scholarly journals Maintaining stroke care during the COVID-19 pandemic in lower- and middle-income countries: World Stroke Organization Position Statement endorsed by American Stroke Association and American Heart Association

2021 ◽  
pp. 174749302110558
Author(s):  
Jeyaraj D Pandian ◽  
Peter D Panagos ◽  
Ivy A Sebastian ◽  
Gisele Sampaio Silva ◽  
Karen L Furie ◽  
...  
Keyword(s):  
Systems Of Care ◽  
Low Cost ◽  
Intravenous Thrombolysis ◽  
Heart Association ◽  
Stroke Care ◽  
Position Statement ◽  
Acute Stroke Care ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

For more than a year, the SARS-CoV-2 pandemic has had a devastating effect on global health. High-, low-, and middle-income countries are struggling to cope with the spread of newer mutant strains of the virus. Delivery of acute stroke care remains a priority despite the pandemic. In order to maintain the time-dependent processes required to optimize delivery of intravenous thrombolysis and endovascular therapy, most countries have reorganized infrastructure to optimize human resources and critical services. Low-and-middle income countries (LMIC) have strained medical resources at baseline and often face challenges in the delivery of stroke systems of care (SSOC). This position statement aims to produce pragmatic recommendations on methods to preserve the existing SSOC during COVID-19 in LMIC and propose best stroke practices that may be low cost but high impact and commonly shared across the world.

Implementing Evidence-Based Practices for Acute Stroke Care in Low- and Middle-Income Countries

2017 ◽  
Vol 19 (12) ◽  
Author(s):  
Rasha Khatib ◽  
Assef M. Jawaada ◽  
Yurany A. Arevalo ◽  
Hiba K. Hamed ◽  
Sukayna H. Mohammed ◽  
...  
Keyword(s):  
Acute Stroke ◽  
Stroke Care ◽  
Evidence Based ◽  
Acute Stroke Care ◽  
Middle Income ◽  
Evidence Based Practices ◽  
Middle Income Countries ◽  
Low And Middle Income

scholarly journals Barriers to training in laparoscopic surgery in low- and middle-income countries: A systematic review

2021 ◽  
pp. 004947552199818
Author(s):  
Ellen Wilkinson ◽  
Noel Aruparayil ◽  
J Gnanaraj ◽  
Julia Brown ◽  
David Jayne
Keyword(s):  
Laparoscopic Surgery ◽  
Low Cost ◽  
Surgical Care ◽  
Successful Implementation ◽  
Middle Income ◽  
Middle Income Countries ◽  
Technological Advances ◽  
Local Access ◽  
And Training ◽  
Low And Middle Income

Laparoscopic surgery has the potential to improve care in resource-deprived low- and-middle-income countries (LMICs). This study aims to analyse the barriers to training in laparoscopic surgery in LMICs. Medline, Embase, Global Health and Web of Science were searched using ‘LMIC’, ‘Laparoscopy’ and ‘Training’. Two researchers screened results with mutual agreement. Included papers were in English, focused on abdominal laparoscopy and training in LMICs. PRISMA guidelines were followed; 2992 records were screened, and 86 full-text articles reviewed to give 26 key papers. Thematic grouping identified seven key barriers: funding; availability and maintenance of equipment; local access to experienced laparoscopic trainers; stakeholder dynamics; lack of knowledge on effective training curricula; surgical departmental structure and practical opportunities for trainees. In low-resource settings, technological advances may offer low-cost solutions in the successful implementation of laparoscopic training and improve access to surgical care.

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.

Low-Cost Bubble-CPAP Treatment of a Severe Case of Pneumonia in a Low- and Middle-Income Country: A Case Report on the Importance of Optimizing Bubble-CPAP Setup

2020 ◽  
Author(s):  
Søren Vinther Larsen ◽  
Anja Poulsen
Keyword(s):  
Low Cost ◽  
Severe Case ◽  
Middle Income ◽  
Healthcare Facilities ◽  
Middle Income Countries ◽  
Efficient Delivery ◽  
Bubble Cpap ◽  
Two Parameters ◽  
Lower Respiratory Disease ◽  
Low And Middle Income

Abstract A homemade low-cost bubble continuous positive airway pressure (bCPAP) setup can be created using resources available at most secondary healthcare facilities in low- and middle-income countries (LMICs). This setup has the potential of saving millions of children’s lives worldwide; however, treatment failure due to bCPAP setup insufficiencies and lack of educated staff remains a significant obstacle. Here, we report a first-hand experience on the use of an established low-cost bCPAP setup to be used in LMICs and how optimization of two parameters was critical to effectively treat a severe case of lower respiratory disease in a 6-month-old infant in Tanzania. We report this case to strengthen that reducing the resistance in the tube system and minimizing air leakage at the nasal interface are crucial for efficient delivery of the CPAP therapy.

scholarly journals Scoping review of acute stroke care management and rehabilitation in low and middle-income countries

