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Nahal B, Owen EM, Jama M, Obasi A, Clarke E. A review of authorship in herpes simplex virus type-2 (HSV-2) research conducted in low-income and middle-income countries between 2000 and 2020. BMJ Glob Health 2024; 9:e012719. [PMID: 38964883 PMCID: PMC11227752 DOI: 10.1136/bmjgh-2023-012719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 03/18/2024] [Indexed: 07/06/2024] Open
Abstract
INTRODUCTION Equitable inclusion of low-income and middle-income country (LMIC) researchers and women in research authorship is a priority. A review of progress in addressing WHO-identified priorities provided an opportunity to examine the geographical and gender distribution of authorship in herpes simplex virus type-2 (HSV-2) research. METHODS Publications addressing five areas prioritised in a WHO workshop and published between 2000 and 2020 were identified. Data on author country, gender, authorship position and research funding source were collected by manuscript review and internet searches and analysed using IBM SPSS V.26. RESULTS Of, 297 eligible papers identified, (n=294) had multiple authors. Of these, 241 (82%) included at least one LMIC author and 143 (49%) and 122 (41%) had LMIC first and last authors, respectively. LMICs funded studies were more than twice as likely to include an LMIC first or last author as high-income country-funded studies (relative risk 2.36, 95% CI 1.93 to 2.89). Respectively, 129 (46%) and 106 (36%) studies had female first and last authors. LMIC first and last authorship varied widely by HSV-2 research area and increased over time to 65% and 59% by 2015-2020. CONCLUSION Despite location of the research itself in LMIC settings, over the 20-year period, LMIC researchers held only a minority of first and last authorship positions. While LMIC representation in these positions improved over time, important inequities remain in key research areas and for women. Addressing current and historical power disparities in global health research, research infrastructure and how it is funded may be key addressing to addressing these issues.
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Affiliation(s)
- Belinder Nahal
- University of Liverpool, Liverpool, UK
- London School of Hygiene & Tropical Medicine, London, UK
| | - Ela Mair Owen
- University of Liverpool, Liverpool, UK
- Liverpool School of Tropical Medicine, Liverpool, UK
| | - Muna Jama
- Liverpool School of Tropical Medicine, Liverpool, UK
- International Rescue Committee, Mogadishu, Somalia
| | - Angela Obasi
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
- AXESS Sexual Health, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Emily Clarke
- University of Liverpool, Liverpool, UK
- AXESS Sexual Health, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
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Kapoor N, Haregu T, Singh K, Oommen AM, Audsley J, Gupta P, Jasper S, Mini GK, Thirunavukkarasu S, Oldenburg B. Strengthening research capacity of early-mid career researchers: Implementation and evaluation of the Excellence in Non-COmmunicable disease REsearch (ENCORE) program. J Investig Med 2024; 72:475-486. [PMID: 38378444 DOI: 10.1177/10815589241236156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
High-quality training and networking are pivotal for enhancing the research capacity of early- to mid-career researchers in the prevention and control of non-communicable diseases. Beyond building research skills, these professionals gain valuable insights from interdisciplinary mentorship, networking opportunities, and exposure to diverse cultures and health systems. Despite the significance of such initiatives, their implementation remains underexplored. Here, we describe the implementation and evaluation of the Excellence in Non-COommunicable disease REsearch (ENCORE) program, a collaborative initiative between Australia and India that was launched in 2016 and spanned a duration of 3 years. Led by a consortium that included the University of Melbourne and leading Indian research and medical institutions, ENCORE involved 15 faculty members and 20 early-mid career researchers. The program comprised various elements, including face-to-face forums, masterclasses, webinars, a health-technology conference, and roundtable events. ENCORE successfully trained the early-career researchers, resulting in over 30 peer-reviewed articles, 36 conference presentations, and the submission of seven grant applications, three of which received funding. Beyond individual achievements, ENCORE fostered robust research collaboration between Australian and Indian institutions, showcasing its broader impact on strengthening research capacities across borders.
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Affiliation(s)
- Nitin Kapoor
- Department of Endocrinology, Diabetes and Metabolism, Christian Medical College & Hospital, Vellore, Tamil Nadu, India
- Non-Communicable Disease Unit, The Nossal Institute for Global Health, University of Melbourne, Melbourne, VIC, Australia
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Tilahun Haregu
- Non-Communicable Disease Unit, The Nossal Institute for Global Health, University of Melbourne, Melbourne, VIC, Australia
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Kavita Singh
- Public Health Foundation of India, Gurugram, Haryana, India
- Centre for Chronic Disease Control, New Delhi, New Delhi, India
- Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Baden-Wurttemberg, Germany
| | - Anu Mary Oommen
- Community Health Department, Christian Medical College & Hospital, Vellore, Tamil Nadu, India
| | - Jennifer Audsley
- Department of Infectious Diseases, Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, VIC, Australia
| | - Priti Gupta
- Centre for Chronic Disease Control, New Delhi, New Delhi, India
| | - Smitha Jasper
- Department of Ophthalmology, Christian Medical College & Hospital, Vellore, Tamil Nadu, India
| | - G K Mini
- Global Institute of Public Health, Ananthapuri Hospitals and Research Institute, Trivandrum, Kerala, India
| | - Sathish Thirunavukkarasu
- Department of Family and Preventive Medicine, School of Medicine, Emory University, Atlanta, Georgia, USA
- Emory Global Diabetes Research Center (EGDRC), Woodruff Health Sciences Center, Emory University, Atlanta, GA, USA
| | - Brian Oldenburg
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
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Ferreira VR, Brayne C, Ragonese P, Ketzoian C, Piccioli M, Tinti L, Casali C, di Lorenzo C, Ramos C, Azevedo J, Gomes A, Stewart R, Haas H, Hoppenbrouwer S, Metting E, Gallo V. A Delphi consensus to identify the key screening tests/questions for a digital neurological examination for epidemiological research. J Neurol 2024; 271:2694-2703. [PMID: 38378908 PMCID: PMC11055750 DOI: 10.1007/s00415-024-12254-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 02/06/2024] [Accepted: 02/11/2024] [Indexed: 02/22/2024]
Abstract
BACKGROUND Most neurological diseases have no curative treatment; therefore, focusing on prevention is key. Continuous research to uncover the protective and risk factors associated with different neurological diseases is crucial to successfully inform prevention strategies. eHealth has been showing promising advantages in healthcare and public health and may therefore be relevant to facilitate epidemiological studies. OBJECTIVE In this study, we performed a Delphi consensus exercise to identify the key screening tests to inform the development of a digital neurological examination tool for epidemiological research. METHODS Twelve panellists (six experts in neurological examination, five experts in data collection-two were also experts in the neurological examination, and three experts in participant experience) of different nationalities joined the Delphi exercise. Experts in the neurological examination provided a selection of items that allow ruling out neurological impairment and can be performed by trained health workers. The items were then rated by them and other experts in terms of their feasibility and acceptability. RESULTS Ten tests and seven anamnestic questions were included in the final set of screening items for the digital neurological examination. Three tests and five anamnestic questions were excluded from the final selection due to their low ratings on feasibility. CONCLUSION This work identifies the key feasible and acceptable screening tests and anamnestic questions to build an electronic tool for performing the neurological examination, in the absence of a neurologist.
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Affiliation(s)
- Vasco Ribeiro Ferreira
- Department of Sustainable Health, University of Groningen, Campus Fryslân, Wirdumerdijk 34, 8911 CE, Leeuwarden, The Netherlands.
| | - Carol Brayne
- Cambridge Public Health, University of Cambridge, Cambridge, United Kingdom
| | - Paolo Ragonese
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BIND), University of Palermo, Palermo, Italy
| | - Carlos Ketzoian
- Institute of Neurology, School of Medicine, Neuroepidemiology Section, University of the Republic, Montevideo, Uruguay
| | - Marta Piccioli
- UOC of Neurology, PO San Filippo Neri, ASL Roma 1, Rome, Italy
| | - Lorenzo Tinti
- Laboratory of Neurology, Mario Negri Institute for Pharmacological Research (IRCCS), Milan, Italy
| | - Carlo Casali
- Department of Medico-Surgical Sciences and Biotechnologies (SBMC), University Rome Sapienza, Rome, Italy
| | - Cherubino di Lorenzo
- Department of Medico-Surgical Sciences and Biotechnologies (SBMC), University Rome Sapienza, Rome, Italy
| | - Claudia Ramos
- Grupo de Neurociencias de Antioquia (GNA), Faculty of Medicine, University of Antioquia, Medellín, Colombia
- Grupo de Neuropsicología y Conducta (GRUNECO), Faculty of Medicine, University of Antioquia, Medellín, Colombia
| | - João Azevedo
- Agrupamento de Centros de Saúde de Gaia, Unidade de Saúde Familiar Nova Salus, Vila Nova de Gaia, Portugal
| | | | | | - Hein Haas
- Parkinson Vereniging, Bunnik, The Netherlands
| | | | - Esther Metting
- University Medical Center Groningen, Groningen, The Netherlands
- Faculty of Economics and Business, University of Groningen, Groningen, The Netherlands
| | - Valentina Gallo
- Department of Sustainable Health, University of Groningen, Campus Fryslân, Wirdumerdijk 34, 8911 CE, Leeuwarden, The Netherlands
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Tchouaket E, Kruglova K, Sieleunou I, Tsafack M, Tankwa JM, Takoguen G, Argiropoulos N, Robins S, Sia D. Knowledge, attitude, and practices of stakeholders involved in healthcare financing programs on economic evaluations in Cameroon. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003101. [PMID: 38662686 PMCID: PMC11045103 DOI: 10.1371/journal.pgph.0003101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 03/22/2024] [Indexed: 04/28/2024]
Abstract
There are many healthcare financing programs (HFPs) in Cameroon; however, there is a lack of information on these programs' economic effectiveness and efficiency. Involvement of local stakeholders in the economic evaluations (EEs) of HFPs is critical for ensuring contextual factors are considered prior to program implementation. We conducted a cross-sectional study to assess the need for EEs of Cameroonian HFPs. Regular staff in supervisory roles aged 18 years and above were recruited in four Cameroonian cities. Data were collected via face-to-face surveys between June 15 and August 1, 2022. Descriptive analyses summarized participants' knowledge, attitudes, and practices in relation to performing EEs of HFPs. Principal component analyses identified organizational, individual, and contextual factors that could influence participants' involvement. The total sample included 106 participants. On average, 65% of participants reported being aware of the listed HFPs; however, of these, only 28% said that they had been involved in the HFPs. Of the 106 participants, 57.5% knew about EEs; yet, almost 90% reported that the HFP in question had never been subject to an EE, and 84% had never been involved in an EE. Most participants indicated that they had intended or would like to receive EE training. Using principal component analyses, the organizational factors were classified into two components ('policy and governance' and 'planning and implementation'), the individual factors were classified into two components ('training' and 'motivation'), and the contextual factors were classified into three components ('funding,' 'political economy,' and 'public expectations'). The findings of this study highlight the need to invest in EE training to improve participation rates of Cameroonian stakeholders in the EEs of HFPs. Improved knowledge, diversified skills, and increased participation of stakeholders from all levels of the Cameroonian healthcare system are critical to the effective and efficient development, implementation, and EE of the country's HFPs.
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Affiliation(s)
- Eric Tchouaket
- Department of Nursing, Université du Québec en Outaouais, Saint-Jérôme, Québec, Canada
| | - Katya Kruglova
- Department of Nursing, Université du Québec en Outaouais, Saint-Jérôme, Québec, Canada
| | | | | | | | | | - Nikolas Argiropoulos
- Department of Mathematics and Statistics, Université de Montréal, Montréal, Québec, Canada
| | - Stephanie Robins
- Department of Nursing, Université du Québec en Outaouais, Saint-Jérôme, Québec, Canada
| | - Drissa Sia
- Department of Nursing, Université du Québec en Outaouais, Saint-Jérôme, Québec, Canada
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Mardini A, Shaykhon N, Khan A, Mardini A, Saeed HN. Global Disparities in Access to Vaccine Clinical Trials: A Review of the Literature. Vaccines (Basel) 2024; 12:348. [PMID: 38675731 PMCID: PMC11054150 DOI: 10.3390/vaccines12040348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 03/06/2024] [Accepted: 03/13/2024] [Indexed: 04/28/2024] Open
Abstract
Vaccines are an effective tool to reduce the disease burden from infectious diseases on a population, infrastructural, and individual level. Before vaccines can be administered to populations at large, they must go through rigorous testing in the form of clinical trials. While vaccine trials can be used to assess the efficacy of interventions on a local populace as well as target local endemic diseases, most clinical trials are sponsored and conducted by companies in high-income countries (HICs). This can lead to vaccines that are not optimized for low- and middle-income countries (LMICs) and that often neglect to address diseases specific to the local population. This narrative review aims to explore the factors leading to discrepancies in the execution of and access to vaccine trials between HICs and LMICs, thus guiding future efforts in confronting them. This review was written using the literature sourced from the PubMed database and supplemented with articles from Google Scholar along with grey literature. Several themes are highlighted including poorly defined regulatory and ethical guidelines, staff shortages, lack of research infrastructure, and logistical barriers. We discuss how these challenges have affected vaccine development in various capacities through case examples of SARS-CoV-2, poliovirus, and malaria. Many challenges remain in equitable vaccine clinical trial development and implementation. Facilitating the implementation of locally sponsored vaccine clinical trials in LMICs may be one avenue to address these challenges. In doing so, LMICs can become active stakeholders in the health of their citizens by addressing endemic diseases, tailoring vaccine specifications based on local needs, and implementing wide-scale vaccine access and delivery.
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Affiliation(s)
- Ali Mardini
- School of Medicine, Royal College of Surgeons in Ireland—Medical University of Bahrain, Busaiteen 228, Bahrain; (A.M.); (N.S.); (A.K.)
| | - Norhan Shaykhon
- School of Medicine, Royal College of Surgeons in Ireland—Medical University of Bahrain, Busaiteen 228, Bahrain; (A.M.); (N.S.); (A.K.)
| | - Asher Khan
- School of Medicine, Royal College of Surgeons in Ireland—Medical University of Bahrain, Busaiteen 228, Bahrain; (A.M.); (N.S.); (A.K.)
- York Hospital, York and Scarborough Teaching Hospital and Foundation Trust, National Health Service (NHS), London SM5 1AA, UK
| | - Ahmad Mardini
- Advocate Christ Medical Center, Chicago, IL 60453, USA;
| | - Hajirah N. Saeed
- Department of Ophthalmology, Illinois Eye and Ear Infirmary, University Illinois Chicago, Chicago, IL 60612, USA
- Department of Ophthalmology, Loyola University Medical Center, Maywood, IL 60153, USA
- Harvard Medical School, Boston, MA 02115, USA
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6
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Nwagbata A, Dutta R, Jayaram A, Thivalapill N, Jain S, Faria I, Alty IG, Gadgil A, Roy N, Raykar NP. Beyond the Ivory Tower: Perception of academic global surgery by surgeons in low- and middle-income countries. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002979. [PMID: 38483892 PMCID: PMC10939292 DOI: 10.1371/journal.pgph.0002979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 02/12/2024] [Indexed: 03/17/2024]
Abstract
Interest in global surgery has surged amongst academics and practitioners in high-income countries (HICs), but it is unclear how frontline surgical practitioners in low-resource environments perceive the new field or its benefit. Our objective was to assess perceptions of academic global surgery amongst surgeons in low- and middle-income countries (LMICs). We conducted a cross-sectional e-survey among surgical trainees and consultants in 62 LMICs, as defined by the World Bank in 2020. This paper is a sub-analysis highlighting the perception of academic surgery and the association between practice setting and responses using Pearson's Chi-square test. Analyses were completed using Stata15. The survey received 416 responses, including 173 consultants (41.6%), 221 residents (53.1%), 8 medical graduates (1.9%), and 14 fellows (3.4%). Of these, 72 responses (17.3%) were from low-income countries, 137 (32.9%) from lower-middle-income countries, and 207 (49.8%) from upper-middle-income countries. 286 respondents (68.8%) practiced in urban areas, 34 (8.2%) in rural areas, and 84 (20.2%) in both rural and urban areas. Only 185 (44.58%) were familiar with the term "global surgery." However, 326 (79.3%) agreed that collaborating with HIC surgeons for research is beneficial to being a global surgeon, 323 (78.8%) agreed that having an HIC co-author improves likelihood of publication in a reputable journal, 337 (81.6%) agreed that securing research funding is difficult in their country, 195 (47.3%) agreed that their institutions consider research for promotion, 252 (61.0%) agreed that they can combine research and clinical practice, and 336 (82%) are willing to train HIC medical students and residents. A majority of these LMIC surgeons noted limited academic incentives to perform research in the field. The academic global surgery community should take note and foster equitable collaborations to ensure that this critical segment of stakeholders is engaged and has fewer barriers to participation.
