Gross national income and antibiotic resistance in invasive isolates: analysis of the top-ranked antibiotic-resistant bacteria on the 2017 WHO priority list

2019 ◽  
Vol 74 (12) ◽  
pp. 3619-3625 ◽  
Author(s):  
Alessia Savoldi ◽  
Elena Carrara ◽  
Beryl Primrose Gladstone ◽  
Anna Maria Azzini ◽  
Siri Göpel ◽  
...  
Keyword(s):  
Low Income ◽  
National Income ◽  
Resistant Bacteria ◽  
Middle Income ◽  
Priority List ◽  
Income Status ◽  
Rate Of Increase ◽  
Invasive Infections ◽  
Per Capita ◽  
Klebsiella Spp

Abstract Objectives To assess the association between country income status and national prevalence of invasive infections caused by the top-ranked bacteria on the WHO priority list: carbapenem-resistant (CR) Acinetobacter spp., Klebsiella spp. and Pseudomonas aeruginosa; third-generation cephalosporin-resistant (3GCR) Escherichia coli and Klebsiella spp.; and MRSA and vancomycin-resistant Enterococcus faecium (VR E. faecium). Methods Active surveillance systems providing yearly prevalence data from 2012 onwards for the selected bacteria were included. The gross national income (GNI) per capita was used as the indicator for income status of each country and was log transformed to account for non-linearity. The association between antibiotic prevalence data and GNI per capita was investigated individually for each bacterium through linear regression. Results Surveillance data were available from 67 countries: 38 (57%) were high income, 16 (24%) upper-middle income, 11 (16%) lower-middle income and two (3%) low income countries. The regression showed significant inverse association (P<0.0001) between resistance prevalence of invasive infections and GNI per capita. The highest rate of increase per unit decrease in log GNI per capita was observed in 3GCR Klebsiella spp. (22.5%, 95% CI 18.2%–26.7%), CR Acinetobacter spp. (19.2% 95% CI 11.3%–27.1%) and 3GCR E. coli (15.3%, 95% CI 11.6%–19.1%). The rate of increase per unit decrease in log GNI per capita was lower in MRSA (9.5%, 95% CI 5.2%–13.7%). Conclusions The prevalence of invasive infections caused by the WHO top-ranked antibiotic-resistant bacteria is inversely associated with GNI per capita at the global level. Public health interventions designed to limit the burden of antimicrobial resistance should also consider determinants of poverty and inequality, especially in lower-middle income and low income countries.

What do Fiscal Indicators of Fifteen Major States of India Reveal? 2005–2006 to 2013–2014

2017 ◽  
Vol 65 (1-4) ◽  
pp. 45-66
Author(s):  
R. Mohan ◽  
N. Ramalingam
Keyword(s):  
Low Income ◽  
Major Part ◽  
Capital Outlay ◽  
Tax Revenue ◽  
Fiscal Deficit ◽  
Middle Income ◽  
Development Expenditure ◽  
Per Capita ◽  
Better Than

The article examines the revenue and expenditure trends of 15 states of India during the period 2005–2006 to 2013–2014, by grouping them into high, middle and low income based on per capita Gross State Domestic Product (GSDP). The analysis reveals that the middle-income states have performed better than the high- and low-income states in own tax effort, whereas low-income states are ahead of all states average in proportion of development expenditure to GSDP. The quality of fiscal deficit has improved, as a major part of it is capital outlay for 12 out of 15 states. Central grants and taxes have shown progressive trends with the degree of progressivity more in the latter. In devolution of resources to local self governments (LSGs), only 5 states are ahead of all states average. The association between development expenditure, own tax revenue effort, devolution of Central taxes and Central grants is positive and statistically significant.

scholarly journals The cost-effectiveness of hypertension management in low-income and middle-income countries: a review

2020 ◽  
Vol 5 (9) ◽  
pp. e002213
Author(s):  
Deliana Kostova ◽  
Garrison Spencer ◽  
Andrew E Moran ◽  
Laura K Cobb ◽  
Muhammad Jami Husain ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Low Income ◽  
Disease Risk ◽  
National Income ◽  
Economic Evaluations ◽  
Health Improvement ◽  
Middle Income ◽  
Middle Income Countries ◽  
Wide Range ◽  
The Cost

