scholarly journals Testing Pooled Sputum with Xpert MTB/RIF for Diagnosis of Pulmonary Tuberculosis To Increase Affordability in Low-Income Countries

2015 ◽  
Vol 53 (8) ◽  
pp. 2502-2508 ◽  
Author(s):  
Saddiq T. Abdurrahman ◽  
Omezikam Mbanaso ◽  
Lovett Lawson ◽  
Olanrewaju Oladimeji ◽  
Matthew Blakiston ◽  
...  
Keyword(s):  
Low Income ◽  
Public Health Problem ◽  
Low Income Countries ◽  
Global Public Health ◽  
Testing Strategy ◽  
Content Type ◽  
Pooled Testing ◽  
Negative Results ◽  
The Individual ◽  
Pooled Samples

Tuberculosis (TB) is a global public health problem, with the highest burden occurring in low-income countries. In these countries, the use of more sensitive diagnostics, such as Xpert MTB/RIF (Xpert), is still limited by costs. A cost-saving strategy to diagnose other diseases is to pool samples from various individuals and test them with single tests. The samples in positive pool samples are then retested individually to identify the patients with the disease. We assessed a pooled testing strategy to optimize the affordability of Xpert for the diagnosis of TB. Adults with presumptive TB attending hospitals or identified by canvassing of households in Abuja, Nigeria, were asked to provide sputum for individual and pooled (4 per pool) testing. The agreement of the results of testing of individual and pooled samples and costs were assessed. A total of 738 individuals submitted samples, with 115 (16%) beingMycobacterium tuberculosispositive. Valid Xpert results for individual and pooled samples were available for 718 specimens. Of these, testing of pooled samples detected 109 (96%) of 114 individualM. tuberculosis-positive samples, with the overall agreement being 99%. Xpert semiquantitativeM. tuberculosislevels had a positive correlation with the smear grades, and the individual sample-positive/pooled sample-negative results were likely due to theM. tuberculosisconcentration being below the detection limit. The strategy reduced cartridge costs by 31%. Savings were higher with samples from individuals recruited in the community, where the proportion of positive specimens was low. The results of testing of pooled samples had a high level of agreement with the results of testing of individual samples, and use of the pooled testing strategy reduced costs and has the potential to increase the affordability of Xpert in countries with limited resources.

scholarly journals Pooled Sputum for Xpert MTB/RIF Testing: A Cost Effectiveness Diagnostic Tool in Mwanza, Tanzania

2021 ◽  
Author(s):  
Shimba Henerico ◽  
Richard V. Makapa ◽  
Bernard C. Okamo ◽  
Benson R. Kidenya ◽  
Geoffrey Japhet ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Low Income ◽  
Public Health Problem ◽  
Positive Sample ◽  
Low Income Countries ◽  
Global Public Health ◽  
Testing Strategy ◽  
Pooled Testing ◽  
The Individual ◽  
Pooled Samples

Abstract Background: Tuberculosis (TB) is a global public health problem, with the highest burden occurring in low-income countries, wherein the use of more sensitive diagnostics, such as Xpert MTB/RIF (GeneXpert), is still limited by costs. Testing of pooled samples from various individuals has been thought and thus investigated as a cost saving strategy to diagnose some diseases including TB. Then in cases where a pool is positive, retesting of the individual samples in that pool is done to identify the positive sample. We assessed the utility of a pooled testing strategy to optimize the affordability of GeneXpert for the diagnosis of TB Mwanza Tanzania. Methods: Remainder of samples from presumptive TB patients submitted for routine TB diagnosis were used for pooled samples (5 per pool) testing. The agreement of the results between individual sample testing against pooled samples testing and cost-effectiveness were assessed.Results: A total of 250 individual routinely submitted samples for TB diagnosis were tested using the established protocols. The median age of study participants was 35 [IQR 27 – 40] years and 143 (57.2%) were males. Of the 250 samples, 28 (11.2%) were detected to have MTB whereas 222 (88.8%) samples, were negative. Of the 50 sputum pools made, MTB were detected in 17 (34.0%) pools. Following retesting of these 17 positive pools, all 28 (100%) individual MTB samples were detected with the overall agreement being 100% (With the sensitivity of 100% and specificity of 100%). The number of individual MTB positive ranged from 1 to 3 per pool. Using pooling of sputum samples, the technique saved 115 (46.0%) of the cartridges in running 250 samples. This is equivalent to saving US$ 1147.7. Conclusion: The pooled sputum testing strategy reduced cartridge costs by 46.0%. The use of the pooled testing strategy reduces costs and has the potential to increase the affordability of GeneXpert testing in countries with limited resources. Pooled sputum for Xpert MTB/RIF can be used as an affordable diagnostic and/or screening tool in resource limited settings, such as Tanzania.

