scholarly journals Association between triage level and outcomes at Médecins Sans Frontières trauma hospital in Kunduz, Afghanistan, 2015

2021 ◽  
pp. emermed-2020-209470
Author(s):  
Hadjer Latif Daebes ◽  
Linnea Latifa Tounsi ◽  
Maximilian Nerlander ◽  
Martin Gerdin Wärnberg ◽  
Momer Jaweed ◽  
...  
Keyword(s):  
Hospital Admission ◽  
Low Income ◽  
Public Health Problem ◽  
Trauma Centre ◽  
Middle Income ◽  
Icu Admission ◽  
Low Income Country ◽  
Medecins Sans Frontieres ◽  
Médecins Sans Frontières ◽  
Triage Level

BackgroundFive million people die annually due to injuries; an increasing part is due to armed conflict in low-income and middle-income countries, demanding resolute emergency trauma care. In Afghanistan, a low-income country that has experienced conflict for over 35 years, conflict related trauma is a significant public health problem. To address this, the non-governmental organisation Médecins Sans Frontières (MSF) set up a trauma centre in Kunduz (Kunduz Trauma Centre (KTC)). MSF’s standardised emergency operating procedures include the South African Triage Scale (SATS). To date, there are few studies that assess how triage levels correspond with outcome in low-resource conflict settingsAimThis study aims to assess to what extent SATS triage levels correlated to outcomes in terms of hospital admission, intensive care unit (ICU) admission and mortality for patients treated at KTC.Method and materialsThis retrospective study used routinely collected data from KTC registries. A total of 17 970 patients were included. The outcomes were hospital admission, ICU admission and mortality. The explanatory variable was triage level. Covariates including age, gender and delay to arrival were used. Logistic regression was used to study the correlation between triage level and outcomes.ResultsOut of all patients seeking care, 70% were triaged as red or orange. The overall mortality was 0.6%. In total, 90% of those that died and 79% of ICU-admitted patients were triaged as red.ConclusionThe risk of positive and negative outcomes correlated with triage level. None of the patients triaged as green died or were admitted to the ICU whereas 90% of patients who died were triaged as red.

Impact of COVID-19 on FDIs, Remittances and Foreign Aids: A Case Study of Nepal

2021 ◽  
pp. 097639962097420
Author(s):  
Gaurav Bhattarai ◽  
Binita Subedi
Keyword(s):  
United Nations ◽  
Low Income ◽  
Global Economy ◽  
Grey Literature ◽  
Foreign Assistance ◽  
Foreign Direct Investments ◽  
Middle Income ◽  
Low Income Country ◽  
The Government ◽  
The Impact

The global economy has been severely paralysed, owing to the unprecedented crisis triggered by the COVID-19 pandemic, and different studies have indicated that the crisis is relatively more maleficent to the lower-income and middle-income economies. Methodologically, this study relied on the review and analysis of the grey literature, media reporting and data published by the Asian Development Bank, United Nations Conference on Trade and Development (UNCTAD), United Nations (UN), World Bank, International Monetary Fund (IMF) among others. The article begins by describing the impact of the pandemic on low-income and middle-income countries, and it discusses how they have responded to the crisis. While discussions have surfaced regarding whether COVID-19 will reverse the process of globalization, what will be its impact on the low-income country like Nepal? The study also highlights that with foreign direct investments speculated to shrink and foreign assistance and remittance taking a hit, how is Nepal struggling to keep its economy afloat? Analysing the new budget that the government unveiled in 2020, this study concludes with a note that instead of effectively implementing the plans and policies directed by the budget, Nepal is unnecessarily engaged in political mess and is needlessly being dragged into the geopolitical complications.

scholarly journals Impact of refugee population on development: A comparative analysis for the case of host economies