Hypertension in low-income and middle-income countries (LMICs) is largely undiagnosed and uncontrolled, representing an untapped opportunity for public health improvement. Implementation of hypertension control strategies in low-resource settings depends in large part on cost considerations. However, evidence on the cost-effectiveness of hypertension interventions in LMICs is varied across geographical, clinical and evaluation contexts. We conducted a comprehensive search for published economic evaluations of hypertension treatment programmes in LMICs. The search identified 71 articles assessing a wide range of hypertension intervention designs and cost components, of which 42 studies across 15 countries reported estimates of cost-effectiveness. Although comparability of results was limited due to heterogeneity in the interventions assessed, populations studied, costs and study quality score, most interventions that reported cost per averted disability-adjusted life-year (DALY) were cost-effective, with costs per averted DALY not exceeding national income thresholds. Programme elements that may reduce cost-effectiveness included screening for hypertension at younger ages, addressing prehypertension, or treating patients at lower cardiovascular disease risk. Cost-effectiveness analysis could provide the evidence base to guide the initiation and development of hypertension programmes.

scholarly journals Distributing development assistance for health: simulating the implications of 11 criteria

2017 ◽  
Vol 12 (2) ◽  
pp. 245-263
Author(s):  
Trygve Ottersen ◽  
Suerie Moon ◽  
John-Arne Røttingen
Keyword(s):  
Low Income ◽  
Economic Transition ◽  
Development Assistance ◽  
National Income ◽  
Low Income Countries ◽  
Economic Downturn ◽  
Middle Income ◽  
Development Assistance For Health ◽  
Middle Income Countries ◽  
Almost All

AbstractAfter years of unprecedented growth in development assistance for health (DAH), the DAH system is challenged on several fronts: by the economic downturn and stagnation of DAH, by the epidemiological transition and increase in non-communicable diseases and by the economic transition and rise of the middle-income countries. Central to any potent response is a fair and effective allocation of DAH across countries. A myriad of criteria has been proposed or is currently used, but there have been no comprehensive assessment of their distributional implications. We simulated the implications of 11 quantitative allocation criteria across countries and country categories. We found that the distributions varied profoundly. The group of low-income countries received most DAH from needs-based criteria linked to domestic capacity, while the group of upper-middle-income countries was most favoured by an income-inequality criterion. Compared to a baseline distribution guided by gross national income per capita, low-income countries received less DAH by almost all criteria. The findings can inform funders when examining and revising the criteria they use, and provide input to the broader debate about what criteria should be used.

scholarly journals Cost of scaling up mental healthcare in low-and middle-income countries

2007 ◽  
Vol 191 (6) ◽  
pp. 528-535 ◽  
Author(s):  
Dan Chisholm ◽  
Crick Lund ◽  
Shekhar Saxena
Keyword(s):  
Low Income ◽  
Scale Up ◽  
Mental Healthcare ◽  
Scaling Up ◽  
Psychosocial Treatment ◽  
Economic Evaluations ◽  
Middle Income ◽  
Middle Income Countries ◽  
Per Capita ◽  
Low And Middle Income

BackgroundNo systematic attempt has been made to calculate the costs of scaling up mental health services in low-and middle-income countries.AimsTo estimate the expenditures needed to scale up the delivery of an essential mental healthcare package over a 10-year period (2006–2015).MethodA core package was defined, comprising pharmacological and/or psychosocial treatment of schizophrenia, bipolar disorder, depression and hazardous alcohol use. Current service levels in 12 selected low-and middle-income countries were established using the WHO–AIMS assessment tool. Target-level resource needs were derived from published need assessments and economic evaluations.ResultsThe cost per capita of providing the core package attarget coverage levels (in US dollars) ranged from $1.85 to $2.60 per year in low-income countries and $3.20 to $6.25 per year in lower-middle-income countries, an additional annual investment of $0.18–0.55 per capita.ConclusionsAlthough significant new resources need to be invested, the absolute amount is not large when considered at the population level and against other health investment strategies.

scholarly journals Effects of Economic Growth, Trade Openness, and Urbanization on Carbon Dioxide Emissions in Ghana, 1960 to 2014

2020 ◽  
Vol 7 (2) ◽  
pp. 9 ◽  
Author(s):  
Forster Kwame Boateng
Keyword(s):  
Carbon Dioxide ◽  
Low Income ◽  
Carbon Dioxide Emissions ◽  
Trade Openness ◽  
Economic Transformation ◽  
Total Carbon ◽  
Annual Data ◽  
Middle Income ◽  
Per Capita Gdp ◽  
Per Capita

