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Lower and lower middle income countries

Amare Deribew, John Ojal, Boniface Karia, Evasius Bauni, Mark Oteinde
BACKGROUND: Several low and middle-income countries (LMIC) use Demographic and Health Surveys (DHS) and/or Health and Demographic Surveillance System (HDSS) to monitor the health of their population. The level and trends of under-five mortality rates could be different in the HDSS sites compared to the DHS reports. In this study, we investigated the change in under-five mortality rates overtime in the HDSS sites and the corresponding DHS reports in eight countries and 13 sites. METHODS: Under-five mortality rates in the HDSS sites were determined using number of under-five deaths (numerator) and live births (denominator)...
October 24, 2016: BMC Public Health
Peter de Jonge, Annelieke M Roest, Carmen C W Lim, Silvia E Florescu, Evelyn J Bromet, Dan J Stein, Meredith Harris, Vladimir Nakov, Jose Miguel Caldas-de-Almeida, Daphna Levinson, Ali O Al-Hamzawi, Josep Maria Haro, Maria Carmen Viana, Guilherme Borges, Siobhan O'Neill, Giovanni de Girolamo, Koen Demyttenaere, Oye Gureje, Noboru Iwata, Sing Lee, Chiyi Hu, Aimee Karam, Jacek Moskalewicz, Viviane Kovess-Masfety, Fernando Navarro-Mateu, Mark Oakley Browne, Marina Piazza, José Posada-Villa, Yolanda Torres, Margreet L Ten Have, Ronald C Kessler, Kate M Scott
CONTEXT: The scarcity of cross-national reports and the changes in Diagnostic and Statistical Manual version 5 (DSM-5) regarding panic disorder (PD) and panic attacks (PAs) call for new epidemiological data on PD and PAs and its subtypes in the general population. OBJECTIVE: To present representative data about the cross-national epidemiology of PD and PAs in accordance with DSM-5 definitions. DESIGN AND SETTING: Nationally representative cross-sectional surveys using the World Health Organization Composite International Diagnostic Interview version 3...
October 24, 2016: Depression and Anxiety
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
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
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
Denice Kamugumya, Jill Olivier
BACKGROUND: Public-private partnership (PPP) has been suggested as a tool to assist governments in lower to middle income countries fulfil their responsibilities in the efficient delivery of health services. In Tanzania, although the idea of PPP has existed for many years in the health sector, there has been limited coordination, especially at a district level - which has contributed to limited health gains or systems strengthening obviously seen as a result of PPP. METHODS: This case study was conducted in the Bagamoyo district of Tanzania, and employed in-depth interviews, document reviews, and observations methods...
October 21, 2016: BMC Health Services Research
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
Anagha Loharikar, Laure Dumolard, Susan Chu, Terri Hyde, Tracey Goodman, Carsten Mantel
Since the global Expanded Program on Immunization (EPI) was launched in 1974, vaccination against six diseases (tuberculosis, polio, diphtheria, tetanus, pertussis, and measles) has prevented millions of deaths and disabilities (1). Significant advances have been made in the development and introduction of vaccines, and licensed vaccines are now available to prevent 25 diseases (2,3). Historically, new vaccines only became available in low-income and middle-income countries decades after being introduced in high-income countries...
October 21, 2016: MMWR. Morbidity and Mortality Weekly Report
Rajeev Gupta, Raghuvir Singh Khedar, Raja Babu Panwar
Hypertension is the most important cause of global burden of disease. It is highly prevalent in India and other low and lower-middle income countries. Prevalence of uncontrolled hypertension varies from 70-90% and is significantly greater in rural vs urban locations. Guidelines based treatment strategy has improved blood pressure (BP) control in high income countries but no context-specific guidelines exist in low and lower-middle income countries such as India. There are numerous barriers to proper BP control in these countries and include political apathy, bureaucratic inertia, weak health systems, overburdened healthcare providers and unempowered patients...
September 2016: Journal of the Association of Physicians of India
Carlos F Cáceres, Annick Borquez, Jeffrey D Klausner, Rachel Baggaley, Chris Beyrer
BACKGROUND: In this article, we present recent evidence from studies focused on the implementation, effectiveness and cost-effectiveness of pre-exposure prophylaxis (PrEP) for HIV infection; discuss PrEP scale-up to date, including the observed levels of access and policy development; and elaborate on key emerging policy and research issues to consider for further scale-up, with a special focus on lower-middle income countries. DISCUSSION: The 2015 WHO Early Release Guidelines for HIV Treatment and Prevention reflect both scientific evidence and new policy perspectives...
2016: Journal of the International AIDS Society
Séverine Erismann, Serge Diagbouga, Peter Odermatt, Astrid M Knoblauch, Jana Gerold, Akina Shrestha, Tarnagda Grissoum, Aminata Kaboré, Christian Schindler, Jürg Utzinger, Guéladio Cissé
BACKGROUND: Unsafe drinking water, unimproved sanitation and lack of hygiene pose health risks, particularly to children in low- and middle-income countries. This study aimed to assess the prevalence and risk factors of intestinal parasitic infections in school-aged children in two regions of Burkina Faso. METHODS: A cross-sectional survey was carried out in February 2015 with 385 children aged 8-14 years from eight randomly selected schools in the Plateau Central and Centre-Ouest regions of Burkina Faso...
