scholarly journals Influence of contextual socioeconomic position on hypertension risk in low- and middle-income countries: disentangling context from composition

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mustapha S. Abba ◽  
Chidozie U. Nduka ◽  
Seun Anjorin ◽  
Shukri F. Mohamed ◽  
Emmanuel Agogo ◽  
...  
Keyword(s):  
Kyrgyz Republic ◽  
Lifestyle Behaviour ◽  
Middle Income ◽  
Individual Level ◽  
Middle Income Countries ◽  
Country Level ◽  
Resource Limited ◽  
The Individual ◽  
Low And Middle Income ◽  
Deprived Areas

Abstract Background Hypertension has emerged as the single most significant modifiable risk factor for cardiovascular disease and death worldwide. Resource-limited settings are currently experiencing the epidemiological transition from infectious diseases to chronic non-communicable diseases, primarily due to modifications in diet and lifestyle behaviour. The objective of this study was to examine the influence of individual-, community- and country-level factors associated with hypertension in low- and middle-income countries (LMICs). Methods Multivariable multi-level logistic regression analysis was applied using 12 Demographic and Health Survey (DHS) datasets collected between 2011 and 2018 in LMICs. We included 888,925 respondents (Level 1) nested within 33,883 neighbourhoods (Level 2) from 12 LMICs (Level 3). Results The prevalence of hypertension ranged from 10.3% in the Kyrgyz Republic to 52.2% in Haiti. After adjusting for the individual-, neighbourhood- and country-level factors, we found respondents living in the least deprived areas were 14% more likely to have hypertension than those from the most deprived areas (OR = 1.14, 95% CI 1.10 to 1.17). We observed a significant variation in the odds of hypertension across the countries and the neighbourhoods. Approximately 26.3 and 47.6% of the variance in the odds of hypertension could be attributed to country- and neighbourhood-level factors, respectively. We also observed that respondents moving to a different neighbourhood or country with a higher risk of hypertension had an increased chance of developing hypertension, the median increase in their odds of hypertension was 2.83-fold (95% CI 2.62 to 3.07) and 4.04- fold (95% CI 3.98 to 4.08), respectively. Conclusions This study revealed that individual compositional and contextual measures of socioeconomic status were independently associated with the risk of developing hypertension. Therefore, prevention strategies should be implemented at the individual level and the socioeconomic and contextual levels to reduce the burden of hypertension.

scholarly journals Prevalence and trends in the childhood dual burden of malnutrition in low- and middle-income countries, 1990–2012

2016 ◽  
Vol 19 (8) ◽  
pp. 1375-1388 ◽  
Author(s):  
Emma Tzioumis ◽  
Melissa C Kay ◽  
Margaret E Bentley ◽  
Linda S Adair
Keyword(s):  
Demographic And Health Surveys ◽  
Cross Sectional ◽  
Middle Income ◽  
Individual Level ◽  
Middle Income Countries ◽  
Country Level ◽  
Before And After ◽  
Dual Burden ◽  
Nationally Representative ◽  
Low And Middle Income

AbstractObjectiveTo describe trends in country- and individual-level dual burden of malnutrition in children <5 years, and age-stratified (<2 years, ≥2 years) country-level trends, in thirty-six low- and middle-income countries (LMIC).DesignUsing repeated cross-sectional nationally representative data, we calculated the prevalence of malnutrition (stunting, wasting, overweight) at each survey wave, annualized rates of prevalence change for each country over time, and trends before and after 2000, for all children <5 years and separately for those </≥2 years. We examined country- (ratio of stunting to overweight) and individual-level (coexistence of stunting and overweight) dual burden in children <5 years.SettingDemographic and Health Surveys from thirty-six LMIC between 1990 and 2012.SubjectsChildren <5 years.ResultsOverall malnutrition prevalence decreased in children <5 years, driven by stunting decreases. Stunting rates decreased in 78 % of countries, wasting rates decreased in 58 % of countries and overweight rates increased in 36 % of countries. Rates of change differed for children </≥2 years, with children <2 years experiencing decreases in stunting in fewer countries yet increases in overweight in more countries. Countries with nearly equal prevalences of stunting and overweight in children <5 years increased from 2000 to the final year. Within a country, 0·3–10·9 % of children <5 years were stunted and overweight, and 0·6–37·8 % of stunted children <5 years were overweight.ConclusionsThe dual burden exists in children <5 years on both country and individual levels, indicating a shift is needed in policies and programmes to address both sides of malnutrition. Children <2 years should be identified as a high-risk demographic.

