scholarly journals The impact of pulse oximetry on diagnosis, management and outcomes of acute febrile illness in low-income and middle-income countries: a systematic review

2021 ◽  
Vol 6 (11) ◽  
pp. e007282
Author(s):  
Rusheng Chew ◽  
Meiwen Zhang ◽  
Arjun Chandna ◽  
Yoel Lubell
Keyword(s):  
Pulse Oximetry ◽  
Patient Outcomes ◽  
Febrile Illness ◽  
Risk Of Bias ◽  
Acute Febrile Illness ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low Middle Income Countries ◽  
Hospital Referral ◽  
The Impact

BackgroundAcute fever is a common presenting symptom in low/middle-income countries (LMICs) and is strongly associated with sepsis. Hypoxaemia predicts disease severity in such patients but is poorly detected by clinical examination. Therefore, including pulse oximetry in the assessment of acutely febrile patients may improve clinical outcomes in LMIC settings.MethodsWe systematically reviewed studies of any design comparing one group where pulse oximetry was used and at least one group where it was not. The target population was patients of any age presenting with acute febrile illness or associated syndromes in LMICs. Studies were obtained from searching PubMed, EMBASE, CABI Global Health, Global Index Medicus, CINAHL, Cochrane CENTRAL, Web of Science and DARE. Further studies were identified through searches of non-governmental organisation websites, snowballing and input from a Technical Advisory Panel. Outcomes of interest were diagnosis, management and patient outcomes. Study quality was assessed using the Cochrane Risk of Bias 2 tool for Cluster Randomised Trials and Risk of Bias in Non-randomized Studies of Interventions tools, as appropriate.ResultsTen of 4898 studies were eligible for inclusion. Their small number and heterogeneity prevented formal meta-analysis. All studies were in children, eight only recruited patients with pneumonia, and nine were conducted in Africa or Australasia. Six were at serious risk of bias. There was moderately strong evidence for the utility of pulse oximetry in diagnosing pneumonia and identifying severe disease requiring hospital referral. Pulse oximetry used as part of a quality-assured facility-wide package of interventions may reduce pneumonia mortality, but studies assessing this endpoint were at serious risk of bias.ConclusionsVery few studies addressed this important question. In LMICs, pulse oximetry may assist clinicians in diagnosing and managing paediatric pneumonia, but for the greatest impact on patient outcomes should be implemented as part of a health systems approach. The evidence for these conclusions is not widely generalisable and is of poor quality.

The Impact of Covid 19 on Pregnant Women and Child Health

2020 ◽  
Vol 11 (SPL1) ◽  
pp. 1367-1373
Author(s):  
Nikhil Sanjay Mujbaile ◽  
Smita Damke
Keyword(s):  
Social Issues ◽  
Middle Income ◽  
Web Based ◽  
Middle Income Countries ◽  
Low Middle Income Countries ◽  
The Social ◽  
Social Separation ◽  
The Impact ◽  
And Child Health ◽  
General Wellbeing

The Covid illness (COVID-19) pandemic has spread rapidly all through the world and has had a drawn-out impact. The Pandemic has done incredible damage to society and made genuine mental injury to numerous individuals. Mental emergencies frequently cause youngsters to deliver sentiments of relinquishment, despondency, insufficiency, and fatigue and even raise the danger of self-destruction. Youngsters with psychological instabilities are particularly powerless during the isolate and colonial removing period. Convenient and proper assurances are expected to forestall the event of mental and social issues. The rising advanced applications and wellbeing administrations, for example, telehealth, web-based media, versatile wellbeing, and far off intuitive online instruction can connect the social separation and backing mental and conduct wellbeing for youngsters. Because of the mental advancement qualities of youngsters, this investigation additionally outlines intercessions on the mental effect of the COVID-19 Pandemic. Further difficulties in Low Middle-Income Countries incorporate the failure to actualize successful general wellbeing estimates, for example, social separating, hand cleanliness, definitive distinguishing proof of contaminated individuals with self-disconnection and widespread utilization of covers The aberrant impacts of the Pandemic on youngster wellbeing are of extensive concern, including expanding neediness levels, upset tutoring, absence of admittance to the class taking care of plans, decreased admittance to wellbeing offices and breaks in inoculation and other kid wellbeing programs. Kept tutoring is critical for kids in Low Middle-Income Countries. Arrangement of safe situations is mainly testing in packed asset obliged schools. 

scholarly journals The needs, challenges, and burden experienced by informal caregivers in Uganda: a scoping review

