scholarly journals Assessing the Burden ofClostridium difficileInfection in Low- and Middle-Income Countries

2018 ◽  
Vol 56 (3) ◽  
Author(s):  
G. A. Roldan ◽  
A. X. Cui ◽  
N. R. Pollock
Keyword(s):  
Clostridium Difficile ◽  
Antibiotic Stewardship ◽  
Morbidity And Mortality ◽  
Resource Limited Settings ◽  
Middle Income ◽  
Content Type ◽  
Middle Income Countries ◽  
Resource Limited ◽  
Hospital Acquired ◽  
Low And Middle Income

ABSTRACTIn contrast to the significant resources invested in the diagnosis and prevention ofClostridium difficileinfection (CDI) in resource-rich settings, in resource-limited settings patients with community- and hospital-acquired diarrhea may not routinely be tested for CDI. Is CDI actually less frequent or severe in resource-limited settings, or might we be missing an important opportunity to prevent CDI-related morbidity and mortality (and to promote antibiotic stewardship) in these settings? Here, we review the literature to assess the overall burden of CDI in low- and middle-income countries.

scholarly journals Characteristics of a Nationwide Voluntary Antibiotic Resistance Awareness Campaign in India; Future Paths and Pointers for Resource Limited Settings/Low and Middle Income Countries

2019 ◽  
Vol 16 (24) ◽  
pp. 5141
Author(s):  
Ashok J. Tamhankar ◽  
Ramesh Nachimuthu ◽  
Ravikant Singh ◽  
Jyoti Harindran ◽  
Gautam Kumar Meghwanshi ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Antibiotic Use ◽  
World Health ◽  
Awareness Campaign ◽  
Resource Limited Settings ◽  
Middle Income ◽  
Middle Income Countries ◽  
Awareness Campaigns ◽  
Resource Limited ◽  
Low And Middle Income

Antibiotic resistance has reached alarming proportions globally, prompting the World Health Organization to advise nations to take up antibiotic awareness campaigns. Several campaigns have been taken up worldwide, mostly by governments. The government of India asked manufacturers to append a ‘redline’ to packages of antibiotics as identification marks and conducted a campaign to inform the general public about it and appropriate antibiotic use. We investigated whether an antibiotic resistance awareness campaign could be organized voluntarily in India and determined the characteristics of the voluntarily organized campaign by administering a questionnaire to the coordinators, who participated in organizing the voluntary campaign India. The campaign characteristics were: multiple electro–physical pedagogical and participatory techniques were used, 49 physical events were organized in various parts of India that included lectures, posters, booklet/pamphlet distribution, audio and video messages, competitions, and mass contact rallies along with broadcast of messages in 11 local languages using community radio stations (CRS) spread all over India. The median values for campaign events were: expenditure—3000 Indian Rupees/day (US$~47), time for planning—1 day, program spread—4 days, program time—4 h, direct and indirect reach of the message—respectively 250 and 500 persons/event. A 2 min play entitled ‘Take antibiotics as prescribed by the doctor’ was broadcast 10 times/day for 5 days on CRS with listener reach of ~5 million persons. More than 85%ofcoordinators thought that the campaign created adequate awareness about appropriate antibiotic use and antibiotic resistance. The voluntary campaign has implications for resource limited settings/low and middle income countries.

scholarly journals Does early goal directed therapy in sepsis still hold relevance in low and middle-income countries?

2017 ◽  
Vol 4 (1) ◽  
pp. 1-2
Author(s):  
Diptesh Aryal ◽  
Apurb Sharma
Keyword(s):  
Usual Care ◽  
Resource Limited Settings ◽  
Middle Income ◽  
Goal Directed Therapy ◽  
Middle Income Countries ◽  
Early Goal Directed Therapy ◽  
Resource Limited ◽  
Low And Middle Income

The efficacy of early goal directed therapy in improving outcomes has been questioned in few recent studies. But, does that hold true for low and middle income countries like Nepal? This editorial expresses the views of the editors on the usual care of sepsis patients and early goal directed therapy in resource limited settings.

Clinical Chemistry for Developing Countries: Mass Spectrometry

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Suji Lee ◽  
Kavyasree Chintalapudi ◽  
Abraham K. Badu-Tawiah
Keyword(s):  
Mass Spectrometry ◽  
Developing Countries ◽  
Developing World ◽  
Early Disease ◽  
Resource Limited Settings ◽  
Middle Income ◽  
Middle Income Countries ◽  
Resource Limited ◽  
Modern Mass ◽  
Low And Middle Income

Early disease diagnosis is necessary to enable timely interventions. Implementation of this vital task in the developing world is challenging owing to limited resources. Diagnostic approaches developed for resource-limited settings have often involved colorimetric tests (based on immunoassays) due to their low cost. Unfortunately, the performance/sensitivity of such simplistic tests are often limited and significantly hinder opportunities for early disease detection. A new criterion for selecting diagnostic tests in low- and middle-income countries is proposed here that is based on performance-to-cost ratio. For example, modern mass spectrometry (MS) now involves analysis of the native sample in the open laboratory environment, enabling applications in many fields, including clinical research, forensic science, environmental analysis, and agriculture. In this critical review, we summarize recent developments in chemistry that enable MS to be applied effectively in developing countries. In particular, we argue that closed automated analytical systems may not offer the analytical flexibility needed in resource-limited settings. Alternative strategies proposed here have potential to be widely accepted in low- and middle-income countries through the utilization of the open-source ambient MS platform that enables microsampling techniques such as dried blood spot to be coupled with miniature mass spectrometers in a centralized analytical platform. Consequently, costs associated with sample handling and maintenance can be reduced by >50% of the total ownership cost, permitting analytical measurements to be operated at high performance-to-cost ratios in the developing world. Expected final online publication date for the Annual Review of Analytical Chemistry, Volume 14 is August 2021. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

scholarly journals Development of immunohistochemistry services for cancer care in western Kenya: Implications for low- and middle-income countries

