scholarly journals Using research to prepare for outbreaks of severe acute respiratory infection

2019 ◽  
Vol 4 (1) ◽  
pp. e001061 ◽  
Author(s):  
Keyword(s):  
Critical Care ◽  
North America ◽  
Data Collection ◽  
East Asia ◽  
Case Fatality ◽  
Sub Saharan Africa ◽  
Hospital Length Of Stay ◽  
Low Middle Income Countries ◽  
Severe Acute Respiratory Infection ◽  
Short Period

Severe acute respiratory infections (SARI) remain one of the leading causes of mortality around the world in all age groups. There is large global variation in epidemiology, clinical management and outcomes, including mortality. We performed a short period observational data collection in critical care units distributed globally during regional peak SARI seasons from 1 January 2016 until 31 August 2017, using standardised data collection tools. Data were collected for 1 week on all admitted patients who met the inclusion criteria for SARI, with follow-up to hospital discharge. Proportions of patients across regions were compared for microbiology, management strategies and outcomes. Regions were divided geographically and economically according to World Bank definitions. Data were collected for 682 patients from 95 hospitals and 23 countries. The overall mortality was 9.5%. Of the patients, 21.7% were children, with case fatality proportions of 1% for those less than 5 years. The highest mortality was in those above 60 years, at 18.6%. Case fatality varied by region: East Asia and Pacific 10.2% (21 of 206), Sub-Saharan Africa 4.3% (8 of 188), South Asia 0% (0 of 35), North America 13.6% (25 of 184), and Europe and Central Asia 14.3% (9 of 63). Mortality in low-income and low-middle-income countries combined was 4% as compared with 14% in high-income countries. Organ dysfunction scores calculated on presentation in 560 patients where full data were available revealed Sequential Organ Failure Assessment (SOFA) scores on presentation were significantly associated with mortality and hospital length of stay. Patients in East Asia and Pacific (48%) and North America (24%) had the highest SOFA scores of >12. Multivariable analysis demonstrated that initial SOFA score and age were independent predictors of hospital survival. There was variability across regions and income groupings for the critical care management and outcomes of SARI. Intensive care unit-specific factors, geography and management features were less reliable than baseline severity for predicting ultimate outcome. These findings may help in planning future outbreak severity assessments, but more globally representative data are required.

scholarly journals Leveraging a Cloud-Based Critical Care Registry for COVID-19 Pandemic Surveillance and Research in Low- and Middle-Income Countries (Preprint)

2020 ◽  
Author(s):  
◽  
Madiha Hashmi ◽  
Abi Beane ◽  
Srinivas Murthy ◽  
Arjen M Dondorp ◽  
...  
Keyword(s):  
Health Care ◽  
Critical Care ◽  
Intensive Care ◽  
Real Time ◽  
Sub Saharan Africa ◽  
Common Data Model ◽  
Middle Income ◽  
Middle Income Countries ◽  
Severe Acute Respiratory Infection ◽  
Low And Middle Income

UNSTRUCTURED The COVID-19 pandemic has revealed limitations in real-time surveillance needed for responsive health care action in low- and middle-income countries (LMICs). The Pakistan Registry for Intensive CarE (PRICE) was adapted to enable International Severe Acute Respiratory and emerging Infections Consortium (ISARIC)–compliant real-time reporting of severe acute respiratory infection (SARI). The cloud-based common data model and standardized nomenclature of the registry platform ensure interoperability of data and reporting between regional and global stakeholders. Inbuilt analytics enable stakeholders to visualize individual and aggregate epidemiological, clinical, and operational data in real time. The PRICE system operates in 5 of 7 administrative regions of Pakistan. The same platform supports acute and critical care registries in eleven countries in South Asia and sub-Saharan Africa. ISARIC-compliant SARI reporting was successfully implemented by leveraging the existing PRICE infrastructure in all 49 member intensive care units (ICUs), enabling clinicians, operational leads, and established stakeholders with responsibilities for coordinating the pandemic response to access real-time information on suspected and confirmed COVID-19 cases (N=592 as of May 2020) via secure registry portals. ICU occupancy rates, use of ICU resources, mechanical ventilation, renal replacement therapy, and ICU outcomes were reported through registry dashboards. This information has facilitated coordination of critical care resources, health care worker training, and discussions on treatment strategies. The PRICE network is now being recruited to international multicenter clinical trials regarding COVID-19 management, leveraging the registry platform. Systematic and standardized reporting of SARI is feasible in LMICs. Existing registry platforms can be adapted for pandemic research, surveillance, and resource planning.