2022 ◽  
Vol 2 (1) ◽  
Author(s):  
A. Komuhangi ◽  
C. Jenkins ◽  
F. Nakaggwa ◽  
P. Agaba ◽  
F. Githinji ◽  
...  
Keyword(s):  
Patient Outcomes ◽  
Scoping Review ◽  
Communicable Disease ◽  
Future Research ◽  
Middle Income ◽  
Physical Support ◽  
Middle Income Countries ◽  
Health And Wellbeing ◽  
Treatment Services ◽  
The Impact

Abstract Background The impact of informal caregiving is increasingly recognised as an important but often particularly neglected area of research in low and middle income countries. It is important to understand not only the effect of care on patient outcomes, but also the impact of caring on caregivers’ health and wellbeing. Methods Guided by the Arksey and O’Malley (Res Methodol 8:19–32, 2005) framework, this scoping review sought to collate and chart existing research on the needs, burdens and challenges experienced by caregivers in Uganda. Results The results of this review indicate that research focusing on the needs of caregivers for individuals with communicable disease, particularly HIV, has been well developed in Uganda, however, there is a lack of research on caregiving related to non-communicable diseases. Research has been dominated by small qualitative studies that are informative for understanding roles, burdens and contextually-specific aspects of care, but there is a need for larger studies that develop and test interventions designed to support the needs of caregivers. Conclusions Recurrent themes identified within this review, such as challenges in providing physical support and accessing treatment services, financial costs of care, psychological and mental health impacts and the experience of stigma, should help to inform well targeted and contextually-appropriate future research and interventions.

scholarly journals The impact of user charges on health outcomes in low-income and middle-income countries: a systematic review

2019 ◽  
Vol 3 (Suppl 3) ◽  
pp. e001087 ◽  
Author(s):  
Vicky Mengqi Qin ◽  
Thomas Hone ◽  
Christopher Millett ◽  
Rodrigo Moreno-Serra ◽  
Barbara McPake ◽  
...  
Keyword(s):  
Health Outcomes ◽  
Low Income ◽  
Risk Of Bias ◽  
Lower Income ◽  
Study Quality ◽  
Middle Income ◽  
User Charges ◽  
Middle Income Countries ◽  
The Impact ◽  
The Relationship

BackgroundUser charges are widely used health financing mechanisms in many health systems in low-income and middle-income countries (LMICs) due to insufficient public health spending on health. This study systematically reviews the evidence on the relationship between user charges and health outcomes in LMICs, and explores underlying mechanisms of this relationship.MethodsPublished studies were identified via electronic medical, public health, health services and economics databases from 1990 to September 2017. We included studies that evaluated the impact of user charges on health in LMICs using randomised control trial (RCT) or quasi-experimental (QE) study designs. Study quality was assessed using Cochrane Risk of Bias and Risk of Bias in Non-Randomized Studies—of Intervention for RCT and QE studies, respectively.ResultsWe identified 17 studies from 12 countries (five upper-middle income countries, five lower-middle income countries and two low-income countries) that met our selection criteria. The findings suggested a modest relationship between reduction in user charges and improvements in health outcomes, but this depended on health outcomes measured, the populations studied, study quality and policy settings. The relationship between reduced user charges and improved health outcomes was more evident in studies focusing on children and lower-income populations. Studies examining infectious disease–related outcomes, chronic disease management and nutritional outcomes were too few to draw meaningful conclusions. Improved access to healthcare as a result of reduction in out-of-pocket expenditure was identified as the possible causal pathway for improved health.ConclusionsReduced user charges were associated with improved health outcomes, particularly for lower-income groups and children in LMICs. Accelerating progress towards universal health coverage through prepayment mechanisms such as taxation and insurance can lead to improved health outcomes and reduced health inequalities in LMICs.Trial registration numberCRD 42017054737.

scholarly journals Prevalence and factors associated with suicide among medical professionals in low/middle-income countries: a systematic review protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e028884
Author(s):  
Godfrey Zari Rukundo ◽  
Helen Byakwaga ◽  
Alison Kinengyere ◽  
Achille Mwira Bapolisi ◽  
Miriela Betancourt ◽  
...  
Keyword(s):  
Suicidal Ideation ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Medical Professionals ◽  
Data Set ◽  
Middle Income ◽  
Factors Associated ◽  
Middle Income Countries ◽  
Low Middle Income Countries ◽  
Statistical Heterogeneity

