A review of gastrointestinal protocols for primary care medical service trips (MSTs) in Latin America and the Caribbean.

BACKGROUND

Gastrointestinal disorders are among the most common conditions encountered on short-term, primary care medical service trips (MSTs) in Latin America and the Caribbean (LAC), but their optimal management remains unclear. There have been no previous attempts to describe the protocols that Western volunteer clinicians use in managing these patients.

METHODS

A systematic web search was used to identify organizations operating MSTs in LAC. Clinical protocols were downloaded from organizational websites, and organizations were contacted online to obtain those that were not publicly available. Protocols were analysed qualitatively, and content compared with existing international guidelines.

RESULTS

Two hundred and twenty-five organizations were identified and contacted to obtain their clinical protocols, and the content of each protocol was qualitatively analysed. Twenty protocols were obtained, of which 75% (15/20) discussed dyspepsia, 65% (13/20) discussed parasites and 60% (12/20) discussed diarrhoea. The protocols infrequently included literature citations.

CONCLUSION

Gastrointestinal disorder protocols used by MSTs in LAC sometimes neglected important aspects of clinical management that are emphasized in international guidelines. This study is a first step in context-specific clinical guideline development for MSTs operating in LAC.