scholarly journals Recent advances in the diagnosis and management of sepsis in pregnancy

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 1546 ◽  
Author(s):  
Amaan Ali ◽  
Ronnie F Lamont
Keyword(s):  
Risk Factors ◽  
Critical Care ◽  
Maternal Death ◽  
Low Income ◽  
Low Income Countries ◽  
Future Research ◽  
Preventative Measures ◽  
Related Risk ◽  
Maternal Sepsis ◽  
In Pregnancy

Background: Maternal sepsis accounts for 11% of all maternal deaths worldwide. It is the third most common direct cause of maternal death and is a major contributor to other common causes of maternal death, such as haemorrhage and thromboembolism. Methods: This review addresses important topics, including the epidemiology, risk factors, prevention, diagnosis, care bundles and management of maternal sepsis, including antibiotic treatment, and critical care interventions such as extracorporeal membrane oxygenation. Preventative measures that have had an impact on maternal sepsis as well as future research directions are also covered in this review. Case studies of maternal sepsis which highlight key learning points relevant to all clinicians involved in the management of obstetric patients will also be presented. Results: Although, historically, maternal death from sepsis was considered to be a problem for low-income countries, severe obstetric morbidity and maternal death from sepsis are increasing in high-income countries. The global burden of maternal sepsis and the obstetric-related and patient-related risk factors and the likely sources are presented. Recent changes in definition and nomenclature are outlined, and challenges in diagnosis and identification are discussed. Conclusions: Following maternal sepsis, early diagnosis and early intervention are critical to save lives and prevent long-term adverse sequelae. Dogma surrounding critical care interventions in pregnancy is being challenged, and future research is warranted to maximise therapeutic options available for maternal septic shock.

A Cross-sectional Study of the Clinical Profile of Children With Cerebral Palsy in Benin, a West African Low-Income Country

2019 ◽  
Vol 34 (13) ◽  
pp. 842-850
Author(s):  
Emmanuel Segnon Sogbossi ◽  
Damienne Houekpetodji ◽  
Toussaint G. Kpadonou ◽  
Yannick Bleyenheuft
Keyword(s):  
Risk Factors ◽  
Cerebral Palsy ◽  
Low Income ◽  
Classification System ◽  
West African ◽  
Low Income Countries ◽  
Cross Sectional ◽  
Common Cause ◽  
Low Income Country ◽  
Children With Cerebral Palsy

Cerebral palsy is a common cause of pediatric motor disability. Although there are increasing amounts of data on the clinical profile of children with cerebral palsy in high-income countries, corresponding information about low-income countries and developing countries is lacking. Therefore, we aimed to describe the clinical spectrum of cerebral palsy in children in Benin, a representative West African low-income country. Our cross-sectional observational study included 114 children with cerebral palsy recruited from community-based rehabilitation centers and teaching hospitals (median age: 7 years, range 2-17; sex: 66% male). Data were collected through review of medical records and interviews with children’s mothers. Assessment included risk factors, clinical subtypes according to the Surveillance of CP in Europe criteria, severity of motor outcome scored by the Gross Motor Function Classification System (GMFCS) and Manual Ability Classification System, comorbidities, and school attendance. We recorded a high prevalence of intrapartum adverse events. Seventeen percent of children had postneonatal cerebral palsy, with cerebral malaria being the most common cause. Most children were severely affected (67.5% as bilateral spastic; 54.4% as GMFCS IV or V), but severity declined substantially with age. Only 23% of the children with cerebral palsy had attended school. Poor motor outcomes and comorbidities were associated with school nonattendance. These results suggest that intrapartum risk factors and postnatal cerebral malaria in infants are opportune targets for prevention of cerebral palsy in Sub-Saharan low-income countries.

scholarly journals Are Nanobiosensors an Improved Solution for Diagnosis of Leishmania?

Pharmaceutics ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 491
Author(s):  
Sona Jain ◽  
Wanessa Santana ◽  
Silvio S. Dolabella ◽  
André L. S. Santos ◽  
Eliana B. Souto ◽  
...  
Keyword(s):  
Low Income ◽  
Neglected Tropical Diseases ◽  
Diagnostic Techniques ◽  
Cross Reactivity ◽  
Low Income Countries ◽  
Future Research ◽  
Immunological Tests ◽  
Diagnostic Approaches ◽  
Signal Improvement ◽  
Adequate Management

