Management of patients with acute infections in resource-limited settings: towards new host biomarker-based tools to improve triage and risk stratification
[eng] INTRODUCTION: Acute infections are a leading reason for seeking healthcare globally. However, the triage and risk stratification of patients with such infections remain challenging across different healthcare levels. In resource-limited settings, this is exacerbated by scarce clinicians, medic...
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| Tipo de recurso: | tesis doctoral |
| Estado: | Versión publicada |
| Fecha de publicación: | 2025 |
| País: | España |
| Institución: | Universidad de Barcelona |
| Repositorio: | Dipòsit Digital de la UB |
| OAI Identifier: | oai:diposit.ub.edu:2445/221580 |
| Acceso en línea: | https://hdl.handle.net/2445/221580 http://hdl.handle.net/10803/694663 |
| Access Level: | acceso abierto |
| Palabra clave: | Malalties infeccioses Epidemiologia Marcadors bioquímics Triatge (Medicina) Moçambic Communicable diseases Epidemiology Biochemical markers Triage (Medicine) Mozambique |
| Sumario: | [eng] INTRODUCTION: Acute infections are a leading reason for seeking healthcare globally. However, the triage and risk stratification of patients with such infections remain challenging across different healthcare levels. In resource-limited settings, this is exacerbated by scarce clinicians, medical supplies, and equipment. Current strategies have inherent limitations and rely heavily on the subjective judgment of healthcare workers. Delays in the recognition and appropriate management of patients at risk of poor outcomes contribute to preventable mortality and morbidity, while unnecessary hospitalizations and overtreatment lead to misallocation of healthcare resources and promote antimicrobial resistance. Furthermore, overreliance on subjective criteria can result in inequities in clinical evaluation and decision-making, including gender-based disparities. New, simple, accurate, objective, and inexpensive tools for triage and risk stratification are needed. HYPOTHESIS: The overarching hypothesis of this thesis is that measuring host biomarkers in patients with acute infections would improve current patient triage and risk stratification practices in resource-limited settings and trigger more equitable management decisions, with a positive impact on clinical outcomes. Specific hypotheses are: i) Boys and girls in Manhiça district, southern Mozambique, differ in access to and provision of healthcare, and ii) In pediatric and adult patients with suspected acute infections in Mozambique, measuring host biomarkers can help identify individuals at risk of adverse outcomes or with specific organ injury. OBJECTIVES: This thesis presents two general objectives: i) To describe pediatric healthcare in Manhiça district through a gender lens, and ii) To evaluate whether measuring host biomarkers can help identify individuals at risk of adverse outcomes or with specific organ injury in different clinical scenarios involving pediatric and adult patients with suspected acute infections in Mozambique. |
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