Implementation of colorectal cancer screening interventions in low-income and middle-income countries: a scoping review protocol

IntroductionColorectal cancer (CRC) imposes a significant global burden of disease. CRC survival rates are much lower in low-income and middle-income countries (LMICs). Screening tends to lead to an improvement in cancer detection and the uptake of available treatments and, in turn, to better chances of cancer survival. Most evidence on CRC screening interventions comes from high-income countries. The objective of this scoping review is to map the available literature on the implementation of CRC screening interventions in LMICs.Methods and analysisWe will conduct a scoping review according to the framework proposed by Arksey and O’Malley (2005). We will search MEDLINE, EMBASE, Web of Science and Google Scholar using a combination of terms such as “colorectal cancer”, “screening” and “low-middle-income countries”. Studies of CRC screening interventions/programmes conducted in the general adult population in LMICs as well as policy reviews (of interventions in LMICs) and commentaries on challenges and opportunities of delivering CRC screening in LMICs, published in the English language before February 2020 will be included in this review. The title and abstract screen will be conducted by one reviewer and two reviewers will screen full-texts and extract data from included papers, independently, into a data charting template that will include criteria from an adapted template for intervention description and replication checklist and implementation considerations. The presentation of the scoping review will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews guidance.Ethics and disseminationThere are no ethical concerns. The results will be used to inform colorectal screening interventions in LMICs. We will publish the findings in a peer-reviewed journal and present them at relevant conferences.

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Examining the double burden of malnutrition for preschool children and women of reproductive age in low-income and middle-income countries: a scoping review protocol

BMJ Open ◽

10.1136/bmjopen-2021-054673 ◽

2021 ◽

Vol 11 (12) ◽

pp. e054673

Author(s):

Jason Mulimba Were ◽

Saverio Stranges ◽

Ishor Sharma ◽

Juan Camilo Vargas-Gonzalez ◽

M. Karen Campbell

Keyword(s):

Preschool Children ◽

Scoping Review ◽

Low Income ◽

Reproductive Age ◽

Women Of Reproductive Age ◽

Double Burden ◽

Middle Income ◽

Middle Income Countries ◽

Scoping Reviews ◽

Double Burden Of Malnutrition

IntroductionThe majority of the populations in low-income and middle-income countries (LMICs) are encountering the double burden of malnutrition (DBM): the coexistence of both undernutrition and overnutrition sequalae. With DBM being a new phenomenon in research, little is known about its aetiology, operational definitions and risk factors influencing its manifestation. The proposed scoping review is aimed at mapping literature with regard to the DBM phenomenon among preschool children and women of reproductive age in LMICs who are among the most high-risk groups to encounter DBM.MethodsA comprehensive literature search will be conducted in the following electronic databases: MEDLINE, EMBASE, Scopus, CINAHL, LILACS and ProQuest Dissertations and Thesis Global. Additionally, searches in other government and institutional sources (WHO website and university repositories) and forward and backward citation tracking of seminal articles will also be done. Two reviewers will independently conduct title and abstract screening and full-text screening. Similarly, data extraction and coding will independently be done by two reviewers. Information extracted from included literature will be analysed qualitatively using thematic analysis approach and reported as per the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines.Ethics and disseminationEthical approval is not required for this study because the review is based on literature from publicly available sources. The dissemination of our findings will be done through presentations in relevant conferences and publication in a peer-reviewed journal.

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Machine learning health-related applications in low-income and middle-income countries: a scoping review protocol

BMJ Open ◽

10.1136/bmjopen-2019-035983 ◽

2020 ◽

Vol 10 (5) ◽

pp. e035983

Author(s):

Rodrigo M Carrillo-Larco ◽

Lorainne Tudor Car ◽

Jonathan Pearson-Stuttard ◽

Trishan Panch ◽

J Jaime Miranda ◽

...

Keyword(s):

Public Health ◽

Machine Learning ◽

Scoping Review ◽

Low Income ◽

Clinical Medicine ◽

Scientific Publications ◽

Middle Income ◽

Middle Income Countries ◽

Low Middle Income Countries ◽

Health Related

IntroductionMachine learning (ML) has been used in bio-medical research, and recently in clinical and public health research. However, much of the available evidence comes from high-income countries, where different health profiles challenge the application of this research to low/middle-income countries (LMICs). It is largely unknown what ML applications are available for LMICs that can support and advance clinical medicine and public health. We aim to address this gap by conducting a scoping review of health-related ML applications in LMICs.Methods and analysisThis scoping review will follow the methodology proposed by Levac et al. The search strategy is informed by recent systematic reviews of ML health-related applications. We will search Embase, Medline and Global Health (through Ovid), Cochrane and Google Scholar; we will present the date of our searches in the final review. Titles and abstracts will be screened by two reviewers independently; selected reports will be studied by two reviewers independently. Reports will be included if they are primary research where data have been analysed, ML techniques have been used on data from LMICs and they aimed to improve health-related outcomes. We will synthesise the information following evidence mapping recommendations.Ethics and disseminationThe review will provide a comprehensive list of health-related ML applications in LMICs. The results will be disseminated through scientific publications. We also plan to launch a website where ML models can be hosted so that researchers, policymakers and the general public can readily access them.