scholarly journals The Regional Impacts of the Asian Crisis on Governance

2018 ◽  
Vol 13 (1) ◽  
pp. 76-89
Author(s):  
Halil Dincer Kaya
Keyword(s):  
Latin America ◽  
North America ◽  
Middle East ◽  
East Asia ◽  
South Asia ◽  
North Africa ◽  
Sub Saharan Africa ◽  
Regional Impacts ◽  
Latin America And Caribbean ◽  
Sub Saharan

AbstractIn this study, we examine the regional impacts of the 1997 Asian Crisis on Governance. We use World Bank’s Worldwide Governance Indicators (i.e. WGI) which includes six dimensions of governance. These six dimensions are “Voice and Accountability”, “Political Stability and Absence of Violence”, “Government Effectiveness”, “Regulatory Quality”, “Rule of Law”, and “Control of Corruption”. The seven regions that we examine are North America, Europe and Central Asia, Latin America and Caribbean, East Asia and Pacific, South Asia, Sub-Saharan Africa, and Middle East and North Africa. Our findings show that, due to the crisis, while the overall rankings of Latin America and Caribbean, and Sub-Saharan Africa improved, the overall rankings of Europe and Central Asia, East Asia and Pacific, South Asia, and Middle East and North Africa declined. There was no change in the ranking of North America due to the crisis. Both pre- and post-crisis, North America has the highest ranking in all six measures of governance.

scholarly journals Leveraging a Cloud-Based Critical Care Registry for COVID-19 Pandemic Surveillance and Research in Low- and Middle-Income Countries

10.2196/21939 ◽  
2020 ◽  
Vol 6 (4) ◽  
pp. e21939
Author(s):  
◽  
Madiha Hashmi ◽  
Abi Beane ◽  
Srinivas Murthy ◽  
Arjen M Dondorp ◽  
...  
Keyword(s):  
Health Care ◽  
Critical Care ◽  
Intensive Care ◽  
Real Time ◽  
Sub Saharan Africa ◽  
Common Data Model ◽  
Middle Income ◽  
Middle Income Countries ◽  
Severe Acute Respiratory Infection ◽  
Low And Middle Income

The COVID-19 pandemic has revealed limitations in real-time surveillance needed for responsive health care action in low- and middle-income countries (LMICs). The Pakistan Registry for Intensive CarE (PRICE) was adapted to enable International Severe Acute Respiratory and emerging Infections Consortium (ISARIC)–compliant real-time reporting of severe acute respiratory infection (SARI). The cloud-based common data model and standardized nomenclature of the registry platform ensure interoperability of data and reporting between regional and global stakeholders. Inbuilt analytics enable stakeholders to visualize individual and aggregate epidemiological, clinical, and operational data in real time. The PRICE system operates in 5 of 7 administrative regions of Pakistan. The same platform supports acute and critical care registries in eleven countries in South Asia and sub-Saharan Africa. ISARIC-compliant SARI reporting was successfully implemented by leveraging the existing PRICE infrastructure in all 49 member intensive care units (ICUs), enabling clinicians, operational leads, and established stakeholders with responsibilities for coordinating the pandemic response to access real-time information on suspected and confirmed COVID-19 cases (N=592 as of May 2020) via secure registry portals. ICU occupancy rates, use of ICU resources, mechanical ventilation, renal replacement therapy, and ICU outcomes were reported through registry dashboards. This information has facilitated coordination of critical care resources, health care worker training, and discussions on treatment strategies. The PRICE network is now being recruited to international multicenter clinical trials regarding COVID-19 management, leveraging the registry platform. Systematic and standardized reporting of SARI is feasible in LMICs. Existing registry platforms can be adapted for pandemic research, surveillance, and resource planning.

scholarly journals COVID-19 pandemic: the implications of the natural history, challenges of diagnosis and management for care in sub-Saharan Africa

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Lawrence Omo-Aghoja ◽  
Emuesiri Goodies Moke ◽  
Kenneth Kelechi Anachuna ◽  
Adrian Itivere Omogbiya ◽  
Emuesiri Kohworho Umukoro ◽  
...  
Keyword(s):  
Public Health ◽  
Natural History ◽  
Low Income ◽  
Sub Saharan Africa ◽  
Low Income Countries ◽  
Diagnosis And Management ◽  
Severe Acute Respiratory Infection ◽  
Identification Technique ◽  
Sub Saharan ◽  
Policies And Programs

