scholarly journals Advancing Age in Africa, the Urgent Need for Institutional Geriatric Care in a Low Resource Setting: A Case Report

2021 ◽  
Vol 12 (2) ◽  
pp. 416-420
Author(s):  
Emmanuel Kobina Mesi Edzie ◽  
Klenam Dzefi-Tettey ◽  
Philip Narteh Gorleku ◽  
Frank Naku Ghartey ◽  
Madison Adanusa ◽  
...  

Background: The demand for geriatric care has been on the increase throughout the world, especially in the developing, low- and middle-income countries (LMICs), due to increasing life expectancy, improvement in technology in healthcare industry coupled with increasing numbers of healthcare personnel. Nonetheless, these increases in the resources to the healthcare industry are still woefully inadequate in the developing and LMICs, compared to the high demand for such services, thereby exposing the drastic challenges and gaps in geriatric services in these countries. Case Presentation: A 74-year-old woman apparently well, who was relocated from the rural area by her biological daughter, with the intention of giving her better care in a comfortable city environment. She was initially appreciative of the relocation. However, the situation went sour when her daughter and son-in-law resumed work after their annual leave period. They started locking her up in a well-furnished mansion with everything she may need until they returned from work. Consistently for eight working days, she was kept under lock and key because they did not want her to roam around the community, they thought was not familiar to her with the intention of keeping her safe. Everything was fine until they returned from work one day to find that she had soiled the house with her excrement, apparently as a protest against her consistent lock-up. This necessitated their visit to the hospital. A diagnosis of social isolation was made after clinical and mental state examination and appropriate interventions were instituted. The patient consequently became fine in the new environment. Conclusion: This case has been presented in order to emphasize the need to improve the systems for geriatric care which is of public health concern, especially as the life expectancy of the developing, low- and middle-income countries keep improving.

Author(s):  
Camila Walters ◽  
Matthew Kynes ◽  
Jenna Sobey ◽  
Tsitsi Chimhundu-Sithole ◽  
Kelly McQueen

Chronic pain is a serious health concern and potentially debilitating condition, leading to anxiety, depression, reduced productivity and functionality, and poor quality of life. This condition can be even more detrimental and incapacitating in the pediatric patient population. In low and middle income countries (LMICs), pain services are inadequate or unavailable, leaving most of the world's pediatric population with chronic pain untreated. Many of these children in LMICs are suffering without treatment, and often die in pain. Awareness and advocacy for this population must be prioritized. We reviewed the available literature on the chronic pediatric pain burden in LMICs, barriers to treatments, and current efforts to treat these patients.


2021 ◽  
Vol 6 (6) ◽  
pp. e005190
Author(s):  
Chanel van Zyl ◽  
Marelise Badenhorst ◽  
Susan Hanekom ◽  
Martin Heine

IntroductionThe effects of healthcare-related inequalities are most evident in low-resource settings. Such settings are often not explicitly defined, and umbrella terms which are easier to operationalise, such as ‘low-to-middle-income countries’ or ‘developing countries’, are often used. Without a deeper understanding of context, such proxies are pregnant with assumptions, insinuate homogeneity that is unsupported and hamper knowledge translation between settings.MethodsA systematic scoping review was undertaken to start unravelling the term ‘low-resource setting’. PubMed, Africa-Wide, Web of Science and Scopus were searched (24 June 2019), dating back ≤5 years, using terms related to ‘low-resource setting’ and ‘rehabilitation’. Rehabilitation was chosen as a methodological vehicle due to its holistic nature (eg, multidisciplinary, relevance across burden of disease, and throughout continuum of care) and expertise within the research team. Qualitative content analysis through an inductive approach was used.ResultsA total of 410 codes were derived from 48 unique articles within the field of rehabilitation, grouped into 63 content categories, and identified nine major themes relating to the term ‘low-resource setting’. Themes that emerged relate to (1) financial pressure, (2) suboptimal healthcare service delivery, (3) underdeveloped infrastructure, (4) paucity of knowledge, (5) research challenges and considerations, (6) restricted social resources, (7) geographical and environmental factors, (8) human resource limitations and (9) the influence of beliefs and practices.ConclusionThe emerging themes may assist with (1) the groundwork needed to unravel ‘low-resource settings’ in health-related research, (2) moving away from assumptive umbrella terms like ‘low-to-middle-income countries’ or ‘low/middle-income countries’ and (3) promoting effective knowledge transfer between settings.