Cross-cultural metacognition as a prior for humanitarian knowledge: when cultures collide in global health emergencies

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Tachia Chin ◽  
Jianwei Meng ◽  
Shouyang Wang ◽  
Yi Shi ◽  
Jianxin Zhang
Keyword(s):  
Low Income ◽  
A Priori ◽  
Normative Theory ◽  
Cross Cultural ◽  
Warning Signs ◽  
Low Income Countries ◽  
Global Public Health ◽  
Business World ◽  
Content Type ◽  
Cultural Conflicts

Purpose A serious global public health emergency (GPHE) like the COVID-19 aggravates the inequilibrium of medical care and other critical resources between wealthy and poor nations, which, coupled with the collision of cultures, indicates the vital need for developing humanitarian knowledge transcending cultures. Given the scarcity of literature addressing such unprecedent issues, this paper thus proposes new, unconventional viewpoints and future themes at the intersection of knowledge management (KM) and humanitarian inquiry. Design/methodology/approach This paper is conceptual in nature. The data of the World Bank and the Office for the Coordination of Humanitarian Affairs are analysed to introduce some emerging real impact topics regarding cross-cultural conflicts and humanitarian knowledge in the post-COVID business world. The theoretical foundation was built upon a critical literature review. Findings This paper synthesizes the perspectives of culture, KM and the humanistic philosophy to distil the core component of cultural intelligence and comparatively and thereby illuminating why cross-cultural metacognition acts as a priori for achieving cosmopolitan humanitarian knowledge. Research limitations/implications This paper provides profound implications to academics by highlighting the importance to formulating new, inter-disciplinary themes or unorthodox, phenomenon-driven assumptions beyond the traditional KM domain. This paper also offers practitioners and policymakers valuable insights into coping with the growing disparity between high- and low-income countries by showing warning signs of a looming humanitarian crisis associated with a GPHE context. Originality/value This paper does not aim to claim the birth of a new domain but call for more research on developing a normative theory of humanitarian knowledge as transcendence of cultures. It implies uncharted territories of great interest and potential for the real impact KM community.

scholarly journals Systematic review and meta-analysis of iodine deficiency and its associated factors among pregnant women in Ethiopia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Robel Hussen kabthymer ◽  
Mohammed Feyisso Shaka ◽  
Getnet Melaku Ayele ◽  
Bereket Geze malako
Keyword(s):  
Pregnant Women ◽  
Iodine Deficiency ◽  
Low Income ◽  
Associated Factors ◽  
Meta Analysis ◽  
Public Health Problem ◽  
Iodized Salt ◽  
Low Income Countries ◽  
Global Public Health ◽  
Pooled Prevalence

