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Sherifali D, da Silva LP, Dewan P, Cader FA, Dakhil Z, Gyawali B, Klassen S, Yaseen IF, Jovkovic M, Khalid S, Fitzpatrick-Lewis D, Alliston P, Racey M. Peer Support for Type 2 Diabetes Management in Low- and Middle-Income Countries (LMICs): A Scoping Review. Glob Heart 2024; 19:20. [PMID: 38404615 PMCID: PMC10885823 DOI: 10.5334/gh.1299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 01/25/2024] [Indexed: 02/27/2024] Open
Abstract
Background Although there is evidence of peer support in high-income countries, the use of peer support as an intervention for cardiometabolic disease management, including type 2 diabetes (T2DM), in low- and middle-income countries (LMICs), is unclear. Methods A scoping review methodology was used to search the databases MEDLINE, Embase, Emcare, PsycINFO, LILACS, CDSR, and CENTRAL. Results Twenty-eight studies were included in this scoping review. Of these, 67% were developed in Asia, 22% in Africa, and 11% in the Americas. The definition of peer support varied; however, peer support offered a social and emotional dimension to help individuals cope with negative emotions and barriers while promoting disease management. Conclusions Findings from this scopingreview highlight a lack of consistency in defining peer support as a component of CMD management in LMICs. A clear definition of peer support and ongoing program evaluation is recommended for future research.
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Affiliation(s)
- Diana Sherifali
- McMaster Evidence Review and Synthesis Team, School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Lilian Pinto da Silva
- Faculty of Physical Therapy, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
| | - Pooja Dewan
- British Heart Foundation Cardiovascular Research Centre, University of Glasgow, Scotland, UK
| | - F. Aaysha Cader
- Ibrahim Cardiac Hospital & Research Institute, Dhaka, Bangladesh
| | - Zainab Dakhil
- Ibn Al-Bitar Cardiac Centre, Al-Kindy College of Medicine/University of Baghdad, Baghdad, Iraq
| | - Bishal Gyawali
- Global Health Section, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Sheila Klassen
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Israa Fadhil Yaseen
- Baghdad Heart Center, Baghdad Teaching Hospital, Medical City, Baghdad, Iraq
| | - Milos Jovkovic
- McMaster Evidence Review and Synthesis Team, School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Saira Khalid
- McMaster Evidence Review and Synthesis Team, School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Donna Fitzpatrick-Lewis
- McMaster Evidence Review and Synthesis Team, School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Paige Alliston
- McMaster Evidence Review and Synthesis Team, School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Megan Racey
- McMaster Evidence Review and Synthesis Team, School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
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Mzembe T, Chikwapulo V, Kamninga TM, Vellemu R, Mohamed S, Nthakomwa L, Chifungo C, Wazny K, Musau K, Abdullahi L, Peterson M, Madise N, Chipeta MG. Interventions to enhance healthcare utilisation among pregnant women to reduce maternal mortality in low- and middle-income countries: a review of systematic reviews. BMC Public Health 2023; 23:1734. [PMID: 37674154 PMCID: PMC10481488 DOI: 10.1186/s12889-023-16558-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 08/18/2023] [Indexed: 09/08/2023] Open
Abstract
BACKGROUND Maternal mortality in low- and middle-income countries (LMIC) has reduced considerably over the past three decades, but it remains high. Effective interventions are available, but their uptake and coverage remain low. We reviewed and synthesised evidence from systematic reviews on interventions to increase healthcare services utilisation to reduce maternal mortality in LMICs. METHODS We searched Medline PubMed and Cochrane Library databases for systematic reviews published between January 2014 and December 2021, investigating interventions to increase healthcare services uptake among pregnant women in LMICs. We used the AMSTAR tool (A Measurement Tool to Assess Systematic Reviews) to assess the methodological quality of the included reviews. We extracted data on the interventions and their effects and grouped them into broad groups based on the outcomes reported in each systematic review. RESULTS We retrieved 4,022 articles. After removing duplicates and screening, we included 14 systematic reviews. Male-partner interventions were effective in increasing skilled birth attendance (SBA) postnatal visits and maternal antiretroviral (ART) uptake for HIV-positive pregnant women. However, there was no evidence of their effectiveness on increased early ANC initiation or adequate ANC visits. Mobile health interventions were effective in increasing adequate ANC visits, SBA, facility-based service utilisation, early ANC initiation, and adherence to nutritional supplements. Incentive-based interventions, particularly financial incentives, were effective in increasing the number of ANC visits but not postnatal visits. Facility-based interventions were effective in increasing postnatal visits, maternal ART initiation and uptake, immunisation uptake and follow-up ANC visits. None of the reviews assessed their impact on SBA or adequate ANC visits. Community-based interventions were effective in increasing SBA, ANC service utilisation, ART initiation and uptake, and nutritional supplements and immunisation uptake. CONCLUSION Our findings show that the different interventions effectively improved different outcomes on the maternal healthcare continuum. Implementing these interventions in combination has the potential to enhance healthcare service uptake further.
