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Salceda-Rivera V, Tejocote-Romero I, Osorio DS, Bellido-Magaña R, López-Facundo A, Anaya-Aguirre SE, Ortiz-Morales D, Rivera-Luna R, Reyes-Gutiérrez E, Rivera-Gómez R, Velasco-Hidalgo L, Cortés-Alva D, Lagarda-Arrechea S, Arreguín-González FE, Benito-Reséndiz AE, Chávez-Gallegos S, Pérez-Rivera E, Gaytán-Fernández GJ, León-Espitia JA, Domínguez-Sánchez J, Leal-Cavazos C, Simón-González C, Larios-Farak TC, Macías-García NA, García-Espinosa AC, Guerrero-Maymes F, Casillas-Toral P, González-Ramella O. Impact of treatment and clinical characteristics on the survival of children with medulloblastoma in Mexico. Front Oncol 2024; 14:1376574. [PMID: 38756654 PMCID: PMC11096484 DOI: 10.3389/fonc.2024.1376574] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 03/26/2024] [Indexed: 05/18/2024] Open
Abstract
Introduction Data on medulloblastoma outcomes and experiences in low- and middle-income countries, especially in Latin America, is limited. This study examines challenges in Mexico's healthcare system, focusing on assessing outcomes for children with medulloblastoma in a tertiary care setting. Methods A retrospective analysis was conducted, involving 284 patients treated at 21 pediatric oncology centers in Mexico. Results High-risk patients exhibited markedly lower event-free survival than standard-risk patients (43.5% vs. 78.3%, p<0.001). Influential factors on survival included anaplastic subtype (HR 2.4, p=0.003), metastatic disease (HR 1.9, p=0.001); residual tumor >1.5cm², and lower radiotherapy doses significantly impacted event-free survival (EFS) and overall survival (OS). Platinum-based chemotherapy showed better results compared to the ICE protocol in terms of OS and EFS, which was associated with higher toxicity. Patients under 3 years old displayed notably lower OS and EFS compared to older children (36.1% vs. 55.9%, p=0.01).
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Affiliation(s)
- Violeta Salceda-Rivera
- Hospital Civil de Guadalajara “Dr. Juan I. Menchaca”, Department of Pediatrics, Divisions of Pediatric Hematology-Oncology, Guadalajara, Jalisco, Mexico
| | - Isidoro Tejocote-Romero
- IMIEM, Instituto Materno Infantil del Estado de Mexico, Secretaria de Salud, Toluca, Estado de Mexico, Mexico
- Department of Pediatric Oncology, ISSEMYM, Instituto de Seguridad Social del Estado de México y Municipios, Toluca, Estado de Mexico, Mexico
| | | | | | - Araceli López-Facundo
- Department of Pediatric Oncology, ISSEMYM, Instituto de Seguridad Social del Estado de México y Municipios, Toluca, Estado de Mexico, Mexico
| | | | - Daniel Ortiz-Morales
- Department of Pediatric Oncology, Hospital General de México “Dr. Eduardo Liceaga”, Mexico City, Mexico
- Department of Pediatric Oncology, Hospital Militar de Especialidades de la Mujer y Neonatología, Mexico City, Mexico
| | - Roberto Rivera-Luna
- Department of Pediatric Oncology, Instituto Nacional de Pediatria, Mexico City, Mexico
| | | | - Rebeca Rivera-Gómez
- Hospital General de Tijuana, Universidad Autonoma de Baja California, Tijuana, Baja California, Mexico
| | | | - Deyanira Cortés-Alva
- Hospital del Niño DIF Hidalgo, Sistema Nacional para el Desarrollo Integral de la Familia, Hidalgo, Mexico
| | | | - Farina E. Arreguín-González
- Centro Médico Nacional “20 de Noviembre” del Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), Mexico City, Mexico
| | - Alma E. Benito-Reséndiz
- Centro Médico Nacional “20 de Noviembre” del Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), Mexico City, Mexico
| | - Silvia Chávez-Gallegos
- Department of Pediatric Oncology, Hospital Infantil “Eva Samano de López Mateos”, Morelia, Michoacan, Mexico
| | - Eloy Pérez-Rivera
- Department of Pediatric Oncology, Hospital Infantil “Eva Samano de López Mateos”, Morelia, Michoacan, Mexico
| | - Guillermo J. Gaytán-Fernández
- Hospital General Regional de Leon, Leon, Guanajuato, Mexico
- Department of Pediatric Oncology, Hospital Regional de Alta Especialidad del Bajío, Leon, Guanajuato, Mexico
| | | | | | - Carlos Leal-Cavazos
- Hospital Universitario “Dr. José Eleuterio González”, Universidad Autónoma de Nuevo Leon, Nuevo Leon, Mexico
| | - Citlalli Simón-González
- Department of Pediatric Oncology, Hospital Regional de Alta Especialidad del Niño “ Dr. Rodolfo Nieto Padrón”, Tabasco, Mexico
| | - Tania C. Larios-Farak
- Department of Pediatric Oncology, Hospital Infantil del Estado de Sonora, Hermosillo, Sonora, Mexico
| | - Nubia A. Macías-García
- Department of Pediatric Oncology, Hospital del Niño “Dr. Federico Gómez Santos”, Saltillo, Coahuila, Mexico
| | - Ana C. García-Espinosa
- Department of Pediatric Oncology, Hospital Infantil de Especialidades de Chihuahua, Chihuahua, Chihuahua, Mexico
| | | | - Paola Casillas-Toral
- Hospital Civil de Guadalajara “Dr. Juan I. Menchaca”, Department of Pediatrics, Divisions of Pediatric Hematology-Oncology, Guadalajara, Jalisco, Mexico
| | - Oscar González-Ramella
- Hospital Civil de Guadalajara “Dr. Juan I. Menchaca”, Department of Pediatrics, Divisions of Pediatric Hematology-Oncology, Guadalajara, Jalisco, Mexico
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Marchetti M, Ceccarelli C, Muneghina O, Stockner M, Lai C, Mazzoni G. Enhancing mental health and well-being in adults from lower-resource settings: A mixed-method evaluation of the impact of problem management plus. Glob Ment Health (Camb) 2024; 11:e56. [PMID: 38751726 PMCID: PMC11094550 DOI: 10.1017/gmh.2024.52] [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] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 03/27/2024] [Accepted: 04/19/2024] [Indexed: 05/18/2024] Open
Abstract
Mental health conditions, recognised as a global crisis, were further exacerbated by the COVID-19 pandemic. Access to mental health services remains limited, particularly in low-income regions. Task-sharing interventions, exemplified by Problem Management Plus (PM+), have emerged as potential solutions to bridge this treatment gap. This study presents an evaluation of the PM+ scale-up in Sub-Saharan Africa (Ethiopia and Benin) and Eastern Europe (Croatia and Bosnia and Herzegovina) as part of a mental health and psychosocial support programming including 87 adult participants. A mixed-method approach assesses the impact of the intervention. Quantitative analyses reveal significant reductions in self-reported problems, depression, anxiety and improved functioning. Qualitative data highlight four main themes: general health, family relationships, psychosocial problems and daily activities. These thematic areas demonstrate consistent improvements across clients, irrespective of the region. The findings underscore the impact of PM+ in addressing a broad spectrum of client issues, demonstrating its potential as a valuable tool for mitigating mental health challenges in diverse settings. This study contributes to the burgeoning body of evidence supporting PM+ and highlights its promise in enhancing mental health outcomes on a global scale, particularly for vulnerable populations.
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Affiliation(s)
- Michela Marchetti
- Department of Dynamic and Clinical Psychology and Health Studies, Sapienza University of Rome, Rome, Italy
| | - Caterina Ceccarelli
- SOS Children’s Villages Italy, Global Expert Group on Mental Health and Psychosocial Support (GPEG in MHPSS), Milan, Italy
- Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Orso Muneghina
- SOS Children’s Villages Italy, Global Expert Group on Mental Health and Psychosocial Support (GPEG in MHPSS), Milan, Italy
| | - Mara Stockner
- Department of Dynamic and Clinical Psychology and Health Studies, Sapienza University of Rome, Rome, Italy
| | - Carlo Lai
- Department of Dynamic and Clinical Psychology and Health Studies, Sapienza University of Rome, Rome, Italy
| | - Giuliana Mazzoni
- Department of Dynamic and Clinical Psychology and Health Studies, Sapienza University of Rome, Rome, Italy
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Seth R, MacRae P, Goldhagen J, Raman S. Street and working children: a call for rights-based approach to their health and well-being. BMJ Paediatr Open 2024; 8:e002486. [PMID: 38548346 PMCID: PMC10982750 DOI: 10.1136/bmjpo-2023-002486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/02/2024] Open
Affiliation(s)
- Rajeev Seth
- Department of Pediatrics, Bal Umang Drishya Sanstha (BUDS), New Delhi, India
| | - Pia MacRae
- Consortium for Street Children, London, UK
| | - Jeffrey Goldhagen
- Division of Community and Societal Pediatrics, University of Florida, Jacksonville, Florida, USA
- Department of Pediatrics, University of Florida College of Medicine--Jacksonville, Ponte Vedra Beach, Florida, USA
| | - Shanti Raman
- Department of Community Paediatrics, South Western Sydney Local Health District, Liverpool, New South Wales, Australia
- Women's & Children's Health, University of New South Wales, Sydney, New South Wales, Australia
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Otaigbe II. Policy entrepreneurs are integral in efforts to curb antimicrobial resistance in low and middle income countries. Front Public Health 2024; 12:1292660. [PMID: 38532974 PMCID: PMC10963478 DOI: 10.3389/fpubh.2024.1292660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 02/27/2024] [Indexed: 03/28/2024] Open
Affiliation(s)
- Idemudia Imonikhe Otaigbe
- Department of Medical Microbiology, School of Basic Clinical Sciences, Benjamin Carson (Snr) College of Health and Medical Sciences, Babcock University/Babcock University Teaching Hospital, Ilishan Remo, Ogun State, Nigeria
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Benda N, Dougherty K, Gebremariam Gobezayehu A, Cranmer JN, Zawtha S, Andreadis K, Biza H, Masterson Creber R. Designing Electronic Data Capture Systems for Sustainability in Low-Resource Settings: Viewpoint With Lessons Learned From Ethiopia and Myanmar. JMIR Public Health Surveill 2024; 10:e47703. [PMID: 38345833 PMCID: PMC10897790 DOI: 10.2196/47703] [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: 03/29/2023] [Revised: 08/19/2023] [Accepted: 12/12/2023] [Indexed: 02/15/2024] Open
Abstract
Electronic data capture (EDC) is a crucial component in the design, evaluation, and sustainment of population health interventions. Low-resource settings, however, present unique challenges for developing a robust EDC system due to limited financial capital, differences in technological infrastructure, and insufficient involvement of those who understand the local context. Current literature focuses on the evaluation of health interventions using EDC but does not provide an in-depth description of the systems used or how they are developed. In this viewpoint, we present case descriptions from 2 low- and middle-income countries: Ethiopia and Myanmar. We address a gap in evidence by describing each EDC system in detail and discussing the pros and cons of different approaches. We then present common lessons learned from the 2 case descriptions as recommendations for considerations in developing and implementing EDC in low-resource settings, using a sociotechnical framework for studying health information technology in complex adaptive health care systems. Our recommendations highlight the importance of selecting hardware compatible with local infrastructure, using flexible software systems that facilitate communication across different languages and levels of literacy, and conducting iterative, participatory design with individuals with deep knowledge of local clinical and cultural norms.
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Affiliation(s)
- Natalie Benda
- School of Nursing, Columbia University, New York, NY, United States
| | - Kylie Dougherty
- School of Nursing, Columbia University, New York, NY, United States
| | | | - John N Cranmer
- Emory-Ethiopia Partnership, Bahir Dar, Ethiopia
- Bahir Dar University, Bahir Dar, Ethiopia
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, United States
| | | | - Katerina Andreadis
- New York University Grossman School of Medicine, New York, NY, United States
| | - Heran Biza
- Emory-Ethiopia Partnership, Bahir Dar, Ethiopia
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Boynito WG, Pauwels NS, Otayto K, De Henauw S, Abbeddou S. Effects of community-based educational video interventions on nutrition, health, and use of health services in low- and middle-income countries: systematic review and meta-analysis. Nutr Rev 2024:nuae004. [PMID: 38341801 DOI: 10.1093/nutrit/nuae004] [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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2024] Open
Abstract
CONTEXT Health education using videos has been promoted for its potential to enhance community health by improving social and behavior change communication. OBJECTIVE To provide stakeholders in maternal and child health with evidence that can inform policies and strategies integrating video education to improve maternal, newborn, and child health. DATA SOURCES Five databases (MEDLINE, Embase, Scopus, Web of Science, and CENTRAL) were searched on January 28, 2022, and November 10, 2022 (updated search). Quantitative and qualitative studies conducted in low- and middle-income countries on the effects of video-based interventions on nutrition, health, and health service use were eligible. There was no restriction on time or language. Study selection was done in 2 stages and in duplicate. DATA EXTRACTION A total of 13 710 records were imported to EndNote. Of these, 8226 records were screened by title and abstract using Rayyan, and 76 records were included for full-text evaluation. RESULTS Twenty-nine articles (n = 12 084 participants) were included in this systematic review, and 7 were included in the meta-analysis. Video interventions improved knowledge about newborn care (n = 234; odds ratio [OR], 1.20; 95% confidence interval [CI], 1.04-1.40), colostrum feeding (n = 990; OR, 60.38; 95%CI, 18.25-199.78), continued breastfeeding (BF; n = 1914; OR, 3.79; 95%CI, 1.14-12.64), intention to use family planning (FP) (n = 814; OR, 1.57; 95%CI, 1.10-2.23), and use of FP (n = 864; OR, 6.55; 95%CI, 2.30-18.70). Video interventions did not result in reduced prelacteal feeding or improvement in early initiation of BF. The qualitative studies showed that video interventions were acceptable and feasible, with perceived impacts on communities. CONCLUSION This systematic review and meta-analysis indicated that video interventions improved knowledge of newborn care, colostrum feeding, and continuing BF, and the intention to use FP. Given the high levels of heterogeneity and inconsistency in reporting, more research with stronger designs is recommended. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42022292190.
