Urbanisation and asthma in low-income and middle-income countries: a systematic review of the urban–rural differences in asthma prevalence

BackgroundUrbanisation has been associated with temporal and geographical differences in asthma prevalence in low-income and middle-income countries (LMICs). However, little is known of the mechanisms by which urbanisation and asthma are associated, perhaps explained by the methodological approaches used to assess the urbanisation-asthma relationship.ObjectiveThis review evaluated how epidemiological studies have assessed the relationship between asthma and urbanisation in LMICs, and explored urban/rural differences in asthma prevalence.MethodsAsthma studies comparing urban/rural areas, comparing cities and examining intraurban variation were assessed for eligibility. Included publications were evaluated for methodological quality and pooled OR were calculated to indicate the risk of asthma in urban over rural areas.ResultsSeventy articles were included in our analysis. Sixty-three compared asthma prevalence between urban and rural areas, five compared asthma prevalence between cities and two examined intraurban variation in asthma prevalence. Urban residence was associated with a higher prevalence of asthma, regardless of asthma definition: current-wheeze OR:1.46 (95% CI:1.22 to 1.74), doctor diagnosis OR:1.89 (95% CI:1.47 to 2.41), wheeze-ever OR:1.44 (95% CI:1.15 to 1.81), self-reported asthma OR:1.77 (95% CI:1.33 to 2.35), asthma questionnaire OR:1.52 (95% CI:1.06 to 2.16) and exercise challenge OR:1.96 (95% CI:1.32 to 2.91).ConclusionsMost evidence for the relationship between urbanisation and asthma in LMICs comes from studies comparing urban and rural areas. These studies tend to show a greater prevalence of asthma in urban compared to rural populations. However, these studies have been unable to identify which specific characteristics of the urbanisation process may be responsible. An approach to understand how different dimensions of urbanisation, using contextual household and individual indicators, is needed for a better understanding of how urbanisation affects asthma.PROSPERO registration numberCRD42017064470.

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Tracing Long- and Short-term Migrants for Participation in Demographic and Epidemiological Studies: Evidence from Senegal

Field Methods ◽

10.1177/1525822x19879892 ◽

2019 ◽

Vol 32 (1) ◽

pp. 38-57

Author(s):

Mufaro Kanyangarara ◽

Laetitia Douillot ◽

Gilles Pison ◽

Cheikh Tidiane Ndiaye ◽

Valerie Delaunay ◽

...

Keyword(s):

Rural Areas ◽

Statistical Power ◽

Epidemiological Studies ◽

Adult Mortality ◽

Short Term ◽

Middle Income ◽

Middle Income Countries ◽

Contact Information

Migration of participants in demographic and epidemiological studies results in missing data. One approach to reduce resulting losses in statistical power and potential biases is to follow up migrants at their new residence. We describe the follow-up of migrants who were eligible for participation in a trial of a new questionnaire to measure adult mortality in Niakhar, Senegal. We conducted a short inquiry in the migrant’s last known household to obtain contact information and then attempted to contact and interview 661 migrants who resided in Dakar, Mbour, and rural areas close to Niakhar. About two-thirds of migrants were successfully enrolled in the study. Having a contact phone number and knowing the name of the head of compound at destination increased the likelihood of successful enrollment. Following up migrants in demographic studies is feasible in low- and middle-income countries, including long-term migrants who have not been contacted for extended periods of time.

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Strategies used to establish palliative care in rural low- and middle-income countries: an integrative review

Health Policy and Planning ◽

10.1093/heapol/czaa051 ◽

2020 ◽

Vol 35 (8) ◽

pp. 1110-1129

Author(s):

Atsede Aregay ◽

Margaret O’Connor ◽

Jill Stow ◽

Nicola Ayers ◽

Susan Lee

Keyword(s):

