Definitions, Classification, and Epidemiology of Intellectual Disability

2020 ◽  
pp. 1-6
Author(s):  
Sally-Ann Cooper
Keyword(s):  
Intellectual Disability ◽  
Low Income ◽  
Adaptive Functioning ◽  
Meta Analysis ◽  
Low Income Countries ◽  
Social Construct ◽  
The Core ◽  
Severe Intellectual Disability ◽  
Considerable Complexity ◽  
Over Time

Intellectual disability is a social construct rather than a purely statistical construct, with the core features being (i) impaired intelligence more than two standard deviations from the population mean, (ii) impaired adaptive functioning, along with (iii) onset during childhood/youth. The majority of people with intellectual impairments have mild intellectual impairments (6 mild:1 moderate-profound impairments), and the majority with intellectual impairments in whom this is disabling have mild rather than severe intellectual disability (ID). There is considerable complexity in interpreting findings from studies and meta-analysis on prevalence of ID, but it appears that in high-income countries, about 5/1,000 adults have ID, falling to about 2/1,000 over the age of 65 years. Prevalence is higher in children and young people, boys/men (about 58%), and in low-income countries (though it may be less disabling in less technology-driven communities). For complex reasons, prevalence varies with geography, and over time.

scholarly journals Birth weight and adult earnings: a systematic review and meta-analysis

2021 ◽  
pp. 1-8
Author(s):  
Mark J. Lambiris ◽  
Mia M. Blakstad ◽  
Nandita Perumal ◽  
Goodarz Danaei ◽  
Lilia Bliznashka ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Income ◽  
Meta Analysis ◽  
Biomedical Literature ◽  
Economic Outcomes ◽  
Childhood Development ◽  
Low Income Countries ◽  
Standard Deviation Increase ◽  
Beneficial Effects ◽  
Adult Earnings

Abstract While substantial evidence has identified low birth weight (LBW; <2500 g) as a risk factor for early life morbidity, mortality and poor childhood development, relatively little is known on the links between birth weight and economic outcomes in adulthood. The objective of this study was to systematically review the economics (EconLit) and biomedical literature (Medline) and estimate the pooled association between birth weight and adult earnings. A total of 15 studies from mostly high-income countries were included. On average, each standard deviation increase in birth weight was associated with a 2.75% increase in annual earnings [(95% CI: 1.44 to 4.07); 9 estimates]. A negative, but not statistically significant, association was found between being born LBW and earnings, compared to individuals not born LBW [mean difference: −3.41% (95% CI: −7.55 to 0.73); 7 estimates]. No studies from low-income countries were identified and all studies were observational. Overall, birth weight was consistently associated with adult earnings, and therefore, interventions that improve birth weight may provide beneficial effects on adult economic outcomes.

scholarly journals Clinical effectiveness of drugs in hospitalized patients with COVID-19 infection: a systematic review and meta-analysis.

2020 ◽  
Author(s):  
Roberto Ariel Abeldano Zuniga ◽  
Silvia Coca ◽  
Giuliana Abeldano ◽  
Ruth Ana Maria Gonzalez Villoria
Keyword(s):  
Systematic Review ◽  
Clinical Improvement ◽  
Low Income ◽  
Randomized Clinical Trials ◽  
Data Extraction ◽  
Meta Analysis ◽  
Clinical Effectiveness ◽  
Hospitalized Patients ◽  
Low Income Countries ◽  
Qualitative Synthesis

Objective. The aim was to assess the clinical effectiveness of drugs used in hospitalized patients with COVID-19 infection. Method. We conducted a systematic review of randomized clinical trials assessing treatment with remdesivir, chloroquine, hydroxychloroquine, lopinavir, ritonavir, dexamethasone, and convalescent plasma, for hospitalized patients with a diagnosis of SARS-CoV-2 infection. The outcomes were mortality, clinical improvement, duration of ventilation, duration of oxygen support, duration of hospitalization), virological clearance, and severe adverse events. Results. A total of 48 studies were retrieved from the databases. Ten articles were finally included in the data extraction and qualitative synthesis of results. The meta-analysis suggests a benefit of dexamethasone versus standard care in the reduction of risk of mortality at day 28; and the clinical improvement at days 14 and 28 in patients treated with remdesivir. Conclusions. Dexamethasone would have a better result in hospitalized patients, especially in low-resources settings. Significance of results. The analysis of the main treatments proposed for hospitalized patients is of vital importance to reduce mortality in low-income countries; since the COVID-19 pandemic had an economic impact worldwide with the loss of jobs and economic decline in countries with scarce resources. Keywords: Drugs; Antivirals; Clinical improvement; Mortality; COVID-19; SARS-CoV2.