This paper examines the effects of per capita gross domestic product (GDP), trade openness, and urbanization on the total carbon dioxide emissions of Ghana using time-series annual data from 1960 to 2014. The 55-year period, from 1960 to 2014, covered economic transformation of Ghana from a low-income agrarian country to a lower-middle income country. The analysis used the autoregressive distributed lag method of co-integration. The results showed that per capita GDP, trade openness, and urbanization all significantly influenced both long-run and short-run levels of carbon dioxide emissions in Ghana. However, increased trade openness led to reduced total emissions, while rising per capita GDP and increased urbanization both increased total emissions albeit at different intensity levels.

scholarly journals Economic Performance and Competitiveness Indicators: The Case of African Economies

2021 ◽  
Author(s):  
Vít Pošta ◽  
Marta Nečadová
Keyword(s):  
Statistical Analysis ◽  
Low Income ◽  
Economic Performance ◽  
Empirical Evaluation ◽  
Middle Income ◽  
Significant Relationships ◽  
Basic Relationship ◽  
Per Capita ◽  
The Relationship

This paper presents a statistical analysis of the relationship between economic performance and competitiveness indicators to address the question of the extent to which competitiveness indicators provideuseful information when assessing economic performance. The analysis was performed on various examples of African economies. The possible relationships between economic performance and competitiveness indicators were examined by extending a basic relationship between economic performance per capita and investment by competitiveness indicators. The models were estimated by means of an Arellano-Bond estimator. The authors detected many statistically significant relationships between economic performance and competitiveness indicators in the cases of both the whole sample and specifically middle-income economies. However, in the case of low-income economies there are no discernible relationships between economic performance and the information included in the competitiveness indicators. The paper contributes to the analysis of the economic performance of African economies, for which the empirical evaluation of possible links between economic performance and competitiveness indicators is altogether missing.

scholarly journals Health spending and vaccination coverage in low-income countries

2020 ◽  
Author(s):  
Francisco Castillo-Zunino ◽  
Pinar Keskinocak ◽  
Dima Nazzal ◽  
Matthew C Freeman
Keyword(s):  
Vaccination Coverage ◽  
Low Income ◽  
National Income ◽  
Health Spending ◽  
Gross National Income ◽  
Low Income Countries ◽  
Childhood Immunization ◽  
Government Health ◽  
Per Capita ◽  
The Impact

SummaryBackgroundRoutine childhood immunization is a cost-effective way to save lives and protect people from disease. Some low-income countries (LIC) have achieved remarkable success in childhood immunization, despite lower levels of gross national income or health spending compared to other countries. We investigated the impact of financing and health spending on vaccination coverage across LIC and lower-middle income countries (LMIC).MethodsAmong LIC, we identified countries with high-performing vaccination coverage (LIC+) and compared their economic and health spending trends with other LIC (LIC-) and LMIC. We used cross-country multi-year linear regressions with mixed-effects to test financial indicators over time. We conducted three different statistical tests to verify if financial trends of LIC+ were significantly different from LIC- and LMIC; p-values were calculated with an asymptotic χ2 test, a Kenward-Roger approximation for F tests, and a parametric bootstrap method.FindingsDuring 2014–18, LIC+ had a mean vaccination coverage between 91–96% in routine vaccines, outperforming LIC- (67–80%) and LMIC (83–89%). During 2000–18, gross national income and development assistance for health (DAH) per capita were not significantly different between LIC+ and LIC- (p > 0·13, p > 0·65) while LIC+ had a significant lower total health spending per capita than LIC- (p < 0·0001). Government health spending per capita per year increased by US$0·42 for LIC+ and decreased by US$0·24 for LIC- (p < 0·0001). LIC+ had a significantly lower private health spending per capita than LIC- (p < 0·012).InterpretationLIC+ had a difference in vaccination coverage compared to LIC- and LMIC that could not be explained by economic development, total health spending, nor aggregated DAH. The vaccination coverage success of LIC+ was associated with higher government health spending and lower private health spending, with the support of DAH on vaccines.

scholarly journals Is the proportion of per capita fat supply associated with the prevalence of overweight and obesity? an ecological analysis

BMC Nutrition ◽  
2022 ◽  
Vol 8 (1) ◽  
Author(s):  
Hasinthi Swarnamali ◽  
Ranil Jayawardena ◽  
Michail Chourdakis ◽  
Priyanga Ranasinghe
Keyword(s):  
Balance Sheet ◽  
National Income ◽  
Population Level ◽  
Overweight And Obesity ◽  
Strong Positive Correlation ◽  
Obesity Prevalence ◽  
Middle Income ◽  
Low Fat Diet ◽  
Per Capita ◽  
United Nations Food

