Development of an alternative saliva test for diagnosis of SARS-CoV-2 using TRIzol: Adapting to countries with lower incomes looking for a large-scale detection program

The use of saliva for the diagnosis of SARS-CoV-2 has shown to be a good alternative to nasopharyngeal swabs (NPS), since it permits self-collection, avoids the exposure of healthy persons to infected patients, reduces waiting times, eliminates the need of personal protective equipment and is non-invasive. Yet current saliva testing is still expensive due to the need of specialized tubes containing buffers to stabilize the RNA of SARS-CoV-2 and inactivate the virus. These tubes are expensive and not always accessible in sufficient quantities. We now developed an alternative saliva testing method, using TRIzol for extraction, viral inactivation, and storage of SARS-CoV-2 RNA, combined with RT-qPCR, which was comparable in its performance to NPS. Paired saliva samples and NPS were taken from 15 asymptomatic healthcare workers and one patient with SARS-CoV-2. Further 13 patients with SARS-CoV-2 were only saliva-tested. All the tests were performed according to CDC 2019-Novel Coronavirus (2019-nCoV) Real-Time RT-PCR Diagnostic Panel. Saliva (4 mL) was taken in sterile 50 mL tubes, 1.5 mL TRIzol were added and mixed. Our results show that 5 μL of saliva RNA extracted with TRIzol allow for an adequate detection of the virus in patients positive for SARS-CoV-2 and was equally sensitive to NPS in TRIzol. We conclude that saliva testing using TRIzol is a recommendable method for diagnosis of SARS-CoV-2 since it has several advantages over currently used saliva tests: it can be done with normal sterile tubes, does not need cold-chain handling, is stable at room temperature, is non-invasive and less costly, making it more accessible for low-income countries. Cheaper saliva testing using TRIzol is especially relevant for low-income countries to optimize diagnosis and help define quarantine durations for families, healthcare workers, schools, and other public workplaces, thus decreasing infections and mortality caused by SARS-CoV-2.

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Evaluation of a Low-Cost Commercial Actigraph and Its Potential Use in Detecting Cultural Variations in Physical Activity and Sleep

Sensors ◽

10.3390/s21113774 ◽

2021 ◽

Vol 21 (11) ◽

pp. 3774

Author(s):

Pavlos Topalidis ◽

Cristina Florea ◽

Esther-Sevil Eigl ◽

Anton Kurapov ◽

Carlos Alberto Beltran Leon ◽

...

Keyword(s):

Physical Activity ◽

Low Income ◽

Large Scale ◽

Low Cost ◽

Low Income Countries ◽

Time Data ◽

Cultural Variations ◽

Step Counts ◽

Scale Step ◽

Potential Use

The purpose of the present study was to evaluate the performance of a low-cost commercial smartwatch, the Xiaomi Mi Band (MB), in extracting physical activity and sleep-related measures and show its potential use in addressing questions that require large-scale real-time data and/or intercultural data including low-income countries. We evaluated physical activity and sleep-related measures and discussed the potential application of such devices for large-scale step and sleep data acquisition. To that end, we conducted two separate studies. In Study 1, we evaluated the performance of MB by comparing it to the GT3X (ActiGraph, wGT3X-BT), a scientific actigraph used in research, as well as subjective sleep reports. In Study 2, we distributed the MB across four countries (Austria, Germany, Cuba, and Ukraine) and investigated physical activity and sleep among these countries. The results of Study 1 indicated that MB step counts correlated highly with the scientific GT3X device, but did display biases. In addition, the MB-derived wake-up and total-sleep-times showed high agreement with subjective reports, but partly deviated from GT3X predictions. Study 2 revealed similar MB step counts across countries, but significant later wake-up and bedtimes for Ukraine than the other countries. We hope that our studies will stimulate future large-scale sensor-based physical activity and sleep research studies, including various cultures.

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The Rotavirus Vaccine Landscape, an Update

Pathogens ◽

10.3390/pathogens10050520 ◽

2021 ◽

Vol 10 (5) ◽

pp. 520

Author(s):

Roberto Cárcamo-Calvo ◽

Carlos Muñoz ◽

Javier Buesa ◽

Jesús Rodríguez-Díaz ◽

Roberto Gozalbo-Rovira

Keyword(s):

Developing Countries ◽

Mortality Rate ◽

Low Income ◽

State Of The Art ◽

The State ◽

Cold Chain ◽

Low Income Countries ◽

Rotavirus Vaccine ◽

Oral Vaccines

Rotavirus is the leading cause of severe acute childhood gastroenteritis, responsible for more than 128,500 deaths per year, mainly in low-income countries. Although the mortality rate has dropped significantly since the introduction of the first vaccines around 2006, an estimated 83,158 deaths are still preventable. The two main vaccines currently deployed, Rotarix and RotaTeq, both live oral vaccines, have been shown to be less effective in developing countries. In addition, they have been associated with a slight risk of intussusception, and the need for cold chain maintenance limits the accessibility of these vaccines to certain areas, leaving 65% of children worldwide unvaccinated and therefore unprotected. Against this backdrop, here we review the main vaccines under development and the state of the art on potential alternatives.

