Safe and Cost-Effective Peritoneal Dialysis Access by Skilled Nephrologists in Developing Countries

Insertion of Tenckhoff catheters for continuous ambulatory peritoneal dialysis by nephrologists remains uncommon in most developing countries, including Indonesia. The aim of this study is to describe our experience on a simple technique of Tenckhoff catheter insertion by a nephrologist called the Bandung method. We conducted a retrospective observational study from May 2012 until December 2018 in 230 patients with end-stage renal disease using the Bandung method, a blind percutaneous insertion approach modified from the Seldinger technique. Early complications after insertion were assessed. The mean age of patients was 47.28 years (range 14–84 years). Within 1 month after insertion, complications occurred in 34 patients: 13 (5.7%) malposition, 8 (3.5%) omental trapping, 6 (2.6%) outlow failure, 3 (1.3%) peritonitis, 1 (0.4%) catheter infections, 1 (0.4%) bleeding, 1 (0.4%) kinking, and 1 (0.4%) hernia. None of these complications led to catheter removal. One patient experienced a late (>1 month) post-insertion complication of malposition that could not be repositioned and led to catheter removal. The Bandung method is a simple, cost effective, and minimally invasive technique for Tenckhoff catheter insertion that is associated with the same rate of complications compared to other techniques. This technique may useful for application in developing countries.

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Peritoneal Dialysis as an Urgent-Start Option for Incident Patients on Chronic Renal Replacement Therapy: World Experience and Review of Literature

Blood Purification ◽

10.1159/000506505 ◽

2020 ◽

Vol 49 (6) ◽

pp. 652-657 ◽

Cited By ~ 1

Author(s):

Dayana Bittencourt Dias ◽

Marcela Lara Mendes ◽

Camila Albuquerque Alves ◽

Jacqueline Teixeira Caramori ◽

Daniela Ponce

Keyword(s):

Peritoneal Dialysis ◽

Observational Studies ◽

Bloodstream Infections ◽

Venous Catheter ◽

Cost Effective ◽

Initial Time ◽

Dialysis Access ◽

Review Of Literature ◽

Collective Experience ◽

Cost Effective Alternative

Chronic kidney disease is a significant problem of public health worldwide, and up to 60% of patients start dialysis in an unplanned manner without a definitive dialysis access. Recently, peritoneal dialysis (PD) has emerged as an alternative to unplanned chronic dialytic method, and the world collective experience shows that PD can be an efficient, safe, and cost-effective alternative with comparable outcomes to the planned PD and urgent-start hemodialysis (HD). More importantly, as compared to urgent-start HD using a central venous catheter, urgent-start PD has significantly fewer incidences of catheter-related bloodstream infections, dialysis-related mechanical complications, and need for dialysis catheter reinsertions during the initial time of the therapy. An integrative review was conducted on PD urgent start compared to HD urgent start and to planned PD, identifying its potential advantages and limitations. Literature search was performed within multiple databases, and observational studies on clinical experience with urgent PD were reviewed and appraised.

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Advances in Environmental Detection and Clinical Diagnostic Tests for Legionella Species

Journal of Health and Allied Sciences NU ◽

10.1055/s-0041-1731863 ◽

2021 ◽

Author(s):

Rajeshwari Vittal ◽

Juliet Roshini Mohan Raj ◽

Ballamoole Krishna Kumar ◽

Indrani Karunasagar

Keyword(s):

Developing Countries ◽

Healthcare System ◽

Diagnostic Tests ◽

Clinical Manifestations ◽

Cost Effective ◽

Clinical Samples ◽

Detection Techniques ◽

Conventional Culture ◽

Legionella Species ◽

Mild Fever

Abstract Legionella is a fastidious organism that is difficult to culture in the lab but is widely distributed in environmental, domestic, and hospital settings. The clinical manifestations due to Legionella infections range from mild fever to fatal pneumonia and multiorgan pathologies. Legionella outbreaks though prevalent globally are not reported in developing countries due to difficulties in isolating this organism and the lack of simple diagnostic protocols. Here, we review the literature from across countries to present various methods used to detect Legionella from environmental and clinical samples. We compare the sensitivity and the specificity of the conventional culture-based assays with the recent methods and discuss approaches to develop better detection and diagnostic tests. With better cost-effective detection techniques and regular monitoring of the susceptible sites, which may harbor Legionella colonies, most of the Legionella infections can be prevented. As a result, considerable burden, caused by Legionella infections, on the healthcare system, in especially economically weaker countries, can be mitigated.