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Affiliation(s)
- Themba Mzembe
- African Institute for Development Policy (AFIDEP), Lilongwe, Malawi.
| | | | | | - Ruth Vellemu
- African Institute for Development Policy (AFIDEP), Lilongwe, Malawi
| | - Sahra Mohamed
- African Institute for Development Policy (AFIDEP), Lilongwe, Malawi
| | | | | | - Kerri Wazny
- The Children's Investment Fund Foundation, London, UK
| | - Kelvin Musau
- The Children's Investment Fund Foundation, Nairobi, Kenya
| | - Leila Abdullahi
- African Institute for Development Policy (AFIDEP), Lilongwe, Malawi
| | - Maame Peterson
- African Institute for Development Policy (AFIDEP), Lilongwe, Malawi
| | - Nyovani Madise
- African Institute for Development Policy (AFIDEP), Lilongwe, Malawi
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Akseer N, Tasic H, Nnachebe Onah M, Wigle J, Rajakumar R, Sanchez-Hernandez D, Akuoku J, Black RE, Horta BL, Nwuneli N, Shine R, Wazny K, Japra N, Shekar M, Hoddinott J. Economic costs of childhood stunting to the private sector in low- and middle-income countries. EClinicalMedicine 2022; 45:101320. [PMID: 35308896 PMCID: PMC8927824 DOI: 10.1016/j.eclinm.2022.101320] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 02/01/2022] [Accepted: 02/09/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Stunting during childhood has long-term consequences on human capital, including decreased physical growth, and lower educational attainment, cognition, workforce productivity and wages. Previous research has quantified the costs of stunting to national economies however beyond a few single-country datasets there has been a limited number of which have used diverse datasets and have had a dedicated focus on the private sector, which employs nearly 90% of the workforce in many low- and middle-income countries (LMICs). We aimed to examine (i) the impact of childhood stunting on income loss of private sector workforce in LMICs; (ii) to quantify losses in sales to private firms in LMICs due to childhood stunting; and (iii) to estimate potential gains (benefit-cost ratios) if stunting levels are reduced in select high prevalence countries. METHODS This multiple-methods study engaged multi-disciplinary technical advisers, executed several literature reviews, used innovative statistical methods, and implemented health and labor economic models. We analyzed data from seven longitudinal datasets (up to 30+ years of follow-up; 1982-2016; Peru, Ethiopia, India, Vietnam, Philippines, Tanzania, Brazil), 108 private firm datasets (spanning 2008-2020), and many global datasets including Joint Malnutrition Estimates, and World Development Indicators to produce estimates for 120+ LMICs (with estimates up to 2021). We studied the impact of childhood stunting on adult cognition, education, and height as pathways to wages/productivity in adulthood. We employed cloud-based artificial intelligence (AI) platforms, and conducted comparative analyses using three analytic approaches: traditional frequentist statistics, Bayesian inferential statistics and machine learning. We employed labour and health economic models to estimate wage losses to the private sector worker and firm revenue losses due to stunting. We also estimated benefit-cost ratios for countries investing in nutrition-specific interventions to prevent stunting. FINDINGS Across 95 LMICs, childhood stunting costs the private sector at least US$135.4 billion in sales annually. Firms from countries in Latin America and the Caribbean and East Asia and Pacific regions had the greatest losses. Totals sales losses to the private sector accumulated to 0.01% to 1.2% of national GDP across countries. Sectors most affected by childhood stunting were manufacturing (non-metallic mineral, fabricated metal, other), garments and food sectors. Sale losses were highest for larger sized private firms. Across regions (representing 123 LMICs), US$700 million (Middle East and North Africa) to US$16.5 billion (East Asia and Pacific) monthly income was lost among private sector workers. Investing in stunting reduction interventions yields gains from US$2 to US$81 per $1 invested annually (or 100% to 8000% across countries). Across sectors, the highest returns were in elementary occupations (US$46) and the lowest were among agricultural workers (US$8). By gender, women incurred a higher income penalty from childhood stunting and earned less than men; due to their relatively higher earnings, the returns for investing in stunting reduction were consistently higher for men across most countries studied. INTERPRETATION Childhood stunting costs the private sector in LMICs billions of dollars in sales and earnings for the workforce annually. Returns to nutrition interventions show that there is an economic case to be made for investing in childhood nutrition, alongside a moral one for both the public and private sector. This research could be used to motivate strong public-private sector partnerships to invest in childhood undernutrition for benefits in the short and long-term.