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ICT and Distance Learning for Agricultural Extension in Low Income Countries

Information Communication Technologies ◽

10.4018/978-1-59904-949-6.ch108 ◽

2008 ◽

pp. 1554-1560

Author(s):

Colin R. Latchem ◽

Ajit Maru

Keyword(s):

Land Tenure ◽

Low Income ◽

Large Scale ◽

Low Income Countries ◽

Environmental Damage ◽

Land Reforms ◽

Economic Changes ◽

Pests And Diseases ◽

Sub Saharan ◽

Value Add

About 2 billion people in low-income countries are dependent upon smallholding farming for their livelihoods. These are among the world’s poorest people. Most of them lack land tenure and farm in regions with limited land and water resources. Many must cope with drought, desertification, and environmental damage caused by failed land reforms, large-scale monocropping, overgrazing, logging, destroyed watersheds, and the encroachment of new pests and diseases. They use only the most primitive of tools and they lack the knowledge and skills to improve their farming methods, value-add their produce, and compete in national and global markets. Many of these smallholder communities have been devastated by HIV/AIDS. In some regions of sub-Saharan Africa, food production has dropped by 40%, and it is estimated that over the next 20 years, 26% of the agricultural labour force will be lost to this pandemic. And demographic and economic changes in the low-income nations are increasingly leaving farming in the hands of women, who lack the knowledge and resources to farm efficiently.

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Radiological staging of rectal cancer in a resource limited setting

BMC Research Notes ◽

10.1186/s13104-020-05327-4 ◽

2020 ◽

Vol 13 (1) ◽

Author(s):

Naradha Lokuhetty ◽

Suranjith L. Seneviratne ◽

Fathima Asma Rahman ◽

Thanushka Marapana ◽

Roshan Niloofa ◽

...

Keyword(s):

Rectal Cancer ◽

Low Income ◽

Regional Lymph Node ◽

Waiting Times ◽

Low Income Countries ◽

Lymph Node Staging ◽

Sri Lankan ◽

Resource Limited ◽

Radiological Staging ◽

The Status

Abstract Objective Current guidelines on rectal cancer (RC) management recommend pre-operative MRI for loco-regional staging and CT for staging of metastases. This allows appropriate selection of patients for chemo-radiotherapy (CRT). However, MRI is not freely available in many low-income countries. We assessed the status of pre-operative imaging for RC in Sri Lanka and evaluated the performance of CT in RC staging. Results A pre-tested interview-administered questionnaire was used to assess the pre-operative use of MRI and CT in RC. CT findings from 37 RC patients were then compared with histopathology findings. Of the 64 surgeons interviewed, 57 (89.1%) did not request an MRI for their RC patients. Reasons cited included limited availability and long waiting times due to competing health needs. A CT was requested by all. In RC, the overall accuracy of CT for T staging was 43.2% and 29.7% of T1–T2 tumours were over-staged as T3. The overall accuracy of CT for regional lymph node staging was 70.3%. In summary, CT alone is not suitable for RC staging in any setting. It leads to over-staging and patients may thus receive unnecessary CRT. Steps must be taken to improve access to pre-operative MRI among Sri Lankan RC patients.

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COVID-19, an Opportunity for Developing Countries?

Frontiers in Public Health ◽

10.3389/fpubh.2020.548708 ◽

2020 ◽

Vol 8 ◽

Author(s):

Lee Smith ◽

Nicola Veronese ◽

Vincenzo Racalbuto ◽

Damiano Pizzol

Keyword(s):

Low Income ◽

Large Scale ◽

World Health ◽

Low Income Countries ◽

Prevention Measures ◽

Viral Reservoirs ◽

Case Scenario ◽

Worst Case ◽

Global Pandemic ◽

Health Organization

The COVID-19 outbreak was declared by the World Health Organization (WHO) as global pandemic in March 2020. Considering the necessity to implement rapid response to control the pandemic and the fragility and the state of need of low income countries, it will be mandatory to develop a global approach in order to reduce the spread of infection and the creation of community viral reservoirs. So far, we could hypothesize a worst case scenario in which when the COVID-19 outbreak hits a peak in Africa and in low-income countries, the majority of such countries will be unprepared, with low resources allocated for affording the viral emergency and the consequences will be catastrophic with no lesson learnt. In the best case scenario, the COVID-19 will not affect Africa or South America on a large scale and, if the prevention measures will be implemented, we could register a lower incidence of hygiene linked diseases that still represent leading causes of death.