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Energy Retrofitting Opportunities Using Renewable Materials—Comparative Analysis of the Current Frameworks in Bosnia-Herzegovina and Slovenia

Sustainability ◽

10.3390/su13020603 ◽

2021 ◽

Vol 13 (2) ◽

pp. 603

Author(s):

Darija Gajić ◽

Slobodan Peulić ◽

Tim Mavrič ◽

Anna Sandak ◽

Črtomir Tavzes ◽

...

Keyword(s):

Developing Countries ◽

Residential Buildings ◽

Cost Effective ◽

Primary Energy ◽

Low Carbon ◽

Resource Exploitation ◽

Renewable Materials ◽

Building Stock ◽

Low Carbon Economy ◽

Eu Member States

Sustainable approaches for retrofitting buildings for energy efficiency are becoming necessary in a time when the building sector is the largest energy consumer. Retrofitting building stock is effective for reducing global energy consumption and decreasing resource exploitation. Less developed EU member states and neighboring developing countries show reluctance towards healthy and renewable materials. Implementation of sustainable materials for energy retrofitting is slowed down due to gaps in legislation and effective strategic programs, availability of bio-based materials, lack of knowledge regarding use and maintenance of renewable products, and marketing lobbies. Use of bio-based materials in refurbishment is important due to their negative or low global warming potential (GWP), low primary energy (PEI) need for production, cost-effective benefits, and recycling/reuse potential. Role of environmentally friendly solutions and low-carbon economy growth is particularly relevant in developing countries, such as Bosnia-Herzegovina, that cannot afford innovative energy recovery systems, yet possess a significant amount of poorly managed building stock. This research aims to analyze frameworks regarding retrofitting of residential buildings in Bosnia-Herzegovina and Slovenia. The analysis tackles indirect causes, studies the legal background, and examines strategic frameworks; thus, it indicates potential barriers for implementation of recommended retrofitting solutions based on renewable materials.

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Peritoneal Dialysis Access Revision in Children: Causes, Interventions, and Outcomes

Clinical Journal of the American Society of Nephrology ◽

10.2215/cjn.05270516 ◽

2016 ◽

Vol 12 (1) ◽

pp. 105-112 ◽

Cited By ~ 16

Author(s):

Dagmara Borzych-Duzalka ◽

T. Fazil Aki ◽

Marta Azocar ◽

Colin White ◽

Elizabeth Harvey ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Dialysis Access

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Outcome of Acute Peritoneal Dialysis in Northern Tanzania

Peritoneal Dialysis International ◽

10.3747/pdi.2012.00083 ◽

2012 ◽

Vol 32 (3) ◽

pp. 261-266 ◽

Cited By ~ 45

Author(s):

Kajiru Gad Kilonzo ◽

Sudakshina Ghosh ◽

Siya Anaeli Temu ◽

Venance Maro ◽

John Callegari ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Patient Outcomes ◽

Kidney Injury ◽

Cost Effective ◽

High Morbidity ◽

Poor Countries ◽

Resource Limited ◽

Northern Tanzania ◽

Nephrology Care ◽

Technical Simplicity

Data on the burden of acute kidney injury (AKI) in resource-poor countries such as Tanzania are minimal because of a lack of nephrology services and an inability to recognize and diagnose AKI with any certainty. In the few published studies, high morbidity and mortality are reported. Improved nephrology care and dialysis may lower the mortality from AKI in these settings. Hemodialysis is expensive and technically challenging in resource-limited settings. The technical simplicity of peritoneal dialysis and the potential to reduce costs if consumables can be made locally, present an opportunity to establish cost-effective programs for managing AKI. Here, we document patient outcomes in a pilot peritoneal dialysis program established in 2009 at a referral hospital in Northern Tanzania.