Abstract Background Iodine deficiency (ID) is a global public health problem and its impact is more pronounced in low-income countries. During pregnancy, iodine requirement is known to elevate sharply, making pregnant women, especially those living in low-income countries highly vulnerable to iodine deficiency. This study aims to assess the prevalence of iodine deficiency and its associated factors among pregnant women in Ethiopia. Methods A systematic literature search was performed by using PubMed, CINAHL, Web of science, global health, and Google scholar electronic databases. Two authors independently extracted all the necessary data using a structured data extraction format. Data analysis was done using STATA Version 14. The heterogeneity of the studies was assessed by using I2 test. A random-effects model was used to estimate the pooled prevalence and pooled odds ratio. The presence of publication bias was checked using Funnel plot and Egger’s test. Results One thousand one hundred and sixteen studies were reviewed and seven studies fulfilling the inclusion criteria were included in the meta-analysis. The meta-analysis of seven studies that included 2190 pregnant women showed a pooled prevalence of iodine deficiency during pregnancy to be 68.76% (95% CI: 55.21–82.31). In a subgroup analysis, the prevalence in Oromia region is 71.93% (95% CI: 54.87–88.99) and in Amhara region is 60.93% (95% CI: 57.39–64.48). Iodized salt use (AOR = 0.18; 95% CI: 0.08–0.44) and 1st trimester pregnancy (AOR = 0.68; 95% CI: 0.47–0.99) were found to have a significant association with iodine deficiency. Conclusions The prevalence of iodine deficiency during pregnancy using urine iodine is considerably high in Ethiopia. Using iodized salt is found to reduce the burden. Hence, there is a need to strengthen iodization programs to tackle the problem.

Foreign capital inflows and economic growth: the experience of low-income countries in Sub Saharan Africa

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Atif Awad
Keyword(s):  
Low Income ◽  
Foreign Capital ◽  
Ordinary Least Squares ◽  
Capital Inflows ◽  
Sub Saharan Africa ◽  
Low Income Countries ◽  
Content Type ◽  
Long Run ◽  
Foreign Capital Inflows ◽  
The Impact

Purpose This paper aims to investigate the long-run impact of selected foreign capital inflows, including aid, remittances, foreign direct investment (FDI), trade and debt, on the economic growth of 21 low-income countries in the Sub Saharan Africa (SSA) region, during the period 1990–2018. Design/methodology/approach To obtain this objective and for robust analysis, a parametric approach, which was dynamic ordinary least squares, and a non-parametric technique, which was fully modified ordinary least squares, were used. Findings The results of both models confirmed that, in the long run, trade and aid affected the growth rate of the per capita income in these countries in a positive way. However, external debt seemed to have an adverse influence on such growth. Originality/value First, this is the initial study that has addressed this matter across a homogenous group of countries in the SSA region. Second, while most of the previous studies regarding capital inflows into the SSA region have focused on the impact of only one or two aspects of such foreign capital inflows on growth, the present study, instead, examined the impact of five types of foreign capital inflows (aid, remittances, FDI, trade and debt).

Private school vouchers for expanding secondary school access? The case of Tanzania

2018 ◽  
Vol 32 (7) ◽  
pp. 1307-1318
Author(s):  
Donald R. Baum ◽  
Jacobus Cilliers
Keyword(s):  
Secondary Education ◽  
Secondary School ◽  
Low Income ◽  
Private School ◽  
Systems Approach ◽  
Financial Burden ◽  
Low Income Countries ◽  
Urban District ◽  
Content Type ◽  
School Voucher

Purpose The purpose of this paper is to provide insight into the current contributions of private schools to education provision in Tanzania, and to consider the feasibility of a school voucher program to contribute to the expansion of the secondary school system, compared to the alternative expansion of public secondary education. Design/methodology/approach The study offers an analysis of current educational circumstances and educational goals in Tanzania, and projects differential costs and outcomes associated with various options for expanding secondary education. Data come from two sources: a census of the private schooling market in the Morogoro Urban district, conducted as part of the World Bank’s Systems Approach for Better Education Results initiative; and Tanzania’s National Panel Survey 2010–2011. Findings For those students unable to cover the full cost of secondary education, findings suggest that a targeted private school voucher would be an efficient and equitable policy mechanism for secondary school expansion. Such an approach would ease the financial burden on government for constructing all new schools, yet assure access for the most vulnerable. Originality/value The implementation of school voucher programs is increasing in low-income countries. It is important for policy makers to carefully consider the appropriateness of this type of policy intervention for their particular educational contexts. This paper models an approach by which researchers and policymakers can assess the educational circumstances of a particular location, and determine the potential effectiveness of a private school voucher policy.

scholarly journals Global e-government development: besides the relative wealth of countries, do policies matter?

