scholarly journals Engineering Insulin Cold Chain Resilience to Improve Global Access

2021 ◽  
Author(s):  
Caitlin L. Maikawa ◽  
Joseph L. Mann ◽  
Aadithya Kannan ◽  
Catherine M. Meis ◽  
Ben S. Ou ◽  
...  
Keyword(s):  
Low Income ◽  
Cold Chain ◽  
Low Income Countries ◽  
Pharmacokinetics And Pharmacodynamics ◽  
Simple Formulation ◽  
Aging Conditions ◽  
Refrigerated Transport ◽  
Treatment Of Diabetes ◽  
Global Access ◽  
And Storage

ABSTRACTThere are 150 million people with diabetes worldwide who require insulin replacement therapy and the prevalence of diabetes is rising fastest in middle and low-income countries. Current formulations require costly refrigerated transport and storage to prevent loss of insulin integrity. This study shows the development of simple “drop-in” amphiphilic copolymer excipients to maintain formulation integrity, bioactivity, pharmacokinetics and pharmacodynamics for over 6 months when subjected to severe stressed aging conditions that cause current commercial formulation to fail in under 2 weeks. Further, when these copolymers are added to Humulin R (Eli Lilly) in original commercial packaging they prevent insulin aggregation for up to 4 days at 50 °C compared to less than 1 day for Humulin R alone. These copolymers demonstrate promise as simple formulation additives to increase the cold chain resilience of commercial insulin formulations, thereby expanding global access to these critical drugs for treatment of diabetes.

scholarly journals The Rotavirus Vaccine Landscape, an Update

Pathogens ◽  
2021 ◽  
Vol 10 (5) ◽  
pp. 520
Author(s):  
Roberto Cárcamo-Calvo ◽  
Carlos Muñoz ◽  
Javier Buesa ◽  
Jesús Rodríguez-Díaz ◽  
Roberto Gozalbo-Rovira
Keyword(s):  
Developing Countries ◽  
Mortality Rate ◽  
Low Income ◽  
State Of The Art ◽  
The State ◽  
Cold Chain ◽  
Low Income Countries ◽  
Rotavirus Vaccine ◽  
Oral Vaccines

Rotavirus is the leading cause of severe acute childhood gastroenteritis, responsible for more than 128,500 deaths per year, mainly in low-income countries. Although the mortality rate has dropped significantly since the introduction of the first vaccines around 2006, an estimated 83,158 deaths are still preventable. The two main vaccines currently deployed, Rotarix and RotaTeq, both live oral vaccines, have been shown to be less effective in developing countries. In addition, they have been associated with a slight risk of intussusception, and the need for cold chain maintenance limits the accessibility of these vaccines to certain areas, leaving 65% of children worldwide unvaccinated and therefore unprotected. Against this backdrop, here we review the main vaccines under development and the state of the art on potential alternatives.

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.

scholarly journals Global Access to Handwashing: Implications for COVID-19 Control in Low-Income Countries

2020 ◽  
Vol 128 (5) ◽  
pp. 057005 ◽  
Author(s):  
Michael Brauer ◽  
Jeff T. Zhao ◽  
Fiona B. Bennitt ◽  
Jeffrey D. Stanaway
Keyword(s):  
Low Income ◽  
Low Income Countries ◽  
Global Access

scholarly journals Botanical Insecticides and their Potential as Anti-Insect/Pests: Are they Successful against Insects and Pests?

2021 ◽  
Author(s):  
Toheed Iqbal ◽  
Nazeer Ahmed ◽  
Kiran Shahjeer ◽  
Saeed Ahmed ◽  
Khalid Awadh Al-Mutairi ◽  
...  
Keyword(s):  
Essential Oil ◽  
Pest Management ◽  
Low Income ◽  
Insect Pests ◽  
Low Income Countries ◽  
Botanical Insecticides ◽  
Development Programs ◽  
Environment Friendly ◽  
Development Organizations ◽  
And Storage

In low-income countries, subsistence and transitional farms frequently use botanical insecticides. The shortage or high cost of industrial pesticides also prompts their use. Botanical insecticides are also prescribed by agricultural and development programs and certain development organizations. However, since insecticidal proof of their effectiveness and protection might not be sufficient or usable, this may be called into question. While insecticidal botanicals have been extensively studied, there has yet to be a fusion that focuses especially on the domestic synthesis of biopesticides that work infield and storage effectively. In this chapter, we look at the effectiveness of botanicals (neem, garlic, and essential oil) that are used as insecticides. In addition, this chapter also focuses on research carried out on the use of these essential oils as insecticides. Processes that use variable amounts of ingredients and concentrations and ratios of active ingredients can have varying impacts on the efficacy of plant-based biological insecticides. Finally, using home-made insecticides would reduce the losses that occur during food production and enable us to use environment-friendly pest management methods.

scholarly journals Erratum: Global Access to Handwashing: Implications for COVID-19 Control in Low-Income Countries

2020 ◽  
Vol 128 (6) ◽  
pp. 069001
Author(s):  
Michael Brauer ◽  
Jeff T. Zhao ◽  
Fiona B. Bennitt ◽  
Jeffrey D. Stanaway
Keyword(s):  
Low Income ◽  
Low Income Countries ◽  
Global Access

scholarly journals Development of an alternative saliva test for diagnosis of SARS-CoV-2 using TRIzol: Adapting to countries with lower incomes looking for a large-scale detection program

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0255807
Author(s):  
Haydee Miranda-Ortiz ◽  
Edith A. Fernández-Figueroa ◽  
Erika B. Ruíz-García ◽  
Anallely Muñoz-Rivas ◽  
Alejandra Méndez-Pérez ◽  
...  
Keyword(s):  
Low Income ◽  
Healthcare Workers ◽  
Large Scale ◽  
Waiting Times ◽  
Good Alternative ◽  
Cold Chain ◽  
Low Income Countries ◽  
Non Invasive ◽  
Diagnostic Panel ◽  
Novel Coronavirus

