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Low- and middle-income

Thanh Tam Tran, Joel Adams-Bedford, Vasoontara Yiengprugsawan, Sam-Ang Seubsman, Adrian Sleigh
INTRODUCTION: Injury and psychological distress are public health priorities because of their high occurrence in the population. This study examines the longitudinal effects of injury characteristics on psychological distress. METHODS: Study participants were enrolled distance learning Thai adults (N = 42,785 at 2013 follow-up) residing nationwide. We analysed 2009 and 2013 data. Injury questions included injury prevalence, causes and levels of severity. Distress was measured using the standard Kessler-6...
2016: PloS One
Mohammad H Rahbar, Maureen Samms-Vaughan, Manouchehr Hessabi, Aisha S Dickerson, MinJae Lee, Jan Bressler, Sara E Tomechko, Emily K Moreno, Katherine A Loveland, Charlene Coore Desai, Sydonnie Shakespeare-Pellington, Jody-Ann Reece, Renee Morgan, Matthew J Geiger, Michael E O'Keefe, Megan L Grove, Eric Boerwinkle
To date much of the biomonitoring related to exposure to polychlorinated biphenyls (PCBs) and organochlorine (OC) pesticides is from middle to high income countries, including the U.S., Canada and Europe, but such data are lacking for the majority of low to middle income countries. Using data from 64 pregnant mothers who were enrolled in 2011, we aimed to assess the concentrations of the aforementioned toxins in umbilical cord blood serum of 67 Jamaican newborns. For 97 of the 100 PCB congeners and 16 of the 17 OC pesticides, all (100%) concentrations were below their respective limits of detection (LOD)...
October 21, 2016: International Journal of Environmental Research and Public Health
Anna E Greer, Brianna Castrogivanni, Richard Marcello
BACKGROUND: Limited research has examined park use and physical activity among economically and ethnically diverse families. This study fills that gap. METHODS: Parents (n=326) completed a questionnaire about their park use (yes/no, parks visited, reasons for non-use) and physical activity (Godin Leisure Time questionnaire). Geographical Information Systems was used to calculate the distance from respondents' home address to their nearest park. The number of activity features (e...
October 24, 2016: Journal of Physical Activity & Health
Roland J Jr Thorpe, Eleanor Simonsick, Alan Zonderman, Michelle K Evans
BACKGROUND: Poor grip strength is an indicator of frailty and a precursor to functional limitations. Although poor grip strength is more prevalent in older disabled African American women, little is known about the association between race and poverty-related disparities and grip strength in middle-aged men and women. METHODS: We examined the cross-sectional relationship between race, socioeconomic status as assessed by household income, and hand grip strength in men and women in the Healthy Aging in Neighborhoods of Diversity across the Life Span study...
October 20, 2016: Ethnicity & Disease
Ken M Kunisaki, Dennis E Niewoehner, Gary Collins, Bitten Aagaard, Nafisah B Atako, Elzbieta Bakowska, Amanda Clarke, Giulio Maria Corbelli, Ernest Ekong, Sean Emery, Elizabeth B Finley, Eric Florence, Rosa M Infante, Cissy M Kityo, Juan Sierra Madero, Daniel E Nixon, Ellen Tedaldi, Jørgen Vestbo, Robin Wood, John E Connett
BACKGROUND: Observational data have been conflicted regarding the potential role of HIV antiretroviral therapy (ART) as a causative factor for, or protective factor against, COPD. We therefore aimed to investigate the effect of immediate versus deferred ART on decline in lung function in HIV-positive individuals. METHODS: We did a nested substudy within the randomised, controlled Strategic Timing of Antiretroviral Treatment (START) trial at 80 sites in multiple settings in 20 high-income and low-to-middle-income countries...
October 20, 2016: Lancet Respiratory Medicine
Racquel E Kohler, Jared Tomlinson, Tiyamike Eletima Chilunjika, Sven Young, Mina Hosseinipour, Clara N Lee
PURPOSE: Low- and middle-income countries face a disproportionate burden of death and disability from injuries, many of which are due to road traffic accidents or falls. Lower extremity injuries in particular have implications not only for physical disabilities affecting work and school performance, but also for quality of life (QOL) of the individual. This qualitative study explores the psychosocial impact and QOL changes due to lower extremity injuries among trauma patients in central Malawi...