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
George Lameck Chimatiro ◽  
Anthea J. Rhoda
Keyword(s):  
Developing Countries ◽  
Scoping Review ◽  
Stroke Care ◽  
Middle Income ◽  
Middle Income Countries ◽  
Care Processes ◽  
Care Structure ◽  
Care Outcomes ◽  
Low And Middle Income

Abstract Background Stroke is a major public health concern, affecting millions of people worldwide. Care of the condition however, remain inconsistent in developing countries. The purpose of this scoping review was to document evidence of stroke care and service delivery in low and middle-income countries to better inform development of a context-fit stroke model of care. Methods An interpretative scoping literature review based on Arksey and O’Malley’s five-stage-process was executed. The following databases searched for literature published between 2010 and 2017; Cochrane Library, Credo Reference, Health Source: Nursing/Academic Edition, Science Direct, BioMed Central, Cumulative Index to Nursing and Allied Health Literature (CINNAHL), Academic Search Complete, and Google Scholar. Single combined search terms included acute stroke, stroke care, stroke rehabilitation, developing countries, low and middle-income countries. Results A total of 177 references were identified. Twenty of them, published between 2010 and 2017, were included in the review. Applying the Donebedian Model of quality of care, seven dimensions of stroke-care structure, six dimensions of stroke care processes, and six dimensions of stroke care outcomes were identified. Structure of stroke care included availability of a stroke unit, an accident and emergency department, a multidisciplinary team, stroke specialists, neuroimaging, medication, and health care policies. Stroke care processes that emerged were assessment and diagnosis, referrals, intravenous thrombolysis, rehabilitation, and primary and secondary prevention strategies. Stroke-care outcomes included quality of stroke-care practice, functional independence level, length of stay, mortality, living at home, and institutionalization. Conclusions There is lack of uniformity in the way stroke care is advanced in low and middle-income countries. This is reflected in the unsatisfactory stroke care structure, processes, and outcomes. There is a need for stroke care settings to adopt quality improvement strategies. Health ministry and governments need to decisively face stroke burden by setting policies that advance improved care of patients with stroke. Stroke Units and Recombinant Tissue Plasminogen Activator (rtPA) administration could be considered as both a structural and process necessity towards improvement of outcomes of patients with stroke in the LMICs.

scholarly journals Strategies to Improve Stroke Care Services in Low- and Middle-Income Countries: A Systematic Review

2017 ◽  
Vol 49 (1-2) ◽  
pp. 45-61 ◽  
Author(s):  
Jeyaraj Durai Pandian ◽  
Akanksha G. William ◽  
Mahesh P. Kate ◽  
Bo Norrving ◽  
George A. Mensah ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care Services ◽  
Cost Effective ◽  
Stroke Care ◽  
Evidence Based ◽  
Middle Income ◽  
Middle Income Countries ◽  
Care Services ◽  
Stroke Services ◽  
Low And Middle Income

Background: The burden of stroke in low- and middle-income countries (LMICs) is large and increasing, challenging the already stretched health-care services. Aims and Objectives: To determine the quality of existing stroke-care services in LMICs and to highlight indigenous, inexpensive, evidence-based implementable strategies being used in stroke-care. Methods: A detailed literature search was undertaken using PubMed and Google scholar from January 1966 to October 2015 using a range of search terms. Of 921 publications, 373 papers were shortlisted and 31 articles on existing stroke-services were included. Results: We identified efficient models of ambulance transport and pre-notification. Stroke Units (SU) are available in some countries, but are relatively sparse and mostly provided by the private sector. Very few patients were thrombolysed; this could be increased with telemedicine and governmental subsidies. Adherence to secondary preventive drugs is affected by limited availability and affordability, emphasizing the importance of primary prevention. Training of paramedics, care-givers and nurses in post-stroke care is feasible. Conclusion: In this systematic review, we found several reports on evidence-based implementable stroke services in LMICs. Some strategies are economic, feasible and reproducible but remain untested. Data on their outcomes and sustainability is limited. Further research on implementation of locally and regionally adapted stroke-services and cost-effective secondary prevention programs should be a priority.

Development of a paper-immobilized yeast biosensor for the detection of physiological concentrations of doxycycline in technology-limited settings

2020 ◽  
Vol 12 (16) ◽  
pp. 2123-2132 ◽  
Author(s):  
Rachel A. Miller ◽  
Galen Brown ◽  
Elsa Barron ◽  
Jamie L. Luther ◽  
Marya Lieberman ◽  
...  
Keyword(s):  
Low Cost ◽  
Dosage Forms ◽  
Middle Income ◽  
Immobilized Yeast ◽  
Middle Income Countries ◽  
Low And Middle Income

To combat pharmaceutical counterfeiting in low- and middle-income countries (LMIC), there is a need for improved low-cost, portable methods that monitor pharmaceutical concentrations relevant to dosage forms and physiological fluids.

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