Clostridium Tetani and Tetanus

2021 ◽  
Author(s):  
Collins Ankunda
Keyword(s):  
Low Income ◽  
Universal Access ◽  
Case Fatality ◽  
High Income ◽  
Neonatal Tetanus ◽  
Low Income Countries ◽  
Immunization Programs ◽  
African Countries ◽  
Clostridium Tetani ◽  
Animal Excreta

Tetanus is acquired through exposure to the environmental spore-forming Gram-positive bacillus Clostridium tetani, which may infect human wounds and cause disease by production of an exotoxin (tetanospasmin). There is no human-to-human transmission. The disease occurs worldwide and it is sporadic in high-income countries with universal access to well-accepted immunization programs. It is more common in agricultural regions and in low-income countries where contact with animal excreta is more likely and immunization programs are inadequate. Neonatal tetanus (NNT) following unclean deliveries and poor postnatal hygiene is still responsible for the majority of tetanus cases and deaths; the majority of NNT occurs in poor Asian and African countries, whereas in high-income countries the disease is extremely rare. Three forms of clinical disease can be distinguished: the most common form is generalized tetanus, whereas local tetanus and cephalic tetanus are rare. Neonatal tetanus (NNT) is a form of generalized tetanus in newborns. The case fatality rate of tetanus is high, 3%–95% depending on age, immune- and immunization-status, form of disease, and availability of proper medical care. The efficacy of tetanus toxoid vaccines was never formally studied, but cases in adequately vaccinated subjects are extremely rare and impact data (e.g. for NNT) convincingly show high vaccine effectiveness. WHO estimates that in 2018, 25,000 newborns died from NNT, an 88% reduction from the situation in 2000.

Current status of HIV treatment in Asia and the Pacific region

Sexual Health ◽  
2014 ◽  
Vol 11 (2) ◽  
pp. 119 ◽  
Author(s):  
Angsana Phuphuakrat ◽  
Sasisopin Kiertiburanakul ◽  
Somnuek Sungkanuparph
Keyword(s):  
Low Income ◽  
Universal Access ◽  
Scale Up ◽  
Hiv Treatment ◽  
High Income ◽  
Low Income Countries ◽  
Current Status ◽  
People Living With Hiv ◽  
The Pacific ◽  
Living With Hiv

Asia and the Pacific represent a diverse group of nations facing HIV epidemic profiles of differing severity. Compared to other parts of the world, the burden of HIV disease is high in this region because of its large populations. At the end of 2011, 5 million people were living with HIV in Asia and the Pacific. This accounted for 15% of people living with HIV worldwide. The prevalence of people living with HIV, as well as access to HIV treatment and care, varies widely between countries. Differences between high-income economies and the rest of the continent are remarkable. Many high-income countries provide antiretroviral therapy (ART) to their citizens. Middle- and low-income countries have rapid ART scale-up and are dependent on international funding. This may compromise the sustainability of ART availability. In addition, lack of access to second- and third-line therapy remains a problem in many countries. The global goal of achieving universal access to ART by 2015 requires mainly low- and middle-income countries to be targeted. Regional policy should be developed in order to identify new infections in key populations, to start earlier treatment, to retain patients in care and to maintain funding.

Monetary Policy in Sub-Saharan Africa

2018 ◽  
Keyword(s):  
Monetary Policy ◽  
Low Income ◽  
Sub Saharan Africa ◽  
Low Income Countries ◽  
African Countries ◽  
Policy Regimes ◽  
Export Prices ◽  
Policy Work ◽  
Sub Saharan ◽  
Policy Guidance

Having broadly stabilized inflation over the past two decades, many policymakers in sub-Saharan Africa are now asking more of their monetary policy frameworks. They are looking to avoid policy misalignments and respond appropriately to both domestic and external shocks, including swings in fiscal policy and spikes in food and export prices. In many cases they are finding current regimes—often characterized as ‘money targeting’—lacking, with opaque and sometimes inconsistent objectives, inadequate transmission of policy to the economy, and difficulties in responding to supply shocks. At the same time, little existing research on monetary policy is targeted to low-income countries. What do we know about the empirics of monetary transmission in low-income countries? (How) Does monetary policy work in countries characterized by a huge share of food in consumption, underdeveloped financial markets, and opaque policy regimes? (How) Can we use methods largely derived in advanced countries to answer these questions? And (how) can we use the results to guide policymakers? This book draws on years of research and practice at the IMF and in central banks from the region to shed empirical and theoretical light on these questions and to provide practical tools and policy guidance. A key feature of the book is the application of dynamic general equilibrium models, suitably adapted to reflect key features of low-income countries, for the analysis of monetary policy in sub-Saharan African countries.