Leishmaniasis is one of the deadliest neglected tropical diseases affecting 12–15 million people worldwide, especially in middle- and low-income countries. Rapid and accurate diagnosis of the disease is important for its adequate management and treatment. Several techniques are available for the diagnosis of leishmaniasis. Among these, parasitological and immunological tests are most widely used. However, in most cases, the utilized diagnostic techniques are not good enough, showing cross-reactivity and reduced accuracy. In recent years, many new methods have been reported with potential for improved diagnosis. This review focuses on the diagnosis of Leishmania exploring the biosensors and nanotechnology-based options for their detection. New developments including the use of nanomaterials as fluorophores, fluorescence quenchers as reducing agents and as dendrimers for signal improvement and amplification, together with the use of aptamers to replace antibodies are described. Future research opportunities to overcome the current limitations on the available diagnostic approaches are also discussed.

scholarly journals The Clean pilot study: evaluation of an environmental hygiene intervention bundle in three Tanzanian hospitals

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Giorgia Gon ◽  
Abdunoor M. Kabanywanyi ◽  
Petri Blinkhoff ◽  
Simon Cousens ◽  
Stephanie J. Dancer ◽  
...  
Keyword(s):  
Pilot Study ◽  
Study Design ◽  
Low Income ◽  
High Volume ◽  
Surface Cleaning ◽  
Low Income Countries ◽  
Training Period ◽  
Future Research ◽  
Environmental Hygiene ◽  
The Impact

Abstract Background Healthcare associated infections (HAI) are estimated to affect up to 15% of hospital inpatients in low-income countries (LICs). A critical but often neglected aspect of HAI prevention is basic environmental hygiene, particularly surface cleaning and linen management. TEACH CLEAN is an educational intervention aimed at improving environmental hygiene. We evaluated the effectiveness of this intervention in a pilot study in three high-volume maternity and newborn units in Dar es Salaam, Tanzania. Methods This study design prospectively evaluated the intervention as a whole, and offered a before-and-after comparison of the impact of the main training. We measured changes in microbiological cleanliness [Aerobic Colony Counts (ACC) and presence of Staphylococcus aureus] using dipslides, and physical cleaning action using gel dots. These were analysed with descriptive statistics and logistic regression models. We used qualitative (focus group discussions, in-depth interviews, and semi-structured observation) and quantitative (observation checklist) tools to measure why and how the intervention worked. We describe these findings across the themes of adaptation, fidelity, dose, reach and context. Results Microbiological cleanliness improved during the study period (ACC pre-training: 19%; post-training: 41%). The odds of cleanliness increased on average by 1.33 weekly during the pre-training period (CI = 1.11–1.60), and by 1.08 (CI = 1.03–1.13) during the post-training period. Cleaning action improved only in the pre-training period. Detection of S. aureus on hospital surfaces did not change substantially. The intervention was well received and considered feasible in this context. The major pitfalls in the implementation were the limited number of training sessions at the hospital level and the lack of supportive supervision. A systems barrier to implementation was lack of regular cleaning supplies. Conclusions The evaluation suggests that improvements in microbiological cleanliness are possible using this intervention and can be sustained. Improved microbiological cleanliness is a key step on the pathway to infection prevention in hospitals. Future research should assess whether this bundle is cost-effective in reducing bacterial and viral transmission and infection using a rigorous study design.

144: Partner- and partnership-related risk factors for preterm birth among low-income women in Lima, Peru

2008 ◽  
Vol 199 (6) ◽  
pp. S53
Author(s):  
Kathleen Paul ◽  
Pedro Garcia ◽  
Lisa Manhart ◽  
King Holmes ◽  
Jane Hitti
Keyword(s):  
Risk Factors ◽  
Preterm Birth ◽  
Low Income ◽  
Related Risk ◽  
Low Income Women

Agricultural Labor Supply

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Alexandra E. Hill ◽  
Izaac Ornelas ◽  
J. Edward Taylor
Keyword(s):  
Labor Supply ◽  
Low Income ◽  
Empirical Work ◽  
Low Income Countries ◽  
Future Research ◽  
Farm Labor ◽  
Annual Review ◽  
Publication Date ◽  
Agricultural Labor ◽  
Farm Work

The labor supply response to agricultural wages is critical to the viability of crop production in high-income countries, which hire a largely foreign farm work force, as well as in low-income countries, where domestic workers move off the farm as the agricultural transformation unfolds. Modeling agricultural labor supply is more challenging than modeling the supply of other agricultural inputs or of labor to other sectors of the economy owing to unique features of agricultural production and farm labor markets. Data and econometric challenges abound, and estimates of agricultural labor supply elasticities are sparse. This review explains the importance and challenges of modeling farm labor supply and describes researchers’ efforts to address these challenges. It summarizes estimates of agricultural labor supply elasticities over the last 80 years, provides insights into variation in these estimates, identifies priority areas for future research, and reviews the most influential empirical work related to this important topic. Expected final online publication date for the Annual Review of Resource Economics, Volume 13 is October 2021. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

scholarly journals Changing Epidemiology of Acute Respiratory Infections in Under-Two Children in Dhaka, Bangladesh