Palliative Care ◽

Low Income ◽

Rural Areas ◽

Urban Areas ◽

Care Home ◽

Sub Saharan Africa ◽

Integrative Review ◽

Middle Income ◽

Middle Income Countries ◽

Low And Middle Income

Abstract Globally, 40 million people need palliative care; about 69% are people over 60 years of age. The highest proportion (78%) of adults are from low- and middle-income countries (LMICs), where palliative care still developing and is primarily limited to urban areas. This integrative review describes strategies used by LMICs to establish palliative care in rural areas. A rigorous integrative review methodology was utilized using four electronic databases (Ovid MEDLINE, Ovid Emcare, Embase classic+Embase and CINAHL). The search terms were: ‘palliative care’, ‘hospice care’, ‘end of life care’, ‘home-based care’, ‘volunteer’, ‘rural’, ‘regional’, ‘remote’ and ‘developing countries’ identified by the United Nations (UN) as ‘Africa’, ‘Sub-Saharan Africa’, ‘low-income’ and ‘middle- income countries’. Thirty papers published in English from 1990 to 2019 were included. Papers were appraised for quality and extracted data subjected to analysis using a public health model (policy, drug availability, education and implementation) as a framework to describe strategies for establishing palliative care in rural areas. The methodological quality of the reviewed papers was low, with 7 of the 30 being simple programme descriptions. Despite the inclusion of palliative care in national health policy in some countries, implementation in the community was often reliant on advocacy and financial support from non-government organizations. Networking to coordinate care and medication availability near-patient homes were essential features of implementation. Training, role play, education and mentorship were strategies used to support health providers and volunteers. Home- and community-based palliative care services for rural LMICs communities may best be delivered using a networked service among health professionals, community volunteers, religious leaders and technology.

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Neonatal mortality and leading causes of deaths: a descriptive study in China, 2014–2018

BMJ Open ◽

10.1136/bmjopen-2020-042654 ◽

2021 ◽

Vol 11 (2) ◽

pp. e042654

Author(s):

Yuxi Liu ◽

Leni Kang ◽

Chunhua He ◽

Lei Miao ◽

Xiaoqiong Qiu ◽

...

Keyword(s):

Mortality Rate ◽

Neonatal Mortality ◽

Low Income ◽

Rural Areas ◽

Urban Areas ◽

Middle Income ◽

Government Interventions ◽

Neonatal Deaths ◽

Live Births ◽

Urban And Rural Areas

ObjectiveThe present study estimated the national and urban–rural levels and causes of neonatal deaths in China annually between 2014 and 2018 to provide data support for the further end of preventable neonatal deaths for China and other low-income and middle-income countries.MethodsThe study was based on data from the National Maternal and Child Health Surveillance System. All neonates of surveillance districts (gestational week: ≥28 weeks) who died after delivery have been involved in the study. The mortality rate and the leading causes of death for neonates were analysed.ResultsThe neonatal mortality rate (NMR) of China has steadily decreased from 5.9 deaths per 1000 live births in 2014 to 3.9 deaths per 1000 live births in 2018. The NMR in 2018 of urban and rural areas was 2.2 deaths per 1000 live births and 4.7 deaths per 1000 live births, respectively. The leading preventable causes of neonatal deaths are the same in the urban and rural areas were same, which were preterm birth, intrapartum complications and pneumonia. Mortality rates of these three causes fell significantly between 2014 and 2018 but contributed to a higher proportion of deaths in rural areas than urban areas. The proportion of preventable deaths accounted for 74.6% in 2018.ConclusionsThe NMR of China has decreased steadily from 2014 to 2018. However, the inequality between urban and rural areas still exists. The goal of government interventions should be to reduce the health inequality of neonates and further take targeted measures to eliminate preventable neonatal death.