Infrastructure deficit and opportunities in Africa

2017 ◽  
Author(s):  
Albert Mafusire ◽  
Zuzana Brixiova ◽  
John Anyanwu ◽  
Qingwei Meng
Keyword(s):  
Private Sector ◽  
Low Income ◽  
Private Investment ◽  
Low Income Countries ◽  
Infrastructure Development ◽  
African Countries ◽  
Policy Makers ◽  
Private Sector Investment ◽  
Investment Opportunities ◽  
Financing Infrastructure

Private sector investment opportunities in Africa’s infrastructure are huge. Regulatory reforms across African countries are identified as critical to the realization of the expected investment flows in the infrastructure sector. However, planners and policy makers need to note that there are infrastructure deficiencies in all subsectors with low income countries (LICs) in Africa facing the greatest challenge. Inefficiencies in implementing infrastructure projects account for USD 17 billion annually and improving the capacity of African countries will help minimize these costs. In this regard, the donor community must play a greater role in African LICs while innovative financing mechanisms must be the focus in the relatively richer countries of the continent. Traditional sources of financing infrastructure development remain important but private investment is critical in closing the current gaps. Countries need to devise mechanisms to exploit opportunities and avoid pitfalls in investing in infrastructure.

scholarly journals Pediatric neurosurgical workforce, access to care, equipment and training needs worldwide

2018 ◽  
Vol 45 (4) ◽  
pp. E13 ◽  
Author(s):  
Michael C. Dewan ◽  
Ronnie E. Baticulon ◽  
Abbas Rattani ◽  
James M. Johnston ◽  
Benjamin C. Warf ◽  
...  
Keyword(s):  
Low Income ◽  
International Collaboration ◽  
Eastern Mediterranean ◽  
Training Needs ◽  
High Income ◽  
Low Income Countries ◽  
Middle Income ◽  
Middle Income Countries ◽  
Surgical Workforce ◽  
And Training

OBJECTIVEThe presence and capability of existing pediatric neurosurgical care worldwide is unknown. The objective of this study was to solicit the expertise of specialists to quantify the geographic representation of pediatric neurosurgeons, access to specialist care, and equipment and training needs globally.METHODSA mixed-question survey was sent to surgeon members of several international neurosurgical and general pediatric surgical societies via a web-based platform. Respondents answered questions on 5 categories: surgeon demographics and training, hospital and practice details, surgical workforce and access to neurosurgical care, training and equipment needs, and desire for international collaboration. Responses were anonymized and analyzed using Stata software.RESULTSA total of 459 surgeons from 76 countries responded. Pediatric neurosurgeons in high-income and upper-middle-income countries underwent formal pediatric training at a greater rate than surgeons in low- and lower-middle-income countries (89.5% vs 54.4%). There are an estimated 2297 pediatric neurosurgeons in practice globally, with 85.6% operating in high-income and upper-middle-income countries. In low- and lower-middle-income countries, roughly 330 pediatric neurosurgeons care for a total child population of 1.2 billion. In low-income countries in Africa, the density of pediatric neurosurgeons is roughly 1 per 30 million children. A higher proportion of patients in low- and lower-middle-income countries must travel > 2 hours to seek emergency neurosurgical care, relative to high-income countries (75.6% vs 33.6%, p < 0.001). Vast basic and essential training and equipment needs exist, particularly low- and lower-middle-income countries within Africa, South America, the Eastern Mediterranean, and South-East Asia. Eighty-nine percent of respondents demonstrated an interest in international collaboration for the purposes of pediatric neurosurgical capacity building.CONCLUSIONSWide disparity in the access to pediatric neurosurgical care exists globally. In low- and lower-middle-income countries, wherein there exists the greatest burden of pediatric neurosurgical disease, there is a grossly insufficient presence of capable providers and equipped facilities. Neurosurgeons across income groups and geographic regions share a desire for collaboration and partnership.

