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Low income country

Susanna Dunachie, Parinya Chamnan
Four out of five people in the world with diabetes now live in low- and middle-income countries (LMIC), and the incidence of diabetes is accelerating in poorer communities. Diabetes increases susceptibility to infection and worsens outcomes for some of the world's major infectious diseases such as tuberculosis, melioidosis and dengue, but the relationship between diabetes and many neglected tropical diseases is yet to be accurately characterised. There is some evidence that chronic viral infections such as hepatitis B and HIV may predispose to the development of type 2 diabetes by chronic inflammatory and immunometabolic mechanisms...
December 4, 2018: Transactions of the Royal Society of Tropical Medicine and Hygiene
Ivan D Florez, Areti-Angeliki Veroniki, Reem Al Khalifah, Juan J Yepes-Nuñez, Javier M Sierra, Robin W M Vernooij, Jorge Acosta-Reyes, Claudia M Granados, Giordano Pérez-Gaxiola, Carlos Cuello-Garcia, Adriana M Zea, Yuan Zhang, Naghmeh Foroutan, Gordon H Guyatt, Lehana Thabane
BACKGROUND: Many interventions have shown effectiveness in reducing the duration of acute diarrhea and gastroenteritis (ADG) in children. Yet, there is lack of comparative efficacy of interventions that seem to be better than placebo among which, the clinicians must choose. Our aim was to determine the comparative effectiveness and safety of the pharmacological and nutritional interventions for reducing the duration of ADG in children. METHODS: Data sources included Medline, Embase, CENTRAL, CINAHL, LILACS, and Global-Health up to May 2017...
2018: PloS One
Ross D Uthoff, Bofan Song, Sumsum Sunny, Sanjana Patrick, Amritha Suresh, Trupti Kolur, G Keerthi, Oliver Spires, Afarin Anbarani, Petra Wilder-Smith, Moni Abraham Kuriakose, Praveen Birur, Rongguang Liang
Oral cancer is a growing health issue in a number of low- and middle-income countries (LMIC), particularly in South and Southeast Asia. The described dual-modality, dual-view, point-of-care oral cancer screening device, developed for high-risk populations in remote regions with limited infrastructure, implements autofluorescence imaging (AFI) and white light imaging (WLI) on a smartphone platform, enabling early detection of pre-cancerous and cancerous lesions in the oral cavity with the potential to reduce morbidity, mortality, and overall healthcare costs...
2018: PloS One
Yanyun He, Ce Shang, Frank J Chaloupka
OBJECTIVES: This study calculates cigarette affordability for 78 countries worldwide from 2001 to 2014 using the Relative Income Price (RIP) ratio defined as the percentage of per capita GDP required to purchase 100 packs of cigarettes using the lowest price from Economist Intelligence Unit (EIU) database, examine the association between cigarette affordability and cigarette consumption, and calculate the affordability elasticity of demand. DESIGN AND METHODS: RIP (2001-2014) was calculated for 16 low-income economies, 19 lower middle-income economies, 13 upper middle-income economies, and 30 high-income economies...
2018: PloS One
Breno Franco Silveira Fernandes, Paulo Caramelli
PURPOSE OF REVIEW: To address the important relationships between stroke and infection, focusing on the most frequent infections found in low-income and middle-income countries. RECENT FINDINGS: Stroke is one of the leading causes of mortality and disability worldwide, with a great proportion of the stroke burden occurring in low-income and middle-income countries. Infectious diseases are still a great health problem in developing countries and it is possible that the proportion of infection-related strokes is greater in these nations...
December 3, 2018: Current Opinion in Neurology
Guadalupe Navarro, Anukriti Sharma, Lara R Dugas, Terrence Forrester, Jack A Gilbert, Brian T Layden
Malnutrition remains a major health problem in low- and middle-income countries. During low protein intake, <0.67 g/kg/day, there is a loss of nitrogen (N2 ) balance, due to the unavailability of amino acid for metabolism and unbalanced protein catabolism results. However, there are individuals, who consume the same low protein intake, and preserve N2 balance for unknown reasons. A novel factor, the gut microbiota, may account for these N2 balance differences. To investigate this, we correlated gut microbial profiles with the growth of four murine strains (C57Bl6/J, CD-1, FVB, and NIH-Swiss) on protein deficient (PD) diet...
