scholarly journals 230. Molecular Typing of Streptococcus pyogenes Isolates Collected at Mongolian Hospital (Ulaanbaatar, Mongolia)

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S132-S133
Author(s):  
Dipendra Thapaliya ◽  
Samantha Mackey ◽  
Jhalka Kadariya ◽  
Bulgan Davaadash ◽  
Tara Smith
Keyword(s):  
Streptococcus Pyogenes ◽  
Low Income ◽  
Antibiotic Susceptibility ◽  
Vaccine Development ◽  
Treatment Strategies ◽  
The United States ◽  
Low Income Countries ◽  
Molecular Characteristics ◽  
Reference Laboratory ◽  
Emm Type

Abstract Background Streptococcus pyogenes is a significant cause of morbidity and mortality worldwide causing an estimated 1.8 million cases and 517,000 deaths each year. S. pyogenes infections disproportionately affect low-income countries where routine surveillance is not available. The objective of this study was to investigate the molecular epidemiology and antibiotic resistance of clinically relevant S. pyogenes isolates in Ulaanbaatar, Mongolia, to better understand the burden in this under-served population. Methods Clinical S. pyogenes isolates (n = 41) collected at the Bacteriological Reference Laboratory, National Center for Communicable Diseases, Ulaanbaatar, Mongolia, were cultured and characterized using PCR techniques. The emm gene was sequenced and emm type was assigned as per Centers for Disease Control and Prevention (CDC) methods and guideline. Multi-locus sequence typing (MLST) was carried out on selected isolates (n = 15). Antibiotic susceptibility testing (AST) was done via the Vitek-2 system as per manufacturer’s instructions. Results We observed 18 distinct emm types among the 41 S. pyogenes isolates. stG6792.0 was the most common emm type, accounting for more than one-third of the isolates (15/41) followed by emm2.0 (ST55) (5/41) and emm 82.0 (ST314) (2/41). A total of seven sequence types (STs) were detected among 15 tested isolates. The most common ST type was ST55 accounting for one-third of the isolates (5/15). Most of the isolates were susceptible to all tested drugs. Conclusion The findings of this study provided some insights regarding the molecular characteristics of S. pyogenes in Mongolia that will be crucial for future surveillance studies. Five isolates of this study had similar emm types (emm74.0, emm66.0, stG480.0, emm83.1, emm89.0) compared with a previous surveillance study. emm89.0 (ST101) was a major epidemiological isolate in the United States between 2000 and 2004. emm89.0 was also implicated with a recent single-clone outbreak in China. This information suggests the possibility of a shifting epidemiological trend of S. pyogenes on the global stage. The information about antibiotic susceptibility patterns and molecular types can help to devise better treatment strategies for S. pyogenes infections, and potentially inform vaccine development. Disclosures All authors: No reported disclosures.

scholarly journals Satisfaction with health care system: A comparative study between market-based insurance model of the United States and “out-of-pocket” model in developing and low-income countries

2020 ◽  
Vol 6 (1) ◽  
pp. 41
Author(s):  
Ram Lakhan ◽  
Sean Y. Gillette ◽  
Sean Lee ◽  
Manoj Sharma
Keyword(s):  
United States ◽  
Health Care ◽  
Health Care System ◽  
Undergraduate Students ◽  
Low Income ◽  
Access To Health Care ◽  
The United States ◽  
Low Income Countries ◽  
Healthcare Needs ◽  
Care System

Background and purpose: Access to healthcare services is an essential component for ensuring the quality of life. Globally, there is inequity and disparities regarding access to health care. To meet the global healthcare needs, different models of healthcare have been adopted around the world. However, all healthcare models have some strengths and weaknesses. The purpose of this study was to examine the satisfaction among a group of undergraduate students from different countries with their health care models namely, insurance-based model in the United States and “out-of-pocket” model prevalent in low-income countries.Methods and materials: The study utilized a cross-sectional research design. Undergraduate students, representing different nationalities from a private Southeastern College, were administered a researcher-designed 14-item self-reported electronic questionnaire. Independent t-test and χ2 statistics were used to examine the differences between two health care systems and the qualitative responses were analyzed thematically.Results: Satisfaction towards health care system between the United States and low-income countries was found significantly different (p < .05). However, students in both settings experienced an inability toward affording quality healthcare due to economic factors and disparities.Conclusions: There is dissatisfaction with health care both in the United States and low-income developing countries among a sample of undergraduate students representing these countries. Efforts to ensure low-cost affordable health care should be a global goal.

scholarly journals Hypertensive Urgency in Tanzanian Adults: A 1-Year Prospective Study

2020 ◽  
Author(s):  
Karl G Reis ◽  
Raymond Wilson ◽  
Fredrick Kalokola ◽  
Bahati Wajanga ◽  
Myung-Hee Lee ◽  
...  
Keyword(s):  
Medication Adherence ◽  
High Risk ◽  
Prospective Study ◽  
Low Income ◽  
Hypertensive Crisis ◽  
The United States ◽  
Low Income Countries ◽  
Improve Medication Adherence ◽  
Hypertensive Urgency ◽  
Poor Outcomes

