Mothers’ perception of cerebral palsy in a low-income country of West Africa: a cross-sectional study

Background: The burden of Diabetes in South Asia is alarming as the prevalence is higher compared to other region, living cost is low after Sub Saharan Africa and health care system are in state of expanding to be more accessible and adequate. Objectives: The objective of the study was to assess the direct cost of illness among diabetic patient regularly visiting at outpatient department (OPD) in BPKIHS. Methods: This was a cross sectional study done in year 2018. 142 patients with at least nine visit per year were enrolled. The direct cost were calculated from the pattern of prescription of medications and laboratory investigations carried out over a year of the individual patient. The data were tabulated and analyzed. Results: Among the 142 patients on 37.5% were in mono-therapy and 62.5% were in poly-therapy. The direct cost of illness was USD 103 per annum that includes drug and investigation cost expensed at OPD visit. The average indirect cost was USD 102 per annum including travel and food. Among 142 patient the cost of illness on inpatient due to DM was USD 85.47 per event. Conclusion: The financial burden of being a diabetic in Nepal is high. Comprehensive quality care by expansion of health system and service with nominal charges to patient seems to be one of the challenges in Nepal.

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Factors influencing depression in individuals with traumatic spinal cord injury and caregivers’ perceived burden in a low-income country: a cross-sectional study

Spinal Cord ◽

10.1038/s41393-020-0451-5 ◽

2020 ◽

Vol 58 (10) ◽

pp. 1112-1118

Author(s):

Shambhu P. Adhikari ◽

Geetu Gurung ◽

Barsha Khadka ◽

Chanda Rana

Keyword(s):

Spinal Cord ◽

Low Income ◽

Cross Sectional Study ◽

Traumatic Spinal Cord Injury ◽

Sectional Study ◽

Cross Sectional ◽

Low Income Country ◽

Factors Influencing ◽

Perceived Burden ◽

Cord Injury

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Representative estimates of COVID-19 infection fatality rates from four locations in India: cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2021-050920 ◽

2021 ◽

Vol 11 (10) ◽

pp. e050920

Author(s):

Rebecca Cai ◽

Paul Novosad ◽

Vaidehi Tandel ◽

Sam Asher ◽

Anup Malani

Keyword(s):

Low Income ◽

Tamil Nadu ◽

Large Population ◽

Cross Sectional Study ◽

High Income ◽

Income Country ◽

Secondary Outcome ◽

Sectional Study ◽

Cross Sectional ◽

Increased Risk

ObjectivesTo estimate age-specific and sex-specific mortality risk among all SARS-CoV-2 infections in four settings in India, a major lower-middle-income country and to compare age trends in mortality with similar estimates in high-income countries.DesignCross-sectional study.SettingIndia, multiple regions representing combined population >150 million.ParticipantsAggregate infection counts were drawn from four large population-representative prevalence/seroprevalence surveys. Data on corresponding number of deaths were drawn from official government reports of confirmed SARS-CoV-2 deaths.Primary and secondary outcome measuresThe primary outcome was age-specific and sex-specific infection fatality rate (IFR), estimated as the number of confirmed deaths per infection. The secondary outcome was the slope of the IFR-by-age function, representing increased risk associated with age.ResultsAmong males aged 50–89, measured IFR was 0.12% in Karnataka (95% CI 0.09% to 0.15%), 0.42% in Tamil Nadu (95% CI 0.39% to 0.45%), 0.53% in Mumbai (95% CI 0.52% to 0.54%) and an imprecise 5.64% (95% CI 0% to 11.16%) among migrants returning to Bihar. Estimated IFR was approximately twice as high for males as for females, heterogeneous across contexts and rose less dramatically at older ages compared with similar studies in high-income countries.ConclusionsEstimated age-specific IFRs during the first wave varied substantially across India. While estimated IFRs in Mumbai, Karnataka and Tamil Nadu were considerably lower than comparable estimates from high-income countries, adjustment for under-reporting based on crude estimates of excess mortality puts them almost exactly equal with higher-income country benchmarks. In a marginalised migrant population, estimated IFRs were much higher than in other contexts around the world. Estimated IFRs suggest that the elderly in India are at an advantage relative to peers in high-income countries. Our findings suggest that the standard estimation approach may substantially underestimate IFR in low-income settings due to under-reporting of COVID-19 deaths, and that COVID-19 IFRs may be similar in low-income and high-income settings.

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A Cross-sectional Study of the Clinical Profile of Children With Cerebral Palsy in Benin, a West African Low-Income Country

Journal of Child Neurology ◽

10.1177/0883073819864516 ◽

2019 ◽

Vol 34 (13) ◽

pp. 842-850

Author(s):

Emmanuel Segnon Sogbossi ◽

Damienne Houekpetodji ◽

Toussaint G. Kpadonou ◽

Yannick Bleyenheuft

Keyword(s):

Risk Factors ◽

Cerebral Palsy ◽

Low Income ◽

Classification System ◽

West African ◽

Low Income Countries ◽

Cross Sectional ◽

Common Cause ◽

Low Income Country ◽

Children With Cerebral Palsy

Cerebral palsy is a common cause of pediatric motor disability. Although there are increasing amounts of data on the clinical profile of children with cerebral palsy in high-income countries, corresponding information about low-income countries and developing countries is lacking. Therefore, we aimed to describe the clinical spectrum of cerebral palsy in children in Benin, a representative West African low-income country. Our cross-sectional observational study included 114 children with cerebral palsy recruited from community-based rehabilitation centers and teaching hospitals (median age: 7 years, range 2-17; sex: 66% male). Data were collected through review of medical records and interviews with children’s mothers. Assessment included risk factors, clinical subtypes according to the Surveillance of CP in Europe criteria, severity of motor outcome scored by the Gross Motor Function Classification System (GMFCS) and Manual Ability Classification System, comorbidities, and school attendance. We recorded a high prevalence of intrapartum adverse events. Seventeen percent of children had postneonatal cerebral palsy, with cerebral malaria being the most common cause. Most children were severely affected (67.5% as bilateral spastic; 54.4% as GMFCS IV or V), but severity declined substantially with age. Only 23% of the children with cerebral palsy had attended school. Poor motor outcomes and comorbidities were associated with school nonattendance. These results suggest that intrapartum risk factors and postnatal cerebral malaria in infants are opportune targets for prevention of cerebral palsy in Sub-Saharan low-income countries.

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