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Affiliation(s)
- Arinzechukwu Nwagbata
- Harvard Medical School, Boston, Massachusetts, United States of America
- Department of Trauma, Burn, and Critical Care, Brigham and Women’s Hospital, Boston, Massachusetts, United States of America
| | - Rohini Dutta
- Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
- WHO Collaborating Centre for Research in Surgical Care Delivery in Low-Middle Income Countries, Mumbai, India
| | - Anusha Jayaram
- Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
- Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States of America
| | - Neil Thivalapill
- WHO Collaborating Centre for Research in Surgical Care Delivery in Low-Middle Income Countries, Mumbai, India
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States of America
| | - Samarvir Jain
- WHO Collaborating Centre for Research in Surgical Care Delivery in Low-Middle Income Countries, Mumbai, India
| | - Isabella Faria
- Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Isaac G. Alty
- Department of Trauma, Burn, and Critical Care, Brigham and Women’s Hospital, Boston, Massachusetts, United States of America
- Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Anita Gadgil
- The George Institute for Global Health, New Delhi, India
| | - Nobhojit Roy
- WHO Collaborating Centre for Research in Surgical Care Delivery in Low-Middle Income Countries, Mumbai, India
- The George Institute for Global Health, New Delhi, India
- Karolinska Institutet, Stockholm, Sweden
| | - Nakul P. Raykar
- Department of Trauma, Burn, and Critical Care, Brigham and Women’s Hospital, Boston, Massachusetts, United States of America
- Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
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Perkins J, Nelson S, Birley E, Mcswiggan E, Dozier M, McCarthy A, Atkins N, Agyei-Manu E, Rostron J, Kameda K, Kelly A, Chandler C, Street A. Is qualitative social research in global health fulfilling its potential?: a systematic evidence mapping of research on point-of-care testing in low- and middle-income contexts. BMC Health Serv Res 2024; 24:172. [PMID: 38326871 PMCID: PMC10848363 DOI: 10.1186/s12913-024-10645-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 01/26/2024] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND Qualitative social research has made valuable contributions to understanding technology-based interventions in global health. However, we have little evidence of who is carrying out this research, where, how, for what purpose, or the overall scope of this body of work. To address these questions, we undertook a systematic evidence mapping of one area of technology-focused research in global health, related to the development, deployment and use of point-of-care tests (POCTs) for low-and middle-income countries (LMICs). METHODS We conducted an exhaustive search to identify papers reporting on primary qualitative studies that explore the development, deployment, and use of POCTs in LMICs and screened results to identify studies meeting the inclusion criteria. Data were extracted from included studies and descriptive analyses were conducted. RESULTS One hundred thirty-eight studies met our inclusion criteria, with numbers increasing year by year. Funding of studies was primarily credited to high income country (HIC)-based institutions (95%) and 64% of first authors were affiliated with HIC-based institutions. Study sites, in contrast, were concentrated in a small number of LMICs. Relatively few studies examined social phenomena related to POCTs that take place in HICs. Seventy-one percent of papers reported on studies conducted within the context of a trial or intervention. Eighty percent reported on studies considering POCTs for HIV and/or malaria. Studies overwhelmingly reported on POCT use (91%) within primary-level health facilities (60%) or in hospitals (30%) and explored the perspectives of the health workforce (70%). CONCLUSIONS A reflexive approach to the role, status, and contribution of qualitative and social science research is crucial to identifying the contributions it can make to the production of global health knowledge and understanding the roles technology can play in achieving global health goals. The body of qualitative social research on POCTs for LMICs is highly concentrated in scope, overwhelmingly focuses on testing in the context of a narrow number of donor-supported initiatives and is driven by HIC resources and expertise. To optimise the full potential of qualitative social research requires the promotion of open and just research ecosystems that broaden the scope of inquiry beyond established public health paradigms and build social science capacity in LMICs.
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Affiliation(s)
- Janet Perkins
- Department of Social Anthropology, School of Social and Political Science, University of Edinburgh, Chrystal Macmillan Building, 15a George Square, Edinburgh, EH8 9LD, Scotland, UK.
| | - Sarah Nelson
- Centre for Population Health Sciences, Old Medical School, Usher Institute, University of Edinburgh, Teviot Place, Edinburgh, EH8 9AG, Scotland, UK
| | - Emma Birley
- Centre for Population Health Sciences, Old Medical School, Usher Institute, University of Edinburgh, Teviot Place, Edinburgh, EH8 9AG, Scotland, UK
| | - Emilie Mcswiggan
- Centre for Population Health Sciences, Old Medical School, Usher Institute, University of Edinburgh, Teviot Place, Edinburgh, EH8 9AG, Scotland, UK
| | - Marshall Dozier
- Library Academic Support Team, Library & University Collections, and Information Services University of Edinburgh, Argyle House, 3 Lady Lawson Street, Edinburgh, EH3 9DR, Scotland, UK
| | - Anna McCarthy
- Department of Social Work, School of Social and Political Science, University of Edinburgh, Chrystal Macmillan Building, 15a George Square, Edinburgh, EH8 9LD, Scotland, UK
| | - Nadege Atkins
- Centre for Population Health Sciences, Old Medical School, Usher Institute, University of Edinburgh, Teviot Place, Edinburgh, EH8 9AG, Scotland, UK
| | - Eldad Agyei-Manu
- Centre for Population Health Sciences, Old Medical School, Usher Institute, University of Edinburgh, Teviot Place, Edinburgh, EH8 9AG, Scotland, UK
| | - Jasmin Rostron
- Centre for Population Health Sciences, Old Medical School, Usher Institute, University of Edinburgh, Teviot Place, Edinburgh, EH8 9AG, Scotland, UK
| | - Koichi Kameda
- Centre Population et Développement (CEPED), 45 Rue Des Saints-Pères, 75006, Paris, France
| | - Ann Kelly
- Department of Global Health and Social Medicine, King's College London, Bush House North East Wing, 30 Aldwych, London, WC2B 4BG, England, UK
| | - Clare Chandler
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, England, UK
| | - Alice Street
- Department of Social Anthropology, School of Social and Political Science, University of Edinburgh, Chrystal Macmillan Building, 15a George Square, Edinburgh, EH8 9LD, Scotland, UK
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8
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Sigudla J, Maritz JE. Exploratory factor analysis of constructs used for investigating research uptake for public healthcare practice and policy in a resource-limited setting, South Africa. BMC Health Serv Res 2023; 23:1423. [PMID: 38102600 PMCID: PMC10724913 DOI: 10.1186/s12913-023-10165-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 10/17/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Low-resource settings are often less capable of responding to and implementing available quality research evidence for public healthcare practice and policy development due to various factors. In most low-resource settings, limited empirical evidence is available to help deal with localised factors that contribute to low public health research uptake, particularly from the perspective of key research stakeholders. METHODS Although the study initially employed a two-phase exploratory sequential approach, this paper focuses on the results generated from a quantitative approach. Considering the determining factors that affect research uptake in the context of low-resource settings, a measuring instrument was developed and its reliability and validity were assessed using an exploratory factor analysis approach. RESULTS A total of 212 respondents, according to their job roles and titles, were identified as researchers, front-line workers, programme managers, and directors/senior managers of higher learning institutions, indicating that the three constructs applied in the questionnaire, namely (1) individual factors, (2) organisational factors, and (3) research characteristics, demonstrated relatively high reliability with a Cronbach's alpha of greater than 0.791. CONCLUSION The study concludes that the instrument can potentially be used to measure factors that affect research uptake in low-resource settings.
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Affiliation(s)
- Jerry Sigudla
- Department of Health Studies, University of South Africa, Pretoria, South Africa.
| | - Jeanette E Maritz
- Department of Health Studies, University of South Africa, Pretoria, South Africa
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Wilmshurst JM, Catsman-Berrevoets C, Gilbert DL, Nagarajan L, Samia P, Serdaroglu E, Triki C, Vidaurre J, Hameed B. Access to Pediatric Neurology Training and Services Worldwide: A Survey by the International Child Neurology Association. Neurology 2023; 101:798-808. [PMID: 37491325 PMCID: PMC10634651 DOI: 10.1212/wnl.0000000000207633] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 05/30/2023] [Indexed: 07/27/2023] Open
Abstract
Pediatric neurology is the medical subspecialty responsible for diagnosing and managing diseases and disorders of the nervous system in childhood and adolescence. In many, but not all, regions of the world, the discipline of pediatric neurology is recognized as a specialty or subspecialty of either neurology or pediatrics. Significant knowledge and competencies in this area are necessary to be effective in clinical practice. The need for this is driven by the high burden of disease from neurologic conditions in children and the effect on their families. As the first part of a multistaged project under the auspices of the International Child Neurology Association, in collaboration with key stakeholders, a survey was undertaken to establish which countries have practicing child neurologists. For those countries that have child neurologists, the survey established the number of practitioners and which countries have access to in-country child neurology training. Responses were obtained from 177 countries. Worldwide, there is a median of 0.07 and mean of 0.39 child neurologists per 100,000 population. The greatest deficits in child neurology specialists and access to training were evident in countries which fell under the World Bank rating of low-income country status (range of 0-0.008 child neurologists per 100,000 population). Seventy-three percent of low-income countries lack access to child neurologists: The majority are in the African and South-East Asia regions. For the population of 1.37 billion in the continent of Africa, there were 324 child neurologists, equating to a median of 0.01 per 100,000 population in comparison with a median of 0.59 child neurologists per 100,000 across high-income countries. Ninety-four countries had capacity to support in-country pediatric neurology training. Worldwide, there are inadequate numbers of child neurologists and a great need for increased training capacity.
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Affiliation(s)
- Jo M Wilmshurst
- From the Department of Paediatric Neurology (J.M.W.), Red Cross War Memorial Children's Hospital, Neuroscience Institute, University of Cape Town, South Africa; Department of Paediatric Neurology (C.C.-B.), ErasmusMC / Sophia Childrens Hospital, Rotterdam, the Netherlands; Division of Neurology (D.L.G.), Cincinnati Children's Hospital Medical Center; Department of Pediatrics, University of Cincinnati College of Medicine, OH; Department of Neurology (L.N.), Perth Children's Hospital; Faculty of Health and Medical Sciences, UWA; Telethon Kids Institute, Perth, Australia; Department of Paediatrics and Child Health (P.S.), Medical College, Aga Khan University, Nairobi, Kenya; Department of Child Neurology (E.S.), Gazi University School of Medicine, Ankara, Turkey; Child Neurology Department (C.T.), Hedi Chaker Hospital, University of Sfax, Tunisia; Pediatric Clinical Neurophysiology Fellowship (J.V.), Nationwide Children's Hospital, The Ohio State University; and Department of Paediatric Neurology and Neurodisability (B.H.), Great Ormond Street Hospital for Children, London.
| | - Coriene Catsman-Berrevoets
- From the Department of Paediatric Neurology (J.M.W.), Red Cross War Memorial Children's Hospital, Neuroscience Institute, University of Cape Town, South Africa; Department of Paediatric Neurology (C.C.-B.), ErasmusMC / Sophia Childrens Hospital, Rotterdam, the Netherlands; Division of Neurology (D.L.G.), Cincinnati Children's Hospital Medical Center; Department of Pediatrics, University of Cincinnati College of Medicine, OH; Department of Neurology (L.N.), Perth Children's Hospital; Faculty of Health and Medical Sciences, UWA; Telethon Kids Institute, Perth, Australia; Department of Paediatrics and Child Health (P.S.), Medical College, Aga Khan University, Nairobi, Kenya; Department of Child Neurology (E.S.), Gazi University School of Medicine, Ankara, Turkey; Child Neurology Department (C.T.), Hedi Chaker Hospital, University of Sfax, Tunisia; Pediatric Clinical Neurophysiology Fellowship (J.V.), Nationwide Children's Hospital, The Ohio State University; and Department of Paediatric Neurology and Neurodisability (B.H.), Great Ormond Street Hospital for Children, London
| | - Donald L Gilbert
- From the Department of Paediatric Neurology (J.M.W.), Red Cross War Memorial Children's Hospital, Neuroscience Institute, University of Cape Town, South Africa; Department of Paediatric Neurology (C.C.-B.), ErasmusMC / Sophia Childrens Hospital, Rotterdam, the Netherlands; Division of Neurology (D.L.G.), Cincinnati Children's Hospital Medical Center; Department of Pediatrics, University of Cincinnati College of Medicine, OH; Department of Neurology (L.N.), Perth Children's Hospital; Faculty of Health and Medical Sciences, UWA; Telethon Kids Institute, Perth, Australia; Department of Paediatrics and Child Health (P.S.), Medical College, Aga Khan University, Nairobi, Kenya; Department of Child Neurology (E.S.), Gazi University School of Medicine, Ankara, Turkey; Child Neurology Department (C.T.), Hedi Chaker Hospital, University of Sfax, Tunisia; Pediatric Clinical Neurophysiology Fellowship (J.V.), Nationwide Children's Hospital, The Ohio State University; and Department of Paediatric Neurology and Neurodisability (B.H.), Great Ormond Street Hospital for Children, London
| | - Lakshmi Nagarajan
- From the Department of Paediatric Neurology (J.M.W.), Red Cross War Memorial Children's Hospital, Neuroscience Institute, University of Cape Town, South Africa; Department of Paediatric Neurology (C.C.-B.), ErasmusMC / Sophia Childrens Hospital, Rotterdam, the Netherlands; Division of Neurology (D.L.G.), Cincinnati Children's Hospital Medical Center; Department of Pediatrics, University of Cincinnati College of Medicine, OH; Department of Neurology (L.N.), Perth Children's Hospital; Faculty of Health and Medical Sciences, UWA; Telethon Kids Institute, Perth, Australia; Department of Paediatrics and Child Health (P.S.), Medical College, Aga Khan University, Nairobi, Kenya; Department of Child Neurology (E.S.), Gazi University School of Medicine, Ankara, Turkey; Child Neurology Department (C.T.), Hedi Chaker Hospital, University of Sfax, Tunisia; Pediatric Clinical Neurophysiology Fellowship (J.V.), Nationwide Children's Hospital, The Ohio State University; and Department of Paediatric Neurology and Neurodisability (B.H.), Great Ormond Street Hospital for Children, London
| | - Pauline Samia
- From the Department of Paediatric Neurology (J.M.W.), Red Cross War Memorial Children's Hospital, Neuroscience Institute, University of Cape Town, South Africa; Department of Paediatric Neurology (C.C.-B.), ErasmusMC / Sophia Childrens Hospital, Rotterdam, the Netherlands; Division of Neurology (D.L.G.), Cincinnati Children's Hospital Medical Center; Department of Pediatrics, University of Cincinnati College of Medicine, OH; Department of Neurology (L.N.), Perth Children's Hospital; Faculty of Health and Medical Sciences, UWA; Telethon Kids Institute, Perth, Australia; Department of Paediatrics and Child Health (P.S.), Medical College, Aga Khan University, Nairobi, Kenya; Department of Child Neurology (E.S.), Gazi University School of Medicine, Ankara, Turkey; Child Neurology Department (C.T.), Hedi Chaker Hospital, University of Sfax, Tunisia; Pediatric Clinical Neurophysiology Fellowship (J.V.), Nationwide Children's Hospital, The Ohio State University; and Department of Paediatric Neurology and Neurodisability (B.H.), Great Ormond Street Hospital for Children, London
| | - Esra Serdaroglu
- From the Department of Paediatric Neurology (J.M.W.), Red Cross War Memorial Children's Hospital, Neuroscience Institute, University of Cape Town, South Africa; Department of Paediatric Neurology (C.C.-B.), ErasmusMC / Sophia Childrens Hospital, Rotterdam, the Netherlands; Division of Neurology (D.L.G.), Cincinnati Children's Hospital Medical Center; Department of Pediatrics, University of Cincinnati College of Medicine, OH; Department of Neurology (L.N.), Perth Children's Hospital; Faculty of Health and Medical Sciences, UWA; Telethon Kids Institute, Perth, Australia; Department of Paediatrics and Child Health (P.S.), Medical College, Aga Khan University, Nairobi, Kenya; Department of Child Neurology (E.S.), Gazi University School of Medicine, Ankara, Turkey; Child Neurology Department (C.T.), Hedi Chaker Hospital, University of Sfax, Tunisia; Pediatric Clinical Neurophysiology Fellowship (J.V.), Nationwide Children's Hospital, The Ohio State University; and Department of Paediatric Neurology and Neurodisability (B.H.), Great Ormond Street Hospital for Children, London
| | - Chahnez Triki