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The implementation of colorectal cancer screening interventions in low-and middle-income countries: a scoping review

BMC Cancer ◽

10.1186/s12885-021-08809-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Désirée Schliemann ◽

Kogila Ramanathan ◽

Nicholas Matovu ◽

Ciaran O’Neill ◽

Frank Kee ◽

...

Keyword(s):

Colorectal Cancer ◽

Scoping Review ◽

Small Scale ◽

Screening Methods ◽

Recruitment Strategies ◽

Middle Income ◽

Crc Screening ◽

Middle Income Countries ◽

Screening Cost ◽

Low And Middle Income

Abstract Background Low- and middle-income countries (LMICs) experienced increasing rates of colorectal cancer (CRC) incidence in the last decade and lower 5-year survival rates compared to high-income countries (HICs) where the implementation of screening and treatment services have advanced. This review scoped and mapped the literature regarding the content, implementation and uptake of CRC screening interventions as well as opportunities and challenges for the implementation of CRC screening interventions in LMICs. Methods We systematically followed a five-step scoping review framework to identify and review relevant literature about CRC screening in LMICs, written in the English language before February 2020. We searched Medline, Embase, Web of Science and Google Scholar for studies targeting the general, asymptomatic, at-risk adult population. The TIDieR tool and an implementation checklist were used to extract data from empirical studies; and we extracted data-informed insights from policy reviews and commentaries. Results CRC screening interventions (n = 24 studies) were implemented in nine middle-income countries. Population-based screening programmes (n = 11) as well as small-scale screening interventions (n = 13) utilised various recruitment strategies. Interventions that recruited participants face-to-face (alone or in combination with other recruitment strategies) (10/15), opportunistic clinic-based screening interventions (5/6) and educational interventions combined with screening (3/4), seemed to be the strategies that consistently achieved an uptake of > 65% in LMICs. FOBT/FIT and colonoscopy uptake ranged between 14 and 100%. The most commonly reported implementation indicator was ‘uptake/reach’. There was an absence of detail regarding implementation indicators and there is a need to improve reporting practice in order to disseminate learning about how to implement programmes. Conclusion Opportunities and challenges for the implementation of CRC screening programmes were related to the reporting of CRC cases and screening, cost-effective screening methods, knowledge about CRC and screening, staff resources and training, infrastructure of the health care system, financial resources, public health campaigns, policy commitment from governments, patient navigation, planning of screening programmes and quality assurance.

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Exploring the Potential of Artificial Intelligence and Machine Learning to Combat COVID-19 and Existing Opportunities for LMIC: A Scoping Review

Journal of Primary Care & Community Health ◽

10.1177/2150132720963634 ◽

2020 ◽

Vol 11 ◽

pp. 215013272096363

Author(s):

Maleeha Naseem ◽

Ramsha Akhund ◽

Hajra Arshad ◽

Muhammad Talal Ibrahim

Keyword(s):

Artificial Intelligence ◽

Machine Learning ◽

Scoping Review ◽

Protein Structures ◽

Learning System ◽

Middle Income ◽

Current Time ◽

Middle Income Countries ◽

Low Middle Income Countries ◽

Scoping Reviews

Background: In the face of the current time-sensitive COVID-19 pandemic, the limited capacity of healthcare systems resulted in an emerging need to develop newer methods to control the spread of the pandemic. Artificial Intelligence (AI), and Machine Learning (ML) have a vast potential to exponentially optimize health care research. The use of AI-driven tools in LMIC can help in eradicating health inequalities and decrease the burden on health systems. Methods: The literature search for this Scoping review was conducted through the PubMed database using keywords: COVID-19, Artificial Intelligence (AI), Machine Learning (ML), and Low Middle-Income Countries (LMIC). Forty-three articles were identified and screened for eligibility and 13 were included in the final review. All the items of this Scoping review are reported using guidelines for PRISMA extension for scoping reviews (PRISMA-ScR). Results: Results were synthesized and reported under 4 themes. (a) The need of AI during this pandemic: AI can assist to increase the speed and accuracy of identification of cases and through data mining to deal with the health crisis efficiently, (b) Utility of AI in COVID-19 screening, contact tracing, and diagnosis: Efficacy for virus detection can a be increased by deploying the smart city data network using terminal tracking system along-with prediction of future outbreaks, (c) Use of AI in COVID-19 patient monitoring and drug development: A Deep learning system provides valuable information regarding protein structures associated with COVID-19 which could be utilized for vaccine formulation, and (d) AI beyond COVID-19 and opportunities for Low-Middle Income Countries (LMIC): There is a lack of financial, material, and human resources in LMIC, AI can minimize the workload on human labor and help in analyzing vast medical data, potentiating predictive and preventive healthcare. Conclusion: AI-based tools can be a game-changer for diagnosis, treatment, and management of COVID-19 patients with the potential to reshape the future of healthcare in LMIC.

