Strengthening emergency care by developing data collection systems in low- and middle-income countries

Background: Pregnant women and neonates represent one of the most vulnerable groups, especially in low- and middle-income countries (LMICs). A recent analysis reported that most vaccine pharmacovigilance systems in LMICs consist of spontaneous (passive) adverse event reporting. Thus, LMICs need effective active surveillance approaches, such as pregnancy registries. We intend to identify currently active maternal and neonatal data collection systems in LMICs, with the potential to inform active safety electronic surveillance for novel vaccines using standardized definitions. Methods: A scoping review will be conducted based on established methodology. Multiple databases of indexed and grey literature will be searched with a specific focus on existing electronic and paper-electronic systems in LMICs that collect continuous, prospective, and individual-level data from antenatal care, delivery, neonatal care (up to 28 days), and postpartum (up to 42 days) at the facility and community level, at the national and district level, and at large hospitals. Also, experts will be contacted to identify unpublished information on relevant data collection systems. General and specific descriptions of Health Information Systems (HIS) extracted from the different sources will be combined and duplicated HIS will be removed, producing a list of unique statements. We will present a final list of Maternal, Newborn, and Child Health systems considered flexible enough to be updated with necessary improvements to detect, assess and respond to safety concerns during the introduction of vaccines and other maternal health interventions. Selected experts will participate in an in-person consultation meeting to select up to three systems to be further explored in situ. Results and knowledge gaps will be synthesized after expert consultation.

Download Full-text

The role of international partnerships in improving urethral reconstruction in low- and middle-income countries

World Journal of Urology ◽

10.1007/s00345-019-02819-2 ◽

2019 ◽

Vol 38 (12) ◽

pp. 3003-3011 ◽

Cited By ~ 3

Author(s):

Maahum Haider ◽

Mohamed Jalloh ◽

Jiaqi Yin ◽

Amadou Diallo ◽

Nancy Puttkammer ◽

...

Keyword(s):

Data Collection ◽

Success Rate ◽

Urethral Stricture ◽

Urethral Reconstruction ◽

Subspecialty Training ◽

Middle Income ◽

Middle Income Countries ◽

Urethral Stricture Disease ◽

The Impact ◽

Low And Middle Income

Abstract Purpose To explore the impact of education and training in international surgical partnerships on outcomes of urethral stricture disease in low- and middle-income countries. To encourage data collection and outcomes assessments to promote evidence-based and safe surgical care. Methods Qualitative data were collected through observation of a reconstructive surgical workshop held by IVUmed at a host site in Dakar, Senegal. Quantitative data were collected through a retrospective review of 11 years of hospital data to assess surgical outcomes of urethral stricture disease before and after IVUmed started reconstructive workshops at the site. Results In the 11-year study period, 569 patients underwent 774 surgical procedures for urethral strictures. The numbers and types of urethroplasty techniques increased after IVUmed started its workshops. The average number of urethroplasties increased from 10 to 18.75/year. There was a statistically significant improvement in the mean success rate of urethroplasties from 12.7% before to 29% after the workshops. Anastomotic urethroplasty success rates doubled from 16.7 to 35.1%, but this was not statistically significant (p = 0.07). The improved success rate was sustained in cases performed without an IVUmed provider. Conclusions Urethral stricture disease treatment in low- and middle-income countries is fraught with challenges due to complex presentations and limited subspecialty training. Improper preoperative management, lack of specialty instruments, and suboptimal wound care all contribute to poor outcomes. International surgical groups like IVUmed who employ the “teach-the-teacher” model enhance local practitioner expertise and independence leading to long-term improvements in patient outcomes. Tailoring practice guidelines to the local resource framework and encouraging data collection and outcomes assessment are vital components of providing responsible care and should be encouraged.

Download Full-text

Measuring the effect of improvement in methodological techniques on data collection in the Gharbiah population-based cancer registry in Egypt: Implications for other Low- and Middle-Income Countries

Cancer Epidemiology ◽

10.1016/j.canep.2015.11.001 ◽

2015 ◽

Vol 39 (6) ◽

pp. 1010-1014 ◽

Cited By ~ 2

Author(s):

Brittney L. Smith ◽

Mohamed Ramadan ◽

Brittany Corley ◽

Ahmed Hablas ◽

Ibrahim A. Seifeldein ◽

...

Keyword(s):

Data Collection ◽

Cancer Registry ◽

Population Based ◽

Middle Income ◽

Middle Income Countries ◽

Low And Middle Income

Download Full-text

Maternal and neonatal data collection systems in low- and middle-income countries for maternal vaccines active safety surveillance systems: A scoping review

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-03686-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Mabel Berrueta ◽

◽

Agustin Ciapponi ◽

Ariel Bardach ◽

Federico Rodriguez Cairoli ◽

...