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Affiliation(s)
- Nadia Akseer
- Johns Hopkins Bloomberg School of Public Health, USA
- Modern Scientist Global, Canada
- Corresponding author at: Johns Hopkins Bloomberg School of Public Health, USA.
| | | | | | | | | | | | | | | | | | - Ndidi Nwuneli
- Sahel Consulting Agriculture and Nutrition Ltd., Nigeria
| | - Ritta Shine
- Global Alliance for Improved Nutrition, Switzerland
| | - Kerri Wazny
- Johns Hopkins Bloomberg School of Public Health, USA
- The Power of Nutrition, UK
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Chen ST, Guo T, Yu Q, Stubbs B, Clark C, Zhang Z, Zhu M, Hossain MM, Yeung A, Griffiths MD, Zou L. Active school travel is associated with fewer suicide attempts among adolescents from low-and middle-income countries. Int J Clin Health Psychol 2020; 21:100202. [PMID: 33363585 PMCID: PMC7753036 DOI: 10.1016/j.ijchp.2020.11.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 11/02/2020] [Indexed: 11/20/2022] Open
Abstract
Background/Objective: This study explored the association between active school travel (AST) and suicide attempts among adolescents in low- and middle-income countries (LMICs). Method: We used the data from the Global School-based Health Survey, including 127,097 adolescents aged 13-17 years from 34 LMICs. A self-reported survey was used to collect data on AST and suicide attempts as well as some variables. Multivariable logistic regression was performed to assess the association between AST and suicide attempts. A meta-analysis with random effects was undertaken to identify the difference in the association between AST and suicide attempts. Results: Across all the adolescents, the prevalence of AST was 37% and the prevalence of suicide attempts was 11.60%. Adolescents who engaged in AST were less likely to have suicide attempts irrespective of gender. The country-wise analysis indicated a large inconsistency in the association between AST and suicide attempt across the countries. Conclusions: AST would appear to be a protective factor for reducing suicide attempts among adolescents. However, the association between AST and suicide attempts varied greatly across the countries. Future studies should confirm the association between AST and suicide attempts.
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Affiliation(s)
- Si-Tong Chen
- Exercise and Mental Health Laboratory, Institute of Mental Health, School of Psychology, Shenzhen University, China
- Institute for Sport and Health, Victoria University, Melbourne, Australia
| | - Tianyou Guo
- Exercise and Mental Health Laboratory, Institute of Mental Health, School of Psychology, Shenzhen University, China
| | - Qian Yu
- Exercise and Mental Health Laboratory, Institute of Mental Health, School of Psychology, Shenzhen University, China
| | - Brendon Stubbs
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK
- South London and Maudsley NHS Foundation Trust, Denmark Hill, London SE5 8AZ, UK
| | - Cain Clark
- Centre for Intelligent Healthcare, Coventry University, United Kingdom
| | - Zhihao Zhang
- Exercise and Mental Health Laboratory, Institute of Mental Health, School of Psychology, Shenzhen University, China
| | - Mingyue Zhu
- Exercise and Mental Health Laboratory, Institute of Mental Health, School of Psychology, Shenzhen University, China
| | - Md Mahhub Hossain
- Department of Health Promotion and Community Health Sciences, School of Public Health, Texas A&M University, USA
| | - Albert Yeung
- Centre for Intelligent Healthcare, Coventry University, United Kingdom
- Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, USA
| | | | - Liye Zou
- Exercise and Mental Health Laboratory, Institute of Mental Health, School of Psychology, Shenzhen University, China
- Corresponding author at: Exercise and Mental Health Laboratory, School of Psychology, Shenzhen University, 518060 China.
