scholarly journals Pooled Sputum for Xpert MTB/RIF Testing: A Cost Effectiveness Diagnostic Tool in Mwanza, Tanzania

2021 ◽  
Author(s):  
Shimba Henerico ◽  
Richard V. Makapa ◽  
Bernard C. Okamo ◽  
Benson R. Kidenya ◽  
Geoffrey Japhet ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Low Income ◽  
Public Health Problem ◽  
Positive Sample ◽  
Low Income Countries ◽  
Global Public Health ◽  
Testing Strategy ◽  
Pooled Testing ◽  
The Individual ◽  
Pooled Samples

Abstract Background: Tuberculosis (TB) is a global public health problem, with the highest burden occurring in low-income countries, wherein the use of more sensitive diagnostics, such as Xpert MTB/RIF (GeneXpert), is still limited by costs. Testing of pooled samples from various individuals has been thought and thus investigated as a cost saving strategy to diagnose some diseases including TB. Then in cases where a pool is positive, retesting of the individual samples in that pool is done to identify the positive sample. We assessed the utility of a pooled testing strategy to optimize the affordability of GeneXpert for the diagnosis of TB Mwanza Tanzania. Methods: Remainder of samples from presumptive TB patients submitted for routine TB diagnosis were used for pooled samples (5 per pool) testing. The agreement of the results between individual sample testing against pooled samples testing and cost-effectiveness were assessed.Results: A total of 250 individual routinely submitted samples for TB diagnosis were tested using the established protocols. The median age of study participants was 35 [IQR 27 – 40] years and 143 (57.2%) were males. Of the 250 samples, 28 (11.2%) were detected to have MTB whereas 222 (88.8%) samples, were negative. Of the 50 sputum pools made, MTB were detected in 17 (34.0%) pools. Following retesting of these 17 positive pools, all 28 (100%) individual MTB samples were detected with the overall agreement being 100% (With the sensitivity of 100% and specificity of 100%). The number of individual MTB positive ranged from 1 to 3 per pool. Using pooling of sputum samples, the technique saved 115 (46.0%) of the cartridges in running 250 samples. This is equivalent to saving US$ 1147.7. Conclusion: The pooled sputum testing strategy reduced cartridge costs by 46.0%. The use of the pooled testing strategy reduces costs and has the potential to increase the affordability of GeneXpert testing in countries with limited resources. Pooled sputum for Xpert MTB/RIF can be used as an affordable diagnostic and/or screening tool in resource limited settings, such as Tanzania.

scholarly journals Testing Pooled Sputum with Xpert MTB/RIF for Diagnosis of Pulmonary Tuberculosis To Increase Affordability in Low-Income Countries

2015 ◽  
Vol 53 (8) ◽  
pp. 2502-2508 ◽  
Author(s):  
Saddiq T. Abdurrahman ◽  
Omezikam Mbanaso ◽  
Lovett Lawson ◽  
Olanrewaju Oladimeji ◽  
Matthew Blakiston ◽  
...  
Keyword(s):  
Low Income ◽  
Public Health Problem ◽  
Low Income Countries ◽  
Global Public Health ◽  
Testing Strategy ◽  
Content Type ◽  
Pooled Testing ◽  
Negative Results ◽  
The Individual ◽  
Pooled Samples

Tuberculosis (TB) is a global public health problem, with the highest burden occurring in low-income countries. In these countries, the use of more sensitive diagnostics, such as Xpert MTB/RIF (Xpert), is still limited by costs. A cost-saving strategy to diagnose other diseases is to pool samples from various individuals and test them with single tests. The samples in positive pool samples are then retested individually to identify the patients with the disease. We assessed a pooled testing strategy to optimize the affordability of Xpert for the diagnosis of TB. Adults with presumptive TB attending hospitals or identified by canvassing of households in Abuja, Nigeria, were asked to provide sputum for individual and pooled (4 per pool) testing. The agreement of the results of testing of individual and pooled samples and costs were assessed. A total of 738 individuals submitted samples, with 115 (16%) beingMycobacterium tuberculosispositive. Valid Xpert results for individual and pooled samples were available for 718 specimens. Of these, testing of pooled samples detected 109 (96%) of 114 individualM. tuberculosis-positive samples, with the overall agreement being 99%. Xpert semiquantitativeM. tuberculosislevels had a positive correlation with the smear grades, and the individual sample-positive/pooled sample-negative results were likely due to theM. tuberculosisconcentration being below the detection limit. The strategy reduced cartridge costs by 31%. Savings were higher with samples from individuals recruited in the community, where the proportion of positive specimens was low. The results of testing of pooled samples had a high level of agreement with the results of testing of individual samples, and use of the pooled testing strategy reduced costs and has the potential to increase the affordability of Xpert in countries with limited resources.

