scholarly journals Emergency care surveillance and emergency care registries in low-income and middle-income countries: conceptual challenges and future directions for research

2019 ◽  
Vol 4 (Suppl 6) ◽  
pp. e001442 ◽  
Author(s):  
Hani Mowafi ◽  
Christine Ngaruiya ◽  
Gerard O'Reilly ◽  
Olive Kobusingye ◽  
Vikas Kapil ◽  
...  
Keyword(s):  
Data Collection ◽  
Emergency Care ◽  
Low Income ◽  
Working Group ◽  
Policy Making ◽  
Population Based ◽  
Middle Income ◽  
Middle Income Countries ◽  
Disability Adjusted Life ◽  
Life Years

Despite the fact that the 15 leading causes of global deaths and disability-adjusted life years are from conditions amenable to emergency care, and that this burden is highest in low-income and middle-income countries (LMICs), there is a paucity of research on LMIC emergency care to guide policy making, resource allocation and service provision. A literature review of the 550 articles on LMIC emergency care published in the 10-year period from 2007 to 2016 yielded 106 articles for LMIC emergency care surveillance and registry research. Few articles were from established longitudinal surveillance or registries and primarily composed of short-term data collection. Using these articles, a working group was convened by the US National Institutes of Health Fogarty International Center to discuss challenges and potential solutions for established systems to better understand global emergency care in LMICs. The working group focused on potential uses for emergency care surveillance and registry data to improve the quality of services provided to patients. Challenges included a lack of dedicated resources for such research in LMIC settings as well as over-reliance on facility-based data collection without known correlation to the overall burden of emergency conditions in the broader community. The group outlined potential solutions including incorporating data from sources beyond traditional health records, use of standard clinical forms that embed data needed for research and policy making and structured population-based research to establish clear linkages between what is seen in emergency units and the wider community. The group then identified current gaps in LMIC emergency care surveillance and registry research to form a research agenda for the future.

Injury prevention and control

2021 ◽  
pp. 361-376
Author(s):  
Corinne Peek-Asa ◽  
Adnan A. Hyder
Keyword(s):  
Injury Prevention ◽  
Low Income ◽  
Prevention And Control ◽  
Low Income Countries ◽  
Middle Income ◽  
Injury Rates ◽  
Middle Income Countries ◽  
Disability Adjusted Life ◽  
Life Years ◽  
And Control

Injuries are among the leading causes of death and disability throughout the world and contribute disproportionately to premature life lost. Injury rates are highest among middle- and low-income countries. According to analyses of the 2016 Global Burden of Disease data, injuries cause over 4.6 million deaths per year, accounting for nearly 8.4% of all deaths and 10.7% of disability-adjusted life years. Many opportunities to implement injury prevention strategies exist, and a systematic approach to injury prevention can help identify the most effective and efficient approaches. Building capacity for injury prevention activities in low- and middle-income countries is an important public health priority.

scholarly journals Global Burden of Stroke

2018 ◽  
Vol 38 (02) ◽  
pp. 208-211 ◽  
Author(s):  
Mira Katan ◽  
Andreas Luft
Keyword(s):  
Hemorrhagic Stroke ◽  
Middle Income ◽  
Stroke Incidence ◽  
Middle Income Countries ◽  
The Past ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Incidence And Mortality ◽  
Geographical Regions ◽  
Life Years Lost

AbstractStroke is the second leading cause of death and a major cause of disability worldwide. Its incidence is increasing because the population ages. In addition, more young people are affected by stroke in low- and middle-income countries. Ischemic stroke is more frequent but hemorrhagic stroke is responsible for more deaths and disability-adjusted life-years lost. Incidence and mortality of stroke differ between countries, geographical regions, and ethnic groups. In high-income countries mainly, improvements in prevention, acute treatment, and neurorehabilitation have led to a substantial decrease in the burden of stroke over the past 30 years. This article reviews the epidemiological and clinical data concerning stroke incidence and burden around the globe.

scholarly journals Advancing research on emergency care systems in low-income and middle-income countries: ensuring high-quality care delivery systems

2019 ◽  
Vol 4 (Suppl 6) ◽  
pp. e001265 ◽  
Author(s):  
Rachel T Moresky ◽  
Junaid Razzak ◽  
Teri Reynolds ◽  
Lee A Wallis ◽  
Benjamin W Wachira ◽  
...  
Keyword(s):  
Health Systems ◽  
Emergency Care ◽  
Low Income ◽  
Communicable Diseases ◽  
Middle Income ◽  
Care Research ◽  
Middle Income Countries ◽  
Emergency Care Systems ◽  
Care Systems ◽  
Research Questions