IntroductionA number of studies in low/middle-income countries (LMICs) have reported varying prevalence of suicide among medical professionals with low rates. This may be because of the methods used in suicide assessment and the stigma associated with it. For this study, the prevalence of suicidal ideation, attempt and completed suicide, as well as the factors associated with suicidality and methods used during suicidal acts, will be documented.Methods and analysisStudies published in peer-reviewed journals in which the prevalence and factors associated with suicidal ideation, attempt and completion among medical professionals in LMICs will be included. The Cochrane Library (CENTRAL), PsychINFO, PubMed and Embase will be systematically searched. We will search for all the papers available in the databases up to March 31 2019. Methodological quality of the articles will be assessed using the quality in prognostic studies tool. The risk of bias of the articles will be assessed using Cochrane risk of bias assessment tool for non-randomised studies. In the event of no statistical heterogeneity, a meta-analysis of the findings will be conducted.Ethics and disseminationEthical permission will not be required since this work does not involve the use of participant data that can be used to identify individuals. Findings from this study will be available for clinicians and other medical professionals, scientists and policy makers. On request, a data set of the study can be provided.Trial registration numberCRD42018095990.

scholarly journals Evaluation of policies for free maternal healthcare in low/middle-income countries: a scoping review protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e031557
Author(s):  
Regina Poima Seki ◽  
Delia Hendrie ◽  
Judith Daire
Keyword(s):  
Maternal Health ◽  
Scoping Review ◽  
Financial Burden ◽  
Healthcare Services ◽  
Global Strategy ◽  
Maternal Healthcare ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low Middle Income Countries ◽  
The Impact

IntroductionImproving maternal health remains a health priority at the global and national levels. As part of the global strategy, many low/middle-income countries (LMICs) have implemented free primary healthcare policies for different service packages including maternal health. Free maternal healthcare policies aim to improve maternal health by removing the financial burden of accessing maternal healthcare services. The objective of this scoping review is to assess evaluations of free maternal healthcare policies and the impact on maternal health in LMICs. This will help identify theoretical and methodological approaches (or gaps if any) for evaluating the impact of free maternal healthcare policies to inform future work. It will also provide an evidence base for policymakers and other stakeholder with an interest in planning, funding and implementing evidence based and effective interventions to improving maternal health outcomes.MethodsThe scoping review will follow the methodological framework proposed by Arksey and O’Malley and refined by Joanna Briggs Institute. It will involve a literature search of the PubMed, Scopus ScienceDirect, Web of Science and CINAHL databases for peer-reviewed journal articles related to the impact of free maternal health policies in LMICs published from 2000 to the present. Two reviewers will screen and appraise eligible articles using preset criteria based on the ‘population-concept-context’ framework. A data extraction framework will be used to extract and chart data from the reviewed articles. The results will be analysed using descriptive numerical summary analysis and qualitative thematic analysis.Ethics and disseminationEthical approval is not required as the scoping review will synthesise information from publicly available materials. Dissemination will be through publication in a peer-reviewed journal and presentation at relevant conferences and workshops.

scholarly journals Respiratory epidemics and older people

2020 ◽  
Vol 49 (6) ◽  
pp. 896-900
Author(s):  
Sathyanarayanan Doraiswamy ◽  
Ravinder Mamtani ◽  
Marco Ameduri ◽  
Amit Abraham ◽  
Sohaila Cheema
Keyword(s):  
Older People ◽  
Well Being ◽  
Middle Income ◽  
Global Epidemic ◽  
The Public ◽  
Middle Income Countries ◽  
Low Middle Income Countries ◽  
Full Participation ◽  
The Impact ◽  
Urgent Action

Abstract Coronavirus disease 2019 (COVID-19) has been particularly severe on older people. Past coronavirus epidemics namely Severe Acute Respiratory Syndrome and the Middle East Respiratory Syndrome have also been severe on older people. These epidemics lasted for only a limited period, however, and have proven short lived in the memories of both the public and public health systems. No lessons were learnt to mitigate the impact of future epidemics of such nature, on older people. This complacency we feel has claimed the lives of many older people during the current COVID-19 global epidemic. The nature of risks associated with acquiring infections and associated mortality among older people in respiratory epidemic situations are varied and of serious concern. Our commentary identifies demographic, biological, behavioural, social and healthcare-related determinants, which increase the vulnerability of older people to respiratory epidemics. We acknowledge that these determinants will likely vary between older people in high- and low-middle income countries. Notwithstanding these variations, we call for urgent action to mitigate the impact of epidemics on older people and preserve their health and dignity. Intersectoral programmes that recognise the special needs of older people and in unique contexts such as care homes must be developed and implemented, with the full participation and agreement of older people. COVID-19 has created upheaval, challenging humanity and threatening the lives, rights, and well-being of older people. We must ensure that we remain an age-friendly society and make the world a better place for all including older people.