2016 ◽  
Vol 5 (1) ◽  
Author(s):  
Kirtika Patel ◽  
R. Matthew Strother ◽  
Francis Ndiangui ◽  
David Chumba ◽  
William Jacobson ◽  
...  
Keyword(s):  
Cancer Care ◽  
Cost Model ◽  
Tertiary Care ◽  
Care Hospital ◽  
Middle Income ◽  
Western Kenya ◽  
Middle Income Countries ◽  
Resource Limited ◽  
Limited Setting ◽  
Low And Middle Income

Background: Cancer is becoming a major cause of mortality in low- and middle-income countries. Unlike infectious disease, malignancy and other chronic conditions require significant supportive infrastructure for diagnostics, staging and treatment. In addition to morphologic diagnosis, diagnostic pathways in oncology frequently require immunohistochemistry (IHC) for confirmation. We present the experience of a tertiary-care hospital serving rural western Kenya, which developed and validated an IHC laboratory in support of a growing cancer care service.Objectives, methods and outcomes: Over the past decade, in an academic North-South collaboration, cancer services were developed for the catchment area of Moi Teaching and Referral Hospital in western Kenya. A major hurdle to treatment of cancer in a resource-limited setting has been the lack of adequate diagnostic services. Building upon the foundations of a histology laboratory, strategic investment and training were used to develop IHC services. Key elements of success in this endeavour included: translation of resource-rich practices to are source-limited setting, such as using manual, small-batch IHC instead of disposable- and maintenance-intensive automated machinery, engagement of outside expertise to develop reagent-efficient protocols and supporting all levels of staff to meet the requirements of an external quality assurance programme.Conclusion: Development of low- and middle-income country models of services, such as the IHC laboratory presented in this paper, is critical for the infrastructure in resource-limited settings to address the growing cancer burden. We provide a low-cost model that effectively develops these necessary services in a challenging laboratory environment.

Peritoneal Dialysis for AKI in Cameroon: Commercial Vs Locally-Made Solutions

2018 ◽  
Vol 38 (4) ◽  
pp. 246-250 ◽  
Author(s):  
Dennis Palmer ◽  
William J. Lawton ◽  
Charles Barrier ◽  
B.D. Fine ◽  
Hayden Hemphill ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
High Mortality ◽  
Retrospective Cohort ◽  
Kidney Injury ◽  
Resource Limited Settings ◽  
Significant Cost ◽  
Middle Income ◽  
Middle Income Countries ◽  
Resource Limited ◽  
Baptist Hospital

Background Acute kidney injury (AKI) is common in low- and middle-income countries, and is associated with a high mortality. The high mortality rate is in large part due to the inability to perform dialysis in resource-limited settings. Due to significant cost advantages, peritoneal dialysis (PD) has been used to treat AKI in these settings. The costs, however, remain high when commercial solutions are used. Methods This is a retrospective cohort study of the outcome, and of the peritonitis rates, of patients with AKI treated with either commercially manufactured PD solutions or locally-made PD solutions. A program to treat AKI with PD was started at Mbingo Baptist Hospital in Cameroon. Between May 2013 and January 2015, solutions and connection sets were provided by the Saving Young Lives Program. From January 2015 through March 2017, solutions were locally produced and available tubing was used. Results Mortality in hospitalized AKI patients was 28% during the period when commercial solutions and tubing were utilized, and 33% when locally produced solutions and available tubing were utilized. In both groups, peritonitis occurred in 16% of treatment courses. Conclusions Locally produced PD solutions, used with locally available tubing, were used to treat AKI with PD. The mortality and peritonitis rates were similar whether locally produced or commercial supplies were used.

scholarly journals Pneumococcal Vaccines: Challenges and Prospects

Vaccines ◽  
2019 ◽  
Vol 7 (1) ◽  
pp. 25
Author(s):  
Paul Licciardi ◽  
Ioanna Papadatou
Keyword(s):  
Streptococcus Pneumoniae ◽  
Morbidity And Mortality ◽  
Pneumococcal Vaccines ◽  
Middle Income ◽  
Middle Income Countries ◽  
Common Causes ◽  
Low And Middle Income

Infections with the bacterium Streptococcus pneumoniae are one of the most common causes of morbidity and mortality in children less than five years of age worldwide, mostly in low- and middle-income countries (LMICs) [...]

Vaccine nationalism could prolong pandemic

2020 ◽  
Keyword(s):  
High Income ◽  
Exit Strategy ◽  
Middle Income ◽  
Content Type ◽  
Middle Income Countries ◽  
Low And Middle Income

Significance Klugge is likely aiming to be optimistic. An effective COVID-19 vaccine is considered to be the only economically and humanely acceptable exit strategy for this pandemic. However, never before has a vaccine been developed, manufactured and distributed in the timescale now required. Impacts High-income countries will initially monopolise access to a vaccine. The country in which the vaccine is developed will be the very first to use it. Low- and middle-income countries covered by GAVI will gain some access to a vaccine, but it will not be comprehensive. Middle-income countries outside GAVI will likely be the last to get access.

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