scholarly journals Clinical stroke research in resource limited settings: Tips and hints

2017 ◽  
Vol 13 (2) ◽  
pp. 129-137 ◽  
Author(s):  
Jeyaraj D Pandian ◽  
Hueiming Liu ◽  
Dorcas BC Gandhi ◽  
Richard I Lindley
Keyword(s):  
Global Health ◽  
Research Training ◽  
Research Question ◽  
Research Capacity ◽  
High Income ◽  
Middle Income ◽  
Middle Income Countries ◽  
Regulatory Processes ◽  
Stroke Research ◽  
Low And Middle Income

Background Most stroke research is conducted in high income countries, yet most stroke occurs in low- and middle-income countries. There is an urgent need to build stroke research capacity in low- and middle-income countries. Aims To review the global health literature on how to improve research capacity in low- and middle-income countries, provide additional data from the recently completed ATTEND Trial and provide examples from our own experience. Summary of review The main themes from our literature review were: manpower and workload, research training, research question and methodology and research funding. The literature and our own experience emphasized the importance of local stakeholders to ensure that the research was appropriate, that there were robust local ethics and regulatory processes, and research was conducted by trained personnel. Research training opportunities can be developed locally, or internationally, with many international schemes available to help support new researchers from low- and middle-income country settings. International collaboration can successfully leverage funding from high income countries that not only generate data for the local country, but also provide new data appropriate to high income countries. Conclusions Building stroke research capacity in low- and middle-income countries will be vital in improving global health given the huge burden of stroke in these countries.

scholarly journals The Global Cohort of Doctoral Students: Building Shared Global Health Research Capacity in High-Income and Low- and Middle-Income Countries

2021 ◽  
Vol 87 (1) ◽  
Author(s):  
Semira Abdelmenan ◽  
Christopher T. Andersen ◽  
Fentabil Getnet ◽  
Hari S. Iyer ◽  
Kesaobaka Molebatsi ◽  
...  
Keyword(s):  
Global Health ◽  
Doctoral Students ◽  
Health Research ◽  
Research Capacity ◽  
High Income ◽  
Global Health Research ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

scholarly journals Alzheimer’s Disease Diagnostics Must Be Globally Accessible

2021 ◽  
pp. 1-3
Author(s):  
Nicholas Clute-Reinig ◽  
Suman Jayadev ◽  
Kristoffer Rhoads ◽  
Anne-Laure Le Ny
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Global Health ◽  
Low Cost ◽  
High Income ◽  
Middle Income ◽  
Middle Income Countries ◽  
Disease Diagnostics ◽  
Low And Middle Income

Dementia and Alzheimer’s disease (AD) are global health crises, with most affected individuals living in low- or middle-income countries. While research into diagnostics and therapeutics remains focused exclusively on high-income populations, recent technological breakthroughs suggest that low-cost AD diagnostics may soon be possible. However, as this disease shifts onto those with the least financial and structural ability to shoulder its burden, it is incumbent on high-income countries to develop accessible AD healthcare. We argue that there is a scientific and ethical mandate to develop low-cost diagnostics that will not only benefit patients in low-and middle-income countries but the AD field as a whole.

scholarly journals Global Justice and Health Systems Research in Low- and Middle-Income Countries

2015 ◽  
Vol 43 (1) ◽  
pp. 143-161 ◽  
Author(s):  
Bridget Pratt ◽  
Adnan A. Hyder
Keyword(s):  
Global Health ◽  
International Research ◽  
Global Justice ◽  
High Income ◽  
Ethical Framework ◽  
Middle Income ◽  
Middle Income Countries ◽  
Systems Research ◽  
Health Justice ◽  
Low And Middle Income

More than a decade ago, Solomon Benatar and Peter Singer argued that “a new, proactive research ethics…must ultimately be concerned with reducing inequities in global health and achieving justice in health research and health care.” Towards this objective, a limited amount of recent scholarship has started to consider whether a theoretical basis exists for the position that international research should help promote global health equity and, if so, what the implications are for its conduct. Theories of justice from political philosophy establish obligations for parties in high-income countries to improve the health of parties in low- and middle-income countries (LMICs). These theories have been shown to provide grounds for the claim that international research should be conducted to advance justice in global health. What this means for research actors from high-income countries is the focus of a recently proposed ethical framework: “research for health justice.”

