The niche reduction approach: an opportunity for optimal control of infectious diseases in low-income countries?

Background: Over 200 million under-five-children born in low-income countries are at risk of not reaching their development potential and infectious diseases are the leading cause of development deficits in these regions.Methods: A cross-sectional study was conducted to investigate personal and household hygiene practices among 154 mothers and their association with the incidence of infectious diseases among 167 children aged 6 months to 59 months in Patuakhali district, Bangladesh.Results: Only 13.6% of the mothers had proper hand washing knowledge. Besides, 14% and 53.9% of the mothers washed their hands with soap and only with water respectively before feeding their child. About 68.2% of mothers prepared food on the ground and half (49.5%) of the toilet did not have a hand washing location beside it. The risk of childhood infectious disease was significantly associated with hand washing of mothers before feeding a child (OR: 2.3, 95% CI: 1.5-4.1, p<0.05) and hand washing of child before eating (OR: 3.4, 95% CI: 1.8-5.7, p<0.05).Conclusions: Hand washing agents were inadequate and compliance to hand washing was poor. Therefore, the continuous focus is needed on the mother's awareness construction to increase the compliance to hand washing practice among mothers as well as their child with soap, especially during child feeding.

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Socially vs. Privately Optimal Control of Livestock Diseases: A Case for Integration of Epidemiology and Economics

Frontiers in Veterinary Science ◽

10.3389/fvets.2020.558409 ◽

2020 ◽

Vol 7 ◽

Author(s):

Ângelo J. Mendes ◽

Daniel T. Haydon ◽

Emma McIntosh ◽

Nick Hanley ◽

Jo E. B. Halliday

Keyword(s):

Optimal Control ◽

Disease Control ◽

Low Income ◽

Disease Risk ◽

Control Measures ◽

Low Income Countries ◽

Control Effort ◽

Optimal Behavior ◽

Wide Range ◽

Livestock Diseases

This paper aims to illustrate the interdependencies between key epidemiological and economic factors that influence the control of many livestock infectious diseases. The factors considered here are (i) farmer heterogeneity (i.e., differences in how farmers respond to a perceived disease risk), (ii) off-farm effects of farmers' actions to control a disease (i.e., costs and benefits borne by agents that are external to the farm), and (iii) misalignment between privately and socially optimal control efforts (i.e., privately optimal behavior not conducive to a socially optimal outcome). Endemic chronic diseases cause a wide range of adverse social and economic impacts, particularly in low-income countries. The actions taken by farmers to control livestock diseases minimize some of these impacts, and heterogeneity in those actions leads to variation in prevalence at the farm level. While some farmers respond to perceived disease risks, others free-ride on the actions of these individuals, thereby compromising the potential benefits of collective, coordinated behavior. When evaluating a plausible range of disease cost to price of control ratios and assuming that farmers choose their privately optimal control effort, we demonstrate that achievement of a socially optimal disease control target is unlikely, occurring in <25% of all price-cost combinations. To achieve a socially optimal disease control outcome (reliant on farmers' voluntary actions), control policies must consider farmer heterogeneity, off-farm effects, and the predicted uptake of control measures under the assumption of optimized behavior.

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1669. Trends in Authorship for Infectious Disease Research Conducted in Low-Income Countries

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.1533 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S610-S611

Author(s):

Chelsea E Modlin ◽

Kimberly Powell ◽

Russell R Kempker

Keyword(s):