scholarly journals Predictors of Contemporary under-5 Child Mortality in Low- and Middle-Income Countries: A Machine Learning Approach

2021 ◽  
Vol 18 (3) ◽  
pp. 1315
Author(s):  
Andrea Bizzego ◽  
Giulio Gabrieli ◽  
Marc H. Bornstein ◽  
Kirby Deater-Deckard ◽  
Jennifer E. Lansford ◽  
...  
Keyword(s):  
Machine Learning ◽  
Child Mortality ◽  
Learning Approach ◽  
Unique Contribution ◽  
Middle Income ◽  
Middle Income Countries ◽  
Country Level ◽  
Machine Learning Approach ◽  
Operational Information ◽  
Low And Middle Income

Child Mortality (CM) is a worldwide concern, annually affecting as many as 6.81% children in low- and middle-income countries (LMIC). We used data of the Multiple Indicators Cluster Survey (MICS) (N = 275,160) from 27 LMIC and a machine-learning approach to rank 37 distal causes of CM and identify the top 10 causes in terms of predictive potency. Based on the top 10 causes, we identified households with improved conditions. We retrospectively validated the results by investigating the association between variations of CM and variations of the percentage of households with improved conditions at country-level, between the 2005–2007 and the 2013–2017 administrations of the MICS. A unique contribution of our approach is to identify lesser-known distal causes which likely account for better-known proximal causes: notably, the identified distal causes and preventable and treatable through social, educational, and physical interventions. We demonstrate how machine learning can be used to obtain operational information from big dataset to guide interventions and policy makers.

scholarly journals Development of immunohistochemistry services for cancer care in western Kenya: Implications for low- and middle-income countries

2016 ◽  
Vol 5 (1) ◽  
Author(s):  
Kirtika Patel ◽  
R. Matthew Strother ◽  
Francis Ndiangui ◽  
David Chumba ◽  
William Jacobson ◽  
...  
Keyword(s):  
Cancer Care ◽  
Cost Model ◽  
Tertiary Care ◽  
Care Hospital ◽  
Middle Income ◽  
Western Kenya ◽  
Middle Income Countries ◽  
Resource Limited ◽  
Limited Setting ◽  
Low And Middle Income

Background: Cancer is becoming a major cause of mortality in low- and middle-income countries. Unlike infectious disease, malignancy and other chronic conditions require significant supportive infrastructure for diagnostics, staging and treatment. In addition to morphologic diagnosis, diagnostic pathways in oncology frequently require immunohistochemistry (IHC) for confirmation. We present the experience of a tertiary-care hospital serving rural western Kenya, which developed and validated an IHC laboratory in support of a growing cancer care service.Objectives, methods and outcomes: Over the past decade, in an academic North-South collaboration, cancer services were developed for the catchment area of Moi Teaching and Referral Hospital in western Kenya. A major hurdle to treatment of cancer in a resource-limited setting has been the lack of adequate diagnostic services. Building upon the foundations of a histology laboratory, strategic investment and training were used to develop IHC services. Key elements of success in this endeavour included: translation of resource-rich practices to are source-limited setting, such as using manual, small-batch IHC instead of disposable- and maintenance-intensive automated machinery, engagement of outside expertise to develop reagent-efficient protocols and supporting all levels of staff to meet the requirements of an external quality assurance programme.Conclusion: Development of low- and middle-income country models of services, such as the IHC laboratory presented in this paper, is critical for the infrastructure in resource-limited settings to address the growing cancer burden. We provide a low-cost model that effectively develops these necessary services in a challenging laboratory environment.