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Affiliation(s)
- Wanzahun Godana Boynito
- School of Public Health, Nutrition Unit, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Nele S Pauwels
- Knowledge Center for Health Ghent, Ghent University and Ghent University Hospital, Ghent, Belgium
| | - Kusse Otayto
- School of Public Health, Nutrition Unit, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Stefaan De Henauw
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Souheila Abbeddou
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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Sharif F, Shahzad L, Batool M. The association between climatic factors and waterborne infectious outbreaks with a focus on vulnerability in Pakistan: integrative review. Int J Environ Health Res 2024:1-18. [PMID: 38195067 DOI: 10.1080/09603123.2024.2302040] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Accepted: 12/31/2023] [Indexed: 01/11/2024]
Abstract
Climate change affects the spread of waterborne infectious diseases, yet research on vulnerability to outbreaks remains limited. This integrative review examines how climate variables (temperature and precipitation) relate to human vulnerability factors in Pakistan. By 2060, mean temperatures are projected to rise from 21.68°C (2021) to 30°C, with relatively stable precipitation. The epidemiological investigation in Pakistan identified Diarrhea (119,000 cases/year), Malaria (2.6 million cases/year), and Hepatitis (A and E) as the most prevalent infections. This research highlighted vulnerability factors, including poverty (52% of the population), illiteracy (59% of the population), limited healthcare accessibility (55% of the population), malnutrition (38% of the population), dietary challenges (48% of the population), as well as exposure to water pollution (80% of the population) and air pollution (55% of the population). The findings suggest that the coordinated strategies are vital across health, environmental, meteorological, and social sectors, considering climatic variability patterns and population vulnerability determinants.
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Affiliation(s)
- Faiza Sharif
- Sustainable development study center (SDSC), Government College University, Lahore, Pakistan
| | - Laila Shahzad
- Sustainable development study center (SDSC), Government College University, Lahore, Pakistan
| | - Masooma Batool
- Sustainable development study center (SDSC), Government College University, Lahore, Pakistan
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Ranganathan P, Dare A, Harrison EM, Kingham TP, Mutebi M, Parham G, Sullivan R, Pramesh CS. Inequities in global cancer surgery: Challenges and solutions. J Surg Oncol 2024; 129:150-158. [PMID: 38073139 DOI: 10.1002/jso.27551] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 11/15/2023] [Indexed: 12/17/2023]
Abstract
The disparity in access to and quality of surgical cancer care between high and low resource settings impacts immediate and long-term oncological outcomes. With cancer incidence and mortality set to increase rapidly in the next few decades, we examine the factors leading to inequities in global cancer surgery, and look at potential solutions to overcome these challenges.
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Affiliation(s)
- Priya Ranganathan
- Department of Anaesthesiology, Critical Care and Pain, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Anna Dare
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Ewen M Harrison
- Centre for Medical Informatics, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - T Peter Kingham
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Miriam Mutebi
- Department of Surgery, Aga Khan University, Nairobi, Kenya
| | - Groesbeck Parham
- Department of Obstetrics and Gynecology, Charles Drew University of Science and Medicine, Los Angeles, California, USA
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Zambia, Lusaka, Zambia
| | - Richard Sullivan
- School of Cancer Sciences, Centre for Cancer Society and Public Health, Institute of Cancer Policy, King's College London, London, UK
| | - C S Pramesh
- Department of Surgical Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
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Chaudhuri KR, Batzu L. Can Continuous Levodopa Delivery Be Achieved in the Absence of Intrajejunal Levodopa Infusion? Implications for India and Underserved Countries. Mov Disord Clin Pract 2024; 11:21-29. [PMID: 38291849 PMCID: PMC10828610 DOI: 10.1002/mdc3.13915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 08/24/2023] [Accepted: 10/12/2023] [Indexed: 02/01/2024] Open
Affiliation(s)
- K. Ray Chaudhuri
- Department of Basic and Clinical NeuroscienceInstitute of Psychiatry, Psychology, and Neuroscience, King's College LondonLondonUK
- Parkinson's Foundation Centre of Excellence, King's College HospitalLondonUK
| | - Lucia Batzu
- Department of Basic and Clinical NeuroscienceInstitute of Psychiatry, Psychology, and Neuroscience, King's College LondonLondonUK
- Parkinson's Foundation Centre of Excellence, King's College HospitalLondonUK
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Gupta P, Rai C, Shahi A, Sharma M, Choudhury R, Kotwal A. A comprehensive roadmap for MedTech innovations uptake into the public healthcare system in India. Front Digit Health 2023; 5:1268010. [PMID: 38107824 PMCID: PMC10722438 DOI: 10.3389/fdgth.2023.1268010] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 11/15/2023] [Indexed: 12/19/2023] Open
Abstract
Background The burden of communicable, non-communicable diseases and reproductive maternal, newborn, child & adolescent health in India, reflects the necessity to develop tailored solutions. The plethora of MedTech innovations has provided healthcare facilities with more effective, affordable and accessible healthcare for people across the country. However, in spite of the Make-in-India scheme in the country, the indigenously developed healthcare technology is far from making an impact on the healthcare system. Objective To present a roadmap for MedTech innovations for their successful deployment into the public healthcare system. Methodology In addition to the literature review, recommendations were included from several stakeholders such as innovators, manufacturers, policymakers, subject matter experts, funding organizations, State health officials etc. Results and conclusion The journey of healthcare innovation from need identification to ideation, to prototyping and validation has paved the way towards the de novo design that caters to unmet needs. Innovations at the advanced technology readiness level (TRL 7/8 and above) demand a holistic and multidisciplinary approach which includes clinical validation, regulatory approval and Health technology assessment. The deployment of healthcare technology into the public healthcare system must consider resources (e.g., time, staff, budget, investment policies), ethical concerns (privacy, security, regulations, ownership), governance (policy, accountability, responsibility etc.), and Skills (capabilities, culture, etc.). The technologies are considered for field trials before the uptake in the public health system. Technology can be a key tool in achieving Universal Health Coverage but its use has to be strategic, judicious, and cognizant of issues around privacy and patient rights.
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Affiliation(s)
| | | | | | | | - Ranjan Choudhury
- Healthcare Technology Division, National Health Systems Resource Center (NHSRC), Munirka, India
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Naqvi S, Saleem S, Billah SM, Moore J, Mwenechanya M, Carlo WA, Esamai F, Bucher S, Derman RJ, Goudar SS, Somannavar M, Patel A, Hibberd PL, Figueroa L, Krebs NF, Petri WA, Lokangaka A, Bauserman M, Koso-Thomas M, McClure EM, Goldenberg RL. The Global Network COVID-19 studies: a review. BJOG 2023; 130 Suppl 3:134-139. [PMID: 37530467 DOI: 10.1111/1471-0528.17610] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 06/30/2023] [Indexed: 08/03/2023]
Abstract
With the paucity of data available regarding COVID-19 in pregnancy in low- and middle-income countries (LMICs), near the start of the pandemic, the Global Network for Women's and Children's Health Research, funded by the National Institute of Child Health and Human Development (NICHD), initiated four separate studies to better understand the impact of the COVID-19 pandemic in eight LMIC sites. These sites included: four in Asia, in Bangladesh, India (two sites) and Pakistan; three in Africa, in the Democratic Republic of the Congo (DRC), Kenya and Zambia; and one in Central America, in Guatemala. The first study evaluated changes in health service utilisation; the second study evaluated knowledge, attitudes and practices of pregnant women in relationship to COVID-19 in pregnancy; the third study evaluated knowledge, attitude and practices related to COVID-19 vaccination in pregnancy; and the fourth study, using antibody status at delivery, evaluated changes in antibody status over time in each of the sites and the relationship of antibody positivity with various pregnancy outcomes. Across the Global Network, in the first year of the study there was little reduction in health care utilisation and no apparent change in pregnancy outcomes. Knowledge related to COVID-19 was highly variable across the sites but was generally poor. Vaccination rates among pregnant women in the Global Network were very low, and were considerably lower than the vaccination rates reported for the countries as a whole. Knowledge regarding vaccines was generally poor and varied widely. Most women did not believe the vaccines were safe or effective, but slightly more than half would accept the vaccine if offered. Based on antibody positivity, the rates of COVID-19 infection increased substantially in each of the sites over the course of the pandemic. Most pregnancy outcomes were not worse in women who were infected with COVID-19 during their pregnancies. We interpret the absence of an increase in adverse outcomes in women infected with COVID-19 to the fact that in the populations studied, most COVID-19 infections were either asymptomatic or were relatively mild.
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Affiliation(s)
| | | | - Sk Masum Billah
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Janet Moore
- RTI International, Durham, North Carolina, USA
| | | | | | | | - Sherri Bucher
- Department of Pediatrics, Indiana School of Medicine, University of Indiana, Indianapolis, Indiana, USA
| | | | - Shivaprasad S Goudar
- KLE Academy of Higher Education and Research, Jawaharlal Nehru Medical College, Belagavi, Karnataka, India
| | - Manjunath Somannavar
- KLE Academy of Higher Education and Research, Jawaharlal Nehru Medical College, Belagavi, Karnataka, India
| | | | | | - Lester Figueroa
- Instituto de Nutrición de Centroamérica y Panamá, Guatemala City, Guatemala
| | - Nancy F Krebs
- Department of Pediatrics, University of Colorado School of Medicine, Denver, Colorado, USA
| | | | - Adrien Lokangaka
- Department of Pediatrics, Kinshasa School of Public Health, Kinshasa, Democratic Republic of the Congo
| | - Melissa Bauserman
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Marion Koso-Thomas
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USA
| | | | - Robert L Goldenberg
- Department of Obstetrics and Gynecology, Columbia University School of Medicine, New York, New York, USA
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Mayora C, Kazibwe J, Ssempala R, Nakimuli B, Ssennyonjo A, Ekirapa E, Byakika S, Aliti T, Musila T, Gad M, Vassall A, Ruiz F, Ssengooba F. Health technology assessment (HTA) readiness in Uganda: stakeholder's perceptions on the potential application of HTA to support national universal health coverage efforts. Int J Technol Assess Health Care 2023; 39:e65. [PMID: 37905441 DOI: 10.1017/s0266462323002635] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
INTRODUCTION Health technology assessment (HTA) is an area that remains less implemented in low- and lower middle-income countries. The aim of the study is to understand the perceptions of stakeholders in Uganda toward HTA and its role in decision making, in order to inform its potential implementation in the country. METHODS The study takes a cross-sectional mixed methods approach, utilizing an adapted version of the International Decision Support Initiative questionnaire with both semi-structured and open-ended questions. We interviewed thirty key informants from different stakeholder institutions in Uganda that support policy and decision making in the health sector. RESULTS All participants perceived HTA as an important tool for decision making. Allocative efficiency was regarded as the most important use of HTA receiving the highest average score (8.8 out of 10), followed by quality of healthcare (7.8/10), transparency (7.6/10), budget control (7.5/10), and equity (6.5/10). There was concern that some of the uses of HTA may not be achieved in reality if there was political interference during the HTA process. The study participants identified development partners as the most likely potential users of HTA (66.7 percent of participants), followed by Ministry of Health (43.3 percent). CONCLUSION Interviewed stakeholders in Uganda viewed the role of HTA positively, suggesting that there exists a promising environment for the establishment and operationalization of HTA as a tool for decision making within the health sector. However, sustainable development and application of HTA in Uganda will require adequate capacity both to undertake HTAs and to support their use and uptake.