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Tu'akoi S, Vickers MH, Bay JL. DOHaD in low- and middle-income countries: a systematic review exploring gaps in DOHaD population studies. J Dev Orig Health Dis 2020; 11:557-63. [PMID: 32314679 DOI: 10.1017/S2040174420000276] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Low- and middle-income countries (LMICs) are disproportionately affected by non-communicable diseases (NCDs), accounting for more than 80% of NCD-related deaths globally. Research into early-life influences on these diseases via the developmental origins of health and disease (DOHaD) paradigm has informed health promotion interventions and policies focused on optimising early-life health. However, little is known about where this research occurs and whether it reaches and reflects the countries most affected by NCDs. This review searched for DOHaD studies that investigated relationships between factors during pregnancy and at birth, with later-life NCD incidence, risk and related mortality. The aim of this review was to identify where DOHaD research has been conducted and whether this focus is appropriate and relevant, given the differential burden of NCDs. Embase, MEDLINE and Scopus were searched, and eligibility screening processes identified 136 final articles. This review found that 49.7% of DOHaD research was conducted on populations within Western Europe, 15.9% in East Asia, 12.7% in North America, 8.3% in Latin America and the Caribbean, and fewer in Australasia, South Asia, the Middle East, the Africas, and Central Asia. When categorised by income, this review found that 76.4% of studies were based in high-income countries, 19.1% in upper-middle-income and 4.5% in lower-middle-income countries. No studies were based in low-income countries. There is therefore a marked disconnect between where DOHaD research is undertaken and where the greatest NCD disease burden exists. Increasing DOHaD research capacity in LMICs is crucial to informing local strategies that can contribute to reducing the incidence of NCDs.
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Rinaldi G, Kiadaliri AA, Haghparast-Bidgoli H. Cost effectiveness of HIV and sexual reproductive health interventions targeting sex workers: a systematic review. Cost Eff Resour Alloc 2018; 16:63. [PMID: 30524207 PMCID: PMC6278021 DOI: 10.1186/s12962-018-0165-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 11/22/2018] [Indexed: 01/10/2023] Open
Abstract
Background Sex workers have high incidences of HIV and other sexually transmitted diseases. Although, interventions targeting sex workers have shown to be effective, evidence on which strategies are most cost-effective is limited. This study aims to systematically review evidence on the cost-effectiveness of sexual health interventions for sex workers on a global level. It also evaluates the quality of available evidence and summarizes the drivers of cost effectiveness. Methods A search of published articles until May 2018 was conducted. A search strategy consisted of key words, MeSH terms and other free text terms related to economic evaluation, sex workers and sexual and reproductive health (SRH) was developed to conduct literature search on Medline, Web of Science, Econlit and the NHS Economic Evaluation Database. The quality of reporting the evidence was evaluated using the CHEERS checklist and drivers of cost-effectiveness were reported. Results Overall, 19 studies met the inclusion criteria. The majority of the studies were based in middle-income countries and only three in low-income settings. Most of the studies were conducted in Asia and only a handful in Sub-Saharan Africa and Latin America. The reviewed studies mainly evaluated the integrated interventions, i.e. interventions consisted a combination of biomedical, structural or behavioural components. All interventions, except for one, were highly cost-effective. The reporting quality of the evidence was relatively good. The strongest drivers of cost-effectiveness, reported in the studies, were HIV prevalence, number of partners per sex worker and commodity costs. Furthermore, interventions integrated into existing health programs were shown to be most cost-effective. Conclusion This review found that there is limited economic evidence on HIV and SRH interventions targeting sex workers. The available evidence indicates that the majority of the HIV and SRH interventions targeting sex workers are highly cost-effective, however, more effort should be devoted to improving the quality of conducting and reporting cost-effectiveness evidence for these interventions to make them usable in policy making. This review identified potential factors that affect the cost-effectiveness and can provide useful information for policy makers when designing and implementing such interventions. Electronic supplementary material The online version of this article (10.1186/s12962-018-0165-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Aliasghar A Kiadaliri
