Peritoneal Dialysis for AKI in Cameroon: Commercial Vs Locally-Made Solutions

2018 ◽  
Vol 38 (4) ◽  
pp. 246-250 ◽  
Author(s):  
Dennis Palmer ◽  
William J. Lawton ◽  
Charles Barrier ◽  
B.D. Fine ◽  
Hayden Hemphill ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
High Mortality ◽  
Retrospective Cohort ◽  
Kidney Injury ◽  
Resource Limited Settings ◽  
Significant Cost ◽  
Middle Income ◽  
Middle Income Countries ◽  
Resource Limited ◽  
Baptist Hospital

Background Acute kidney injury (AKI) is common in low- and middle-income countries, and is associated with a high mortality. The high mortality rate is in large part due to the inability to perform dialysis in resource-limited settings. Due to significant cost advantages, peritoneal dialysis (PD) has been used to treat AKI in these settings. The costs, however, remain high when commercial solutions are used. Methods This is a retrospective cohort study of the outcome, and of the peritonitis rates, of patients with AKI treated with either commercially manufactured PD solutions or locally-made PD solutions. A program to treat AKI with PD was started at Mbingo Baptist Hospital in Cameroon. Between May 2013 and January 2015, solutions and connection sets were provided by the Saving Young Lives Program. From January 2015 through March 2017, solutions were locally produced and available tubing was used. Results Mortality in hospitalized AKI patients was 28% during the period when commercial solutions and tubing were utilized, and 33% when locally produced solutions and available tubing were utilized. In both groups, peritonitis occurred in 16% of treatment courses. Conclusions Locally produced PD solutions, used with locally available tubing, were used to treat AKI with PD. The mortality and peritonitis rates were similar whether locally produced or commercial supplies were used.

scholarly journals Characteristics of a Nationwide Voluntary Antibiotic Resistance Awareness Campaign in India; Future Paths and Pointers for Resource Limited Settings/Low and Middle Income Countries

2019 ◽  
Vol 16 (24) ◽  
pp. 5141
Author(s):  
Ashok J. Tamhankar ◽  
Ramesh Nachimuthu ◽  
Ravikant Singh ◽  
Jyoti Harindran ◽  
Gautam Kumar Meghwanshi ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Antibiotic Use ◽  
World Health ◽  
Awareness Campaign ◽  
Resource Limited Settings ◽  
Middle Income ◽  
Middle Income Countries ◽  
Awareness Campaigns ◽  
Resource Limited ◽  
Low And Middle Income

Antibiotic resistance has reached alarming proportions globally, prompting the World Health Organization to advise nations to take up antibiotic awareness campaigns. Several campaigns have been taken up worldwide, mostly by governments. The government of India asked manufacturers to append a ‘redline’ to packages of antibiotics as identification marks and conducted a campaign to inform the general public about it and appropriate antibiotic use. We investigated whether an antibiotic resistance awareness campaign could be organized voluntarily in India and determined the characteristics of the voluntarily organized campaign by administering a questionnaire to the coordinators, who participated in organizing the voluntary campaign India. The campaign characteristics were: multiple electro–physical pedagogical and participatory techniques were used, 49 physical events were organized in various parts of India that included lectures, posters, booklet/pamphlet distribution, audio and video messages, competitions, and mass contact rallies along with broadcast of messages in 11 local languages using community radio stations (CRS) spread all over India. The median values for campaign events were: expenditure—3000 Indian Rupees/day (US$~47), time for planning—1 day, program spread—4 days, program time—4 h, direct and indirect reach of the message—respectively 250 and 500 persons/event. A 2 min play entitled ‘Take antibiotics as prescribed by the doctor’ was broadcast 10 times/day for 5 days on CRS with listener reach of ~5 million persons. More than 85%ofcoordinators thought that the campaign created adequate awareness about appropriate antibiotic use and antibiotic resistance. The voluntary campaign has implications for resource limited settings/low and middle income countries.

scholarly journals Does early goal directed therapy in sepsis still hold relevance in low and middle-income countries?