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Affiliation(s)
- Chrispus Mayora
- Department of Health Policy Planning and Management, Makerere University School of Public Health, Kampala, Uganda
| | - Joseph Kazibwe
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
| | - Richard Ssempala
- Department of Economic Theory and Analysis, Makerere University School of Economics, Kampala, Uganda
| | - Brenda Nakimuli
- Department of Health Policy Planning and Management, Makerere University School of Public Health, Kampala, Uganda
| | - Aloysius Ssennyonjo
- Department of Health Policy Planning and Management, Makerere University School of Public Health, Kampala, Uganda
| | - Elizabeth Ekirapa
- Department of Health Policy Planning and Management, Makerere University School of Public Health, Kampala, Uganda
| | - Sarah Byakika
- Department of Planning, Financing and Policy, Ministry of Health, Kampala, Uganda
| | - Tom Aliti
- Department of Planning, Financing and Policy, Ministry of Health, Kampala, Uganda
| | - Timothy Musila
- Department of Planning, Financing and Policy, Ministry of Health, Kampala, Uganda
| | - Mohamed Gad
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
| | - Anna Vassall
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
| | - Francis Ruiz
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
| | - Freddie Ssengooba
- Department of Health Policy Planning and Management, Makerere University School of Public Health, Kampala, Uganda
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Alam N, Merry L, Browne JL, Nahar Q. Editorial: Adolescent sexual and reproductive health challenges in low-income settings. Front Public Health 2023; 11:1287625. [PMID: 37809005 PMCID: PMC10557041 DOI: 10.3389/fpubh.2023.1287625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Accepted: 09/11/2023] [Indexed: 10/10/2023] Open
Affiliation(s)
- Nazmul Alam
- Asian University for Women, Chittagong, Bangladesh
| | - Lisa Merry
- University of Montreal, Montreal, QC, Canada
| | | | - Quamrun Nahar
- International Centre for Diarrhoeal Disease Research (icddr, b), Dhaka, Bangladesh
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Lautenbach E, Mosepele M, Smith RM, Styczynski A, Gross R, Cressman L, Jaskowiak-Barr A, Alby K, Glaser L, Richard-Greenblatt M, Cowden L, Sewawa K, Otukile D, Paganotti GM, Mokomane M, Bilker WB, Mannathoko N. Risk Factors for Community Colonization With Extended-Spectrum Cephalosporin-Resistant Enterobacterales (ESCrE) in Botswana: An Antibiotic Resistance in Communities and Hospitals (ARCH) Study. Clin Infect Dis 2023; 77:S89-S96. [PMID: 37406040 DOI: 10.1093/cid/ciad259] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/07/2023] Open
Abstract
BACKGROUND The epidemiology of extended-spectrum cephalosporin-resistant Enterobacterales (ESCrE) in low- and middle-income countries (LMICs) is poorly described. Identifying risk factors for ESCrE colonization is critical to inform antibiotic resistance reduction strategies because colonization is typically a precursor to infection. METHODS From 15 January 2020 to 4 September 2020, we surveyed a random sample of clinic patients at 6 sites in Botswana. We also invited each enrolled participant to refer up to 3 adults and children. All participants had rectal swabs collected that were inoculated onto chromogenic media followed by confirmatory testing. Data were collected on demographics, comorbidities, antibiotic use, healthcare exposures, travel, and farm and animal contact. Participants with ESCrE colonization (cases) were compared with noncolonized participants (controls) to identify risk factors for ESCrE colonization using bivariable, stratified, and multivariable analyses. RESULTS A total of 2000 participants were enrolled. There were 959 (48.0%) clinic participants, 477 (23.9%) adult community participants, and 564 (28.2%) child community participants. The median (interquartile range) age was 30 (12-41) and 1463 (73%) were women. There were 555 cases and 1445 controls (ie, 27.8% of participants were ESCrE colonized). Independent risk factors (adjusted odds ratio [95% confidence interval]) for ESCrE included healthcare exposure (1.37 [1.08-1.73]), foreign travel [1.98 (1.04-3.77]), tending livestock (1.34 [1.03-1.73]), and presence of an ESCrE-colonized household member (1.57 [1.08-2.27]). CONCLUSIONS Our results suggest healthcare exposure may be important in driving ESCrE. The strong links to livestock exposure and household member ESCrE colonization highlight the potential role of common exposure or household transmission. These findings are critical to inform strategies to curb further emergence of ESCrE in LMICs.
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Affiliation(s)
- Ebbing Lautenbach
- Division of Infectious Diseases, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Mosepele Mosepele
- Department of Internal Medicine, University of Botswana, Gaborone, Botswana
| | - Rachel M Smith
- Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Ashley Styczynski
- Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Robert Gross
- Division of Infectious Diseases, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Leigh Cressman
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Anne Jaskowiak-Barr
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Kevin Alby
- Department of Pathology and Laboratory Medicine, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Laurel Glaser
- Department of Pathology and Laboratory Medicine, University Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Melissa Richard-Greenblatt
- Department of Microbiology, Public Health Ontario, Toronto, ON, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | - Laura Cowden
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Kgotlaetsile Sewawa
- Department of Medicine, Botswana-University of Pennsylvania Partnership (BUP), Gaborone, Botswana
| | - Dimpho Otukile
- Department of Medicine, Botswana-University of Pennsylvania Partnership (BUP), Gaborone, Botswana
| | - Giacomo M Paganotti
- Division of Infectious Diseases, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Biomedical Sciences, University of Botswana, Gaborone, Botswana
| | - Margaret Mokomane
- Department of Biomedical Sciences, University of Botswana, Gaborone, Botswana
| | - Warren B Bilker
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Naledi Mannathoko
- Department of Biomedical Sciences, University of Botswana, Gaborone, Botswana
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Levican A, Varela C, Porte L, Weitzel T, Briceño I, Guerra F, Mena B, Hinton A. Head-to-head comparison of CAMPYAIR aerobic culture medium versus standard microaerophilic culture for Campylobacter isolation from clinical samples. Front Cell Infect Microbiol 2023; 13:1153693. [PMID: 37384222 PMCID: PMC10293832 DOI: 10.3389/fcimb.2023.1153693] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 05/24/2023] [Indexed: 06/30/2023] Open
Abstract
Campylobacter spp. are considered the most frequent cause of acute gastroenteritis worldwide. However, outside high-income countries, its burden is poorly understood. Limited published data suggest that Campylobacter prevalence in low- and middle-income countries is high, but their reservoirs and age distribution are different. Culturing Campylobacter is expensive due to laboratory equipment and supplies needed to grow the bacterium (e.g., selective culture media, microaerophilic atmosphere, and a 42°C incubator). These requirements limit the diagnostic capacity of clinical laboratories in many resource-poor regions, leading to significant underdiagnosis and underreporting of isolation of the pathogen. CAMPYAIR, a newly developed selective differential medium, permits Campylobacter isolation without the need for microaerophilic incubation. The medium is supplemented with antibiotics to allow Campylobacter isolation in complex matrices such as human feces. The present study aims to evaluate the ability of the medium to recover Campylobacter from routine clinical samples. A total of 191 human stool samples were used to compare the ability of CAMPYAIR (aerobic incubation) and a commercial Campylobacter medium (CASA, microaerophilic incubation) to recover Campylobacter. All Campylobacter isolates were then identified by MALDI-TOF MS. CAMPYAIR showed sensitivity and specificity values of 87.5% (95% CI 47.4%-99.7%) and 100% (95% CI 98%-100%), respectively. The positive predictive value of CAMPYAIR was 100% and its negative predictive value was 99.5% (95% CI 96.7%-99.9%); Kappa Cohen coefficient was 0.93 (95% CI 0.79-1.0). The high diagnostic performance and low technical requirements of the CAMPYAIR medium could permit Campylobacter culture in countries with limited resources.
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Affiliation(s)
- Arturo Levican
- Tecnología Médica, Facultad de Ciencias, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile
| | - Carmen Varela
- Laboratorio Clínico, Clínica Alemana, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Lorena Porte
- Laboratorio Clínico, Clínica Alemana, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Thomas Weitzel
- Laboratorio Clínico, Clínica Alemana, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
- Instituto de Ciencias e Innovación en Medicina (ICIM), Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Isabel Briceño
- Laboratorio Clínico, Hospital Naval Almirante Nef, Viña del Mar, Chile
| | - Francisco Guerra
- Laboratorio Clínico, Hospital Naval Almirante Nef, Viña del Mar, Chile
| | - Benjamín Mena
- Laboratorio Clínico, Hospital Naval Almirante Nef, Viña del Mar, Chile
| | - Arthur Hinton
- Poultry Microbiological Safety and Processing Research Unit, U.S. National Poultry Research Center, Agricultural Research Service, Athens, GA, United States
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Rukundo GZ, Ogbolu RE, Mugisha J. Editorial: Hopelessness and suicide among children and adolescents in low and middle income countries. Front Sociol 2023; 8:1215073. [PMID: 37333065 PMCID: PMC10271234 DOI: 10.3389/fsoc.2023.1215073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 05/16/2023] [Indexed: 06/20/2023]
Affiliation(s)
- Godfrey Zari Rukundo
- Department of Psychiatry, Mbarara University of Science and Technology, Mbarara, Uganda
- African Centre for Suicide Prevention and Research, Mbarara, Uganda
| | | | - James Mugisha
- Faculty of Social Sciences, Kyambogo University, Kampala, Uganda
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Abdoola S, Swanepoel DW, Graham MA, van der Linde J. Developmental characteristics of young children in a low-income South African community. J Child Health Care 2023:13674935231173023. [PMID: 37150599 DOI: 10.1177/13674935231173023] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Adequate early childhood development is critical for later-life success. Developmental profiles of specific populations are required to support implementation of early intervention services. Three hundred fifty-three caregivers of children with mean age 17.9 months (SD = 10.5) were selected from a primary healthcare clinic. Overall positive identification of signs of a developmental delay, with the Bayley Scales of Infant and Toddler Development III, was 51.8% (n = 183). Logistic regression analysis determined the effect of age and gender on results. Prevalence of developmental delay increased with age from 33.1% for children under 12 months to 61.7% and 66.3% for children between 13-24 months and 25-36 months, respectively. Females were 1.82 times (95% CI [1.16, 2.85]) more likely to have had no signs of developmental delay; 2.30 times (95% CI [1.14, 4.65]) in motor and 2.06 times (95% CI [1.23, 3.45]) in adaptive behaviour domains. One-third of children presented with low levels of adaptive behaviour functioning. One hundred and one (28.6%) participants across age groups displayed superior social-emotional ability, possibly due to familial structures and relationships. One-third of children presented with poor adaptive behaviour function, attributed to cultural differences. This study contributes to information on developmental characteristics of children in South Africa.
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Affiliation(s)
- Shabnam Abdoola
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
| | - De Wet Swanepoel
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
| | - Marien Alet Graham
- Department of Science Mathematics and Technology Education, Faculty of Education, University of Pretoria, Pretoria, South Africa
| | - Jeannie van der Linde
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
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Vu TT, Lu W, Weiss M, Nguyen LTH, Ngo VK. Mental health, functional impairment, and barriers to mental health access among cancer patients in Vietnam. Psychooncology 2023; 32:701-711. [PMID: 36797820 DOI: 10.1002/pon.6114] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 02/02/2023] [Accepted: 02/11/2023] [Indexed: 02/18/2023]
Abstract
OBJECTIVE This study evaluated the prevalence and severity of depression and anxiety symptomatology, barriers to mental health access, and correlates of functional impairment among cancer inpatients. METHODS This cross-sectional study recruited adult cancer patients (N = 300) in June and July 2022 at the largest oncological hospital in Vietnam. Multivariable linear regression analyses examined the association between demographics, clinical characteristics, and patients' functional impairment. RESULTS Approximately 46.3% and 27.0% showed some depression and anxiety symptomatology, while 8.0% and 3.0% experienced major depressive and anxiety symptoms, respectively. Patients reported the most impairment in mobility and capacity for life activities. More functional impairment was identified in patients with gastrointestinal cancers, those receiving radiation therapy alone, and those scoring higher on depression and anxiety than in those with cancers originating in the head, neck, or lung or those receiving chemotherapy alone. Reports of better overall health status were negatively associated with functional impairment. Patients reported extensive perceived barriers to seeking psychiatric care, including not knowing where to get mental health support (86.7%), wanting to manage mental health independently (73.7%), and thinking mental health will resolve on its own (73.7%), and denying mental health concerns (61.0%). CONCLUSION High frequency and severity of depression and anxiety symptomatology underscore the importance of integrating mental health services into existing oncological treatment protocols. Increasing mental health literacy and provision of psychoeducation is critical to addressing barriers to mental health service access. Integration of functional impairment evaluations into hospital admission and discharge planning is also needed.
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Affiliation(s)
- Thinh Toan Vu
- Center for Innovation in Mental Health, Graduate School of Public Health & Health Policy, The City University of New York, New York, New York, USA
- Department of Community Health and Social Sciences, Graduate School of Public Health & Health Policy, The City University of New York, New York, New York, USA
| | - Wenhua Lu
- Department of Community Health and Social Medicine, School of Medicine, The City University of New York, New York, New York, USA
| | - Marina Weiss
- Center for Innovation in Mental Health, Graduate School of Public Health & Health Policy, The City University of New York, New York, New York, USA
| | | | - Victoria Khanh Ngo
- Center for Innovation in Mental Health, Graduate School of Public Health & Health Policy, The City University of New York, New York, New York, USA
- Department of Community Health and Social Sciences, Graduate School of Public Health & Health Policy, The City University of New York, New York, New York, USA
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S. Sairras, S. Baldew, C. Goberdhan, K. van der Hilst, A. Shankar, W. Zijlmans, H. Covert, M. Lichtveld, K. Ferdinand. The impact of COVID-19 on heart failure admissions in Suriname-A call for action. J Natl Med Assoc 2023. [PMID: 37024313 PMCID: PMC10071347 DOI: 10.1016/j.jnma.2022.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 10/28/2022] [Accepted: 12/07/2022] [Indexed: 04/07/2023]
Abstract
Introduction During the height of the COVID-19 pandemic, there was a worldwide reorganization of healthcare systems focusing on limiting the spread of the virus. The impact of these measures on heart failure (HF) admissions is scarcely reported in Low and Middle Income Countries (LMICs) including Suriname. We therefore assessed HF hospitalizations before and during the pandemic and call for action to improve healthcare access in Suriname through the development and implementation of telehealth strategies. Methods Retrospectively collected clinical (# hospitalizations per patient, in hospital mortality, comorbidities) and demographic (sex, age, ethnicity) data of people hospitalized with a primary or secondary HF discharge ICD10 code in the Academic Hospital Paramaribo (AZP) from February to December 2019 (pre-pandemic) and February to December 2020 (during the pandemic) were used for analysis. Data are presented as frequencies with corresponding percentages. T-tests were used to analyze continuous variables and the two-sample test for proportions for categorical variables. Results There was an overall slight decrease of 9.1% HF admissions (N pre-pandemic:417 vs N during the pandemic: 383). Significantly less patients (18.3%, p-value<0.00) were hospitalized during the pandemic (N: 249 (65.0%)) compared to pre-pandemic (N: 348 (83.3%)), while readmissions increased statistically significantly for both readmissions within 90 days (75 (19.6%) vs 55 (13.2%), p-value = 0.01) and readmissions within 365 days (122 (31.9%) vs 70 (16.7%), p-value = 0.00) in 2020 compared to 2019. Patients admitted during the pandemic also had significantly more of the following comorbidities: hypertension (46.2% vs 30.6%, p-value = 0.00), diabetes (31.9% vs 24.9%, p-value = 0.03) anemia (12.8% vs 3.1%, p-value = 0.00), and atrial fibrillation (22.7% vs 15.1%, p-value = 0.00). Conclusion HF admissions were reduced during the pandemic while HF readmissions increased compared to the pre-pandemic period. Due to in-person consultation restrictions, the HF clinic was inactive during the pandemic period. Distance monitoring of HF patients via telehealth tools could help in reducing these adverse effects. This call for action identifies key elements (digital and health literacy, telehealth legislation, integration of telehealth tools within the current healthcare sector) needed for the successful development and implementation of these tools in LMICs.