2018 ◽  
Vol 18 (1) ◽  
pp. 77-96
Author(s):  
Mohamed Kouni
Keyword(s):  
Labor Force ◽  
Direct Effect ◽  
Low Income ◽  
Indirect Effect ◽  
Point Of View ◽  
Low Income Countries ◽  
Middle Income ◽  
Refugee Population ◽  
Low Income Country ◽  
Middle Income Countries

Abstract This study was carried out to investigate the relationship between refugees and development in host economies from a macroeconomic point of view. The results obtained show that this relationship is non-linear. The empirical results demonstrate that refugees have a positive and significant direct effect in high and lower-middle-income countries. A positive and significant indirect effect of refugees through labor force and RD channels is also present in the same groups. In upper-middle-income and low-income countries, the direct effect of refugees is negative and significant. Similarly, the indirect effect of the refugee population on development through labor force channel is also negative and statistically significant. However, the indirect effect of refugees through RD channel is statistically significant only for the low-income country group.

scholarly journals Antiparasitic phytotherapy perspectives, scope and current development

Infectio ◽  
2019 ◽  
Vol 23 (2) ◽  
pp. 189 ◽  
Author(s):  
Jhon Carlos Castaño Osorio ◽  
Alejandra María Giraldo García
Keyword(s):  
Low Income ◽  
Public Health Problem ◽  
Cost Effective ◽  
Prolonged Treatment ◽  
Major Public Health Problem ◽  
Middle Income ◽  
Middle Income Countries ◽  
Commercial Markets ◽  
Health And Economic Development ◽  
New Treatments

Tropical protozoan diseases are currently a major public health problem throughout the world and are strongly linked with poverty, this combined with a lack of commercial markets for potential drugs has created a large burden on the health and economic development of low-income and middle-income countries in Africa, Asia, and the Americas. Due to the low research interest and the high increase of resistance against the existing treatments, as well as increasing inefficiency, toxicity, prolonged treatment schedules and costs, there is an urgent need for cost-effective, safe and easy-to-administer, new effective compounds with novel mechanisms of action. Several studies of crude plant extracts have already identified potential compounds to treat Chagas’ disease, Leishmaniasis, Toxoplasmosis, Giardiasis, and Malaria among other protozoan parasites. Natural compounds of medicinal plants have shown lower toxicity together with higher specificity, creating an optimistic view of new treatments for diseases. Out of 1010 new active substances approved as drugs for medical conditions by regulatory agencies during the past 25 years, 490(48.5%) were from a natural origin.

scholarly journals Population genomics of Cryptosporidium hominis across five continents identifies two subspecies that have diverged and recombined during 500 years of evolution

2021 ◽  
Author(s):  
Swapnil Tichkule ◽  
Simone M. Cacciò ◽  
Guy Robinson ◽  
Rachel M. Chalmers ◽  
Ivo Mueller ◽  
...  
Keyword(s):  
Gene Flow ◽  
Low Income ◽  
Population Genomics ◽  
Balancing Selection ◽  
Public Health Problem ◽  
High Income ◽  
Secondary Contact ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

AbstractCryptosporidium is a significant public health problem and one of the primary causes of diarrhoea in humans, particularly in very young children living in low- and middle-income countries. While the zoonotic Cryptosporidium parvum and anthroponotic C. hominis species collectively account for most cases globally, the latter is predominant in low- and middle-income countries. Here, we present a comprehensive whole genome study of C. hominis, comprising 114 isolates from 16 countries within five continents. We detect two highly diverged lineages with a distinct biology and demography that have diverged circa 500 years ago. We consider these lineages as two subspecies, and provisionally propose the names C. hominis hominis (clade 1) and C. hominis aquapotentis (clade 2 or gp60 subtype IbA10G2). C. h. hominis is mostly found in low-income countries in Africa and Asia, and it appears to have recently undergone population contraction. In marked contrast, C. h. aquapotentis was found in high-income countries, mainly in Europe, North America and Oceania, and we reveal a signature of population expansion. Moreover, we detected genomic regions of introgression representing gene flow after a secondary contact between the subspecies from low- and high-income countries. We demonstrate that this gene flow resulted in genomic island of high diversity and divergence, and that this diversity at potential virulence genes is maintained by balancing selection, suggesting that they are involved in a coevolutionary arms race.

