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dc.contributor.authorCochran, Margaret
dc.date.accessioned2019-12-05T09:16:34Z
dc.date.created2018-05
dc.date.issued2019-03-26
dc.date.submitted2018
dc.identifier.citationCochran, Margaret. 2018. Heat CT Findings at a Public Hospital in Rural Haiti. Doctoral dissertation, Harvard Medical School.
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:41973505*
dc.description.abstractBackground: Neuroimaging is often unavailable in low-income countries, creating challenges for precise diagnosis of neurologic disease in individual patients, and impeding acquisition of precise neuroepidemiologic data for program and policy development. Methods: We analyzed reports from 3614 head CTs performed between July 2013 and January 2016 at Hôpital Universitaire de Mirebalais, a publicacademic hospital in rural Haiti, extracting patients' age, study indication, and radiologic findings. Results: The most common indications for head CT were headache (27%), trauma (19.9%), abnormal neurological exam (12.2%), and stroke (11.3%). The most common categories of neurologic abnormalities were traumatic (31%), vascular (25.8%), and infectious (12%). Of 291 strokes, 64% were ischemic (median age at diagnosis 60.8 years, SD 17.4) and 36% were hemorrhagic (median age 52.0, SD 15.5). In patients undergoing head CT for seizures or epilepsy, 17.5% had evidence of neurocysticercosis. In patients with head trauma, 42.6% had intracranial hemorrhage or fracture. Atrophy was noted on 10% of CTs (median age 57.1; SD 23.8), and was characterized as out of proportion to age in 2% (median age 34.1, SD 15.3). Conclusions: Median age of stroke patients in this rural low-income population is lower than in high-income countries and proportion of stroke due to intracerebral hemorrhage is higher. Neurocysticercosis is present in nearly one fifth of patients with seizures/epilepsy. These findings can inform policies and programs for prevention and treatment of neurologic disease in low-income settings.
dc.description.sponsorshipScholarly Project
dc.format.mimetypeapplication/pdf
dc.language.isoen
dash.licenseLAA
dc.subjectGlobal health
dc.subjectneurology
dc.subjectepidemiology
dc.titleHeat CT Findings at a Public Hospital in Rural Haiti
dc.typeThesis or Dissertation
dash.depositing.authorCochran, Margaret
dc.date.available2019-12-05T09:16:34Z
thesis.degree.date2018
thesis.degree.grantorHarvard Medical School
thesis.degree.grantorHarvard Medical School
thesis.degree.levelDoctoral
thesis.degree.levelDoctoral
thesis.degree.nameDoctor of Medicine
thesis.degree.nameDoctor of Medicine
dc.type.materialtext
dash.identifier.vireo
dash.author.emailmaggiefcochran@gmail.com


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