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Greffeuille V, Dass M, Fanou‐Fogny N, Nyako J, Berger J, Wieringa FT. Micronutrient intake of children in Ghana and Benin: Estimated contribution of diet and nutrition programs. Matern Child Nutr 2023; 19:e13453. [PMID: 36394283 PMCID: PMC10019049 DOI: 10.1111/mcn.13453] [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] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 09/23/2022] [Accepted: 10/20/2022] [Indexed: 11/19/2022]
Abstract
We estimated how micronutrient needs of young children, aged 6-24 months were covered by the standard (traditional) diets in Ghana and Benin, and the contributions of partial breastfeeding and national nutrition programs aimed at improving micronutrient status to overall micronutrient intakes. Estimates of micronutrient intake from standard diets were based on previous surveys, using the food composition table of West Africa (INFOOD). Recommended micronutrient intakes were based on World Health Organization recommendations. Children were grouped in three age groups (6-8, 9-12, and 13-24 months) to capture the changing dynamics of the complementary feeding period. As expected, from 6 months of age onwards, breastmilk didn't cover the micronutrient needs. The standard diets contributed only minimal to micronutrient intakes of children ranging from 0% to 37% of recommended intakes for Ca, Fe, Zn, vitamin A, vitamin D and iodine depending on the micronutrient considered. The contribution of mass (bio)-fortification programs to the coverage of micronutrient needs varied widely, depending on the staple food considered and the country, but overall did not allow to fill the gap in micronutrient needs of children except for vitamin A in some contexts. In contrast, consumption of voluntary fortified complementary food, especially formulated for the needs in this age groups, contributed substantially to overall micronutrient intake and could fill the gap for several micronutrients. The development of young child-targeted programs including micronutrient-dense foods, associated with interventions to increase the diet diversity and meal frequency, could significantly improve micronutrients intakes of children in both Ghana and Benin.
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Affiliation(s)
- Valérie Greffeuille
- Institut de Recherche pour le Développement (IRD)MontpellierFrance
- QualiSud, Univ Montpellier, Avignon Université, CIRAD, Institut Agro, IRD, Université de La RéunionMontpellierFrance
| | - Mamta Dass
- Institut de Recherche pour le Développement (IRD)MontpellierFrance
- QualiSud, Univ Montpellier, Avignon Université, CIRAD, Institut Agro, IRD, Université de La RéunionMontpellierFrance
| | - Nadia Fanou‐Fogny
- Faculté des Sciences Agronomiques (FSA)Université d'Abomey‐Calavi (UAC)GodomeyBenin
| | - Jolene Nyako
- Nutrition Unit, Food Research Institute, Council for Scientific and Industrial Research (CSIR)AccraGhana
| | - Jacques Berger
- Institut de Recherche pour le Développement (IRD)MontpellierFrance
- QualiSud, Univ Montpellier, Avignon Université, CIRAD, Institut Agro, IRD, Université de La RéunionMontpellierFrance
| | - Frank T. Wieringa
- Institut de Recherche pour le Développement (IRD)MontpellierFrance
- QualiSud, Univ Montpellier, Avignon Université, CIRAD, Institut Agro, IRD, Université de La RéunionMontpellierFrance
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Ricardo LIC, Gatica-Domínguez G, Neves PAR, Vaz JDS, Barros AJD, Wehrmeister FC. Sociodemographic inequalities in vegetables, fruits, and animal source foods consumption in children aged 6-23 months from 91 LMIC. Front Nutr 2023; 10:1046686. [PMID: 36866060 PMCID: PMC9972219 DOI: 10.3389/fnut.2023.1046686] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 01/24/2023] [Indexed: 02/16/2023] Open
Abstract
Introduction No multi-country analysis described patterns and inequalities for the brand-new feeding indicators proposed by WHO/UNICEF: zero consumption of vegetables and fruits (ZVF) and consumption of eggs and/or flesh (EFF). Our aim was to describe patterns in the prevalence and social inequalities of ZVF and EFF among children aged 6-23 months in low-and middle-income countries. Methods Data from nationally representative surveys (2010-2019) in 91 low-and middle-income countries were used to investigate within-country disparities in ZVF and EFF by place of residence, wealth quintiles, child sex and child age. The slope index of inequality was used to assess socioeconomic inequalities. Analyses were also pooled by World Bank income groups. Results The prevalence of ZVF was 44.8% and it was lowest in children from upper-middle income countries, from urban areas, and those 18-23 months. The slope index of inequality showed that socioeconomic inequalities in the prevalence of ZVF were higher among poor children in comparison to richest children (mean SII = -15.3; 95%CI: -18.5; -12.1). Overall, 42.1% of children consumed egg and/or flesh foods. Being a favorable indicator, findings for EFF were generally in the opposite direction than for ZVF. The prevalence was highest in children from upper-middle income countries, from urban areas, and those 18-23 months of age. The slope index of inequality showed pro-rich patterns in most countries (mean SII = 15.4; 95%CI: 12.2; 18.6). Discussion Our findings demonstrate that inequalities exist in terms of household wealth, place of residence, and age of the child in the prevalence of the new complementary feeding indicators. Moreover, children from low-and lower-middle countries had the lowest consumption of fruits, vegetables, eggs, and flesh foods. Such findings provide new insights towards effective approaches to tackle the malnutrition burden through optimal feeding practices.
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Affiliation(s)
- Luiza I. C. Ricardo
- International Center for Equity in Health, Federal University of Pelotas, Pelotas, Brazil
| | | | - Paulo A. R. Neves
- International Center for Equity in Health, Federal University of Pelotas, Pelotas, Brazil
| | | | - Aluisio J. D. Barros
- International Center for Equity in Health, Federal University of Pelotas, Pelotas, Brazil
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Abstract
BACKGROUND In February 2022, Russia began its invasion of Ukraine. War increases the demand for mental healthcare among affected populations, but with devastating losses across the nation, it is unclear if Ukrainian mental health services are able to meet the needs of the people. AIMS We aimed to evaluate the state of Ukrainian in-patient mental health services, which remains the backbone of the nation's psychiatric services, early in the 2022 Russian invasion. METHOD We conducted a nationwide cross-sectional study on Ukrainian in-patient mental health facilities during the 2022 Russian invasion. Using an online questionnaire, we obtained responses from the heads of 32 in-patient mental health facilities across Ukraine, representing 52.5% of all in-patient mental health facilities in the nation. We gathered information on hospital admissions, staff, humanitarian aid received and the additional needs of each facility. RESULTS Hospital admissions were reduced by 23.5% during the war (April 2022) compared with before the war (January 2022). Across facilities, 9.6% of hospital admissions in April 2022 were related to war trauma, with facilities reporting percentages as high as 30.0%. Facilities reported reductions in staff, with 9.1% of total medical workers displaced and 0.5% injured across facilities. One facility reported that 45.6% of their total medical workers were injured. Although facilities across Ukraine have received humanitarian aid (such as medical supplies, food, volunteers), they reported additionally needing equipment as well as more staff. CONCLUSIONS The mental health service structure in Ukraine has been severely damaged during the 2022 invasion, with staff shortages despite a significant number of hospital admissions related to war trauma.
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Affiliation(s)
- Ryunosuke Goto
- Department of Pediatrics, The University of Tokyo Hospital, Japan
| | - Irina Pinchuk
- Institute of Psychiatry, Taras Shevchenko National University of Kyiv, Ukraine
| | - Oleksiy Kolodezhny
- Institute of Psychiatry, Taras Shevchenko National University of Kyiv, Ukraine
| | - Nataliia Pimenova
- Institute of Psychiatry, Taras Shevchenko National University of Kyiv, Ukraine
| | - Norbert Skokauskas
- Regional Centre for Children and Youth Mental Health and Child Welfare - Central Norway, IPH, Norwegian University of Science and Technology, Norway; and Chair, Child and Adolescent Psychiatry Section, World Psychiatric Association
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Niyibizi BA, Muhizi E, Rangira D, Ndoli DA, Nzeyimana IN, Muvunyi J, Irakoze M, Kazindu M, Rugamba A, Uwimana K, Cao Y, Rugengamanzi E, de Dieu Kwizera J, Manirakiza AVC, Rubagumya F. Multidisciplinary approach to cancer care in Rwanda: the role of tumour board meetings. Ecancermedicalscience 2023; 17:1515. [PMID: 37113712 PMCID: PMC10129399 DOI: 10.3332/ecancer.2022.1515] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Indexed: 04/29/2023] Open
Abstract
Introduction Cancer treatment is complex and necessitates a multidisciplinary approach. Tumour Board Meetings (TBMs) provide a multidisciplinary platform for health care providers to communicate about treatment plans for patients. TBMs improve patient care, treatment outcomes and, ultimately, patient satisfaction by facilitating information exchange and regular communication among all parties involved in a patient's treatment. This study describes the current status of case conference meetings in Rwanda including their structure, process and outcomes. Methods The study included four hospitals providing cancer care in Rwanda. Data gathered included patients' diagnosis, number of attendance and pre-TBM treatment plan, as well as changes made during TBMs, including diagnostic and management plan changes. Results From 128 meetings that took place at the time of the study, Rwanda Military Hospital hosted 45 (35%) meetings, King Faisal Hospital had 32 (25%), Butare University Teaching Hospital (CHUB) had 32 (25%) and Kigali University Teaching Hospital (CHUK) had 19 (15%). In all hospitals, General Surgery 69 (29%) was the leading speciality in presenting cases. The top three most presented disease site were head and neck 58 (24%), gastrointestinal 28 (16%) and cervix 28 (12%). Most (85% (202/239)) presented cases sought inputs from TBMs on management plan. On average, two oncologists, two general surgeons, one pathologist and one radiologist attended each meeting. Conclusion TBMs in Rwanda are increasingly getting recognised by clinicians. To influence the quality of cancer care provided to Rwandans, it is crucial to build on this enthusiasm and enhance TBMs conduct and efficiency.
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Affiliation(s)
| | - Eulade Muhizi
- Rwanda Cancer Relief, Kigali, Rwanda
- Department of Gynecology, Munini District Hospital, Nyabihu, Rwanda
| | - Daniella Rangira
- Rwanda Cancer Relief, Kigali, Rwanda
- Department of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto M5T 3M7, Canada
| | - Diane A Ndoli
- Rwanda Cancer Relief, Kigali, Rwanda
- Department of Oncology, Rwanda Military Hospital, Kigali, Rwanda
| | | | - Jackson Muvunyi
- Department of Oncology, Rwanda Military Hospital, Kigali, Rwanda
| | - Magnifique Irakoze
- Department of Gynecology, Kigali University Teaching Hospital, Kigali, Rwanda
| | - Madeleine Kazindu
- Rwanda Cancer Relief, Kigali, Rwanda
- School of Medicine, College of Medical and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Alex Rugamba
- Rwanda Cancer Relief, Kigali, Rwanda
- Department of Internal Medicine, Ruhango Provincial Hospital, Ruhango, Rwanda
| | - Khadidja Uwimana
- Rwanda Cancer Relief, Kigali, Rwanda
- School of Medicine, College of Medical and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Yuanzhen Cao
- Department of Internal Medicine, Dartmouth–Hitchcock Medical Center, Lebanon, NH 03766, USA
| | - Eulade Rugengamanzi
- Rwanda Cancer Relief, Kigali, Rwanda
- Department of Oncology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
- Ocean Road Cancer Institute, Dar es Salaam, Tanzania
| | - Jean de Dieu Kwizera
- Rwanda Cancer Relief, Kigali, Rwanda
- Department of Internal Medicine, Gisenyi Hospital, Rubavu, Gisenyi, Rwanda
| | - Achille VC Manirakiza
- Rwanda Cancer Relief, Kigali, Rwanda
- Unit of Oncology, Department of Internal Medicine, King Faisal Hospital, Kigali, Rwanda
| | - Fidel Rubagumya
- Rwanda Cancer Relief, Kigali, Rwanda
- Department of Oncology, Rwanda Military Hospital, Kigali, Rwanda
- School of Medicine, College of Medical and Health Sciences, University of Rwanda, Kigali, Rwanda
- Unit of Oncology, Department of Internal Medicine, King Faisal Hospital, Kigali, Rwanda
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Abstract
Background Assistive technologies promote participation and quality of life for people with disabilities and other functional limitations. There is a global call to develop and implement policies to improve access to assistive technologies. In response, a stakeholder led initiative in Malawi is working towards the development of such a policy. Objective The objective of this study was to assess the existing network of stakeholders, and the strength of relationship between organizations who deliver assistive products and related services. Method We conducted a survey-based network analysis of assistive technology stakeholder organizations in Malawi. Results Stakeholders (n = 19) reported a range of connections, from no awareness to collaboration with organizations within the assistive technology network. No single organization or government ministry was most central to the network. International NGOs were less central to the network than local organizations for disabled people, service providers, and ministries. Conclusion The assistive technology stakeholder network in Malawi is distributed, with a range of responsibility across a variety of stakeholders, including three government ministries. An effective assistive technology policy must engage all stakeholders and may benefit from a collective leadership approach that spans the inter-sectoral need for a cohesive assistive technology system.