December 2018: Physiological Reports
Rajendra Kc, Shakti D Shukla, Sanjay S Gautam, Philip M Hansbro, Ronan F O'Toole
Chronic exposure to household indoor smoke and outdoor air pollution is a major contributor to global morbidity and mortality. The majority of these deaths occur in low and middle-income countries. Children, women, the elderly and people with underlying chronic conditions are most affected. In addition to reduced lung function, children exposed to biomass smoke have an increased risk of developing lower respiratory tract infections and asthma-related symptoms. In adults, chronic exposure to biomass smoke, ambient air pollution, and opportunistic exposure to fumes and dust are associated with an increased risk of developing chronic bronchitis, chronic obstructive pulmonary disease (COPD), lung cancer and respiratory infections, including tuberculosis...
December 5, 2018: Clinical and Translational Medicine
Andrew P Stringer, Rob M Christley, Catriona E Bell, Feseha Gebreab, Gebre Tefera, Karen Reed, Andrew Trawford, Gina L Pinchbeck
The objectives of this study were to evaluate the efficacy of several knowledge-transfer interventions about donkey health, utilizing a cluster-randomized controlled trial (c-RCT), on the long-term knowledge change (~6 months post intervention) of Ethiopian rural working equid owners. Knowledge transfer interventions included: an audio programme, a village meeting and a diagrammatic hand-out, which were also compared to a control group, which received no intervention. All interventions addressed identical learning objectives...
2018: Frontiers in Veterinary Science
Reneé de Waal, Richard Lessells, Anthony Hauser, Roger Kouyos, Mary-Ann Davies, Matthias Egger, Gilles Wandeler
The prevalence of pretreatment resistance to non-nucleoside reverse transcriptase inhibitors (NNRTIs) is >10% in many low-income countries. As a consequence, several sub-Saharan African countries have implemented, or are considering the introduction of, non-NNRTI-based first-line antiretroviral therapy (ART) for treatment-naïve and treatment-experienced patients. This is occurring at a time when ART programmes are expanding, in response to the World Health Organization guidelines, which recommend ART initiation regardless of CD4 cell count...
November 15, 2018: Journal of Virus Eradication
Joel Sim, Andrew Hill
Objectives: Differences in marketed prices of antiretrovirals raises questions about the fairness of pricing medicines of significant public health importance such as dolutegravir (DTG). In view of the reduced prices of generically available efavirenz (EFV), there is a need to determine if previous conclusions on DTG's cost-effectiveness need to be re-assessed. Methods: Lowest list prices of DTG were extracted from national drug price or reimbursement databases for 52 countries...
October 1, 2018: Journal of Virus Eradication
Lutango D Simangwa, Anne N Åstrøm, Anders Johansson, Irene K Minja, Ann-Katrin Johansson
BACKGROUND: Oral diseases may cause serious health problems, especially in socially disadvantaged populations and in low-income countries. In populations living in the rural areas of Tanzania there is paucity of reports on oral health. The study aim was to estimate the prevalence, severity and socio-demographic distribution of oral diseases/conditions in adolescents living in Maasai population areas of Tanzania and to compare oral diseases/conditions between Maasai and non-Maasai ethnic groups...
December 4, 2018: BMC Oral Health
Winfrida T Kaihula, Hendry R Sawe, Michael S Runyon, Brittany L Murray
BACKGROUND: Early and effective CPR increases both survival rate and post-arrest quality of life. In limited resource countries like Tanzania, there is scarce data describing the basic knowledge of CPR among Healthcare providers (HCP). This study aimed to determine the current level of knowledge on, and ability to perform, CPR among HCP at Muhimbili National Hospital (MNH). METHODS: This was a descriptive cross sectional study of a random sample of 350 HCP from all cadres and departments at MNH from October 2015 to March 2016...
December 4, 2018: BMC Health Services Research
Truong Tam Nguyen, Véronique Lemee, Karine Bollore, Hai Vinh Vu, Karine Lacombe, Xuan Lien Truong Thi, Que Anh Luong, Charline Dubos, Jean-Christophe Plantier, Huong Duong Thi, Didier Laureillard, Maud Lemoine, Edouard Tuaillon
BACKGROUND: Nucleic acid tests performed on blood samples collected on Dried Blood Spot (DBS) and detection of HCV core antigen (HCVcAg) are two approaches that may facilitate access to HCV diagnosis in low and middle incomes countries. In this study we evaluate HCV RNA and HCV antigen testing on DBS in HIV/HCV co-infected peoples who inject drugs in Vietnam. METHOD: One hundred and four HIV/HCV seropositive patients managed in outpatient care at the Haiphong Viet Tiep hospital were included in this study from February to March, 2014 (ANRS 12262 study)...
