scholarly journals The Landscape of Randomised Controlled Trials of Therapies in Breast Cancer in Low and Middle Income Countries

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Katharine Lynch-Kelly ◽  
Matthew Singer ◽  
Norman R. Williams

Objectives. The objectives of this study were to identify the randomised controlled trials in breast cancer occurring in low and middle income countries (LMICs) generally and within Sub-Saharan Africa specifically, to describe the current status and identify opportunities for further research in these areas. Materials and Methods. Data for this study were obtained from ClinicalTrials.gov. The search term “Breast Cancer Research” was used, and relevant information extracted and analysed. Results. 2414 trials were identified, of which 1099 were eligible for inclusion. 69 of these trials occurred in LMICs. Of the 52 LMICs globally, 30% were participating in breast cancer research. Of the 17 LMICs in Africa, 77% are situated in Sub-Saharan Africa; 23% were participating in breast cancer research, which accounted for 9% of total Sub-Saharan African studies. Conclusion. This study provides current evidence for the need for breast cancer research in LMICs globally and within Sub-Saharan Africa. Within LMIC regions where research is active, the type and numbers of studies are unevenly distributed. High quality research within such areas should be encouraged as the results may have both local and global applications, particularly in the provision of affordable health care.

2021 ◽  
Vol 5 (3) ◽  
Author(s):  
Oladayo Nathaniel Awojobi

This paper summarises the arguments and counterarguments within the scientific discussion on cash transfers and child nutrition. The main purpose of the research is to assess the effectiveness of cash transfers in improving nutritional outcomes in vulnerable children in sub-Saharan Africa. Systematisation of the literary sources indicates that studies have justified cash transfer as social-income support that addresses a vital social determinant of health (income) for children in low-and-middle-income countries. The methodological basis of this study is a systematic review that searched a wide range of academic and grey literature databases, including PubMed, Cochrane Library and Google Scholar. This study included cluster-randomised controlled trials (R.C.T.s), randomised controlled trials, quasi-experimental studies, mixed-methods studies, and non-randomised cluster trials. Studies included in this systematic review were screened for their eligibility. The systematic review uses the Cochrane data collection form to extract data from the included studies. It was not feasible to statistically combine the results of the studies due to the heterogeneity of most of the studies. Preferably, the review employs a narrative synthesis to present the estimated effects of cash transfers on children’s nutritional outcomes. The systematic review presents the results of data synthesis, of which eleven studies met the inclusion criteria. Overall, the evidence from the systematic review indicates that cash transfer programmes targeted at children effectively improve anthropometric and nutritional outcomes. Further research is needed to spell out the multiple pathways to how cash transfers improve children’s nutritional outcomes. Moreover, this systematic review shows the importance of cash transfers in improving child nutrition. Policymakers should continue to employ institutional mechanisms to strengthen the nutritional status of children, especially the vulnerable ones since cash transfer intervention is a temporary measure.


BMJ Open ◽  
2014 ◽  
Vol 4 (10) ◽  
pp. e005983 ◽  
Author(s):  
Gbenga Ogedegbe ◽  
Joyce Gyamfi ◽  
Jacob Plange-Rhule ◽  
Alisa Surkis ◽  
Diana Margot Rosenthal ◽  
...  

ObjectiveTo evaluate evidence from published randomised controlled trials (RCTs) for the use of task-shifting strategies for cardiovascular disease (CVD) risk reduction in low-income and middle-income countries (LMICs).DesignSystematic review of RCTs that utilised a task-shifting strategy in the management of CVD in LMICs.Data SourcesWe searched the following databases for relevant RCTs: PubMed from the 1940s, EMBASE from 1974, Global Health from 1910, Ovid Health Star from 1966, Web of Knowledge from 1900, Scopus from 1823, CINAHL from 1937 and RCTs from ClinicalTrials.gov.Eligibility criteria for selecting studiesWe focused on RCTs published in English, but without publication year. We included RCTs in which the intervention used task shifting (non-physician healthcare workers involved in prescribing of medications, treatment and/or medical testing) and non-physician healthcare providers in the management of CV risk factors and diseases (hypertension, diabetes, hyperlipidaemia, stroke, coronary artery disease or heart failure), as well as RCTs that were conducted in LMICs. We excluded studies that are not RCTs.ResultsOf the 2771 articles identified, only three met the predefined criteria. All three trials were conducted in practice-based settings among patients with hypertension (2 studies) and diabetes (1 study), with one study also incorporating home visits. The duration of the studies ranged from 3 to 12 months, and the task-shifting strategies included provision of medication prescriptions by nurses, community health workers and pharmacists and telephone follow-up posthospital discharge. Both hypertension studies reported a significant mean blood pressure reduction (2/1 mm Hg and 30/15 mm Hg), and the diabetes trial reported a reduction in the glycated haemoglobin levels of 1.87%.ConclusionsThere is a dearth of evidence on the implementation of task-shifting strategies to reduce the burden of CVD in LMICs. Effective task-shifting interventions targeted at reducing the global CVD epidemic in LMICs are urgently needed.


2019 ◽  
Vol 11 (4) ◽  
pp. 326-331
Author(s):  
Evangelia Razis ◽  
James Balogun ◽  
Manjola Lushi ◽  
Khalid Abdel Karim ◽  
Despoina Kalapanida ◽  
...  

BMJ ◽  
2014 ◽  
Vol 348 (apr15 6) ◽  
pp. g2267-g2267 ◽  
Author(s):  
E. K. Gough ◽  
E. E. M. Moodie ◽  
A. J. Prendergast ◽  
S. M. A. Johnson ◽  
J. H. Humphrey ◽  
...  

2020 ◽  
Author(s):  
Elena M. C. Riedel ◽  
David T. Turner ◽  
Clara Miguel Sanz ◽  
Loulou Hassan Kobeissi ◽  
Eirini Karyotaki ◽  
...  

Abstract Background Despite progress in medical and skilled delivery care worldwide, neonatal and maternal mortality is still a major public health problem in resource-limited settings.Objective To determine whether psychosocial interventions (PSI) can reduce neonatal and maternal mortality in low-and middle-income countries, and which approaches are most promising.Methods Randomised controlled trials comparing a PSI with a control condition were identified through systematic searches in seven databases. Effects were pooled as risk ratios in random-effects meta-analyses. Risk of bias was assessed using the Cochrane risk of bias tool, and publication bias was estimated. Sensitivity analyses were conducted to investigate sources of heterogeneity.ResultsOf 22 eligible RCTs (20 cluster randomised trials), the outcomes of 21 were synthesized for the outcome of neonatal mortality and 14 for maternal mortality. PSIs effectively reduced the risk of neonatal mortality by about 15% (RR 0.85, 95% CI 0.78-0.94). The risk of maternal death was reduced by almost 21% (RR 0.79, 95% CI 0.68-0.93) with low levels of heterogeneity. There was low to medium risk of bias and no indication for substantial publication bias.Conclusions Results suggest that PSIs, mainly multi-method and group-based approaches, have the potential to substantially decrease the risk of maternal and neonatal death in low- and middle-income countries. The results of the latter outcome are marked by high heterogeneity and thus to be taken with caution.


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