Perceived Trust and Confidence for Cryptocurrency Adoption

2022 ◽  
pp. 250-279
Author(s):  
Ewilly Jie Ying Liew ◽  
Wei Li Peh ◽  
Zhuan Kee Leong
Keyword(s):  
Large Scale ◽  
Social Impact ◽  
Public Perceptions ◽  
Middle Income ◽  
Individual Level ◽  
Perceived Trust ◽  
Middle Income Countries ◽  
Regulatory Bodies ◽  
The Individual ◽  
National Databases

This chapter seeks to examine the influence of public perceptions of trust in people and confidence in institutions on cryptocurrency adoption, taking into account the individual-level demographic factors and the regional-level contextual factors. Data is obtained from three large-scale international surveys and national databases and analyzed using R software. The multivariate results demonstrate that individuals' public perceptions of trust and confidence significantly contribute to cryptocurrency adoption. Lower perceived trust in people and higher perceived confidence in civil service and international regulatory bodies increase cryptocurrency adoption, while perceived confidence in political and financial institutions discourages cryptocurrency adoption. Additionally, the univariate results find significant comparisons of gender and perceived trust differences on the predictors of cryptocurrency adoption. This chapter discusses and provides insights on the social impact and future of cryptocurrency adoption, particularly among the upper- and lower-middle-income countries.

scholarly journals Characteristics of a Nationwide Voluntary Antibiotic Resistance Awareness Campaign in India; Future Paths and Pointers for Resource Limited Settings/Low and Middle Income Countries

2019 ◽  
Vol 16 (24) ◽  
pp. 5141
Author(s):  
Ashok J. Tamhankar ◽  
Ramesh Nachimuthu ◽  
Ravikant Singh ◽  
Jyoti Harindran ◽  
Gautam Kumar Meghwanshi ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Antibiotic Use ◽  
World Health ◽  
Awareness Campaign ◽  
Resource Limited Settings ◽  
Middle Income ◽  
Middle Income Countries ◽  
Awareness Campaigns ◽  
Resource Limited ◽  
Low And Middle Income

Antibiotic resistance has reached alarming proportions globally, prompting the World Health Organization to advise nations to take up antibiotic awareness campaigns. Several campaigns have been taken up worldwide, mostly by governments. The government of India asked manufacturers to append a ‘redline’ to packages of antibiotics as identification marks and conducted a campaign to inform the general public about it and appropriate antibiotic use. We investigated whether an antibiotic resistance awareness campaign could be organized voluntarily in India and determined the characteristics of the voluntarily organized campaign by administering a questionnaire to the coordinators, who participated in organizing the voluntary campaign India. The campaign characteristics were: multiple electro–physical pedagogical and participatory techniques were used, 49 physical events were organized in various parts of India that included lectures, posters, booklet/pamphlet distribution, audio and video messages, competitions, and mass contact rallies along with broadcast of messages in 11 local languages using community radio stations (CRS) spread all over India. The median values for campaign events were: expenditure—3000 Indian Rupees/day (US$~47), time for planning—1 day, program spread—4 days, program time—4 h, direct and indirect reach of the message—respectively 250 and 500 persons/event. A 2 min play entitled ‘Take antibiotics as prescribed by the doctor’ was broadcast 10 times/day for 5 days on CRS with listener reach of ~5 million persons. More than 85%ofcoordinators thought that the campaign created adequate awareness about appropriate antibiotic use and antibiotic resistance. The voluntary campaign has implications for resource limited settings/low and middle income countries.

scholarly journals Consumption of breast milk, formula and other non-human milk by children aged under 2 years: analysis of eighty-six low- and middle-income countries

2020 ◽  
pp. 1-9
Author(s):  
Paulo AR Neves ◽  
Aluísio JD Barros ◽  
Phillip Baker ◽  
Ellen Piwoz ◽  
Thiago M Santos ◽  
...  
Keyword(s):  
Breast Milk ◽  
Human Milk ◽  
Breast Feeding ◽  
Milk Formula ◽  
Milk Consumption ◽  
Middle Income ◽  
Middle Income Countries ◽  
Country Level ◽  
Low And Middle Income ◽  
Economic Inequalities

