Epidemiology

2019 ◽  
pp. 14-23
Author(s):  
Navneet Kapur ◽  
Robert Goldney
Keyword(s):  
Suicidal Behaviour ◽  
Large Population ◽  
Population Based ◽  
High Income ◽  
Middle Income ◽  
Middle Income Countries ◽  
Global Epidemiology ◽  
Current Concern ◽  
A Current ◽  
Low And Middle Income

This chapter examines the global epidemiology of suicidal behaviour. Up to one million people die by suicide every year, and about three quarters of these are in low- and middle-income countries. Twenty to thirty times this number harm themselves or attempt suicide. Global rates are probably under-reported, and the iceberg model of suicidal behaviour (showing that much suicidal behaviour is ‘under the waterline’ and thus hidden) is a helpful way of conceptualizing this. In most countries, men are greatly over-represented amongst people who die by suicide. There is a current concern about men in midlife in many high-income settings. Although suicidal behaviour can vary widely in incidence, it tends to share common antecedents. However, it should be borne in mind that the results of large population-based studies do not always apply to individuals.

scholarly journals Early Detection of CKD: Implications for Low-Income, Middle-Income, and High-Income Countries

2020 ◽  
Vol 31 (9) ◽  
pp. 1931-1940 ◽  
Author(s):  
Marcello Tonelli ◽  
James A. Dickinson
Keyword(s):  
Early Detection ◽  
Low Income ◽  
Population Based ◽  
Case Finding ◽  
High Income ◽  
Opportunity Costs ◽  
Middle Income ◽  
Middle Income Countries ◽  
Use Of Resources ◽  
Low And Middle Income

CKD is common, costly, and associated with adverse health outcomes. Because inexpensive treatments can slow the rate of kidney function loss, and because CKD is asymptomatic until its later stages, the idea of early detection of CKD to improve outcomes ignites enthusiasm, especially in low- and middle-income countries where renal replacement is often unavailable or unaffordable. Available data and prior experience suggest that the benefits of population-based screening for CKD are uncertain; that there is potential for harms; that screening is not a wise use of resources, even in high-income countries; and that screening has substantial opportunity costs in low- and middle-income countries that offset its hypothesized benefits. In contrast, some of the factors that diminish the value of population-based screening (such as markedly higher prevalence of CKD in people with diabetes, hypertension, and cardiovascular disease, as well as high preexisting use of kidney testing in such patients) substantially increase the appeal of searching for CKD in people with known kidney risk factors (case finding) in high-income countries as well as in low- and middle-income countries. For both screening and case finding, detection of new cases is the easiest component; the real challenge is ensuring appropriate management for a chronic disease, usually for years or even decades. This review compares and contrasts the benefits, harms, and opportunity costs associated with these two approaches to early detection of CKD. We also suggest criteria (discussed separately for high-income countries and for low- and middle-income countries) to use in assessing when countries should consider case finding versus when they should consider foregoing systematic attempts at early detection and focus on management of known cases.

Abstract 32: Global Burden and Control of Hypertension in 2010: Analysis of Population-Based Studies from 89 Countries

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Katherine T Mills ◽  
Joshua D Bundy ◽  
Tanika N Kelly ◽  
Jennifer E Reed ◽  
Patricia M Kearney ◽  
...  
Keyword(s):  
Global Health ◽  
Population Based ◽  
High Income ◽  
Global Burden ◽  
Middle Income ◽  
Middle Income Countries ◽  
Preventable Risk Factor ◽  
High Prevalence ◽  
And Control ◽  
Low And Middle Income