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Affiliation(s)
- Emma M Smith
- Assisting Living and Learning Institute, John Hume Building, Maynooth University, Maynooth, Ireland
| | - Ikenna D Ebuenyi
- Assisting Living and Learning Institute, John Hume Building, Maynooth University, Maynooth, Ireland
| | - Juba Kafumba
- Centre for Social Research, Chancellor's College, University of Malawi, Zomba, Malawi
| | - Monica Jamali-Phiri
- Centre for Social Research, Chancellor's College, University of Malawi, Zomba, Malawi
| | - Alister Munthali
- Centre for Social Research, Chancellor's College, University of Malawi, Zomba, Malawi
| | - Malcolm MacLachlan
- Assisting Living and Learning Institute, John Hume Building, Maynooth University, Maynooth, Ireland
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Puvanachandra P, Ssesumugabo C, Balugaba BE, Ivers R, Kobusingye O, Peden M. The epidemiology and characteristics of injuries to under 5's in a secondary city in Uganda: a retrospective review of hospital data. Int J Inj Contr Saf Promot 2022; 29:550-555. [PMID: 35797975 DOI: 10.1080/17457300.2022.2089686] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Child injuries are largely preventable yet cause significant mortality and morbidity globally. Injury data from low-income countries is limited for children under the age of 5 and therefore the current understanding of the magnitude of injuries in this age group is low. Hospital-based registries are one mechanism by which injury data can be gathered. This paper presents findings from a retrospective hospital record review of 4 hospitals in Jinja, a rural setting in Uganda, involving the extraction of data for children under the age of 5-years who sustained an injury during a 6-month period in 2019. A total of 225 injury cases were retrieved from the hospitals. Over half (57.3%) of the events occurred among males. The majority (92%) suffered one injury per injury event. Most of the injuries occurred among those aged 13 to 24 months (32.9%). Burns (32%) and cuts (20%) were the most common cause of injury. This study presents a hospital-based analysis of injuries amongst under 5's in rural Uganda. It provides information on the characteristics of children entering healthcare facilities in Uganda and highlights the burden of paediatric injuries in the hospital setting.
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Affiliation(s)
- P Puvanachandra
- The George Institute for Global Health, UK, Imperial College London, London, UK
| | - C Ssesumugabo
- School of Public Health, Makerere School of Public Health, Kampala, Uganda
| | - B E Balugaba
- School of Public Health, Makerere School of Public Health, Kampala, Uganda
| | - R Ivers
- School of Population Health, University of New South Wales, Sydney, Australia
| | - O Kobusingye
- School of Public Health, Makerere School of Public Health, Kampala, Uganda
| | - M Peden
- The George Institute for Global Health, UK, Imperial College London, London, UK
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26
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McConkey R. Responding to Autism in Low and Middle Income Countries (LMIC): What to Do and What Not to Do. Brain Sci 2022; 12:1475. [PMID: 36358400 PMCID: PMC9688501 DOI: 10.3390/brainsci12111475] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 08/29/2022] [Revised: 10/21/2022] [Accepted: 10/27/2022] [Indexed: 01/12/2024] Open
Abstract
Autism is a spectrum disorder that occurs globally with increasing numbers of children and adults being identified with this condition. Although rates are higher in more affluent nations, the bulk of people with autism reside in Low and Middle Income Countries (LMICs). However, most do not have access to timely and appropriate support. The types of services delivered in high income countries are often ill-suited to the needs and resources of LMICs. Rather alternative forms of provision need to be devised. In common with other public health initiatives, these should be family-focused and community based, with suitably qualified and experienced leaders who in turn train and supervise a cadre of knowledgeable support workers drawn from local communities and cultures. As well as providing personalized, home-based guidance to people with autism and to their primary carers, regular group-based advocacy and training activities are undertaken in partnership with available mainstream services such as schools and social services. The principles and operations of these new forms of services are described in this paper albeit with an acknowledgment of their limitations. In recent decades, the cost-effectiveness of these approaches have been demonstrated with other chronic illnesses and disabling conditions in LMICs but their extension to autism has barely begun. More affluent countries are being forced to adopt similar strategies in response to the increased numbers of people identified with autism. A transformation in research strategies is essential to building better international support for persons with autism.
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Affiliation(s)
- Roy McConkey
- Institute of Nursing and Health Research, Ulster University, Belfast BT15 1ED, N. Ireland, UK
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27
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Jamal MH, Abdul Aziz AF, Aizuddin AN, Aljunid SM. Successes and obstacles in implementing social health insurance in developing and middle-income countries: A scoping review of 5-year recent literatures. Front Public Health 2022; 10:918188. [PMID: 36388320 PMCID: PMC9648174 DOI: 10.3389/fpubh.2022.918188] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 08/22/2022] [Indexed: 01/22/2023] Open
Abstract
Social health insurance (SHI) is a form of health finance mechanism that had been implemented in many countries to achieve universal health care (UHC). To emulate the successes of SHI in many developed countries, many developing and middle-income countries (MICs) have attempted to follow suit. However, the SHI implementation has problems and obstacles. Many more obstacles were observed despite some successes. This scoping review aimed to study the various developments of SHI globally in its uses, implementation, successes, and obstacles within the last 5 years from 2017 to 2021. Using three databases (i.e., PubMed, EBSCO, and Google Scholar), we reviewed all forms of articles on SHI, including gray literature. The PRISMA-ScR protocol was adapted as the guideline. We used the following search terms: social health insurance, national health insurance, and community health insurance. A total of 57,686 articles were screened, and subsequently, 46 articles were included in the final review. Results showed that the majority of SHI studies were in China and African countries, both of which were actively pursuing SHI programs to achieve UHC. China was still regarded as a developing country. There were also recent experiences from other Asian countries, but only a few from South America. Implementing SHI to achieve UHC was desirable but will need to consider several factors and issues. This was especially the case in developing and MICs. Eventually, full UHC would only be possible with a combination of general taxation and SHI.
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Affiliation(s)
- Mohammad Husni Jamal
- University of Cyberjaya, Cyberjaya, Malaysia,Academy of Family Physicians of Malaysia, Kuala Lumpur, Malaysia
| | - Aznida Firzah Abdul Aziz
- Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Malaysia
| | - Azimatun Noor Aizuddin
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Malaysia,International Centre for Casemix and Clinical Coding, Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan Malaysia, Cheras, Malaysia,*Correspondence: Azimatun Noor Aizuddin
| | - Syed Mohamed Aljunid
- Department of Health Policy and Management, College of Public Health, Kuwait University, Kuwait City, Kuwait
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Bulat J, Gove A. Commentary: Vulnerable children-A global perspective. New Dir Child Adolesc Dev 2022; 2022:95-102. [PMID: 35523428 PMCID: PMC9790728 DOI: 10.1002/cad.20461] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
In this commentary, we discuss the global similarities in the intersections of poverty, disability, and learning, and share lessons that are being learned internationally that can inform U.S. domestic research and implementation. These lessons cover multiple aspects of learning and development, instructional materials and approaches, integration of social emotional and school climate considerations, and engagement of families and communities.
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29
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Johnson D, Dissanayake VH, Korf BR, Towery M, Haspel RL. An international genomics health workforce education priorities assessment. Per Med 2022; 19:299-306. [PMID: 35708143 DOI: 10.2217/pme-2021-0094] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Aim: Global implementation of genomic medicine will require education of healthcare providers. There are limited international needs assessment data to guide curriculum development. Materials & methods: Genomics education experts developed and distributed a survey to individuals with knowledge of country-specific needs: 113 completed surveys (19% response rate) from 34 countries. A high percentage of respondents ranked non genetics physicians as the #1 target for genetics education. Over 70% indicated a need for moderate/extensive modification in physician training. The majority considered germline and somatic topics and targeting primary care and specialist providers equally important. Conclusion: Regardless of country economic level, there is a clear need for genomics education of healthcare providers. The study results can be used to focus future genomic medicine education efforts.
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Affiliation(s)
- Desalyn Johnson
- The University of Alabama at Birmingham, Heersink School of Medicine, Birmingham, AL 35233, USA
| | - Vajira Hw Dissanayake
- Department of Anatomy, Genetics & Biomedical Informatics, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Bruce R Korf
- The University of Alabama at Birmingham, Heersink School of Medicine, Birmingham, AL 35233, USA
| | - Meredith Towery
- North Carolina State University, College of Agriculture & Life Sciences, Raleigh, NC 27695, USA
| | - Richard L Haspel
- Beth Israel Deaconess Medical Center & Harvard Medical School, Boston, MA 02215, USA
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30
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Afari-Asiedu S, Abdulai MA, Tostmann A, Boamah-Kaali E, Asante KP, Wertheim HF, Hulscher M. Interventions to improve dispensing of antibiotics at the community level in low and middle income countries: A systematic review. J Glob Antimicrob Resist 2022; 29:259-274. [PMID: 35342021 DOI: 10.1016/j.jgar.2022.03.009] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 02/28/2022] [Accepted: 03/14/2022] [Indexed: 10/18/2022] Open
Abstract
BACKGROUND Inappropriate antibiotic dispensing is one of the key drivers of antibiotic resistance. This review documents the effectiveness of interventions aimed at improving antibiotic dispensing practices at the community level by drug dispensers in low and middle income countries (LMIC). METHODS We conducted a systematic search in PubMed, EMBASE, Cochrane Central Register of Controlled Trials, and Web of Science (November 11, 2019). Studies were included if they reported data on the outcome measure: appropriate dispensing of medicine including antibiotics. The effectiveness of studies was assessed based on quantitative results reported in the studies included. RESULTS A total of 1158 papers were screened. Thirteen studies from Asia (6), Africa (5), South America (one) and one study from both Africa and Asia were included in this review. Nine (69.2%) studies reported significant effectiveness of interventions on all or more than 50% of antibiotic related outcomes. Cochrane Effective Practice and Organization of Care interventions frequently applied were educational meetings (9/13), distribution of educational materials (7/13), educational outreach meetings (7/13), reminders (6/13), local consensus processes (6/13), distribution of supplies (6/14) and clinical practice guidelines (4/14), Nine studies reported on stakeholder involvement. CONCLUSION This review shows that it is possible to improve antibiotic dispensing practices at the community level in LMIC. Stakeholders' involvement was key in the design and implementation of interventions.
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Affiliation(s)
- Samuel Afari-Asiedu
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Kintampo, Bono East Region, Ghana; Radboud University Medical Center, Center for Infectious Diseases Nijmegen, The Netherlands; Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Medical Microbiology, Nijmegen, The Netherlands.
| | - Martha Ali Abdulai
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Kintampo, Bono East Region, Ghana
| | - Alma Tostmann
- Radboud University Medical Center, Center for Infectious Diseases Nijmegen, The Netherlands; Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Medical Microbiology, Nijmegen, The Netherlands
| | - Ellen Boamah-Kaali
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Kintampo, Bono East Region, Ghana
| | - Kwaku Poku Asante
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Kintampo, Bono East Region, Ghana
| | - Heiman Fl Wertheim
- Radboud University Medical Center, Center for Infectious Diseases Nijmegen, The Netherlands; Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Medical Microbiology, Nijmegen, The Netherlands
| | - Marlies Hulscher
- Radboud University Medical Center, Center for Infectious Diseases Nijmegen, The Netherlands; Radboud University Medical Center, Radboud Institute for Health Sciences, Scientific Center for Quality of Healthcare, Nijmegen, The Netherlands
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Ongeri L, Kariuki SM, Nyawira M, Schubart C, Tijdink JK, Newton CRJC, Penninx BWJH. Suicidal attempts and ideations in Kenyan adults with psychotic disorders: An observational study of frequency and associated risk factors. Front Psychiatry 2022; 13:1085201. [PMID: 36741571 PMCID: PMC9892760 DOI: 10.3389/fpsyt.2022.1085201] [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] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 12/28/2022] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Psychotic disorders increase the risk for premature mortality with up to 40% of this mortality attributable to suicide. Although suicidal ideation (SI) and suicidal behavior (SB) are high in persons with psychotic disorders in sub-Saharan Africa, there is limited data on the risk of suicide and associated factors among persons with psychotic disorders. METHODS We assessed SI and SB in persons with psychotic disorders, drawn from a large case-control study examining the genetics of psychotic disorders in a Kenyan population. Participants with psychotic disorders were identified using a clinical review of records, and the diagnosis was confirmed with the Mini-International Neuropsychiatric Interview (MINI). We conducted bivariate and multivariate logistic (for binary suicide outcomes) or linear regression (for suicide risk score) analysis for each of the suicide variables, with demographic and clinical variables as determinants. RESULTS Out of 619 participants, any current SI or lifetime suicidal attempts was reported by 203 (32.8%) with psychotic disorders, of which 181 (29.2%) had a lifetime suicidal attempt, 60 (9.7%) had SI in the past month, and 38 (20.9%) had both. Family history of suicidality was significantly associated with an increased risk of suicidality across all the following four outcomes: SI [OR = 2.56 (95% CI: 1.34-4.88)], suicidal attempts [OR = 2.01 (95% CI: 1.31-3.06)], SI and SB [OR = 2.00 (95% CI: 1.31-3.04)], and suicide risk score [beta coefficient = 7.04 (2.72; 11.36), p = 0.001]. Compared to persons aged <25 years, there were reduced odds for SI for persons aged ≥ 25 years [OR = 0.30 (95% CI: 0.14-0.62)] and ≥ 45 years [OR = 0.32 (95% CI: 0.12-0.89)]. The number of negative life events experienced increased the risk of SI and SB [OR = 2.91 (95% CI: 1.43-5.94)] for 4 or more life events. Higher negative symptoms were associated with more suicidal attempts [OR = 2.02 (95%CI: 1.15-3.54)]. Unemployment was also associated with an increased risk for suicidal attempts [OR = 1.58 (95%CI: 1.08-2.33)] and SI and SB [OR = 1.68 (95% CI: 1.15-2.46)]. CONCLUSION Suicidal ideation and SB are common in persons with psychotic disorders in this African setting and are associated with sociodemographic factors, such as young age and unemployment, and clinical factors, such as family history of suicidality. Interventions targeted at the community (e.g., economic empowerment) or at increasing access to care and treatment for persons with psychotic disorders may reduce the risk of suicide in this vulnerable population group.