Abstract Objective: To investigate the prevalence and socio-economic inequalities in breast milk, breast milk substitutes (BMS) and other non-human milk consumption, by children under 2 years in low- and middle-income countries (LMIC). Design: We analysed the prevalence of continued breast-feeding at 1 and 2 years and frequency of formula and other non-human milk consumption by age in months. Indicators were estimated through 24-h dietary recall. Absolute and relative wealth indicators were used to describe within- and between-country socio-economic inequalities. Setting: Nationally representative surveys from 2010 onwards from eighty-six LMIC. Participants: 394 977 children aged under 2 years. Results: Breast-feeding declined sharply as children became older in all LMIC, especially in upper-middle-income countries. BMS consumption peaked at 6 months of age in low/lower-middle-income countries and at around 12 months in upper-middle-income countries. Irrespective of country, BMS consumption was higher in children from wealthier families, and breast-feeding in children from poorer families. Multilevel linear regression analysis showed that BMS consumption was positively associated with absolute income, and breast-feeding negatively associated. Findings for other non-human milk consumption were less straightforward. Unmeasured factors at country level explained a substantial proportion of overall variability in BMS consumption and breast-feeding. Conclusions: Breast-feeding falls sharply as children become older, especially in wealthier families in upper-middle-income countries; this same group also consumes more BMS at any age. Country-level factors play an important role in explaining BMS consumption by all family wealth groups, suggesting that BMS marketing at national level might be partly responsible for the observed differences.

scholarly journals Assessing mortality registration in Kerala: the MARANAM study

Genus ◽  
2022 ◽  
Vol 78 (1) ◽  
Author(s):  
Aashish Gupta ◽  
Sneha Sarah Mani
Keyword(s):  
Vital Statistics ◽  
Middle Income ◽  
Registration System ◽  
Individual Level ◽  
Civil Registration ◽  
Middle Income Countries ◽  
Registration Data ◽  
Life Expectancy At Birth ◽  
Sample Registration System ◽  
Low And Middle Income

AbstractComplete or improving civil registration systems in sub-national areas in low- and middle-income countries provide several opportunities to better understand population health and its determinants. In this article, we provide an assessment of vital statistics in Kerala, India. Kerala is home to more than 33 million people and is a comparatively low-mortality context. We use individual-level vital registration data on more than 2.8 million deaths between 2006 and 2017 from the Kerala MARANAM (Mortality and Registration Assessment and Monitoring) Study. Comparing age-specific mortality rates from the Civil Registration System (CRS) to those from the Sample Registration System (SRS), we do not find evidence that the CRS underestimates mortality. Instead, CRS rates are smoother across ages and less variable across periods. In particular, the CRS records higher death rates than the SRS for ages, where mortality is usually low and for women. Using these data, we provide the first set of annual sex-specific life tables for any state in India. We find that life expectancy at birth was 77.9 years for women in 2017 and 71.4 years for men. Although Kerala is unique in many ways, our findings strengthen the case for more careful attention to mortality records within low- and middle-income countries, and for their better dissemination by government agencies.

scholarly journals The prevalence and correlates of the double burden of malnutrition among women in Ghana

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0244362
Author(s):  
Sandra Boatemaa Kushitor ◽  
Lily Owusu ◽  
Mawuli Kobla Kushitor
Keyword(s):  
Normal Weight ◽  
Chi Square ◽  
Double Burden ◽  
Middle Income ◽  
Individual Level ◽  
Factors Associated ◽  
Middle Income Countries ◽  
Chi Square Test ◽  
Double Burden Of Malnutrition ◽  
The Individual