Author(s):  
Buddhika Lalanie Fernando ◽  
Athula Sumathipala

Half of the world’s population lives in countries with one psychiatrist to serve 200,000 people and in low and middle income countries (LAMICs), even most people with severe mental disorders remain untreated. As curative care is prioritized, public mental health is inundated with deep-seated problems, primarily due to the lack of funding. From an ethical perspective, such underlying issues in public mental health exist regardless of income levels; they are, however, further exacerbated by the lack of resources and awareness in LAMICs. Ironically, the ethics of public mental health have received much less attention than that of psychiatric research. We therefore use a public health ethics framework to broaden the ethical perspective in public mental health and examine it from a low-resource setting viewpoint. Next, we examine public mental health from a social justice perspective. Third, we examine issues critical to ensuring better access to mental health services in LAMICs.


2020 ◽  
Vol 4 (2) ◽  
pp. 241-258
Author(s):  
Nicholas Metheny ◽  
Rob Stephenson

Intimate partner violence is a global public health concern that is widely under-reported. Socio-demographic factors of the interviewer may contribute to a reluctance to report violence. The introduction of the fieldworker survey to the 2015 Zimbabwe Demographic and Health Survey provides the first opportunity to test associations between interviewer characteristics and the reporting of intimate partner violence in the largest source of IPV data on intimate partner violence available for low- and middle-income countries. Three separate, multilevel logistic regression models were used to examine associations between the reporting of physical, sexual and emotional intimate partner violence and interviewer characteristics (age, sex and marital status, as well as differences in these indicators between interviewer and respondent), language of the interview and the interviewer’s previous experience conducting the Demographic and Health Survey. Previous experience as a Demographic and Health Survey interviewer was associated with significantly lower odds (OR: 0.67) of reporting physical intimate partner violence. Researchers should consider using the fieldworker data set in future studies to control for potential interviewer error, account for the clustering of data by interviewer and increase the robustness of Demographic and Health Survey analyses. Understanding how interviewers may shape the reporting of intimate partner violence is a step towards accurately measuring its burden in low- and middle-income countries.


2021 ◽  
Vol 2021 ◽  
pp. 1-12
Author(s):  
Betregiorgis Zegeye ◽  
Bight Opoku Ahinkorah ◽  
Edward Kwabena Ameyaw ◽  
Abdul-Aziz Seidu ◽  
Mpho Keetile ◽  
...  

Background. Anemia constitutes a major public health concern, which is associated with maternal and perinatal mortality. In low- and middle-income countries, the burden of anemia is profoundly high. Cameroon, as one of the low- and middle-income countries, has a disproportionate anemia burden. Factors associated with anemia prevalence are largely unknown in Cameroon. Hence, we determined the prevalence of anemia and its individual/household and community-level factors among adult women in Cameroon. Methods. We derived data from the 2018 Cameroon Demographic and Health Survey for analysis in this study. Using the Stata version 14 software, univariate multilevel logistic regression analysis was used to select variables that had significant association with anemia at p < 0.05 . Statistically significant variables were included in a multivariable multilevel logistic regression modelling to examine their associations with anemia. Results were reported using adjusted odds ratios (AOR) with their respective 95% confidence interval (CI). Results. A total of 6,809 women aged 15-49 years were involved in this study with a mean age 30 ± 11.87 years. Approximately two-fifths of women were anemic. Of them, 0.8% were severely anemic, while 17.4% and 21.5% were moderately and mildly anemic, respectively. Current employment status (yes AOR = 0.77 , 95% CI; 0.61-0.96) and parity (1-2 children AOR = 0.61 , 95% CI; 0.44-0.86) were the main individual level factors associated with anemia, whereas region (Douala region AOR = 2.65 , 95% CI; 1.61-4.36, North-West region AOR = 0.53 , 95% CI; 0.28-0.99) was the community-level factor associated with anaemia. Conclusion. Empowerment of women through employment opportunities as well as focusing special attention in region where high prevalence of anemia could be crucial to decrease the burden of anemia and related maternal and perinatal mortality in the country.


2020 ◽  
pp. 297-318
Author(s):  
Victoria Howell

Many tropical diseases will be unfamiliar to anaesthetists from high-resource settings but are common in low- and middle-income countries. They lead to a significant burden of morbidity and mortality, and some knowledge of the commonly presenting ones and how they might impact on conduct of anaesthesia is essential to anaesthetists practising in these settings. The chapter covers the essentials of several tropical diseases including malaria, tuberculosis, cholera, and typhoid. The chapter outlines for each disease the aetiology, pathophysiology, clinical features, diagnosis, management, and anaesthetic implications. Diseases that are also found in high-resource settings, such as diarrhoea and HIV, are also covered on the basis that they are much more likely to be encountered in a low-resource setting.