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Tanzanian primary healthcare workers’ experiences of antibiotic prescription and understanding of antibiotic resistance in common childhood infections: A qualitative phenomenographic study

10.21203/rs.3.rs-145860/v1 ◽

2021 ◽

Author(s):

Matilda Emgård ◽

Rose Mwangi ◽

Celina Mayo ◽

Ester Mshana ◽

Gertrud Nkini ◽

...

Keyword(s):

Antibiotic Resistance ◽

Antibiotic Treatment ◽

Low Income ◽

Primary Healthcare ◽

Healthcare Workers ◽

Antibiotic Prescription ◽

Symptomatic Treatment ◽

Low Income Countries ◽

Prescribing Practices ◽

The Individual

Abstract BackgroundAntibiotic resistance is a threat to global child health. Primary healthcare workers play a key role in antibiotic stewardship in the community, but few studies in low-income countries have described their experiences of initiating antibiotic treatment in children. Thus, the present study aimed to describe primary healthcare workers’ experiences of antibiotic prescription for children under five years of age and their conceptions of antibiotic resistance in Northern Tanzania.MethodsA qualitative study involving individual in-depth interviews with 20 prescribing primary healthcare workers in Moshi urban and rural districts, Northern Tanzania, was performed in 2019. Interviews were transcribed verbatim, translated from Kiswahili into English and analysed according to the phenomenographic approach.FindingsFour conceptual themes emerged during the analysis; conceptions in relation to the prescriber, the mother and child, other healthcare actors and in relation to outcome. The healthcare workers relied mainly on clinical examination and medical history provided by the mother to determine the need for antibiotics. Confidence in giving advice concerning non-antibiotic treatment varied among the participants and expectations of antibiotic treatment were perceived to be common among the mothers. Antibiotic resistance was mainly perceived as a problem for the individual patient who was misusing the antibiotics.ConclusionsTo increase rational antibiotic prescription, an awareness needs to be raised among Tanzanian primary healthcare workers of the threat of antibiotic resistance, not only to a few individuals, but to public health. Guidelines on childhood illnesses should be updated with advice concerning symptomatic treatment when antibiotics are not necessary, to support rational prescribing practices and promote trust in the clinician and mother relationship.

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Policy and Science for Global Health Security: Shaping the Course of International Health

Tropical Medicine and Infectious Disease ◽

10.3390/tropicalmed4020060 ◽

2019 ◽

Vol 4 (2) ◽

pp. 60 ◽

Cited By ~ 3

Author(s):

Kavita Berger ◽

James Wood ◽

Bonnie Jenkins ◽

Jennifer Olsen ◽

Stephen Morse ◽

...

Keyword(s):

Public Health ◽

Low Income ◽

Large Scale ◽

Scientific Information ◽

International Health ◽

Decision Makers ◽

Low Income Countries ◽

Policy And Practice ◽

Health Security ◽

Public Health Decision

The global burden of infectious diseases and the increased attention to natural, accidental, and deliberate biological threats has resulted in significant investment in infectious disease research. Translating the results of these studies to inform prevention, detection, and response efforts often can be challenging, especially if prior relationships and communications have not been established with decision-makers. Whatever scientific information is shared with decision-makers before, during, and after public health emergencies is highly dependent on the individuals or organizations who are communicating with policy-makers. This article briefly describes the landscape of stakeholders involved in information-sharing before and during emergencies. We identify critical gaps in translation of scientific expertise and results, and biosafety and biosecurity measures to public health policy and practice with a focus on One Health and zoonotic diseases. Finally, we conclude by exploring ways of improving communication and funding, both of which help to address the identified gaps. By leveraging existing scientific information (from both the natural and social sciences) in the public health decision-making process, large-scale outbreaks may be averted even in low-income countries.

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Solar-powered oxygen, quality improvement and child pneumonia deaths: a large-scale effectiveness study

Archives of Disease in Childhood ◽

10.1136/archdischild-2020-320107 ◽

2020 ◽

pp. archdischild-2020-320107

Author(s):

Trevor Duke ◽

Francis Pulsan ◽

Doreen Panauwe ◽

Ilomo Hwaihwanje ◽

Martin Sa'avu ◽

...