Abstract Background Although it is reported in numerous interventional and observational studies, that a low-fat diet is an effective method to combat overweight and obesity, the relationship at the global population level is not well established. This study aimed to quantify the associations between worldwide per capita fat supply and prevalence of overweight and obesity and further classify this association based on per capita Gross National Income (GNI). Methods A total of 93 countries from four GNI groups were selected. Country-specific overweight and obesity prevalence data were retrieved from the most recent WHO Global Health Observatory database. Per capita supply of fat and calories were obtained from the United Nations Food and Agricultural Organization database; FAOSTAT, Food Balance Sheet for years 2014–2016. The categorizations of countries were done based on GNI based classification by the World Bank. Results Among the selected countries, the overweight prevalence ranged from 3.9% (India) to 78.8% (Kiribati), while obesity prevalence ranged from 3.6% (Bangladesh) to 46.0% (Kiribati). The highest and the lowest per capita fat supply from total calorie supply were documented in Australia (41.2%) and Madagascar (10.5%) respectively. A significant strong positive correlation was observed between the prevalence of overweight (r = 0.64, p < 0.001) and obesity (r = 0.59, p < 0.001) with per capita fat supply. The lower ends of both trend lines were densely populated by the low- and lower-middle-income countries and the upper ends of both lines were greatly populated by the high-income countries. Conclusions Per capita fat supply per country is significantly associated with both prevalence of overweight and obesity.

scholarly journals Factors Influencing Recovery among Children with Moderate Acute Malnutrition Treated at Kirehe District Health Centers

2020 ◽  
Vol 3 (1) ◽  
pp. 20-27
Author(s):  
Vianney Bihibindi Kabundi ◽  
Camille Kayihura ◽  
Onesmus Marete ◽  
Nicodeme Habarurema ◽  
Erigene Rutayisire
Keyword(s):  
Low Income ◽  
Family Income ◽  
Health Facilities ◽  
Health Centers ◽  
Acute Malnutrition ◽  
District Health ◽  
Middle Income ◽  
Factors Associated ◽  
Income Status ◽  
Moderate Acute Malnutrition

Acute malnutrition affects nearly 52 million of under five years children globally, 75% of them live in low to middle income countries. The treatment of acute malnutrition using supplement foods could help children recovering and could reduce the risk of sickness. The present study investigated the factors associated with recovery among children with moderate acute malnutrition (MAM) under a follow-up program at health facilities. A prospective study was conducted in 16 health centers of Kirehe District of Rwanda and included 200 children from 6 to 59 months. A semi-structured questionnaire was used for data collection. All children enrolled in the study spent three months in nutrition program at health centers. The results show that after 3 months in the program 77.5% recovered from MAM. Children aged above 36 to 59 months were recovered at 90% whereas children aged from 24-35 months were recovered at 73.5%. Micronutrients and deworming provided at health facility were contributed to the recovery as children who received them were recovered at 89.1% and for those who didn’t were recovery at 72.1%. The findings demonstrated that boys were 16 times more likely to recover from MAM in three months of intervention than girls (AOR=16.19, p<0.001, 95% CI: 5.39- 48.63). Children from moderate income families were 3 more likely to recover than those from very low income families (AOR=2.8, p=0.029, 95% CI: 1.11-7.51). Male gender, receiving micronutrients and deworming from health facilities and family income status were factors associated with MAM recovery status

scholarly journals Nanomedicine for the poor: a lost cause or an idea whose time has yet to come?

Nanomedicine ◽  
2021 ◽  
Author(s):  
Vuk Uskoković
Keyword(s):  
Low Income ◽  
Low Income Countries ◽  
Gdp Per Capita ◽  
Lost Cause ◽  
Middle Income ◽  
Middle Income Countries ◽  
The Poor ◽  
Scientific Innovation ◽  
Per Capita ◽  
To Come

The most effective COVID-19 vaccines, to date, utilize nanotechnology to deliver immunostimulatory mRNA. However, their high cost equates to low affordability. Total nano-vaccine purchases per capita and their proportion within the total vaccine lots have increased directly with the GDP per capita of countries. While three out of four COVID-19 vaccines procured by wealthy countries by the end of 2020 were nano-vaccines, this amounted to only one in ten for middle-income countries and nil for the low-income countries. Meanwhile, economic gains of saving lives with nano-vaccines in USA translate to large costs in middle-/low-income countries. It is discussed how nanomedicine can contribute to shrinking this gap between rich and poor instead of becoming an exquisite technology for the privileged. Two basic routes are outlined: (1) the use of qualitative contextual analyses to endorse R&D that positively affects the sociocultural climate; (2) challenging the commercial, competitive realities wherein scientific innovation of the day operates.

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