- From the Department of Paediatric Neurology (J.M.W.), Red Cross War Memorial Children's Hospital, Neuroscience Institute, University of Cape Town, South Africa; Department of Paediatric Neurology (C.C.-B.), ErasmusMC / Sophia Childrens Hospital, Rotterdam, the Netherlands; Division of Neurology (D.L.G.), Cincinnati Children's Hospital Medical Center; Department of Pediatrics, University of Cincinnati College of Medicine, OH; Department of Neurology (L.N.), Perth Children's Hospital; Faculty of Health and Medical Sciences, UWA; Telethon Kids Institute, Perth, Australia; Department of Paediatrics and Child Health (P.S.), Medical College, Aga Khan University, Nairobi, Kenya; Department of Child Neurology (E.S.), Gazi University School of Medicine, Ankara, Turkey; Child Neurology Department (C.T.), Hedi Chaker Hospital, University of Sfax, Tunisia; Pediatric Clinical Neurophysiology Fellowship (J.V.), Nationwide Children's Hospital, The Ohio State University; and Department of Paediatric Neurology and Neurodisability (B.H.), Great Ormond Street Hospital for Children, London
| | - Jorge Vidaurre
- From the Department of Paediatric Neurology (J.M.W.), Red Cross War Memorial Children's Hospital, Neuroscience Institute, University of Cape Town, South Africa; Department of Paediatric Neurology (C.C.-B.), ErasmusMC / Sophia Childrens Hospital, Rotterdam, the Netherlands; Division of Neurology (D.L.G.), Cincinnati Children's Hospital Medical Center; Department of Pediatrics, University of Cincinnati College of Medicine, OH; Department of Neurology (L.N.), Perth Children's Hospital; Faculty of Health and Medical Sciences, UWA; Telethon Kids Institute, Perth, Australia; Department of Paediatrics and Child Health (P.S.), Medical College, Aga Khan University, Nairobi, Kenya; Department of Child Neurology (E.S.), Gazi University School of Medicine, Ankara, Turkey; Child Neurology Department (C.T.), Hedi Chaker Hospital, University of Sfax, Tunisia; Pediatric Clinical Neurophysiology Fellowship (J.V.), Nationwide Children's Hospital, The Ohio State University; and Department of Paediatric Neurology and Neurodisability (B.H.), Great Ormond Street Hospital for Children, London
| | - Biju Hameed
- From the Department of Paediatric Neurology (J.M.W.), Red Cross War Memorial Children's Hospital, Neuroscience Institute, University of Cape Town, South Africa; Department of Paediatric Neurology (C.C.-B.), ErasmusMC / Sophia Childrens Hospital, Rotterdam, the Netherlands; Division of Neurology (D.L.G.), Cincinnati Children's Hospital Medical Center; Department of Pediatrics, University of Cincinnati College of Medicine, OH; Department of Neurology (L.N.), Perth Children's Hospital; Faculty of Health and Medical Sciences, UWA; Telethon Kids Institute, Perth, Australia; Department of Paediatrics and Child Health (P.S.), Medical College, Aga Khan University, Nairobi, Kenya; Department of Child Neurology (E.S.), Gazi University School of Medicine, Ankara, Turkey; Child Neurology Department (C.T.), Hedi Chaker Hospital, University of Sfax, Tunisia; Pediatric Clinical Neurophysiology Fellowship (J.V.), Nationwide Children's Hospital, The Ohio State University; and Department of Paediatric Neurology and Neurodisability (B.H.), Great Ormond Street Hospital for Children, London
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Amegee Quach J, Valea I, Bates I, Pulford J. Factors affecting African postdoctoral researcher capacity development within 'learn-by-doing' international research partnerships: findings from the 'Partnership for Increasing the Impact of Vector Control (PIIVeC)'. BMJ Glob Health 2023; 8:e012626. [PMID: 37678937 PMCID: PMC10496693 DOI: 10.1136/bmjgh-2023-012626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 08/06/2023] [Indexed: 09/09/2023] Open
Abstract
INTRODUCTION The Partnership to Increase the Impact of Vector Control sought to develop the research and leadership capacity of 10 African postdoctoral vectorborne disease scientists via a 'learn-by-doing' approach. We identified factors that either supported or hindered their development and, drawing on this information, determined key lessons for future programmes with similar objectives. METHODS A longitudinal qualitative study encompassing focus group discussions and semistructured interviews conducted with the cohort of African postdoctoral fellows, programme leadership, supervisory and research support staff (N=28). Data analysis was informed by a general inductive approach. RESULTS Numerous supportive and hindering factors were identified. Supportive factors were primarily structural or attitudinal in nature, whereas hindering factors were primarily operational or contextual. None of the supporting or hindering factors were specific to vectorborne disease research. Four key lessons for future programme implementation emerged, including: the value in exposing postdoctoral fellows to a diverse work-mix and training-mix to improve understanding of the broad skillset needed for scientific career advancement; recognising and managing the potentially competing interests of different partnership members to ensure everyone benefits from participation; ensuring equity of opportunity and rewarding engagement; and ensuring flexibility in support provision. CONCLUSION Our study highlights numerous factors that may be readily incorporated into early career researcher capacity strengthening initiatives based on a learn-by-doing approach. Many of these factors are supported by a growing weight of evidence and would be appropriate to research capacity strengthening programmes both within and outside of a vectorborne disease context.
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Affiliation(s)
- Jessica Amegee Quach
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Innocent Valea
- Unité de Recherche Clinique de Nanoro, Institut de Recherche en Sciences de la Santé, Nanoro, Burkina Faso
| | - Imelda Bates
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Justin Pulford
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
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11
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Ferreira JC, Pizzichini MMM. The MECOR program: almost three decades inspiring and improving respiratory clinical research in Brazil and across the globe. J Bras Pneumol 2023; 49:e20230213. [PMID: 37493794 PMCID: PMC10578909 DOI: 10.36416/1806-3756/e20230213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2023] Open
Affiliation(s)
- Juliana Carvalho Ferreira
- . Methods in Epidemiologic, Clinical, and Operations Research-MECOR-program, American Thoracic Society/Asociación Latinoamericana del Tórax, Montevideo, Uruguay
- . Divisão de Pneumologia, Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo (SP) Brasil
| | - Marcia M M Pizzichini
- . Methods in Epidemiologic, Clinical, and Operations Research-MECOR-program, American Thoracic Society/Asociación Latinoamericana del Tórax, Montevideo, Uruguay
- . Programa de Pós-Graduação em Ciências Médicas, Universidade Federal de Santa Catarina, Florianópolis (SC) Brasil
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Barriers to conducting independent quantitative research in low-income countries: A cross-sectional study of public health graduate students in Liberia. PLoS One 2023; 18:e0280917. [PMID: 36730248 PMCID: PMC9894428 DOI: 10.1371/journal.pone.0280917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 01/12/2023] [Indexed: 02/03/2023] Open
Abstract
INTRODUCTION During recent disease outbreaks, quantitative research has been used to investigate intervention scenarios while accounting for local epidemiological, social, and clinical context. Despite the value of such work, few documented research efforts have been observed to originate from low-income countries. This study aimed to assess barriers that may be limiting the awareness and conduct of quantitative research among Liberian public health graduate students. METHODS A semi-structured questionnaire was administered September-November 2021 to Master's in Public Health (MPH) students in Liberia. Potential barriers around technology access, understanding of quantitative science, and availability of mentorship were interrogated. Associations between barriers and self-reported likelihood of conducting quantitative research within six months of the investigation period were evaluated using ordinal logistic regression. RESULTS Among 120 participating MPH students, 86% reported owning a personal computer, but 18.4% and 39.4% had machines with malfunctioning hardware and/or with battery power lasting ≤2 hours, respectively. On average, students reported having poor internet network 3.4 days weekly. 47% reported never using any computer software for analysis, and 46% reported no specific knowledge on statistical analysis. Students indicated spending a median 30 minutes per week reading scientific articles. Moreover, 50% had no access to quantitative research mentors. Despite barriers, 59% indicated they were very likely to undertake quantitative research in the next 6 months; only 7% indicated they were not at all likely. Computer ownership was found to be statistically significantly associated with higher likelihood of conducting quantitative research in the multivariable analysis (aOR: 4.90,95% CI: 1.54-16.3). CONCLUSION The high likelihood of conducting quantitative research among MPH students contrasts with limitations around computing capacity, awareness of research tools/methods, and access to mentorship. To promote rigorous analytical research in Liberia, there is a need for systematic measures to enhance capacity for diverse quantitative methods through efforts sensitive to the local research environment.
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Patel LN, Gurumurthy M, Bronson G, Sanders K, Rusen ID. Implementation challenges and lessons learned from the STREAM clinical trial-a survey of trial sites. Trials 2023; 24:51. [PMID: 36691098 PMCID: PMC9869607 DOI: 10.1186/s13063-023-07068-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 01/03/2023] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Design and implementation of multi-country clinical trials for multidrug-resistant tuberculosis (MDR-TB) are complex for several reasons, including trial duration, varying levels of experience and infrastructure across settings, and different regulatory requirements. STREAM was an MDR-TB clinical trial that recruited over 1000 participants. We documented challenges and best practices/lessons learned from the site perspective to improve implementation of future trials. METHODS We conducted a voluntary survey of trial staff at all sites to obtain information on challenges encountered and best practices/lessons learned from implementation of the STREAM trial. Respondents were asked to identify substantive aspects of trial implementation from a list that included: trial administration, laboratory strengthening/infrastructure, pharmacy and supply chain management, community engagement, regulatory and ethics requirements, health economics, and other (respondent designated) about which a practical guide would be useful to improve future trial implementation. For each aspect of trial implementation selected, respondents were asked to report challenges and best practices/lessons learned during STREAM. Lastly, respondents were asked to list up to three things they would do differently when implementing future trials. Summary statistics were generated for quantitative data and thematic analysis was undertaken for qualitative data. RESULTS Of 67 responses received from 13 of 15 sites, 47 (70%) were included in the analyses, after excluding duplicate or incomplete responses. Approximately half the respondents were investigators or trial coordinators. The top three aspects of trial implementation identified for a best practices/lessons learned practical guide to improve future trial implementation were: trial administration, community engagement, and laboratory strengthening/infrastructure. For both challenges and best practices/lessons learned, three common themes were identified across different aspects of trial implementation. Investment in capacity building and ongoing monitoring; investment in infrastructure and well-designed trial processes; and communication and coordination between staff and meaningful engagement of stakeholders were all thought to be critical to successful trial implementation. CONCLUSIONS Existing practices for clinical trial implementation should be reevaluated. Sponsors should consider the local context and the need to increase upfront investment in the cross-cutting thematic areas identified to improve trial implementation.
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Affiliation(s)
- Leena N. Patel
- grid.475681.9Vital Strategies, 100 Broadway, 4th Floor, New York, NY 10005 USA
| | - Meera Gurumurthy
- Vital Strategies Health Systems, Asia Pacific, Singapore, Singapore
| | - Gay Bronson
- grid.475681.9Vital Strategies, 100 Broadway, 4th Floor, New York, NY 10005 USA
| | - Karen Sanders
- grid.415052.70000 0004 0606 323XMedical Research Council Clinical Trials Unit at UCL, London, England
| | - I. D. Rusen
- grid.475681.9Vital Strategies, 100 Broadway, 4th Floor, New York, NY 10005 USA
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Eckmann P, Bandrowski A. PreprintMatch: A tool for preprint to publication detection shows global inequities in scientific publication. PLoS One 2023; 18:e0281659. [PMID: 36888577 PMCID: PMC9994746 DOI: 10.1371/journal.pone.0281659] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 01/30/2023] [Indexed: 03/09/2023] Open
Abstract
Preprints, versions of scientific manuscripts that precede peer review, are growing in popularity. They offer an opportunity to democratize and accelerate research, as they have no publication costs or a lengthy peer review process. Preprints are often later published in peer-reviewed venues, but these publications and the original preprints are frequently not linked in any way. To this end, we developed a tool, PreprintMatch, to find matches between preprints and their corresponding published papers, if they exist. This tool outperforms existing techniques to match preprints and papers, both on matching performance and speed. PreprintMatch was applied to search for matches between preprints (from bioRxiv and medRxiv), and PubMed. The preliminary nature of preprints offers a unique perspective into scientific projects at a relatively early stage, and with better matching between preprint and paper, we explored questions related to research inequity. We found that preprints from low income countries are published as peer-reviewed papers at a lower rate than high income countries (39.6% and 61.1%, respectively), and our data is consistent with previous work that cite a lack of resources, lack of stability, and policy choices to explain this discrepancy. Preprints from low income countries were also found to be published quicker (178 vs 203 days) and with less title, abstract, and author similarity to the published version compared to high income countries. Low income countries add more authors from the preprint to the published version than high income countries (0.42 authors vs 0.32, respectively), a practice that is significantly more frequent in China compared to similar countries. Finally, we find that some publishers publish work with authors from lower income countries more frequently than others.
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Affiliation(s)
- Peter Eckmann
- Department of Computer Science and Engineering, UC San Diego, La Jolla, CA, United States of America
| | - Anita Bandrowski
- Department of Neuroscience, UC San Diego, La Jolla, CA, United States of America
- * E-mail:
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Elmore CE, Acharya SC, Dulal S, Enneking-Norton F, Hamal PK, Kattel R, Maurer MA, Paudel D, Paudel BD, Shilpakar R, Shrestha DS, Thapa U, Wilson DT, LeBaron V. Building a 'Virtual Library': continuing a global collaboration to strengthen research capacity within Nepal and other low- and middle-income countries. Glob Health Action 2022; 15:2112415. [PMID: 36200469 PMCID: PMC9553149 DOI: 10.1080/16549716.2022.2112415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
To fill the gap in health research capacity-building efforts, we created the ‘Virtual Library’ (VL) – a web-based repository of context-relevant resources for health researchers in low- and middle-income countries (LMICs). This paper describes the participatory process used to systematically develop the VL, and describes how our interprofessional team – representing both an LMIC (Nepal) and a high-income country (HIC) (USA, US) – engaged in shared meaning-making. A team of researchers and clinicians representing a range of subdisciplines from Nepal and the US created a replicable search strategy and standardized Resource Screening Guide (RSG) to systematically assess resources to be included within the VL. Descriptive methods were used to summarize findings from the RSG and lessons learned from the collaborative process. Collectively, 14 team members reviewed 564 potential resources (mean = 40, SD = 22.7). Mean RSG score was 7.02/10 (SD = 2). More than 76% of resources met each of the four quality criteria (relevant; reputable, accessible; understandable). Within the published VL, 298 resources were included, organized by 15 topics and 45 sub-topics. Of these, 223 resources were evaluated by the RSG; 75 were identified by team member expertise. The collaborative process involved regular meetings, iterative document revisions, and peer review. Resource quality was better than expected, perhaps because best practices/principles related to health research are universally relevant, regardless of context. While the RSG was essential to systematize our search and ensure reproducibility, team member expertise was valuable. Pairing team members during peer-review led to bi-directional knowledge sharing and was particularly successful. This work reflects a highly collaborative global partnership and offers a model for future health research capacity-building efforts. We invite engagement with the Virtual Library <https://lmicresearch.org> as one supportive pillar of infrastructure to develop individual and institutional research capacity.