Anaemia and underweight or overweight/obesity are major public health problems driving maternal and child mortality in low- and middle-income countries. While the burden of these conditions is recognised, the evidence for the co-occurrence of these conditions is fragmented and mixed, especially at the individual level. Further, many studies have focused on families and communities. The different pathways for the occurrence of anaemia and BMI challenges indicate that an individual can potentially live with both conditions and suffer the complications. This study examined the prevalence and factors associated with the co-occurrence of anaemia and BMI challenges among a cohort of women in Ghana. Data from the 2014 Ghana Demographic and Health Survey were used. The sample size was 4 337 women aged 15–49 years who were not pregnant during the survey. Women who suffered simultaneously from underweight or overweight/obesity and anaemia were considered as having the double burden of malnutrition. The data were analysed using descriptive statistics, Chi-square test and logistic regression in STATA. One-fifth of the participants were overweight (21%), 4% were underweight and about one-tenth were obese (12%). The prevalence of anaemia was 41%. Only one in three women had normal weight and was not anaemic (34%). About 14% of the women experienced the double burden of malnutrition. Being overweight and anaemic (57%) was the most common form of this double burden. Age, marital status, parity, and wealth were t key risk factors associated with the double burden of malnutrition. The findings from this study show that women experience multiple nutritional challenges concurrently and that only a few women had healthy nutritional status. This information is particularly important and can be introduced into health education programmes to help address misconceptions about body weight and health.

scholarly journals Nurse staffing and patient care outcomes: protocol for an umbrella review to identify evidence gaps for low and middle-income countries

2021 ◽  
Vol 6 ◽  
pp. 363
Author(s):  
Abdulazeez Imam ◽  
Sopuruchukwu Obiesie ◽  
Jalemba Aluvaala ◽  
Michuki Maina ◽  
David Gathara ◽  
...  
Keyword(s):  
Systematic Reviews ◽  
Meta Analysis ◽  
Nurse Staffing ◽  
Published Data ◽  
Umbrella Review ◽  
Middle Income ◽  
Middle Income Countries ◽  
Registration Number ◽  
The Individual ◽  
Low And Middle Income

Background: Adequate staffing is key to the delivery of nursing care and thus to improved inpatient and health service outcomes. Several systematic reviews have addressed the relationship between nurse staffing and these outcomes. Most primary studies within each systematic review are likely to be from high-income countries which have different practice contexts to low and middle-income countries (LMICs), although this has not been formally examined. We propose conducting an umbrella review to characterise the existing evidence linking nurse staffing to key outcomes and explicitly aim to identify evidence gaps in nurse staffing research in LMICs. Methods and analysis: This protocol was developed using the Preferred Reporting Items for Systematic Reviews and Meta-analysis Protocols (PRISMA-P). Literature searching will be conducted across Ovid Medline, Embase and EBSCO Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases. Two independent reviewers will conduct searching and data abstraction and discordance will be handled by discussion between both parties. The risk of bias of the individual studies will be performed using the AMSTAR-2. Ethics and dissemination: Ethical permission is not required for this review as we will make use of already published data. We aim to publish the findings of our review in peer-reviewed journals. PROSPERO registration number: CRD42021286908

scholarly journals Building youth and family resilience for better mental health: developing and testing a hybrid model of intervention in low- and middle-income countries

2021 ◽  
pp. 1-3
Author(s):  
Debasish Basu ◽  
Sugandha Nagpal ◽  
Renjith R. Pillai ◽  
Victoria Mutiso ◽  
David Ndetei ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Beliefs ◽  
Hybrid Model ◽  
Cost Effective ◽  
Family Resilience ◽  
Childhood Experiences ◽  
Middle Income ◽  
Middle Income Countries ◽  
The Individual ◽  
Low And Middle Income

Summary Resilience is a dynamic, multi-level, multi-systemic process of positive adaptation at the individual, family and community levels. Promoting resilience can be a cost-effective form of preventive and early intervention, offering significant health advantages for young people throughout their lives. Developing resiliency interventions for youth and their families in low- and middle-income countries (LMICs), particularly in the context of the ongoing pandemic, is especially important given a lack of services and trained specialists, and poor levels of public spend on mental health, alongside marked and clustered psychosocial disadvantages and adverse childhood experiences. We propose a ‘hybrid’ model targeting 10- to 17 year-old children and their families, and options to engage through communities, schools and the family unit. These options will enhance individual and family resilience, and possibly buffer against adversity. The adaptations respect cultural and health beliefs, take account of structural drivers of inequalities and are suitable for LMICs.

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