- 2Clinical Epidemiology Unit, Department of Clinical Sciences, Orthopaedics, Faculty of Medicine, Lund University, Lund, Sweden
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Alp E, Cookson B, Erdem H, Rello J; Survey Group. Infection control bundles in intensive care: an international cross-sectional survey in low- and middle-income countries. J Hosp Infect 2019; 101:248-56. [PMID: 30036635 DOI: 10.1016/j.jhin.2018.07.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 07/13/2018] [Indexed: 12/29/2022]
Abstract
BACKGROUND In low- and middle-income countries (LMICs), the burden of healthcare-associated infections (HCAIs) is not known due to a lack of national surveillance systems, standardized infection definitions, and paucity of infection prevention and control (IPC) organizations and legal infrastructure. AIM To determine the status of IPC bundle practice and the most frequent interventional variables in LMICs. METHODS A questionnaire was emailed to Infectious Diseases International Research Initiative (ID-IRI) Group Members and dedicated IPC doctors working in LMICs to examine self-reported practices/policies regarding IPC bundles. Responding country incomes were classified by World Bank definitions into low, middle, and high. Comparison of LMIC results was then made to a control group of high-income countries (HICs). FINDINGS This survey reports practices from one low-income country (LIC), 16 middle-income countries (MICs) (13 European), compared to eight high-income countries (HICs). Eighteen (95%) MICs had an IPC committee in their hospital, 12 (63.2%) had an annual agreed programme and produced an HCAI report. Annual agreed programmes (87.5% vs 63.2%, respectively) and an annual HCAI report (75.0% vs 63.2%, respectively) were more common in HICs than MICs. All HICs had at least one invasive device-related surveillance programme. Seven (37%) MICs had no invasive device-related surveillance programme, six (32%) had no ventilator-associated pneumonia prevention bundles, seven (37%) had no catheter-associated urinary tract infection prevention bundles, and five (27%) had no central line-associated bloodstream infection prevention bundles. CONCLUSION LMICs need to develop their own bundles with low-cost and high-level-of-evidence variables adapted to the limited resources, with further validation in reducing infection rates.
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O'Keefe D, Aung SM, Pasricha N, Wun T, Linn SK, Lin N, Aitken C, Hughes C, Dietze P. Measuring individual-level needle and syringe coverage among people who inject drugs in Myanmar. Int J Drug Policy 2018; 58:22-30. [PMID: 29754104 DOI: 10.1016/j.drugpo.2018.04.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Revised: 03/23/2018] [Accepted: 04/16/2018] [Indexed: 12/24/2022]
Abstract
BACKGROUND Myanmar has prioritised people who inject drugs (PWID) as a key population for HIV mitigation efforts, with targets for needle and syringe distribution set at a population level. However, individual-level coverage, defined as the percentage of an individual's injecting episodes covered by a sterile syringe, is a more sensitive measure of intervention coverage. We sought to examine individual-level coverage in a sample of PWID in Myanmar. METHODS We recruited 512 PWID through urban drop-in-centres in Yangon, Mandalay and Pyin Oo Lwin. Participants were administered a quantitative questionnaire covering five domains: demographics, drug use, treatment and coverage, and injecting risk behaviour. We calculated past fortnight individual-level syringe coverage, estimating levels of sufficient (≥100% of injecting episodes covered by a sterile syringe) and insufficient (<100%) coverage, and examined associations between key variables and insufficient coverage via logistic regression. RESULTS Our sample was predominately male (97%), employed (76%), and living in stable accommodation (96%), with a median age of 27. All participants reported heroin as the drug most frequently injected, and injected a median of 27 times in the past two weeks. Nineteen per cent of participants had insufficient coverage in the two weeks before interview. Insufficient coverage was positively associated with syringe re-use (AOR: 5.19, 95% CIs: 2.57, 10.48) and acquiring sterile syringes from a location other than a formal drop-in-centre (AOR: 2.04, 95% CIs: 1.08, 3.82). Participants recruited in Mandalay (AOR: 0.30, 95% CIs: 0.11, 0.80) and Pyin Oo Lwin (AOR: 0.39, 95% CIs: 0.18, 0.87) had lower odds of insufficient coverage than those recruited in Yangon. CONCLUSION Our study shows coverage in selected areas of Myanmar was comparable with studies in other countries. Our results inform the delivery of harm reduction services for PWID, specifically by encouraging the use of formal drop-in-centres, over other sources of syringe distribution, such as pharmacies.