October 18, 2016: Parasites & Vectors
Dorairaj Prabhakaran
Among individuals with established CVD, multiple medications (aspirin, blood pressure lowering drugs and statins) are required to manage CVD and it is well established that non adherence to prescribed treatments is substantial in the long term. Such discontinuation of CV-preventive medications and low adherence rates has been shown to affect the success of CVD prevention efforts. In low- and middle income countries only less than 20% patients receive recommended therapy for CVD prevention, but even in high-income countries treatment coverage in the community is only about 50% in those with heart disease and 35% in those with stroke...
September 2016: Journal of Hypertension
Francesco Cappuccio
The evidence. Salt (i.e. sodium chloride) is causally related to blood pressure (BP). The higher the salt intake, the higher the BP, an effect seen since birth. A small and sustained reduction in salt intake causes a fall in BP. The evidence from controlled studies, small and large, short and long, all agree on the following: (1) salt intake is one of the major determinants of BP in populations and individuals; (2) a reduction in salt intake causes a dose-dependent reduction in BP - the lower the salt the lower the BP; (3) the effect is seen in both sexes, in people of all ages and ethnic groups, and with all starting BPs...
September 2016: Journal of Hypertension
Ernesto Schiffrin
Clinical practice guidelines, which are systematically developed statements aimed at helping people make clinical, policy-related and system-related decisions, frequently vary widely in quality. A strategy is needed to differentiate among guidelines and ensure that those of the highest quality are implemented. Hypertension Canada provides annually updated standardized recommendations and clinical practice guidelines to detect, treat and control hypertension. The annual, evidence-based recommendations are developed through intense discussion of the clinical implications via a systematic review of the literature followed by critical appraisals of all the new clinical research, taking into account the assessment criteria in the Appraisal of Guidelines for Research & Evaluation (AGREE) II instrument that evaluates the process of practice guideline development and the quality of reporting...
September 2016: Journal of Hypertension
Il Suh
Cardiovascular disease (CVD) is a global leading cause of death nowadays. Fortunately, the majority of risk factors which cause CVD are preventable. The INTERSTROKE study recently reported that about 90% of the population-attributable risk of stroke is associated with ten modifiable risk factors. Especially high blood pressure levels are well established to be associated with cardiovascular morbidity and mortality.Recently CVD mortality has been decreasing in high-income countries but increasing in some middle-income countries and low-income countries...
September 2016: Journal of Hypertension
Tazeen Jafar
Chronic kidney disease (CKD) defined as reduced estimated glomerular filtration rate (eGFR) or presence of albuminuria, progresses to end stage renal disease (ESRD), needing dialysis or kidney transplant to sustain life, and is associated with increased risks of premature cardiovascular disease (CVD) and mortality. CKD ranked 18 leading (and most rapidly rising cause of mortality by the Global Burden of Disease Study 2010. The social and economic consequences of CKD are far worse in low and middle income countries (LMICs) including India, Pakistan, Bangladesh, and Sri Lanka...
September 2016: Journal of Hypertension
Desta Ayode, Abebayehu Tora, David Farrell, Getnet Tadele, Gail Davey, Colleen M McBride
Background: Disease-related stigma is a public health concern steadily gaining global attention. Evidence consistently shows that an individual's attribution of disease cause can prompt or justify interpersonal stigma. However, few studies have explored causal beliefs about inherited disease and their influence on stigmatising behaviours in low and middle income countries. Design and methods: The study was conducted in 2013, in six communities in Wolaita zone, Southern Ethiopia. A total of 1800 respondents took part in the study, 600 were affected by an inherited disease and 1200 were unaffected neighbours...
August 19, 2016: Journal of Public Health Research
Subas Neupane, Freddie Bray, Anssi Auvinen
BACKGROUND: Macroeconomic indicators are likely associated with prostate cancer (PCa) incidence and mortality globally, but have rarely been assessed. METHODS: Data on PCa incidence in 2003-2007 for 49 countries with either nationwide cancer registry or at least two regional registries were obtained from Cancer Incidence in Five Continents Vol X and national PCa mortality for 2012 from GLOBOCAN 2012. We compared PCa incidence and mortality rates with various population-level indicators of health, economy and development in 2000...
October 15, 2016: World Journal of Urology
Amar Salam, Kadhim Sulaiman, Ibrahim Al-Zakwani, Alawi Alsheikh-Ali, Mohammed Aljaraallah, Husam Al Faleh, Abdelfatah Elasfar, Prasanth Panduranga, Rajvir Singh, Charbel Abi Khalil, Jassim Al Suwaidi
OBJECTIVES: The purpose of this study was to report prevalence, clinical characteristics, precipitating factors, management and outcome of patients with coronary artery disease (CAD) among patients hospitalized with heart failure (HF) in seven Middle Eastern countries and compare them to non-CAD patients. METHODS: Data were derived from Gulf CARE (Gulf aCute heArt failuRe rEgistry), a prospective multicenter study of 5005 consecutive patients hospitalized with acute HF during February-November 2012 in 7 Middle Eastern countries...
October 13, 2016: Hospital Practice (Minneapolis)
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