Abstract 32: Global Burden and Control of Hypertension in 2010: Analysis of Population-Based Studies from 89 Countries

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Katherine T Mills ◽  
Joshua D Bundy ◽  
Tanika N Kelly ◽  
Jennifer E Reed ◽  
Patricia M Kearney ◽  
...  
Keyword(s):  
Global Health ◽  
Population Based ◽  
High Income ◽  
Global Burden ◽  
Middle Income ◽  
Middle Income Countries ◽  
Preventable Risk Factor ◽  
High Prevalence ◽  
And Control ◽  
Low And Middle Income

Background: Hypertension is an important global health challenge due to its high prevalence and resulting cardiovascular disease and chronic kidney disease. Hypertension is the leading preventable risk factor for premature death and disability worldwide. Objective: We estimated the prevalence, awareness, treatment and control of hypertension worldwide in 2010 and compared the global burden of hypertension in 2000 and 2010. Methods: We searched MEDLINE for published reports from January 1, 2001 to June 30, 2014 and supplemented with manual searches of references from retrieved articles. We included population-based studies and applied sex-age-specific prevalence of hypertension from each country to population data to assess the number of hypertensive adults in each region and globally. Proportions of awareness, treatment and control from each country were applied to hypertensive populations to obtain regional and global estimates. Results: An estimated 29.8% (95% confidence interval 29.6-30.0%) of the world’s adult population in 2010 had hypertension (30.7% [30.4-31.0%] in men and 28.8% [28.6-29.0%] in women). The estimated total number of hypertensive adults in 2010 was 1.33 billion (1.32-1.34 billion); 346 million (336-356 million) in high-income and 985 million (977-994 million) in low- and middle-income countries. From 2000 to 2010, the age-standardized prevalence of hypertension increased by 2.5% worldwide. The hypertension prevalence decreased 3.5% in high-income countries, whereas the prevalence increased 4.5% in low- and middle-income countries. In addition, from 2000 to 2010 the number of hypertensive adults increased by 354 million (334 million in low- and middle-income countries compared to 19 million in high-income countries). Proportions of hypertension awareness, treatment and control worldwide in 2010 were 43.5% (43.1-44.0%), 33.8% (33.3-34.2%), and 12.3% (12.1-12.6%), respectively. The proportion of hypertension control was 27.7% (27.0-28.3%) in high-income and 6.9% (6.7-7.1) in low- and middle-income countries. Conclusions: Prevention and treatment of hypertension should be a global health priority due to its high prevalence and low control rate globally, especially in low- and middle-income countries.

scholarly journals Adherence to Food-Based Dietary Guidelines: A Systemic Review of High-Income and Low- and Middle-Income Countries

Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 1038
Author(s):  
Ana Carolina B. Leme ◽  
Sophia Hou ◽  
Regina Mara Fisberg ◽  
Mauro Fisberg ◽  
Jess Haines
Keyword(s):  
English Language ◽  
Economic Status ◽  
High Income ◽  
Dietary Guidelines ◽  
Systemic Review ◽  
Healthy Children ◽  
Future Health ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

Research comparing the adherence to food-based dietary guidelines (FBDGs) across countries with different socio-economic status is lacking, which may be a concern for developing nutrition policies. The aim was to report on the adherence to FBDGs in high-income (HIC) and low-and-middle-income countries (LMIC). A systematic review with searches in six databases was performed up to June 2020. English language articles were included if they investigated a population of healthy children and adults (7–65 years), using an observational or experimental design evaluating adherence to national FBDGs. Findings indicate that almost 40% of populations in both HIC and LMIC do not adhere to their national FBDGs. Fruit and vegetables (FV) were most adhered to and the prevalence of adhering FV guidelines was between 7% to 67.3%. HIC have higher consumption of discretionary foods, while results were mixed for LMIC. Grains and dairy were consumed below recommendations in both HIC and LMIC. Consumption of animal proteins (>30%), particularly red meat, exceeded the recommendations. Individuals from HIC and LMIC may be falling short of at least one dietary recommendation from their country’s guidelines. Future health policies, behavioral-change strategies, and dietary guidelines may consider these results in their development.

scholarly journals Designing the next generation of implementation research training for learners in low- and middle-income countries

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Michael J. Penkunas ◽  
Shiau Yun Chong ◽  
Emma L. M. Rhule ◽  
Evangelia Berdou ◽  
Pascale Allotey
Keyword(s):  
Implementation Research ◽  
Research Training ◽  
Training Model ◽  
Learning By Doing ◽  
Health Interventions ◽  
System Level ◽  
High Quality Research ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