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Affiliation(s)
- Catherine E Elmore
- University of Virginia School of Nursing, Charlottesville, Virginia, USA
| | | | - Soniya Dulal
- Department of Internal Medicine, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | | | - Pawan Kumar Hamal
- National Academy of Medical Sciences, National Trauma Center, Kathmandu, Nepal
| | - Regina Kattel
- Department of Palliative Medicine, Nepal Cancer Hospital and Research Center, Patan, Nepal
| | - Martha A Maurer
- University of Wisconsin - Madison School of Pharmacy, Sonderegger Research Center, Madison, Wisconsin, USA
| | - Damodar Paudel
- Department of Medicine, Nepal Police Hospital, Kathmandu, Nepal
| | | | - Ramila Shilpakar
- Department of Medical Oncology, Bhaktapur Cancer Hospital, Bhaktapur, Nepal
| | | | - Usha Thapa
- B.P. Koirala Memorial Cancer Hospital, Bharatpur, Nepal
| | - Daniel T Wilson
- Claude Moore Health Sciences Library, University of Virginia, Charlottesville, Virginia, USA
| | - Virginia LeBaron
- University of Virginia School of Nursing, Charlottesville, Virginia, USA
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Casamitjana N, Vahedi M, Davoren S, Kavoura E, Tallada J, Yamaka S, Launois P. Benefits and barriers in a clinical research competency development scheme for low- and middle-income countries. Glob Health Action 2022; 15:2035504. [PMID: 35322762 PMCID: PMC8956300 DOI: 10.1080/16549716.2022.2035504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background The EDCTP-TDR Clinical Research and Development Fellowship (CRDF) scheme has offered one-year clinical research training placements for early- and mid-career researchers from LMIC since 1999. Objective Using the results of a 2018 external evaluation of the CRDF, the current article aims to identify the principal benefits for the main stakeholders of the CRDF scheme as well as the main barriers to accessing these benefits. Method Data analysis was derived from an external evaluation of the CRDF scheme. Based on a logical framework approach, data for the external evaluation was collected through document review, interviews, focus groups, and questionnaires collected from the main stakeholder groups. The evaluation was structured along six main themes: relevance, effectiveness, efficiency, impact, sustainability, and equity. Results The current paper focuses on the expected benefits, unexpected benefits, and barriers to enjoying benefits of the scheme for key stakeholders. Discussion Expected benefits were aligned with the development of clinical research competencies, which is the objective of the scheme. Unexpected benefits centred on transferable professional skills in scientific leadership and knowledge translation. Barriers mainly were found around engagement with home institutions and the return and reintegration of fellows following the training period. Conclusions and Recommendations Recommendations include further engagement with and support for home institutions and developing a formal framework for the development of transferable professional competencies, including leadership and knowledge transfer competencies.
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Affiliation(s)
- Núria Casamitjana
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Mahnaz Vahedi
- Special Programme for Research and Training in Tropical Diseases (TDR), Geneva, Switzerland
| | - Sarah Davoren
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Eleni Kavoura
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Joan Tallada
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Sara Yamaka
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Pascal Launois
- Special Programme for Research and Training in Tropical Diseases (TDR), Geneva, Switzerland
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Komolafe AO, Ijarotimi OA, Adetutu OM, Okunola OA, Ojo TO, Oyinlola FF, Olorunmoteni OE, Olodu MD, Agunbiade OM, Otuyemi OD. Acceptability, appropriateness and feasibility of webinar in strengthening research capacity in COVID-19 era in Nigeria. Niger Postgrad Med J 2022; 29:288-295. [PMID: 36308257 DOI: 10.4103/npmj.npmj_167_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
INTRODUCTION The challenges posed by the COVID-19 pandemic have necessitated the increasing use of online virtual training platforms. The objectives of the study were to assess the acceptability, appropriateness and feasibility of virtual space in strengthening the research capacity in Nigeria. MATERIALS AND METHODS Data were collected through an adapted online questionnaire from participants following a 2-day webinar. Both descriptive and inferential (bivariate and multivariate) analyses were done. RESULTS The findings of the study revealed that 55.2% of participants (n = 424) were males and 66.0% (n = 424) were early career researchers. Two hundred and thirty-six participants (55.7%) (n = 424) reported very good acceptability, 67.9% (n = 424) reported very good appropriateness while 54.7% (n = 424) reported good feasibility of webinar for research capacity strengthening. The rating of knowledge obtained from the webinar as 'excellent' increased the odds of acceptability (odd ratio [OR] = 38.30; P < 0.001), appropriateness (OR = 15.65; P < 0.05), and feasibility (OR = 20.85; P < 0.05). Furthermore, the preference for zoom and other online platforms for learning increased odds of acceptability of the webinar (OR = 2.29; confidence interval [CI]: 0.97-57.39; P < 0.05), appropriateness (OR = 2.55; CI: 1.10-5.91; P < 0.05) and feasibility (OR = 2.34; CI: 0.96-5.74; P < 0.05). CONCLUSION The study concluded that webinar was acceptable, appropriate and feasible for strengthening research capacity, although poor internet connectivity and cost of data were the major challenges in Nigeria. However, a learner-centred approach in contents' delivery that ensures optimal learning has the potential of enhancing research capacity strengthening via virtual space.
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Affiliation(s)
| | | | - Olufemi Mayowa Adetutu
- Department of Demography and Social Statistics, Obafemi Awolowo University, Ile-Ife, Nigeria
| | | | | | | | | | - Monday Daniel Olodu
- Department of Community Health, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Ojo Melvin Agunbiade
- Department of Sociology and Anthropology, Obafemi Awolowo University, Ile-Ife, Nigeria
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Mirzoev T, Topp SM, Afifi RA, Fadlallah R, Obi FA, Gilson L. Conceptual framework for systemic capacity strengthening for health policy and systems research. BMJ Glob Health 2022; 7:bmjgh-2022-009764. [PMID: 35922082 PMCID: PMC9353002 DOI: 10.1136/bmjgh-2022-009764] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 07/24/2022] [Indexed: 11/17/2022] Open
Abstract
Health policy and systems research (HPSR) is critical in developing health systems to better meet the health needs of their populations. The highly contextualised nature of health systems point to the value of local knowledge and the need for context-embedded HPSR. Despite such need, relatively few individuals, groups or organisations carry out HPSR, particularly in low-income and middle-income countries. Greater effort is required to strengthen capacity for, and build the field of, HPSR by capturing the multilevel and nuanced representation of HPSR across contexts. No comprehensive frameworks were found that inform systemic HPSR capacity strengthening. Existing literature on capacity strengthening for health research and development tends to focus on individual-level capacity with less attention to collective, organisational and network levels. This paper proposes a comprehensive framework for systemic capacity strengthening for HPSR, uniquely drawing attention to the blurred boundaries and amplification potential for synergistic capacity strengthening efforts across the individual, organisational and network levels. Further, it identifies guiding values and principles that consciously acknowledge and manage the power dynamics inherent to capacity strengthening work. The framework was developed drawing on available literature and was peer-reviewed by the Board and Thematic Working Groups of Health Systems Global. While the framework focuses on HPSR, it may provide a useful heuristic for systemic approaches to capacity strengthening more generally; facilitate its mainstreaming within organisations and networks and help maintain a focused approach to, and structure repositories of resources on, capacity strengthening.
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Affiliation(s)
- Tolib Mirzoev
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK .,Capacity Strengthening Working Group, Health Systems Global, Ottawa, Ontario, Canada
| | - Stephanie M Topp
- Capacity Strengthening Working Group, Health Systems Global, Ottawa, Ontario, Canada.,College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
| | - Rima A Afifi
- Capacity Strengthening Working Group, Health Systems Global, Ottawa, Ontario, Canada.,Department of Community and Behavioral Health, University of Iowa, Iowa City, Iowa, USA
| | - Racha Fadlallah
- Capacity Strengthening Working Group, Health Systems Global, Ottawa, Ontario, Canada.,Department of Health Management and Policy, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Felix Abrahams Obi
- Capacity Strengthening Working Group, Health Systems Global, Ottawa, Ontario, Canada.,Nigeria Country Office, Results for Development Institute, Abuja, Nigeria.,Health Policy Research Group, University of Nigeria-Enugu Campus, Enugu, Nigeria
| | - Lucy Gilson
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK.,Capacity Strengthening Working Group, Health Systems Global, Ottawa, Ontario, Canada.,School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
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Kizub D, Manner CK, Graef K, Abubakar B, Orem J, Odedina F, Adeyeye MC, Nakigudde G, Ayalew K, Kalidas C, Lyerly HK, Norman T, Fashoyin-Aje L, Freedman J, Dent J, Cance B, Gralow J. Action for Increasing Diversity, Market Access, and Capacity in Oncology Registration Trials—Is Africa the Answer? Report From a Satellite Session of the Accelerating Anti-Cancer Agent Development and Validation Workshop. JCO Glob Oncol 2022; 8:e2200117. [PMID: 35714309 PMCID: PMC9232363 DOI: 10.1200/go.22.00117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Patients of African ancestry are not well-represented in cancer clinical trials despite bearing a disproportionate share of mortality both in United States and Africa. We describe key stakeholder perspectives and priorities related to bringing early-stage cancer clinical trials to Africa and outline essential action steps. Increasing Diversity, Market Access, and Capacity in Oncology Registration Trials—Is Africa the Answer? satellite session was organized at 2021 Accelerating Anti-Cancer Agent Development and Validation Workshop. Panelists included representatives of African Organization for Research and Training in Cancer, Uganda Cancer Institute, Uganda Women's Cancer Support Organization, BIO Ventures for Global Health, Bill & Melinda Gates Foundation, the US Food and Drug Administration, Nigeria's National Agency for Food and Drug Administration and Control, Bayer, and Genentech, with moderators from ASCO and American Cancer Society. Key discussion themes and resulting action steps were agreed upon by all participants. Panelists agreed that increasing diversity in cancer clinical trials by including African patients is key to ensuring novel drugs are safe and effective across populations. They underscored the importance of equity in clinical trial access for patients in Africa. Panelists discussed their values related to access and barriers to opening clinical trials in Africa and described innovative solutions from their work aimed at overcoming these obstacles. Multisectoral collaboration efforts that allow leveraging of limited resources and result in sustainable capacity building and mutually beneficial long-term partnerships were discussed as key to outlined action steps. The panel discussion resulted in valuable insights about key stakeholder values and priorities related to bringing early-stage clinical trials to Africa, as well as specific actions for each stakeholder group.
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Affiliation(s)
- Darya Kizub
- University of Texas MD Anderson Research Center, Houston, TX
| | | | - Katy Graef
- BIO Ventures for Global Health, Seattle, WA
| | - Bello Abubakar
- National Hospital, Abuja, Nigeria
- African Organization for Research and Training in Cancer (AORTIC), Rondebosch, South Africa
| | | | - Folakemi Odedina
- African Organization for Research and Training in Cancer (AORTIC), Rondebosch, South Africa
- Mayo Clinic, Rochester, MN
| | | | | | - Kassa Ayalew
- United States Food and Drug Administration, Silver Spring, MD
| | | | | | - Thea Norman
- Bill & Melinda Gates Foundation, Seattle, WA
| | | | | | | | | | - Julie Gralow
- American Society of Clinical Oncology, Alexandria, VA
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20
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Eala MAB, Basilio PAS, Dee EC, Cereno REP, Ang CD, Magsanoc NJ, Ting FIL, Sacdalan DL. Cancer clinical trials in the Philippines. Cancer Causes Control 2022; 33:1273-1275. [PMID: 35857181 DOI: 10.1007/s10552-022-01611-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 06/22/2022] [Indexed: 11/28/2022]
Abstract
In this Commentary, we discuss disparities in resources for and access to cancer trials from the perspective of the Philippines, a lower-middle-income country in Southeast Asia, where cancer is the fourth leading cause of death. Geographic disparities play out such that academic institutions and clinical trials are centralized in the island of Luzon, particularly in the capital, Manila. These disparities are compounded by the lack of comprehensive cancer patient and clinical trial registries in the Philippines. Additionally, sociocultural considerations influence clinical trial implementation. Providers must consider the role of a patient's family in the decision to participate in clinical trials; a patient's degree of health literacy; and the economic burden of cancer care, with attention to both the direct and indirect financial toxicities associated with cancer care. Our call to action is threefold. (1) Bolster locally led trials and encourage international collaboration to improve diversity in trial participation and trials' generalizability. (2) Strengthen national trial registries to improve awareness of trials for which patients are eligible. (3) Integrate cultural competency frameworks that move beyond parachutism and parasitism in research and instead promote trust, reciprocity, and collaboration. These challenges may yet evolve, but in emphasizing these barriers, we hope to kindle further dialogue, new insights, and innovative action towards solving these disparities in cancer research, not just in the Philippines, but also in other low- and middle-income countries.
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Affiliation(s)
- Michelle Ann B Eala
- College of Medicine, University of the Philippines, 547 Pedro Gil Street, 1000, Manila, Philippines.
| | - Patricia Anne S Basilio
- College of Medicine, University of the Philippines, 547 Pedro Gil Street, 1000, Manila, Philippines
| | - Edward Christopher Dee
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Reno Eufemon P Cereno
- Department of Radiation Oncology, British Columbia Cancer Agency, Kelowna, BC, Canada
| | - Christian Daniel Ang
- Department of Surgical Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Department of Surgery, University of Santo Tomas Faculty of Medicine and Surgery, Manila, Philippines
| | - Nikko J Magsanoc
- Division of Urology, Department of Surgery, Philippine General Hospital, Manila, Philippines
| | - Frederic Ivan L Ting
- Section of Medical Oncology, Department of Internal Medicine, Dr. Pablo O. Torre Memorial Hospital, Bacolod, Philippines
| | - Dennis L Sacdalan
- Division of Medical Oncology, Department of Internal Medicine, Philippine General Hospital, Manila, Philippines
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21
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Global Inequity and its Consequences in Radiation Oncology Research. Int J Radiat Oncol Biol Phys 2022; 113:509-510. [PMID: 35777395 DOI: 10.1016/j.ijrobp.2022.04.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 04/23/2022] [Indexed: 11/20/2022]
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22
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Ameh PO, McGuire CM, Van Waes A, Fatusin BB, MacIntyre LS, Lelei-Mailu F, Kodicherla H, Egyirwa Buadu MA, Dankyau M, Yakubu K. Research activity, facilitators and barriers amongst trainee and early-career family physicians in sub-Saharan Africa: A cross-sectional survey. Afr J Prim Health Care Fam Med 2022; 14:e1-e10. [PMID: 35792629 PMCID: PMC9257712 DOI: 10.4102/phcfm.v14i1.3367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 04/26/2022] [Accepted: 04/26/2022] [Indexed: 11/03/2022] Open
Abstract
Background Primary health care systems in sub-Saharan Africa (SSA) need context-specific evidence to address current challenges. Increased family physician (FP) research activity could help fill this gap. Aim To describe the research activity, facilitators and barriers amongst AfriWon Renaissance members. Setting An online programme was designed to improve research activity amongst members of AfriWon Renaissance, an organisation of early-career and trainee FPs in SSA. This article provides a baseline description of their research activity. Methods All AfriWon Renaissance members were invited to participate in an online survey. A content-validated study tool assessed research activity, including participation in research meetings, engagement in research mentorship, number of projects and published articles. Facilitators and barriers were assessed via Likert scales and two open-ended questions. The researchers conducted descriptive statistics using Epi Info 7, a content analysis of open-ended responses and triangulation. Results Amongst the 77 respondents, 49 (63.6%) were still in training. Over two-thirds (71.4%) had participated in a research discussion in the past month. Whilst more than half (63.5%) reported having a manuscript under development, only 26 (33.8%) reported a recent publication. Nearly all (94.8%) intend to continue research in their FP careers. The most common facilitators were the institutional requirement to conduct research and having supportive peers and mentors. The most predominant barriers were time constraints and a lack of training on analysis. Conclusion There is a cohort of committed young FP researchers who would benefit from efforts to address identified barriers and support for their ongoing research activity, in order to increase primary care research outputs in SSA.
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Affiliation(s)
- Pius O Ameh
- Department of Family Medicine, Federal Medical Centre, Keffi.
