scholarly journals Pneumococcal Vaccines: Past Findings, Present Work, and Future Strategies

Vaccines ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. 1338
Author(s):  
Giuliana S. Oliveira ◽  
Maria Leonor S. Oliveira ◽  
Eliane N. Miyaji ◽  
Tasson C. Rodrigues
Keyword(s):  
Viral Vectors ◽  
New Technologies ◽  
High Morbidity ◽  
Pneumococcal Vaccines ◽  
Herd Effect ◽  
Middle Income ◽  
Middle Income Countries ◽  
Advantages And Disadvantages ◽  
Serotype Replacement ◽  
Improve Cost

The importance of Streptococcus pneumoniae has been well established. These bacteria can colonize infants and adults without symptoms, but in some cases can spread, invade other tissues and cause disease with high morbidity and mortality. The development of pneumococcal conjugate vaccines (PCV) caused an enormous impact in invasive pneumococcal disease and protected unvaccinated people by herd effect. However, serotype replacement is a well-known phenomenon that has occurred after the introduction of the 7-valent pneumococcal conjugate vaccine (PCV7) and has also been reported for other PCVs. Therefore, it is possible that serotype replacement will continue to occur even with higher valence formulations, but the development of serotype-independent vaccines might overcome this problem. Alternative vaccines are under development in order to improve cost effectiveness, either using proteins or the pneumococcal whole cell. These approaches can be used as a stand-alone strategy or together with polysaccharide vaccines. Looking ahead, the next generation of pneumococcal vaccines can be impacted by the new technologies recently approved for human use, such as mRNA vaccines and viral vectors. In this paper, we will review the advantages and disadvantages of the addition of new polysaccharides in the current PCVs, mainly for low- and middle-income countries, and we will also address future perspectives.

scholarly journals Determinants of COVID-19 Vaccine Acceptance in Six Lower- and Middle-Income Countries

2021 ◽  
Author(s):  
Adugna Kebede ◽  
Robert Kanwagi ◽  
Asrat Dibaba Tolossa ◽  
Md Abul Kalam ◽  
Thomas Davis ◽  
...  
Keyword(s):  
Perceived Risk ◽  
P Value ◽  
Negative Consequences ◽  
Vaccine Acceptance ◽  
Middle Income ◽  
Perceived Safety ◽  
Middle Income Countries ◽  
Advantages And Disadvantages ◽  
Vaccine Refusal ◽  
Behavioural Determinants

Abstract Background: While a vaccine is the only clinical preventive measure to control the infection and mortality caused by SARS-CoV-2 (COVID-19), delayed acceptance or refusal of COVID-19 vaccines may increase and prolong the threat to global public health and the economy. Identifying behavioural determinants is considered a critical step in explaining and addressing the barriers of vaccine refusal, but there is a lack of evidence around COVID-19 vaccine refusal and delay from a behavioural perspective. This study aims to identify the behavioural determinants of COVID-19 vaccine acceptance and provide recommendations to design actionable interventions to increase the uptake of the COVID-19 vaccine in six lower-and-middle income countries. Methods: Taking into consideration the Health Belief Model (HBM), Theory of Reasoned Action (TRA), and other behavioural models, a Barrier Analysis (BA) approach was employed to examine twelve potential behavioural determinants of vaccine acceptance in Bangladesh, India, Myanmar, Kenya, the Democratic Republic of Congo, and Tanzania. In all six countries, at least 45 interviews with those who intended to take the vaccine (“Acceptors”) and another 45 or more interviews with those who did not (“Non-Acceptors”) were conducted, totalling 542 interviews. Data analysis was performed to find statistically significant (a p-value of less than 0.05) differences between Acceptors and Non-acceptors and to identify which beliefs were most highly associated with acceptance and non-acceptance of the behaviour based on estimated relative risk (ERR). Results: The analysis showed that perceived social norms, perceived positive and negative consequences, perceived risk of getting COVID-19, perceived severity of COVID-19, trust in COVID-19 vaccines, perceived safety of COVID-19 vaccines, and expected access to COVID-19 vaccines had the highest association with COVID-19 vaccine acceptance in Bangladesh, Kenya, Tanzania, and DRC. Additional behavioural determinants found to be significant in both Myanmar and India were perceived self-efficacy, trust in COVID-19 information provided by leaders, perceived divine will, and perceived action efficacy of the COVID-19 vaccines. The study also identified important perceptions and beliefs around COVID-19 and its severity, advantages and disadvantages of being vaccinated, and action efficacy of the vaccine to control the spread of the virus. Conclusion: Many of the determinants found to be significant and their level of significance varied from country to country. National and local plans should include messages and activities that address the behavioural determinants found in this study in order to significantly increase the uptake of COVID-19 vaccine across these countries.

scholarly journals New technologies to improve healthcare in low- and middle-income countries: Global Grand Challenges satellite event, Oxford University Clinical Research Unit, Ho Chi Minh City, 17th-18th September 2019