Modification of Access Policies for the Poverty Reduction and Growth Facility and the Exogenous Shocks Facility

Policy Papers ◽  
2009 ◽  
Vol 09 ◽  
Author(s):  
Keyword(s):  
Low Income ◽  
Poverty Reduction ◽  
Low Income Countries ◽  
Economic Downturn ◽  
Medium Term ◽  
Exogenous Shocks ◽  
World Economic ◽  
Access Policies ◽  
Over Time

The paper proposes a doubling of access limits on concessional lending to ensure that the Fund can respond effectively to the needs of low-income countries (LICs) severely affected by the current world economic downturn. Pending adoption of broader reforms to the LIC facilities architecture, higher access limits under the Poverty Reduction and Growth Facility (PRGF) and Exogenous Shocks Facility-High-Access Component (ESF-HAC) would give the Fund greater flexibility in assisting LICs, which have become more exposed to global volatility over time. A doubling of access limits would restore them to their 1998 levels in percent of GDP and would be consistent with the approach taken in determining new access limits for General Resources Account (GRA) resources. It would also be in line with the projected doubling of medium-term demand for concessional resources.

scholarly journals Global epidemiology of COVID-19 knowledge, attitude and practice: a systematic review and meta-analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e051447
Author(s):  
Bodrun Naher Siddiquea ◽  
Aishwarya Shetty ◽  
Oashe Bhattacharya ◽  
Afsana Afroz ◽  
Baki Billah
Keyword(s):  
Systematic Review ◽  
General Population ◽  
Low Income ◽  
Meta Analysis ◽  
Good Practice ◽  
Low Income Countries ◽  
Middle Income ◽  
Attitude And Practice ◽  
Global Epidemiology ◽  
Knowledge Attitude And Practice

ObjectiveTo assess the knowledge, attitude and practice (KAP) of the global general population regarding COVID-19.DesignSystematic review and meta-analysis.MethodsMEDLINE, Embase, CINAHL and PsycINFO were used to identify articles published between 1 January and 30 June 2021 assessing KAP regarding COVID-19 in the global general population. The quality of eligible studies was assessed. Random effects model was used to obtain the pooled proportion of each component of KAP of COVID-19. Heterogeneity (I2) was tested, and subgroup and correlation analyses were performed.ResultsOut of 3099 records, 84 studies from 45 countries across all continents assessing 215 731 participants’ COVID-19 KAP were included in this study. The estimated overall correct answers for knowledge, good attitude and good practice in this review were 75% (95% CI 72% to 77%), 74% (95% CI 71% to 77%) and 70% (95% CI 66% to 74%), respectively. Low-income countries, men, people aged below 30 years and people with 12 years of education or less had the lowest practice scores. Practice scores were below 60% in Africa and Europe/Oceania. Overall heterogeneity was high (I2 ≥98%), and publication bias was present (Egger’s regression test, p<0.01). A positive significant correlation between knowledge and practice (r=0.314, p=0.006), and attitude and practice (r=0.348, p=0.004) was observed.ConclusionsThis study’s findings call for community-based awareness programmes to provide a simple, clear and understandable message to reinforce knowledge especially regarding efficacy of the preventive measures in low and lower middle-income countries, and in Africa and Europe/Oceania, which will translate into good practice. Targeted intervention for men, people with low education, unemployed people and people aged below 30 years should be recommended. As most of the included studies were online surveys, underprivileged and remote rural people may have been missed out. Additional studies are needed to cover heterogeneous populations.PROSPERO registration numberCRD42020203476.

scholarly journals Prevalence of frailty and prefrailty among community-dwelling older adults in low-income and middle-income countries: a systematic review and meta-analysis