scholarly journals Establishment of a road traffic trauma registry for northern Sri Lanka

2020 ◽  
Vol 5 (1) ◽  
pp. e001818 ◽  
Author(s):  
Thayasivam Gobyshanger ◽  
Alison M Bales ◽  
Claire Hardman ◽  
Mary McCarthy
Keyword(s):  
Sri Lanka ◽  
Low Income ◽  
Trauma Registry ◽  
Road Traffic ◽  
Prehospital Care ◽  
Public Health Problem ◽  
Global Public Health ◽  
Middle Income ◽  
Road Traffic Crashes ◽  
Middle Income Countries

Road traffic injuries are a neglected global public health problem. Over 1.25 million people are killed each year, and middle-income countries, which are motorising rapidly, are the hardest hit. Sri Lanka is dealing with an injury-related healthcare crisis, with a recent 85% increase in road traffic fatality rates. Road traffic crashes now account for 25 000 injuries annually and 10 deaths daily. Development of a trauma registry is the foundation for injury control, care and prevention. Five northern Sri Lankan provinces collaborated with Jaffna Teaching Hospital to develop a local electronic registry. The Centre for Clinical Excellence and Research was established to provide organisational leadership, hardware and software were purchased, and data collectors trained. Initial data collection was modified after implementation challenges were resolved. Between 1 June 2017 and 30 September 2017, 1708 injured patients were entered into the registry. Among these patients, 62% were male, 76% were aged 21–50, 71.3% were motorcyclists and 34% were in a collision with another motorcyclist. There were frequent collisions with uncontrolled livestock (12%) and with fixed objects (14%), and most patients were transported by private vehicles without prehospital care. Head (n=315) and lower extremity (n=497) injuries predominated. Establishment of a trauma registry in low-income and middle-income countries is a significant challenge and requires invested local leadership; the most challenging issue is ongoing funding. However, this pilot registry provides a valuable foundation, identifying unique injury mechanisms, establishing priorities for prevention and patient care, and introducing the concept of an organised system to this region.

scholarly journals Post-hospital Care for People Recovering from Acute Injuries in Low and Middle Income Countries: 5 Domains of Health Management

2017 ◽  
Vol 11 (29) ◽  
pp. 1704-1729
Author(s):  
Nicole Toomey ◽  
Deena El-Gabri ◽  
Joao Ricardo Nickenig Vissoci ◽  
Janet Prvu Bettger ◽  
Catherine Staton
Keyword(s):  
Low Income ◽  
Health Management ◽  
Healthcare Management ◽  
Care Plan ◽  
Care Transition ◽  
Transition Model ◽  
Middle Income ◽  
Mortality And Morbidity ◽  
Low Income Country ◽  
Low And Middle Income

Injury is a leading cause of death and disability globally. After an acute hospitalization for an injury, a care transition model has been shown to reduce mortality and morbidity but these are uncommon in a low and middle income setting. When planning a post hospitalization care plan, many health management factors should be taken into account as they can impact outcome. This manuscript delineates a 5 Domains of Healthcare Management or ‘5 Domains’ which should be addressed in this care transition model. The literature behind each of these domains and their impact on post hospitalization outcomes along with a case study of a care transition plan for a low income country is described. 

scholarly journals Improving Oncology-Pathology Collaboration in Resource-Limited Settings: An American Society of Clinical Oncology/College of American Pathologists Initiative