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China’s urban-rural relationship: evolution and prospects

China Agricultural Economic Review ◽

10.1108/caer-02-2018-0038 ◽

2018 ◽

Vol 10 (2) ◽

pp. 260-276 ◽

Cited By ~ 3

Author(s):

Zhenghe Zhang ◽

Yawen Lu

Keyword(s):

Rural Areas ◽

People’S Republic Of China ◽

People's Republic Of China ◽

Content Type ◽

Republic Of China ◽

The Future ◽

Urban Rural ◽

Urban And Rural Areas ◽

Reform And Opening Up ◽

The Relationship

Purpose In the 69 years since the founding of the People’s Republic of China, especially the 40 years since the reform and opening-up, the relationship between urban and rural areas has undergone profound change. When the deepening reform of the urban-rural relationship is entering a critical period, it is necessary to reassess the evolution of the urban-rural relationship in China and draw a picture for that relationship in the future. The paper aims to discuss these issues. Design/methodology/approach This paper combs the policies on the urban and rural development since the founding of the People’s Republic of China, and analyzes macro data on the industries, population, personal income, and other aspects. Findings The study found that this urbanism affects individuals’ lives and the choices of society through the will of the state, and then provides feedback at the whole level of social values. Originality/value This paper divides the evolution of China’s urban-rural relationship into two major stages – nurturing cities with rural areas and leading rural areas with cities, which are then subdivided into five periods. The features of the relationship between the urban and rural areas in different periods are analyzed, and the future development of urban-rural relations is also considered.

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Are inequities decreasing? Birth registration for children under five in low-income and middle-income countries, 1999–2016

BMJ Global Health ◽

10.1136/bmjgh-2019-001926 ◽

2019 ◽

Vol 4 (6) ◽

pp. e001926

Author(s):

Amiya Bhatia ◽

Nancy Krieger ◽

Jason Beckfield ◽

Aluisio J D Barros ◽

Cesar Victora

Keyword(s):

Low Income ◽

Maternal Education ◽

Vital Statistics ◽

Birth Registration ◽

Middle Income ◽

Children Under Five ◽

Under Five ◽

Rural Location ◽

Middle Income Countries ◽

Urban Rural

IntroductionAlthough global birth registration coverage has improved from 58% to 71% among children under five globally, inequities in birth registration coverage by wealth, urban/rural location, maternal education and access to a health facility persist. Few studies examine whether inequities in birth registration in low-income and middle-income countries have changed over time.MethodsWe combined information on caregiver reported birth registration of 1.6 million children in 173 publicly available, nationally representative Demographic Health Surveys and Multiple Indicator Cluster Surveys across 67 low-income and middle-income countries between 1999 and 2016. For each survey, we calculated point estimates and 95% CIs for the percentage of children under 5 years without birth registration on average and stratified by sex, urban/rural location and wealth. For each sociodemographic variable, we estimated absolute measures of inequality. We then examined changes in non-registration and inequities between surveys, and annually.Results14 out of 67 countries had achieved complete birth registration. Among the remaining 53 countries, 39 countries successfully decreased the percentage of children without birth registration. However, this reduction occurred alongside statistically significant increases in wealth inequities in 9 countries and statistically significant decreases in 10 countries. At the most recent survey, the percentage of children without birth registration was greater than 50% in 16 out of 67 countries.ConclusionAlthough birth registration improved on average, progress in reducing wealth inequities has been limited. Findings highlight the importance of monitoring changes in inequities to improve birth registration, to monitor Sustainable Development Goal 16.9 and to strengthen Civil Registration and Vital Statistics systems.

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A Bibliometric Analysis of Published Literature in Postoperative Pain in Elderly Patients in Low- and Middle-Income Countries

Journal of Clinical Medicine ◽

10.3390/jcm10112334 ◽

2021 ◽

Vol 10 (11) ◽

pp. 2334

Author(s):

João Batista Santos Garcia ◽

Érica Brandão de Moraes ◽

José Osvaldo Barbosa Neto

Keyword(s):

