scholarly journals Impact of national interventions to promote responsible antibiotic use: a systematic review

2019 ◽  
Vol 75 (1) ◽  
pp. 14-29 ◽  
Author(s):  
Jane Mingjie Lim ◽  
Shweta Rajkumar Singh ◽  
Minh Cam Duong ◽  
Helena Legido-Quigley ◽  
Li Yang Hsu ◽  
...  
Keyword(s):  
Systematic Review ◽  
National Level ◽  
Public Health Problem ◽  
Antibiotic Use ◽  
Antibiotic Consumption ◽  
Middle Income ◽  
Middle Income Countries ◽  
Policy Interventions ◽  
The Impact

Abstract Background Global recognition of antimicrobial resistance (AMR) as an urgent public health problem has galvanized national and international efforts. Chief among these are interventions to curb the overuse and misuse of antibiotics. However, the impact of these initiatives is not fully understood, making it difficult to assess the expected effectiveness and sustainability of further policy interventions. We conducted a systematic review to summarize existing evidence for the impact of nationally enforced interventions to reduce inappropriate antibiotic use in humans. Methods We searched seven databases and examined reference lists of retrieved articles. To be included, articles had to evaluate the impact of national responsible use initiatives. We excluded studies that only described policy implementations. Results We identified 34 articles detailing interventions in 21 high- and upper-middle-income countries. Interventions addressing inappropriate antibiotic access included antibiotic committees, clinical guidelines and prescribing restrictions. There was consistent evidence that these were effective at reducing antibiotic consumption and prescription. Interventions targeting inappropriate antibiotic demand consisted of education campaigns for healthcare professionals and the general public. Evidence for this was mixed, with several studies showing no impact on overall antibiotic consumption. Conclusions National-level interventions to reduce inappropriate access to antibiotics can be effective. However, evidence is limited to high- and upper-middle-income countries, and more evidence is needed on the long-term sustained impact of interventions. There should also be a simultaneous push towards standardized outcome measures to enable comparisons of interventions in different settings.

Defining Preterm Birth and Stillbirth in the Western Pacific: A Systematic Review

2021 ◽  
pp. 101053952110260
Author(s):  
Mairead Connolly ◽  
Laura Phung ◽  
Elise Farrington ◽  
Michelle J. L. Scoullar ◽  
Alyce N. Wilson ◽  
...  
Keyword(s):  
Preterm Birth ◽  
National Level ◽  
Health Indicators ◽  
Western Pacific ◽  
World Health ◽  
Middle Income ◽  
Middle Income Countries ◽  
Definition Of ◽  
Health Organization ◽  
The Impact

Preterm birth and stillbirth are important global perinatal health indicators. Definitions of these indicators can differ between countries, affecting comparability of preterm birth and stillbirth rates across countries. This study aimed to document national-level adherence to World Health Organization (WHO) definitions of preterm birth and stillbirth in the WHO Western Pacific region. A systematic search of government health websites and 4 electronic databases was conducted. Any official report or published study describing the national definition of preterm birth or stillbirth published between 2000 and 2020 was eligible for inclusion. A total of 58 data sources from 21 countries were identified. There was considerable variation in how preterm birth and stillbirth was defined across the region. The most frequently used lower gestational age threshold for viability of preterm birth was 28 weeks gestation (range 20-28 weeks), and stillbirth was most frequently classified from 20 weeks gestation (range 12-28 weeks). High-income countries more frequently used earlier gestational ages for preterm birth and stillbirth compared with low- to middle-income countries. The findings highlight the importance of clear, standardized, internationally comparable definitions for perinatal indicators. Further research is needed to determine the impact on regional preterm birth and stillbirth rates.

scholarly journals Epidemics, Lockdown Measures and Vulnerable Populations: A Mixed-Methods Systematic Review of the Evidence of Impacts on Mother and Child Health in Low-And- Lower Middle-Income Countries