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23
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Samia P, Hassell J, Hudson J, Ahmed A, Shah J, Hammond C, Kija E, Auvin S, Wilmshurst J. Epilepsy research in Africa: A scoping review by the ILAE Pediatric Commission Research Advocacy Task Force. Epilepsia 2022; 63:2225-2241. [PMID: 35729725 DOI: 10.1111/epi.17321] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 06/04/2022] [Accepted: 06/06/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Despite the high prevalence of epilepsy in Africa, evaluation of epilepsy research trends on the continent is lacking. Without establishing effective research, improvement in care for people with epilepsy cannot be effectively strategized or targeted. METHODS A scoping review of the peer-reviewed literature on epilepsy from Africa (1989-2019) was conducted. The aim was to understand from this what areas are well researched versus underresearched based on published epilepsy topics. RESULTS A total of 1227 publications were identified and assessed. A significant increase in publications occurred over the 30 years assessed. African author leadership was evident in most reports. Nine countries had >50 publications identified; the remaining 45 countries had <50 or no publications. Research studies were typically of lower quality (case series and observational studies). Research themes were more focused on clinical epilepsy (descriptive observational studies) and social aspects (qualitative surveys). However, there were a number of unique and strong themes, specifically for neurocysticercosis and nodding syndrome, where strong research collaborations were evident, basic science understandings were explored, and interventional models were established. SIGNIFICANCE Despite Africa being the continent with the most countries, it is lacking in the quantity, quality, and for some areas, relevance of research on epilepsy. Targeted approaches are needed to upskill the strength of research undertaken with more basic science, interventional, and randomized controlled studies. Themes of research need to promote those with unique African content but also to align with current international research areas that have impact on care delivery, such as epilepsy surgery and epilepsy genetics. For this to be possible, it is important to strengthen research hubs with collaborations that empower Africa to own its epilepsy research journey.
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Affiliation(s)
- Pauline Samia
- Department of Paediatrics and Child Health, Medical College, Aga Khan University, Nairobi, Kenya.,Brain and Mind institute, Aga Khan University, Nairobi, Kenya.,Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Jane Hassell
- Department of Paediatric Neurology, Great Ormond Street Hospital for Children, London, UK.,Gertrude's Garden Children's Hospital, Nairobi, Kenya
| | - Jessica Hudson
- Department of Paediatrics, Oxford University Hospitals, Oxford, UK
| | - Azim Ahmed
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jasmit Shah
- Brain and Mind institute, Aga Khan University, Nairobi, Kenya.,Department of Internal Medicine, Aga Khan University, Nairobi, Kenya
| | - Charles Hammond
- Department of Child Health, Komfo Anokye Teaching Hospital, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Edward Kija
- Department of Paediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Stéphane Auvin
- Department of Pediatric Neurology, Public Hospital Network of Paris, Robert Debré Hospital, Neuro Diderot, National Institute of Health and Medical Research, University of Paris, Paris, France.,University Institute of France, Paris, France
| | - Jo Wilmshurst
- Department of Paediatric Neurology, Red Cross War Memorial Children's Hospital, Cape Town, South Africa.,Neuroscience Institute, University of Cape Town, Cape Town, South Africa
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24
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Driver S, Gray S, Sikhondze W, Awuonda K, Wilcox H, Segrt A, Pandya L, Roth J, Makanga M, Lang T. The European & Developing Countries Clinical Trials Partnership (EDCTP) Knowledge Hub: developing an open platform for facilitating high-quality clinical research. Trials 2022; 23:374. [PMID: 35526046 PMCID: PMC9077850 DOI: 10.1186/s13063-022-06311-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 03/21/2022] [Indexed: 11/10/2022] Open
Abstract
There is stark global inequity in health research in terms of where studies happen, who leads the research and the ultimate beneficiaries of the results generated. Despite significant efforts made, limited research ideas are conceptualised and implemented in low-resource settings to tackle diseases of poverty, and this is especially true in sub-Saharan Africa. There is strong evidence to show that the barriers to locally led research do not vary largely between disease, study type and location and can be largely solved by addressing these common gaps. The European & Developing Countries Clinical Trials Partnership (EDCTP) was established in 2003 as a European response to the global health crisis caused by the three main poverty-related diseases HIV, tuberculosis and malaria. EDCTP has established a model of long-term sustainable capacity development integrated into clinical trials which addresses this lack of locally led research in sub-Saharan Africa, supporting the development of individual and institutional capacity and research outputs that change the management, prevention and treatment of poverty-related and neglected infectious diseases across Africa. In recognition of emergent data on what the barriers and enablers are to long-term, sustainable capabilities to run studies, EDCTP formed a new collaboration with The Global Health Network (TGHN) in September 2017, with the aim to make a set of cross-cutting tools and resources to support the planning, writing and delivery of high-quality clinical trials available to research staff wherever they are in the world, especially those in low- and middle-income countries (LMICs) via TGHN platform. These new resources developed on the ‘EDCTP Knowledge Hub’ are those identified in the mixed method study described in this commentary as being key to addressing the gaps that the research community report as the most limiting elements in their ability to design and implement studies. The Knowledge Hub aims to make these tools freely available to any potential health research team in need of support and guidance in designing and running their own studies, particularly in low-resource settings. The purpose is to provide open access to the specific guidance, information and tools these teams cannot otherwise access freely. Ultimately, this will enable them to design and lead their own high-quality studies addressing local priorities with global alignment, generating new data that can change health outcomes in their communities.
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Affiliation(s)
- Samuel Driver
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, OX3 7FZ, UK.
| | - Shan Gray
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, OX3 7FZ, UK
| | - Welile Sikhondze
- National TB Control Program, Ministry of Health, Mbabane, Eswatini
| | - Ken Awuonda
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, OX3 7FZ, UK
| | - Helena Wilcox
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, OX3 7FZ, UK
| | - Alexis Segrt
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, OX3 7FZ, UK
| | - Lara Pandya
- European & Developing Countries Clinical Trials Partnership, The Hague, The Netherlands
| | - Johanna Roth
- European & Developing Countries Clinical Trials Partnership, The Hague, The Netherlands
| | - Michael Makanga
- European & Developing Countries Clinical Trials Partnership, The Hague, The Netherlands
| | - Trudie Lang
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, OX3 7FZ, UK
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25
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Tirupakuzhi Vijayaraghavan BK, Gupta E, Ramakrishnan N, Beane A, Haniffa R, Lone N, de Keizer N, Adhikari NKJ. Barriers and facilitators to the conduct of critical care research in low and lower-middle income countries: A scoping review. PLoS One 2022; 17:e0266836. [PMID: 35511911 PMCID: PMC9071139 DOI: 10.1371/journal.pone.0266836] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 03/28/2022] [Indexed: 11/18/2022] Open
Abstract
Background
Improvements in health-related outcomes for critically ill adults in low and lower-middle income countries need systematic investments in research capacity and infrastructure. High-quality research has been shown to strengthen health systems; yet, research contributions from these regions remain negligible or absent. We undertook a scoping review to describe barriers and facilitators for the conduct of critical care research.
Methods
We searched MEDLINE and EMBASE up to December 2021 using a strategy that combined keyword and controlled vocabulary terms. We included original studies that reported on barriers or facilitators to the conduct of critical care research in these settings. Two reviewers independently reviewed titles and abstracts, and where necessary, the full-text to select eligible studies. For each study, reviewers independently extracted data using a standardized data extraction form. Barriers and facilitators were classified along the lines of a previous review and based on additional themes that emerged. Study quality was assessed using appropriate tools.
Results
We identified 2693 citations, evaluated 49 studies and identified 6 for inclusion. Of the included studies, four were qualitative, one was a cross-sectional survey and one was reported as an ‘analysis’. The total number of participants ranged from 20–100 and included physicians, nurses, allied healthcare workers and researchers. Barriers identified included limited funding, poor institutional & national investment, inadequate access to mentors, absence of training in research methods, limited research support staff, and absence of statistical support. Our review identified potential solutions such as developing a mentorship network, streamlining of regulatory processes, implementing a centralized institutional research agenda, developing a core-outcome dataset and enhancing access to low-cost technology.
Conclusion
Our scoping review highlights important barriers to the conduct of critical care research in low and lower-middle income countries, identifies potential solutions, and informs researchers, policymakers and governments on the steps necessary for strengthening research systems.
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Affiliation(s)
| | - Ena Gupta
- Department of Pulmonary and Critical Care Medicine, Einstein Health Network, Philadelphia, Pennsylvania, United States of America
| | | | - Abi Beane
- Mahidol-Oxford Tropical Research Unit, Bangkok, Thailand
| | - Rashan Haniffa
- Mahidol-Oxford Tropical Research Unit, Bangkok, Thailand
- Department of Anaesthesia and Critical Care Medicine, University College London, London, United Kingdom
| | - Nazir Lone
- Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Nicolette de Keizer
- Department of Medical Informatics, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Neill K. J. Adhikari
- Interdepartmental Division of Critical Care Medicine, Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada
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26
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Diao K, Lombe DC, Mwaba CK, Wu J, Kizub DA, Cameron CA, Chiao EY, Msadabwe SC, Lin LL. Building Capacity for Cancer Research in the Era of COVID-19: Implementation and Results From an International Virtual Clinical Research Training Program in Zambia. JCO Glob Oncol 2022; 8:e2100372. [PMID: 35594499 PMCID: PMC9173571 DOI: 10.1200/go.21.00372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The incidence of cancer in sub-Saharan Africa is increasing rapidly, yet cancer research in the region continues to lag. One contributing factor is limited exposure to clinical research among trainees. We describe implementation and results of a virtual clinical research training program for Zambian clinical oncology fellows developed jointly by the Cancer Diseases Hospital in Zambia and the MD Anderson Cancer Center to address this need.
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Affiliation(s)
- Kevin Diao
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Dorothy C. Lombe
- Department of Radiation Oncology, MidCentral District Health Board, Palmerston North, New Zealand
| | | | - Juliana Wu
- University of Texas Health Science Center School of Public Health, Houston, TX
| | - Darya A. Kizub
- Department of Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Carrie A. Cameron
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Elizabeth Y. Chiao
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - Lilie L. Lin
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
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27
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Tagoe N, Molyneux S, Pulford J, Kinyanjui S. Consortium management structures, processes, and approaches: The DELTAS Africa example. Wellcome Open Res 2022; 7:139. [PMID: 37664416 PMCID: PMC10474346 DOI: 10.12688/wellcomeopenres.17721.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2022] [Indexed: 09/05/2023] Open
Abstract
Background: Global efforts to strengthen health research capacity in low- and middle-income countries (LMICs) have intensified in the past few decades, and these efforts are often implemented by consortia. Our review of the literature indicated that reports on health research capacity strengthening (HRCS) consortia have primarily focused on programme outputs and outcomes while management processes and their contributions to consortia goals have received little attention. This qualitative study sought to identify the consortium management processes employed by 10 DELTAS Africa consortia, factors influencing these processes, and leaders' consortium management experiences. Methods: We conducted 24 key informant interviews with the directors and programme managers of all the 10 DELTAS Africa consortia, and funding actors who worked closely with the consortia. The interviews were supplemented by reviews of DELTAS and consortium-specific documents. Data were analysed using the content analysis approach. Results: The consortia studied employed similar management processes but adopted different strategies in executing these processes. Study results indicate that decision-making in consortia is not always a straightforward process as leaders were often faced with dilemmas when determining management strategies to adopt, and often tried to balance multiple factors which were not always aligned. This was demonstrated as consortia selected partners, determined goals and activities, assigned roles and responsibilities, allocated resources, established governance and partner management systems, and coordinated and monitored consortia activities. Factors that influenced the choice of processes and approaches included previous experiences, funders expectations, and the pressure to deliver research outputs. Consortia's unique approaches to management were due to varying contexts and influences and indicate that management decisions are nuanced and cannot easily be formularized. Conclusion: The study has highlighted the importance of flexibility in consortium management and the need to generate research capacity strengthening (RCS)-specific guidance that can assist consortia in resolving dilemmas and making appropriate management decisions.
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Affiliation(s)
- Nadia Tagoe
- Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Sassy Molyneux
- KEMRI Wellcome Trust Research Programme, Kilifi, Kenya
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Justin Pulford
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Sam Kinyanjui
- KEMRI Wellcome Trust Research Programme, Kilifi, Kenya
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
- School of Business Studies, Strathmore University, Nairobi, Kenya
- Bioscence Research Centre, Pwani University, Kilifi, Kenya
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28
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Lang T. Enabling evidence to tackle everyday diseases to mitigate another pandemic. Gates Open Res 2022; 6:45. [PMID: 35923865 PMCID: PMC9296833 DOI: 10.12688/gatesopenres.13497.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2022] [Indexed: 11/20/2022] Open
Abstract
The next emergent novel pathogen is likely to occur where the ability to undertake health research and collect life-saving data is lacking. Without embedded and ongoing research activities in place spotting and stopping a new threat is not possible, thereby enabling undetected infection and unchecked transmission within a community. Without local existing capabilities to collect such data delay is catastrophic. Fundamental goals in pandemic preparedness should be to stop an outbreak before it becomes a pandemic. This requires immediate action from teams already in place with the right skills, this could be readily achieved if we shift our thinking and enable research capabilities to be present in every healthcare setting. Addressing fundamental gaps in health research capacity and equity could tackle this and then we would be better prepared, globally.
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Affiliation(s)
- Trudie Lang
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, OX3 7FZ, UK
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29
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Guilbert E, Perry R, Whitmarsh A, Sauchelli S. Short-term effectiveness of nutrition therapy to treat type 2 diabetes in low-income and middle-income countries: systematic review and meta-analysis of randomised controlled trials. BMJ Open 2022; 12:e056108. [PMID: 35273056 PMCID: PMC8915303 DOI: 10.1136/bmjopen-2021-056108] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES This review examined the evidence arising from randomised controlled trials regarding the impact of nutrition therapy on glycaemic control in people living with type 2 diabetes mellitus (T2DM) in low/middle-income countries (LMICs). DESIGN Systematic review and meta-analysis using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) Approach. DATA SOURCES MEDLINE, EMBASE, Web of Science, OpenGrey and the International Clinical Trials Registry were searched (up to July 3 2020). ELIGIBILITY CRITERIA Trials were included if they evaluated nutrition therapy in adults diagnosed with T2DM, were conducted in LMICs, measured glycaemic control and the trial included a 3-month post-intervention assessment. Nutrition therapy was defined according to American Diabetes Association recommendations. DATA EXTRACTION AND SYNTHESIS Two independent reviewers screened the database. Study characteristics and outcome data were extracted using a data collection form. Meta-analyses were conducted for glycated haemoglobin (HbA1c) and fasting blood glucose. Trials were assessed for risk of bias (Cochrane Risk-of-Bias, Version 2.0) and overall certainty of evidence (GRADE). RESULTS Four trials met inclusion criteria (total n=463), conducted in Malaysia, Iran and South Africa. All trials focused on nutrition education with no direct prescription or manipulation of diet. Mean differences between intervention and standard care were -0.63% (95% CI -1.47% to 0.21%) for HbA1c and -13.63 mg/dL (95% CI -37.61 to 10.34) for fasting blood glucose in favour of the intervention. Given the small number of eligible trials, moderate to high risk of publication bias and serious concerns regarding consistency and precision of the evidence, certainty of evidence was deemed to be very low. CONCLUSIONS There is a lack of well-conducted randomised controlled trials that examine the long-term impact of nutrition therapy in LMICs, preventing firm conclusions to be made on their effectiveness. Further research is essential to discover realistic, evidence-based solutions. PROSPERO REGISTRATION NUMBER CRD42020188435.
