scholarly journals What are the Environmental Determinants to Participate Among Stroke Survivors in Africa? a Scoping Review

Author(s):  
Yohannes Awoke Assefa ◽  
Zelalem Dessalegn Demeke

Abstract Background Stroke is the main cause of serious long-term disability worldwide, and it is the second commonest cause of death and a leading cause of adult disability. Two-thirds of stroke cases occur in low- and middle-income countries, which all African countries fall. In Africa, the incidence and survival rate of stroke is increasing. Various personal and environmental factors limit the participation of stroke survivors. As a result, in this review, we aimed to review the environmental factors that are influencing the participation of stroke survivors in Africa. Methods Five electronic databases were systematically searched in August 2021 and identified articles were screened by three authors based on predetermined criteria. We followed Arksey and O'Malley (2005) framework and the whole finding is reported using PRISMA-ScR. No date restrictions were imposed, and we included any type of papers including grey literature. Results 584 articles were generated by our search, after removing duplicates, the title and abstract of 497 articles were screened. From the screening, 42 articles were selected for full article review from which 12 met the criteria to be included. We also manually searched and included one more article for the review. Conclusion Studies were mainly conducted in South Africa and assessed the adult population. We followed the International Classification of Functioning, Disability and Health (ICF) framework for the environmental determinants to present our findings. Products and Technology; Natural Environment and Human-Made Changes to Environment; and Services, Systems and Policies found to be a barrier for participation. Conversely, stroke survivors are getting good support from their immediate family and health professionals, which is found to be facilitating. This review could be used by policymakers to understand the environmental barriers that are hindering participation and help to improve the accessibility of the environment so stroke survivors can participate in the community.

Parasitology ◽  
2011 ◽  
Vol 138 (12) ◽  
pp. 1508-1518 ◽  
Author(s):  
YENNY DJUARDI ◽  
LINDA J. WAMMES ◽  
TANIAWATI SUPALI ◽  
ERLIYANI SARTONO ◽  
MARIA YAZDANBAKHSH

SUMMARYThe shaping of a child's immune system starts in utero, with possible long-term consequences in later life. This review highlights the studies conducted on the development of the immune system in early childhood up to school-age, discussing the impact that environmental factors may have. Emphasis has been put on studies conducted in geographical regions where exposure to micro-organisms and parasites are particularly high, and the effect that maternal exposures to these may have on an infant's immune responses to third-party antigens. In this respect we discuss the effect on responses to vaccines, co-infections and on the development of allergic disorders. In addition, studies of the impact that such environmental factors may have on slightly older (school) children are highlighted emphasizing the need for large studies in low to middle income countries, that are sufficiently powered and have longitudinal follow-up components to understand the immunological footprint of a child and the consequences throughout life.


2020 ◽  
Vol 287 (1928) ◽  
pp. 20200538
Author(s):  
Warren S. D. Tennant ◽  
Mike J. Tildesley ◽  
Simon E. F. Spencer ◽  
Matt J. Keeling

Plague, caused by Yersinia pestis infection, continues to threaten low- and middle-income countries throughout the world. The complex interactions between rodents and fleas with their respective environments challenge our understanding of human plague epidemiology. Historical long-term datasets of reported plague cases offer a unique opportunity to elucidate the effects of climate on plague outbreaks in detail. Here, we analyse monthly plague deaths and climate data from 25 provinces in British India from 1898 to 1949 to generate insights into the influence of temperature, rainfall and humidity on the occurrence, severity and timing of plague outbreaks. We find that moderate relative humidity levels of between 60% and 80% were strongly associated with outbreaks. Using wavelet analysis, we determine that the nationwide spread of plague was driven by changes in humidity, where, on average, a one-month delay in the onset of rising humidity translated into a one-month delay in the timing of plague outbreaks. This work can inform modern spatio-temporal predictive models for the disease and aid in the development of early-warning strategies for the deployment of prophylactic treatments and other control measures.


2021 ◽  
Author(s):  
Abimbola Olaniran ◽  
Jane Briggs ◽  
Ami Pradhan ◽  
Erin Bogue ◽  
Benjamin Schreiber ◽  
...  

