scholarly journals P. pastoris (Komagataella phaffii) as a Cost-Effective Tool for Vaccine Production for Low- and Middle-Income Countries (LMICs)

2021 ◽  
Vol 8 (9) ◽  
pp. 119
Author(s):  
Salomé de Sá Magalhães ◽  
Eli Keshavarz-Moore
Keyword(s):  
Vaccine Development ◽  
Production Systems ◽  
Cost Effective ◽  
Effective Vaccine ◽  
Heterologous Proteins ◽  
Vaccine Production ◽  
Middle Income ◽  
Middle Income Countries ◽  
Komagataella Phaffii ◽  
Low And Middle Income

Vaccination is of paramount importance to global health. With the advent of the more recent pandemics, the urgency to expand the range has become even more evident. However, the potential limited availability and affordability of vaccines to resource low- and middle-income countries has created a need for solutions that will ensure cost-effective vaccine production methods for these countries. Pichia pastoris (P. pastoris) (also known as Komagataella phaffii) is one of the most promising candidates for expression of heterologous proteins in vaccines development. It combines the speed and ease of highly efficient prokaryotic platforms with some key capabilities of mammalian systems, potentially reducing manufacturing costs. This review will examine the latest developments in P. pastoris from cell engineering and design to industrial production systems with focus on vaccine development and with reference to specific key case studies.

scholarly journals Overview of the Development, Impacts, and Challenges of Live-Attenuated Oral Rotavirus Vaccines

Vaccines ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. 341 ◽  
Author(s):  
Olufemi Samuel Folorunso ◽  
Olihile M. Sebolai
Keyword(s):  
Low Income ◽  
Vaccine Development ◽  
Cost Effective ◽  
Low Income Countries ◽  
Effective Vaccine ◽  
Middle Income ◽  
Middle Income Countries ◽  
Rotavirus Vaccines ◽  
The Impact ◽  
Infants And Young Children

Safety, efficacy, and cost-effectiveness are paramount to vaccine development. Following the isolation of rotavirus particles in 1969 and its evidence as an aetiology of severe dehydrating diarrhoea in infants and young children worldwide, the quest to find not only an acceptable and reliable but cost-effective vaccine has continued until now. Four live-attenuated oral rotavirus vaccines (LAORoVs) (Rotarix®, RotaTeq®, Rotavac®, and RotaSIIL®) have been developed and licensed to be used against all forms of rotavirus-associated infection. The efficacy of these vaccines is more obvious in the high-income countries (HIC) compared with the low- to middle-income countries (LMICs); however, the impact is far exceeding in the low-income countries (LICs). Despite the rotavirus vaccine efficacy and effectiveness, more than 90 countries (mostly Asia, America, and Europe) are yet to implement any of these vaccines. Implementation of these vaccines has continued to suffer a setback in these countries due to the vaccine cost, policy, discharging of strategic preventive measures, and infrastructures. This review reappraises the impacts and effectiveness of the current live-attenuated oral rotavirus vaccines from many representative countries of the globe. It examines the problems associated with the low efficacy of these vaccines and the way forward. Lastly, forefront efforts put forward to develop initial procedures for oral rotavirus vaccines were examined and re-connected to today vaccines.

scholarly journals Achieving Viral Suppression in 90% of People Living With Human Immunodeficiency Virus on Antiretroviral Therapy in Low- and Middle-Income Countries: Progress, Challenges, and Opportunities

2018 ◽  
Vol 66 (10) ◽  
pp. 1487-1491 ◽  
Author(s):  
Jean B Nachega ◽  
Nadia A Sam-Agudu ◽  
Lynne M Mofenson ◽  
Mauro Schechter ◽  
John W Mellors
Keyword(s):  
Human Immunodeficiency Virus ◽  
Viral Suppression ◽  
Cost Effective ◽  
Term Treatment ◽  
Middle Income ◽  
Middle Income Countries ◽  
Long Term Treatment ◽  
Wide Range ◽  
Immunodeficiency Virus ◽  
Low And Middle Income

Abstract Although significant progress has been made, the latest data from low- and middle-income countries show substantial gaps in reaching the third “90%” (viral suppression) of the UNAIDS 90-90-90 goals, especially among vulnerable and key populations. This article discusses critical gaps and promising, evidence-based solutions. There is no simple and/or single approach to achieve the last 90%. This will require multifaceted, scalable strategies that engage people living with human immunodeficiency virus, motivate long-term treatment adherence, and are community-entrenched and ‑supported, cost-effective, and tailored to a wide range of global communities.

scholarly journals Patients' perceptions of self-management of high blood pressure in three low- and middle-income countries: findings from the BPMONITOR study

