scholarly journals The Overlooked Issue of Outpatient Combination Antibiotic Prescribing in Low- and Middle-Income Countries: An Example from Syria

Antibiotics ◽  
2022 ◽  
Vol 11 (1) ◽  
pp. 74
Author(s):  
Ana Tomas ◽  
Saleh Aljadeeah
Keyword(s):  
Age Groups ◽  
World Health ◽  
Antibiotic Prescribing ◽  
Resistance Development ◽  
Middle Income ◽  
Middle Income Countries ◽  
The World ◽  
Combination Antibiotics ◽  
Health Organization ◽  
Third Generation Cephalosporins

This study aimed to determine and describe the prevalence of combination antibiotics dispensed in outpatients with health insurance in Syria. Data on all dispensed medicines between June 2018 and May 2019 for 81,314 adults were obtained, and medicines belonging to the J01 group of the World Health Organization (WHO) anatomical therapeutic classification (ATC) were included in the analysis. Prescriptions were stratified according to the number of antibiotics, age, and sex. Antibiotic utilization was expressed as the number of prescriptions per 1000 persons per year. Out of 59,404 prescriptions for antibiotics, 14.98% contained antibiotic combinations, distributed to 22.49% of the patients. The prevalence of dispensing antibiotic combinations was higher in female patients (23.00%), and the youngest (18–30 years, 26.19%) and oldest age groups (>70 years, 25.19%). The antibiotics most commonly combined were co-amoxiclav, second- and third-generation cephalosporins, and macrolides. Over 60% of the combinations contained ceftriaxone alone or in combination with sulbactam. The present study shows an alarmingly widespread prescription of antibiotic combinations, posing a risk to global health by promoting resistance development.

scholarly journals A Symptom-based COVID-19 Diagnostic Tool in case of Limited Testing Facilities

2020 ◽  
pp. 71-75
Author(s):  
Raiiq Ridwan ◽  
Md Robed Amin ◽  
Md Ridwanur Rahman
Keyword(s):  
World Health ◽  
Atypical Pneumonia ◽  
New Disease ◽  
Middle Income ◽  
Middle Income Countries ◽  
The World ◽  
Health Organization ◽  
Transmission Of Disease ◽  
Limited Testing ◽  
Low And Middle Income

Since December 2019, when a cluster of atypical pneumonia cases were identified in Wuhan, China a new disease has spread across the world. COVID-19 has since become the biggest pandemic in a century, touching lives in almost every country in the world. At the outset of COVID-19, the World Health Organization advised for testing to become a priority so that patients with COVID-19 could be quickly identified, isolated and treated to interrupt transmission of disease. However, testing shortages have been an increasing problem in low and middle income countries. Even when tests are available, it has proved time-consuming. Therefore, we propose a symptom-based tool to assist in the diagnosis of COVID-19 management in low and middle income Countries. It is based on the symptoms that have so far been described in the literature and advises the frontline healthcare worker on how to diagnose the likelihood of having COVID-19 and separate the patient into Red (very likely), Yellow (possible) and Green (unlikely) categories. J Bangladesh Coll Phys Surg 2020; 38(0): 71-75

scholarly journals Mental health e-supervision for primary care doctors in Sudan using the WHO mhGAP Intervention Guide

2015 ◽  
Vol 12 (S1) ◽  
pp. S-16-S-19 ◽  
Author(s):  
Anne Aboaja ◽  
Puja Myles ◽  
Peter Hughes
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
World Health ◽  
Middle Income ◽  
Middle Income Countries ◽  
The World ◽  
Health Gap ◽  
Action Programme ◽  
Primary Care Doctors ◽  
Health Organization

This paper describes the evaluation of a pilot e-supervision programme, with a focus on feasibility. The findings suggest that e-supervision in mental health using the World Health Organization (WHO) Mental Health Gap Action Programme (mhGAP) Intervention Guide and case-based discussions is valued by participants and can improve the knowledge, confidence and beliefs of primary care doctors in low- and middle-income countries.

scholarly journals Cervical cancer screening – The challenges of complete pathways of care in low-income countries: Focus on Malawi

2020 ◽  
Vol 16 ◽  
pp. 174550652091480
Author(s):  
Heather A Cubie ◽  
Christine Campbell
Keyword(s):  
Cervical Cancer ◽  
Human Papillomavirus ◽  
World Health ◽  
Middle Income ◽  
Low Resource ◽  
Middle Income Countries ◽  
The World ◽  
Health Organization ◽  
Pathways Of Care ◽  
Low And Middle Income