Pathogens ◽  
2021 ◽  
Vol 10 (3) ◽  
pp. 256
Author(s):  
Ahmed Donia ◽  
Sammer-ul Hassan ◽  
Xunli Zhang ◽  
Lamiaa Al-Madboly ◽  
Habib Bokhari

The spectrum of emerging new diseases as well as re-emerging old diseases is broadening as infectious agents evolve, adapt, and spread at enormous speeds in response to changing ecosystems. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a recent phenomenon and may take a while to understand its transmission routes from less traveled territories, ranging from fomite exposure routes to wastewater transmission. The critical challenge is how to negotiate with such catastrophic pandemics in high-income countries (HICs ~20% of the global population) and low-and middle-income countries (LMICs ~ 80% of the global population) with a total global population size of approximately eight billion, where practical mass testing and tracing is only a remote possibility, particularly in low-and middle-income countries (LMICs). Keeping in mind the population distribution disparities of high-income countries (HICs) and LMICs and urbanisation trends over recent years, traditional wastewater-based surveillance such as that used to combat polio may help in addressing this challenge. The COVID-19 era differs from any previous pandemics or global health challenges in the sense that there is a great deal of curiosity within the global community to find out everything about this virus, ranging from diagnostics, potential vaccines/therapeutics, and possible routes of transmission. In this regard, the fact that the gut is the common niche for both poliovirus and SARS-CoV-2, and due to the shedding of the virus through faecal material into sewerage systems, the need for long-term wastewater surveillance and developing early warning systems for better preparedness at local and global levels is increasingly apparent. This paper aims to provide an insight into the ongoing COVID-19 crisis, how it can be managed, and what measures are required to deal with a current global international public health concern. Additionally, it shed light on the importance of using wastewater surveillance strategy as an early warning practical tool suitable for massive passive screening, as well as the urgent need for microfluidic technology as a rapid and cost-effective approach tracking SARS-CoV-2 in wastewater.


2020 ◽  
Vol 45 (2) ◽  
pp. 220-220
Author(s):  
Taru Manyanga

The emergency of malnutrition and physical inactivity among children as serious public health challenges in low- and middle-income countries (LMICs) is concerning and requires urgent attention. The main objective of this dissertation was to examine relationships between lifestyle behaviours and weight status among schoolchildren in Mozambique and use findings to highlight important data gaps that exist in LMICs. Narrative literature searches conducted identified data gaps and research needs. A published protocol was used for this dissertation (n = 683) to facilitate data comparability. Anthropometric and accelerometry data were objectively measured while data about lifestyle behaviours and environmental factors were collected using context-adapted questionnaires. As part of this dissertation, 6 manuscripts were developed and submitted for publication in peer-reviewed scientific journals. Results showed a dearth of information and that overweight/obesity is an emerging public health concern, especially among urban children. Moderate- to vigorous-intensity physical activity (MVPA), active transport, and maternal body mass index (BMI) were important modifiable correlates of weight status for Mozambican children. Distinct differences in prevalences of lifestyle behaviours were observed between urban and rural children in Mozambique. Compared with children from 12 other countries, children from Mozambique had lower BMI, higher daily MVPA, lower daily sedentary time, and comparable sleep duration. Linear distributions of study site-specific BMI, minutes of daily MVPA, and daily sedentary time by country human development index were observed. Findings revealed important differences between urban and rural children, supporting the need to include both in study samples and especially in LMICs where most people live in rural areas.


2018 ◽  
Vol 2018 ◽  
pp. 1-12 ◽  
Author(s):  
Mpho Magwalivha ◽  
Jean-Pierre Kabue ◽  
Afsatou Ndama Traore ◽  
Natasha Potgieter

Background. Sapovirus (SV) infection is a public health concern which plays an important role in the burden of diarrhoeal diseases, causing acute gastroenteritis in people of all ages in both outbreaks and sporadic cases worldwide. Objective/Study Design. The purpose of this report is to summarise the available data on the detection of human SV in low and middle income countries. A systematic search on PubMed and ScienceDirect database for SV studies published between 2004 and 2017 in low and middle income countries was done. Studies of SV in stool and water samples were part of the inclusion criteria. Results. From 19 low and middle income countries, 45 published studies were identified. The prevalence rate for SV was 6.5%. A significant difference (P=0) in SV prevalent rate was observed between low income and middle income countries. Thirty-three (78.6%) of the studies reported on children and 8 (19%) studies reported on all age groups with diarrhoea. The majority (66.7%) of studies reported on hospitalised patients with acute gastroenteritis. Sapovirus GI was shown as the dominant genogroup, followed by SV-GII. Conclusion. The detection of human SV in low and middle income countries is evident; however the reports on its prevalence are limited. There is therefore a need for systematic surveillance of the circulation of SV, and their role in diarrhoeal disease and outbreaks, especially in low and middle income countries.


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