2017 ◽  
Vol 4 (1) ◽  
pp. 1-2
Author(s):  
Diptesh Aryal ◽  
Apurb Sharma
Keyword(s):  
Usual Care ◽  
Resource Limited Settings ◽  
Middle Income ◽  
Goal Directed Therapy ◽  
Middle Income Countries ◽  
Early Goal Directed Therapy ◽  
Resource Limited ◽  
Low And Middle Income

The efficacy of early goal directed therapy in improving outcomes has been questioned in few recent studies. But, does that hold true for low and middle income countries like Nepal? This editorial expresses the views of the editors on the usual care of sepsis patients and early goal directed therapy in resource limited settings.

scholarly journals Using Technology to Improve Quality of Cancer Care in Resource-Limited Settings

2019 ◽  
Vol 5 (Supplement_1) ◽  
pp. 12-12 ◽  
Author(s):  
O.A. Silas ◽  
C.J. Achenbach ◽  
L. Hou ◽  
R.L. Murphy
Keyword(s):  
Cancer Research ◽  
Data Management ◽  
Cancer Care ◽  
Improve Quality ◽  
Resource Limited Settings ◽  
Middle Income ◽  
Middle Income Countries ◽  
Resource Limited ◽  
Data Management Software

PURPOSE To highlight the importance of adapting affordable, holistic point-of-care technology (POCT) and data management software to improve quality of cancer care in resource-limited settings. Cancer is the second leading cause of death globally and was responsible for an estimated 9.6 million deaths in 2018, with low- and middle-income countries accounting for as much as 70% of these deaths. METHODS In 2004, the WHO outlined a set of criteria, called the ASSURED guidelines, to promote affordable, sensitive, specific, user-friendly, rapid, robust, equipment-free, and deliverable to end-user POCT. Although advances in POC cancer technology are relatively underexploited, early successes show that the field has significant potential to contribute to improving cancer detection, diagnosis, and treatment in low- and middle-income countries. RESULTS The current global disparity in cancer care can be addressed through mobilization of the research community to improve POCT, funding unique POCT concepts adapted for resource-limited settings, and training of scientists and engineers in designing robust data management software, such as the research electronic data capture for cancer research. CONCLUSION Improving cancer care holistically requires use of POCT with designs adapted to resource-limited settings and leveraging software with robust features for cancer research.

Interventions for smoking cessation with supporting of health staff in low - and middle-income countries: a systematic review and meta-analysis study

2021 ◽  
Vol 30 (9) ◽  
pp. 68-82
Author(s):  
Do Thi Thanh Toan ◽  
Chun Huang- Erick Wan ◽  
Nguyen Thu Anh ◽  
Pham Ngoc Yen ◽  
Luu Ngoc Minh ◽  
...  
Keyword(s):  
Systematic Review ◽  
Smoking Cessation ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Resource Limited Settings ◽  
Middle Income ◽  
Middle Income Countries ◽  
Randomized Controlled ◽  
Resource Limited

The level of smoking cessation support in hospitals are low, especially in resource limited settings. Current healthcare systems are not well organized to address the issue. This review aimed to evaluate the effectiveness of smoking cessation interventions initiated in health facilities in resource-limited settings. A systematic review using meta-analysis techniques was applied. Bibliographic databases included PubMed, Medline, LILACS, the United States Clinical Trials and the Cochrane Collaboration Library. Eligibility criteria included smoking cessation intervention studies were published in English or Vietnamese, from the year 1990 to 2018. Study designs were randomized controlled trials, quasi-randomized controlled trials, cohort studies and before and after studies. Populations were limited to those in low and middle-income countries. Interventions were limited smoking cessation programs conducted in health facilities. 17 studies had included for the reviewing. 12 studies had been assessed to the meta-analysis. The proportion of successful smoking cessation in 6 months follow-up were range from 11.7% to 62.2% for the intervention group. In 12 months, follow-up, the abstinence rate ranges from 13.6% to 73%. The popularly of medical staff support the intervention was the physicians (8/17, 47.1%) and doctor (5/17, 29.4%). The evidence from our study suggests that the abstinence rate can be affected by the supporting of medical staff follow the smoking cessation (SC) program.

Clinical Chemistry for Developing Countries: Mass Spectrometry

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Suji Lee ◽  
Kavyasree Chintalapudi ◽  
Abraham K. Badu-Tawiah
Keyword(s):  
Mass Spectrometry ◽  
Developing Countries ◽  
Developing World ◽  
Early Disease ◽  
Resource Limited Settings ◽  
Middle Income ◽  
Middle Income Countries ◽  
Resource Limited ◽  
Modern Mass ◽  
Low And Middle Income

