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Community—Minimal Invasive Tissue Sampling (cMITS) using a modified ambulance for ascertaining the cause of death: A novel approach piloted in a remote inaccessible rural area in India

BACKGROUND: Melghat in India is a hilly, forested, difficult to access, impoverished rural area in northeast part of Maharashtra (Central India) with difficult healthcare access. Melghat has very high Mortality rates, because of grossly inadequate medical facilities. (1) Home deaths contribute to 67...

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Autores principales: Satav, Ashish, Wairagkar, Niteen, Khirwadkar, Shubhada, Dani, Vibhawari, Rasaily, Reeta, Agrawal, Usha, Thakar, Yagnesh, Raje, Dhananjay, Siraj, Fouzia, Garge, Pradyot, Palaskar, Sameer, Kumbhare, Shraddha, Simões, Eric A. F.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10134564/
https://www.ncbi.nlm.nih.gov/pubmed/37106423
http://dx.doi.org/10.1186/s13690-023-01062-x
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author Satav, Ashish
Wairagkar, Niteen
Khirwadkar, Shubhada
Dani, Vibhawari
Rasaily, Reeta
Agrawal, Usha
Thakar, Yagnesh
Raje, Dhananjay
Siraj, Fouzia
Garge, Pradyot
Palaskar, Sameer
Kumbhare, Shraddha
Simões, Eric A. F.
author_facet Satav, Ashish
Wairagkar, Niteen
Khirwadkar, Shubhada
Dani, Vibhawari
Rasaily, Reeta
Agrawal, Usha
Thakar, Yagnesh
Raje, Dhananjay
Siraj, Fouzia
Garge, Pradyot
Palaskar, Sameer
Kumbhare, Shraddha
Simões, Eric A. F.
author_sort Satav, Ashish
collection PubMed
description BACKGROUND: Melghat in India is a hilly, forested, difficult to access, impoverished rural area in northeast part of Maharashtra (Central India) with difficult healthcare access. Melghat has very high Mortality rates, because of grossly inadequate medical facilities. (1) Home deaths contribute to 67% of deaths,(2) which are difficult to track and where cause of death is mostly unknown. METHODS: A feasibility study was carried out in 93 rural villages and 5 hospitals to assess feasibility of tracking real-time community mortality and to ascertain cause of death in 0–60 months and 16–60 years age group using Minimal Invasive Tissue Sampling (MITS) in purpose-modified ambulance. We used the network of village health workers (VHW)s, to establish real-time community mortality tracking. Upon receipt of reports of home death, we performed MITS within 4 h of death in the vicinity of the village. RESULTS: We conducted 16 MITS. Nine, in MITS ambulance in community and seven at MAHAN hospital. The acceptance rate of MITS was 59.26%. Standard operating procedure (SOP) of conducting community MITS in an ambulance, is established. Major challenges were, Covid19 lockdown, reluctance of tribal parents for consent for MITS due to illiteracy, superstitions and fear of organ removal. Ambulance was an easy to reach transport means in remote area, provided a well-designed and discrete facility to perform MITS in community, winning the confidence of bereaved family. This has reduced time interval between time of death and performing MITS. CONCLUSIONS: MITS in purpose-modified Ambulance can be used worldwide for community MITS especially in areas which are remote and lack healthcare access. This solution needs to be assessed in different cultural settings to document culture specific issues. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13690-023-01062-x.
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spelling pubmed-101345642023-04-28 Community—Minimal Invasive Tissue Sampling (cMITS) using a modified ambulance for ascertaining the cause of death: A novel approach piloted in a remote inaccessible rural area in India Satav, Ashish Wairagkar, Niteen Khirwadkar, Shubhada Dani, Vibhawari Rasaily, Reeta Agrawal, Usha Thakar, Yagnesh Raje, Dhananjay Siraj, Fouzia Garge, Pradyot Palaskar, Sameer Kumbhare, Shraddha Simões, Eric A. F. Arch Public Health Research BACKGROUND: Melghat in India is a hilly, forested, difficult to access, impoverished rural area in northeast part of Maharashtra (Central India) with difficult healthcare access. Melghat has very high Mortality rates, because of grossly inadequate medical facilities. (1) Home deaths contribute to 67% of deaths,(2) which are difficult to track and where cause of death is mostly unknown. METHODS: A feasibility study was carried out in 93 rural villages and 5 hospitals to assess feasibility of tracking real-time community mortality and to ascertain cause of death in 0–60 months and 16–60 years age group using Minimal Invasive Tissue Sampling (MITS) in purpose-modified ambulance. We used the network of village health workers (VHW)s, to establish real-time community mortality tracking. Upon receipt of reports of home death, we performed MITS within 4 h of death in the vicinity of the village. RESULTS: We conducted 16 MITS. Nine, in MITS ambulance in community and seven at MAHAN hospital. The acceptance rate of MITS was 59.26%. Standard operating procedure (SOP) of conducting community MITS in an ambulance, is established. Major challenges were, Covid19 lockdown, reluctance of tribal parents for consent for MITS due to illiteracy, superstitions and fear of organ removal. Ambulance was an easy to reach transport means in remote area, provided a well-designed and discrete facility to perform MITS in community, winning the confidence of bereaved family. This has reduced time interval between time of death and performing MITS. CONCLUSIONS: MITS in purpose-modified Ambulance can be used worldwide for community MITS especially in areas which are remote and lack healthcare access. This solution needs to be assessed in different cultural settings to document culture specific issues. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13690-023-01062-x. BioMed Central 2023-04-27 /pmc/articles/PMC10134564/ /pubmed/37106423 http://dx.doi.org/10.1186/s13690-023-01062-x Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Satav, Ashish
Wairagkar, Niteen
Khirwadkar, Shubhada
Dani, Vibhawari
Rasaily, Reeta
Agrawal, Usha
Thakar, Yagnesh
Raje, Dhananjay
Siraj, Fouzia
Garge, Pradyot
Palaskar, Sameer
Kumbhare, Shraddha
Simões, Eric A. F.
Community—Minimal Invasive Tissue Sampling (cMITS) using a modified ambulance for ascertaining the cause of death: A novel approach piloted in a remote inaccessible rural area in India
title Community—Minimal Invasive Tissue Sampling (cMITS) using a modified ambulance for ascertaining the cause of death: A novel approach piloted in a remote inaccessible rural area in India
title_full Community—Minimal Invasive Tissue Sampling (cMITS) using a modified ambulance for ascertaining the cause of death: A novel approach piloted in a remote inaccessible rural area in India
title_fullStr Community—Minimal Invasive Tissue Sampling (cMITS) using a modified ambulance for ascertaining the cause of death: A novel approach piloted in a remote inaccessible rural area in India
title_full_unstemmed Community—Minimal Invasive Tissue Sampling (cMITS) using a modified ambulance for ascertaining the cause of death: A novel approach piloted in a remote inaccessible rural area in India
title_short Community—Minimal Invasive Tissue Sampling (cMITS) using a modified ambulance for ascertaining the cause of death: A novel approach piloted in a remote inaccessible rural area in India
title_sort community—minimal invasive tissue sampling (cmits) using a modified ambulance for ascertaining the cause of death: a novel approach piloted in a remote inaccessible rural area in india
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10134564/
https://www.ncbi.nlm.nih.gov/pubmed/37106423
http://dx.doi.org/10.1186/s13690-023-01062-x
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