2020 ◽  
Vol 14 (3) ◽  
pp. 381-400 ◽  
Author(s):  
Gonçalo Paiva Dias
Keyword(s):  
Low Income ◽  
Public Policies ◽  
Low Income Countries ◽  
Political Commitment ◽  
Content Type ◽  
Secondary Sources ◽  
Relative Wealth ◽  
Innovative Thinking ◽  
High Level ◽  
Government Development

Purpose This study aims to investigate whether, discounting the effect of the relative wealth of countries, it is possible to observe the relevance of policies for e-government development. Design/methodology/approach The deviations of countries' results from what could be expected, considering their relative wealth is calculated by using the residuals of a linear regression using the Gross Domestic Product per capita as the independent variable and the UN E-Government Development Index as the dependent variable. The countries that achieve better and worse results than expected are then identified and their cases are analyzed by resorting to secondary sources, namely, published research referring to their cases. Those research documents were identified by successively searching the Scopus database, the Google Scholar database and the Web of Science. Findings The existence of formal e-government strategies and plans and the capacity to implement them can make a difference, allowing countries to achieve better results than expected or, in their absence, to perform worse than expected. Research limitations/implications The proposed methodology can be useful to e-government researchers, particularly as a basis for deeper and more detailed studies. Practical implications Countries should invest in well-developed and focused strategies and continuity of public policies and their capacity to deliver results. For that purpose, political commitment and high-level coordination are key factors. For low-income countries, long-lasting cooperation with external experienced partners is crucial. For high-income countries, innovative thinking is a key enabler. Originality/value This study uses an innovative method to look beyond the effect of the relative wealth of countries and investigate the relevance of public policies for e-government development.

State fragility and human development: a study with special emphasis on social cohesion

2020 ◽  
Vol 48 (1) ◽  
pp. 39-61
Author(s):  
Belay Seyoum
Keyword(s):  
Human Development ◽  
Social Cohesion ◽  
Low Income ◽  
Ordinary Least Squares ◽  
Low Income Countries ◽  
Least Squares Regression ◽  
Content Type ◽  
State Fragility ◽  
State Legitimacy ◽  
The Impact

PurposeThe purpose of this paper is to examine the effect of state fragility on select indicators of human development and identify aspects of state fragility that have the greatest impact on poverty reduction and sustainable development. The paper also explores the impact of social cohesion on human development as well as the mediating role of state legitimacy in mediating the relationship between social cohesion and human development.Design/methodology/approachThe study is based on data from 180 countries and uses ordinary least squares regression and mediation analysis to explore the effects of social cohesion on human development.FindingsThe findings show a significant relationship between state fragility and human development. It suggests that policies and efforts aimed at enhancing social cohesion would have the most significant impact on human development. The findings also show that social cohesion not only has a direct effect on human development but it also has an indirect effect on human development through state legitimacy (mediator).Practical implicationsEven though state fragility has been largely associated with low income countries, different facets of fragility are manifested in various countries regardless of levels of economic development.Originality/valueThe study is timely in view of the evidence of increasing state fragility in many countries. Furthermore, this is the first scholarly work linking lack of social cohesion, state fragility and human development.

Food away from home and obesity in Brazil

2015 ◽  
Vol 5 (1) ◽  
pp. 44-56 ◽  
Author(s):  
Caroline Pauletto Spanhol Finocchio ◽  
Homero Dewes
Keyword(s):  
Fruits And Vegetables ◽  
Public Health Problem ◽  
Overweight And Obesity ◽  
Content Type ◽  
The Public ◽  
Food Away From Home ◽  
Balanced Diet ◽  
Expenditure Data ◽  
Food Expenditure ◽  
The Individual