Abstract BACKGROUND Hypertensive urgency is associated with a high risk for cardiovascular events and mortality in the United States and Europe, but data from low-income countries and interventions to improve outcomes are lacking. METHODS We conducted a 1-year prospective study of the prevalence and outcomes of hypertensive urgency (blood pressure (BP) ≥180 mm Hg/120 mm Hg without end-organ damage) in a busy outpatient clinic in Tanzania. RESULTS Of 7,600 consecutive adult outpatients screened with 3 unattended automated BP measurements according to standard protocol, the prevalence of hypertensive crisis was 199/7,600 (2.6%) (BP ≥180 mm Hg/120 mm Hg) and the prevalence of hypertensive urgency was 164/7,600 (2.2%). Among 150 enrolled patients with hypertensive urgency, median age was 62 years (54–68), 101 (67.3%) were women, and 53 (35%) were either hospitalized or died within 1 year. In a multivariate model, the strongest predictor of hospitalization/death was self-reported medication adherence on a 3 question scale (hazard ratio: 0.06, P &lt; 0.001); 90% of participants with poor adherence were hospitalized or died within 1 year. CONCLUSIONS Patients with hypertensive urgency in Africa are at high risk of poor outcomes. Clinicians can identify the patients at highest risk for poor outcomes with simple questions related treatment adherence. New interventions are needed to improve medication adherence in patients with hypertensive urgency.

scholarly journals Multivalue ethical framework for fair global allocation of a COVID-19 vaccine

2020 ◽  
Vol 46 (8) ◽  
pp. 499-501 ◽  
Author(s):  
Yangzi Liu ◽  
Sanjana Salwi ◽  
Brian C Drolet
Keyword(s):  
Low Income ◽  
Vaccine Development ◽  
Ethical Framework ◽  
Low Income Countries ◽  
Ethical Considerations ◽  
Allocation Model ◽  
Public And Private ◽  
Successful Vaccine ◽  
Global Access ◽  
Pandemic Vaccine

The urgent drive for vaccine development in the midst of the current COVID-19 pandemic has prompted public and private organisations to invest heavily in research and development of a COVID-19 vaccine. Organisations globally have affirmed the commitment of fair global access, but the means by which a successful vaccine can be mass produced and equitably distributed remains notably unanswered. Barriers for low-income countries include the inability to afford vaccines as well as inadequate resources to vaccinate, barriers that are exacerbated during a pandemic. Fair distribution of a pandemic vaccine is unlikely without a solid ethical framework for allocation. This piece analyses four allocation paradigms: ability to develop or purchase; reciprocity; ability to implement; and distributive justice, and synthesises their ethical considerations to develop an allocation model to fit the COVID-19 pandemic.

Immigration and Contract Problems Experienced by Foreign-Educated Nurses

2012 ◽  
Vol 69 (3) ◽  
pp. 351-365 ◽  
Author(s):  
Patricia Pittman ◽  
Carolina Herrera ◽  
Joanne Spetz ◽  
Catherine R. Davis
Keyword(s):  
United States ◽  
Health Care ◽  
Low Income ◽  
The United States ◽  
Low Income Countries ◽  
Labor Rights ◽  
Care Practice ◽  
Quality Health Care ◽  
International Recruitment ◽  
The Impact

More than 8% of employed RNs licensed since 2004 in the United States were educated overseas, yet little is known about the conditions of their recruitment or the impact of that experience on health care practice. This study assessed whether the labor rights of foreign-educated nurses were at risk during the latest period of high international recruitment: 2003 to 2007. Using consensus-based standards contained in the Voluntary Code of Ethical Conduct for the Recruitment of Foreign-Educated Health Professionals to the United States, this study found 50% of actively recruited foreign-educated nurses experienced a negative recruitment practice. The study also found that nurses educated in low-income countries and nurses with high contract breach fees, were significantly more likely to report such problems. If, as experts believe may occur, the nursing shortage in the United States returns around 2014, oversight of international recruitment will become critically important to delivering high-quality health care to Americans.

scholarly journals Disease burden and associated risk factors for metabolic syndrome among adults in Ethiopia

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Samrawit Solomon ◽  
Wudeneh Mulugeta
Keyword(s):  
Risk Factors ◽  
Metabolic Syndrome ◽  
Low Income ◽  
Disease Burden ◽  
Addis Ababa ◽  
Treatment Strategies ◽  
Density Lipoprotein ◽  
World Health ◽  
Low Income Countries ◽  
Cross Sectional