Keyword(s):

Quality Improvement ◽

Low Income ◽

Large Scale ◽

Incidence Rates ◽

Health Care Facilities ◽

Health Facilities ◽

Low Income Countries ◽

Continuous Quality ◽

Child Deaths ◽

Solar Powered

BackgroundPneumonia is the largest cause of child deaths in low-income countries. Lack of availability of oxygen in small rural hospitals results in avoidable deaths and unnecessary and unsafe referrals.MethodWe evaluated a programme for improving reliable oxygen therapy using oxygen concentrators, pulse oximeters and sustainable solar power in 38 remote health facilities in nine provinces in Papua New Guinea. The programme included a quality improvement approach with training, identification of gaps, problem solving and corrective measures. Admissions and deaths from pneumonia and overall paediatric admissions, deaths and referrals were recorded using routine health information data for 2–4 years prior to the intervention and 2–4 years after. Using Poisson regression we calculated incidence rates (IRs) preintervention and postintervention, and incidence rate ratios (IRR).ResultsThere were 18 933 pneumonia admissions and 530 pneumonia deaths. Pneumonia admission numbers were significantly lower in the postintervention era than in the preintervention era. The IRs for pneumonia deaths preintervention and postintervention were 2.83 (1.98–4.06) and 1.17 (0.48–1.86) per 100 pneumonia admissions: the IRR for pneumonia deaths was 0.41 (0.24–0.71, p<0.005). There were 58 324 paediatric admissions and 2259 paediatric deaths. The IR for child deaths preintervention and postintervention were 3.22 (2.42–4.28) and 1.94 (1.23–2.65) per 100 paediatric admissions: IRR 0.60 (0.45–0.81, p<0.005). In the years postintervention period, an estimated 348 lives were saved, at a cost of US$6435 per life saved and over 1500 referrals were avoided.ConclusionsSolar-powered oxygen systems supported by continuous quality improvement can be achieved at large scale in rural and remote hospitals and health care facilities, and was associated with reduced child deaths and reduced referrals. Variability of effectiveness in different contexts calls for strengthening of quality improvement in rural health facilities.Trial registration numberACTRN12616001469404.

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Entitlements, Capabilities, and Crisis in the United Kingdom

Journal of Applied Social Science ◽

10.1177/1936724419899972 ◽

2020 ◽

Vol 14 (1) ◽

pp. 40-54

Author(s):

Christopher Hartworth ◽

Carol Richards ◽

Ian Convery

Keyword(s):

United Kingdom ◽

Social Welfare ◽

Low Income ◽

Large Scale ◽

Low Income Countries ◽

Political Debate ◽

Social Welfare Programs ◽

The United Kingdom ◽

Poverty And Inequality ◽

Causes Of Poverty

This paper examines whether Amartya Sen’s entitlements and capabilities concepts can be transferred in their application from low-income countries to high-income countries, specifically Cumbria, Northern England. Originally used to understand the causes of famine, these concepts have previously been used in several different geographical contexts to broadly understand poverty and inequality but almost entirely in low-income countries. This paper applies these concepts to a United Kingdom context in an attempt to understand the causes of poverty and inequality among people experiencing “livelihood crisis.” The research uses data from two nongovernmental social welfare projects to examine the causes of crisis and the remedial effects of the intervention. Our findings indicate that these concepts can help to explain how people find themselves in crisis in Cumbria. On a broader level, they can also be used to explain poverty, inequality, and disadvantage in communities in the United Kingdom. The authors put forward that entitlements and capabilities provide a useful framework to advance the policy and political debate on the causes of poverty by providing a straightforward language and broad application. Entitlement and capabilities can also assist social welfare programs in framing their aims and objectives and through improved understanding about the causes of inequality, will be better able to support people out of disadvantage by strengthening entitlements and building capabilities, without the necessity of large-scale investment.

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More than poverty

International Journal of Behavioral Development ◽

10.1177/0165025416648231 ◽

2016 ◽

Vol 40 (6) ◽

pp. 536-543 ◽

Cited By ~ 4

Author(s):

Theodore D. Wachs ◽

Santiago Cueto ◽

Haogen Yao

Keyword(s):

Low Income ◽

Large Scale ◽

Cumulative Risk ◽

Low Income Countries ◽

Data Set ◽

Middle Income ◽

Middle Income Countries ◽

Developmental Risks ◽

The Impact ◽

Low And Middle Income

Studies from both high and low-middle income (LAMI) countries have documented how being reared in poverty is linked to compromised child development. Links between poverty and development are mediated by the timing and extent of exposure to both risk factors nested under poverty and to protective influences which can attenuate the impact of risk. While children from high-, middle-, and low-income countries are exposed to similar types of developmental risks, children from low- and middle-income countries are exposed to a greater number, more varied and more intense risks. Given these contextual differences, cumulative risk models may provide a better fit than mediated models for understanding the nature of pathways linking economic insufficiency and developmental inequality in low- and middle-income countries, and for designing interventions to promote development of children from these countries. New evidence from a large scale UNICEF data set illustrates the application of a cumulative risk/protective perspective in low- and middle-income countries.

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