2020 ◽  
Vol 5 ◽  
Author(s):  
Tala Al-Rousan ◽  
M. Amalia Pesantes ◽  
Sufia Dadabhai ◽  
Namratha R. Kandula ◽  
Mark D. Huffman ◽  
...  
Keyword(s):  
Blood Pressure ◽  
High Blood Pressure ◽  
Cost Effective ◽  
Self Management ◽  
Middle Income ◽  
Self Monitoring ◽  
Caregiver Support ◽  
Middle Income Countries ◽  
Perceptions And Attitudes ◽  
Low And Middle Income

Abstract Hypertension is the leading risk factor for global disease burden. Self-management of high blood pressure (BP) through self-monitoring and self-titration of medications, has proved to be one successful and cost-effective tool to achieve better BP control in many high-income countries but not much is known about its potential in low- and middle-income countries (LMICs). We used semi-structured questionnaires and focus groups in three LMICs; Peru, Cameroon and Malawi to examine perceptions and attitudes of patients diagnosed with essential hypertension towards living with hypertension, BP measurement and treatment, patient–physician relationship and opinions about self-management of high blood pressure. Results in all three countries were comparable. Patients showed varied levels of health literacy related to hypertension. BP measurement habits were mostly affected by resources available and caregiver support. Treatment and adherence to it were primarily affected by cost. Most patients were welcoming of the idea of self-management but skeptical about the ability to do self-monitoring accurately and the safety involving self-titration of medications.

scholarly journals Strategies to Improve Stroke Care Services in Low- and Middle-Income Countries: A Systematic Review

2017 ◽  
Vol 49 (1-2) ◽  
pp. 45-61 ◽  
Author(s):  
Jeyaraj Durai Pandian ◽  
Akanksha G. William ◽  
Mahesh P. Kate ◽  
Bo Norrving ◽  
George A. Mensah ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care Services ◽  
Cost Effective ◽  
Stroke Care ◽  
Evidence Based ◽  
Middle Income ◽  
Middle Income Countries ◽  
Care Services ◽  
Stroke Services ◽  
Low And Middle Income

Background: The burden of stroke in low- and middle-income countries (LMICs) is large and increasing, challenging the already stretched health-care services. Aims and Objectives: To determine the quality of existing stroke-care services in LMICs and to highlight indigenous, inexpensive, evidence-based implementable strategies being used in stroke-care. Methods: A detailed literature search was undertaken using PubMed and Google scholar from January 1966 to October 2015 using a range of search terms. Of 921 publications, 373 papers were shortlisted and 31 articles on existing stroke-services were included. Results: We identified efficient models of ambulance transport and pre-notification. Stroke Units (SU) are available in some countries, but are relatively sparse and mostly provided by the private sector. Very few patients were thrombolysed; this could be increased with telemedicine and governmental subsidies. Adherence to secondary preventive drugs is affected by limited availability and affordability, emphasizing the importance of primary prevention. Training of paramedics, care-givers and nurses in post-stroke care is feasible. Conclusion: In this systematic review, we found several reports on evidence-based implementable stroke services in LMICs. Some strategies are economic, feasible and reproducible but remain untested. Data on their outcomes and sustainability is limited. Further research on implementation of locally and regionally adapted stroke-services and cost-effective secondary prevention programs should be a priority.

scholarly journals Wastewater-Based Epidemiology for Cost-Effective Mass Surveillance of COVID-19 in Low- and Middle-Income Countries: Challenges and Opportunities

Water ◽  
2021 ◽  
Vol 13 (20) ◽  
pp. 2897
Author(s):  
Sadhana Shrestha ◽  
Emi Yoshinaga ◽  
Saroj K. Chapagain ◽  
Geetha Mohan ◽  
Alexandros Gasparatos ◽  
...  
Keyword(s):  
Population Size ◽  
Cost Effective ◽  
Management Systems ◽  
Current Evidence ◽  
Wastewater Management ◽  
Middle Income ◽  
Middle Income Countries ◽  
Challenges And Opportunities ◽  
Mass Surveillance ◽  
Low And Middle Income

Wastewater-based epidemiology (WBE) is an approach that can be used to estimate COVID-19 prevalence in the population by detecting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA in wastewater. As the WBE approach uses pooled samples from the study population, it is an inexpensive and non-invasive mass surveillance method compared to individual testing. Thus, it offers a good complement in low- and middle-income countries (LMICs) facing high costs of testing or social stigmatization, and it has a huge potential to monitor SARS-CoV-2 and its variants to curb the global COVID-19 pandemic. The aim of this review is to systematize the current evidence about the application of the WBE approach in mass surveillance of COVID-19 infection in LMICs, as well as its future potential. Among other parameters, population size contributing the fecal input to wastewater is an important parameter for COVID-19 prevalence estimation. It is easier to back-calculate COVID-19 prevalence in the community with centralized wastewater systems, because there can be more accurate estimates about the size of contributing population in the catchment. However, centralized wastewater management systems are often of low quality (or even non-existent) in LMICs, which raises a major concern about the ability to implement the WBE approach. However, it is possible to mobilize the WBE approach, if large areas are divided into sub-areas, corresponding to the existing wastewater management systems. In addition, a strong coordination between stakeholders is required for estimating population size respective to wastewater management systems. Nevertheless, further international efforts should be leveraged to strengthen the sanitation infrastructures in LMICs, using the lessons gathered from the current COVID-19 pandemic to be prepared for future pandemics.