Abstract Background Coronavirus disease (COVID-19) is a severe acute respiratory infection which has afflicted virtually almost all nations of the earth. It is highly transmissible and represents one of the most serious pandemics in recent times, with the capacity to overwhelm any healthcare system and cause morbidity and fatality. Main content The diagnosis of this disease is daunting and challenging as it is dependent on emerging clinical symptomatology that continues to increase and change very rapidly. The definitive test is the very expensive and scarce polymerase chain reaction (PCR) viral identification technique. The management has remained largely supportive and empirical, as there are no officially approved therapeutic agents, vaccines or antiviral medications for the management of the disease. Severe cases often require intensive care facilities and personnel. Yet there is paucity of facilities including the personnel required for diagnosis and treatment of COVID-19 in sub-Saharan Africa (SSA). It is against this backdrop that a review of key published reports on the pandemic in SSA and globally is made, as understanding the natural history of a disease and the documented responses to diagnosis and management is usually a key public health strategy for designing and improving as appropriate, relevant interventions. Lead findings were that responses by most nations of SSA were adhoc, paucity of public health awareness strategies and absence of legislations that would help enforce preventive measures, as well as limited facilities (including personal protective equipment) and institutional capacities to deliver needed interventions. Conclusion COVID-19 is real and has overwhelmed global health care system especially low-income countries of the sub-Sahara such as Nigeria. Suggestions for improvement of healthcare policies and programs to contain the current pandemic and to respond more optimally in case of future pandemics are made herein.

scholarly journals Mapping of affordability levels for photovoltaic-based electricity generation in the solar belt of sub-Saharan Africa, East Asia and South Asia

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sándor Szabó ◽  
Irene Pinedo Pascua ◽  
Daniel Puig ◽  
Magda Moner-Girona ◽  
Mario Negre ◽  
...  
Keyword(s):  
East Asia ◽  
South Asia ◽  
Electricity Generation ◽  
Sub Saharan Africa ◽  
Solar Photovoltaic ◽  
Term Operation ◽  
Sub Saharan ◽  
High Level ◽  
Do So

AbstractLack of access to modern forms of energy hampers efforts to reduce poverty. The provision of electricity to off-grid communities is therefore a long-standing developmental goal. Yet, many off-grid electrification projects neglect mid- and long-term operation and maintenance costs. When this is the case, electricity services are unlikely to be affordable to the communities that are the project’s primary target. Here we show that, compared with diesel-powered electricity generation systems, solar photovoltaic systems are more affordable to no less than 36% of the unelectrified populations in East Asia, South Asia, and sub-Saharan Africa. We do so by developing geo-referenced estimates of affordability at a high level of resolution (1 km2). The analysis illustrates the differences in affordability that may be found at the subnational level, which underscores that electrification investments should be informed by subnational data.

scholarly journals Assessing trauma care systems in low-income and middle-income countries: a systematic review and evidence synthesis mapping the Three Delays framework to injury health system assessments

2021 ◽  
Vol 6 (5) ◽  
pp. e004324
Author(s):  
John Whitaker ◽  
Nollaig O'Donohoe ◽  
Max Denning ◽  
Dan Poenaru ◽  
Elena Guadagno ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health System ◽  
Evidence Synthesis ◽  
Rapid Assessment ◽  
Sub Saharan Africa ◽  
Trauma Systems ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low Middle Income Countries ◽  
Three Delays

BackgroundThe large burden of injuries falls disproportionately on low/middle-income countries (LMICs). Health system interventions improve outcomes in high-income countries. Assessing LMIC trauma systems supports their improvement. Evaluating systems using a Three Delays framework, considering barriers to seeking (Delay 1), reaching (Delay 2) and receiving care (Delay 3), has aided maternal health gains. Rapid assessments allow timely appraisal within resource and logistically constrained settings. We systematically reviewed existing literature on the assessment of LMIC trauma systems, applying the Three Delays framework and rapid assessment principles.MethodsWe conducted a systematic review and narrative synthesis of articles assessing LMIC trauma systems. We searched seven databases and grey literature for studies and reports published until October 2018. Inclusion criteria were an injury care focus and assessment of at least one defined system aspect. We mapped each study to the Three Delays framework and judged its suitability for rapid assessment.ResultsOf 14 677 articles identified, 111 studies and 8 documents were included. Sub-Saharan Africa was the most commonly included region (44.1%). Delay 3, either alone or in combination, was most commonly assessed (79.3%) followed by Delay 2 (46.8%) and Delay 1 (10.8%). Facility assessment was the most common method of assessment (36.0%). Only 2.7% of studies assessed all Three Delays. We judged 62.6% of study methodologies potentially suitable for rapid assessment.ConclusionsWhole health system injury research is needed as facility capacity assessments dominate. Future studies should consider novel or combined methods to study Delays 1 and 2, alongside care processes and outcomes.