Keyword(s):

Data Collection ◽

Health Information ◽

Scoping Review ◽

Active Safety ◽

Middle Income ◽

Middle Income Countries ◽

Maternal Immunization ◽

Safety Surveillance ◽

Perinatal Data ◽

Low And Middle Income

Abstract Background Most post-licensure vaccine pharmacovigilance in low- and middle-income countries (LMICs) are passive reporting systems. These have limited utility for maternal immunization pharmacovigilance in LMIC settings and need to be supplemented with active surveillance. Our study’s main objective was to identify existing perinatal data collection systems in LMICs that collect individual information on maternal and neonatal health outcomes and could be developed to inform active safety surveillance of novel vaccines for use during pregnancy. Methods A scoping review was performed following the Arksey and O’Malley six-stage approach. We included studies describing electronic or mixed paper-electronic data collection systems in LMICs, including research networks, electronic medical records, and custom software platforms for health information systems. Medline PubMed, EMBASE, Global Health, Cochrane Library, LILACS, Bibliography of Asian Studies (BAS), and CINAHL were searched through August 2019. We also searched grey literature including through Google and websites of existing relevant perinatal data collection systems, as well as contacted authors of key studies and experts in the field to validate the information and identify additional sources of relevant unpublished information. Results A total of 11,817 records were identified. The full texts of 264 records describing 96 data collection systems were assessed for eligibility. Eight perinatal data collection systems met our inclusion criteria: Global Network’s Maternal Newborn Health Registry, International Network for the Demographic Evaluation of Populations and their Health; Perinatal Informatic System; Pregnancy Exposure Registry & Birth Defects Surveillance; SmartCare; Open Medical Record System; Open Smart Register Platform and District Health Information Software 2. These selected systems were qualitatively characterized according to seven different domains: governance; system design; system management; data management; data sources, outcomes and data quality. Conclusion This review provides a list of active maternal and neonatal data collection systems in LMICs and their characteristics as well as their outreach, strengths, and limitations. Findings could potentially help further understand where to obtain population-based high-quality information on outcomes to inform the conduct of maternal immunization active vaccine safety surveillance activities and research in LMICs.

Download Full-text

The ethical considerations for emergency care research in low- and middle-income countries: A scoping review of the published literature

African Journal of Emergency Medicine ◽

10.1016/j.afjem.2021.12.001 ◽

2022 ◽

Vol 12 (1) ◽

pp. 71-76

Author(s):

Sarah Hirner ◽

Colleen Saunders ◽

Willem Stassen

Keyword(s):

Scoping Review ◽

Emergency Care ◽

Ethical Considerations ◽

Middle Income ◽

Care Research ◽

Middle Income Countries ◽

Low And Middle Income

Download Full-text

Adolescent levers for diet and physical activity intervention across socio-ecological levels in Kenya, South Africa, Cameroon and Jamaica: A mixed-methods study protocol (Preprint)

10.2196/preprints.26739 ◽

2020 ◽

Author(s):

Feyisayo Adeola Odunitan-Wayas ◽

Pamela Wadende ◽

Ebele R.I Mogo ◽

Anna Brugulat-Panés ◽

Lisa K Micklesfield ◽

...

Keyword(s):

Physical Activity ◽

South Africa ◽

Mixed Methods ◽

Food Intake ◽

Data Collection ◽

Communicable Diseases ◽

Middle Income ◽

Non Communicable Diseases ◽

Middle Income Countries ◽

Low And Middle Income

BACKGROUND The increasing burden of non-communicable diseases (NCDs), which are prevalent in low and middle income countries (LMICs), is largely attributed to modifiable behavioural risk factors such as poor/unhealthy diets and insufficient physical activity (PA). The adolescent stage–recently defined as 10-24 years of age–is an important formative phase of life and offers an opportunity to reduce NCD risk across the life course and for future generations. This protocol describes a portfolio of projects within the Global Diet and Activity Research (GDAR) Network, which aims to support the prevention of non-communicable diseases (NCD), including cardiovascular diseases, type 2 diabetes, and cancers in low and middle income countries (LMICs), with a specific focus on Kenya, Cameroon, South Africa and Jamaica. OBJECTIVE To utilise a convergent mixed methods design to explore exposures in the household, neighbourhood, school, and the journey from home to school, that may influence diet and PA behaviours in adolescents from LMICs. METHODS Male and female adolescents (n ≥150) aged between 13-24 years will be recruited from purposively selected high schools or households in project site countries to ensure socioeconomic diversity of perspectives and experiences at individual, home and neighbourhood levels. The project will be conducted in five sites in four countries; Kenya, Cameroon, Jamaica and South Africa (Cape Town and Johannesburg). Data on anthropometric measures, food intake and PA knowledge and behaviour will be collected using self-report questionnaires and objective measurement in a sub-sample. Additionally, a small number of learners (n=30-45) from each site will be purposively selected as citizen scientists to capture data (photos, audio notes, text, and geolocations) on their “lived experiences” in relation to food and physical activity, in their homes, the journey to and from school, and school and neighbourhood environments, using a mobile application (EpiCollect5). In-depth interviews will be conducted with the citizen scientists’ caregivers to explore household experiences and determinants of food intake and foodways, as well as physical activity of household members RESULTS This project is fully funded by the UK National Institutes of Health Research and conducted by the GDAR Network. Data collection is on-going and analysis will follow once data collection is complete. CONCLUSIONS This project protocol contributes to research that focuses on adolescents and the socio-ecological 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 multi-level system of factors that can be leveraged through upstream and downstream strategies and interventions to improve health outcomes

Download Full-text