The use of saliva for the diagnosis of SARS-CoV-2 has shown to be a good alternative to nasopharyngeal swabs (NPS), since it permits self-collection, avoids the exposure of healthy persons to infected patients, reduces waiting times, eliminates the need of personal protective equipment and is non-invasive. Yet current saliva testing is still expensive due to the need of specialized tubes containing buffers to stabilize the RNA of SARS-CoV-2 and inactivate the virus. These tubes are expensive and not always accessible in sufficient quantities. We now developed an alternative saliva testing method, using TRIzol for extraction, viral inactivation, and storage of SARS-CoV-2 RNA, combined with RT-qPCR, which was comparable in its performance to NPS. Paired saliva samples and NPS were taken from 15 asymptomatic healthcare workers and one patient with SARS-CoV-2. Further 13 patients with SARS-CoV-2 were only saliva-tested. All the tests were performed according to CDC 2019-Novel Coronavirus (2019-nCoV) Real-Time RT-PCR Diagnostic Panel. Saliva (4 mL) was taken in sterile 50 mL tubes, 1.5 mL TRIzol were added and mixed. Our results show that 5 μL of saliva RNA extracted with TRIzol allow for an adequate detection of the virus in patients positive for SARS-CoV-2 and was equally sensitive to NPS in TRIzol. We conclude that saliva testing using TRIzol is a recommendable method for diagnosis of SARS-CoV-2 since it has several advantages over currently used saliva tests: it can be done with normal sterile tubes, does not need cold-chain handling, is stable at room temperature, is non-invasive and less costly, making it more accessible for low-income countries. Cheaper saliva testing using TRIzol is especially relevant for low-income countries to optimize diagnosis and help define quarantine durations for families, healthcare workers, schools, and other public workplaces, thus decreasing infections and mortality caused by SARS-CoV-2.

scholarly journals Response to “Comment on ‘Global Access to Handwashing: Implications for COVID-19 Control in Low-Income Countries’”

2020 ◽  
Vol 128 (9) ◽  
pp. 098002
Author(s):  
Michael Brauer ◽  
Jeff T. Zhao ◽  
Fiona B. Bennitt ◽  
Jeffrey D. Stanaway
Keyword(s):  
Low Income ◽  
Low Income Countries ◽  
Global Access

Disparities in treatment of diabetes and hypertension among groups of foreign origin and the general Finnish population

2019 ◽  
Vol 29 (5) ◽  
pp. 894-899
Author(s):  
Daniel T Etchi ◽  
Eero Lilja ◽  
Päivikki Koponen ◽  
Tiina Laatikainen
Keyword(s):  
Risk Factors ◽  
General Population ◽  
Low Income ◽  
Service Use ◽  
Antihypertensive Drugs ◽  
Low Income Countries ◽  
Cardiometabolic Health ◽  
Finnish Population ◽  
Foreign Origin ◽  
Treatment Of Diabetes

Abstract Background Migrants from low-income countries are more predisposed to diabetes and cardiovascular risks than host European natives, but how treatment targets are met in migrant patients is unclear. We examined health service use and treatment of diabetes and hypertension among selected migrant groups and the general Finnish population and compared prevalence of cardiovascular risk factors between patients and non-patients. Methods Cross-sectional data from randomly sampled 30- to 64-year-old participants (387 Russian, 198 Somali and 343 Kurdish origin migrants) of the Migrant Health and Wellbeing Survey (2010–2012) were used. Health 2011 survey data (n = 1086) were used as a comparison group. Results Compared with the general population, diabetes-related doctor/nurse visits were more frequent among Russian and Somali, but not the Kurdish group. Use of prescribed antidiabetic and antihypertensive drugs were significantly lower among Russians (78%/56%) and Kurdish (68%/58%), but not in Somalis (85%/62%) compared with the general population (96%/78%). Obesity, elevated blood pressure and elevated glucose levels were more prevalent in patients than non-patients, and over 60% of patients and over 70% of non-patients had elevated plasma low density lipoprotein cholesterol. Differences in cardiovascular disease (CVD) risk profiles between patients and non-patients were not associated with socio-economic factors. Conclusions This study indicates disparities in prevalence and management of diabetes and hypertension and their associated risk factors among ethnic groups. Diabetes, CVD risks and treatment outcomes in patients were sub-optimal, especially among foreign origin groups. Comprehensive health promotion strategies are needed to improve cardiometabolic health in vulnerable populations.

scholarly journals The status of refrigeration techniques for vaccine storage and transportation in low-income settings

2020 ◽  
Author(s):  
Magali Cattin ◽  
Sashidhar Jonnalagedda ◽  
Solomzi Makoliso ◽  
Klaus Schönenberger
Keyword(s):  
Low Income ◽  
Performance Enhancement ◽  
Grey Literature ◽  
Cold Chain ◽  
Scientific Publications ◽  
The Status ◽  
Working Principle ◽  
High Degree ◽  
And Storage ◽  
Made In

Vaccines need to be continuously stored between 2°C to 8°C, from their production to administration to beneficiaries. Every year, more than 25% of vaccines are wasted. One of the main reasons for this wastage is the lack of cold chain continuity in low-income settings, where electricity is scarce. Recently, several advances have been made in cooling technologies to store and transport vaccines. The current paper presents a review of refrigeration technologies based on scientific publications, industry white papers and other grey literature. For each refrigeration method, we describe its working principle, the best performing devices available as well as the remaining research challenges in order to obtain a very high degree of performance enhancement. Finally, we comment on their applicability for vaccine transport and storage.

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