2021 ◽  
Author(s):  
Giuliano Russo ◽  
Tiago Silva Jesus ◽  
Kevin Deane ◽  
Abdinasir Yusuf Osman ◽  
David McCoy
Keyword(s):  
Systematic Review ◽  
Mixed Methods ◽  
Inclusion Criteria ◽  
Middle Income ◽  
Middle Income Countries ◽  
Premature Deaths ◽  
Trade Offs ◽  
Mother And Child ◽  
New Research ◽  
The Impact

Background: The aim of this research was to synthetise the existing evidence on the impact of epidemic-related lockdown measures on women and children’s health in low-and-lower-middle-income countries. Methods: A mixed-methods systematic review was conducted of qualitative, quantitative and mixed-methods evidence. Between November 1st-10th 2021, seven scientific databases were searched. The inclusion criteria were that the paper provided evidence on the impact of lockdown and related measures, focused on low-and-lower-middle-income countries, addressed impacts on women and child’s health, addressed epidemics from 2000-2020, was peer-reviewed, provided original evidence, and was published in English. The Joanne Briggs Institute’s critical appraisal tools were used to assess the quality of the studies, and the PRISMA guidelines for reporting. The evidence from the papers was grouped by type of lockdown measure and categories of impact, using a narrative data-based convergent synthesis design. Results: The review process identified 46 papers meeting the inclusion criteria from 17 countries whichall focussed on the COVID-19 and Ebola epidemics. The evidence on the decrease of utilisation of health services showed plummeting immunisation rates and faltering use of maternal and perinatal services, which was linked to a growth of premature deaths. Impacts on the mental health of children and women is well-established, with lockdowns associated with surges in depression, anxiety and low life satisfaction. Vulnerability may be compounded by lockdowns, as livelihoods are disrupted, and poverty levels increase. Conclusion: Limitations included that searches were conducted in late-2020 as new research was being published, and that some evidence not published in English may have been excluded. Epidemic-related lockdown measures carry consequences for the health of women and children in lower-income settings. Governments will need to weigh the trade-offs of introducing such measures and consider policies to mitigate their impacts on the most vulnerable.

Household Air Pollution in Low and Middle Income Countries

2017 ◽  
Author(s):  
Caroline A. Ochieng ◽  
Cathryn Tonne ◽  
Sotiris Vardoulakis ◽  
Jan Semenza
Keyword(s):  
Air Pollution ◽  
National Level ◽  
Household Air Pollution ◽  
Solid Fuels ◽  
Chronic Obstructive ◽  
Biomass Fuels ◽  
Middle Income ◽  
Middle Income Countries ◽  
The Impact ◽  
Low And Middle Income

Household air pollution from use of solid fuels (biomass fuels and coal) is a major problem in low and middle income countries, where 90% of the population relies on these fuels as the primary source of domestic energy. Use of solid fuels has multiple impacts, on individuals and households, and on the local and global environment. For individuals, the impact on health can be considerable, as household air pollution from solid fuel use has been associated with acute lower respiratory infections, chronic obstructive pulmonary disease, lung cancer, and other illnesses. Household-level impacts include the work, time, and high opportunity costs involved in biomass fuel collection and processing. Harvesting and burning biomass fuels affects local environments by contributing to deforestation and outdoor air pollution. At a global level, inefficient burning of solid fuels contributes to climate change. Improved biomass cookstoves have for a long time been considered the most feasible immediate intervention in resource-poor settings. Their ability to reduce exposure to household air pollution to levels that meet health standards is however questionable. In addition, adoption of improved cookstoves has been low, and there is limited evidence on how the barriers to adoption and use can be overcome. However, the issue of household air pollution in low and middle income countries has gained considerable attention in recent years, with a range of international initiatives in place to address it. These initiatives could enable a transition from biomass to cleaner fuels, but such a transition also requires an enabling policy environment, especially at the national level, and new modes of financing technology delivery. More research is also needed to guide policy and interventions, especially on exposure-response relationships with various health outcomes and on how to overcome poverty and other barriers to wide-scale transition from biomass fuels to cleaner forms of energy.

