototype system. During the first half of 2010, the pilot project will be implemented in Asunción, Paraguay.

Health diagnosis improvement in remote community health centers through telemedicine

Introduction: Information and communication technologies (ICTs) applied to the healthcare offer multiple advantages for diagnostic services and remote consultations. However, evidence on the diagnosis improvement in rural communities is limited. The usability of telemedicine to improve the coverage of diagnostic services in Paraguay was investigated. Methods: The goal of this descriptive study was to evaluate whether a telemedicine system implemented in remote public regional and district hospitals in Paraguay over a period of 3 years from 2014 to 2016 could facilitate the universal coverage of diagnostic services in rural communities. Results: In the study period, 182,406 remote diagnoses from 54 hospitals through a telemedicine system were performed. Of the total, 37.31% (68,085) corresponded to tomography, 62.00% (113,059) to electrocardiogram (ECG), 0.68% (1243) to electroencephalogram (EEG), and 0.01% (19) to ultrasound (US). Tomography was performed in 12 hospitals: 54.4% corresponded to head injuries, 13.8% to chest, and the rest to other anatomical regions. ECG was carried out in 52 hospitals; and in 62.1% of the cases, the results were normal; 12.5% unspecified arrhythmias; and 10.4% sinus bradycardia among the most frequent pathologies. EEG diagnosis showed history of seizure (54.3%), evolutionary control (14.0%), and headache (11.5%) among the most frequent diagnoses. All 19 US studies corresponded to prenatal control. Conclusion: These results showed that telemedicine may enhance the diagnostic services in rural communities, thus reducing the number of referrals and optimizing human and financial resources.

Exploring the Implementation of e-Health Practices in a Low Income Country

In low income countries like Paraguay, broad segments of the population have only limited access to health services and lack sufficient human and financial resources as well as infrastructure for an appropriate health service delivery. At the same time, access to information and communication technologies (ICTs) varies across countries and population groups.

P1-104 Community syndromic surveillance system using information and communication technology in Paraguay

The objective of syndromic surveillance is to identify illness clusters early and to mobilise a rapid response, thereby reducing morbidity and mortality. Objective To describe the system named Bonis, which uses Information and Communication Technology to prevent, warn, monitor and control the spread of febrile syndromes and influenza like illness (ILI) at the community level. Methods Bonis has a kernel free software application; Asterisk, a phone center with VoIP service, PHP as Script language and Mysql as data base management. The system was implemented in a primary healthcare. Results The developed system has the ability to record, classify, and prioritise automatically through the Interactive Voice Response the suspected cases. It has been programmed in a PHP language script AGI to improve the functionality of the Asterisk, in a way that during the user call to report a possible case, the system feeds a database, through the manager module based in a web application developed in PHP. The system, to which the users access from a mobile or fixed telephone, automatically receives the call with 9 questions on signs and symptoms. The system is working since May 2010 and records the phone calls correctly; follow-ups of these patients are performed by the teams within a period of 24 h. Conclusion The developed system is allowing the community to notify and register events that require surveillance, and the community health agents is prioritising visits to those homes from where fever cases are reported for sooner and more appropriate interventions.