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Affiliation(s)
- Daniel O'Keefe
- Burnet Institute, 85 Commercial Rd, Melbourne, VIC, 3004, Australia; School of Public Health and Preventive Medicine, Monash University, 99 Commercial Rd, Melbourne, VIC, 3004, Australia.
| | - Soe Moe Aung
- Burnet Institute Myanmar, Second floor, 226 U Wisara Road, Wizaya Plaza, Bahan Township, Yangon, Myanmar.
| | - Naanki Pasricha
- Burnet Institute, 85 Commercial Rd, Melbourne, VIC, 3004, Australia.
| | - Thu Wun
- Burnet Institute Myanmar, Second floor, 226 U Wisara Road, Wizaya Plaza, Bahan Township, Yangon, Myanmar.
| | - Soe Khaing Linn
- Burnet Institute Myanmar, Second floor, 226 U Wisara Road, Wizaya Plaza, Bahan Township, Yangon, Myanmar.
| | - Nay Lin
- Burnet Institute Myanmar, Second floor, 226 U Wisara Road, Wizaya Plaza, Bahan Township, Yangon, Myanmar.
| | - Campbell Aitken
- Burnet Institute, 85 Commercial Rd, Melbourne, VIC, 3004, Australia; School of Public Health and Preventive Medicine, Monash University, 99 Commercial Rd, Melbourne, VIC, 3004, Australia.
| | - Chad Hughes
- Burnet Institute, 85 Commercial Rd, Melbourne, VIC, 3004, Australia; School of Public Health and Preventive Medicine, Monash University, 99 Commercial Rd, Melbourne, VIC, 3004, Australia.
| | - Paul Dietze
- Burnet Institute, 85 Commercial Rd, Melbourne, VIC, 3004, Australia; School of Public Health and Preventive Medicine, Monash University, 99 Commercial Rd, Melbourne, VIC, 3004, Australia.
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Gandhi S, Verma S, Ethier JL, Simmons C, Burnett H, Alibhai SM. A systematic review and quality appraisal of international guidelines for early breast cancer systemic therapy: Are recommendations sensitive to different global resources? Breast 2015; 24:309-17. [PMID: 25900382 DOI: 10.1016/j.breast.2014.12.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Revised: 10/19/2014] [Accepted: 12/08/2014] [Indexed: 12/25/2022] Open
Abstract
The breast cancer incidence in low and middle income countries (LMCs) is increasing globally, and patient outcomes are generally worse in these nations compared to high income countries (HICs). This is partly due to resource constraints associated with implementing recommended breast cancer therapies. Clinical practice guideline (CPG) adherence can improve breast cancer outcomes, however, many CPGs are created in HICs, and include costly recommendations that may not be feasible in LMCs. In addition, the quality of CPGs can be variable. The aim of this study was to perform a systematic review of CPGs on early breast cancer systemic therapy with potential international impact, to evaluate their content, quality, and resource sensitivity. A MEDLINE and gray literature search was completed for English language CPGs published between 2005 and 2010, and then updated to July 2014. Extracted guidelines were evaluated using the AGREE 2 instrument. Guidelines were specifically analyzed for resource sensitivity. Most of the extracted CPGs had similar recommendations with regards to systemic therapy. However, only one, the Breast Health Global Initiative, made recommendations with consideration of different global resources. Overall, the CPGs were of variable quality, and most scored poorly in the quality domain evaluating implementation barriers such as resources. Published CPGs for early breast cancer are created in HICs, have similar recommendations, and are generally resource-insensitive. Given the visibility and influence of these CPGs on LMCs, efforts to create higher quality, resource-sensitive guidelines with less redundancy are needed.
