PUBLIC HEALTH RESEARCH

A primary objective of the organization is to conduct research in public health topics that improve the health of the local population.  Past research projects have included new methods for cervical cancer screening including visual inspection with acetic acid, focus groups to determine satisfaction with tubal sterilization, surveys about contraceptive practices,age and risk factors for early menopause, and prevalence of urinary and pelvic floor disorders.

In 1999, Dr. Cremer was honored with first prize for original research by the Latin American Federation of Obstetrics and Gynecology (FLASOG).

DIGITAL CAMERA ASSESSMENT OF THE REPRODUCTIVE TRACT (DART)

In collaboration with Dr. Paul Blumenthal, a researcher from Johns Hopkins University, in 2004, BasicHealth: El Salvador conducted a pilot project using a digital camera to take images of the cervix.  Visual inspection is becoming a popular screening modality because of its cost-effectiveness and simplicity. The main limitation of visual inspection is high sensitivity which leads to over-treatment. DART could theoretically improve the quality of visual inspection and also establish a permanent record for patient files, education and training. BasicHealth supports the use of visual inspection and continues to train local providers in this technique.

FINDINGS

A research project was designed to compare digital imaging to other evaluation processes including visual inspection, conventional/ThinPrep Pap smear as well as to the gold standard, colposcopy. 

The study personnel included 7 OB/Gyn physicians, 2 nurses and 1 Gyn pathologist. Each patient was seen by three independent examiners who were responsible for collecting different specimens/data for comparison. The enrollment goal of 500 patients was exceeded having enrolled 526 patients during the three weeks study.

A BasicHealth: El Salvador delegation returned in April 2004 to counsel and treat patients with lesions. "Digital Camera Assessment of the Reproductive Tract" was published in International Journal of Obstetrics and Gynecology in 2005.

A follow up study was completed at the Cancer Institute of El Salvador in 2005. Two hundred patients with abnormal Pap smears underwent DART and colposcopy. The objective of this study was to determine if DART is an effective method to direct biopsies in women with abnormal Pap smears. An oral abstract of this study was presented in November of 2006 at the FIGO meeting in Kuala Lumpur, Malaysia.   This technology holds promise since it is cost-effective, readily available and portable.