BMJ Open ◽  
2018 ◽  
Vol 8 (3) ◽  
pp. e018195 ◽  
Author(s):  
Dhammika D Siriwardhana ◽  
Sarah Hardoon ◽  
Greta Rait ◽  
Manuj C Weerasinghe ◽  
Kate R Walters
Keyword(s):  
Older Adults ◽  
Low Income ◽  
Meta Analysis ◽  
Community Dwelling ◽  
Low Income Countries ◽  
Middle Income ◽  
Middle Income Countries ◽  
Pooled Prevalence ◽  
Registration Number ◽  
Community Dwelling Older Adults

ObjectiveTo systematically review the research conducted on prevalence of frailty and prefrailty among community-dwelling older adults in low-income and middle-income countries (LMICs) and to estimate the pooled prevalence of frailty and prefrailty in community-dwelling older adults in LMICs.DesignSystematic review and meta-analysis. PROSPERO registration number is CRD42016036083.Data sourcesMEDLINE, EMBASE, AMED, Web of Science, CINAHL and WHO Global Health Library were searched from their inception to 12 September 2017.SettingLow-income and middle-income countries.ParticipantsCommunity-dwelling older adults aged ≥60 years.ResultsWe screened 7057 citations and 56 studies were included. Forty-seven and 42 studies were included in the frailty and prefrailty meta-analysis, respectively. The majority of studies were from upper middle-income countries. One study was available from low-income countries. The prevalence of frailty varied from 3.9% (China) to 51.4% (Cuba) and prevalence of prefrailty ranged from 13.4% (Tanzania) to 71.6% (Brazil). The pooled prevalence of frailty was 17.4% (95% CI 14.4% to 20.7%, I2=99.2%) and prefrailty was 49.3% (95% CI 46.4% to 52.2%, I2=97.5%). The wide variation in prevalence rates across studies was largely explained by differences in frailty assessment method and the geographic region. These findings are for the studies with a minimum recruitment age 60, 65 and 70 years.ConclusionThe prevalence of frailty and prefrailty appears higher in community-dwelling older adults in upper middle-income countries compared with high-income countries, which has important implications for healthcare planning. There is limited evidence on frailty prevalence in lower middle-income and low-income countries.PROSPERO registration numberCRD42016036083.

Review of the Debt Sustainability Framework for Low Income Countries

Policy Papers ◽  
2017 ◽  
Vol 17 ◽  
Author(s):  
Keyword(s):  
Low Income ◽  
Stress Test ◽  
External Debt ◽  
Low Income Countries ◽  
Debt Sustainability ◽  
Debt Burden ◽  
The Core ◽  
Sustainability Framework ◽  
Test Scenarios ◽  
Capacity Estimates

The Debt Sustainability Framework for Low-income Countries (LIC DSF) has been the cornerstone of assessments of risks to debt sustainability in LICs. The framework classifies countries based on their assessed debt-carrying capacity, estimates threshold levels for selected debt burden indicators, evaluates baseline projections and stress test scenarios relative to these thresholds, and then combines indicative rules and staff judgment to assign risk ratings of external debt distress. The framework has demonstrated its operational value since the last review was conducted in 2012, but there are areas where new features can be introduced to enhance its performance in assessing risks. Against the backdrop of the evolving nature of risks facing LICs, both staff analysis and stakeholder feedback suggest gaps in the framework to be addressed. Complexity and lack of transparency have also been highlighted as causes for concern. This paper proposes a set of reforms to enhance the value of the LIC DSF for all users. In developing these reforms, staff has been guided by two over-arching principles: a) the core architecture of the DSF—model-based results complemented by judgment—remains appropriate; and b) reforms should ensure that the DSF maintains an appropriate balance by providing countries with early warnings of potential debt distress without unnecessarily constraining their borrowing for development.

scholarly journals Perioperative mortality rates in low-income and middle-income countries: a systematic review and meta-analysis