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Evaluation of Non-coverage Cost Effective Technique for Management of Epidermolysis Bullosa Mitten Hands in Developing Countries

The Egyptian Journal of Plastic and Reconstructive Surgery ◽

10.21608/ejprs.2021.61226.1050 ◽

2021 ◽

Vol 0 (0) ◽

pp. 0-0

Author(s):

adel sayed amr ◽

Omar Mahmoud ◽

Mohamed Ghanem

Keyword(s):

Developing Countries ◽

Epidermolysis Bullosa ◽

Cost Effective ◽

Effective Technique ◽

Cost Effective Technique

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Automotive Industry in BRIC Countries

World Economy and International Relations ◽

10.20542/0131-2227-2014-9-55-65 ◽

2014 ◽

pp. 55-65

Author(s):

S. Afanas'ev ◽

V. Kondrat’ev

Keyword(s):

Developing Countries ◽

Automotive Industry ◽

Developing Economies ◽

Cost Effective ◽

State Regulation ◽

Bric Countries ◽

Final Assembly ◽

Catching Up ◽

The Future ◽

Assembly Operations

For the next decade, the future of the automotive industry lies in BRIC’ countries. Together, Brazil, Russia, India, and China will account for some 30 percent of world auto sales in 2014 while also offering significant opportunities for cost-effective R&D, sourcing, and manufacturing. The authors analyze the degree of localization of leading TNC and supplies in each BRIC country, for each function, compare localization across BRIC countries, assess the future development of these markets, compare local capabilities and resources, and identify particularly promising combinations of functions and countries. Key trends in developing countries include continuing liberalization and globalization, increased foreign investment and ownership, and the increasing importance of follow-source and follow-design forces. The article concerns the trends and factors of national automotive industry formation in BRIC countries. Special emphasis is made on localization of R&D activities, final assembly operations and components production by global automotive companies in BRIC countries. It systemizes the factors of investment opportunities of different developing markets. It is concluded that active state regulation is playing the principle role in localization and catching-up process in automotive industry in developing countries. The comparison of the automotive industry in BRIC countries allows shedding light on the economic processes of emergence at large. There is a stark contrast in the capacities of development of the sector in these countries. This contrast serves as an analyzer between the modes of sector opening and the paths of technological catching-up that is the core of the phenomenon of emergence. The analysis and best practices presented in the topic, while focusing on the BRIC countries, are applicable also to other rapidly developing economies.

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Modification of the percutaneous approach to peritoneal dialysis catheter placement under peritoneoscopic visualization: clinical results in 78 patients.

Journal of the American Society of Nephrology ◽

10.1681/asn.v31103 ◽

1992 ◽

Vol 3 (1) ◽

pp. 103-107

Author(s):

N S Nahman ◽

D F Middendorf ◽

W H Bay ◽

R McElligott ◽

S Powell ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Catheter Placement ◽

Seldinger Technique ◽

First Episode ◽

Dialysis Access ◽

Peritoneal Dialysis Catheter ◽

Exit Site ◽

Exit Site Infection ◽

Percutaneous Approach ◽

Tunnel Infection

The placement of percutaneous peritoneal dialysis catheters under direct peritoneoscopic visualization is a relatively new technique for establishing peritoneal dialysis access. In this study, in which a modification of the Seldinger technique was used to facilitate the placement of the peritoneoscope, the experience with 82 consecutive catheterization procedures in 78 patients is reported. In 2 (2.4%) of 82 catheterization procedures, we were unable to enter the peritoneal cavity but experienced no other complications unique to the percutaneous approach. Of the 80 successful catheterization procedures, 76 represented first-time catheter placement and constituted a population subjected to life-table analysis examining catheter survival rates, the time to first cutaneous exit site or s.c. tunnel infection, and the time to first episode of peritonitis. After a follow-up period of 50.1 patient yr, 11 catheters were lost because of catheter dysfunction. Other clinical complications included peritoneal fluid leaks at the cutaneous exit site in 11 instances (0.22/patient yr), cutaneous exit site infection in 7 instances (0.14/patient yr), s.c. tunnel infection in 2 instances (0.04/patient yr), and 34 episodes of peritonitis (0.68/patient yr). The results of this study demonstrate that the suggested modification of the percutaneous placement of peritoneal dialysis catheters, under peritoneoscopic visualization, is a viable method for establishing peritoneal access.

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Use of cost-effective technologies for a routine clinical pathology laboratory

Lab on a Chip ◽

10.1039/d1lc00658d ◽

2021 ◽

Author(s):

Mercedes Vazquez ◽

L. Anfossi ◽

Hader Ben-Yoav ◽

Lorena Diéguez ◽

Thomas Karopka ◽

...

Keyword(s):

Developing Countries ◽

Clinical Pathology ◽

Cost Effective ◽

Limiting Factor ◽

Economic Costs ◽

Pathology Laboratory

Classically, the need for highly sophisticated instruments with important economic costs has been a major limiting factor for clinical pathology laboratories, especially in developing countries. With the aim of making...

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