Cervical cancer is the fourth most common cancer among women globally, with approximately 580,000 new diagnoses in 2018. Approximately, 90% of deaths from this disease occur in low- and middle-income countries, especially in areas of high HIV prevalence, and largely due to limited prevention and screening opportunities and scarce treatment options. In this overview, we describe the opportunities and challenges faced in many low- and middle-income countries in delivery of cervical cancer detection, treatment and complete pathways of care. In particular, drawing on our experience and that of colleagues, we describe cervical screening and pathways of care provision in Malawi, as a case study of a low-resource country with high incidence and mortality rates of cervical cancer. Screening methods such as cytology – although widely used in high-income countries – have limited relevance in many low-resource settings. The World Health Organization recommends screening using human papillomavirus testing wherever possible; however, although human papillomavirus primary testing is more sensitive and detects precancers and cancers earlier than cytology, there are currently costs, infrastructure considerations and specificity issues that limit its use in low- and middle-income countries. The World Health Organization accepts the alternative screening approach of visual inspection with acetic acid as part of ‘screen and treat’ programmes as a simple and inexpensive test that can be undertaken by trained health workers and hence give wider screening coverage; however, subjectivity and variability in interpretation of findings between providers raise issues of false positives and overtreatment. Cryotherapy using either nitrous oxide or carbon dioxide is an established treatment for precancerous lesions within ‘screen and treat’ programmes; more recently, thermal ablation has been recognized as suitable to low-resource settings due to lightweight equipment, short treatment times, and hand-held battery-operated and solar-powered models. For larger lesions and cancers, complete clinical pathways (including loop excision, surgery, radiotherapy, chemotherapy and palliative care) are required for optimal care of women. However, provision of each of these components of cancer control is often limited due to limited infrastructure and lack of trained personnel. Hence, global initiatives to reduce cervical mortality need to adopt a holistic approach to health systems strengthening.

scholarly journals The cross-national epidemiology of specific phobia in the World Mental Health Surveys

2017 ◽  
Vol 47 (10) ◽  
pp. 1744-1760 ◽  
Author(s):  
K. J. Wardenaar ◽  
C. C. W. Lim ◽  
A. O. Al-Hamzawi ◽  
J. Alonso ◽  
L. H. Andrade ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Epidemiological Data ◽  
Specific Phobia ◽  
World Health ◽  
Middle Income ◽  
Middle Income Countries ◽  
Co Morbidity ◽  
The World ◽  
Health Organization ◽  
Cross National

BackgroundAlthough specific phobia is highly prevalent, associated with impairment, and an important risk factor for the development of other mental disorders, cross-national epidemiological data are scarce, especially from low- and middle-income countries. This paper presents epidemiological data from 22 low-, lower-middle-, upper-middle- and high-income countries.MethodData came from 25 representative population-based surveys conducted in 22 countries (2001–2011) as part of the World Health Organization World Mental Health Surveys initiative (n = 124 902). The presence of specific phobia as defined by the Diagnostic and Statistical Manual of Mental Disorders, fourth edition was evaluated using the World Health Organization Composite International Diagnostic Interview.ResultsThe cross-national lifetime and 12-month prevalence rates of specific phobia were, respectively, 7.4% and 5.5%, being higher in females (9.8 and 7.7%) than in males (4.9% and 3.3%) and higher in high- and higher-middle-income countries than in low-/lower-middle-income countries. The median age of onset was young (8 years). Of the 12-month patients, 18.7% reported severe role impairment (13.3–21.9% across income groups) and 23.1% reported any treatment (9.6–30.1% across income groups). Lifetime co-morbidity was observed in 60.5% of those with lifetime specific phobia, with the onset of specific phobia preceding the other disorder in most cases (72.6%). Interestingly, rates of impairment, treatment use and co-morbidity increased with the number of fear subtypes.ConclusionsSpecific phobia is common and associated with impairment in a considerable percentage of cases. Importantly, specific phobia often precedes the onset of other mental disorders, making it a possible early-life indicator of psychopathology vulnerability.

scholarly journals Feasibility Study of the World Health Organization Health Care Facility-Based Antimicrobial Stewardship Toolkit for Low- and Middle-Income Countries

