Current control strategies for infectious diseases in low-income countries

Author(s):  
Fréric Pagè ◽  
Dominique Maison ◽  
Michael Faulde

The burden of communicable diseases is ten times higher in low- and middle-income countries (LMICs) in terms of mortality rate and of years of life lost. Most of the LMCIs are in tropical or subtropical areas with vector-favorable climate conditions and poverty impeding access to improved water supply, sanitation, and efficient health care coverage. Public health strategies to control infectious diseases can be sorted by prevention level. Infectious diseases control strategies often combine actions from different prevention levels according to the stage of a disease. At the individual level, actions and interventions are succeeding in a logical cascade following the stage of the disease as community-level actions are implemented. We present strategies that have been implemented to control infectious diseases, their limits and the needs to attain successful control of infectious diseases in LMICs.

Author(s):  
Benjamin Roche ◽  
Thierry Baldet ◽  
Simard Frédéric

It is widely documented that infectious diseases have a very deep impact on numerous human populations. While public health campaigns have achieved spectacular successes, they do not appear to be evenly distributed throughout the world. Indeed, although many infectious diseases have been eliminated in the Western world, deadly pathogens are still spreading in many low-income countries. This chapter aims to describe the current epidemiological situations, reviewing control strategies and the progress that has been made in the fight against major human pathogens with the strongest impact in low-income countries. This chapter, therefore, introduces most of the pathogens that will be discussed in the book, and it describes why some epidemiological situations improved for some diseases more than for others.


2020 ◽  
Vol 11 (1) ◽  
Author(s):  
Santo Milasi

AbstractDespite the bulk of international migrants being youth, little is known about the factors driving young people’s migration behavior at the global level. Using the individual-level survey data from Gallup World Poll across 139 countries over the period 2010–2016, this study contributes to the literature by exploring a wide range of factors potentially shaping young people’s (aged 15–34) desire, and a more concrete plan, to migrate abroad permanently. Results show that factors, such as holding post-secondary education, being unemployed, and working part-time involuntary, are increasing the desire of youth to migrate abroad as well as the probability that they turn this aspiration into a more concrete plan over the following year. Similarly, having negative expectations about the economic outlook, the number of available job opportunities, and the prospects for upward career mobility are found to increase the propensity to migrate abroad, both among unemployed and employed youth. Results also show that material deprivation may represent a significant push factor behind youth migration, although budgetary constraints may prevent youth from transforming their migration desires into actual plans in low-income countries. Moreover, findings suggest that contextual factors, such as discontent with local amenities and national governments, increase the desire of youth to migrate abroad, but they have little or no influence on the probability that these dreams are turned into more concrete plans. Finally, this study shows that while youth’s and adults’ migration propensities are often driven by the same motives, the influence of education and labor market-related factors on migration intentions is considerably stronger among youth than adults.


Author(s):  
D. García ◽  
Francesco Alessandro Massucci ◽  
Alessandro Mosca ◽  
Ismael Ràfols ◽  
A. Rodríguez ◽  
...  