Purpose – The purpose of this paper is to characterize food consumption outside the home and verify the existence of relationships between income, expenditure and the prevalence of overweight and obesity in adult individuals in Brazil. Design/methodology/approach – Food expenditure data were used as well as those on the prevalence of overweight and obesity available in the reports from Family Budgets Research carried out by the Brazilian Institute of Geography and Statistics (IBGE) in the years 2002-2003 and 2008-2009. In addition, the authors used the Kruskall-Wallis test to verify whether there were significant differences between the classes of income with respect to the average expenditure on food outside the home. Findings – It was observed that the higher the income of the individual, the greater the expenditure on food outside the home. It was also found that the prevalence of overweight and obesity is higher in individuals who have higher income, particularly among men. Thus, it is suggested that the higher the income of the individual, the larger the expenditure on food outside the home and the greater the prevalence of overweight and obesity. Research limitations/implications – This study used spending on food away from home (FAFH), but the authors know that is need to use other variables like frequency of FAFH and quantities but this data were not available. Practical implications – The study points to the importance of restaurants in the prevention of obesity, since they can offer in their menus foods with fewer calories, and they can also increase the variety and availability of fruits and vegetables. Originality/value – The study discusses the public health problem, obesity, at the same time as it presents the importance of agribusiness in providing a balanced diet for individuals.

scholarly journals School Nurses Avoid Addressing Child Sexual Abuse

2016 ◽  
Vol 33 (2) ◽  
pp. 133-142 ◽  
Author(s):  
Lisbet Engh Kraft ◽  
GullBritt Rahm ◽  
Ulla-Britt Eriksson
Keyword(s):  
Sexual Abuse ◽  
Child Sexual Abuse ◽  
Sexually Abused ◽  
Secondary Analysis ◽  
Public Health Problem ◽  
School Nurses ◽  
Global Public Health ◽  
Abused Children ◽  
Group Interviews ◽  
The Individual

Child sexual abuse (CSA) is a global public health problem with major consequences for the individual child and society. An earlier Swedish study showed that the school nurses did not initially talk about nor mention CSA as one form of child abuse. For the child to receive adequate support, the disclosure is a precondition and is dependent on an available person prepared to listen. The aim of the study was to explore the ability of the school nurses to detect and support sexually abused children. It is a secondary analysis of focus group interviews with school nurses. Thematic analysis was performed. Results showed that the school nurses avoided addressing CSA due to arousal of strong emotions, ambivalence, and a complicated disclosure process. In order to detect CSA and support abused children, attentiveness of sexual abuse as a possible cause of physical and mental ill-health is crucial.

scholarly journals Actions Targeting the Double Burden of Malnutrition: A Scoping Review

Nutrients ◽  
2019 ◽  
Vol 12 (1) ◽  
pp. 81 ◽  
Author(s):  
Sonia Menon ◽  
José L. Peñalvo
Keyword(s):  
Nutrition Education ◽  
Scoping Review ◽  
Low Income ◽  
Sub Saharan Africa ◽  
World Health ◽  
Low Income Countries ◽  
Nutrient Deficiencies ◽  
Global Public Health ◽  
Double Burden ◽  
Double Burden Of Malnutrition

Background: In many developing countries, nutritional and epidemiological transitions are contributing to continuous undernutrition and escalating overnutrition, resulting in coexisting forms of malnutrition often referred as the “double burden of malnutrition” (DBM). This complex phenomenon constitutes an unprecedented challenge to global public health and has been prioritized by international health organizations, prompting governments to swift action. Specifically, five years ago the World Health Organization (WHO) proposed a roadmap to tackle the DBM though so-called “double-duty actions”. The objective of this review was to synthesize the literature on interventions which address the DBM. Methods: We developed a scoping review to identify interventions addressing the DBM. We searched PUBMED for papers reporting interventions until December 2019. Articles examining interventions, government policies, or tools at the individual, household, or community level to address the DBM were included. Results: Seven articles met the inclusion criteria. Three were from sub-Saharan Africa, one was from Southeast Asia, and one was from Central America. Two were modelling studies, with one covering 24 low-income countries and the other focusing on Ghana. Conclusion: Notwithstanding the pressing issue of the DBM, there is a paucity of studies examining double-duty actions despite the attention that it has garnered within the global nutrition community. Whilst nutrient deficiencies may be curbed by poverty reduction measures, for obesity prevention nutrition, education and promotion of physical activity, along with the encouragement of local food production, may be instrumental.

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