Infectious Disease ◽

Infectious Diseases ◽

Low Income ◽

Research Capacity ◽

Low Income Countries ◽

Health Priorities ◽

Original Research ◽

Local Health ◽

Open Forum ◽

Research Collaborations

Abstract Background Research capacity in low-income countries (LICs) plays an important role in strengthening national healthcare systems and addressing local health priorities. Research in infectious diseases is especially important as they comprise five of the top 10 causes of death in LICs. While academic collaborations between high-income countries (HICs) and LICs offer many benefits, they also risk structural and professional imbalances. This study explores research capacity as a function of first or last authorship and funding for research conducted in LICs that is published in high-impact infectious disease journals. Methods A literature search using the abstract database Scopus was completed for original research conducted within LICs or using samples collected from LIC subjects published between 1998 – 2017 in Clinical Infectious Diseases, Journal of Infectious Diseases, and Open Forum Infectious Diseases. Primary outcomes included the number of LIC first and last authors compared with HIC authors over time. Secondary outcomes included the geographic distribution of research and the proportion of research financed by LICs. Results A total of 1380 articles were identified of which 20% had LIC first authors and 21% had first authors with dual LIC/HIC affiliations. For last authors, 13% were affiliated with a LIC and 15% had dual LIC/HIC affiliation. HIC researchers compiled the majority of first and last authors regardless of geography (Figure 1). The number of studies conducted in LICs increased over the 20-year timeframe (Figure 2) but is attributed to an increase in articles with HIC authors. The number of LIC authors remained unchanged resulting in a decreasing proportion of LIC authors. Only 4% of articles received funding from a LIC; however, 79% of these studies were authored by LIC researchers vs. 39% of studies funded by HIC sources. Conclusion There is a growing appreciation for international HIC/LIC research collaborations with the objective to reduce the burden of infectious diseases that disproportionately affect low-income settings. However, with this increased attention comes the responsibility to improve LIC research capacity. This includes promoting LIC researchers via authorship and supporting sustainability with funding that highlights LIC priorities. Disclosures All authors: No reported disclosures.

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Postscript Evolutionary ecology to reconcile public health, ethics and politics for infectious diseases control in low-income countries: time to move forward!

10.1093/oso/9780198789833.003.0025 ◽

2018 ◽

Author(s):

Awa Marie Coll Seck ◽

Ibrahima Seck

Keyword(s):

Public Health ◽

Infectious Diseases ◽

Low Income ◽

Evolutionary Ecology ◽

Childhood Vaccination ◽

Low Income Countries ◽

Vaccination Programs ◽

Guinea Worm ◽

High Profile ◽

Public Health Challenge

Infectious diseases (IDs) remain a major public health challenge in low-income countries (LICs) despite several striking successes and improvements in their control during the last decades. This includes the eradication of smallpox and rinderpest, and several other pathogens are on the edge of eradication, such as polio or guinea worm. It also concerns other high-profile pathogens that are increasingly more controlled, such as malaria, which has strongly diminished in several regions or measles for which transmission has been strongly impacted by childhood vaccination programs....

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The analysis of evolution in eradicating mortalities caused by infectious diseases in East and Central African Countries coinciding with gross national income

10.21203/rs.2.10776/v1 ◽

2019 ◽

Author(s):

Xiao Haijun ◽

Jean Pierre Namahoro

Keyword(s):

Infectious Diseases ◽

Low Income ◽

National Income ◽

Gross National Income ◽

Low Income Countries ◽

East African ◽

African Countries ◽

National Budget ◽

Study Results ◽

The Government

Abstract Background: Infectious diseases are predominantly within poor population living in low-income countries, while are either treatable or preventable with existing medicines in the first occurring. The highlighted cause is some government choose to spend national budget on several projects do not coincide the basic needs and demands of the population. The objectives of this study were to 1) compare the performance between new cases and deaths caused by diseases; 2) show the effect of gross national income (GNI) in the mortalities reduction, and 3) assess potential evolution in eradicating mortalities in East African countries. Method: WHO database contains data on several responses (new cases of Malaria, Neonates protected at birth against neonatal tetanus, mortalities from tuberculosis among HIV-negative people and new cases of leprosy) recorded from 2004 to 2015. IMB SPSS modeler and Origin 8 were used especially, One-way ANOVA and Pearson’s correlation to achieve the objectives of the study. Results: The p-values for either Levene’ and Brown-Forsythe compared with 0.05 significant level for testing the performance between countries, correlation between GNI with leprosy is -0.5 to -1.0, in five countries, with TB is closer t0 -1.0 in four countries, with deaths from Malaria, is -0.5 to -1.0 in three countries, and new cases from Malaria and protected neonates is 0.5 to 1.0. Conclusion: The relationship between GNI and new cases and deaths indicate the weak effect of GNI in the process of eradicating mortalities, therefore, the government should prioritize the healthcare and use a national budget to monitoring the all complications related to infectious diseases. Key wards: infectious diseases, eradicating mortalities, gross national income

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After 2015: infectious diseases in a new era of health and development

Philosophical Transactions of the Royal Society B Biological Sciences ◽

10.1098/rstb.2013.0426 ◽

2014 ◽

Vol 369 (1645) ◽

pp. 20130426 ◽

Cited By ~ 155

Author(s):

Christopher Dye

Keyword(s):