Emergency care systems (ECS) address a wide range of acute conditions, including emergent conditions from communicable diseases, non-communicable diseases, pregnancy and injury. Together, ECS represent an area of great potential for reducing morbidity and mortality in low-income and middle-income countries (LMICs). It is estimated that up to 54% of annual deaths in LMICs could be addressed by improved prehospital and facility-based emergency care. Research is needed to identify strategies for enhancing ECS to optimise prevention and treatment of conditions presenting in this context, yet significant gaps persist in defining critical research questions for ECS studies in LMICs. The Collaborative on Enhancing Emergency Care Research in LMICs seeks to promote research that improves immediate and long-term outcomes for clients and populations with emergent conditions. The objective of this paper is to describe systems approaches and research strategies for ECS in LMICs, elucidate priority research questions and methodology, and present a selection of studies addressing the operational, implementation, policy and health systems domains of health systems research as an approach to studying ECS. Finally, we briefly discuss limitations and the next steps in developing ECS-oriented interventions and research.

scholarly journals The burden of serious health-related suffering among cancer decedents: Global projections study to 2060

2020 ◽  
pp. 026921632095756
Author(s):  
Katherine E Sleeman ◽  
Barbara Gomes ◽  
Maja de Brito ◽  
Omar Shamieh ◽  
Richard Harding
Keyword(s):  
Palliative Care ◽  
Low Income ◽  
Population Based ◽  
World Health ◽  
Low Income Countries ◽  
Cancer Type ◽  
Middle Income ◽  
Middle Income Countries ◽  
Health Related ◽  
Health Organization

Background: Palliative care improves outcomes for people with cancer, but in many countries access remains poor. Understanding future needs is essential for effective health system planning in response to global policy. Aim: To project the burden of serious health-related suffering associated with death from cancer to 2060 by age, gender, cancer type and World Bank income region. Design: Population-based projections study. Global projections of palliative care need were derived by combining World Health Organization cancer mortality projections (2016–2060) with estimates of serious health-related suffering among cancer decedents. Results: By 2060, serious health-related suffering will be experienced by 16.3 million people dying with cancer each year (compared to 7.8 million in 2016). Serious health-related suffering among cancer decedents will increase more quickly in low income countries (407% increase 2016–2060) compared to lower-middle, upper-middle and high income countries (168%, 96% and 39% increase 2016-2060, respectively). By 2060, 67% of people who die with cancer and experience serious health-related suffering will be over 70 years old, compared to 47% in 2016. In high and upper-middle income countries, lung cancer will be the single greatest contributor to the burden of serious health-related suffering among cancer decedents. In low and lower-middle income countries, breast cancer will be the single greatest contributor. Conclusions: Many people with cancer will die with unnecessary suffering unless there is expansion of palliative care integration into cancer programmes. Failure to do this will be damaging for the individuals affected and the health systems within which they are treated.

scholarly journals Early Detection of CKD: Implications for Low-Income, Middle-Income, and High-Income Countries

2020 ◽  
Vol 31 (9) ◽  
pp. 1931-1940 ◽  
Author(s):  
Marcello Tonelli ◽  
James A. Dickinson
Keyword(s):  
Early Detection ◽  
Low Income ◽  
Population Based ◽  
Case Finding ◽  
High Income ◽  
Opportunity Costs ◽  
Middle Income ◽  
Middle Income Countries ◽  
Use Of Resources ◽  
Low And Middle Income

CKD is common, costly, and associated with adverse health outcomes. Because inexpensive treatments can slow the rate of kidney function loss, and because CKD is asymptomatic until its later stages, the idea of early detection of CKD to improve outcomes ignites enthusiasm, especially in low- and middle-income countries where renal replacement is often unavailable or unaffordable. Available data and prior experience suggest that the benefits of population-based screening for CKD are uncertain; that there is potential for harms; that screening is not a wise use of resources, even in high-income countries; and that screening has substantial opportunity costs in low- and middle-income countries that offset its hypothesized benefits. In contrast, some of the factors that diminish the value of population-based screening (such as markedly higher prevalence of CKD in people with diabetes, hypertension, and cardiovascular disease, as well as high preexisting use of kidney testing in such patients) substantially increase the appeal of searching for CKD in people with known kidney risk factors (case finding) in high-income countries as well as in low- and middle-income countries. For both screening and case finding, detection of new cases is the easiest component; the real challenge is ensuring appropriate management for a chronic disease, usually for years or even decades. This review compares and contrasts the benefits, harms, and opportunity costs associated with these two approaches to early detection of CKD. We also suggest criteria (discussed separately for high-income countries and for low- and middle-income countries) to use in assessing when countries should consider case finding versus when they should consider foregoing systematic attempts at early detection and focus on management of known cases.

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