In low- and middle-income countries, how does a strategy to increase the use of antenatal corticosteroids compare with usual care for women with anticipated preterm birth?

The efficacy of early goal directed therapy in improving outcomes has been questioned in few recent studies. But, does that hold true for low and middle income countries like Nepal? This editorial expresses the views of the editors on the usual care of sepsis patients and early goal directed therapy in resource limited settings.

Download Full-text

A Worldwide Epidemic: The Problem and Challenges of Preterm Birth in Low- and Middle-Income Countries

American Journal of Perinatology ◽

10.1055/s-0035-1571199 ◽

2016 ◽

Vol 33 (03) ◽

pp. 276-289 ◽

Cited By ~ 23

Author(s):

Elizabeth Stringer ◽

Jeffrey Stringer ◽

Marcela Smid

Keyword(s):

Preterm Birth ◽

Middle Income ◽

Middle Income Countries ◽

Low And Middle Income

Download Full-text

Impact of improved cookstoves on women’s and child health in low and middle income countries: a systematic review and meta-analysis

Thorax ◽

10.1136/thoraxjnl-2017-210952 ◽

2018 ◽

Vol 73 (11) ◽

pp. 1026-1040 ◽

Cited By ~ 17

Author(s):

Megha Thakur ◽

Paulien A W Nuyts ◽

Esther A Boudewijns ◽

Javier Flores Kim ◽

Timor Faber ◽

...

Keyword(s):

Systematic Review ◽

Preterm Birth ◽

Child Health ◽

Meta Analysis ◽

Experimental Studies ◽

Middle Income ◽

Middle Income Countries ◽

Quasi Experimental ◽

Women And Children ◽

Low And Middle Income

ObjectivesImproved biomass cookstoves may help reduce the substantial global burden of morbidity and mortality due to household air pollution (HAP) that disproportionately affects women and children in low and middle income countries (LMICs).DesignSystematic review and meta-analysis of (quasi-)experimental studies identified from 13 electronic databases (last update: 6 April 2018), reference and citation searches and via expert consultation.SettingLMICsParticipantsWomen and childrenInterventionsImproved biomass cookstovesMain outcome measuresLow birth weight (LBW), preterm birth, perinatal mortality, paediatric acute respiratory infections (ARIs) and COPD among women.ResultsWe identified 53 eligible studies, including 24 that met prespecified design criteria. Improved cookstoves had no demonstrable impact on paediatric lower ARIs (three studies; 11 560 children; incidence rate ratio (IRR)=1.02 (95% CI 0.84 to 1.24)), severe pneumonia (two studies; 11 061 children; IRR=0.88 (95% CI 0.39 to 2.01)), LBW (one study; 174 babies; OR=0.74 (95% CI 0.33 to 1.66)) or miscarriages, stillbirths and infant mortality (one study; 1176 babies; risk ratio (RR) change=15% (95% CI –13 to 43)). No (quasi-)experimental studies assessed preterm birth or COPD. In observational studies, improved cookstoves were associated with a significant reduction in COPD among women: two studies, 9757 participants; RR=0.74 (95% CI 0.61 to 0.90). Reductions in cough (four studies, 1779 participants; RR=0.72 (95% CI 0.60 to 0.87)), phlegm (four studies, 1779 participants; RR=0.65 (95% CI 0.52 to 0.80)), wheezing/breathing difficulty (four studies; 1779 participants; RR=0.41 (95% CI 0.29 to 0.59)) and conjunctivitis (three studies, 892 participants; RR=0.58 (95% CI 0.43 to 0.78)) were observed among women.ConclusionImproved cookstoves provide respiratory and ocular symptom reduction and may reduce COPD risk among women, but had no demonstrable child health impact.RegistrationPROSPERO: CRD42016033075

Download Full-text