Master's Culminating Experience
Introduction. International medical aid in the form of short-term medical missions (STTMs) receives more than $250 million in annual donations. Needs assessments prior to the STTM and outcomes analysis for improvement are often lacking. Objective. Describe the patient population attended to during a one-week STTM in Paraguay, South America, while examining “parasites” as a presenting concern, as a diagnosis by the providers, and the prescription of antiparasitic treatment. This analysis identified variance in intestinal parasite presentation and management by age, gender, and location. The administration frequency of antiparasitic medication was considered as prophylactic versus disease-treatment based.
Methods. This study was a chart review of de-identified clinic records from a temporary primary care clinic in the Capital District, Paraguay, in June, 2011.
Results. Thirty percent of patients presented with “parasites,” most prevalent among females and adults (p = 0.0520 and p = 0.0730, respectively). Forty-six percent of patients were diagnosed with “parasites” and 51% were prescribed antiparasitic medication. Females more frequently received antiparasitic medication (p = 0.0660). Seventy-eight percent of patients were indicated for prophylactic antiparasitic administration; only 48% received medication. Eighty-eight percent of patients indicated for antiparasitic administration (either prophylactically or by diagnosis) received medication.
Conclusion. Antiparasitic medication prescription tended toward treating newly diagnosed clinical disease, as opposed to broad prophylactic administration of antiparasitic medication to at-risk populations. Future STMMs should focus on an approach to the prevention, treatment, and eradication of intestinal parasites via education, improved sanitation, and longitudinal presence in conjunction with local medical infrastructure.
Eick, R. A. (2013). Parasites in Paraguay: An Analysis of the Presentation and Management of Intestinal Parasites by Short-Term Medical Mission Volunteers in Paraguay. Wright State University, Dayton, Ohio.