Study question: What are the current trends of research in Human Assisted Reproduction around the world? Summary answer: USA is the leading country, followed by the UK, China, France and Italy. The largest research area is “laboratory techniques”, although other areas such as “public health”, “quality, ethics and law” and “female factor” are gaining ground worldwide. What is known already: Scientific research, especially in health and medical sciences, aims at addressing specific needs that society (and, especially, patients) perceives as pressing. One of the main challenges for policymakers and research funders alike is therefore to align research priorities to societal needs. We can thus think of research agendas in terms of a demand side (societal needs) and a supply side (research outputs). Research output in Human Assisted Reproduction has expanded in the past years, as indicated by the increasing number of scientific publications in indexed journals in this area. Nevertheless, no map of research related to assisted reproduction has been produced so far, hindering the identification of potential areas of improvement and need. Study design, size, duration:  26,000+ scientific publications (articles, letters, and reviews) on Human Assisted Reproduction produced worldwide between 2005 and 2016 were analyzed. These publications were indexed in PubMed or obtained from reference list of indexed publications included in the analysis.Participants/materials, setting, methods: The corpus of publications was obtained by combining the MeSH terms: “Reproductive techniques”, “Reproductive medicine”, “Reproductive health”, “Fertility”, “Infertility”, and “Germ cells”. Then it was analyzed by means of text mining algorithms (Topic Modeling (TM) based on Latent Dirichlet Allocation (LDA)), in order to obtain the main topics of interest. Finally, these categories were analyzed across world regions and time. Main results and the role of chance:  We identified 44 main topics, which were further grouped in 11 macro categories, form larger to smaller: “laboratory techniques”, “male factor”, “quality, ethics and law”, “female factor”, “public health and infectious diseases”, “basic research and genetics”, “pregnancy complications and risks”, “general infertility and ART”, “psychosocial aspects”, “cancer”, and “research methodology”. The USA was the leading country in number of publications, followed by the UK, China, France and Italy. Interestingly, research contents in high income countries is fairly homogeneous across macro-categories, and it is dominated by “laboratory techniques” in Western and Southern Europe, and by “quality, ethics and law” in North America, Australia and New Zealand. In middle income countries we observe that research is mainly performed on “male factor”, and noticeably less on “female factor”. Finally, research on “public health and infectious diseases” predominates in low-income countries. Regarding temporal evolution of research, “laboratory techniques” is the most abundant topic on a yearly basis, and relatively constant over time. However, since production in most of the other categories is increasing, the relative contribution of this research category is actually decreasing. Publication is especially increasing in “public health and infectious diseases” (in all world regions, but especially in low income countries), “quality, ethics and law” (high income countries), and “female factor” (middle income countries). Limitations, reasons for caution: Three main factors might limit the robustness of our work: the textual corpus analyzed is based on abstract and titles, the reproducibility of the stochastic algorithms applied, which may produce slightly differing results at each run, and the interpretation of the topics obtained. Wider implications of the findings: This study should prove beneficial in the design of research strategies and policies that foster the alignment between supply (assisted reproduction research) and demand (society). Study funding/competing interest(s): PTQ-14-06718 of the Spanish MINECO Torres Quevedo programme (FAM).


Author(s):  
Brendon Stubbs ◽  
Kamran Siddiqi ◽  
Helen Elsey ◽  
Najma Siddiqi ◽  
Ruimin Ma ◽  
...  

Tuberculosis (TB) is a leading cause of mortality in low- and middle-income countries (LMICs). TB multimorbidity [TB and ≥1 non-communicable diseases (NCDs)] is common, but studies are sparse. Cross-sectional, community-based data including adults from 21 low-income countries and 27 middle-income countries were utilized from the World Health Survey. Associations between 9 NCDs and TB were assessed with multivariable logistic regression analysis. Years lived with disability (YLDs) were calculated using disability weights provided by the 2017 Global Burden of Disease Study. Eight out of 9 NCDs (all except visual impairment) were associated with TB (odds ratio (OR) ranging from 1.38–4.0). Prevalence of self-reported TB increased linearly with increasing numbers of NCDs. Compared to those with no NCDs, those who had 1, 2, 3, 4, and ≥5 NCDs had 2.61 (95% confidence interval (CI) = 2.14–3.22), 4.71 (95%CI = 3.67–6.11), 6.96 (95%CI = 4.95–9.87), 10.59 (95%CI = 7.10–15.80), and 19.89 (95%CI = 11.13–35.52) times higher odds for TB. Among those with TB, the most prevalent combinations of NCDs were angina and depression, followed by angina and arthritis. For people with TB, the YLDs were three times higher than in people without multimorbidity or TB, and a third of the YLDs were attributable to NCDs. Urgent research to understand, prevent and manage NCDs in people with TB in LMICs is needed.


2021 ◽  
Vol 6 (4) ◽  
pp. e004858
Author(s):  
Modhurima Moitra ◽  
Ian Cogswell ◽  
Emilie Maddison ◽  
Kyle Simpson ◽  
Hayley Stutzman ◽  
...  

IntroductionIn 2017, development assistance for health (DAH) comprised 5.3% of total health spending in low-income countries. Despite the key role DAH plays in global health-spending, little is known about the characteristics of assistance that may be associated with committed assistance that is actually disbursed. In this analysis, we examine associations between these characteristics and disbursement of committed assistance.MethodsWe extracted data from the Creditor Reporting System of the Organization for Economic Co-operation and Development, Institute for Health Metrics and Evaluation, and the WHO National Health Accounts database. Factors examined were off-budget assistance, administrative assistance, publicly sourced assistance and assistance to health systems strengthening. Recipient-country characteristics examined were perceived level of corruption, civil fragility and gross domestic product per capita (GDPpc). We used linear regression methods for panel of data to assess the proportion of committed aid that was disbursed for a given country-year, for each data source.ResultsFactors that were associated with a higher disbursement rates include off-budget aid (p<0.001), lower administrative expenses (p<0.01), lower perceived corruption in recipient country (p<0.001), lower fragility in recipient country (p<0.05) and higher GDPpc (p<0.05).ConclusionSubstantial gaps remain between commitments and disbursements. Characteristics of assistance (administrative, publicly sourced) and indicators of government transparency and fragility are also important drivers associated with disbursement of DAH. There remains a continued need for better aid flow reporting standards and clarity around aid types for better measurement of DAH.