scholarly journals Building youth and family resilience for better mental health: developing and testing a hybrid model of intervention in low- and middle-income countries

2021 ◽  
pp. 1-3
Author(s):  
Debasish Basu ◽  
Sugandha Nagpal ◽  
Renjith R. Pillai ◽  
Victoria Mutiso ◽  
David Ndetei ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Beliefs ◽  
Hybrid Model ◽  
Cost Effective ◽  
Family Resilience ◽  
Childhood Experiences ◽  
Middle Income ◽  
Middle Income Countries ◽  
The Individual ◽  
Low And Middle Income

Summary Resilience is a dynamic, multi-level, multi-systemic process of positive adaptation at the individual, family and community levels. Promoting resilience can be a cost-effective form of preventive and early intervention, offering significant health advantages for young people throughout their lives. Developing resiliency interventions for youth and their families in low- and middle-income countries (LMICs), particularly in the context of the ongoing pandemic, is especially important given a lack of services and trained specialists, and poor levels of public spend on mental health, alongside marked and clustered psychosocial disadvantages and adverse childhood experiences. We propose a ‘hybrid’ model targeting 10- to 17 year-old children and their families, and options to engage through communities, schools and the family unit. These options will enhance individual and family resilience, and possibly buffer against adversity. The adaptations respect cultural and health beliefs, take account of structural drivers of inequalities and are suitable for LMICs.

scholarly journals Complementary Feeding Diets Made of Local Foods Can Be Optimized, but Additional Interventions Will Be Needed to Meet Iron and Zinc Requirements in 6- to 23-Month-Old Children in Low- and Middle-Income Countries

2016 ◽  
Vol 37 (4) ◽  
pp. 544-570 ◽  
Author(s):  
Saskia J. M. Osendarp ◽  
Britt Broersen ◽  
Marti J. van Liere ◽  
Luz M. De-Regil ◽  
Lavannya Bahirathan ◽  
...  
Keyword(s):  
Cost Effective ◽  
Local Foods ◽  
Nutrient Requirements ◽  
Nutrient Intakes ◽  
Middle Income ◽  
Middle Income Countries ◽  
Modeling Techniques ◽  
Iron And Zinc ◽  
Calcium Iron ◽  
Low And Middle Income

Background: The question whether diets composed of local foods can meet recommended nutrient intakes in children aged 6 to 23 months living in low- and middle-income countries is contested. Objective: To review evidence of studies evaluating whether (1) macro- and micronutrient requirements of children aged 6 to 23 months from low- and middle-income countries are met by the consumption of locally available foods (“observed intake”) and (2) nutrient requirements can be met when the use of local foods is optimized, using modeling techniques (“modeled intake”). Methods: Twenty-three articles were included after conducting a systematic literature search. To allow for comparisons between studies, findings of 15 observed intake studies were compared against their contribution to a standardized recommended nutrient intake from complementary foods. For studies with data on intake distribution, %< estimated average requirements were calculated. Results: Data from the observed intake studies indicate that children aged 6 to 23 months meet requirements of protein, while diets are inadequate in calcium, iron, and zinc. Also for energy, vitamin A, thiamin, riboflavin, niacin, folate, and vitamin C, children did not always fulfill their requirements. Very few studies reported on vitamin B6, B12, and magnesium, and no conclusions can be drawn for these nutrients. When diets are optimized using modeling techniques, most of these nutrient requirements can be met, with the exception of iron and zinc and in some settings calcium, folate, and B vitamins. Conclusion: Our findings suggest that optimizing the use of local foods in diets of children aged 6 to 23 months can improve nutrient intakes; however, additional cost-effective strategies are needed to ensure adequate intakes of iron and zinc.

scholarly journals Early intervention for psychosis in low- and middle-income countries needs a public health approach

2013 ◽  
Vol 202 (3) ◽  
pp. 168-169 ◽  
Author(s):  
Saeed Farooq
Keyword(s):  
Public Health ◽  
Early Intervention ◽  
Treatment Algorithm ◽  
Cost Effective ◽  
Public Health Approach ◽  
Middle Income ◽  
Middle Income Countries ◽  
Improved Outcomes ◽  
Early Intervention In Psychosis ◽  
Low And Middle Income

SummaryEarly intervention in psychosis has significantly improved outcomes compared with standard treatment but it is considered as a luxury for low- and middle-income (LAMI) countries. However, a public health approach that is based on the principles of supplying all essential medication free of charge for at least the first 2 years of illness, medication being taken under supervision of a caregiver and treatment following a standardised treatment algorithm can prove a cost-effective early intervention model for LAMI countries.

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