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Affiliation(s)
| | - Rachel Perry
- National Institute for Health Research Bristol Biomedical Research Centre; University Hospitals of Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK
| | - Alex Whitmarsh
- National Institute for Health Research Bristol Biomedical Research Centre; University Hospitals of Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK
| | - Sarah Sauchelli
- National Institute for Health Research Bristol Biomedical Research Centre; University Hospitals of Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK
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Diallo BA, Usuf E, Ceesay O, D'Alessandro U, Roca A, Martinez-Alvarez M. Clinical research on COVID-19: perceptions and barriers to participation in The Gambia. BMJ Glob Health 2022; 7:e007533. [PMID: 35190459 PMCID: PMC8861886 DOI: 10.1136/bmjgh-2021-007533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 01/29/2022] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION The need to rapidly identify safe and efficacious drug therapies for COVID-19 has resulted in the implementation of multiple clinical trials investigating potential treatment options. These are being undertaken in an unprecedented research environment and at a higher speed than ever before. It is unclear how West African communities perceive such activities and how such perceptions influence participation in COVID-19 clinical trials. This qualitative study was conducted to assess the level of acceptability of a clinical trial on the prevention and treatment of COVID-19 in The Gambia and identify strategies to better engage communities in participating in such a trial. METHODS Data were collected using digitally recorded semistructured interviews (SSIs) and focus group discussions (FGDs) in Brikama and Kanifing local government areas. These are two of the most densely populated administrative subdivisions in The Gambia, where the clinical trial was to be implemented by the MRC Unit The Gambia. 26 men and 22 women aged between 19 and 70 years, with diverse socioeconomic profiles, participated in 8 FGDs (n=36) and 12 SSIs (n=12). Thematic analysis was used to analyse the data. RESULTS Fear of stigmatisation of patients with COVID-19 was a recurring theme in most FGDs and SSIs, with detrimental effects on willingness to accept COVID-19 testing and home visits to follow up patients with COVID-19 and their household contacts. Preserving the privacy of individuals enrolled in the study was key to potentially increase trial participation. Trust in the implementing institution and its acknowledged expertise were facilitators to accepting the administration of investigational products to sick individuals and their close contacts. CONCLUSION COVID-19 is a stigmatising disease. Developing a research-participant collaboration through an ongoing engagement with community members is crucial to a successful enrolment in COVID-19 clinical trials. Trust and acknowledged expertise of the implementing institution are key facilitators to foster such collaboration.
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Affiliation(s)
- Brahima Amara Diallo
- Disease Control and Elimination (DCE), Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Banjul, The Gambia
| | - Effua Usuf
- Disease Control and Elimination (DCE), Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Banjul, The Gambia
| | - Omar Ceesay
- Disease Control and Elimination (DCE), Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Banjul, The Gambia
| | - Umberto D'Alessandro
- Disease Control and Elimination (DCE), Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Banjul, The Gambia
| | - Anna Roca
- Disease Control and Elimination (DCE), Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Banjul, The Gambia
| | - Melisa Martinez-Alvarez
- Disease Control and Elimination (DCE), Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Banjul, The Gambia
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Lang T, Reeder J, Moorthy V, Trindade Lima N, Gray G, Kaleebu P, Ihekweazu C, Nsanzimana S, Kang G, Makanga M, Swaminathan S. Creating equity in health research to drive more and better evidence. Wellcome Open Res 2022; 7:15. [PMID: 38031536 PMCID: PMC10685064 DOI: 10.12688/wellcomeopenres.17287.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2021] [Indexed: 12/01/2023] Open
Abstract
Health research is rapidly changing with evidence being gathered through new agile methods. This evolution is critical but must be globally equitable so the poorest nations do not lose out. We must harness this change to better tackle the daily burden of diseases that affect the most impoverished populations and bring research capabilities to every corner of the world so that rapid and fair responses to new pathogen are possible; anywhere they appear. We must seize this opportunity to make research easier, better and more equitable. Currently too many nations are unable to generate the evidence or translate it to directly change health outcomes in their own communities. It is essential to act and harness this emerging change in how research data can be generated and shared, so that all nations sustainably gain from this development. There are positive examples to draw on from COVID-19, but we now need to act. Here we present an initiative to develop a new framework that can guide researchers in the design and execution of their studies. This highly agile system will work by adapting to risk and complexity in any given study, whilst generating quality, safe and ethical data.
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Affiliation(s)
- Trudie Lang
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, OX3 7FZ, UK
| | - John Reeder
- Department of Research for Health, World Health Organization, Geneva, Switzerland
- Special Programme for Research and Training in Tropical Diseases (TDR), World Health Organization, Geneva, Switzerland
| | - Vasee Moorthy
- Department of Research for Health, World Health Organization, Geneva, Switzerland
| | | | - Glenda Gray
- South African Medical Research Council, Western Cape, South Africa
| | - Pontiano Kaleebu
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda
| | - Chikwe Ihekweazu
- Nigeria Centre for Disease Control (NCDC), Federal Ministry of Health, Abuja, Nigeria
| | | | - Gagandeep Kang
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | - Michael Makanga
- European & Developing Countries Clinical Trials Partnership (EDCTP), The Hague, The Netherlands
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Modlin CE, Deng Q, Benkeser D, Mulate YW, Aseffa A, Waller L, Powell KR, Kempker RR. Authorship trends in infectious diseases society of America affiliated journal articles conducted in low-income countries, 1998-2018. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000275. [PMID: 36962330 PMCID: PMC10021251 DOI: 10.1371/journal.pgph.0000275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 05/04/2022] [Indexed: 11/19/2022]
Abstract
An increasing amount of infectious diseases research is conducted in low-income countries (LIC) given their high burden of disease; however, the contribution of LIC investigators as measured by authorship metrics, specifically to infectious diseases research, has not been thoroughly studied. We performed a literature search for primary research conducted either within LICs or using samples from LIC participants published between 1998-2017 in the Infectious Disease Society of America-affiliated journals Clinical Infectious Diseases, Journal of Infectious Diseases, and Open Forum Infectious Diseases. Primary outcomes included proportion of LIC-affiliated first and last authors (i.e. lead authors) per year and authorship trends over time. Secondary outcomes included proportion of LIC-affiliated authorship by geographic distribution and disease focus. Among 1308 publications identified, 50% had either a first or last LIC-affiliated author. Among these authors, 48% of LIC-affiliated first authors and 52% of LIC-affiliated last authors also reported a non-LIC institutional affiliation. While the absolute number of articles by LIC-affiliated lead authors increased over the 20-year period, the proportion of articles with LIC-affiliated lead authors decreased. There is a growing literature for infectious disease research conducted in LICs yet authorship trends in a small subset of these publications demonstrate a pronounced and worsening exclusion of LIC-affiliated investigators from publishing as lead authors.
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Affiliation(s)
- Chelsea E Modlin
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Qiao Deng
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - David Benkeser
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | | | - Abraham Aseffa
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Lance Waller
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Kimberly R Powell
- Emory University Woodruff Health Sciences Center Library, Atlanta, Georgia, United States of America
| | - Russell R Kempker
- Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia, United States of America
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Davies P, Davies AK, Kirkham JJ, Young AE. Secondary analysis of data from a core outcome set for burns demonstrated the need for involvement of lower income countries. J Clin Epidemiol 2021; 144:56-71. [PMID: 34906674 PMCID: PMC9094759 DOI: 10.1016/j.jclinepi.2021.12.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 11/17/2021] [Accepted: 12/07/2021] [Indexed: 11/08/2022]
Abstract
Objective To compare the views of participants from different income-status countries on outcome selection for a burn care Core Outcome Set (COS). Methods A retrospective analysis of data collected during a two round Delphi survey to prioritise the most important outcomes in burn care research. Results There was considerable agreement between participants from low- and middle-income countries (LMICs) and high-income countries (HICs) across outcomes. The groups agreed on 91% of 88 outcomes in round 1 and 92% of 100 in round 2. In cases of discordance, the consensus of participants from LMICs was to include the outcome and for participants from HICs to exclude. There was also considerable agreement between the groups for the top-ten ranking outcomes. Discordance in outcome prioritisation gives an insight into the different values clinicians from LMICs place on outcomes compared to those from HICs. Limitations of the study were that outcome rankings from international patients were not available. Healthcare professionals from LMICs were not involved in the final consensus meeting. Conclusion COS developers should consider the need for a COS to be global at protocol stage. Global COS should include equal representation from both LMICs and HICs at all stages of development.
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Affiliation(s)
- P Davies
- Bristol Centre for Surgical Research, Bristol Biomedical Research Centre, Population Health Sciences, University of Bristol, United Kingdom
| | - A K Davies
- Centre for Academic Child Health, University of Bristol, United Kingdom
| | - J J Kirkham
- Centre for Biostatistics, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom
| | - A E Young
- Bristol Centre for Surgical Research, Bristol Biomedical Research Centre, Population Health Sciences, University of Bristol, United Kingdom.
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Sobngwi-Tambekou JL, Jones CM, Wenham C, Ratsimbason M, Ratsimbazafy MR, Andriamizarasoa FA, Juma P, Mijumbi-Deve R, Parkhurst J. [Health research in Madagascar: state-of-the-art, challenges and perspectives]. Pan Afr Med J 2021; 39:36. [PMID: 34422159 PMCID: PMC8356933 DOI: 10.11604/pamj.2021.39.36.27462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 03/23/2021] [Indexed: 11/11/2022] Open
Abstract
The evolution and contemporary challenges of health research (HR) in Madagascar are poorly documented. We aim to gain insights on the factors that shape Madagascar's National Health Research System (NHRS) to better understand their influence. We conducted a qualitative case study, which included a documentary review and semi-structured interviews with 38 key informants. We carried out a thematic analysis and used the WHO/AFRO NHRS Barometer to structure the presentation of the results. There is no legislative framework to support HR activities and institutions. There is, however, a policy document outlining national priorities for HS. Human resources for HR are insufficient, due to challenges in training and retaining researchers. International collaboration is almost the only source of HR funding. Collaborations contribute to developing human and institutional capacity, but they are not always aligned with research carried out locally and the country's priority health needs. Incomplete efforts to improve regulation and low public investment in research training and research implementation reflect an insufficient commitment to HR by the government. Negotiating equitable international partnerships, the availability of public funding, and aligning HR with national health priorities would constitute a solid basis for the development of the NHRS in Madagascar.
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Affiliation(s)
- Joëlle Laure Sobngwi-Tambekou
- London School of Economics (LSE) and Political Science, LSE Health, London, United Kingdom.,Recherche Santé et Développement (RSD Institut), Yaoundé, Cameroun
| | - Catherine Marie Jones
- London School of Economics (LSE) and Political Science, LSE Health, London, United Kingdom
| | - Clare Wenham
- London School of Economics and Political Science, Department of Health Policy, London, United Kingdom
| | - Michel Ratsimbason
- Centre National d´Application de Recherches Pharmaceutiques, Antananarivo, Madagascar
| | - Marie-Rolland Ratsimbazafy
- Service d´Appui à la Recherche et à la Gestion des Connaissances, Direction de la formation et de la Recherche, Institut National de Santé Publique et Communautaire, Antananarivo, Madagascar
| | - Fidelis Adolphe Andriamizarasoa
- Direction des Études, de la Planification et du Système d'Information, Ministère de la Santé Publique, Antananarivo, Madagascar
| | - Pamela Juma
- London School of Economics (LSE) and Political Science, LSE Health, London, United Kingdom
| | - Rhona Mijumbi-Deve
- London School of Economics (LSE) and Political Science, LSE Health, London, United Kingdom.,Centre for Rapid Evidence Synthesis, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Justin Parkhurst
- London School of Economics and Political Science, Department of Health Policy, London, United Kingdom
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Adegboyega G, Ozair A, Kanmounye US, Bandyopadhyay S, Vaqas B. Letter: Is the Stupp Protocol an Expensive and Unsustainable Standard of Care for Glioblastoma in Low- and Middle-Income Country Settings? A Call to Action! Neurosurgery 2021; 89:E249-E251. [PMID: 34318884 DOI: 10.1093/neuros/nyab273] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 06/10/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Gideon Adegboyega
- Barts and The London School of Medicine and Dentistry Queen Mary University of London London, UK.,Research Department Association of Future African Neurosurgeons Yaounde, Cameroon
| | - Ahmad Ozair
- Faculty of Medicine King George's Medical University Lucknow, India
| | | | - Soham Bandyopadhyay
- Oxford University Global Surgery Group Nuffield Department of Surgical Sciences University of Oxford Oxford, UK
| | - Babar Vaqas
- Department of Neurosurgery Queens Hospital Romford, UK.,Imperial College London London, UK
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Erber AC, Ewing V, Turner M, Molla M, Murbe G, Enquoselassie F, Davey G, Lang T. Setting up a pragmatic clinical trial in a low-resource setting: A qualitative assessment of GoLBeT, a trial of podoconiosis management in Northern Ethiopia. PLoS Negl Trop Dis 2021; 15:e0009582. [PMID: 34319977 PMCID: PMC8370641 DOI: 10.1371/journal.pntd.0009582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 08/17/2021] [Accepted: 06/21/2021] [Indexed: 11/23/2022] Open
Abstract
Background Clinical trials are often perceived as being expensive, difficult and beyond the capacity of healthcare workers in low-resource settings. However, in order to improve healthcare coverage, the World Health Organization (WHO) World Health Report 2013 stated that all countries need to become generators as well as recipients of data. This study is a methodological examination of the steps and processes involved in setting up the Gojjam Lymphoedema Best Practice Trial (GoLBeT; ISRCTN67805210), a highly pragmatic clinical trial conducted in northern Ethiopia. Challenges to the trial and strategies used to deal with them were explored, together with the reasons for delays. Methodology and principal findings Qualitative research methods were used to analyse emails and reports from the period between trial inception and recruitment. This analysis was complemented by interviews with key informants from the trial operational team. The Global Health Research Process Map was used as a framework against which to compare the steps involved in setting up the trial. A mini-group discussion was conducted with the trial operational team after study completion for reflection and further recommendations. This study showed that the key areas of difficulty in setting up and planning this trial were: the study design, that is, deciding on the study endpoint, where and how best to measure it, and assuring statistical power; recruitment and appropriate training of staff; planning for data quality; and gaining regulatory approvals. Collaboration, for example with statisticians, the trial steering committee, the study monitors, and members of the local community was essential to successfully setting up the trial. Conclusions and significance Lessons learnt from this trial might guide others planning pragmatic trials in settings where research is not common, allowing them to anticipate possible challenges and address them through trial design, planning and operational delivery. We also hope that this example might encourage similar pragmatic studies to be undertaken. Such studies are rarely undertaken or locally led, but are an accessible and efficient way to drive improved outcomes in public health. Podoconiosis is a disease of the lymphatic vessels of the lower extremities, caused by chronic exposure to irritant soils. It results in leg swelling, commonly complicated by acute dermatolymphangioadenitis (ADLA, or ‘acute attacks’), characterised by severe pain, fever and disability. The Gojjam Lymphoedema Best Practice Trial (GoLBeT) trial is a successfully completed randomised controlled trial of podoconiosis treatment that was conducted in the highlands of northern Ethiopia. In this study we report the steps involved in the setup of this trial, from inception to recruitment. The challenges faced are discussed, along with recommendations on how these could be overcome.
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Affiliation(s)
- Astrid C. Erber
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Victoria Ewing
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Mark Turner
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
- Office for National Statistics, Government Buildings, Newport, United Kingdom
| | - Meseret Molla
- School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Gharib Murbe
- Centre for Global Health Research, Brighton & Sussex Medical School, University of Sussex, Brighton, United Kingdom
| | | | - Gail Davey
- School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
- Centre for Global Health Research, Brighton & Sussex Medical School, University of Sussex, Brighton, United Kingdom
| | - Trudie Lang
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
- * E-mail:
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Abstract
OBJECTIVES A key barrier in supporting health research capacity development (HRCD) is the lack of empirical measurement of competencies to assess skills and identify gaps in research activities. An effective tool to measure HRCD in healthcare workers would help inform teams to undertake more locally led research. The objective of this systematic review is to identify tools measuring healthcare workers' individual capacities to conduct research. DESIGN Systematic review and narrative synthesis using Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist for reporting systematic reviews and narrative synthesis and the Critical Appraisals Skills Programme (CASP) checklist for qualitative studies. DATA SOURCES 11 databases were searched from inception to 16 January 2020. The first 10 pages of Google Scholar results were also screened. ELIGIBILITY CRITERIA We included papers describing the use of tools/to measure/assess HRCD at an individual level among healthcare workers involved in research. Qualitative, mixed and quantitative methods were all eligible. Search was limited to English language only. DATA EXTRACTION AND SYNTHESIS Two authors independently screened and reviewed studies using Covidence software, and performed quality assessments using the extraction log validated against the CASP qualitative checklist. The content method was used to define a narrative synthesis. RESULTS The titles and abstracts for 7474 unique records were screened and the full texts of 178 references were reviewed. 16 papers were selected: 7 quantitative studies; 1 qualitative study; 5 mixed methods studies; and 3 studies describing the creation of a tool. Tools with different levels of accuracy in measuring HRCD in healthcare workers at the individual level were described. The Research Capacity and Culture tool and the 'Research Spider' tool were the most commonly defined. Other tools designed for ad hoc interventions with good generalisability potential were identified. Three papers described health research core competency frameworks. All tools measured HRCD in healthcare workers at an individual level with the majority adding a measurement at the team/organisational level, or data about perceived barriers and motivators for conducting health research. CONCLUSIONS Capacity building is commonly identified with pre/postintervention evaluations without using a specific tool. This shows the need for a clear distinction between measuring the outcomes of training activities in a team/organisation, and effective actions promoting HRCD. This review highlights the lack of globally applicable comprehensive tools to provide comparable, standardised and consistent measurements of research competencies. PROSPERO REGISTRATION NUMBER CRD42019122310.