2021 ◽  
pp. 199-220
Author(s):  
Jose Angel Sanchez ◽  
Silvia Portillo ◽  
Matthew A. Zarka ◽  
Devon Snedden ◽  
Doug Pyle ◽  
...  
Keyword(s):  
Clinical Oncology ◽  
Low Income ◽  
International Workshop ◽  
Delayed Diagnosis ◽  
Diagnosis And Treatment ◽  
Low Income Countries ◽  
Cancer Awareness ◽  
Middle Income ◽  
Low Income Country ◽  
Pathologic Evaluation

Accurate pathologic evaluation is essential for proper diagnosis and treatment of patients with cancer. ASCO and the College of American Pathologists have successfully collaborated over the last 15 years to improve collaboration between clinical oncologists and pathologists and to standardize pathologic assay techniques. Cancer is an increasingly recognized societal burden in low- and middle-income countries. In 2015, ASCO and the College of American Pathologists implemented an initiative to identify countries that could benefit from peer insights by jointly convening an international workshop among members of both organizations and pathologists and clinical oncologists from Haiti, Honduras, Vietnam, and Uganda. Honduras was chosen as a pilot site, and representatives of ASCO, the College of American Pathologists, and the Honduras pathology and clinical oncology communities have identified areas in which collaboration might be productive. Multiple barriers, including high poverty levels, poor cancer awareness educational programs, lack of human resources, and delayed diagnosis and treatment, have resulted in a higher cancer mortality rate in Honduras compared with high/moderate-income countries and are shared by other low-income countries. ASCO and the College of American Pathologists member faculty supported a symposium led by Honduras colleagues for interested Honduran pathologists and oncologists. The Honduran communities are now working to establish national resource-appropriate guidelines for both pathology and clinical oncology. Taken together, these efforts indicate that barriers to meet the needs of the clinical oncologists in a low-income country such as Honduras are challenging but not insurmountable.

The reality of the Noncommunicable disease policy landscape in Low Income Countries: the example of Mozambique

2021 ◽  
Author(s):  
Khatia Rebeca Munguambe ◽  
Tavares Madede ◽  
Vasco Muchanga ◽  
Claire Somerville ◽  
David Henri Beran ◽  
...  
Keyword(s):  
Low Income ◽  
Well Being ◽  
Noncommunicable Disease ◽  
Low Income Countries ◽  
Noncommunicable Diseases ◽  
Middle Income ◽  
External Resources ◽  
Low Income Country ◽  
Middle Income Countries ◽  
Government Documents

Abstract Background Noncommunicable diseases (NCD) are the leading cause of morbidity and mortality worldwide with a disproportionate burden affecting low- and middle-income countries (LMIC). Mozambique, is a low income country situated in Southern Africa with an emerging burden of NCDs, but still facing a large challenge with regards to communicable diseases. Using the policy prioritisation framework developed by Shiffman and Smith this study aims to present the different elements that have shaped the current policy landscape for NCDs in Mozambique.Results The policy review identified 18 documents, and seven KIs were interviewed. The policy community could be seen as cohesive in that a few leading experts in Mozambique agreed on both the challenges of NCDs and the possible response, but overall leadership was lacking. Although the Ministry of Health and its NCD Department were seen as the guiding institutions the Department was not resourced to be able to fulfil its mandate. Some external resources were available to assist, but these were insufficient. In addition civil society mobilisation was missing. With regards to ideas three disconnects were present: language used in overarching government documents and their translation into practice; the views of experts; and the perceptions of NCDs in a context like Mozambique in contrast to other health issues. The NCD Department and different strategies and government documents laid out the governing structure, but again a lack of resources hampered progress. This was compounded by a lack of understanding of the problem and solutions, as well as barriers to integrate the NCD response with HIV/AIDS for example. Conclusions This study shows that despite gaining prominence on the global health agenda, NCDs have yet to truly gain a strong foothold on the policy agenda of LMICs such as Mozambique. In order to do this both governments and donors need to be sensitised to this issue as well as clear guidance developed to enable countries to have practical solutions to address both prevention and treatment of NCDs in underfunded and weak health systems, but also be able to build on existing initiatives to improve the health and well-being of populations.

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