2020 ◽  
Vol 5 ◽  
pp. 142
Author(s):  
Minh Ngoc Dinh ◽  
Joseph Nygate ◽  
Van Hoang Minh Tu ◽  
C. Louise Thwaites ◽  
Keyword(s):  
New Technologies ◽  
Research Unit ◽  
Ho Chi Minh City ◽  
Middle Income ◽  
Grand Challenges ◽  
Middle Income Countries ◽  
Oxford University ◽  
Key Stakeholders ◽  
Clinical Research Unit ◽  
Low And Middle Income

We report the outputs of a satellite event in Ho Chi Minh City, Vietnam, organized as part of the “2nd Global Grand Challenges of Engineering Summit”. The event considered challenges and potential solutions for improving low- and middle-income country (LMIC) healthcare systems, with particular reference to critical care.  Participants from key regional and local stakeholders in healthcare and engineering discussed how new advances in technology, especially in the field of Artificial Intelligence, could be of potential benefit. This article summarizes the perspectives and conclusions of a group of key stakeholders from LMICs across South and South East Asia.

scholarly journals Mycetoma in Timor-Leste and first report of nocardiosis

2018 ◽  
Vol 10 (3) ◽  
Author(s):  
Nicola Townell ◽  
Thomas Locke ◽  
Margaret Gibbons ◽  
Dan Murphy ◽  
Joshua Francis ◽  
...  
Keyword(s):  
Causative Organism ◽  
Molecular Testing ◽  
High Morbidity ◽  
Middle Income ◽  
Diagnosis And Management ◽  
Middle Income Countries ◽  
First Case ◽  
Soft Tissue Involvement ◽  
Timor Leste ◽  
Resource Issue

Mycetoma is a neglected tropical disease with an unknown global burden. Although considered endemic to South-east Asia, it has not previously been reported from Timor-Lest. We describe two cases in Timor-Leste, highlighting the challenges surrounding microbiological diagnosis and management shared by many low to middle-income countries. As characteristically described, both patients lived rurally and presented late with marked soft tissue involvement and multiple draining sinuses following a prolonged period of high morbidity. Nocardia brasiliensis, a beadedbranched, modified acid-fast, gram-positive bacilli, was isolated and confirmed by molecular testing in the first case. The causative organism in the second case could not be confirmed due to limited microbiological capabilities. Due to limited local laboratory capabilities, Nocardia spp. infection cannot be routinely confirmed in Timor- Leste. However, the microbiology laboratory is essential for the successful diagnosis and management of Mycetoma. In both cases, medical therapy alone resulted in cure and favorable outcomes, although supply of antibiotic remains an ongoing resource issue.

scholarly journals Pneumococcal Vaccines: Challenges and Prospects

Vaccines ◽  
2019 ◽  
Vol 7 (1) ◽  
pp. 25
Author(s):  
Paul Licciardi ◽  
Ioanna Papadatou
Keyword(s):  
Streptococcus Pneumoniae ◽  
Morbidity And Mortality ◽  
Pneumococcal Vaccines ◽  
Middle Income ◽  
Middle Income Countries ◽  
Common Causes ◽  
Low And Middle Income

Infections with the bacterium Streptococcus pneumoniae are one of the most common causes of morbidity and mortality in children less than five years of age worldwide, mostly in low- and middle-income countries (LMICs) [...]

scholarly journals Challenges and solutions: surveying researchers on what type of community engagement and involvement activities are feasible in low and middle income countries during the COVID-19 pandemic

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e052135
Author(s):  
Karolin Kroese ◽  
Katie Porter ◽  
Heidi Surridge ◽  
Doreen Tembo
Keyword(s):  
Global Health ◽  
Community Engagement ◽  
Health Research ◽  
Round Table ◽  
Global Health Research ◽  
Middle Income ◽  
Middle Income Countries ◽  
Advantages And Disadvantages ◽  
Health And Social Care ◽  
Low And Middle Income

ObjectivesMeasures to limit the spread of infection during the COVID-19 global pandemic have made engaging and involving members of the community in global health research more challenging. This research aimed to explore how global health researchers adapted to the imposed pandemic measures in low and middle income countries (LMICs) and how they overcame challenges to effective community engagement and involvement (CEI).DesignA qualitative two-stage mixed-methods study involving an online survey and a virtual round table.SettingThe survey and round table were completed online.ParticipantsOf 53 participants, 43 were LMIC-based or UK-based global health researchers and/or CEI professionals, and 10 worked for the National Institute for Health Research or UK Government’s Department of Health and Social Care.Outcome measuresThis study aimed to capture data on: the number of CEI activities halted and adapted because of the COVID-19 pandemic; where CEI is possible; how it has been adapted; what the challenges and successes were; and the potential impact of adapted or halted CEI on global health research.ResultsPandemic control measures forced the majority of researchers to stop or amend their planned CEI activities. Most face-to-face CEI activities were replaced with remote methods, such as online communication. Virtual engagement enabled researchers to maintain already established relationships with community members, but was less effective when developing new relationships or addressing challenges around the inclusion of marginalised community groups.ConclusionsCOVID-19 has highlighted the need for contingency planning and flexibility in CEI. The redesigning and adopting of remote methods has come with both advantages and disadvantages, and required new skills, access to technology, funding, reliable services and enthusiasm from stakeholders. The methods suggested have the potential to augment or substitute previously preferred CEI activities. The effectiveness and impact of these remote CEI activities need to be assessed.