2022 ◽  
Vol 9 ◽  
Author(s):  
Karine Vidal ◽  
Shamima Sultana ◽  
Alberto Prieto Patron ◽  
Irene Salvi ◽  
Maya Shevlyakova ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Low Income ◽  
Respiratory Infections ◽  
Monsoon Season ◽  
Low Income Countries ◽  
Health Study ◽  
Acute Respiratory Infections ◽  
Respiratory Pathogens ◽  
Prevention Measures

Objectives: Risk factors for acute respiratory infections (ARIs) in community settings are not fully understood, especially in low-income countries. We examined the incidence and risk factors associated with ARIs in under-two children from the Microbiota and Health study.Methods: Children from a peri-urban area of Dhaka (Bangladesh) were followed from birth to 2 years of age by both active surveillance of ARIs and regular scheduled visits. Nasopharyngeal samples were collected during scheduled visits for detection of bacterial facultative respiratory pathogens. Information on socioeconomic, environmental, and household conditions, and mother and child characteristics were collected. A hierarchical modeling approach was used to identify proximate determinants of ARIs.Results: Of 267 infants, 87.3% experienced at least one ARI episode during the first 2 years of life. The peak incidence of ARIs was 330 infections per 100 infant-years and occurred between 2 and 4 months of age. Season was the main risk factor (rainy monsoon season, incidence rate ratio [IRR] 2.43 [1.92–3.07]; cool dry winter, IRR 2.10 [1.65–2.67] compared with hot dry summer) in the first 2 years of life. In addition, during the first 6 months of life, young maternal age (<22 years; IRR 1.34 [1.01–1.77]) and low birth weight (<2,500 g; IRR 1.39 [1.03–1.89]) were associated with higher ARI incidence.Conclusions: Reminiscent of industrialized settings, cool rainy season rather than socioeconomic and hygiene conditions was a major risk factor for ARIs in peri-urban Bangladesh. Understanding the causal links between seasonally variable factors such as temperature, humidity, crowding, diet, and ARIs will inform prevention measures.

scholarly journals Predisposing Factors Promoting COVID-19 Infection and Mortality

2021 ◽  
pp. 43-48
Author(s):  
Azike, Chidimma Anthonia ◽  
Jeremiah Owubokiri Ngowari ◽  
Orudukobipi Tamunonengiye-Ofori
Keyword(s):  
Risk Factors ◽  
Chronic Disease ◽  
Low Income ◽  
Negative Impact ◽  
Healthcare Delivery ◽  
Respiratory Illness ◽  
Vulnerable Groups ◽  
Future Research ◽  
Movement Restriction ◽  
Quality Health Care

The pandemic of COVID-19 infection has had an untold adverse impact on patients living with chronic disease, across various ethnicity/race, age and gender. Underlying hypertension, cardiovascular disease, diabetes and respiratory illness are key risk factors for the development of severe COVID-19 pneumonia and systematic inflammation. Patients who are immunosuppressed by virtue of their chronic disease, age or a therapy have been identified as susceptible groups. The redirection of healthcare services towards the increasing numbers of COVID-19 patients has compromised the healthcare delivery to patients with chronic illness. Movement restriction measures as approach to curb the spread of the infection have also compromised the metabolic health of many patients who need enhanced physical activity to improve their health. Media publications on COVID-19 infection and restrictions may have also contributed to the poor mental health of some individuals, especially patients with underlying mental conditions or its risk factors. The inadequate or availability of quality health care system across low income and developing regions especially, those with older age groups, has further accelerated the spread and death rate from COVID-19. Future research should be directed towards protecting vulnerable groups from possible waves of COVID-19 as a measure to reduce the negative impact of the pandemic on these individuals.

scholarly journals Fe0/H2O Filtration Systems for Decentralized Safe Drinking Water: Where to from Here?

Water ◽  
2019 ◽  
Vol 11 (3) ◽  
pp. 429 ◽  
Author(s):  
Charles Nanseu-Njiki ◽  
Willis Gwenzi ◽  
Martin Pengou ◽  
Mohammad Rahman ◽  
Chicgoua Noubactep
Keyword(s):  
Drinking Water ◽  
Low Income ◽  
Universal Access ◽  
Low Cost ◽  
Low Income Countries ◽  
Future Research ◽  
Systematic Research ◽  
Safe Drinking Water ◽  
Iron Corrosion ◽  
Small Communities