scholarly journals Can Policy Interventions Affect HIV-Related Behaviors? A Systematic Review of the Evidence from Low- and Middle-Income Countries

2016 ◽  
Vol 21 (3) ◽  
pp. 626-642 ◽  
Author(s):  
Kevin R. O’Reilly ◽  
Erica d’Aquila ◽  
Virginia Fonner ◽  
Caitlin Kennedy ◽  
Michael Sweat
Keyword(s):  
Systematic Review ◽  
Middle Income ◽  
Middle Income Countries ◽  
Policy Interventions ◽  
Low And Middle Income

Immunological footprint: the development of a child's immune system in environments rich in microorganisms and parasites

Parasitology ◽  
2011 ◽  
Vol 138 (12) ◽  
pp. 1508-1518 ◽  
Author(s):  
YENNY DJUARDI ◽  
LINDA J. WAMMES ◽  
TANIAWATI SUPALI ◽  
ERLIYANI SARTONO ◽  
MARIA YAZDANBAKHSH
Keyword(s):  
Immune System ◽  
Environmental Factors ◽  
Later Life ◽  
Third Party ◽  
Middle Income ◽  
Middle Income Countries ◽  
Geographical Regions ◽  
Micro Organisms ◽  
The Impact

SUMMARYThe shaping of a child's immune system starts in utero, with possible long-term consequences in later life. This review highlights the studies conducted on the development of the immune system in early childhood up to school-age, discussing the impact that environmental factors may have. Emphasis has been put on studies conducted in geographical regions where exposure to micro-organisms and parasites are particularly high, and the effect that maternal exposures to these may have on an infant's immune responses to third-party antigens. In this respect we discuss the effect on responses to vaccines, co-infections and on the development of allergic disorders. In addition, studies of the impact that such environmental factors may have on slightly older (school) children are highlighted emphasizing the need for large studies in low to middle income countries, that are sufficiently powered and have longitudinal follow-up components to understand the immunological footprint of a child and the consequences throughout life.

scholarly journals Impact of traditional bonesetters on contemporary fracture care in Low and Middle Income Countries (LMICs): a systematic review

2019 ◽  
Author(s):  
Ndubuisi Onyemaechi ◽  
William N.A. Menson ◽  
Xan Goodman ◽  
Samantha Slinkard ◽  
Obinna E Onwujekwe ◽  
...  
Keyword(s):  
Systematic Review ◽  
Retrospective Studies ◽  
Web Of Science ◽  
Clinical Effects ◽  
Middle Income ◽  
Fracture Care ◽  
Middle Income Countries ◽  
Meta Analyses ◽  
The Impact ◽  
Low And Middle Income

Abstract Background: The review aimed at systematically examining the evidence in articles that assess the clinical effects and impact of traditional bonesetters on contemporary fracture care in Low and Middle Income Countries (LMICs).Methods: A systematic review was conducted. Articles were identified by database searching ((PubMed, Embase, ScienceDirect, SCOPUS, and Web of Science). Searching, selecting and reporting were conducted according to the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) Statement. The key words that were used in search for literature were: “Bonesetter”, “fracture healer” and “traditional bone setting”. Publications included for review were original articles, set in an LMIC and directly talked about the role and/or impact of traditional bonesetters in providing fracture care. Papers that focused on Low and Middle Income (LMIC) settings were reviewed.Results: A total of 176 papers were screened for eligibility and 15 studies were finally included. Nine were prospective studies, while 6 were retrospective studies. Most of the studies focused on clinical impacts of bone setter intervention. The evidence from the publications show that the main clinical effects of traditional bonesetters had been deleterious, but they had the potential to contribute positively when trained.Conclusion: Few well designed studies are available that assessed the impact of traditional bonesetters. Reported cases and reviews indicate their impact to be deleterious. However, the potential exist that when trained, these deleterious impact can be reduced through training for traditional bonesetters who contribute to fracture care in many LMICs.

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