2010 ◽  
Vol 2010 ◽  
pp. 1-5 ◽  
Author(s):  
Arafat Tfayli ◽  
Sally Temraz ◽  
Rachel Abou Mrad ◽  
Ali Shamseddine

Breast cancer is a major health care problem that affects more than one million women yearly. While it is traditionally thought of as a disease of the industrialized world, around 45% of breast cancer cases and 55% of breast cancer deaths occur in low and middle income countries. Managing breast cancer in low income countries poses a different set of challenges including access to screening, stage at presentation, adequacy of management and availability of therapeutic interventions. In this paper, we will review the challenges faced in the management of breast cancer in low and middle income countries.


2017 ◽  
Vol 102 (1) ◽  
pp. 9-13 ◽  
Author(s):  
Justin S Mora ◽  
Christopher Waite ◽  
Clare E Gilbert ◽  
Brenda Breidenstein ◽  
John J Sloper

BackgroundTo ascertain which countries in the world have retinopathy of prematurity (ROP) screening programmes and guidelines and how these were developed.MethodsAn email database was created and requests were sent to ophthalmologists in 141 nations to complete an online survey on ROP screening in their country.ResultsRepresentatives from 92/141 (65%) countries responded. 78/92 (85%) have existing ROP screening programmes, and 68/78 (88%) have defined screening criteria. Some countries have limited screening and those areas which have no screening or for which there is inadequate knowledge are mainly Southeast Asia, Africa and some former Soviet states.DiscussionWith the increasing survival of premature babies in lower-middle-income and low-income countries, it is important to ensure that adequate ROP screening and treatment is in place. This information will help organisations focus their resources on those areas most in need.


2018 ◽  
Vol 45 (4) ◽  
pp. E13 ◽  
Author(s):  
Michael C. Dewan ◽  
Ronnie E. Baticulon ◽  
Abbas Rattani ◽  
James M. Johnston ◽  
Benjamin C. Warf ◽  
...  

OBJECTIVEThe presence and capability of existing pediatric neurosurgical care worldwide is unknown. The objective of this study was to solicit the expertise of specialists to quantify the geographic representation of pediatric neurosurgeons, access to specialist care, and equipment and training needs globally.METHODSA mixed-question survey was sent to surgeon members of several international neurosurgical and general pediatric surgical societies via a web-based platform. Respondents answered questions on 5 categories: surgeon demographics and training, hospital and practice details, surgical workforce and access to neurosurgical care, training and equipment needs, and desire for international collaboration. Responses were anonymized and analyzed using Stata software.RESULTSA total of 459 surgeons from 76 countries responded. Pediatric neurosurgeons in high-income and upper-middle-income countries underwent formal pediatric training at a greater rate than surgeons in low- and lower-middle-income countries (89.5% vs 54.4%). There are an estimated 2297 pediatric neurosurgeons in practice globally, with 85.6% operating in high-income and upper-middle-income countries. In low- and lower-middle-income countries, roughly 330 pediatric neurosurgeons care for a total child population of 1.2 billion. In low-income countries in Africa, the density of pediatric neurosurgeons is roughly 1 per 30 million children. A higher proportion of patients in low- and lower-middle-income countries must travel > 2 hours to seek emergency neurosurgical care, relative to high-income countries (75.6% vs 33.6%, p < 0.001). Vast basic and essential training and equipment needs exist, particularly low- and lower-middle-income countries within Africa, South America, the Eastern Mediterranean, and South-East Asia. Eighty-nine percent of respondents demonstrated an interest in international collaboration for the purposes of pediatric neurosurgical capacity building.CONCLUSIONSWide disparity in the access to pediatric neurosurgical care exists globally. In low- and lower-middle-income countries, wherein there exists the greatest burden of pediatric neurosurgical disease, there is a grossly insufficient presence of capable providers and equipped facilities. Neurosurgeons across income groups and geographic regions share a desire for collaboration and partnership.


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