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Affiliation(s)
- Linnet Ongeri
- Centre for Clinical Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Symon M Kariuki
- Department of Public Health, Pwani University, Kilifi, Kenya.,Neuroscience Unit, Kenya Medical Research Institute-Wellcome Trust Research Program, Kilifi, Kenya.,Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Miriam Nyawira
- Neuroscience Unit, Kenya Medical Research Institute-Wellcome Trust Research Program, Kilifi, Kenya
| | | | - Joeri K Tijdink
- Department of Ethics, Law and Humanities, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Department of Philosophy, Faculty of Humanities, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Charles R J C Newton
- Department of Public Health, Pwani University, Kilifi, Kenya.,Neuroscience Unit, Kenya Medical Research Institute-Wellcome Trust Research Program, Kilifi, Kenya.,Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Brenda W J H Penninx
- Department of Psychiatry, Amsterdam Public Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
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Zavala GA, Todowede O, Mazumdar P, Aslam F, Choudhury AH, Jarde A, Khalid H, Reddy S, Gilbody S, Siddiqi N. Effectiveness of interventions to address obesity and health risk behaviours among people with severe mental illness in low- and middle-income countries (LMICs): a systematic review and meta analysis. Glob Ment Health (Camb) 2022; 9:264-73. [PMID: 36618743 DOI: 10.1017/gmh.2022.21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 02/28/2022] [Accepted: 03/13/2022] [Indexed: 01/11/2023] Open
Abstract
INTRODUCTION People with severe mental illness (SMI) are more likely to have obesity and engage in health risk behaviours than the general population. The aims of this study are (1) evaluate the effectiveness of interventions that focus on body weight, smoking cessation, improving sleeping patterns, and alcohol and illicit substance abuse; (2) Compare the number of interventions addressing body weight and health risk behaviours in low- and middle-income countries (LMICs) v. those reported in published systematic reviews focusing on high-income countries (HICs). METHODS Intervention studies published up to December 2020 were identified through a structured search in the following database; OVID MEDLINE (1946-December 2020), EMBASE (1974-December 2020), CINAHL (1975-2020), APA PsychoINFO (1806-2020). Two authors independently selected studies, extracted study characteristics and data and assessed the risk of bias. and risk of bias was assessed using the Cochrane risk of bias tool V2. We conducted a narrative synthesis and, in the studies evaluating the effectiveness of interventions to address body weight, we conducted random-effects meta-analysis of mean differences in weight gain. We did a systematic search of systematic reviews looking at cardiometabolic and health risk behaviours in people with SMI. We compared the number of available studies of LMICs with those of HICs. RESULTS We assessed 15 657 records, of which 9 met the study inclusion criteria. Six focused on healthy weight management, one on sleeping patterns and two tested a physical activity intervention to improve quality of life. Interventions to reduce weight in people with SMI are effective, with a pooled mean difference of -4.2 kg (95% CI -6.25 to -2.18, 9 studies, 459 participants, I 2 = 37.8%). The quality and sample size of the studies was not optimal, most were small studies, with inadequate power to evaluate the primary outcome. Only two were assessed as high quality (i.e. scored 'low' in the overall risk of bias assessment). We found 5 reviews assessing the effectiveness of interventions to reduce weight, perform physical activity and address smoking in people with SMI. From the five systematic reviews, we identified 84 unique studies, of which only 6 were performed in LMICs. CONCLUSION Pharmacological and activity-based interventions are effective to maintain and reduce body weight in people with SMI. There was a very limited number of interventions addressing sleep and physical activity and no interventions addressing smoking, alcohol or harmful drug use. There is a need to test the feasibility and cost-effectiveness of context-appropriate interventions to address health risk behaviours that might help reduce the mortality gap in people with SMI in LMICs.
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Gadappa S, Prabhu P, Deshpande S, Gaikwad N, Arora S, Rege S, Meyer SR, Garcia-Moreno C, Amin A. Innovations in implementing a health systems response to violence against women in 3 tertiary hospitals of Maharashtra India: Improving provider capacity and facility readiness. Implement Res Pract 2022; 3:26334895211067988. [PMID: 37091087 PMCID: PMC9924251 DOI: 10.1177/26334895211067988] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Violence against women [VAW] is an urgent public health issue and health care providers [HCPs] are in a unique position to respond to such violence within a multi-sectoral health system response. In 2013, the World Health Organization (WHO) published clinical and policy guidelines (henceforth - the Guidelines) for responding to intimate partner violence and sexual violence against women. In this practical implementation report, we describe the adaptation of the Guidelines to train HCPs to respond to violence against women in tertiary health facilities in Maharashtra, India. Methods We describe the strategies employed to adapt and implement the Guidelines, including participatory methods to identify and address HCPs' motivations and the barriers they face in providing care for women subjected to violence. The adaptation is built on querying health-systems level enablers and obstacles, as well as individual HCPs' perspectives on content and delivery of training and service delivery. Results The training component of the intervention was delivered in a manner that included creating ownership among health managers who became champions for other health care providers; joint training across cadres to have clear roles, responsibilities and division of labour; and generating critical reflections about how gender power dynamics influence women's experience of violence and their health. The health systems strengthening activities included establishment of standard operating procedures [SOPs] for management of VAW and strengthening referrals to other services. Conclusions In this intervention, standard training delivery was enhanced through participatory, joint and reflexive methods to generate critical reflection about gender, power and its influence on health outcomes. Training was combined with health system readiness activities to create an enabling environment. The lessons learned from this case study can be utilized to scale-up response in other levels of health facilities and states in India, as well as other LMIC contexts. Plain language summary Violence against women affects millions of women globally. Health care providers may be able to support women in various ways, and finding ways to train and support health care providers in low and middle-income countries to provide high-quality care to women affected by violence is an urgent need. The WHO developed Clinical and Policy Guidelines in 2013, which provide guidance on how to improve health systems response to violence against women. We developed and implemented a series of interventions, including training of health care providers and innovations in service delivery, to implement the WHO guidelines for responding to violence against women in 3 tertiary hospitals of Maharashtra, India. The nascent published literature on health systems approaches to addressing violence against women in low and middle-income countries focuses on the impact of these interventions. This practical implementation report focuses on the interventions themselves, describes the processes of developing and adapting the intervention, and thus provides important insights for donors, policy-makers and researchers.
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Affiliation(s)
- Srinivas Gadappa
- Aurangabad Government Medical College and Hospital, Maharashtra,
India
| | - Priya Prabhu
- Miraj Government Medical College and
Hospital, Maharashtra, India
| | - Sonali Deshpande
- Aurangabad Government Medical College and Hospital, Maharashtra,
India
| | | | - Sanjida Arora
- Center for Enquiry on Health and Allied Themes (CEHAT), Mumbai,
Maharashtra, India
| | - Sangeeta Rege
- Center for Enquiry on Health and Allied Themes (CEHAT), Mumbai,
Maharashtra, India
| | - Sarah R. Meyer
- Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Claudia Garcia-Moreno
- Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Avni Amin
- Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
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Hadders-Algra M. The developing brain: Challenges and opportunities to promote school readiness in young children at risk of neurodevelopmental disorders in low- and middle-income countries. Front Pediatr 2022; 10:989518. [PMID: 36340733 PMCID: PMC9634632 DOI: 10.3389/fped.2022.989518] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 07/08/2022] [Accepted: 09/27/2022] [Indexed: 11/14/2022] Open
Abstract
This paper discusses possibilities for early detection and early intervention in infants with or at increased risk of neurodevelopmental disorders in low- and middle-income countries (LMICs). The brain's high rate of developmental activity in the early years post-term challenges early detection. It also offers opportunities for early intervention and facilitation of school readiness. The paper proposes that in the first year post-term two early detection options are feasible for LMICs: (a) caregiver screening questionnaires that carry little costs but predict neurodevelopmental disorders only moderately well; (b) the Hammersmith Infant Neurological Examination and Standardized Infant NeuroDevelopmental Assessment (SINDA) which are easy tools that predict neurodisability well but require assessment by health professionals. The young brain's neuroplasticity offers great opportunities for early intervention. Ample evidence indicates that families play a critical role in early intervention of infants at increased risk of neurodevelopmental disorders. Other interventional key elements are responsive parenting and stimulation of infant development. The intervention's composition and delivery mode depend on the infant's risk profile. For instance, in infants with moderately increased risk (e.g., preterm infants) lay community health workers may provide major parts of intervention, whereas in children with neurodisability (e.g., cerebral palsy) health professionals play a larger role.
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Affiliation(s)
- Mijna Hadders-Algra
- University of Groningen, University Medical Center Groningen, Department of Pediatrics, Division of Developmental Neurology and University of Groningen, Faculty of Theology and Religious Studies, Groningen, The Netherlands
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35
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Alemayehu T, Buonsenso D. Children with trisomy 21 are a group at risk for severe COVID-19: Case reports from a COVID-19 treatment unit in Addis Ababa, Ethiopia. Front Pediatr 2022; 10:991142. [PMID: 36313884 PMCID: PMC9612718 DOI: 10.3389/fped.2022.991142] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 09/13/2022] [Indexed: 11/13/2022] Open
Abstract
Trisomy 21 (Down syndrome) is a chromosomal disorder associated with humoral and cellular immunologic impairments among other systemic manifestations. It occurs at a frequency of 1 in 750 live births. There are increasing reports of children with Down syndrome presenting signs of severe COVID-19. The literature from Africa on pediatric COVID-19 and risk stratification for severe disease is scant. A summary of the clinical features, complications, and treatment outcomes of three Ethiopian children with Trisomy 21 and severe COVID-19 along with a discussion of the correlation between trisomy 21 immunology and severe SARS CoV-2 infection is presented.
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Affiliation(s)
- Tinsae Alemayehu
- American Medical Center, Addis Ababa, Ethiopia.,St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Centro di Salute Globale, Università Cattolica del Sacro Cuore, Rome, Italy
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36
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Soylemezoglu F, Oz B, Egılmez R, Pekmezcı M, Bozkurt S, Ersen Danyelı A, Onguru O, Kulac I, Tıhan T. Towards Development of a Standard Terminology of the World Health Organization Classification of Tumors of the Central Nervous System in the Turkish Language, and a Perspective on the Practical Implications of the WHO Classification for Low and Middle Income Countries. Turk Patoloji Derg 2022; 38:185-204. [PMID: 35969220 PMCID: PMC10508422 DOI: 10.5146/tjpath.2022.01584] [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: 05/20/2022] [Accepted: 07/03/2022] [Indexed: 11/18/2022] Open
Abstract
In our manuscript, we propose a common terminology in the Turkish language for the newly adopted WHO classification of the CNS tumors, also known as the WHO CNS 5th edition. We also comment on the applicability of this new scheme in low and middle income countries, and warn about further deepening disparities between the global north and the global south. This division, augmented by the recent COVID-19 pandemic, threatens our ability to coordinate efforts worldwide and may create significant disparities in the diagnosis and treatment of cancers between the "haves" and the "have nots".
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Affiliation(s)
| | - Buge Oz
- Istanbul University, Cerrahpasa School of Medicine, Istanbul, Turkey
| | - Reyhan Egılmez
- Cumhuriyet University, School of Medicine, Sivas, Turkey
| | - Melike Pekmezcı
- Division of Neuropathology, University of California San Francisco, California, USA
| | | | - Ayca Ersen Danyelı
- Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul, Turkey
| | | | - Ibrahim Kulac
- Koç University, School of Medicine, Istanbul, Turkey
| | - Tarik Tıhan
- Division of Neuropathology, University of California San Francisco, California, USA
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37
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Marks M, Lal S, Brindle H, Gsell PS, MacGregor M, Stott C, van de Rijdt M, Almazor GG, Golia S, Watson C, Diallo A, Toure A, Houlihan C, Keating P, Martin H, Restrepo AMH, Anokwa Y, Roberts CH. Electronic Data Management for Vaccine Trials in Low Resource Settings: Upgrades, Scalability, and Impact of ODK. Front Public Health 2021; 9:665584. [PMID: 34805059 PMCID: PMC8599145 DOI: 10.3389/fpubh.2021.665584] [Citation(s) in RCA: 5] [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: 05/11/2021] [Accepted: 09/30/2021] [Indexed: 11/14/2022] Open
Abstract
Background: ODK provides software and standards that are popular solutions for off-grid electronic data collection and has substantial code overlap and interoperability with a number of related software products including CommCare, Enketo, Ona, SurveyCTO, and KoBoToolbox. These tools provide open-source options for off-grid use in public health data collection, management, analysis, and reporting. During the 2018–2020 Ebola epidemic in the North Kivu and Ituri regions of Democratic Republic of Congo, we used these tools to support the DRC Ministère de la Santé RDC and World Health Organization in their efforts to administer an experimental vaccine (VSV-Zebov-GP) as part of their strategy to control the transmission of infection. Method: New functions were developed to facilitate the use of ODK, Enketo and R in large scale data collection, aggregation, monitoring, and near-real-time analysis during clinical research in health emergencies. We present enhancements to ODK that include a built-in audit-trail, a framework and companion app for biometric registration of ISO/IEC 19794-2 fingerprint templates, enhanced performance features, better scalability for studies featuring millions of data form submissions, increased options for parallelization of research projects, and pipelines for automated management and analysis of data. We also developed novel encryption protocols for enhanced web-form security in Enketo. Results: Against the backdrop of a complex and challenging epidemic response, our enhanced platform of open tools was used to collect and manage data from more than 280,000 eligible study participants who received VSV-Zebov-GP under informed consent. These data were used to determine whether the VSV-Zebov-GP was safe and effective and to guide daily field operations. Conclusions: We present open-source developments that make electronic data management during clinical research and health emergencies more viable and robust. These developments will also enhance and expand the functionality of a diverse range of data collection platforms that are based on the ODK software and standards.