Abstract Background: This paper explores the extent of community-level stock-out of essential medicines among Community Health Workers (CHWs) in Low- and Middle-Income Countries (LMICs) and identifies the reasons for and consequences of essential medicine stock-outs. Methods: A systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was conducted. Five electronic databases were searched with a prespecified strategy and the grey literature examined, January 2006 - March 2021. Papers containing information on (i) the percentage of CHWs stocked out or (ii) reasons for stock-outs along the supply chain and consequences of stock-out were included and appraised for risk of bias. Outcomes were quantitative data on the extent of stock-out, summarized using descriptive statistics, and qualitative data regarding reasons for and consequences of stock-outs, analyzed using thematic content analysis and narrative synthesis. Results: Two reviewers screened 1083 records; 78 evaluations were included. Over the last fifteen years, CHWs experienced stock-outs of essential medicines nearly one third of the time and at a significantly (p < 0.01) higher rate than the health centers to which they are affiliated (28.93% [CI 95%: 28.79 - 29.07] vs 9.17 % [CI 95%: 8.64 - 9.70], respectively). A comparison of the period 2006-2015 and 2016-2021 showed a significant (p < 0.01) increase in CHW stock-out level from 26.36% [CI 95%: 26.22 -26.50] to 48.65% [CI 95%: 48.02- 49.28] while that of health centers increased from 7.79% [95% CI: 7.16 - 8.42] to 14.28% [95% CI: 11.22- 17.34]. Distribution barriers were the most cited reasons for stock-outs. Ultimately, patients were the most affected: stock-outs resulted in out-of-pocket expenses to buy unavailable medicines, poor adherence to medicine regimes, dissatisfaction, and low service utilization. Conclusion: Community-level stock-out of essential medicines constitutes a serious threat to achieving universal health coverage and equitable improvement of health outcomes. This paper suggests stock-outs are getting worse, and that there are particular barriers at the last mile. There is an urgent need to address the health and non-health system constraints that prevent the essential medicines procured for LMICs by international and national stakeholders from reaching the people who need them the most.


2015 ◽  
Vol 18 (4) ◽  
pp. 449-462 ◽  
Author(s):  
Aye Mengistu Alemu ◽  
Jin-Sang Lee

Previous empirical studies on the effects of foreign aid on economic growth have generated mixed results that make it difficult to draw policy recommendations. The main reason for such mixed results is the choice of a single aggregate list of countries, regardless of the disparities in levels of development. This study therefore fills the development gap by disaggregating the African data into a panel of 20 middle- income and 19 low- income African countries over a period of 15 years between 1995 and 2010, and employing a dynamic generalized method of moments (GMM) model to address the dynamic nature of economic growth as well as the problems of endogeneity. The results of this study support the theoretical hypothesis that a positive relationship between aid and GDP growth exists, but only for low-income African countries, not middle-income ones. On the other hand, the study reveals that middle- income African countries tend to experience a greater impact on their economic growth from foreign direct investment (FDI) and natural resources revenues, mainly oil exports. This implies that the frequent criticism that foreign aid has not contributed to economic growth is flawed, at least in the case of low-income African countries. In fact, foreign aid has played a critical role in stimulating economic growth in such countries through supplementing domestic sources of finance such as savings, thus increasing the amount of investment and capital stock in them.


Author(s):  
Ahmad Alkhatib ◽  
Lawrence Achilles Nnyanzi ◽  
Brian Mujuni ◽  
Geofrey Amanya ◽  
Charles Ibingira

