High-burden cancers in middle-income countries (MICs): prevention and early detection strategies for at-risk populations

Small and nutritionally at-risk infants under six months, defined as those with wasting, underweight, or other forms of growth failure, are at high-risk of mortality and morbidity. The World Health Organisation 2013 guidelines on severe acute malnutrition highlight the need to effectively manage this vulnerable group, but programmatic challenges are widely reported. This review aims to inform future management strategies for small and nutritionally at-risk infants under six months in low- and middle-income countries (LMICs) by synthesising evidence on existing breastfeeding support packages for all infants under six months. We searched PubMed, CINAHL, Cochrane Library, EMBASE, and Global Health databases from inception to 18 July 2018. Intervention of interest were breastfeeding support packages. Studies reporting breastfeeding practices and/or caregivers’/healthcare staffs’ knowledge/skills/practices for infants under six months from LMICs were included. Study quality was assessed using NICE quality appraisal checklist for intervention studies. A narrative data synthesis using the Synthesis Without Meta-analysis (SWiM) reporting guideline was conducted and key features of successful programmes identified. Of 15,256 studies initially identified, 41 were eligible for inclusion. They were geographically diverse, representing 22 LMICs. Interventions were mainly targeted at mother–infant pairs and only 7% (n = 3) studies included at-risk infants. Studies were rated to be of good or adequate quality. Twenty studies focused on hospital-based interventions, another 20 on community-based and one study compared both. Among all interventions, breastfeeding counselling (n = 6) and education (n = 6) support packages showed the most positive effect on breastfeeding practices followed by breastfeeding training (n = 4), promotion (n = 4) and peer support (n = 3). Breastfeeding education support (n = 3) also improved caregivers’ knowledge/skills/practices. Identified breastfeeding support packages can serve as "primary prevention" interventions for all infants under six months in LMICs. For at-risk infants, these packages need to be adapted and formally tested in future studies. Future work should also examine impacts of breastfeeding support on anthropometry and morbidity outcomes. The review protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO 2018 CRD42018102795).

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Early screening and diagnosis of autism spectrum disorders in Vietnam: A population-based cross-sectional survey

Journal of Public Health Research ◽

10.4081/jphr.2021.2460 ◽

2021 ◽

Author(s):

Le Thi Vui ◽

Duong Minh Duc ◽

Nguyen Thuy Quynh ◽

Nguyen Thi Huong Giang ◽

Vu Thi Thanh Mai ◽

...

Keyword(s):

Autism Spectrum Disorders ◽

Early Detection ◽

Public Health Problem ◽

Population Based ◽

Autism Spectrum ◽

Urban Setting ◽

Cross Sectional ◽

Middle Income ◽

Middle Income Countries ◽

Spectrum Disorders

Background: Early detection of autism spectrum disorders (ASDs) is essential given the under-reported cases in low- and middle-income countries. This first national representative survey was conducted to explore the prevalence of ASDs amongst 18 and 30 months in seven provinces in Vietnam.Design and Method: During 2017- 2018, a national cross-sectional and population-based survey for autism spectrum disorder (ASD) amongst 40,243 children aged 18 to 30 months was conducted in 7 provinces representing the socio-economic regions of Vietnam. M-CHAT was used to screen children and then confirmed by diagnostic assessment using DSM-IV criteria.Results: The prevalence of ASDs amongst children aged 18 and 30 months in Vietnam was high (0.758% or 1 in 132 children). Urban setting, male gender, and hereditable genes were associated with ASD prevalence.Conclusion: ASDs amongst children aged 18 and 30 months in Vietnam tend to be increasing and are similar to this rate in other middle-income countries but lower than that in Western countries. This under-recognized public health problem amongst children should be addressed by early detection and intervention for families with affected children.

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Research and Publication from Developing Countries

Journal of Institute of Medicine ◽

10.3126/jiom.v42i3.37478 ◽

2020 ◽

Vol 42 (3) ◽

Author(s):

Mohan R Sharma

Keyword(s):

Developing Countries ◽

Burden Of Disease ◽

Disease Burden ◽

Developed Countries ◽

Publishing Research ◽

Economic Factors ◽

Middle Income ◽

High Burden ◽

Middle Income Countries ◽

The Developed Countries

In 2002, Richard Smith wrote an editorial, “publishing research from developing countries” in the Journal “Statistics in Medicine” highlighting the importance of research and publication from the developing countries (DCs).1 In that article, he mentioned the disparity in research and publication between the developed and developing countries. Almost two decades on, the problem still largely remains the same. It is estimated that more than 80% of the world’s population lives in more than 100 developing countries.2 In terms of disease burden, the prevalence and mortality from diseases in the low and middle-income countries are disproportionately high compared to developed countries.3 Although there is a high burden of disease, we base our treatment inferring results from research and publication from the developed countries which may not be fully generalizable due to geographical cultural, racial, and economic factors. This is where the problem lies.

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Proton Radiotherapy Could Reduce the Risk of Fatal Second Cancers for Children with Intracranial Tumors in Low- and Middle-Income Countries

International Journal of Particle Therapy ◽

10.14338/ijpt-20-00041.1 ◽

2021 ◽

Vol 7 (4) ◽

pp. 1-10

Author(s):

Kyle J. Gallagher ◽

Bassem Youssef ◽

Rola Georges ◽

Anita Mahajan ◽

Joelle Ann Feghali ◽

...