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Affiliation(s)
- Michael Marks
- London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Sham Lal
- London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Hannah Brindle
- London School of Hygiene & Tropical Medicine, London, United Kingdom
| | | | - Matthew MacGregor
- London School of Hygiene & Tropical Medicine, London, United Kingdom
| | | | | | | | - Suman Golia
- London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Conall Watson
- London School of Hygiene & Tropical Medicine, London, United Kingdom
| | | | | | | | - Patrick Keating
- Médecins Sans Frontières UK, London, United Kingdom.,UK Public Health Rapid Support Team, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | | | | | | | - Chrissy H Roberts
- London School of Hygiene & Tropical Medicine, London, United Kingdom
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38
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Khan RQ, Khan AM. Crime and punishment: Pakistan's legal failure to account for mental illness. BJPsych Int 2021; 18:94-96. [PMID: 34747943 PMCID: PMC8554968 DOI: 10.1192/bji.2020.30] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 12/11/2019] [Accepted: 05/28/2020] [Indexed: 11/23/2022] Open
Abstract
The Mental Health Ordinance 2001 was the last comprehensive legislation on mental health policy in Pakistan, replacing the Lunacy Act 1912. Since then, most of the amendments to the act have only delineated the jurisdiction of the provincial governments. Failure to account for mental illness in Pakistan brings with it unique challenges, such as the criminalisation of suicide and exploitation of blasphemy laws. There is a need for organised efforts to promote awareness of mental illness, amend the obsolete legislation in conformity with the scientific evidence, implement mental health policy effectively and deal with sensitive issues that have a strong sociocultural or religious background.
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Affiliation(s)
| | - Abdul Moiz Khan
- Second Year Internal Medicine Resident, Albany Medical Center, New York, USA.
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39
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Negida A, Raslan AM. The Global NeuroSurg Research Collaborative: A Novel Student-Based Model to Expand Global Neurosurgery Research. Front Surg 2021; 8:721863. [PMID: 34778355 PMCID: PMC8578111 DOI: 10.3389/fsurg.2021.721863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 09/13/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Ahmed Negida
- Global NeuroSurg Research Collaborative, Oregon Health and Science University, Portland, OR, United States
- Global Neurosurgery Initiative, Program of Global Surgery and Social Change, Harvard Medical School, Boston, MA, United States
- School of Pharmacy and Biomedical Sciences, University of Portsmouth, Portsmouth, United Kingdom
- Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Ahmed M. Raslan
- Global NeuroSurg Research Collaborative, Oregon Health and Science University, Portland, OR, United States
- Neurological Surgery Department, Oregon Health and Science University, Portland, OR, United States
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40
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Meredith HR, Giles JR, Perez-Saez J, Mande T, Rinaldo A, Mutembo S, Kabalo EN, Makungo K, Buckee CO, Tatem AJ, Metcalf CJE, Wesolowski A. Characterizing human mobility patterns in rural settings of sub-Saharan Africa. eLife 2021; 10:e68441. [PMID: 34533456 PMCID: PMC8448534 DOI: 10.7554/elife.68441] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 08/21/2021] [Indexed: 11/27/2022] Open
Abstract
Human mobility is a core component of human behavior and its quantification is critical for understanding its impact on infectious disease transmission, traffic forecasting, access to resources and care, intervention strategies, and migratory flows. When mobility data are limited, spatial interaction models have been widely used to estimate human travel, but have not been extensively validated in low- and middle-income settings. Geographic, sociodemographic, and infrastructure differences may impact the ability for models to capture these patterns, particularly in rural settings. Here, we analyzed mobility patterns inferred from mobile phone data in four Sub-Saharan African countries to investigate the ability for variants on gravity and radiation models to estimate travel. Adjusting the gravity model such that parameters were fit to different trip types, including travel between more or less populated areas and/or different regions, improved model fit in all four countries. This suggests that alternative models may be more useful in these settings and better able to capture the range of mobility patterns observed.
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Affiliation(s)
- Hannah R Meredith
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States
| | - John R Giles
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States
| | - Javier Perez-Saez
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States
| | - Théophile Mande
- Bureau d'Etudes Scientifiques et Techniques - Eau, Energie, Environnement (BEST-3E), Ouagadougou, Burkina Faso
| | - Andrea Rinaldo
- Dipartimento di Ingegneria Civile Edile ed Ambientale, Università di Padova, Padova, Italy
- Laboratory of Ecohydrology, School of Architecture, Civil and Environmental Engineering, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Simon Mutembo
- Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States
- Macha Research Trust, Choma, Zambia
| | - Elliot N Kabalo
- Zambia Information and Communications Technology Authority, Lusaka, Zambia
| | | | - Caroline O Buckee
- Department of Epidemiology and the Center for Communicable Disease Dynamics, Harvard TH Chan School of Public Health, Boston, United States
| | - Andrew J Tatem
- WorldPop, School of Geography and Environmental Science, University of Southampton, Southampton, United Kingdom
| | - C Jessica E Metcalf
- Department of Ecology and Evolutionary Biology and the Princeton School of Public and International Affairs, Princeton University, Princeton, United States
| | - Amy Wesolowski
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States
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41
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Aymerich C, Rodríguez-Lázaro M, Solana G, Farré R, Otero J. Low-Cost Open-Source Device to Measure Maximal Inspiratory and Expiratory Pressures. Front Physiol 2021; 12:719372. [PMID: 34512389 PMCID: PMC8427661 DOI: 10.3389/fphys.2021.719372] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 06/02/2021] [Accepted: 07/30/2021] [Indexed: 11/13/2022] Open
Abstract
The measurement of maximal inspiratory (MIP) and maximal expiratory (MEP) pressures is a widely used technique to non-invasively evaluate respiratory muscle strength in clinical practice. The commercial devices that perform this test range from whole body plethysmographs to portable spirometers, both expensive and include a wide range of other respiratory tests. Given that a portable, low-cost, and specific option for MIP and MEP measuring device is not currently available in the market. A high-performance and easy-to-build prototype has been developed and the detailed technical information to easily reproduce it is freely released. A novel device is based on an Arduino microcontroller with a digital display, an integrated pressure transducer, and three-dimensional (3D) printed enclosure (total retail cost €80). The validation of the device was performed by comparison with a laboratory reference setting, and results showed accuracy within ±1%. As the device design is available according to the open-source hardware approach, measuring MIP/MEP can greatly facilitate easily available point-of-care devices for the monitoring of patients and, most important, for making this lung function measurement tool affordable to users in low- and middle-income countries.
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Affiliation(s)
- Claudia Aymerich
- Unitat de Biofísica i Bioenginyeria, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
| | - Miguel Rodríguez-Lázaro
- Unitat de Biofísica i Bioenginyeria, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
| | - Gorka Solana
- Faculdade de Engenharias e Tecnologias, Universidade Save - Moçambique, Maxixe, Mozambique
| | - Ramon Farré
- Unitat de Biofísica i Bioenginyeria, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Madrid, Spain.,Institut d'Investigacions Biomediques August Pi Sunyer, Barcelona, Spain
| | - Jorge Otero
- Unitat de Biofísica i Bioenginyeria, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Madrid, Spain
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42
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Vinikoor MJ. TREAT-B: Simple Low-Cost Diagnostic Score for When to Treat Hepatitis B. Clin Infect Dis 2021; 73:e1078-e1079. [PMID: 33277659 PMCID: PMC8423460 DOI: 10.1093/cid/ciaa1820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Indexed: 11/14/2022] Open
Affiliation(s)
- Michael J Vinikoor
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
- School of Medicine, University of Zambia, Lusaka, Zambia
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43
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Ooi SZY, Sichimba D, Dalle DU, Higginbotham G, Takoutsing BD, Bankole NDA, Egiz A, Kotecha J, de Koning R, Nguembu S, Zolo Y, Dokponou YCH, Chilawa S, Bandyopadhyay S, Kanmounye US. Management and Outcomes of Paediatric Intracranial Suppurations in Low- and Middle-Income Countries: A Scoping Review. Front Surg 2021; 8:690895. [PMID: 34466410 PMCID: PMC8403063 DOI: 10.3389/fsurg.2021.690895] [Citation(s) in RCA: 5] [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: 04/04/2021] [Accepted: 07/12/2021] [Indexed: 12/02/2022] Open
Abstract
Introduction: Intracranial suppurations account for a significant proportion of intracranial masses in low- and middle-income countries (LMICs), particularly among children. The development of better imaging equipment, antibiotics, and surgical techniques has enabled significant progress in detecting and treating intracranial abscesses. However, it is unclear whether these advances are accessible and utilised by LMICs. In this review, we aimed to describe the landscape of paediatric intracranial suppurations in LMICs. Methods: This scoping review was conducted using the Arksey and O'Malley framework. MEDLINE, EMBASE, WHO Global Index Medicus, AJOL and Google scholar were searched for relevant articles from database inception to January 18th, 2021. Publications in English and French were included. Results: Of the 1,011 records identified, 75 were included. The studies, on average, included 18.8 (95% CI = 8.4-29.1) children (mean age: 8.2 years). Most children were male (62.2%, 95% CI = 28.7-95.7%). Intracranial suppurations were most commonly (46.5%) located in the supratentorial brain parenchyma. The most prevalent causative mechanism was otitis (37.4%) with streptococcus species being the most common causative organism (19.4%). CT scan (71.2%) was most commonly used as a diagnostic tool and antibiotics were given to all patients. Symptoms resolved in 23.7% and improved in 15.3% of patients. The morbidity rate was 6.9%, 18.8% of patients were readmitted, and the mortality rate was 11.0%. Conclusion: Most intracranial suppurations were complications of preventable infections and despite MRI being the gold standard for detecting intracranial suppurations, CT scans were mostly used in LMICs. These differences are likely a consequence of inequities in healthcare and have resulted in a high mortality rate in LMICs.
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44
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Ojagbemi A. HIV Associated Neurocognitive Disorders Subsidence Through Citalopram Addition in Anti-retroviral Therapy (HANDS-CARE): A Concept Note. Front Neurol 2021; 12:658705. [PMID: 34381409 PMCID: PMC8350562 DOI: 10.3389/fneur.2021.658705] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 06/18/2021] [Indexed: 11/13/2022] Open
Abstract
There is a pressing need to effectively manage HIV Associated Neurocognitive Disorders (HAND) in sub-Saharan Africa (SSA) where the burden is among the highest in the world. Contemporary approaches based on the use of Highly Active Antiretroviral Therapy (HAART) alone are inadequate interventions for HAND, especially in SSA where there is limited availability of the required combinations of HAART for effective central nervous system penetration and where many currently prescribed agents, including efavirenz, have neurotoxicity as a major drawback. This article reviews data supporting the rationale for additive citalopram in antiretroviral therapy as a latent approach to abate HAND. It proposes the conduct of a HIV Associated Neurocognitive Disorders Subsidence through Citalopram addition in Anti-Retroviral therapy (HANDS-CARE) pilot feasibility trial (RCT) to assess whether the adjunctive use of citalopram, a widely prescribed serotonergic antidepressant, will lead to a meaningful improvement in neurocognitive functioning and quality of life in patients with HAND who are receiving HAART. A preliminarily feasible and efficacy-suggesting HANDS-CARE trial could generate statistical, clinical and operational data necessary to design and conduct a future definitive RCT. If successful, this intervention will be applicable to resource-limited settings as well as developed countries. Effective management of HAND will improve the quality of life of HIV patients, and reduce the cost of managing the disease.