scholarly journals Systematic review and meta-analysis of iodine deficiency and its associated factors among pregnant women in Ethiopia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Robel Hussen kabthymer ◽  
Mohammed Feyisso Shaka ◽  
Getnet Melaku Ayele ◽  
Bereket Geze malako
Keyword(s):  
Pregnant Women ◽  
Iodine Deficiency ◽  
Low Income ◽  
Associated Factors ◽  
Meta Analysis ◽  
Public Health Problem ◽  
Iodized Salt ◽  
Low Income Countries ◽  
Global Public Health ◽  
Pooled Prevalence

Abstract Background Iodine deficiency (ID) is a global public health problem and its impact is more pronounced in low-income countries. During pregnancy, iodine requirement is known to elevate sharply, making pregnant women, especially those living in low-income countries highly vulnerable to iodine deficiency. This study aims to assess the prevalence of iodine deficiency and its associated factors among pregnant women in Ethiopia. Methods A systematic literature search was performed by using PubMed, CINAHL, Web of science, global health, and Google scholar electronic databases. Two authors independently extracted all the necessary data using a structured data extraction format. Data analysis was done using STATA Version 14. The heterogeneity of the studies was assessed by using I2 test. A random-effects model was used to estimate the pooled prevalence and pooled odds ratio. The presence of publication bias was checked using Funnel plot and Egger’s test. Results One thousand one hundred and sixteen studies were reviewed and seven studies fulfilling the inclusion criteria were included in the meta-analysis. The meta-analysis of seven studies that included 2190 pregnant women showed a pooled prevalence of iodine deficiency during pregnancy to be 68.76% (95% CI: 55.21–82.31). In a subgroup analysis, the prevalence in Oromia region is 71.93% (95% CI: 54.87–88.99) and in Amhara region is 60.93% (95% CI: 57.39–64.48). Iodized salt use (AOR = 0.18; 95% CI: 0.08–0.44) and 1st trimester pregnancy (AOR = 0.68; 95% CI: 0.47–0.99) were found to have a significant association with iodine deficiency. Conclusions The prevalence of iodine deficiency during pregnancy using urine iodine is considerably high in Ethiopia. Using iodized salt is found to reduce the burden. Hence, there is a need to strengthen iodization programs to tackle the problem.

scholarly journals Assessment of the Potential Impact and Cost-effectiveness of Self-Testing for HIV in Low-Income Countries

2015 ◽  
Vol 212 (4) ◽  
pp. 570-577 ◽  
Author(s):  
Valentina Cambiano ◽  
Deborah Ford ◽  
Travor Mabugu ◽  
Sue Napierala Mavedzenge ◽  
Alec Miners ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Low Income ◽  
Low Income Countries ◽  
Self Testing ◽  
Potential Impact

Cross-cultural metacognition as a prior for humanitarian knowledge: when cultures collide in global health emergencies

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Tachia Chin ◽  
Jianwei Meng ◽  
Shouyang Wang ◽  
Yi Shi ◽  
Jianxin Zhang
Keyword(s):  
Low Income ◽  
A Priori ◽  
Normative Theory ◽  
Cross Cultural ◽  
Warning Signs ◽  
Low Income Countries ◽  
Global Public Health ◽  
Business World ◽  
Content Type ◽  
Cultural Conflicts

Purpose A serious global public health emergency (GPHE) like the COVID-19 aggravates the inequilibrium of medical care and other critical resources between wealthy and poor nations, which, coupled with the collision of cultures, indicates the vital need for developing humanitarian knowledge transcending cultures. Given the scarcity of literature addressing such unprecedent issues, this paper thus proposes new, unconventional viewpoints and future themes at the intersection of knowledge management (KM) and humanitarian inquiry. Design/methodology/approach This paper is conceptual in nature. The data of the World Bank and the Office for the Coordination of Humanitarian Affairs are analysed to introduce some emerging real impact topics regarding cross-cultural conflicts and humanitarian knowledge in the post-COVID business world. The theoretical foundation was built upon a critical literature review. Findings This paper synthesizes the perspectives of culture, KM and the humanistic philosophy to distil the core component of cultural intelligence and comparatively and thereby illuminating why cross-cultural metacognition acts as a priori for achieving cosmopolitan humanitarian knowledge. Research limitations/implications This paper provides profound implications to academics by highlighting the importance to formulating new, inter-disciplinary themes or unorthodox, phenomenon-driven assumptions beyond the traditional KM domain. This paper also offers practitioners and policymakers valuable insights into coping with the growing disparity between high- and low-income countries by showing warning signs of a looming humanitarian crisis associated with a GPHE context. Originality/value This paper does not aim to claim the birth of a new domain but call for more research on developing a normative theory of humanitarian knowledge as transcendence of cultures. It implies uncharted territories of great interest and potential for the real impact KM community.