AbstractEfficacious health interventions tested through controlled trials often fail to show desired impacts when implemented at scale. These challenges can be particularly pervasive in low- and middle-income settings where health systems often lack the capacity and mechanisms required for high-quality research and evidence translation. Implementation research is a powerful tool for identifying and addressing the bottlenecks impeding the success of proven health interventions. Implementation research training initiatives, although growing in number, remain out of reach for many investigators in low- and middle-income settings, who possess the knowledge required to contextualize challenges and potential solutions in light of interacting community- and system-level features. We propose a realigned implementation research training model that centers on team-based learning, tailored didactic opportunities, learning-by-doing, and mentorship.

Abstract WP418: A Systematic Comparison of Key Features of Ischaemic Stroke Prevention Guidelines in Low- and Middle-income vs High-income Countries

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Hernan O Bayona ◽  
Mayowa Owolabi ◽  
Wayne Feng ◽  
James R Sawers ◽  
Paul Olowoyo ◽  
...  
Keyword(s):  
Stroke Prevention ◽  
High Income ◽  
Evidence Based ◽  
Vascular Risk ◽  
Eligibility Criteria ◽  
Middle Income ◽  
Middle Income Countries ◽  
Prevention Guideline ◽  
Prevention Guidelines ◽  
Low And Middle Income

Introduction: Implementation of contextually appropriate, evidence-based, expert-recommended stroke prevention guideline is particularly important in Low- and Middle-Income Countries (LMICs), which bear disproportional larger burden of stroke while possessing fewer resources. Focus therefore, should be on approaches enabling healthcare systems to improve control of vascular risk factors. Objective: We aimed to compare important features of stroke prevention guidelines between LMICs and High Income Countries (HICs). Methods: We systematically searched PubMed, AJOL, SciELO, and LILACS databases for stroke prevention guidelines published between January 2005 and December 2015 by country. Primary search items included: “Stroke” and “Guidelines”. We critically appraised the articles for evidence level, issuance frequency and implementation aspects to clinical practice. Results: Among 45 stroke prevention guidelines published, 28 (62%) met eligibility criteria: 7 from LMICs (25%) and 21 from HICs (75%). LMIC-issued guidelines were less likely to have conflict of interest declarations (57% vs. 100%, p=0.01), involve high quality systematic reviews (57% vs. 95%, p= 0.03), had good dissemination channels (14% vs 71%, p=0.02). The patient views and preferences were the most significant stakeholder considerations in HICs (43%, p=0.04) compared with LMICs. Conclusion: The quality and quantity of stroke prevention guidelines in LMICs are less than those of HICs and need to be significantly improved upon.

scholarly journals Effective Strategies for Global Health Training Programs A Systematic Review of Training Outcomes in Low and Middle Income Countries

2016 ◽  
Vol 8 (11) ◽  
pp. 278 ◽  
Author(s):  
Aprill Z. Dawson ◽  
Rebekah J. Walker ◽  
Jennifer A. Campbell ◽  
Leonard E. Egede
Keyword(s):  
Medical Training ◽  
Skills Training ◽  
High Income ◽  
Training Methods ◽  
Middle Income ◽  
Training Outcomes ◽  
Effective Strategies ◽  
Middle Income Countries ◽  
Low Middle Income Countries ◽  
Low And Middle Income

<p><strong>INTRODUCTION: </strong>Low and middle-income countries face a continued burden of chronic illness and non-communicable diseases while continuing to show very low health worker utilization. With limited numbers of medical schools and a workforce shortage the poor health outcomes seen in many low and middle income countries are compounded by a lack of within country medical training.</p><p><strong>METHODS: </strong>Using a systematic approach, this paper reviews the existing literature on training outcomes in low and middle-income countries in order to identify effective strategies for implementation in the developing world. This review examined training provided by high-income countries to low- and middle-income countries.</p><p><strong>RESULTS: </strong>Based on article eligibility, 24 articles were found to meet criteria. Training methods found include workshops, e-learning modules, hands-on skills training, group discussion, video sessions, and role-plays. Of the studies with statistically significant results training times varied from one day to three years. Studies using both face-to-face and video found statistically significant results.</p><p><strong>DISCUSSION:</strong> Based on the results of this review, health professionals from high-income countries should be encouraged to travel to low- middle-income countries to assist with providing training to health providers in those countries.</p>

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