Case Definition

Clinical assessment

  • Vague, generalized, non-disabling discomfort in joints and muscle, minimal physical findings3,5, 1
  • “Olivia’s syndrome”: headache, shoulder, chest, arm, neck and back pain18
  • Headache, cough, abdominal pain, back pain, rash, due to multifactorial causes (stress, sleeping on ground, smoke exposure, heavy lifting, soccer collision, body mechanics, stooping over)5, 7, 19 , leaning over pila to wash clothes14
  • Dull localized leg pain due to dehydration, walking long distances, malnutrition, osteoarthritis9, 14 : increase liquids, vitamin supplements, calcium supplements14

Red Flags

  • Signs of infection, recent fall or accident, if SOB, muscle weaknes, inability to move3
  • Headache: If severe pain, recent head trauma, fever, stiff neck, nasal congestion, cough, visual changes3
  • Back pain: Recent injury, MVA, fall, symptoms of acute nerve dysfunction, loss of bowel or bladder control 3

Management

General recommendations

  • ACE wraps (for knee supports) 6,, stretching activities and analgesic creams, consider physio referral7, 20
  • Massage neck daily, improve postural mechanics, roll towel and put in the small of the back when sitting18,6
  • Headache: consider dental caries, vision problem5
  • Oral rehydration salts, reading glasses7.
  • Alcohol withdrawal: hydration 1-2L/day8

Pharmacologic management

  • NSAIDs or acetaminophen3,5,13, 1
  • Back pain: Fever, dysuria and pyuria: UTI treatment with cipro 500mg bid 3 days or Bactrim DS BID 7 days3
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1. Organization A

Locations: Nicaragua
Trips per year: 4
Format of trips: Mobile medical clinics and standing clinics
Setting: Rural
Type of Organization: Secular

2. Organization B

Locations: Guatemala
Trips per year: Variable
Format of trips: Clinics
Setting: Rural
Type of Organization: Secular

3. Organization C

Locations: Haiti
Trips per year: Variable
Format of trips: Clinic
Setting: Urban
Type of Organization: Faith-based

4. Organization D

Locations: Dominican Republic
Trips per year: 3
Format of trips: Clinic
Setting: Rural
Type of Organization: Secular

5. Organization E

Locations: Haiti
Trips per year: 7
Format of trips: Not mentioned
Setting: Rural
Type of Organization: Secular

6. Organization F

Locations: Honduras, Ecuador, Belize, Guyana, Guatemala
Trips per year: 5
Format of trips: Mobile brigades
Setting: Rural and Urban
Type of Organization: Faith-based

7. Organization G

Locations: Ecuador, Guatemala, Dominican Republic
Trips per year: 100 (spread over 6 sites)
Format of trips: Mobile brigades
Setting: Rural and Urban
Type of Organization: Secular

8. Organization H

Locations: Ecuador
Trips per year: 3
Format of trips: Mobile brigades in schools/Clinics in health centers
Setting: Rural
Type of Organization: Secular

9. Organization I

Locations: Honduras
Trips per year: 1
Format of trips: Mobile brigades in 20 villages
Setting: Rural
Type of Organization: Faith-based

10. Organization J

Locations: Jamaica, Haiti
Trips per year: 4
Format of trips: Mobile brigades, Permanent clinics/hospital medicine
Setting: Rural and urban
Type of Organization: Secular

11. Organization K

Locations: Haiti
Trips per year: 4
Format of trips: Clinic
Setting: Rural
Type of Organization: Secular

12. Organization L

Locations: Guatemala, Nicaragua
Trips per year: 3
Format of trips: Mobile clinics
Setting: Rural
Type of Organization: Faith-based

13. Organization M

Locations: Nicaragua, Honduras
Trips per year: 51
Format of trips: Mobile brigades, Hospital-based
Setting: Rural
Type of Organization: Faith-based

14. Organization N

Locations: Guatemala
Trips per year: 12
Format of trips: Hospital
Setting: Rural
Type of Organization: Secular

15. Organization O

Locations: Honduras
Trips per year: Up to 50
Format of trips: Mobile brigades in school and churches
Setting: Rural
Type of Organization: Faith-based

16. Organization P

Locations: Haiti
Trips per year: Variable
Format of trips: Mobile brigades and clinics
Setting: Rural and urban
Type of Organization: Secular

17. Organization Q

Locations: Dominican Republic, Haiti
Trips per year: 12 to 15
Format of trips: Mobile brigades
Setting: Rural
Type of Organization: Secular

18. Organization R

Locations: Honduras, Nicaragua, Panama
Trips per year: Hundreds
Format of trips: Mobile brigades in community centre or school
Setting: Rural
Type of Organization: Secular

19. Organization S

Locations: Honduras
Trips per year: 4
Format of trips: Mobile brigades, Specialty hospital services
Setting: Rural
Type of Organization: Secular

20. Organization T

Locations: Haiti
Trips per year: Approximately 40
Format of trips: Mobile clinics in 14 villages and Standing clinic
Setting: Rural
Type of Organization: Faith-based