The connection of east Asia and southwestern north America in climate change mode since the last glacial maximum at various timescales

2021 ◽  
Vol 260 ◽  
pp. 106935
Author(s):  
Yu Li ◽  
Simin Peng ◽  
Yichan Li ◽  
Wangting Ye ◽  
Xinzhong Zhang
Keyword(s):  
Climate Change ◽  
North America ◽  
East Asia ◽  
Last Glacial Maximum ◽  
Glacial Maximum ◽  
Last Glacial ◽  
The Last Glacial Maximum ◽  
The Last Glacial

scholarly journals Akwenda intervention programme for children and youth with cerebral palsy in a low-resource setting in sub-Saharan Africa: protocol for a quasi-randomised controlled study

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e047634
Author(s):  
Gillian Saloojee ◽  
Francis Ekwan ◽  
Carin Andrews ◽  
Diane L Damiano ◽  
Angelina Kakooza-Mwesige ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Sub Saharan Africa ◽  
Children And Youth ◽  
Controlled Study ◽  
Motor Disorder ◽  
National Council ◽  
Low Resource ◽  
Resource Setting ◽  
Low Middle Income Countries ◽  
Randomised Controlled

IntroductionCerebral palsy (CP) is the most common childhood-onset motor disorder accompanied by associated impairments, placing a heavy burden on families and health systems. Most children with CP live in low/middle-income countries with little access to rehabilitation services. This study will evaluate the Akwenda CP programme, a multidimensional intervention designed for low-resource settings and aiming at improving: (1) participation, motor function and daily activities for children with CP; (2) quality of life, stress and knowledge for caregivers; and (3) knowledge and attitudes towards children with CP in the communities.MethodsThis quasi-randomised controlled clinical study will recruit children and youth with CP aged 2–23 years in a rural area of Uganda. Children will be allocated to one of two groups with at least 44 children in each group. Groups will be matched for age, sex and motor impairment. The intervention arm will receive a comprehensive, multidimensional programme over a period of 11 months comprising (1) caregiver-led training workshops, (2) therapist-led practical group sessions, (3) provision of technical assistive devices, (4) goal-directed training and (5) community communication and advocacy. The other group will receive usual care. The outcome of the intervention will be assessed before and after the intervention and will be measured at three levels: (1) child, (2) caregiver and (3) community. Standard analysis methods for randomised controlled trial will be used to compare groups. Retention of effects will be examined at 12-month follow-up.Ethics and disseminationThe study has been approved by the Uganda National Council for Science and Technology (SS 5173) and registered in accordance with WHO and ICMJE standards. Written informed consent will be obtained from caregivers. Results will be disseminated among participants and stakeholders through public engagement events, scientific reports and conference presentations.Trial registration numberPan African Clinical Trials Registry (PACTR202011738099314) Pre-results.

I See Myself through My Avatar: Evidence from East Asia and North America for Acculturated Effects on Virtual Representation Preference

2016 ◽  
Vol 3 (1-2) ◽  
pp. 79-96 ◽  
Author(s):  
Gunwoo Yoon ◽  
Patrick T. Vargas
Keyword(s):  
North America ◽  
East Asia ◽  
Cultural Psychology ◽  
Self Concept ◽  
Future Research ◽  
East Asians ◽  
Two Cultures ◽  
North Americans ◽  
The Two Cultures ◽  
Quasi Experiment

In the present research we argue that avatars, as identity containers, can mirror people’s self-concepts. Research in cultural psychology suggests that East Asians tend to be more tolerant of contradictions and that they more easily adjust their self-concepts in accordance with changing contexts compared to North Americans (see Heine 2001). We therefore assume that preferred forms of avatars among East Asians and North Americans are different because of this self-concept variability across cultures. We conducted a quasi-experiment to explore how people in the two cultures differently evaluate two forms of avatars, human-like and cartoon-like avatars, in terms of likeability and preference. We found that East Asians rated cartoon-like avatars more favourably than North Americans. Moreover, compared to North Americans, East Asians preferred cartoon-like avatars to human-like avatars for their hypothetical avatars to play games. We conclude by discussing implications for future research.

Mechanism for Asian dust transport during blocking episode days in east Asia and North America in spring 2001

2003 ◽  
Author(s):  
Y.K. Kim ◽  
H.W. Lee ◽  
Y.S. Moon ◽  
K. Strong ◽  
Y.K. Lim ◽  
...  
Keyword(s):  
North America ◽  
East Asia ◽  
Asian Dust ◽  
Dust Transport
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