Abstract Background Metabolic Syndrome (MetS) and Non-communicable diseases (NCDs) are alarmingly increasing in low-income countries. Yet, very limited is known about the prevalence and risk factors associated with MetS in Ethiopia. Methods A cross-sectional study was conducted among adult outpatients (N = 325) at St. Paul’s Hospital Millennium Medical College in Addis Ababa, Ethiopia. The study was conducted in accordance with STEPwise approach of the World Health Organization. MetS was defined using modified National Cholesterol Education Program’s Adult Treatment Panel III criteria. Univariate and multivariate analyses were performed. Results The overall prevalence of MetS was 20.3%. Among the 325 participants, 76.9% had at least one MetS components. Reduced high-density lipoprotein cholesterol was the most common MetS component at 48.6%, followed by elevated blood pressure at 36.3%, and elevated fasting glucose at 32.6%. Older age (odds ratio [OR] = 4.15; 95% confidence interval [CI] = 1.43–12.04), Amhara ethnicity (OR = 2.36; 95%CI = 1.14–4.88), overweight status (OR = 2.21; 95%CI = 1.03–4.71), higher income (OR = 3.31; 95%CI = 1.11–9.84) and higher education levels (OR = 2.19; 95%CI = 1.05–4.59) were risk factors for MetS. Conclusion The disease burden of MetS among Ethiopians is high, and is associated with age, weight, income, education and ethnicity. Comprehensive screening and assessment of MetS is needed along with effective preventive and treatment strategies in low-income countries, such as Ethiopia.

scholarly journals Article processing charges, the geographic diversity of author communities, and barriers to publication for authors in the Global South

2020 ◽  
Author(s):  
Audrey Culver Smith ◽  
Leandra Merz ◽  
Jesse B. Borden ◽  
Chris Gulick ◽  
Akhil Ravindra Kshirsagar ◽  
...  
Keyword(s):  
Low Income ◽  
United States Of America ◽  
The United States ◽  
Global South ◽  
Low Income Countries ◽  
Editorial Boards ◽  
Geographic Diversity ◽  
The Usa ◽  
Article Processing Charges ◽  
The Relationship

Many OA journals require authors pay an article processing charge (APC), which researchers in the Global South often cite as an insurmountable financial barrier. This has led to speculation that there will be lower representation of these authors in OA journals charging APCs. We used “mirror journals” – APC-charging OA versions of paywalled (PW) titles with whom they share editorial boards and standards for acceptance – to investigate the relationship between APCs and the geographic diversity of authors. Most of the &gt;41,000 articles we reviewed were published in PW journals. Although lead authors were based in &gt;140 countries, ~45% were based in either the United States of America (USA) or China. After correcting for differences in sample size, we found no difference between OA and PW journals in the number of countries in which lead authors were based. After correcting for the dominance of China and the USA, we found that author diversity in OA journals was significantly lower than in PW journals. Most OA articles were written by authors in high-income countries; no articles in OA journals had first authors from low-income countries. Our results suggest APCs are a barrier to OA publication for scientists from the Global South.

scholarly journals Micronutrients - a Global Perspective on Intake, Health Benefits and Economics

2012 ◽  
Vol 82 (5) ◽  
pp. 316-320 ◽  
Author(s):  
Birgit Hoeft ◽  
Peter Weber ◽  
Manfred Eggersdorfer
Keyword(s):  
Low Income ◽  
Health Care Systems ◽  
The Elderly ◽  
The United States ◽  
Global Perspective ◽  
Low Income Countries ◽  
Micronutrient Deficiencies ◽  
Micronutrient Status ◽  
Care Systems ◽  
Development And Aging

The link between a sufficient intake of vitamins and long term health, cognition, healthy development and aging is increasingly supported by experimental animal, human and epidemiology studies. In low income countries billions of people still suffer from the burden of malnutrition and micronutrient deficiencies. However, inadequate micronutrient status might also be an issue in industrialized countries. Recent results from nutritional surveys in countries like the United States, Germany, and Great Britain indicate that the recommended intake of micronutrients is not reached. This notably concerns certain vulnerable population groups, such as pregnant women, young children and the elderly, but also greatly influences the general healthcare costs. An overview is provided on the gap that exists between current vitamin intakes and requirements, even in countries where diverse foods are plentiful. Folic acid and vitamin D intake and status are evaluated in more detail, providing insight on health and potential impact on health care systems.

Scalable Obesity Solutions (S.O.S.)

2010 ◽  
Vol 7 (s3) ◽  
pp. S307-S312 ◽  
Author(s):  
James A. Levine
Keyword(s):  
Health Care ◽  
Low Income ◽  
Medication Use ◽  
Developed Countries ◽  
The United States ◽  
Low Income Countries ◽  
Direct Response ◽  
Obesity Epidemic ◽  
Know How ◽  
Care Costs

The know-how is available to reverse the obesity epidemic. Reversing obesity is a societal necessity because it is the predominant contributor to chronic ill health in developed countries and a growing precipitant of illness in middle and low-income countries. In the United States, for example, obesity is the chief driver of health care costs in a country that can no longer afford health care. Although some might advocate population-wide medication use to mitigate the effects of obesity on health, the more direct response is to end obesity. The goal of this paper is explain how mass-scalable obesity containment can be designed, built, and disseminated. Scalable Obesity Solutions (S.O.S.) are discussed from concept through deployment.

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