scholarly journals School Nurses Avoid Addressing Child Sexual Abuse

2016 ◽  
Vol 33 (2) ◽  
pp. 133-142 ◽  
Author(s):  
Lisbet Engh Kraft ◽  
GullBritt Rahm ◽  
Ulla-Britt Eriksson
Keyword(s):  
Sexual Abuse ◽  
Child Sexual Abuse ◽  
Sexually Abused ◽  
Secondary Analysis ◽  
Public Health Problem ◽  
School Nurses ◽  
Global Public Health ◽  
Abused Children ◽  
Group Interviews ◽  
The Individual

Child sexual abuse (CSA) is a global public health problem with major consequences for the individual child and society. An earlier Swedish study showed that the school nurses did not initially talk about nor mention CSA as one form of child abuse. For the child to receive adequate support, the disclosure is a precondition and is dependent on an available person prepared to listen. The aim of the study was to explore the ability of the school nurses to detect and support sexually abused children. It is a secondary analysis of focus group interviews with school nurses. Thematic analysis was performed. Results showed that the school nurses avoided addressing CSA due to arousal of strong emotions, ambivalence, and a complicated disclosure process. In order to detect CSA and support abused children, attentiveness of sexual abuse as a possible cause of physical and mental ill-health is crucial.

scholarly journals Actions Targeting the Double Burden of Malnutrition: A Scoping Review

Nutrients ◽  
2019 ◽  
Vol 12 (1) ◽  
pp. 81 ◽  
Author(s):  
Sonia Menon ◽  
José L. Peñalvo
Keyword(s):  
Nutrition Education ◽  
Scoping Review ◽  
Low Income ◽  
Sub Saharan Africa ◽  
World Health ◽  
Low Income Countries ◽  
Nutrient Deficiencies ◽  
Global Public Health ◽  
Double Burden ◽  
Double Burden Of Malnutrition

Background: In many developing countries, nutritional and epidemiological transitions are contributing to continuous undernutrition and escalating overnutrition, resulting in coexisting forms of malnutrition often referred as the “double burden of malnutrition” (DBM). This complex phenomenon constitutes an unprecedented challenge to global public health and has been prioritized by international health organizations, prompting governments to swift action. Specifically, five years ago the World Health Organization (WHO) proposed a roadmap to tackle the DBM though so-called “double-duty actions”. The objective of this review was to synthesize the literature on interventions which address the DBM. Methods: We developed a scoping review to identify interventions addressing the DBM. We searched PUBMED for papers reporting interventions until December 2019. Articles examining interventions, government policies, or tools at the individual, household, or community level to address the DBM were included. Results: Seven articles met the inclusion criteria. Three were from sub-Saharan Africa, one was from Southeast Asia, and one was from Central America. Two were modelling studies, with one covering 24 low-income countries and the other focusing on Ghana. Conclusion: Notwithstanding the pressing issue of the DBM, there is a paucity of studies examining double-duty actions despite the attention that it has garnered within the global nutrition community. Whilst nutrient deficiencies may be curbed by poverty reduction measures, for obesity prevention nutrition, education and promotion of physical activity, along with the encouragement of local food production, may be instrumental.

scholarly journals How Do Hours Worked Vary with Income? Cross-Country Evidence and Implications

2018 ◽  
Vol 108 (1) ◽  
pp. 170-199 ◽  
Author(s):  
Alexander Bick ◽  
Nicola Fuchs-Schündeln ◽  
David Lagakos
Keyword(s):  
Low Income ◽  
High Income ◽  
Low Income Countries ◽  
Aggregate Productivity ◽  
Intensive Margin ◽  
Hours Worked ◽  
Men And Women ◽  
Education Levels ◽  
Cross Country ◽  
The Individual

This paper builds a new internationally comparable database of hours worked to measure how hours vary with income across and within countries. We document that average hours worked per adult are substantially higher in low-income countries than in high-income countries. The pattern of decreasing hours with aggregate income holds for both men and women, for adults of all ages and education levels, and along both the extensive and intensive margin. Within countries, hours worked per worker are also decreasing in the individual wage for most countries, though in the richest countries, hours worked are flat or increasing in the wage. One implication of our findings is that aggregate productivity and welfare differences across countries are larger than currently thought. (JEL E23, E24, J22, J31, O11, O15)

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