Objectives: Low and Middle-Income Countries are experiencing a fast-paced epidemiological rise in clusters of non-communicable diseases such as diabetes and cardiovascular disease, forming an imminent rise in multimorbidity. However, preventing multimorbidity has received little attention in LMICs, especially in Sub-Saharan African Countries. Methods: Narrative review which scoped the most recent evidence in LMICs about multimorbidity determinants and appropriated them for potential multimorbidity prevention strategies. Results: MMD in LMICs is affected by several determinants including increased age, female sex, environment, lower socio-economic status, obesity, and lifestyle behaviours, especially poor nutrition, and physical inactivity. Multimorbidity public health interventions in LMICs, especially in Sub-Saharan Africa are currently impeded by local and regional economic disparity, underdeveloped healthcare systems, and concurrent prevalence of communicable and non-communicable diseases. However, lifestyle interventions that are targeted towards preventing highly prevalent multimorbidity clusters, especially hypertension, diabetes, and cardiovascular disease, can provide early prevention of multimorbidity, especially within Sub-Saharan African countries with emerging economies and socio-economic disparity. Conclusion: Future public health initiatives should consider targeted lifestyle interventions and appropriate policies and guidelines in preventing multimorbidity in LMICs.


2021 ◽  
Vol 8 ◽  
Author(s):  
George Higginbotham

The field of neurosurgery has always been propelled by the adoption of novel technologies to improve practice. Although advancements have occurred in the diagnosis, treatment, and long-term outcomes of patients, these have not translated to global patient benefit. Up to five million people each year do not have access to safe and affordable neurosurgical interventions, and those in low- and middle-income countries (LMICs) are disproportionately affected. Current approaches to increase neurosurgical capacity are unlikely to meet the UN Sustainable Development Goals target by 2030, and many of the most successful programs have been disrupted by the travel restrictions of the COVID-19 pandemic. There is therefore a pressing need for creative virtual solutions. An area of growing relevance is the use of immersive technologies: virtual reality (VR) and augmented reality (AR). AR allows additional information to be superimposed onto the surgeon's visual field, thus enhancing intra-operative visualization. This can be used for remote tele-proctoring, whereby an experienced surgeon can virtually assist with a procedure regardless of geographical location. Expert guidance can therefore be given to both neurosurgical trainees and non-neurosurgical practitioners, further facilitating the growing practice of neurosurgical task-shifting in LMICs. VR simulation is another useful tool in remote neurosurgical training, with the potential to reduce the learning curve of complex procedures whilst conserving supplies in low-resource settings. The adoption of immersive technologies into practice is therefore a promising approach for achieving global neurosurgical equity, whilst adapting to the long-term disruptions of the pandemic.


2020 ◽  
Author(s):  
Gibran Cruz-Martinez ◽  
Gokce Cerev

Global AgeWatch Index and Insights by HelpAge International aim to contribute to achievement of long-term transformative change in respect to ageing and the lives of older people by advocating for better production of timely and good quality data to inform policy and program response.The Global AgeWatch Index is a composite index that measures quality of life of older people, and ranks countries based on four domains – income security, health status, enabling environment and capability. The index was developed in partnership with Professor Asghar Zaidi. The index was published during 2013-2015.The Global AgeWatch Insights is a research-based advocacy tool that examines situation of older people in low- and middle-income countries, assesses availability of relevant data and evidence to support the analysis, and identification of policy actions. The Insights are produced in partnership with AARP. The reports were launched in 2018 are planned to be released every three years with a different thematic focus. The first report focuses on the inequities of the health systems in twelve low- and middle-income countries.


Field Methods ◽  
2019 ◽  
Vol 32 (1) ◽  
pp. 38-57
Author(s):  
Mufaro Kanyangarara ◽  
Laetitia Douillot ◽  
Gilles Pison ◽  
Cheikh Tidiane Ndiaye ◽  
Valerie Delaunay ◽  
...  

Migration of participants in demographic and epidemiological studies results in missing data. One approach to reduce resulting losses in statistical power and potential biases is to follow up migrants at their new residence. We describe the follow-up of migrants who were eligible for participation in a trial of a new questionnaire to measure adult mortality in Niakhar, Senegal. We conducted a short inquiry in the migrant’s last known household to obtain contact information and then attempted to contact and interview 661 migrants who resided in Dakar, Mbour, and rural areas close to Niakhar. About two-thirds of migrants were successfully enrolled in the study. Having a contact phone number and knowing the name of the head of compound at destination increased the likelihood of successful enrollment. Following up migrants in demographic studies is feasible in low- and middle-income countries, including long-term migrants who have not been contacted for extended periods of time.


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