scholarly journals The acceptance of covid-19 vaccines in Sub-Saharan Africa: Evidence from 6 national phone surveys

2021 ◽  
Author(s):  
Shelton Kanyanda ◽  
Yannick Markhof ◽  
Philip Wollburg ◽  
Alberto Zezza
Keyword(s):  
Side Effects ◽  
Low Income ◽  
Urban Areas ◽  
Vaccine Coverage ◽  
Sub Saharan Africa ◽  
Low Income Countries ◽  
Vaccine Hesitancy ◽  
African Countries ◽  
Representative Sampling ◽  
Sub Saharan

Introduction Recent debates surrounding the lagging covid-19 vaccination campaigns in low-income countries center around vaccine supply and financing. Yet, relatively little is known about attitudes towards covid-19 vaccines in these countries and in Africa in particular. In this paper, we provide cross-country comparable estimates of the willingness to accept a covid-19 vaccine in six Sub-Saharan African countries. Methods We use data from six national high-frequency phone surveys from countries representing 38% of the Sub-Saharan African population (Burkina Faso, Ethiopia, Malawi, Mali, Nigeria, and Uganda). Samples are drawn from large, nationally representative sampling frames providing a rich set of demographic and socio-economic characteristics by which we disaggregate our analysis. Using a set of re-calibrated survey weights, our analysis adjusts for the selection biases common in remote surveys. Results Acceptance rates in the six Sub-Saharan African countries studied are generally high, with at least four in five people willing to be vaccinated in all but one country. Vaccine acceptance ranges from nearly universal in Ethiopia (97.9%, 97.2% to 98.6%) to below what would likely be required for herd immunity in Mali (64.5%, 61.3% to 67.8%). We find little evidence for systematic differences in vaccine hesitancy by sex or age but some clusters of hesitancy in urban areas, among the better educated, and in richer households. Safety concerns about the vaccine in general and its side effects emerge as the primary reservations toward a covid-19 vaccine across countries. Conclusions Our findings suggest that limited supply, not inadequate demand, likely presents the key bottleneck to reaching high covid-19 vaccine coverage in Sub-Saharan Africa. To turn intent into effective demand, targeted communication campaigns bolstering confidence in the safety of approved vaccines and reducing concerns about side effects will be crucial to safeguard the swift progression of vaccine rollout in one of the world's poorest regions.

scholarly journals The effect of physical activity on mortality and cardiovascular disease in 130 000 people from 17 high-income, middle-income, and low-income countries: the PURE study

The Lancet ◽  
2017 ◽  
Vol 390 (10113) ◽  
pp. 2643-2654 ◽  
Author(s):  
Scott A Lear ◽  
Weihong Hu ◽  
Sumathy Rangarajan ◽  
Danijela Gasevic ◽  
Darryl Leong ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cardiovascular Disease ◽  
Low Income ◽  
High Income ◽  
Low Income Countries ◽  
Middle Income

Comparative Analysis of Mobile Pain Management Applications in Developed versus Developing Countries (Preprint)

2021 ◽  
Author(s):  
Wilson Mupfururirwa ◽  
Victoria Nembaware ◽  
Jack Morrice ◽  
Khuthala Mnika ◽  
Gaston Kuzamunu Mazandu ◽  
...  
Keyword(s):  
Pain Management ◽  
Uniform Distribution ◽  
Mobile Health ◽  
Low Income ◽  
Cochrane Review ◽  
High Income ◽  
Low Income Countries ◽  
App Store ◽  
Significant Difference ◽  
The Impact