Infectious Diseases ◽

Chronic Diseases ◽

Low Income ◽

Poverty Reduction ◽

International Health ◽

Low Income Countries ◽

Health Coverage ◽

Childhood Immunization ◽

New Era ◽

Health And Development

Running over timescales that span decades or centuries, the epidemiological transition provides the central narrative of global health. In this transition, a reduction in mortality is followed by a reduction in fertility, creating larger, older populations in which the main causes of illness and death are no longer acute infections of children but chronic diseases of adults. Since the year 2000, the Millennium Development Goals (MDGs) have provided a framework for accelerating the decline of infectious diseases, backed by a massive injection of foreign investment to low-income countries. Despite the successes of the MDGs era, the inhabitants of low-income countries still suffer an enormous burden of disease owing to diarrhoea, pneumonia, HIV/AIDS, tuberculosis, malaria and other pathogens. Adding to the predictable burden of endemic disease, the threat of pandemics is ever-present and global. With a view to the future, this review spotlights five aspects of the fight against infection beyond 2015, when the MDGs will be replaced by a new set of goals for poverty reduction and sustainable development. These aspects are: exploiting the biological links between infectious and non-infectious diseases; controlling infections among the new urban majority; enhancing the response to international health threats; expanding childhood immunization programmes to prevent acute and chronic diseases in adults; and working towards universal health coverage. By scanning the wider horizon now, infectious disease specialists have the chance to shape the post-2015 era of health and development.

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The Interplay between the Gut Microbiome and the Immune System in the Context of Infectious Diseases throughout Life and the Role of Nutrition in Optimizing Treatment Strategies

Nutrients ◽

10.3390/nu13030886 ◽

2021 ◽

Vol 13 (3) ◽

pp. 886

Author(s):

Selma P. Wiertsema ◽

Jeroen van Bergenhenegouwen ◽

Johan Garssen ◽

Leon M. J. Knippels

Keyword(s):

Immune System ◽

Infectious Diseases ◽

Low Income ◽

Gut Microbiome ◽

Low Income Countries ◽

Vulnerable Groups ◽

Gut Health ◽

Human Pathogens ◽

Systemic Immunity ◽

The Impact

Infectious diseases and infections remain a leading cause of death in low-income countries and a major risk to vulnerable groups, such as infants and the elderly. The immune system plays a crucial role in the susceptibility, persistence, and clearance of these infections. With 70–80% of immune cells being present in the gut, there is an intricate interplay between the intestinal microbiota, the intestinal epithelial layer, and the local mucosal immune system. In addition to the local mucosal immune responses in the gut, it is increasingly recognized that the gut microbiome also affects systemic immunity. Clinicians are more and more using the increased knowledge about these complex interactions between the immune system, the gut microbiome, and human pathogens. The now well-recognized impact of nutrition on the composition of the gut microbiota and the immune system elucidates the role nutrition can play in improving health. This review describes the mechanisms involved in maintaining the intricate balance between the microbiota, gut health, the local immune response, and systemic immunity, linking this to infectious diseases throughout life, and highlights the impact of nutrition in infectious disease prevention and treatment.

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Epidemiology of central nervous system infectious diseases: a meta-analysis and systematic review with implications for neurosurgeons worldwide

Journal of Neurosurgery ◽

10.3171/2017.10.jns17359 ◽

2019 ◽

Vol 130 (4) ◽

pp. 1107-1126 ◽

Cited By ~ 6

Author(s):

Faith C. Robertson ◽

Jacob R. Lepard ◽

Rania A. Mekary ◽

Matthew C. Davis ◽

Ismaeel Yunusa ◽

...

Keyword(s):