scholarly journals Tuberculosis innovations mean little if they cannot save lives

eLife ◽  
2017 ◽  
Vol 6 ◽  
Author(s):  
Madhukar Pai ◽  
Jennifer Furin
Keyword(s):  
New Technologies ◽  
Middle Income ◽  
Innovative Technologies ◽  
Middle Income Countries ◽  
The Past ◽  
Financial Investments ◽  
Implementation Gaps ◽  
Urgent Action ◽  
Low And Middle Income

The past decade has seen the emergence of new diagnostics and drugs for tuberculosis, a disease that kills over 1.8 million people each year. However, these new tools are yet to reach scale, and access remains a major challenge for patients in low and middle income countries. Urgent action is needed if we are committed to ending the TB epidemic. This means raising the level of ambition, embracing innovation, increasing financial investments, addressing implementation gaps, and ensuring that new technologies reach those who need them to survive. Otherwise, the promise of innovative technologies will never be realized.

The Future of Telemedicine in Europe and Methods for the Evaluation of Health Services

2012 ◽  
Vol 1 (3) ◽  
pp. 20-26 ◽  
Author(s):  
Paola Di Giacomo
Keyword(s):  
Low Income ◽  
New Technologies ◽  
Controlled Trial ◽  
Evaluation Methods ◽  
Low Income Countries ◽  
Middle Income ◽  
Middle Income Countries ◽  
Randomized Controlled ◽  
Analytical Work ◽  
The One

Despite the accumulation of evidence for the effects of approaches to chronic illness, methodological and analytical work is still needed to develop widely accepted evaluation methods that are scientifically sound and also practicable in routine settings. Given all the diversity and variability of disease management, a key issue for this work concerns the difficulties in establishing a useful “comparator” in settings where it is not practical or possible to execute an evaluation as a randomized controlled trial (RCT). This is indeed an important task because evaluation methods are a precondition to select efficient and effective programs, or components within a program that can address the growing burden of chronic and more in general health conditions. This is evident, in particular, when it comes to new technologies in medicine and implementation and evaluation, in the healthcare sectors, distinguishing low-income countries, on the one-hand, and those in other middle income countries.

scholarly journals MAIA (Medical Artificial Intelligence Assistant) as interface for a new cancer healthcare integrative platform.

2019 ◽  
Vol 5 (suppl) ◽  
pp. 25-25 ◽  
Author(s):  
Luis Eduardo Pino ◽  
Eduardo Large ◽  
Jorge Mejía ◽  
Ivan Camilo Triana
Keyword(s):  
Artificial Intelligence ◽  
Molecular Biology ◽  
Decision Trees ◽  
New Technologies ◽  
Middle Income ◽  
Care Experience ◽  
Cancer Pathways ◽  
Middle Income Countries ◽  
Virtual Platform ◽  
Low And Middle Income

25 Background: Cancer healthcare systems are an example of inequity and waste in low and middle income countries. Access to high quality cancer pathways focused in early diagnosis, molecular biology, proper staging and evidence based treatments are scarce and the patient`s care experience is dramatic and difficult in a majority of cases. There are no integrative healthcare models based on new technologies that improve outcomes and make more comfortable and expeditious all the patient and physician´s journey in cancer. Methods: Our team developed and trained a talkbot called MAIA (Medical Artificial Intelligence Assistant) using an algorithmic translation of medical language focused in the state or art for non small cell lung cancer. Our clinical team developed decision trees in diagnosis, staging, medical and surgical treatment and molecular biology that were incorporated in a virtual platform and then integrated onto a narrow artificial intelligence bot brain using neural networks with the proposal of generate clinical support to the physician and create a standard text using the verbal information captured in the oncological consultation and integrated images (reports) through a image edition software and then create a unique medical record without using computers by the physician. MAIA also can create medical treatment choices in first line of treatment and create alerts and alarms through an own app (MAIA Hip). Results: Our proof of concept was released in video at this link https://drive.google.com/file/d/12YtiOkhfEmIsL2bFp9T3QyfHHWxBvvKU/view?ts=5ceec096 Due to our decision trees size we can´t upload them, but are available for presentation. Conclusions: A talkbot trained as a narrow artificial intelligence interface for an integrative cancer healthcare platform (HIP) is possible through the clinical and engineer integration of languages using a neural network method and other software tools. MAIA is for now a patient and physician experience improvement, but the real impact will be in the data standarization and acquisition for advanced analytics. The final scope of MAIA HIP will be a blockchain for cancer in low and middle income countries.

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