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Affiliation(s)
- Davide Bilardi
- Nuffield Department of Medicine, University of Oxford Centre for Tropical Medicine and Global Health, Oxford, UK
- Fondazione Penta Onlus, Padova, Italy
| | - Elizabeth Rapa
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Sarah Bernays
- School of Public Health, University of Sydney-Sydney Medical School Nepean, Sydney, New South Wales, Australia
- Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Trudie Lang
- Nuffield Department of Medicine, University of Oxford Centre for Tropical Medicine and Global Health, Oxford, UK
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Adegnika AA, Amuasi JH, Basinga P, Berhanu D, Medhanyie AA, Okwaraji YB, Persson LÅ, Savadogo B, Schellenberg J, Steinmann P. Embed capacity development within all global health research. BMJ Glob Health 2021; 6:bmjgh-2020-004692. [PMID: 33597279 PMCID: PMC7893651 DOI: 10.1136/bmjgh-2020-004692] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 01/15/2021] [Accepted: 01/20/2021] [Indexed: 11/16/2022] Open
Affiliation(s)
| | - John H Amuasi
- School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Paulin Basinga
- Bill & Melinda Gates Foundation, Seattle, Washington, USA
| | - Della Berhanu
- London School of Hygiene & Tropical Medicine, London, UK
| | - Araya Abrha Medhanyie
- MARCH Research Centre and School of Public Health, Mekelle University, Mekelle, Tigray, Ethiopia
| | | | | | | | | | - Peter Steinmann
- Swiss Tropical and Public Health Institute, Basel, Basel-Stadt, Switzerland
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The IHAT-GUT Iron Supplementation Trial in Rural Gambia: Barriers, Facilitators, and Benefits. Nutrients 2021; 13:nu13041140. [PMID: 33808403 PMCID: PMC8066312 DOI: 10.3390/nu13041140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 03/26/2021] [Accepted: 03/27/2021] [Indexed: 11/29/2022] Open
Abstract
Introduction: In most sub-Saharan African countries iron deficiency anaemia remains highly prevalent in children and this has not changed in the last 25 years. Supplementation with iron hydroxide adipate tartrate (IHAT) was being investigated in anaemic children in a phase two clinical trial (termed IHAT-GUT), conducted at the Medical Research Council Unit the Gambia at the London School of Hygiene and Tropical Medicine (LSHTM) (abbreviated as MRCG hereof). This qualitative study aimed to explore the personal perceptions of the trial staff in relation to conducting a clinical trial in such settings in order to highlight the health system specific needs and strengths in the rural, resource-poor setting of the Upper River Region in the Gambia. Methods: Individual interviews (n = 17) were conducted with local trial staff of the IHAT-GUT trial. Data were analysed using inductive thematic analysis. Results: Potential barriers and facilitators to conducting this clinical trial were identified at the patient, staff, and trial management levels. Several challenges, such as the rural location and cultural context, were identified but noted as not being long-term inhibitors. Participants believed the facilitators and benefits outnumbered the barriers, and included the impact on education and healthcare, the ambitious and knowledgeable locally recruited staff, and the local partnership. Conclusions: While facilitators and barriers were identified to conducting this clinical trial in a rural, resource-poor setting, the overall impact was perceived as beneficial, and this study is a useful example of community involvement and partnership for further health improvement programs. To effectively implement a nutrition intervention, the local health systems and context must be carefully considered through qualitative research beforehand.
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Compaoré R, Brizuela V, Khisa AM, Gómez AL, Baguiya A, Bonet M, Thorson A, Gitau E, Kouanda S. 'We always find things to learn from.' Lessons from the implementation of the global maternal sepsis study on research capacity: a qualitative study. BMC Health Serv Res 2021; 21:208. [PMID: 33685446 PMCID: PMC7938552 DOI: 10.1186/s12913-021-06195-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Accepted: 02/19/2021] [Indexed: 11/25/2022] Open
Abstract
Background Research capacity strengthening could be an indirect outcome of implementing a research project. The objective of this study was to explore the ability of the global maternal sepsis study (GLOSS), implemented in 52 countries, to develop and strengthen sexual and reproductive health research capacity of local participants in low- and middle- income participating countries. Methods We carried out a qualitative study employing grounded theory in sixteen countries in Africa and Latin America. We used inductive and deductive methods through a focus group discussion and semi-structured interviews for the emergence of themes. Participants of the focus group discussion (n = 8) were GLOSS principal investigators (PIs) in Latin America. Interviewees (n = 63) were selected by the country GLOSS PIs in both Africa and Latin America, and included a diverse sample of participants involved in different aspects of study implementation. Eighty-two percent of the participants were health workers. We developed a conceptual framework that took into consideration data obtained from the focus group and refined it based on data from the interviews. Results Six themes emerged from the data analysis: recognized need for research capacity, unintended effects of participating in research, perceived ownership and linkage with the research study, being just data collectors, belonging to an institution that supports and fosters research, and presenting study results back to study implementers. Research capacity strengthening needs were consistently highlighted including involvement in protocol development, training and technical support, data analysis, and project management. The need for institutional support for researchers to conduct research was also emphasised. Conclusion This study suggests that research capacity strengthening of local researchers was an unintentional outcome of the large multi-country study on maternal sepsis. However, for sustainable research capacity to be built, study coordinators and funders need to deliberately plan for it, addressing needs at both the individual and institutional level. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-06195-9.
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Affiliation(s)
| | - Vanessa Brizuela
- UNDP/UNFPA/ UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Anne M Khisa
- African Population and Health Research Centre, Nairobi, Kenya
| | - Alejandra López Gómez
- Programme of Gender, Reproductive Health and Sexuality/Institute of Psychology of Health, School of Psychology, University of the Republic, Montevideo, Uruguay
| | - Adama Baguiya
- Research Institute for Health Sciences, Ouagadougou, Burkina Faso
| | - Mercedes Bonet
- UNDP/UNFPA/ UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Anna Thorson
- UNDP/UNFPA/ UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Evelyn Gitau
- African Population and Health Research Centre, Nairobi, Kenya
| | - Seni Kouanda
- Research Institute for Health Sciences, Ouagadougou, Burkina Faso
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Aryal D, Beane A, Dondorp AM, Green C, Haniffa R, Hashmi M, Jayakumar D, Marshall JC, McArthur CJ, Murthy S, Webb SA, Acharya SP, Ishani PGP, Jawad I, Khanal S, Koirala K, Luitel S, Pabasara U, Paneru HR, Kumar A, Patel SS, Ramakrishnan N, Salahuddin N, Shaikh M, Tolppa T, Udayanga I, Umrani Z. Operationalisation of the Randomized Embedded Multifactorial Adaptive Platform for COVID-19 trials in a low and lower-middle income critical care learning health system. Wellcome Open Res 2021; 6:14. [PMID: 33604455 PMCID: PMC7883321 DOI: 10.12688/wellcomeopenres.16486.1] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/15/2021] [Indexed: 01/05/2023] Open
Abstract
The Randomized Embedded Multifactorial Adaptive Platform (REMAP-CAP) adapted for COVID-19) trial is a global adaptive platform trial of hospitalised patients with COVID-19. We describe implementation in three countries under the umbrella of the Wellcome supported Low and Middle Income Country (LMIC) critical care network: Collaboration for Research, Implementation and Training in Asia (CCA). The collaboration sought to overcome known barriers to multi centre-clinical trials in resource-limited settings. Methods described focused on six aspects of implementation: i, Strengthening an existing community of practice; ii, Remote study site recruitment, training and support; iii, Harmonising the REMAP CAP- COVID trial with existing care processes; iv, Embedding REMAP CAP- COVID case report form into the existing CCA registry platform, v, Context specific adaptation and data management; vi, Alignment with existing pandemic and critical care research in the CCA. Methods described here may enable other LMIC sites to participate as equal partners in international critical care trials of urgent public health importance, both during this pandemic and beyond.
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Affiliation(s)
- Diptesh Aryal
- Critical Care and Anaesthesia, Nepal Mediciti Hospital, Lalitpur, Bagmati Pradesh, 44600, Nepal
| | - Abi Beane
- Critical Care, Mahidol Oxford Tropical Medicine Research Unit, Bangkok, Central Thailand, 10400, Thailand.,Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - Arjen M Dondorp
- Critical Care, Mahidol Oxford Tropical Medicine Research Unit, Bangkok, Central Thailand, 10400, Thailand.,Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - Cameron Green
- Australian and New Zealand Intensive Care Research Centre, School of Epidemiology and Preventive Medicine Monash University, Melbourne, Victoria, Australia
| | - Rashan Haniffa
- Critical Care, Mahidol Oxford Tropical Medicine Research Unit, Bangkok, Central Thailand, 10400, Thailand.,Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - Madiha Hashmi
- Department of Critical Care, Ziauddin University, Karachi, Sindh, Pakistan
| | - Devachandran Jayakumar
- Chennai Critical Care Consultants, Chennai, Tamil Nadu, 600 040, India.,Critical Care Medicine, Apollo Specialty Hospital OMR, Chennai, Tamil Nadu, India
| | - John C Marshall
- The Keenan Research Centre for Biomedical Science, St Michael's Hospital, Toronto, Ontario, Canada
| | - Colin J McArthur
- Department of Critical Care Medicine, Auckland City Hospital, Auckland, New Zealand.,Medical Research Institute of New Zealand, Wellington, New Zealand
| | - Srinivas Murthy
- Faculty of Medicine, University of British Columbia School of Medicine, Vancouver, British Columbia, Canada
| | - Steven A Webb
- Australian and New Zealand Intensive Care Research Centre, School of Epidemiology and Preventive Medicine Monash University, Melbourne, Victoria, Australia.,School of Medicine and Pharmacology, University of Western Australia, Crawley, Western Australia, Australia.,St John of God Hospital, Subiaco, Western Australia, Australia
| | - Subhash P Acharya
- Critical Care Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Bagmati Pradesh, 44600, Nepal
| | - Pramodya G P Ishani
- National Intensive Care Surveillance- MORU, Borella, Colombo, Western Province, 08, Sri Lanka
| | - Issrah Jawad
- National Intensive Care Surveillance- MORU, Borella, Colombo, Western Province, 08, Sri Lanka
| | - Sushil Khanal
- Critical Care Medicine, Grande International Hospital, Kathmandu, Bagmati Pradesh, 44600, Nepal
| | - Kanchan Koirala
- Critical Care and Anaesthesia, Nepal Mediciti Hospital, Lalitpur, Bagmati Pradesh, 44600, Nepal
| | - Subekshya Luitel
- Nepal Intensive Care Foundation, Kathmandu, Bagmati Pradesh, Nepal
| | - Upulee Pabasara
- National Intensive Care Surveillance- MORU, Borella, Colombo, Western Province, 08, Sri Lanka
| | - Hem Raj Paneru
- Pulmonary and Critical Care, Hospital for Advanced Medicine and Surgery, Kathmandu, Bagmati Pradesh, Nepal
| | - Ashok Kumar
- Department of Chest Medicine and Critical Care, Ziauddin University, Karachi, Sindh, Pakistan
| | - Shoaib Siddiq Patel
- South East Asian Research in Critical care and Health, Remedial Centre Hospital, Karachi, Sindh, Pakistan
| | | | - Nawal Salahuddin
- Pulmonary & Critical Care Medicine, National Institute of Cardiovascular Diseases, Karachi, Sindh, Pakistan
| | - Mohiuddin Shaikh
- South East Asian Research in Critical care and Health, Remedial Centre Hospital, Karachi, Sindh, Pakistan
| | - Timo Tolppa
- National Intensive Care Surveillance- MORU, Borella, Colombo, Western Province, 08, Sri Lanka
| | - Ishara Udayanga
- National Intensive Care Surveillance- MORU, Borella, Colombo, Western Province, 08, Sri Lanka
| | - Zulfiqar Umrani
- Office of Research, Innovation & Commercialization (ORIC), Zuiddin University, Karachi, Pakistan
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Annett RD, Bickel S, Carlson JC, Cowan K, Cox S, Fisher MJ, Jarvis JD, Kong AS, Kosut JS, Kulbeth KR, Laptook A, McElfish PA, McNally MM, Pachter LM, Pahud BA, Pyles LA, Shaw J, Simonsen K, Snowden J, Turley CB, Atz AM. Capacity Building for a New Multicenter Network Within the ECHO IDeA States Pediatric Clinical Trials Network. Front Pediatr 2021; 9:679516. [PMID: 34336738 PMCID: PMC8316720 DOI: 10.3389/fped.2021.679516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 06/10/2021] [Indexed: 11/20/2022] Open
Abstract
Introduction: Research capacity building is a critical component of professional development for pediatrician scientists, yet this process has been elusive in the literature. The ECHO IDeA States Pediatric Clinical Trials Network (ISPCTN) seeks to implement pediatric trials across medically underserved and rural populations. A key component of achieving this objective is building pediatric research capacity, including enhancement of infrastructure and faculty development. This article presents findings from a site assessment inventory completed during the initial year of the ISPCTN. Methods: An assessment inventory was developed for surveying ISPCTN sites. The inventory captured site-level activities designed to increase clinical trial research capacity for pediatrician scientists and team members. The inventory findings were utilized by the ISPCTN Data Coordinating and Operations Center to construct training modules covering 3 broad domains: Faculty/coordinator development; Infrastructure; Trials/Research concept development. Results: Key lessons learned reveal substantial participation in the training modules, the importance of an inventory to guide the development of trainings, and recognizing local barriers to clinical trials research. Conclusions: Research networks that seek to implement successfully completed trials need to build capacity across and within the sites engaged. Our findings indicate that building research capacity is a multi-faceted endeavor, but likely necessary for sustainability of a unique network addressing high impact pediatric health problems. The ISPCTN emphasis on building and enhancing site capacity, including pediatrician scientists and team members, is critical to successful trial implementation/completion and the production of findings that enhance the lives of children and families.