Postoperative Pain ◽

Elderly Patients ◽

Bibliometric Analysis ◽

Low Income ◽

The Elderly ◽

Epidemiological Studies ◽

Middle Income ◽

Middle Income Countries ◽

Citation Indexes ◽

Low And Middle Income

Postoperative pain (POP) remains a major challenge for surgeons and anesthesiologists worldwide, especially in low- and middle-income countries. Elderly patients are at higher risk for undertreatment of pain. Despite that, there is a paucity of papers addressing POP among this population in developing countries. This study aimed to provide a bibliometric analysis of the literature concerning postoperative pain in elderly patients from low- and middle-income countries. It was performed an extensive search of papers on this subject through the Web of Science and Scopus database using a series of uniterms and, including publications from 2001 to 2021. Publication quality was assessed by using total citation frequency, average citations per item and other citation indexes. Citation indexes were low, with the highest reaching 15 citations. In conclusion, few studies of postoperative pain in the elderly in countries with medium and low income, indicating a need that has not yet been met for this population and in these areas of the world. The published studies were not specifically aimed at the elderly, had limited impact, low international visibility. They were not epidemiological studies and are not robust, weakening knowledge and decision-making towards policies directed at this vulnerable population.

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40 years after Alma-Ata, is building new hospitals in low-income and lower-middle-income countries beneficial?

BMJ Global Health ◽

10.1136/bmjgh-2018-001293 ◽

2019 ◽

Vol 3 (Suppl 3) ◽

pp. e001293 ◽

Cited By ~ 1

Author(s):

Fanny Chabrol ◽

Lucien Albert ◽

Valéry Ridde

Keyword(s):

Low Income ◽

Environmental Sustainability ◽

Public Hospitals ◽

Decision Makers ◽

Middle Income ◽

Middle Income Countries ◽

Geographical Inequalities ◽

Urban Rural ◽

Hospital Construction

Public hospitals in low-income and lower-middle-income countries face acute material and financial constraints, and there is a trend towards building new hospitals to contend with growing population health needs. Three cases of new hospital construction are used to explore issues in relation to their funding, maintenance and sustainability. While hospitals are recognised as a key component of healthcare systems, their role, organisation, funding and other aspects have been largely neglected in health policies and debates since the Alma Ata Declaration. Building new hospitals is politically more attractive for both national decision-makers and donors because they symbolise progress, better services and nation-building. To avoid the ‘white elephant’ syndrome, the deepening of within-country socioeconomic and geographical inequalities (especially urban–rural), and the exacerbation of hospital-centrism, there is an urgent need to investigate in greater depth how these hospitals are integrated into health systems and to discuss their long-term economic, social and environmental sustainability.

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Screening for various non communicable diseases: a community based multi-diagnostic mega camp approach study from Raichur, Karnataka

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20214855 ◽

2021 ◽

Author(s):

Amruth Reddy S. ◽

Sai Anurag Reddy A. ◽

Anant A. Takalkar

Keyword(s):

Rural Areas ◽

Research Centre ◽

Healthy Population ◽

Community Based ◽

College Hospital ◽

Middle Income ◽

Medical College ◽

Middle Income Countries ◽

Urban And Rural Areas ◽

Rural Part

Background: The 77% of all non-communicable illnesses (NCDs) deaths are in low-and middle-income countries. Cardiovascular diseases account for most NCD deaths, or 17.9 million people annually, followed by cancers (9.3 million), respiratory diseases (4.1 million), and diabetes (1.5 million). These 4 groups of diseases account for over 80% of all premature NCD deaths. Objective was to study prevalence of NCDs and its trends with respect to age and gender.Methods: The present community based descriptive observational study was conducted at Navodaya medical college hospital and research centre, Raichur that caters Urban and rural area of Raichur. The 4063 apparently healthy population from urban and rural part of Raichur were screened during the multi diagnostic mega camp at urban and rural areas around Raichur during the period of January to September 2021. Results: Prevalence of diabetes in our study was 46.3%, hypertension 45.3%, cataract 46.3% and COPD as 20.7%. Prevalence of diabetes was more in 41-60 years i.e., 41.6%. Prevalence of hypertension was more in 41-50 years i.e., 25.3%. Prevalence of diabetes was more in males i.e., 54.1%. Prevalence of hypertension was more in males i.e., 50.8%.Conclusions: Prevalence of all NCDs was more in above 40 years and more in males except COPD.

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