Systematic Review ◽

Central Nervous System ◽

Nervous System ◽

Infectious Diseases ◽

Low Income ◽

Meta Analysis ◽

Case Fatality ◽

Low Income Countries ◽

Cns Infection ◽

Cns Infections

OBJECTIVECentral nervous system (CNS) infections cause significant morbidity and mortality and often require neurosurgical intervention for proper diagnosis and treatment. However, neither the international burden of CNS infection, nor the current capacity of the neurosurgical workforce to treat these diseases is well characterized. The objective of this study was to elucidate the global incidence of surgically relevant CNS infection, highlighting geographic areas for targeted improvement in neurosurgical capacity.METHODSA systematic literature review and meta-analysis were performed to capture studies published between 1990 and 2016. PubMed, EMBASE, and Cochrane databases were searched using variations of terms relating to CNS infection and epidemiology (incidence, prevalence, burden, case fatality, etc.). To deliver a geographic breakdown of disease, results were pooled using the random-effects model and stratified by WHO region and national income status for the different CNS infection types.RESULTSThe search yielded 10,906 studies, 154 of which were used in the final qualitative analysis. A meta-analysis was performed to compute disease incidence by using data extracted from 71 of the 154 studies. The remaining 83 studies were excluded from the quantitative analysis because they did not report incidence. A total of 508,078 cases of CNS infections across all studies were included, with a total sample size of 130,681,681 individuals. Mean patient age was 35.8 years (range: newborn to 95 years), and the male/female ratio was 1:1.74. Among the 71 studies with incidence data, 39 were based in high-income countries, 25 in middle-income countries, and 7 in low-income countries. The pooled incidence of studied CNS infections was consistently highest in low-income countries, followed by middle- and then high-income countries. Regarding WHO regions, Africa had the highest pooled incidence of bacterial meningitis (65 cases/100,000 people), neurocysticercosis (650/100,000), and tuberculous spondylodiscitis (55/100,000), whereas Southeast Asia had the highest pooled incidence of intracranial abscess (49/100,000), and Europe had the highest pooled incidence of nontuberculous vertebral spondylodiscitis (5/100,000). Overall, few articles reported data on deaths associated with infection. The limited case fatality data revealed the highest case fatality for tuberculous meningitis/spondylodiscitis (21.1%) and the lowest for neurocysticercosis (5.5%). In all five disease categories, funnel plots assessing for publication bias were asymmetrical and suggested that the results may underestimate the incidence of disease.CONCLUSIONSThis systematic review and meta-analysis approximates the global incidence of neurosurgically relevant infectious diseases. These results underscore the disproportionate burden of CNS infections in the developing world, where there is a tremendous demand to provide training and resources for high-quality neurosurgical care.

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Infectious diseases in low-income countries: where are we now?

10.1093/oso/9780198789833.003.0001 ◽

2018 ◽

Author(s):

Benjamin Roche ◽

Thierry Baldet ◽

Simard Frédéric

Keyword(s):

Infectious Diseases ◽

Low Income ◽

Control Strategies ◽

Low Income Countries ◽

Western World ◽

Human Populations ◽

Health Campaigns ◽

Human Pathogens ◽

Public Health Campaigns ◽

Made In

It is widely documented that infectious diseases have a very deep impact on numerous human populations. While public health campaigns have achieved spectacular successes, they do not appear to be evenly distributed throughout the world. Indeed, although many infectious diseases have been eliminated in the Western world, deadly pathogens are still spreading in many low-income countries. This chapter aims to describe the current epidemiological situations, reviewing control strategies and the progress that has been made in the fight against major human pathogens with the strongest impact in low-income countries. This chapter, therefore, introduces most of the pathogens that will be discussed in the book, and it describes why some epidemiological situations improved for some diseases more than for others.

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Ecology and Evolution of Infectious Diseases

10.1093/oso/9780198789833.001.0001 ◽

2018 ◽

Cited By ~ 2

Keyword(s):

Public Health ◽

Infectious Diseases ◽

Low Income ◽

Evolutionary Biology ◽

Evolutionary Ecology ◽

Economic Resources ◽

Low Income Countries ◽

Health Strategy ◽

Pathogen Control ◽

Effective Public Health

During the last thirty years, the ecology and evolution of infectious diseases has been studied extensively. Understanding how pathogens are transmitted in time and space, how they are evolving according to different selective pressures, and how the environment can influence their transmission, has paved the way for new approaches to the study of host/pathogen interactions. At the same time, pathogen control in low-income countries (LIC) has tended to remain largely inspired and informed by classical epidemiology, where the objective is to treat as many people as possible, despite recent findings in ecology and evolutionary biology suggesting new opportunities for improved disease control in the context of limited economic resources. The need to integrate the scientific developments in ecology and evolution of infectious diseases with public health strategy in low-income countries is clearly as important today as it has ever been. In this book, the authors provide an up to date, authoritative, and challenging review of the ecology and evolution of infectious diseases focusing on low-income countries for effective public health applications and outcomes. Accessible to students and researchers working on evolutionary ecology of infectious diseases and public health scientists working on their control in low-income countries, this book combines chapters exposing fundamental concepts in evolutionary ecology with others exploring the most recent advances in the field as well as highlighting how they can provide new innovative approach on the field. This work is concluded by an integrative chapter signed by all the authors highlighting the key missing points to improve this connection between evolutionary ecology and public health in low-income countries.

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