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Affiliation(s)
- Robert D Annett
- Department of Pediatrics, University of Mississippi Medical Center, Jackson, MS, United States
| | - Scott Bickel
- Department of Pediatrics, University of Louisville School of Medicine and Norton Children's Hospital, Louisville, KY, United States
| | - John C Carlson
- Department of Pediatrics, Tulane University School of Medicine, New Orleans, LA, United States
| | - Kelly Cowan
- Department of Pediatrics, University of Vermont, Burlington, VT, United States
| | - Sara Cox
- Department of Community and Public Health Sciences, University of Montana, Missoula, MT, United States
| | - Mark J Fisher
- Fran and Earl Ziegler College of Nursing, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - J Dean Jarvis
- Dartmouth-Hitchcock Clinic: Dartmouth-Hitchcock Medical Center, Lebanon, NH, United States
| | - Alberta S Kong
- Department of Pediatrics, University of New Mexico Health Sciences Center, Albuquerque, NM, United States
| | - Jessica S Kosut
- Department of Pediatrics, Division of Hospitalist Medicine, John A. Burns School of Medicine, University of Hawai'i at Manoa, Honolulu, HI, United States
| | - Kurtis R Kulbeth
- ECHO IDeA States Pediatric Clinical Trials Network Data Coordinating and Operations Center, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Abbot Laptook
- Department of Pediatrics, Warren Alpert Medical School, Brown University, Providence, RI, United States
| | - Pearl A McElfish
- College of Medicine, University of Arkansas for Medical Sciences, Fayetteville, AR, United States
| | - Mary M McNally
- Dartmouth-Hitchcock Clinic: Dartmouth-Hitchcock Medical Center, Lebanon, NH, United States
| | - Lee M Pachter
- Institute for Research on Equity and Community Health, Thomas Jefferson University, Newark, DE, United States
| | - Barbara A Pahud
- Children's Mercy Hospital - Kansas City Department of Infectious Diseases, Kansas University Medical Center, University of Missouri Kansas City, Kansas City, MO, United States
| | - Lee A Pyles
- Department of Pediatrics, West Virginia University, Morgantown, WV, United States
| | - Jennifer Shaw
- Division of Organizational Development and Innovation, Southcentral Foundation, Anchorage, AK, United States
| | - Kari Simonsen
- Department of Pediatrics, University of Nebraska Medical Center, Omaha, NE, United States
| | - Jessica Snowden
- Department of Pediatric Infectious Disease, ECHO IDeA States Pediatric Clinical Trials Network Data Coordinating and Operations Center, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Christine B Turley
- Department of Pediatrics, Medical University of South Carolina, Charleston, SC, United States
| | - Andrew M Atz
- Department of Pediatrics, Medical University of South Carolina, Charleston, SC, United States
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Griswold DP, Khan AA, Chao TE, Clark DJ, Budohoski K, Devi BI, Azad TD, Grant GA, Trivedi RA, Rubiano AM, Johnson WD, Park KB, Broekman M, Servadei F, Hutchinson PJ, Kolias AG. Neurosurgical Randomized Trials in Low- and Middle-Income Countries. Neurosurgery 2020; 87:476-483. [PMID: 32171011 PMCID: PMC7426187 DOI: 10.1093/neuros/nyaa049] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Accepted: 12/28/2019] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND The setting of a randomized trial can determine whether its findings are generalizable and can therefore apply to different settings. The contribution of low- and middle-income countries (LMICs) to neurosurgical randomized trials has not been systematically described before. OBJECTIVE To perform a systematic analysis of design characteristics and methodology, funding source, and interventions studied between trials led by and/or conducted in high-income countries (HICs) vs LMICs. METHODS From January 2003 to July 2016, English-language trials with >5 patients assessing any one neurosurgical procedure against another procedure, nonsurgical treatment, or no treatment were retrieved from MEDLINE, Scopus, and Cochrane Library. Income classification for each country was assessed using the World Bank Atlas method. RESULTS A total of 73.3% of the 397 studies that met inclusion criteria were led by HICs, whereas 26.7% were led by LMICs. Of the 106 LMIC-led studies, 71 were led by China. If China is excluded, only 8.8% were led by LMICs. HIC-led trials enrolled a median of 92 patients vs a median of 65 patients in LMIC-led trials. HIC-led trials enrolled from 7.6 sites vs 1.8 sites in LMIC-led studies. Over half of LMIC-led trials were institutionally funded (54.7%). The majority of both HIC- and LMIC-led trials evaluated spinal neurosurgery, 68% and 71.7%, respectively. CONCLUSION We have established that there is a substantial disparity between HICs and LMICs in the number of published neurosurgical trials. A concerted effort to invest in research capacity building in LMICs is an essential step towards ensuring context- and resource-specific high-quality evidence is generated.
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Affiliation(s)
- Dylan P Griswold
- Stanford University School of Medicine, Stanford, California
- Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom
| | - Ahsan A Khan
- NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, United Kingdom
- Neuroscience Institute, INUB-MEDITECH Research Group, El Bosque University, Bogotá, Colombia
| | - Tiffany E Chao
- Stanford University School of Medicine, Stanford, California
- Department of Surgery, Santa Clara Valley Medical Center, San Jose, California
| | - David J Clark
- NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, United Kingdom
- Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom
| | - Karol Budohoski
- NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, United Kingdom
- Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom
| | - B Indira Devi
- NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, United Kingdom
- Department of Neurosurgery, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Tej D Azad
- Stanford University School of Medicine, Stanford, California
- Department of Neurosurgery, Johns Hopkins University, Baltimore, Maryland
| | - Gerald A Grant
- Stanford University School of Medicine, Stanford, California
| | - Rikin A Trivedi
- NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, United Kingdom
- Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom
| | - Andres M Rubiano
- NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, United Kingdom
- Neuroscience Institute, INUB-MEDITECH Research Group, El Bosque University, Bogotá, Colombia
| | - Walter D Johnson
- Emergency and Essential Surgical Care Programme, World Health Organization, Geneva, Switzerland
| | - Kee B Park
- Global Neurosurgery Initiative, Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts
| | - Marike Broekman
- Department of Neurosurgery, Leiden University Medical Center, Leiden and Haaglanden Medical Center, the Hague, the Netherlands
| | - Franco Servadei
- Department of Neurosurgery, Humanitas Research Hospital, Humanitas University, Milan, Italy
| | - Peter J Hutchinson
- NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, United Kingdom
- Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom
| | - Angelos G Kolias
- NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, United Kingdom
- Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom
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Adu-Bonsaffoh K, Oppong SA, Dassah ET, Seffah JD. Challenges in preterm birth research: Ghanaian perspective. Placenta 2020; 98:24-28. [PMID: 33039028 DOI: 10.1016/j.placenta.2020.04.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 04/25/2020] [Accepted: 04/27/2020] [Indexed: 01/30/2023]
Abstract
Preterm birth is highly prevalent in Ghana. It is a major public health concern because of the high burden as well as the associated immediate and long-term consequences including increased healthcare cost. Studies conducted in high-income countries may not be sufficiently generalizable in our context. Locally generated evidence-based interventions will be indispensable in improving the clinical management and prevention of preterm birth in the country. However, there are limited published literature on preterm birth and prematurity in the country. This review seeks to discuss the major challenges associated with preterm birth research in Ghana and proposes evidence-based strategies to improve biomedical and epidemiological research on preterm birth and prematurity. The limited high quality preterm birth research is partly attributable to a variety of challenges related to accurate gestational age estimation, research training, capacity and support including funding, efficient ethics committees, local and international collaboration as well as effective health management information systems. Other related challenges include unavailability of reliable internet connectivity, poor compensation for researchers and lack of conductive research environment. There is the need to expedite advocacy on implementation of practical interventions and strategies aimed at increasing high quality research in the area of preterm birth and prematurity in the country. A paradigm shift in preterm birth research with appropriate integration of concerted multidisciplinary research groups should be constituted to put basic science research to clinical practice as well as the prevention of preterm birth in the country.
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Affiliation(s)
- K Adu-Bonsaffoh
- Department of Obstetrics and Gynecology, School of Medicine and Dentistry, University of Ghana, Accra, Ghana.
| | - S A Oppong
- Department of Obstetrics and Gynecology, School of Medicine and Dentistry, University of Ghana, Accra, Ghana
| | - E T Dassah
- School of Public Health, Kwame Nkrumah University of Science & Technology, Kumasi, Ghana; Department of Obstetrics & Gynecology, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - J D Seffah
- Department of Obstetrics and Gynecology, School of Medicine and Dentistry, University of Ghana, Accra, Ghana
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von Kaeppler E, Donnelley C, Roberts HJ, O'Hara NN, Won N, Shearer DW, Morshed S. Impact of North American Institutions on Orthopedic Research in Low- and Middle-Income Countries. Orthop Clin North Am 2020; 51:177-188. [PMID: 32138856 DOI: 10.1016/j.ocl.2019.11.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
There exists an unmet need for locally relevant and sustainable orthopedic research in low- and middle-income countries. Partnerships between high-income countries and low- and middle-income countries can bridge gaps in resources, knowledge, infrastructure, and skill. This article presents a select list of models for high-income countries/low- and middle-income countries research partnerships including academic partnerships, international research consortia, professional society-associated working groups, and nongovernmental organization partnerships. Models that produce research with lasting legacy are those that promote mutually beneficial partnerships over individual gains.
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Affiliation(s)
- Ericka von Kaeppler
- Department of Orthopaedic Surgery, University of California San Francisco, 2550 23rd Street, Building 9, 2nd Floor, San Francisco, CA 94110, USA
| | - Claire Donnelley
- Department of Orthopaedic Surgery, University of California San Francisco, 2550 23rd Street, Building 9, 2nd Floor, San Francisco, CA 94110, USA
| | - Heather J Roberts
- Department of Orthopaedic Surgery, University of California San Francisco, 2550 23rd Street, Building 9, 2nd Floor, San Francisco, CA 94110, USA
| | - Nathan N O'Hara
- Department of Orthopaedics, University of Maryland School of Medicine, Suite 300, 110 South Paca Street, Baltimore, MD 21201, USA
| | - Nae Won
- Department of Orthopaedic Surgery, University of California San Francisco, 2550 23rd Street, Building 9, 2nd Floor, San Francisco, CA 94110, USA
| | - David W Shearer
- Department of Orthopaedic Surgery, University of California San Francisco, 2550 23rd Street, Building 9, 2nd Floor, San Francisco, CA 94110, USA
| | - Saam Morshed
- Department of Orthopaedic Surgery, University of California San Francisco, 2550 23rd Street, Building 9, 2nd Floor, San Francisco, CA 94110, USA.
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Zannad F, Sobhy M, Almahmeed W, Balghith M, Butler J, Dziri S, Ebrahim S, El Fiky A, Elshal A, Fradi I, Ghazzal Z, Jeribi C, Samad Z, Kostrubiec M, Milhem M, Morsi M, Oto A, Ragy H, Saade G, Malkawi R, Saleh A, Shokri D, Sliwa K, Gamra H. Clinical research in Africa And Middle East: Roadmap for reform and harmonisation of the regulatory framework and sustainable capacity development. JOURNAL OF GLOBAL HEALTH REPORTS 2019. [DOI: 10.29392/joghr.3.e2019082] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
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Byrnes A, Haregu TN, Pasricha N, Singh K, Thirunavukkarasu S, Wickkramasinghe K, Thankappan KR, Oldenburg B. Strengthening Noncommunicable Disease Research Capacity and Chronic Disease Outcomes in Low- and Middle-Income Countries in South Asia: Implementation and Evaluation of the ASCEND Program. Asia Pac J Public Health 2019; 31:536-547. [PMID: 31409121 PMCID: PMC10419968 DOI: 10.1177/1010539519867791] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This article describes the design, outcomes, challenges, and lessons learned from the ASian Collaboration for Excellence in Non-Communicable Disease (ASCEND) program, implemented between 2011 and 2015 in India, Sri Lanka, and Malaysia. The program involved a blended-delivery model, incorporating online and face-to-face training, mentoring, and supervision of trainees' research projects. Evaluation data were collected at baseline, 6, 12, 18, and 24 months. Intended outcomes, lessons, and challenges were summarized using a logic model. During the program period, 48 participants were trained over 2 cohorts in June 2011 and 2012. The trainees published 83 peer-reviewed articles between 2011 and 2015. Additionally, 154 presentations were given by trainees at national and international conferences. Underutilization of the online learning management system was an important challenge. Utilizing a combination of intensive face-to-face and online learning and mentoring of early career researchers in low- and middle-income countries has great potential to enhance the research capacity, performance, and outputs.
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Affiliation(s)
- Allison Byrnes
- Family Life Limited, Sandringham, Melbourne, Victoria, Australia
| | | | | | - Kavita Singh
- Centre for Chronic Disease Control, New Delhi, India
| | - Sathish Thirunavukkarasu
- University of Melbourne, Melbourne, Victoria, Australia
- McMaster University, Hamilton, Ontario, Canada
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Maleka EN, Currie P, Schneider H. Research collaboration on community health worker programmes in low-income countries: an analysis of authorship teams and networks. Glob Health Action 2019; 12:1606570. [PMID: 31066343 PMCID: PMC6508047 DOI: 10.1080/16549716.2019.1606570] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Global health research partnerships, which promote the exchange of ideas, knowledge and expertise across countries, are considered key to addressing complex challenges facing health systems. Yet, many studies report inequalities in these partnerships, particularly in those between high and low-and-middle-income countries (LMICs). OBJECTIVE This paper examines global research collaborations on community health worker (CHW) programmes, specifically analysing the structures of authorship teams and networks in publications reporting research on CHW programmes in low-income countries (LICs). METHODS A sub-set of 206 indexed journal articles reporting on CHW programmes in LICs was purposefully selected from a prior review of research authorship on CHW programmes in all LMICs over a five year period (2012-2016). Data on country and primary organisational affiliation and number of publications for all individual authors, programme area (e.g. maternal child health) and total citations per paper were extracted and coded in excel spreadsheets. Data were then exported and analysed in Stata/ICV.14 and Gephi. RESULTS The 206 papers were authored by 1045 authors from 299 institutions, based in 43 countries. Half (50.1%) the authors came from LIC-based institutions, 43.8% from high-income country (HIC) institutions, 2.9% from middle-income country (MIC) institutions and 3.2% had different first affiliations in different publications. Authors based in the USA (302) and UK (68) accounted for just over a third (35.4%) of all authors. Partnership patterns revealed a primary mode of North-South collaboration with authors from the US, and to a lesser extent the UK, playing central bridging roles between institutions. Strong network clusters of multiple-affiliated authors were evident in research on MCH and HIV/TB aspects of CHW programmes. CONCLUSION Knowledge production on CHW programmes in LICs flows predominantly through a pool of connected HIC authors and North-South collaborations. There is a need for strategies harnessing more diverse, including South-South, forms of partnership.
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Affiliation(s)
- Elma Nelisiwe Maleka
- a School of Public Health , University of the Western Cape , Cape Town , South Africa
| | - Paul Currie
- b School of Public Leadership , Stellenbosch University , Stellenbosch , South Africa
| | - Helen Schneider
- c School of Public Health & SAMRC/UWC Health Services to Systems Unit , University of the Western Cape , Cape Town , South Africa
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Sweileh WM. A bibliometric analysis of global research output on health and human rights (1900-2017). Glob Health Res Policy 2018; 3:30. [PMID: 30377667 PMCID: PMC6196451 DOI: 10.1186/s41256-018-0085-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 10/08/2018] [Indexed: 01/08/2023] Open
Abstract
Background Baseline data on global research activity on health and human rights (HHR) needs to be assessed and analyzed to identify research gaps and to prioritize funding and research agendas. Therefore, the aim of this study was to assess the growth of publications and research pattern on HHR. Methods A bibliometric methodology was used. Literature on HHR was retrieved using SciVerse Scopus for the study period from 1900 to 2017. Nine different search scenarios with different keyword combinations were used to retrieve the required documents. All types of documents published in peer-reviewed journals, including editorials, were included. The search strategy was validated. Results In total 6513 documents were retrieved with an h-index of 88 and an average of 9.8 citations per document. Publications on HHR field started as early as 1950 but showed a steep rise in the past two decades. Visualization of author keywords revealed that HIV/ AIDS, mental health, maternal and reproductive health, violence, ethics, torture, and refugees were most commonly encountered keywords. The journal "Health and Human Rights" was most active (n = 467; 7.2%) in this field. However, documents that appeared in The Lancet received the highest impact (29.5 citations per document). The United States of America produced the most in this field (n = 1817; 27.9%). Researchers in the region of Americas participated in approximately 45% of the retrieved documents while researchers in the Eastern Mediterranean region had the least contribution (2.5%). Researchers in high-income countries contributed to approximately 78% of the retrieved documents while researchers in low-income countries contributed to less than 5% of the retrieved documents. When data were standardized by population size, the research output from high-income countries was approximately four documents per one million inhabitants. For middle-income countries, the research output was 0.3 document per one million inhabitants. For low-income countries, the research output was 0.5 document per one million inhabitants. Conclusions Differential research productivity on HHR was seen among scholars in different world regions. World countries need to encourage and strengthen research on HHR in order to achieve the goals set in international agreements of human rights.
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Affiliation(s)
- Waleed M Sweileh
- Department of Physiology, Pharmacology/Toxicology, Division of Biomedical Sciences, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
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Abstract
OBJECTIVES To describe the discordance in contributions to the literature between developed and low- and middle-income countries (LMICs); identify global challenges in accessing the literature, publishing, and conducting research; and describe successful collaborative publishing models. DATA SOURCES Published literature; survey data; personal experience. CONCLUSION There is a scarcity of literature written by nurse authors in LMICs. Limited support for nursing research, inconsistent internet access, workforce shortages, and language barriers are significant barriers to publishing success. IMPLICATIONS FOR NURSING PRACTICE Nurses from developed countries can build relationships with global partners from LMICs to increase dissemination capacity. Mentorship programs and academic partnerships are two possible solutions for increasing publications from nurses in LMICs.
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