Background: Hypertension is an important global health challenge due to its high prevalence and resulting cardiovascular disease and chronic kidney disease. Hypertension is the leading preventable risk factor for premature death and disability worldwide. Objective: We estimated the prevalence, awareness, treatment and control of hypertension worldwide in 2010 and compared the global burden of hypertension in 2000 and 2010. Methods: We searched MEDLINE for published reports from January 1, 2001 to June 30, 2014 and supplemented with manual searches of references from retrieved articles. We included population-based studies and applied sex-age-specific prevalence of hypertension from each country to population data to assess the number of hypertensive adults in each region and globally. Proportions of awareness, treatment and control from each country were applied to hypertensive populations to obtain regional and global estimates. Results: An estimated 29.8% (95% confidence interval 29.6-30.0%) of the world’s adult population in 2010 had hypertension (30.7% [30.4-31.0%] in men and 28.8% [28.6-29.0%] in women). The estimated total number of hypertensive adults in 2010 was 1.33 billion (1.32-1.34 billion); 346 million (336-356 million) in high-income and 985 million (977-994 million) in low- and middle-income countries. From 2000 to 2010, the age-standardized prevalence of hypertension increased by 2.5% worldwide. The hypertension prevalence decreased 3.5% in high-income countries, whereas the prevalence increased 4.5% in low- and middle-income countries. In addition, from 2000 to 2010 the number of hypertensive adults increased by 354 million (334 million in low- and middle-income countries compared to 19 million in high-income countries). Proportions of hypertension awareness, treatment and control worldwide in 2010 were 43.5% (43.1-44.0%), 33.8% (33.3-34.2%), and 12.3% (12.1-12.6%), respectively. The proportion of hypertension control was 27.7% (27.0-28.3%) in high-income and 6.9% (6.7-7.1) in low- and middle-income countries. Conclusions: Prevention and treatment of hypertension should be a global health priority due to its high prevalence and low control rate globally, especially in low- and middle-income countries.

scholarly journals Adherence to Food-Based Dietary Guidelines: A Systemic Review of High-Income and Low- and Middle-Income Countries

Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 1038
Author(s):  
Ana Carolina B. Leme ◽  
Sophia Hou ◽  
Regina Mara Fisberg ◽  
Mauro Fisberg ◽  
Jess Haines
Keyword(s):  
English Language ◽  
Economic Status ◽  
High Income ◽  
Dietary Guidelines ◽  
Systemic Review ◽  
Healthy Children ◽  
Future Health ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

Research comparing the adherence to food-based dietary guidelines (FBDGs) across countries with different socio-economic status is lacking, which may be a concern for developing nutrition policies. The aim was to report on the adherence to FBDGs in high-income (HIC) and low-and-middle-income countries (LMIC). A systematic review with searches in six databases was performed up to June 2020. English language articles were included if they investigated a population of healthy children and adults (7–65 years), using an observational or experimental design evaluating adherence to national FBDGs. Findings indicate that almost 40% of populations in both HIC and LMIC do not adhere to their national FBDGs. Fruit and vegetables (FV) were most adhered to and the prevalence of adhering FV guidelines was between 7% to 67.3%. HIC have higher consumption of discretionary foods, while results were mixed for LMIC. Grains and dairy were consumed below recommendations in both HIC and LMIC. Consumption of animal proteins (>30%), particularly red meat, exceeded the recommendations. Individuals from HIC and LMIC may be falling short of at least one dietary recommendation from their country’s guidelines. Future health policies, behavioral-change strategies, and dietary guidelines may consider these results in their development.

scholarly journals Suicide prevention in low- and middle-income countries: part perceptions, partial solutions

2017 ◽  
Vol 211 (5) ◽  
pp. 264-265 ◽  
Author(s):  
K. S. Jacob
Keyword(s):  
Public Health ◽  
Suicide Prevention ◽  
Cause Of Death ◽  
Population Based ◽  
Personal Distress ◽  
Public Health Perspective ◽  
Middle Income ◽  
Common Cause ◽  
Middle Income Countries ◽  
Low And Middle Income

SummarySuicide, a common cause of death in many low- and middle-income countries, has often been viewed through a medical/psychiatric lens. Such perspectives medicalise social and personal distress and suggest individual and medication-based treatments. This editorial argues for the need to examine suicide from a public health perspective and suggests the need for population-based social and economic interventions.