October 22, 2016: Quality of Life Research
Chaevia Clendinen, Yapei Zhang, Rebecca N Warburton, Donald W Light
BACKGROUND: Nearly all of the 500,000 new cases of cervical cancer and 270,000 deaths occur in middle or lower income countries. Yet the two most prevalent HPV vaccines are unaffordable to most. Even prices to Gavi, the Vaccine Alliance, are unaffordable to graduating countries, once they lose Gavi subsidies. Merck and Glaxosmithkline (GSK) claim their prices to Gavi equal their manufacturing costs; but these costs remain undisclosed. We undertook this investigation to estimate those costs...
October 19, 2016: Vaccine
Tim Stokes, Elizabeth J Shaw, Janette Camosso-Stefinovic, Mari Imamura, Lovney Kanguru, Julia Hussein
BACKGROUND: Maternal mortality remains a major international health problem in low- and middle-income countries (LMIC), and most could have been prevented by quality improvement interventions already demonstrated to be effective, such as clinical guideline implementation strategies. The aim of this systematic review was to synthesise qualitative evidence on guideline implementation strategies to improve obstetric care practice in LMIC in order to identify barriers and enablers to their successful implementation...
October 22, 2016: Implementation Science: IS
Wai Jia Tam, Philip Yap
Approximately two-thirds of the world's older adults live in developing nations. By 2050, as many as 80% of such older people will live in low- and middle-income countries. In sub-Saharan Africa alone, the number of individuals aged 60 and older is projected to reach 163 million. Despite this demographic wave, the majority of Africa has limited access to qualified geriatric health care.(3) Although foreign aid and capacity-building efforts can help to close this gap over time, it is likely that failure to understand the unique context of Africa's older adults, many of whom are marginalized, will lead to inadequacies in service delivery and poor health outcomes...
October 22, 2016: Journal of the American Geriatrics Society
Stéphane Verguet, Solomon Tessema Memirie, Ole Frithjof Norheim
BACKGROUND: Out-of-pocket (OOP) medical expenses often lead to catastrophic expenditure and impoverishment in low- and middle-income countries. Yet, there has been no systematic examination of which specific diseases and conditions (e.g., tuberculosis, cardiovascular disease) drive medical impoverishment, defined as OOP direct medical costs pushing households into poverty. METHODS: We used a cost and epidemiological model to propose an assessment of the burden of medical impoverishment in Ethiopia, i...
October 21, 2016: BMC Medicine
Roxanne Keynejad, Maya Semrau, Mark Toynbee, Sara Evans-Lacko, Crick Lund, Oye Gureje, Sheila Ndyanabangi, Emilie Courtin, Jibril O Abdulmalik, Atalay Alem, Abebaw Fekadu, Graham Thornicroft, Charlotte Hanlon
BACKGROUND: Little is known about the interventions required to build the capacity of mental health policy-makers and planners in low- and middle-income countries (LMICs). We conducted a systematic review with the primary aim of identifying and synthesizing the evidence base for building the capacity of policy-makers and planners to strengthen mental health systems in LMICs. METHODS: We searched MEDLINE, Embase, PsycINFO, Web of Knowledge, Web of Science, Scopus, CINAHL, LILACS, ScieELO, Google Scholar and Cochrane databases for studies reporting evidence, experience or evaluation of capacity-building of policy-makers, service planners or managers in mental health system strengthening in LMICs...
October 21, 2016: BMC Health Services Research
Minh D Pham, Paul A Agius, Lorena Romero, Peter McGlynn, David Anderson, Suzanne M Crowe, Stanley Luchters
BACKGROUND: Point-of-care (POC) CD4 testing increases patient accessibility to assessment of antiretroviral therapy eligibility. This review evaluates field performance in low and middle-income countries (LMICs) of currently available POC CD4 technologies. METHODS: Eight electronic databases were searched for field studies published between January 2005 and January 2015 of six POC CD4 platforms: PointCare NOW™, Alere Pima™ CD4, Daktari™ CD4 Counter, CyFlow® CD4 miniPOC, BD FACSPresto™, and MyT4™ CD4...
October 21, 2016: BMC Infectious Diseases
Wen Yea Hwong, Michiel L Bots, Sharmini Selvarajah, L Jaap Kappelle, Zariah Abdul Aziz, Norsima Nazifah Sidek, Ilonca Vaartjes
BACKGROUND: A shortage of computed tomographic (CT) machines in low and middle income countries often results in delayed CT imaging for patients suspected of a stroke. Yet, time constraint is one of the most important aspects for patients with an ischemic stroke to benefit from thrombolytic therapy. We set out to assess whether application of the Siriraj Stroke Score is able to assist physicians in prioritizing patients with a high probability of having an ischemic stroke for urgent CT imaging...
