TY - JOUR
T1 - Using geospatial techniques to develop an emergency referral transport system for suspected sepsis patients in Bangladesh
AU - Chowdhury, Atique Iqbal
AU - Haider, Rafiqul
AU - Abdullah, Abu Yousuf Md
AU - Christou, Aliki
AU - Ali, Nabeel Ashraf
AU - Rahman, Ahmed Ehsnaur
AU - Iqbal, Afrin
AU - Bari, Sanwarul
AU - Hoque, D M Emdadul
AU - Arifeen, Shams El
AU - Kissoon, Niranjan
AU - Larson, Charles P
N1 - FTX; DOAJ; (CC BY 4.0)
PY - 2018
Y1 - 2018
N2 - BACKGROUND: A geographic information system (GIS)-based transport network within an emergency referral system can be the key to reducing health system delays and increasing the chances of survival, especially during an emergency. We employed a GIS to design an emergency transport system for the rapid transfer of pregnant or early post-partum women, newborns, and children under 5 years of age with suspected sepsis under the Interrupting Pathways to Sepsis Initiative (IPSI) project.METHODS: A GIS database was developed by mapping the villages, roads, and relevant physical features of the study area. A travel-time algorithm was developed to incorporate the time taken by different modes of local transport to reach the health complexes. These were used in a network analysis to identify the shortest routes to the hospitals from the villages, which were categorized into green, yellow, and red zones based on their proximity to the nearest hospitals to provide transport facilities. An emergency call-in centre established for the project managed the transport system, and its data was used to assess the uptake of this transport system amongst distant communities.RESULTS: Fifteen pre-existing and two new routes were identified as the shortest routes to the health complexes. The call-in centre personnel used this route information to direct both patients and transport drivers to the nearest transport hubs or pick-up points. Adherence with referral advice was high in areas where the IPSI transport operated. Over the study period, the utilisation of the project's transport doubled and referral compliance from distant zones similarly increased.CONCLUSIONS: The GIS system created for this study facilitated rapid referral of patients in emergency from distant zones, using locally available transport and resources. The methodology described in this study to develop and implement an emergency transport system can be applied in similar, rural, low-income country settings.
AB - BACKGROUND: A geographic information system (GIS)-based transport network within an emergency referral system can be the key to reducing health system delays and increasing the chances of survival, especially during an emergency. We employed a GIS to design an emergency transport system for the rapid transfer of pregnant or early post-partum women, newborns, and children under 5 years of age with suspected sepsis under the Interrupting Pathways to Sepsis Initiative (IPSI) project.METHODS: A GIS database was developed by mapping the villages, roads, and relevant physical features of the study area. A travel-time algorithm was developed to incorporate the time taken by different modes of local transport to reach the health complexes. These were used in a network analysis to identify the shortest routes to the hospitals from the villages, which were categorized into green, yellow, and red zones based on their proximity to the nearest hospitals to provide transport facilities. An emergency call-in centre established for the project managed the transport system, and its data was used to assess the uptake of this transport system amongst distant communities.RESULTS: Fifteen pre-existing and two new routes were identified as the shortest routes to the health complexes. The call-in centre personnel used this route information to direct both patients and transport drivers to the nearest transport hubs or pick-up points. Adherence with referral advice was high in areas where the IPSI transport operated. Over the study period, the utilisation of the project's transport doubled and referral compliance from distant zones similarly increased.CONCLUSIONS: The GIS system created for this study facilitated rapid referral of patients in emergency from distant zones, using locally available transport and resources. The methodology described in this study to develop and implement an emergency transport system can be applied in similar, rural, low-income country settings.
KW - Bangladesh
KW - Emergency Medical Services/organization & administration
KW - Geographic Information Systems
KW - Humans
KW - Referral and Consultation
KW - Sepsis/therapy
KW - Transportation of Patients
U2 - 10.1371/journal.pone.0191054
DO - 10.1371/journal.pone.0191054
M3 - A1: Web of Science-article
C2 - 29338012
SN - 1932-6203
VL - 13
JO - PLoS ONE
JF - PLoS ONE
IS - 1
M1 - e0191054
ER -