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Vegetables for Healthy Diets in Low- and Middle-Income Countries: A Scoping Review of the Food Systems Literature

Food and Nutrition Bulletin ◽

10.1177/03795721211068652 ◽

2022 ◽

pp. 037957212110686

Author(s):

Jody Harris ◽

Winson Tan ◽

Jessica E. Raneri ◽

Pepijn Schreinemachers ◽

Anna Herforth

Keyword(s):

Scoping Review ◽

Low Income ◽

Food Systems ◽

Food System ◽

Food Group ◽

Middle Income ◽

Middle Income Countries ◽

Scoping Reviews ◽

Healthy Diets ◽

Low And Middle Income

Background: Vegetables are an essential element in healthy diets, but intakes are low around the world and there is a lack of systematic knowledge on how to improve diets through food system approaches. Methods: This scoping review assessed how studies of food systems for healthy diets have addressed the role of vegetables in low- and middle-income countries. We apply the PRISMA guidelines for scoping reviews to narratively map the literature to an accepted food systems framework and identify research gaps. Results: We found 1383 relevant articles, with increasing numbers over 20 years. Only 6% of articles looked at low-income countries, and 93% looked at single-country contexts. Over half of articles assessed vegetables as a food group, without looking at diversity within the food group. 15% looked at traditional vegetables. Issues of physical access to food were among the least studied food system topics in our review (7% of articles). Only 15% of articles used a comprehensive food system lens across multiple dimensions. There is also a research gap on the impacts of different policy and practice interventions (13% of articles) to enable greater vegetable consumption. Conclusions: Food system studies necessarily drew on multiple disciplines, methods and metrics to describe, analyze, and diagnose parts of the system. More work is needed across disciplines, across contexts, and across the food system, including understanding interventions and trade-offs, and impacts and change for diets particularly of marginalized population groups. Filling these gaps in knowledge is necessary in order to work toward healthy vegetable-rich diets for everyone everywhere.

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Colorectal cancer screening practices among low-income women

Clinical Journal of Women s Health ◽

10.1053/cjwh.2000.1053 ◽

2000 ◽

Vol 1 (1) ◽

pp. 3-9 ◽

Cited By ~ 5

Author(s):

Electra D. Paskett ◽

Ralph D'Agostino ◽

Cathy Tatum ◽

Ramon Velez ◽

Gretchen A. Brenes

Keyword(s):

Colorectal Cancer ◽

Cancer Screening ◽

Colorectal Cancer Screening ◽

Low Income ◽

Screening Practices ◽

Low Income Women

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National Colorectal Cancer Screening Program in Lithuania: Description of the 5-Year Performance on Population Level

Cancers ◽

10.3390/cancers13051129 ◽

2021 ◽

Vol 13 (5) ◽

pp. 1129

Author(s):

Audrius Dulskas ◽

Tomas Poskus ◽

Inga Kildusiene ◽

Ausvydas Patasius ◽

Rokas Stulpinas ◽

...

Keyword(s):

Colorectal Cancer ◽

Quality Assurance ◽

Cancer Screening ◽

Colorectal Cancer Screening ◽

Screening Program ◽

Histopathological Examination ◽

Insurance Fund ◽

Crc Screening ◽

Cancer Screening Program ◽

The Impact

We aimed to report the results of the implementation of the National Colorectal Cancer (CRC) Screening Program covering all the country. The National Health Insurance Fund (NHIF) reimburses the institutions for performing each service; each procedure within the program has its own administrative code. Information about services provided within the program was retrieved from the database of NHIF starting from the 1 January 2014 to the 31 December 2018. Exact date and type of all provided services, test results, date and results of biopsy and histopathological examination were extracted together with the vital status at the end of follow-up, date of death and date of emigration when applicable for all men and women born between 1935 and 1968. Results were compared with the guidelines of the European Union for quality assurance in CRC screening and diagnosis. The screening uptake was 49.5% (754,061 patients) during study period. Participation rate varied from 16% to 18.1% per year and was higher among women than among men. Proportion of test-positive and test-negative results was similar during all the study period—8.7% and 91.3% annually. Between 9.2% and 13.5% of test-positive patients received a biopsy of which 52.3–61.8% were positive for colorectal adenoma and 4.6–7.3% for colorectal carcinoma. CRC detection rate among test-positive individuals varied between 0.93% and 1.28%. The colorectal cancer screening program in Lithuania coverage must be improved. A screening database is needed to systematically evaluate the impact and performance of the national CRC screening program and quality assurance within the program.