Abstract WP418: A Systematic Comparison of Key Features of Ischaemic Stroke Prevention Guidelines in Low- and Middle-income vs High-income Countries

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Hernan O Bayona ◽  
Mayowa Owolabi ◽  
Wayne Feng ◽  
James R Sawers ◽  
Paul Olowoyo ◽  
...  
Keyword(s):  
Stroke Prevention ◽  
High Income ◽  
Evidence Based ◽  
Vascular Risk ◽  
Eligibility Criteria ◽  
Middle Income ◽  
Middle Income Countries ◽  
Prevention Guideline ◽  
Prevention Guidelines ◽  
Low And Middle Income

Introduction: Implementation of contextually appropriate, evidence-based, expert-recommended stroke prevention guideline is particularly important in Low- and Middle-Income Countries (LMICs), which bear disproportional larger burden of stroke while possessing fewer resources. Focus therefore, should be on approaches enabling healthcare systems to improve control of vascular risk factors. Objective: We aimed to compare important features of stroke prevention guidelines between LMICs and High Income Countries (HICs). Methods: We systematically searched PubMed, AJOL, SciELO, and LILACS databases for stroke prevention guidelines published between January 2005 and December 2015 by country. Primary search items included: “Stroke” and “Guidelines”. We critically appraised the articles for evidence level, issuance frequency and implementation aspects to clinical practice. Results: Among 45 stroke prevention guidelines published, 28 (62%) met eligibility criteria: 7 from LMICs (25%) and 21 from HICs (75%). LMIC-issued guidelines were less likely to have conflict of interest declarations (57% vs. 100%, p=0.01), involve high quality systematic reviews (57% vs. 95%, p= 0.03), had good dissemination channels (14% vs 71%, p=0.02). The patient views and preferences were the most significant stakeholder considerations in HICs (43%, p=0.04) compared with LMICs. Conclusion: The quality and quantity of stroke prevention guidelines in LMICs are less than those of HICs and need to be significantly improved upon.

scholarly journals Effective Strategies for Global Health Training Programs A Systematic Review of Training Outcomes in Low and Middle Income Countries

2016 ◽  
Vol 8 (11) ◽  
pp. 278 ◽  
Author(s):  
Aprill Z. Dawson ◽  
Rebekah J. Walker ◽  
Jennifer A. Campbell ◽  
Leonard E. Egede
Keyword(s):  
Medical Training ◽  
Skills Training ◽  
High Income ◽  
Training Methods ◽  
Middle Income ◽  
Training Outcomes ◽  
Effective Strategies ◽  
Middle Income Countries ◽  
Low Middle Income Countries ◽  
Low And Middle Income

<p><strong>INTRODUCTION: </strong>Low and middle-income countries face a continued burden of chronic illness and non-communicable diseases while continuing to show very low health worker utilization. With limited numbers of medical schools and a workforce shortage the poor health outcomes seen in many low and middle income countries are compounded by a lack of within country medical training.</p><p><strong>METHODS: </strong>Using a systematic approach, this paper reviews the existing literature on training outcomes in low and middle-income countries in order to identify effective strategies for implementation in the developing world. This review examined training provided by high-income countries to low- and middle-income countries.</p><p><strong>RESULTS: </strong>Based on article eligibility, 24 articles were found to meet criteria. Training methods found include workshops, e-learning modules, hands-on skills training, group discussion, video sessions, and role-plays. Of the studies with statistically significant results training times varied from one day to three years. Studies using both face-to-face and video found statistically significant results.</p><p><strong>DISCUSSION:</strong> Based on the results of this review, health professionals from high-income countries should be encouraged to travel to low- middle-income countries to assist with providing training to health providers in those countries.</p>

scholarly journals Experiences of menstruation in high income countries: a systematic review, qualitative meta-synthesis and comparison to low- and middle-income countries