Keyword(s):

At Risk ◽

Proton Therapy ◽

Pediatric Patients ◽

Income Country ◽

High Income Country ◽

Intracranial Tumors ◽

Proton Radiotherapy ◽

Middle Income ◽

Middle Income Countries ◽

Low And Middle Income

Abstract Purpose To test our hypothesis that, for young children with intracranial tumors, proton radiotherapy in a high-income country does not reduce the risk of a fatal subsequent malignant neoplasm (SMN) compared with photon radiotherapy in low- and middle-income countries. Materials and Methods We retrospectively selected 9 pediatric patients with low-grade brain tumors who were treated with 3-dimensional conformal radiation therapy in low- and middle-income countries. Images and contours were deidentified and transferred to a high-income country proton therapy center. Clinically commissioned treatment planning systems of each academic hospital were used to calculate absorbed dose from the therapeutic fields. After fusing supplemental computational phantoms to the patients' anatomies, models from the literature were applied to calculate stray radiation doses. Equivalent doses were determined in organs and tissues at risk of SMNs, and the lifetime attributable risk of SMN mortality (LAR) was predicted using a dose-effect model. Our hypothesis test was based on the average of the ratios of LARs from proton therapy to that of photon therapy ()(H0: = 1; HA: < 1). Results Proton therapy reduced the equivalent dose in organs at risk for SMNs and LARs compared with photon therapy for which the for the cohort was 0.69 ± 0.10, resulting in the rejection of H0 (P < .001, α = 0.05). We observed that the younger children in the cohort (2-4 years old) were at a factor of approximately 2.5 higher LAR compared with the older children (8-12 years old). Conclusion Our findings suggest that proton radiotherapy has the strong potential of reducing the risk of fatal SMNs in pediatric patients with intracranial tumors if it were made available globally.

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A scoping review of health-related stigma outcomes for high-burden diseases in low- and middle-income countries

BMC Medicine ◽

10.1186/s12916-019-1250-8 ◽

2019 ◽

Vol 17 (1) ◽

Cited By ~ 27

Author(s):

Jeremy C. Kane ◽

Melissa A. Elafros ◽

Sarah M. Murray ◽

Ellen M. H. Mitchell ◽

Jura L. Augustinavicius ◽

...

Keyword(s):

Scoping Review ◽

Middle Income ◽

High Burden ◽

Middle Income Countries ◽

Related Stigma ◽

Health Related ◽

Low And Middle Income

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EARLY DETECTION OF PANCREATIC ADENOCARCINOMA IN ‘AT-RISK’ POPULATIONS USING A BIOMARKER PANEL IN URINE (UROPANC)

Pancreatology ◽

10.1016/j.pan.2020.10.004 ◽

2020 ◽

Vol 20 (8) ◽

pp. e14

Author(s):

Tatjana Crnogorac-Jurcevic ◽

Silvana Debernardi ◽

Daria Jach ◽

Greta Brezgyte ◽

Alexander Ney ◽

...

Keyword(s):

At Risk ◽

Early Detection ◽

Pancreatic Adenocarcinoma ◽

Biomarker Panel ◽

At Risk Populations

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Urbanicity and risk of first-episode psychosis: incidence study in Brazil

The British Journal of Psychiatry ◽

10.1192/bjp.2019.110 ◽

2019 ◽

Vol 215 (6) ◽

pp. 726-729 ◽

Cited By ~ 5

Author(s):

Cristina Marta Del-Ben ◽

Rosana Shuhama ◽

Camila Marcelino Loureiro ◽

Taciana Cristina Carvalho Ragazzi ◽

Daniela Perocco Zanatta ◽

...

Keyword(s):

At Risk ◽

First Episode Psychosis ◽

Incidence Rates ◽

First Episode ◽

World Population ◽

Middle Income ◽

Middle Income Countries ◽

Episode Psychosis ◽

Gender And Age ◽

Lower Population

We estimated the incidence of first-episode psychosis over a 3-year period in a Brazilian catchment area comprising the region's main city, Ribeirão Preto (1 425 306 persons-years at risk), and 25 other municipalities with a total of 1 646 556 persons-years at risk. The incidence rates were estimated and adjusted by gender and age, using the direct standardisation method to the world population as reference. The incidence of psychosis was higher in the younger groups, men, and among Black and minority ethnic Brazilians. Psychosis incidence was lower in Ribeirão Preto (16.69/100 000 person-years at risk; 95% CI 15.68–17.70) compared with the average incidence in the remaining municipalities (21.25/100 000 person-years at risk; 95% CI 20.20–22.31), which have lower population density, suggesting a distinct role for urbanicity in the incidence of first-episode psychosis in low- and middle-income countries.

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Promotion, prevention and treatment interventions for mental health in low- and middle-income countries through a task-shifting approach

Epidemiology and Psychiatric Sciences ◽

10.1017/s204579602000061x ◽

2020 ◽

Vol 29 ◽

Author(s):

Marianna Purgato ◽

Eleonora Uphoff ◽

Rakesh Singh ◽

Ambika Thapa Pachya ◽

Jibril Abdulmalik ◽

...

Keyword(s):

Mental Health ◽

At Risk ◽

Global Mental Health ◽

Task Shifting ◽

Treatment Interventions ◽

Middle Income ◽

Middle Income Countries ◽

Prevention And Treatment ◽

Prevention Interventions ◽

Definition Of

Abstract Recently, mental health and ill health have been reframed to be seen as a continuum from health to ill health, through the stages of being asymptomatic ‘at risk’, to experiencing ‘mental distress’, ‘sub-syndromal symptoms’ and finally ‘mental disorders’. This new conceptualisation emphasised the importance of mental health promotion and prevention interventions, aimed at reducing the likelihood of future disorders with the general population or with people who are identified as being at risk of a disorder. This concept generated discussion on the distinction between prevention and treatment interventions, especially for those mental health conditions which lie between psychological distress and a formal psychiatric diagnosis. The present editorial aims to clarify the definition of promotion, prevention and treatment interventions delivered through a task-shifting approach according to a global mental health perspective.

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