December 4, 2018: BMC Infectious Diseases
Andreas Älgå, Karin Karlow Herzog, Murad Alrawashdeh, Sidney Wong, Hamidreza Khankeh, Cecilia Stålsby Lundborg
Healthcare-associated infections (HAIs) constitute a major contributor to morbidity and mortality worldwide, with a greater burden on low- and middle-income countries. War-related injuries generally lead to large tissue defects, with a high risk of infection. The aim of this study was to explore how physicians in a middle-income country in an emergency setting perceive HAI and antibiotic resistance (ABR). Ten physicians at a Jordanian hospital supported by Médecins Sans Frontières were interviewed face-to-face...
December 1, 2018: International Journal of Environmental Research and Public Health
Victor M Rivera
Multiple sclerosis (MS) has become a common neurological disorder involving populations previously considered to be infrequently affected. Genetic dissemination from high- to low-risk groups is a determining influence interacting with environmental and epigenetic factors, mostly unidentified. Disease modifying therapies (DMT) are effective in treating relapsing MS in variable degrees; one agent is approved for primary progressive disease, and several are in development. In the era of high-efficacy medications, complex molecules, and monoclonal antibodies (MAB), including anti-VLA4 (natalizumab), anti-CD52 (alemtuzumab), and anti-CD20 (ocrelizumab), obtaining NEDA (no evidence of disease activity) becomes an elusive accomplishment in areas of the world where access to MS therapies and care are generally limited...
November 30, 2018: Biomedicines
Anna Lena Lopez, Peter Francis Raguindin, Maria Wilda T Silva
Rotavirus (RV) diarrhea is one of the most common cause of childhood morbidity and mortality in the world. The World Health Organization has recommended RV vaccines' use in national immunization programmes since 2009. However, access to vaccines remain limited, particularly for most low- and middle-income countries where the burden of the disease is high. The Philippines is a lower-middle income country in Asia where RV vaccination remains limited. Recent studies in the Philippines indicate an estimated vaccine effectiveness of 60% against RV hospitalization, and a 50-60% reduction of all cause diarrhea among children aged under 5 within the population...
December 4, 2018: Human Vaccines & Immunotherapeutics
Sophia Holmlund, Joseph Ntaganira, Kristina Edvardsson, Pham Thi Lan, Jean Paul Semasaka Sengoma, Hussein Lesio Kidanto, Matilda Ngarina, Rhonda Small, Ingrid Mogren
OBJECTIVES: Implementation of ultrasound in antenatal care (ANC) in low-income countries has been shown to increase pregnant women's compliance with ANC visits, and facilitate detection of high-risk pregnancies. In Rwanda, as in other low-income countries, access to ultrasound has increased significantly, but lack of training is often a barrier to its use. The aim of this study was to investigate Rwandan health professionals' experiences and views of obstetric ultrasound in relation to clinical management, resources and skills...
2018: PloS One
Derrick Aarons
Guideline 20 of the updated International Ethics Guidelines for Health-related Research Involving Humans (2016) by the Council for International Organizations of Medical Sciences (CIOMS) provides guidance on research in disasters and disease outbreaks against the background of the need to generate knowledge quickly, overcome practical impediments to implementing such research, and the need to maintain public trust. The guideline recommends that research ethics committees could pre-screen study protocols to expedite ethical reviews in a situation of crisis, that pre-arrangements be made regarding data sharing and biomedical sample sharing, and that sponsors and research ethics committees seek to minimize risk to researchers conducting research during a disaster...
December 4, 2018: Bioethics
Lamis Jomaa, Farah Naja, Samer Kharroubi, Nahla Hwalla
OBJECTIVE: Food insecurity (FI) is a major public health problem in Lebanon, a small middle-income country with the highest refugee per capita concentration worldwide and prolonged political and economic challenges. The present study aimed to measure the prevalence and sociodemographic correlates of household FI and to explore the association of household FI with anthropometric measures of children and their mothers. DESIGN: Cross-sectional survey (2014-2015). SETTING: Lebanon...
December 4, 2018: Public Health Nutrition
Patchimaporn Udomkun, John Ilukor, Jonathan Mockshell, Gaudiose Mujawamariya, Christopher Okafor, Renee Bullock, Nsharwasi Léon Nabahungu, Bernard Vanlauwe
Dietary patterns for consumers among the elite and middle-income classes in developing countries are shifting rapidly toward the consumption of more animal-based products. Although this shift presents opportunities, there are significant market failures affecting their preferences and willingness to pay (WTP). This study used a multistage sample survey of 309 consumers from three different communities of Bukavu, Eastern DRC, to examine the effect of socioeconomic/socio-demographic characteristics and quality attributes on consumers' purchasing decisions and WTP for meat products...
November 2018: Food Science & Nutrition
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