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Exploration of recovery of people living with severe mental illness (SMI) in low/middle-income countries (LMICs): a scoping review

BMJ Open ◽

10.1136/bmjopen-2020-045005 ◽

2021 ◽

Vol 11 (3) ◽

pp. e045005

Author(s):

Fadia Gamieldien ◽

Roshan Galvaan ◽

Bronwyn Myers ◽

Zarina Syed ◽

Katherine Sorsdahl

Keyword(s):

Mental Illness ◽

Severe Mental Illness ◽

Scoping Review ◽

Data Extraction ◽

Flow Diagram ◽

Personal Recovery ◽

Middle Income ◽

Middle Income Countries ◽

Provider Perspectives ◽

Low Middle Income Countries

ObjectiveTo examine the literature on how recovery of people with severe mental illness (SMI) is conceptualised in low/middle-income countries (LMICs), and in particular what factors are thought to facilitate recovery.DesignScoping review.Data sources and eligibilityWe searched 14 electronic databases, hand searched citations and consulted with experts during the period May–December 2019. Eligible studies were independently screened for inclusion and exclusion by two reviewers. Unresolved discrepancies were referred to a third reviewer.Data extraction and synthesisAll bibliographical data and study characteristics were extracted using a data charting form. Selected studies were analysed through a thematic analysis emerging from extracted data.ResultsThe Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram offers a summary of the results: 4201 titles, 1530 abstracts and 109 full-text articles were screened. Ten articles were selected for inclusion: two from Turkey, two from India, and one each from China, Swaziland, Indonesia, Egypt, South Africa and Vietnam. Although most studies used qualitative methods, data collection and sampling methods were heterogeneous. One study reported on service provider perspectives while the rest provided perspectives from a combination of service users and caregivers. Three themes emerged from the data analysis. First, studies frame recovery as a personal journey occurring along a continuum. Second, there was an emphasis on social relationships as a facilitator of recovery. Third, spirituality emerged as both a facilitator and an indicator of recovery. These themes were not mutually exclusive and some overlap exists.ConclusionAlthough there were commonalities with how high-income countries describe recovery, we also found differences in conceptualisation. These differences in how recovery was understood reflect the importance of framing the personal recovery concept in relation to local needs and contextual issues found in LMICs. This review highlighted the current sparse evidence base and the need to better understand recovery from SMI in LMICs.

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Economics of healthcare access in low-income and middle-income countries: a protocol for a scoping review of the economic impacts of seeking healthcare on slum-dwellers compared with other city residents

BMJ Open ◽

10.1136/bmjopen-2020-045441 ◽

2021 ◽

Vol 11 (7) ◽

pp. e045441

Author(s):

Noemia Teixeira de Siqueira-Filha ◽

Jinshuo Li ◽

Eliud Kibuchi ◽

Zahidul Quayyum ◽

Penelope Phillips-Howard ◽

...

Keyword(s):

Economic Impact ◽

Scoping Review ◽

Low Income ◽

Purchase Power Parity ◽

Healthcare Access ◽

Well Being ◽

Power Parity ◽

Middle Income ◽

Slum Dwellers ◽

Scoping Reviews

IntroductionPeople living in slums face several challenges to access healthcare. Scarce and low-quality public health facilities are common problems in these communities. Costs and prevalence of catastrophic health expenditures (CHE) have also been reported as high in studies conducted in slums in developing countries and those suffering from chronic conditions and the poorest households seem to be more vulnerable to financial hardship. The COVID-19 pandemic may be aggravating the economic impact on the extremely vulnerable population living in slums due to the long-term consequences of the disease. The objective of this review is to report the economic impact of seeking healthcare on slum-dwellers in terms of costs and CHE. We will compare the economic impact on slum-dwellers with other city residents.Methods and analysisThis scoping review adopts the framework suggested by Arksey and O’Malley. The review is part of the accountability and responsiveness of slum-dwellers (ARISE) research consortium, which aims to enhance accountability to improve the health and well-being of marginalised populations living in slums in India, Bangladesh, Sierra Leone and Kenya. Costs of accessing healthcare will be updated to 2020 prices using the inflation rates reported by the International Monetary Fund. Costs will be presented in International Dollars by using purchase power parity. The prevalence of CHE will also be reported.Ethics and disseminationEthical approval is not required for scoping reviews. We will disseminate our results alongside the events organised by the ARISE consortium and international conferences. The final manuscript will be submitted to an open-access international journal. Registration number at the Research Registry: reviewregistry947.

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