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Affiliation(s)
- Akin Ojagbemi
- Department of Psychiatry, World Health Organization Collaborating Centre for Research and Training in Mental Health, Substance Abuse and Neuroscience, College of Medicine, University of Ibadan, Ibadan, Nigeria
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45
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Affiliation(s)
- Archchun Ariyarajah
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Natasha S Crowcroft
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Centre for Vaccine Preventable Diseases, University of Toronto, Toronto, ON, Canada.,Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland
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46
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Odunitan-Wayas FA, Wadende P, Mogo ERI, Brugulat-Panés A, Micklesfield LK, Govia I, Mapa-Tassou C, Mukoma G, Smith JA, Motlhalhedi M, Wasnyo Y, Were V, Assah F, Okop KJ, Norris SA, Obonyo C, Mbanya JC, Tulloch-Reid MK, King AC, Lambert EV, Oni T. Adolescent Levers for a Diet and Physical Activity Intervention Across Socioecological Levels in Kenya, South Africa, Cameroon, and Jamaica: Mixed Methods Study Protocol. JMIR Res Protoc 2021; 10:e26739. [PMID: 34255729 PMCID: PMC8317027 DOI: 10.2196/26739] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 05/05/2021] [Accepted: 05/07/2021] [Indexed: 11/14/2022] Open
Abstract
Background The increasing burden of noncommunicable diseases that are prevalent in low- and middle-income countries (LMICs) is largely attributed to modifiable behavioral risk factors such as unhealthy diets and insufficient physical activity (PA). The adolescent stage, defined as 10 to 24 years of age, is an important formative phase of life and offers an opportunity to reduce the risk of noncommunicable diseases across the life course and for future generations. Objective The aim of this paper is to describe a protocol for a study using a convergent mixed methods design to explore exposures in the household, neighborhood, school, and the journey from home to school that may influence diet and PA behaviors in adolescents from LMICs. Methods Male and female adolescents (n≥150) aged between 13 and 24 years will be recruited from selected high schools or households in project site countries to ensure the socioeconomic diversity of perspectives and experiences at the individual, home, and neighborhood levels. The project will be conducted at 5 sites in 4 countries: Kenya, Cameroon, Jamaica, and South Africa (Cape Town and Johannesburg). Data on anthropometric measures, food intake, and PA knowledge and behavior will be collected using self-report questionnaires. In addition, a small number of learners (n=30-45) from each site will be selected as citizen scientists to capture data (photographs, audio notes, text, and geolocations) on their lived experiences in relation to food and PA in their homes, the journey to and from school, and the school and neighborhood environments using a mobile app, and for objective PA measurements. In-depth interviews will be conducted with the citizen scientists and their caregivers to explore household experiences and determinants of food intake and foodways, as well as the PA of household members. Results The study described in this protocol paper was primarily funded through a UK National Institute for Health Research grant in 2017 and approved by the relevant institutional ethics review boards in the country sites (South Africa, Cameroun, and Jamaica in 2019, and Kenya in 2020). As of December 23, 2020, we had completed data collection from adolescents (n≥150) in all the country sites, except Kenya, and data collection for the subgroup (n=30-45) is ongoing. Data analysis is ongoing and the output of findings from the study described in this protocol is expected to be published by 2022. Conclusions This project protocol contributes to research that focuses on adolescents and the socioecological determinants of food intake and PA in LMIC settings. It includes innovative methodologies to interrogate and map the contexts of these determinants and will generate much-needed data to understand the multilevel system of factors that can be leveraged through upstream and downstream strategies and interventions to improve health outcomes. International Registered Report Identifier (IRRID) DERR1-10.2196/26739
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Affiliation(s)
- Feyisayo A Odunitan-Wayas
- Health Through Physical Activity, Lifestyle and Sport Research Centre, Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Pamela Wadende
- School of Education and Human Resource Development, Kisii University, Kisii, Kenya
| | - Ebele R I Mogo
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | | | - Lisa K Micklesfield
- Health Through Physical Activity, Lifestyle and Sport Research Centre, Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.,South African Medical Research Council/Wits Developmental Pathways for Health Research Unit (DPHRU), School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Ishtar Govia
- Caribbean Institute for Health Research, The University of the West Indies, Kingston, Jamaica
| | - Clarisse Mapa-Tassou
- Health of Populations in Transition (HoPiT) Research Group, University of Yaoundé I, Yaoundé, Cameroon
| | - Gudani Mukoma
- South African Medical Research Council/Wits Developmental Pathways for Health Research Unit (DPHRU), School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Joanne A Smith
- Caribbean Institute for Health Research, The University of the West Indies, Kingston, Jamaica
| | - Molebogeng Motlhalhedi
- South African Medical Research Council/Wits Developmental Pathways for Health Research Unit (DPHRU), School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Yves Wasnyo
- Health of Populations in Transition (HoPiT) Research Group, University of Yaoundé I, Yaoundé, Cameroon
| | - Vincent Were
- Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Felix Assah
- Health of Populations in Transition (HoPiT) Research Group, University of Yaoundé I, Yaoundé, Cameroon
| | - Kufre J Okop
- Health Through Physical Activity, Lifestyle and Sport Research Centre, Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Shane A Norris
- South African Medical Research Council/Wits Developmental Pathways for Health Research Unit (DPHRU), School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Charles Obonyo
- Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Jean Claude Mbanya
- Health of Populations in Transition (HoPiT) Research Group, University of Yaoundé I, Yaoundé, Cameroon
| | - Marshall K Tulloch-Reid
- Caribbean Institute for Health Research, The University of the West Indies, Kingston, Jamaica
| | - Abby C King
- Department of Epidemiology & Population Health, Stanford University School of Medicine, Stanford, CA, United States.,Department of Medicine, Stanford University School of Medicine, Stanford, CA, United States
| | - Estelle V Lambert
- Health Through Physical Activity, Lifestyle and Sport Research Centre, Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Tolu Oni
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom.,Research Initiative for Cities Health and Equity, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
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Adegboyega G, Kanmounye US, Petrinic T, Ozair A, Bandyopadhyay S, Kuri A, Zolo Y, Marks K, Ramjee S, Baticulon RE, Vaqas B. Global Landscape of Glioblastoma Multiforme Management in the Stupp Protocol Era: Systematic Review Protocol. Int J Surg Protoc 2021; 25:108-113. [PMID: 34222733 PMCID: PMC8231457 DOI: 10.29337/ijsp.148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background Glioblastoma multiforme is the most common and aggressive primary adult brain neoplasm. The current standard of care is maximal safe surgical resection, radiotherapy with concomitant temozolomide, followed by adjuvant temozolomide according to the Stupp protocol. Although the protocol is well adopted in high-income countries (HICs), little is known about its adoption in low- and middle-income countries (LMICs). The aim of this study is to describe a protocol design for a systematic review of published studies outlining the differences in GBM management between HICs and LMICs. Methods A systematic review will be conducted. MedLine via Ovid, Embase and Global Index Medicus will be searched from inception to date in order to identify the relevant studies. Adult patients (>18 years) with histologically confirmed primary unifocal GBM will be included. Surgical and chemoradiation management of GBM tumours will be considered. Commentaries, original research, non-peer reviewed pieces, opinion pieces, editorials and case reports will be included. Results Primary outcomes will include rates of complications, disability-adjusted life years (DALYs), prognosis, progression-free survival (PFS), overall survival (OS) as well as rate of care abandonment and delay. Secondary outcomes will include the presence of neuro-oncology subspecialty training programs. Discussion This systematic review will be the first to compare the current landscape of GBM management in HICs and LMICs, highlighting pertinent themes that may be used to optimise treatment in both financial brackets. Systematic Review Registration The protocol has been registered on the International Prospective Register of Systematic Reviews (PROSPERO; registration number: CRD42020215843). Highlights Glioblastoma multiforme (GBM) remains the most common primary adult cerebral neoplasm, with an age-adjusted incidence rate of 3.22 per 100,000 population and a 5-year survival rate of 6.8%Despite the well-evidenced efficacy of Stupp protocol, the implementation of this approach bears an institutional and individual financial burden that is particularly notable in low- and middle-income countries (LMICs)This systematic review will be the first to compare the current landscape of GBM management in HICs and LMICs, highlighting pertinent themes that may be used to optimise treatment in both financial brackets.
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Affiliation(s)
- Gideon Adegboyega
- Queen Mary University of London, Barts and The London School of Medicine and Dentistry, London, United Kingdom.,Research Department, Association of Future African Neurosurgeons, Yaounde, Cameroon
| | | | - Tatjana Petrinic
- Bodleian Health Care Libraries, University of Oxford, Oxfordshire, United Kingdom
| | - Ahmad Ozair
- Faculty of Medicine, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Soham Bandyopadhyay
- Oxford University Global Surgery Group, Nuffield Department of Surgical Sciences, University of Oxford, Oxfordshire, United Kingdom
| | - Ashvin Kuri
- Queen Mary University of London, Barts and The London School of Medicine and Dentistry, London, United Kingdom
| | - Yvan Zolo
- Research Department, Association of Future African Neurosurgeons, Yaounde, Cameroon.,Faculty of Health Sciences, University of Buea, Buea, Cameroon
| | - Katya Marks
- Medical Sciences Division, John Radcliffe Hospital, University of Oxford, OX3 9DU Oxfordshire, Oxford, United Kingdom
| | - Serena Ramjee
- Queen Mary University of London, Barts and The London School of Medicine and Dentistry, London, United Kingdom
| | - Ronnie E Baticulon
- Division of Neurosurgery, Department of Neurosciences, Philippine General Hospital, Manila, Philippines.,Department of Anatomy, College of Medicine, University of the Philippines Manila, Manila, Philippines
| | - Babar Vaqas
- Department of Neurosurgery, Queens Hospital, Romford, United Kingdom.,Imperial College London, London, United Kingdom
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Mohsen F, Bakkar B, Melhem S, Aldakkak S, Mchantaf D, Marrawi M, Latifeh Y. Psychological health problems among Syrians during war and the COVID-19 pandemic: national survey. BJPsych Int 2021; 18:E8. [PMID: 34382955 PMCID: PMC8314981 DOI: 10.1192/bji.2021.16] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 12/27/2020] [Revised: 02/19/2021] [Accepted: 03/08/2021] [Indexed: 11/23/2022] Open
Abstract
This study aims to assess the prevalence of depression and anxiety during the COVID-19 outbreak embedded within the war in Syria. A web-based cross-sectional survey design was employed. The 9-item Patient Health Questionnaire and the 7-item Generalized Anxiety Disorder scale revealed a high prevalence of depressive (n = 3326; 83.4%) and anxiety symptoms (n = 2777; 69.6%) among the 3989 participants. Multivariable logistic regression analysis was performed to identify factors associated with depression and anxiety. There is an urgent need within the healthcare system in Syria to provide mental healthcare to alleviate acute mental health disturbances and associated physical health perceptions among Syrians.
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Affiliation(s)
- Fatema Mohsen
- Faculty of Medicine, Syrian Private University, Damascus, Syria.
| | - Batoul Bakkar
- Faculty of Medicine, Syrian Private University, Damascus, Syria
| | - Sara Melhem
- Faculty of Medicine, Syrian Private University, Damascus, Syria
| | - Samar Aldakkak
- Faculty of Medicine, Syrian Private University, Damascus, Syria
| | - Dana Mchantaf
- Faculty of Medicine, Syrian Private University, Damascus, Syria
| | - Marah Marrawi
- Department of Statistics, Syrian Private University, Damascus, Syria
| | - Youssef Latifeh
- Department of Psychiatry, Faculty of Medicine, Syrian Private University, Damascus, Syria; and Department of Psychiatry, Faculty of Medicine, Damascus University, Damascus, Syria
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Ljungstrom E, Chibwe F, O'Brien C, Musowoya J, Grimes CE. Living with a hernia: A qualitative study of patient experience of abdominal wall hernias in Ndola, Zambia. Trop Doct 2021; 51:671-672. [PMID: 33940996 DOI: 10.1177/00494755211010635] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Despite hernias being one of the most common surgical problems in low and middle income countries, very little is known about the impact that having a hernia has on the quality of life of patients in these settings. We performed a pilot study to understand how living with a hernia impacts on the quality of life. Twelve semistructured interviews were performed. A number of themes were identified. These demonstrated the significant impact on physical health, ability to work, psychological health and social relationships. Further work is required to better understand the patient perspective and ensure that hernia operations improve quality of life in these settings.
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Affiliation(s)
- Elin Ljungstrom
- MSc Student, King's Centre for Global Health and Health Partnerships, King's College London and King's Health Partners, UK
| | - Felix Chibwe
- Surgical Registrar, Ndola Teaching Hospital, Ndola, Zambia
| | - Catherine O'Brien
- MSc student, King's Centre for Global Health and Health Partnerships, King's College London and King's Health Partners, UK
| | - Joseph Musowoya
- Senior Medical Superintendent, Ndola Teaching Hospital, Ndola, Zambia
| | - Caris E Grimes
- Honorary Senior Clinical Lecturer, King's Centre for Global Health and Health Partnerships, King's College London and King's Health Partners, UK.,8952Medway NHS Foundation Trust, Gillingham, Kent, UK
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50
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Bertola L, Benseñor IM, Gross AL, Caramelli P, Barreto SM, Moreno AB, Griep RH, Viana MC, Lotufo PA, Suemoto CK. Longitudinal measurement invariance of neuropsychological tests in a diverse sample from the ELSA-Brasil study. Braz J Psychiatry 2021; 43:254-261. [PMID: 32997074 PMCID: PMC8136397 DOI: 10.1590/1516-4446-2020-0978] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 06/03/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Longitudinal measurement invariance analyses are an important way to assess a test's ability to estimate the underlying construct over time, ensuring that cognitive scores across visits represent a similar underlying construct, and that changes in test performance are attributable to individual change in cognitive abilities. We aimed to evaluate longitudinal measurement invariance in a large, social and culturally diverse sample over time. METHODS A total of 5,949 participants from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) were included, whose cognition was reassessed after four years. Longitudinal measurement invariance analysis was performed by comparing a nested series of multiple-group confirmatory factor analysis models (for memory and executive function factors). RESULTS Configural, metric, scalar and strict invariance were tested and supported over time. CONCLUSION Cognitive temporal changes in this sample are more likely to be due to normal and/or pathological aging. Testing longitudinal measurement invariance is essential for diverse samples at high risk of dementia, such as in low- and middle-income countries.
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Affiliation(s)
- Laiss Bertola
- Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Isabela M. Benseñor
- Centro de Pesquisa Clínica e Epidemiológica, Hospital Universitário, USP, São Paulo, SP, Brazil
- Departamento de Medicina Interna, Faculdade de Medicina, USP, São Paulo, SP, Brazil
| | - Alden L. Gross
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Paulo Caramelli
- Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | | | - Arlinda B. Moreno
- Departamento de Epidemiologia e Métodos Quantitativos em Saúde (DEMQS), Escola Nacional de Saúde Pública Sergio Arouca (ENSP), Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro, RJ, Brazil
| | - Rosane H. Griep
- Laboratório de Educação em Ambiente e Saúde, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro, RJ, Brazil
| | - Maria Carmen Viana
- Departamento de Medicina Social, Universidade Federal do Espírito Santo (UFES), Vitória, ES, Brazil
| | - Paulo A. Lotufo
- Departamento de Medicina Interna, Faculdade de Medicina, USP, São Paulo, SP, Brazil
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