Inadequate access to safe drinking water is one of the most pervasive problems currently afflicting the developing world. Scientists and engineers are called to present affordable but efficient solutions, particularly applicable to small communities. Filtration systems based on metallic iron (Fe0) are discussed in the literature as one such viable solution, whether as a stand-alone system or as a complement to slow sand filters (SSFs). Fe0 filters can also be improved by incorporating biochar to form Fe0-biochar filtration systems with potentially higher contaminant removal efficiencies than those based on Fe0 or biochar alone. These three low-cost and chemical-free systems (Fe0, biochar, SSFs) have the potential to provide universal access to safe drinking water. However, a well-structured systematic research is needed to design robust and efficient water treatment systems based on these affordable filter materials. This communication highlights the technology being developed to use Fe0-based systems for decentralized safe drinking water provision. Future research directions for the design of the next generation Fe0-based systems are highlighted. It is shown that Fe0 enhances the efficiency of SSFs, while biochar has the potential to alleviate the loss of porosity and uncertainties arising from the non-linear kinetics of iron corrosion. Fe0-based systems are an affordable and applicable technology for small communities in low-income countries, which could contribute to attaining self-reliance in clean water supply and universal public health.

scholarly journals Developing obstetric medicine training in Latin America

2017 ◽  
Vol 10 (1) ◽  
pp. 16-20 ◽  
Author(s):  
José Rojas-Suarez ◽  
Niza Suarez ◽  
Oier Ateka-Barrutia
Keyword(s):  
Latin America ◽  
Maternal Mortality ◽  
Latin American ◽  
Low Income ◽  
Morbidity And Mortality ◽  
Low Income Countries ◽  
Important Indicator ◽  
Obstetric Medicine ◽  
The Impact ◽  
In Pregnancy

Maternal mortality is an important indicator of health in populations around the world. The distribution of maternal mortality ratio globally shows that middle- and low-income countries have ∼99% of the mortality burden. Most countries of Latin America are considered to be middle- or low-income countries, as well as areas of major inequities among the different social classes. Medical problems in pregnancy remain an important cause of morbidity and mortality in this region. Previous data indicate the need for a call to action for adequate diagnosis and care of medical diseases in obstetric care. The impact of nonobstetric and medical pathologies on maternal mortality in Latin America is largely unknown. In Latin America, two educational initiatives have been proposed to improve skills in maternity care. The Advanced Life Support in Obstetrics (ALSO®) was first started to address obstetric emergencies, and subsequently adapted for low-middle-income country settings as the Global ALSO®. In parallel, the Latin American obstetric anesthesia community has progressively focused on improvement of several intrapartum/intraoperative issues, which has secondarily taken them to embrace the obstetric medicine area on interest and join the former initiatives. In the present review, we summarize the available data regarding medical morbidity and mortality in pregnancy in Latin America, as well as the challenges, achievements, issues, initiatives, and future directions encouraging maternal health educators, health care trainers, and physicians in middle- and low-income countries, such as many Latin American ones, to improve and/or change attitudes, if needed, on current clinical practice.

scholarly journals Road Safety in Low-Income Countries: State of Knowledge and Future Directions

2019 ◽  
Vol 11 (22) ◽  
pp. 6249 ◽  
Author(s):  
Shahram Heydari ◽  
Adrian Hickford ◽  
Rich McIlroy ◽  
Jeff Turner ◽  
Abdulgafoor M. Bachani
Keyword(s):  
Low Income ◽  
Traffic Engineering ◽  
Road Safety ◽  
Scale Up ◽  
Safety Data ◽  
Low Income Countries ◽  
Future Research ◽  
Improvement Programs ◽  
Behavioural Aspects ◽  
The Impact

Road safety in low-income countries (LICs) remains a major concern. Given the expected increase in traffic exposure due to the relatively rapid motorisation of transport in LICs, it is imperative to better understand the underlying mechanisms of road safety. This in turn will allow for planning cost-effective road safety improvement programs in a timely manner. With the general aim of improving road safety in LICs, this paper discusses the state of knowledge and proposes a number of future research directions developed from literature reviews and expert elicitation. Our study takes a holistic approach based on the Safe Systems framework and the framework for the UN Decade of Action for Road Safety. We focused mostly on examining the problem from traffic engineering and safety policy standpoints, but also touched upon other sectors, including public health and social sciences. We identified ten focus areas relating to (i) under-reporting; (ii) global best practices; (iii) vulnerable groups; (iv) disabilities; (v) road crash costing; (vi) vehicle safety; (vii) proactive approaches; (viii) data challenges; (ix) social/behavioural aspects; and (x) capacity building. Based on our findings, future research ought to focus on improvement of data systems, understanding the impact of and addressing non-fatal injuries, improving estimates on the economic burden, implementation research to scale up programs and transfer learnings, as well as capacity development. Our recommendations, which relate to both empirical and methodological frontiers, would lead to noteworthy improvements in the way road safety data collection and research is conducted in the context of LICs.

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