Early disease diagnosis is necessary to enable timely interventions. Implementation of this vital task in the developing world is challenging owing to limited resources. Diagnostic approaches developed for resource-limited settings have often involved colorimetric tests (based on immunoassays) due to their low cost. Unfortunately, the performance/sensitivity of such simplistic tests are often limited and significantly hinder opportunities for early disease detection. A new criterion for selecting diagnostic tests in low- and middle-income countries is proposed here that is based on performance-to-cost ratio. For example, modern mass spectrometry (MS) now involves analysis of the native sample in the open laboratory environment, enabling applications in many fields, including clinical research, forensic science, environmental analysis, and agriculture. In this critical review, we summarize recent developments in chemistry that enable MS to be applied effectively in developing countries. In particular, we argue that closed automated analytical systems may not offer the analytical flexibility needed in resource-limited settings. Alternative strategies proposed here have potential to be widely accepted in low- and middle-income countries through the utilization of the open-source ambient MS platform that enables microsampling techniques such as dried blood spot to be coupled with miniature mass spectrometers in a centralized analytical platform. Consequently, costs associated with sample handling and maintenance can be reduced by >50% of the total ownership cost, permitting analytical measurements to be operated at high performance-to-cost ratios in the developing world. Expected final online publication date for the Annual Review of Analytical Chemistry, Volume 14 is August 2021. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

scholarly journals Harnessing technology and portability to conduct molecular epidemiology of endemic pathogens in resource-limited settings

2020 ◽  
Author(s):  
Christina L Faust ◽  
Kirstyn Brunker ◽  
Diana Ajambo ◽  
Mary Ryan ◽  
Arinaitwe Moses ◽  
...  
Keyword(s):  
Infectious Diseases ◽  
Molecular Epidemiology ◽  
Field Research ◽  
Transmission Dynamics ◽  
Molecular Field ◽  
Resource Limited Settings ◽  
Middle Income ◽  
Middle Income Countries ◽  
Resource Limited ◽  
Medicine Community

Abstract Improvements in genetic and genomic technology have enabled field-deployable molecular laboratories and these have been deployed in a variety of epidemics that capture headlines. In this editorial, we highlight the importance of building physical and personnel capacity in low and middle income countries to deploy these technologies to improve diagnostics, understand transmission dynamics and provide feedback to endemic communities on actionable timelines. We describe our experiences with molecular field research on schistosomiasis, trypanosomiasis and rabies and urge the wider tropical medicine community to embrace these methods and help build capacity to benefit communities affected by endemic infectious diseases.

scholarly journals Assessing the Burden ofClostridium difficileInfection in Low- and Middle-Income Countries

2018 ◽  
Vol 56 (3) ◽  
Author(s):  
G. A. Roldan ◽  
A. X. Cui ◽  
N. R. Pollock
Keyword(s):  
Clostridium Difficile ◽  
Antibiotic Stewardship ◽  
Morbidity And Mortality ◽  
Resource Limited Settings ◽  
Middle Income ◽  
Content Type ◽  
Middle Income Countries ◽  
Resource Limited ◽  
Hospital Acquired ◽  
Low And Middle Income

ABSTRACTIn contrast to the significant resources invested in the diagnosis and prevention ofClostridium difficileinfection (CDI) in resource-rich settings, in resource-limited settings patients with community- and hospital-acquired diarrhea may not routinely be tested for CDI. Is CDI actually less frequent or severe in resource-limited settings, or might we be missing an important opportunity to prevent CDI-related morbidity and mortality (and to promote antibiotic stewardship) in these settings? Here, we review the literature to assess the overall burden of CDI in low- and middle-income countries.

scholarly journals Utilization Patterns and Projected Demand of Antiretroviral Drugs in Low- and Middle-Income Countries

2011 ◽  
Vol 2011 ◽  
pp. 1-8 ◽  
Author(s):  
Françoise Renaud-Théry ◽  
Carlos Avila-Figueroa ◽  
John Stover ◽  
Sigrid Thierry ◽  
Marco Vitoria ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Treatment Guidelines ◽  
Scale Up ◽  
Antiretroviral Drugs ◽  
Resource Limited Settings ◽  
Middle Income ◽  
Middle Income Countries ◽  
Resource Limited ◽  
Utilization Patterns ◽  
Phase Out

Background. The rapid scale-up of antiretroviral therapy in resource-limited settings has greatly increased demand for antiretroviral medicines and raised the importance of good forward planning, especially in the context of the new 2010 WHO treatment guidelines.Methods. Forecasting of the number of people receiving antiretroviral therapy from 2010 to 2012 was produced using three approaches: linear projection, country-set targets, and a restricted scenario. Two additional scenarios were then used to project the demand for various antiretroviral medicines under a fast and slower phase-out of stavudine.Results. We projected that between 7.1 million and 8.4 million people would be receiving ART by the end of 2012. Of these, 6.6% will be on second-line therapy. High variation in forecast includes reductions in the demand for d4T and d4T increases in the demand for tenofovir, emtricitabine followed by efavirenz, ritonavir, zidovudine and lopinavir; lamivudine, atazanavir, and nevirapine.Conclusion. Despite the global economic crisis and in response to the revised treatment guidelines, our model forecasts an increasing and shifting demand for antiretrovirals in resource-limited settings not only to provide treatment to new patients, but also to those switching to less toxic regimens.

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