scholarly journals Effect of exercise on symptoms of premenstrual syndrome in low and middle-income countries: a protocol for systematic review and meta-analysis

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e039274
Author(s):  
Pratik Pokharel ◽  
Juwel Rana ◽  
Jude Moutchia ◽  
Shreeshti Uchai ◽  
Aldiona Kerri ◽  
...  
Keyword(s):  
Premenstrual Syndrome ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Cochrane Central Register ◽  
Middle Income ◽  
Middle Income Countries ◽  
Management Interventions ◽  
Statistical Heterogeneity ◽  
The Impact ◽  
Low And Middle Income

IntroductionPremenstrual syndrome (PMS) has the potential to affect the quality of life adversely. Published guidelines recommend the use of exercise as part of the first-line management interventions for PMS. However, the published evidence related to the effectiveness of physical activity and PMS is inconclusive. This review will assess the effectiveness of exercise-based interventions in reducing PMS in women screened or diagnosed with PMS in low and middle-income countries, where the prevalence of PMS is high.Methods and analysisElectronic databases will be researched, including Embase, Cochrane Central Register of Controlled Trials, MEDLINE, PsycINFO, Web of Science, ClinicalTrials.gov and Google Scholar. All the studies published until March 2020 will be included. A standardised data extraction form will be used adapted from the Cochrane Handbook of Systematic Reviews of Interventions. Included articles will be assessed using the risk of bias tools based on study design. Data will be analysed using Review Manager V.5.3. The inverse-variance random-effects method will be used to report the standardised mean difference. A meta-analysis will be used only if studies are sufficiently homogenous. A narrative synthesis will be undertaken when studies are heterogeneous. Methodological heterogeneity between studies will be evaluated by considering the study types. Statistical heterogeneity will be tested using the I2 test. Subgroup analyses may be performed only for the primary outcome in case of sufficient studies. Sensitivity analysis will be conducted to assess the impact of intervention excluding studies without randomisation and studies with a high risk of bias. Funnel plots will be used to assess the potential reporting bias and small-study effects only when there are more than 10 studies included in the meta-analysis.Ethics and disseminationThis study does not require ethical approval, as the review is entirely based on published studies. The results will be published and/or will be presented at a pertinent conference.PROSPERO registration numberCRD42020163377.

The Impact of Funding Insulin Research on Open Access Publishing: A 20-Years Bibliometric Analysis

2020 ◽  
Vol 16 (5) ◽  
pp. 497-502
Author(s):  
Hiba Abbasi ◽  
Noor Abu-Farsakh ◽  
Farah Abuazzam ◽  
Rasha Halaseh ◽  
Othman Alaraj ◽  
...  
Keyword(s):  
Open Access ◽  
Bibliometric Analysis ◽  
World Health ◽  
European Research ◽  
Middle Income ◽  
Funded Research ◽  
Middle Income Countries ◽  
Low Middle Income Countries ◽  
Significant Difference ◽  
The Impact

Background:: The recent report of The World Health Organization on diabetes has stressed on the burden of diabetes on low/middle income countries. Recent studies advocated the importance of funding more research on diabetes and insulin in these countries. Recently, the European Research Council advocated the importance of gold Open Access (OA) publishing, where the funded research should be immediately accessible. In this study, we aim to assess funding for insulin research, where we will compare the OA status between funded and unfunded research. Methods:: We used Scopus database to assess insulin research published from January 1st, 1999 to December 31st, 2018. Our bibliometric analysis consisted of three main sections: analysis of all publications on insulin, analysis of funded insulin publications, and analysis of unfunded insulin publications. Results:: We found a total of 388,202 publications, of which only 83,180 (21.4%) were funded. USA produced around 30.1% of the total publications, and the National Institute of Health (NIH) was the major funder with 18.6% of all publications. Of the funded publications, 29,143 (35%) were OA publications, compared to 97,347 (31.9%) of the unfunded publications. We didn’t find a significant difference in OA status between funded and unfunded research. Conclusion:: In concordance with the European Research Council’s decision to support gold OA publishing model, we found that only 35% of the funded and 31.9% of the unfunded insulin research were OA. Although the funded research is increasing in China, most of it is produced in high income countries. This highlights the importance of allocating more funds to low/middle income countries.

Sign in / Sign up

Export Citation Format

Share Document