Antibiotics ◽  
2020 ◽  
Vol 9 (9) ◽  
pp. 556
Author(s):  
Gina Maki ◽  
Ingrid Smith ◽  
Sarah Paulin ◽  
Linda Kaljee ◽  
Watipaso Kasambara ◽  
...  
Keyword(s):  
Health Care ◽  
World Health Organization ◽  
Feasibility Study ◽  
Care Facility ◽  
Health Care Facility ◽  
World Health ◽  
Middle Income ◽  
Middle Income Countries ◽  
The World ◽  
Health Organization

Antimicrobial stewardship (AMS) has emerged as a systematic approach to optimize antimicrobial use and reduce antimicrobial resistance. To support the implementation of AMS programs, the World Health Organization developed a draft toolkit for health care facility AMS programs in low- and middle-income countries. A feasibility study was conducted in Bhutan, the Federated States of Micronesia, Malawi, and Nepal to obtain local input on toolkit content and implementation of AMS programs. This descriptive qualitative study included semi-structured interviews with national- and facility-level stakeholders. Respondents identified AMS as a priority and perceived the draft toolkit as a much-needed document to further AMS program implementation. Facilitators for implementing AMS included strong national and facility leadership and clinical staff engagement. Barriers included lack of human and financial resources, inadequate regulations for prescription antibiotic sales, and insufficient AMS training. Action items for AMS implementation included improved laboratory surveillance, establishment of a stepwise approach for implementation, and mechanisms for reporting and feedback. Recommendations to improve the AMS toolkit’s content included additional guidance on defining the responsibilities of the committees and how to prioritize AMS programming based on local context. The AMS toolkit was perceived to be an important asset as countries and health care facilities move forward to implement AMS programs.

scholarly journals Introduction

2021 ◽  
pp. 1-2
Author(s):  
Mahmoud Aljurf ◽  
Navneet S. Majhail ◽  
Mickey B. C. Koh ◽  
Mohamed A. Kharfan-Dabaja ◽  
Nelson J. Chao
Keyword(s):  
World Health ◽  
International Agency ◽  
Cancer Death ◽  
Middle Income ◽  
Death Rates ◽  
Middle Income Countries ◽  
Global Age ◽  
The World ◽  
Significant Public Health ◽  
Health Organization

AbstractCancer is a growing healthcare problem worldwide with significant public health and economic burden to both developed and developing countries. According to the World Health Organization, cancer is the second leading cause of death globally, with an estimated 20 million new cancer cases and 10 million cancer deaths in 2020. The International Agency for Cancer Research (IARC) estimates that globally one in five people will develop cancer in their lifetime. Low- and middle-income countries have been disproportionately affected by the rise of cancer incidence and account for approximately 70% of global cancer deaths. At the same time, substantial innovations in screening, diagnosis, and treatment of cancer have improved patient outcomes; global age-standardized cancer death rates showed a 17% decline from 1990 to 2016.

scholarly journals Epidemic of undernutrition during COVID-19 pandemic

2021 ◽  
Vol 9 (3) ◽  
pp. 923
Author(s):  
Swayam Pragyan Parida ◽  
Vikas Bhatia ◽  
Prajna Paramita Giri ◽  
Binod K. Behera ◽  
G. Alekhya ◽  
...  
Keyword(s):  
Public Health ◽  
World Health ◽  
Family Welfare ◽  
Middle Income ◽  
Middle Income Countries ◽  
Manual Search ◽  
The World ◽  
Public Health Challenge ◽  
Policies And Programs ◽  
Health Organization

Undernutrition continues to be a major public health challenge for ages. Under-five age children are still at risk of undernutrition even though there exist many policies and programs at various levels. The lower–middle-income countries (LMIC) struggle hard to combat the undernutrition epidemic. The unprecedented advent of the COVID-19 pandemic has worsened the existing undernutrition scenario. This article reviews the burden and impact of the COVID-19 on undernutrition among children. Necessary measures have to be taken to mitigate the crisis and thereby reduce the risks due to morbidity and mortality related to undernutrition. A manual search of relevant data has been taken from the website of the World Health Organization (WHO), UNICEF, Ministry Health and Family Welfare (MOHFW), government of India. (GOI). A search of relevant publications was done through electronic databases such as PUBMED.

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