Jerome R. Lechien, MD, PhD, FACS: No relevant relationships to disclose.
Introduction: Most clinical humanitarian studies consisted of retrospective case-series of surgical outreaches conducted in hospital settings. This study aimed to investigate demographic, clinical data and pattern of patients presenting with otolaryngological conditions in a rural Kenyan facility, identifying factors limiting access to quality healthcare.
Methods: Demographics and clinical findings of consecutive outpatients consulting in a rural dispensary in Iten (Kenya) for otolaryngological conditions were prospectively collected from December 14, 2024 to January 3, 2025. A comprehensive assessment of healthcare delivery barriers was prospectively conducted, followed by systematic evaluation and proposition of strategic solutions for care optimization. The usefulness of an ear HD-camera device was evaluated for improving ear and nose examination.
Results: Sixty-three consecutive outpatients were included, including 37 children (12 females) and 26 adults (14 females). The mean ages of children and adults were 5.1±3.1 and 49.1±18.7 years, respectively. A language barrier was found in 23 (36.5%) cases. Rhinological, otological, and head and neck conditions were found in 30 (44.8%), 15 (22.4%), and 18 (26.9%) cases. There were no barriers or limitations in resources for 4 patients (6.0%), while in 27 cases (40.3%), practitioners reported more than 3 limitations in equipment/medication resources for achieving adequate management, with significantly higher limitations in the pediatric group compared with adults (p=0.041). The otoscopic device demonstrated significant and absolute usefulness in 27 cases (42.9%) and 14 cases (22.2%), with both being higher in pediatric versus adult groups (p=0.014).
Conclusions: This study demonstrates substantial healthcare delivery barriers in rural Kenya for otolaryngological conditions, especially in children. The implementation of innovative diagnostic tools (HD-otoscopic device) can improve patient care, strengthening that targeted technological solutions may be relevant in resource-limited settings.