2018 ◽  
Vol 3 (3) ◽  
pp. e000810 ◽  
Author(s):  
Joshua S Ng-Kamstra ◽  
Sumedha Arya ◽  
Sarah L M Greenberg ◽  
Meera Kotagal ◽  
Catherine Arsenault ◽  
...  
Keyword(s):  
Systematic Review ◽  
Surgical Procedures ◽  
Low Income ◽  
Meta Analysis ◽  
Surgical Care ◽  
Low Income Countries ◽  
Perioperative Mortality ◽  
Middle Income ◽  
Middle Income Countries ◽  
Wide Range

IntroductionThe Lancet Commission on Global Surgery proposed the perioperative mortality rate (POMR) as one of the six key indicators of the strength of a country’s surgical system. Despite its widespread use in high-income settings, few studies have described procedure-specific POMR across low-income and middle-income countries (LMICs). We aimed to estimate POMR across a wide range of surgical procedures in LMICs. We also describe how POMR is defined and reported in the LMIC literature to provide recommendations for future monitoring in resource-constrained settings.MethodsWe did a systematic review of studies from LMICs published from 2009 to 2014 reporting POMR for any surgical procedure. We extracted select variables in duplicate from each included study and pooled estimates of POMR by type of procedure using random-effects meta-analysis of proportions and the Freeman-Tukey double arcsine transformation to stabilise variances.ResultsWe included 985 studies conducted across 83 LMICs, covering 191 types of surgical procedures performed on 1 020 869 patients. Pooled POMR ranged from less than 0.1% for appendectomy, cholecystectomy and caesarean delivery to 20%–27% for typhoid intestinal perforation, intracranial haemorrhage and operative head injury. We found no consistent associations between procedure-specific POMR and Human Development Index (HDI) or income-group apart from emergency peripartum hysterectomy POMR, which appeared higher in low-income countries. Inpatient mortality was the most commonly used definition, though only 46.2% of studies explicitly defined the time frame during which deaths accrued.ConclusionsEfforts to improve access to surgical care in LMICs should be accompanied by investment in improving the quality and safety of care. To improve the usefulness of POMR as a safety benchmark, standard reporting items should be included with any POMR estimate. Choosing a basket of procedures for which POMR is tracked may offer institutions and countries the standardisation required to meaningfully compare surgical outcomes across contexts and improve population health outcomes.

scholarly journals Tracking the effects of COVID-19 in rural China over time

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Huan Wang ◽  
Markus Zhang ◽  
Robin Li ◽  
Oliver Zhong ◽  
Hannah Johnstone ◽  
...  
Keyword(s):  
Health Care ◽  
Rural Communities ◽  
Low Income ◽  
Negative Impact ◽  
Rural China ◽  
Control Measures ◽  
Low Income Countries ◽  
Rural Villages ◽  
Government Aid ◽  
Over Time

Abstract Background China issued strict nationwide guidelines to combat the COVID-19 outbreak in January 2020 and gradually loosened the restrictions on movement in early March. Little is known about how these disease control measures affected the 600 million people who live in rural China. The goal of this paper is to document the quarantine measures implemented in rural China outside the epicenter of Hubei Province and to assess the socioeconomic effect of the measures on rural communities over time. Methods We conducted three rounds of interviews with informants from 726 villages in seven provinces, accounting for over 25% of China’s overall rural population. The survey collected data on rural quarantine implementation; COVID-19 infections and deaths in the survey villages; and effects of the quarantine on employment, income, education, health care, and government policies to address any negative impacts. The empirical findings of the work established that strict quarantine measures were implemented in rural villages throughout China in February. Results There was little spread of COVID-19 in rural communities: an infection rate of 0.001% and zero deaths reported in our sample. However, there were negative social and economic outcomes, including high rates of unemployment, falling household income, rising prices, and disrupted student learning. Health care was generally accessible, but many delayed their non-COVID-19 health care due to the quarantine measures. Only 20% of villagers received any form of local government aid, and only 11% of villages received financial subsidies. There were no reports of national government aid programs that targeted rural villagers in the sample areas. Conclusions By examining the economic and social effects of the COVID-19 restrictions in rural communities, this study will help to guide other middle- and low-income countries in their containment and restorative processes. Without consideration for economically vulnerable populations, economic hardships and poverty will likely continue to have a negative impact on the most susceptible communities.

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