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Avilés-Robles M, Ojha RP, González M, Ojeda-Diezbarroso K, Dorantes-Acosta E, Jackson BE, Johnson KM, Caniza MA. Bloodstream infections and inpatient length of stay among pediatric cancer patients with febrile neutropenia in Mexico City. Am J Infect Control 2014; 42:1235-7. [PMID: 25234044 DOI: 10.1016/j.ajic.2014.07.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Revised: 07/17/2014] [Accepted: 07/21/2014] [Indexed: 11/17/2022]
Abstract
We assessed the association between bloodstream infections (BSIs) and inpatient length of stay among pediatric cancer patients with febrile neutropenia in Mexico City. The estimated length of stay for BSIs was 19 days, which corresponded with a 100% (95% confidence limits, 60%-160%) relative increase in the length of stay compared with patients for whom no pathogen was identified. Feasible options for reducing the length of stay should be considered to alleviate patient and resource burden.
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Affiliation(s)
- Martha Avilés-Robles
- Department of Infectious Diseases, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Rohit P Ojha
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN.
| | - Miriam González
- International Outreach Program, St. Jude Children's Research Hospital, Memphis, TN
| | - Karla Ojeda-Diezbarroso
- Department of Infectious Diseases, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Elisa Dorantes-Acosta
- Department of Oncology, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Bradford E Jackson
- Department of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - Kyle M Johnson
- Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, TN
| | - Miguela A Caniza
- International Outreach Program, St. Jude Children's Research Hospital, Memphis, TN; Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, TN
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Gupta S, Wong EG, Mahmood U, Charles AG, Nwomeh BC, Kushner AL. Burn management capacity in low and middle-income countries: a systematic review of 458 hospitals across 14 countries. Int J Surg 2014; 12:1070-3. [PMID: 25152443 DOI: 10.1016/j.ijsu.2014.08.353] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Revised: 06/23/2014] [Accepted: 08/13/2014] [Indexed: 10/24/2022]
Abstract
IMPORTANCE More than 90% of thermal injury-related deaths occur in low-resource settings. While baseline assessment of burn management capabilities is necessary to guide capacity building strategies, limited data exist from low and middle-income countries (LMICs). OBJECTIVE The objective of our review is to assess burn management capacity in LMICs. EVIDENCE REVIEW A PubMed literature review was performed based on studies assessing baseline surgical capacity in individual LMICs. Seven criteria were used to assess burn management capabilities: presence of surgeon, presence of anesthesiologist, basic resuscitation capabilities, acute burn management, management of burn complications, endotracheal intubation and skin grafts. FINDINGS Fourteen studies were reviewed using data from 458 hospitals in fourteen countries. Of these, 82.3% (284/345) of hospitals had the capacity to provide basic resuscitation and 84.9% (275/324) were capable of providing acute burn management. Endotracheal intubation was only available at 38.3% (51/133) of hospitals. Moreover, only 35.6% (111/312) and 37.9% (120/317) of hospitals were able to provide skin grafts and treat burn complications, respectively. CONCLUSION Many hospitals in LMICs are capable of initial burn management and basic resuscitation. However, deficiencies still exist in the capacity to systematically provide advanced burn care. Efforts should be made to better document resources in order to guide burn management resource allocation.
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Affiliation(s)
- Shailvi Gupta
- Department of Surgery, University of California, San Francisco East Bay, Oakland, CA, USA; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Surgeons OverSeas (SOS), New York, NY, USA.
| | - Evan G Wong
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Surgeons OverSeas (SOS), New York, NY, USA; Centre for Global Surgery, McGill University Health Centre, Montreal, QC, Canada.
| | - Umbareen Mahmood
- Department of Surgery, Division of Plastic Surgery, University of South Florida, Tampa, FL, USA.
| | - Anthony G Charles
- Department of Surgery, University of North Carolina, Chapel Hill, NC, USA.
| | - Benedict C Nwomeh
- Surgeons OverSeas (SOS), New York, NY, USA; Department of Pediatric Surgery, Nationwide's Children Hospital, Columbus, OH, USA.
| | - Adam L Kushner
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Surgeons OverSeas (SOS), New York, NY, USA; Department of Surgery, Columbia University, New York, NY, USA.
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