2016: PloS One
Helen J Sims-Williams, Hugh P Sims-Williams, Edith Mbabazi Kabachelor, James Fotheringham, Benjamin C Warf
OBJECTIVE Myelomeningocele (MM) is a neural tube defect complicated by neurological deficits below the level of the spinal lesion and, in many cases, hydrocephalus. Long-term survival of infants treated for MM in a low- and middle-income country has never been reported. This retrospective cohort study reports 10-year outcomes and factors affecting survival for infants undergoing MM repair at CURE Children's Hospital of Uganda. METHODS Patients were traced by telephone or home visit. Survival was estimated using the Kaplan-Meier method...
October 21, 2016: Journal of Neurosurgery. Pediatrics
Derek Richards
Data sourcesPubMed Central, CINAHL, Embase and reference lists of identified articles.Study selectionObservational and experimental studies published in English where breastfeeding was the exposure and development of caries was the outcome of interest were considered. Two reviewers independently selected studies for inclusionData extraction and synthesisStudy quality was assessed independently by two researchers using the Newcastle Ottawa Scale (NOS). Key data items, exposure and outcome definitions and effect estimates (odds ratios (OR), relative risks, prevalence ratios) with 95% Confidence Interval (95%CI) were abstracted where available for inclusion in a meta-analysis...
September 2016: Evidence-based Dentistry
Biswajyoti Borkakoty, Dipankar Biswas, Aniruddha Jakharia, Jagadish Mahanta
OBJECTIVE: Toxoplasma gondii infection is primarily asymptomatic and one third of world's population is estimated to be infected by this protozoan parasite. This study was carried out to determine the seroprevalence of T. gondii infection among pregnant women from north east India, where data on this important parasitic infection is scanty. METHODS: A total of 1141 serum archival samples collected from antenatal clinic attendees in 2007-09, were screened for T. gondii IgG by ELISA and analyzed with their socio demographic information...
October 2016: Journal of the Association of Physicians of India
Huifang Yin, Michael R Phillips, Klaas J Wardenaar, Guangming Xu, Johan Ormel, Hongjun Tian, Robert A Schoevers
Mental health in China is of growing concern to both policy-makers and researchers. The Tianjin Mental Health Survey (TJMHS) was conducted between July 2011 and March 2012 to assess the prevalence and risk factors of mental disorders in the context of recent economic growth and other socio-demographic changes in Tianjin, a municipality of 13 million on China's eastern seaboard. A multistage cluster random sample selected using probability proportionate to size methods participated in a two-phase screening procedure: 11,748 subjects 18 or older were screened for risk of psychopathology and then an enriched risk-proportional subsample of 4,438 subjects was interviewed by psychiatrists using an expanded Chinese version of the Structured Clinical Interview for Diagnostic and Statistical Manual, Fourth Edition (DSM-IV) Axis I disorders (SCID)...
October 21, 2016: International Journal of Methods in Psychiatric Research
Gavin Tansley, Barclay T Stewart, Adam Gyedu, Godfred Boakye, Daniel Lewis, Marius Hoogerboord, Charles Mock
BACKGROUND: Surgical disease burden falls disproportionately on individuals in low- and middle-income countries. These populations are also the least likely to have access to surgical care. Understanding the barriers to access in these populations is therefore necessary to meet the global surgical need. METHODS: Using geospatial methods, this study explores the district-level variation of two access barriers in Ghana: poverty and spatial access to care. National survey data were used to estimate the average total household expenditure (THE) in each district...
October 20, 2016: World Journal of Surgery
Minh T H Le, Sara Holton, Huong T Nguyen, Rory Wolfe, Jane Fisher
BACKGROUND: Limited evidence is available about poly-victimisation (exposure to multiple forms of victimisation) and mental health among adolescents in low and lower-middle-income countries. The aim of this study was to examine the associations between lifetime exposure to poly-victimisation, health risk behaviours, symptoms of common mental health problems and suicidal ideas in the previous year among high school students in Vietnam. METHODS: Participants were high school students in rural and urban districts of Hanoi, Vietnam...
2016: International Journal of Mental Health Systems
Songyuan Tang, Weiming Tang, Kathrine Meyers, Polin Chan, Zhongdan Chen, Joseph D Tucker
BACKGROUND: Despite global efforts to control HIV among key populations, new infections among men who have sex with men (MSM) and transgender (TG) individuals are still increasing. The increasing HIV epidemic among MSM/TG in China indicates that more effective services are urgently needed. However, policymakers and program managers must have a clear understanding of MSM/TG sexual health in China to improve service delivery. To meet this need, we undertook a scoping review to summarize HIV epidemiology and responses among MSM and TG individuals in China...
October 20, 2016: BMC Infectious Diseases
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