BACKGROUND The impact of mobile phones and their applications in healthcare (mobile health) is well established for a range of diseases and cross-cutting complications, such as pain. While numerous mobile health (mHealth) pain interventions have been established, an evaluation of their prevalence, adequacy and distribution remains limited. OBJECTIVE This study aims at reviewing and comparing current pain management mHealth tools in high- versus low-income countries. METHODS A literature and application (app) store search was conducted in May 2021 using combinations of the following keywords: “pain management”, “pain”, “mobile health”, “telemedicine”, and “app”. Literature searches were conducted in PubMed, Scopus, Cochrane Review Library, and Google scholar. App store searches were conducted in Google Play and Apple App Store. Data characteristics descriptive analysis was performed using R software to summarize different datasets and compute p-values (P) for testing the significance of different hypotheses with the significance level set to 0.05. RESULTS The search identified 40 publications (literature search) and 230 mHealth applications (app store search), revealing a non uniform distribution of search categories (χ2= 133.7, P < 0.004) with a ratio approximating 1:6 (OR = 5.730, 95%CI:3.745-8.909, P < 0.004). About 86.7% of these 270 applications (apps) are from high-income countries, showing a statistically significant non uniform distribution of country categories: high- and low-income (χ2= 145.2, P < 0.004) approximating the theoretical distribution of a 7:1 ratio (OR = 6.476, 95%CI:4.180-10.222, P < 0.004). Moreover, there is no significant difference in the proportion of search categories between country categories ( χ2= 0.113, P = 0.737) and the difference in pain app prevalence in high- versus low-income countries is not statistically significant. Finally, we have observed that pain-tracking apps are significantly more prevalent in developed countries in comparison to low-income countries. CONCLUSIONS As expected, pain management app prevalence is higher in high-income countries. However, more research is required to readily comprehend the effectiveness of these apps.

Managing and Motivating

2011 ◽  
pp. 79-95
Author(s):  
Eilish Mc Auliffe ◽  
Ogenna Manafa ◽  
Cameron Bowie ◽  
Lucy Makoae ◽  
Fresier Maseko ◽  
...  
Keyword(s):  
Human Resources ◽  
Low Income ◽  
Low Income Countries ◽  
Critical Element ◽  
African Countries ◽  
Bilateral Agreements ◽  
Working Environments ◽  
Sub Saharan ◽  
And Performance ◽  
Source Countries

It is now more than a decade since the acknowledgement of the health human resources crisis that exists in many low-income countries. During that decade much attention has focused on addressing the “pull” factors (e.g. developing voluntary international recruitment guidelines and bilateral agreements between recruiting and source countries) and on scaling up the supply of health professionals. Drawing on research conducted in two sub-Saharan African countries, we argue that a critical element in the human resources crisis is the poor working environments in these countries that not only continue to act as a strong “push” factor, but also impact on the motivation and performance of those who remain in their home countries. Unless attention is focused on improving work environments, the human resources crisis will continue in a vicious cycle leading to further decline in the health systems of low-income countries.

Comparing the Effects of Unsustainable Production and Consumption of Food on Health and Policy Across Developed and Less Developed Countries

2021 ◽  
pp. 1011-1035
Author(s):  
Josue Mbonigaba
Keyword(s):  
Systematic Review ◽  
Health Outcomes ◽  
Food Consumption ◽  
Low Income ◽  
Developed Countries ◽  
High Income ◽  
Low Income Countries ◽  
Less Developed Countries ◽  
Review Of The Literature ◽  
Production And Consumption

The unsustainable food consumption across high-income countries (HICs) and low-income countries (LICs) is expected to differ in nature and extent, although no formal evidence in this respect has been documented. Documenting this evidence is the aim of this chapter. Specifically, the chapter seeks to answer the following questions: 1) Do the contexts in less developed countries (LDCs) and developed countries (DCs) make the nature and extent of unsustainability in food consumption different? 2) Do the mechanisms of the linkage between unsustainability of food consumption and health outcomes independent of countries' contexts? 3) Are current policies against unsustainable food consumption equally effective in DCs and LDCs? These questions are answered by means of a systematic review of the literature for the period 2000-2017. The findings are that the nature and extent of unsustainability is quite different across contexts of LICs and HICs.

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