2021 ◽  
Author(s):  
Dani Jennifer Barrington ◽  
Hannah Robinson ◽  
Emily Wilson ◽  
Julie Hennegan
Keyword(s):  
Cultural Context ◽  
Research Policy ◽  
Integrated Model ◽  
High Income ◽  
Policy And Practice ◽  
Middle Income ◽  
Negative Experiences ◽  
Middle Income Countries ◽  
Protocol Registration ◽  
Low And Middle Income

Background: There is growing recognition of the importance of menstruation in achieving health, education, and gender equality for all. New policies in high income countries (HICs) have responded to anecdotal evidence that many struggle to meet their menstrual health needs. Qualitative research has explored lived experiences of menstruating in HICs and can inform intervention approaches. Methods and findings: Primary, qualitative studies capturing experiences of menstruation in HICs were eligible for inclusion. Systematic database and hand searching identified 11485 records. Following screening and quality appraisal using the EPPI-Centre checklist, 104 studies (120 publications) detailing the menstrual experiences of over 3800 individuals across sixteen countries were included. We used the integrated model of menstrual experiences developed from studies in low- and middle-income countries (LMICs) as a starting framework and deductively and inductively identified antecedents contributing to menstrual experiences; menstrual experiences themselves and impacts of menstrual experiences. Included studies described consistent themes and relationships that fit well with the LMIC integrated model, with modifications to themes and model pathways identified through our analysis. The socio-cultural context heavily shaped menstrual experiences, manifesting in strict behavioural expectations to conceal menstruation and limiting the provision of menstrual materials. Resource limitations contributed to negative experiences, where dissatisfaction with menstrual practices and management environments were expressed along with feelings of disgust if participants felt they failed to manage their menstruation in a discrete, hygienic way. Physical menstrual factors such as pain were commonly associated with negative experiences, with mixed experiences of healthcare reported. Across studies participants described negative impacts of their menstrual experience including increased mental burden and detrimental impacts on participation and personal relationships. Positive experiences were more rarely reported, although relationships between cis-women were sometimes strengthened by shared experiences of menstrual bleeding. Included studies reflected a broad range of disciplines and epistemologies. Many aimed to understand the constructed meanings of menstruation, but few were explicitly designed to inform policy or practice. Few studies focused on socioeconomically disadvantaged groups relevant to new policy efforts.Conclusions: We developed an integrated model of menstrual experience in HICs which can be used to inform research, policy and practice decisions by emphasising the pathways through which positive and negative menstrual experiences manifestReview protocol registration: The review protocol registration is PROSPERO: CRD42019157618.

scholarly journals Capital account opening and economic growth——an empirical test based on systematic GMM

2021 ◽  
Vol 235 ◽  
pp. 01019
Author(s):  
Siming Jia
Keyword(s):  
Economic Growth ◽  
Empirical Test ◽  
Statistical Significance ◽  
High Income ◽  
Capital Account ◽  
Middle Income ◽  
Middle Income Countries ◽  
National Differences ◽  
The Impact ◽  
Low And Middle Income

This paper collected panel data of 74 countries from 1990 to 2017, and based on the Chinn-It index to depict the degree of capital account opening. Under the framework of the neoclassical economic growth model, the impact of capital account opening on economic growth was empirically tested by systematic GMM. The results show that: first, taking the overall capital account openness as the explanatory variable, the coefficient of the capital account openness of the whole sample is significantly positive. Further, considering the national differences found that high income countries capital account openness coefficient is significantly positive, but in low and middle-income countries capital account openness coefficient on economic and statistical significance were not significant, indicating that high income countries made open dividends, while in low and middle-income countries and earnings in the capital account liberalization. Finally, it proposes to open the capital account sub-projects step by step, strengthen prudent supervision in the process of further opening the capital account, and improve the regulatory legal system.

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