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Chronic kidney disease (CKD) is an important contributor to mortality from noncommunicable diseases. No decrease has been seen for CKD mortality contrary to many other important non-communicable diseases (e.g., cardiovascular disease). The prevalence of CKD and kidney failure are increasing all over
...
the world – and thereby also the need for dialysis. Unfortunately, the prevalence increases most rapidly in lowand middle-income countries. Globally, there are great inequities in access and quality of management of kidney failure. Many low- and middle-income countries cannot meet the increased need for dialysis. If the patients receive dialysis, it might only be for a limited period due to the out-of-pocket expenses. There are global disparities in CKD mortality reflecting the disparities in access to care. Lack of access to dialysis is an important cause of the increased CKD mortality in low- and middle-income countries.
more
Non-communicable diseases (NCDs) are the second common cause of death in sub-Saharan Africa (SSA) accounting for about 35% of all deaths, after a composite of communicable, maternal, neonatal, and nutritional diseases. Despite prior perception of low
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NCDs mortality rates, current evidence suggests that SSA is now at the dawn of the epidemiological transition with contemporary double burden of disease from NCDs and communicable diseases. In SSA, cardiovascular diseases (CVDs) are the most frequent causes of NCDs deaths, responsible for approximately 13% of all deaths and 37% of all NCDs deaths. Although ischemic heart disease (IHD) has been identified as the leading cause of CVDs mortality in SSA followed by stroke and hypertensive heart disease from statistical models, real field data suggest IHD rates are still relatively low. The neglected endemic CVDs of SSA such as endomyocardial fibrosis and rheumatic heart disease as well as congenital heart diseases remain unconquered. While the underlying aetiology of heart failure among adults in high-income countries (HIC) is IHD, in SSA the leading causes are hypertensive heart disease, cardiomyopathy, rheumatic heart disease, and congenital heart diseases. Of concern is the tendency of CVDs to occur at younger ages in SSA populations, approximately two decades earlier compared to HIC. Obstacles hampering primary and secondary prevention of CVDs in SSA include insufficient health care systems and infrastructure, scarcity of cardiac professionals, skewed budget allocation and disproportionate prioritization away from NCDs, high cost of cardiac treatments and interventions coupled with rarity of health insurance systems. This review gives an overview of the descriptive epidemiology of CVDs in SSA, while contrasting with the HIC and highlighting impediments to their management and making recommendations.
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This Interim Guidance outlines how key public health and social measures needed to reduce the risk of COVID-19 spread and the impact of the disease can be adapted for use in low capacity and humanitarian settings. The recommendations outlined here n
...
eed to be adjusted to the scale of transmission, context and resources, in order to achieve the objective of managing COVID-19, namely to reduce transmission and facilitate the detection and management of infected and exposed individuals within the population. The Guidance is intended for humanitarian and development actors of all operational levels working with communities ocal authorities involved in COVID-19 preparedness and response operations in these settings, in support of national and local governments and plans. Additional considerations for support to residents of urban informal settlements and slums are available in Annex 1.
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Mental Health in the Asia-Pacific Region: An Overview
Alexander Lourdes Samy, Zahra Fazli Khalaf, & Wah-Yun Low
International Journal of Behavioral Science
(2015)
CC
Mental health problem is one of the growing major public health issues in the Asia Pacific region. It contributes to the high number of Disability Adjusted Life Years (DALYs), morbidity and mortality in the region. It is expected that leading mental health problems will occur in the
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low-and middle-income countries (LMICs) and majority of the countries which comes under this category are in the Asia Pacific region. In addition, mental health problem hamper the achievement of Millennium Development Goals (MDGs), particularly MDG 1, MDG 4 and MDG 5. The most common mental health problems in the region are depression, anxiety, posttraumatic stress disorder, suicidal behaviour and substance abuse disorder. Several modifiable and non-modifiable risk factors were identified for the cause of these major mental health issues. Interventions, programmes and policies need to be designed in order to curb mental health problems at all levels.
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Access to Services and Barriers faced by People with Disabilities: A Quantitative Survey
Nathan Grills, Lawrence Singh, Hira Pant, Jubin Varghese, GVS Murthy, Monsurul Hoq, Manjula Marella
Disability, CBR & Inclusive Development Journal (DCIDJ)
(2017)
CC
In low- and middle-income middle-income countries, reliable and disaggregated disability data on prevalence, participation and barriers are often u
...
navailable. This study aimed to estimate disability prevalence, determine associated socio-demographic factors and compare access in the community between people with and without disability in Dehradun district of Uttarakhand, India, using the Rapid Assessment of Disability survey.
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Low- and middle-income countries (LMICs) experience a high disease burden for epilepsy, a chronic neurological condition.The authors evaluate the cost-effectiveness of community health workers (CHWs
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) to improve adherence to medication for epilepsy in South Africa. They found that utilizing CHWs to improve medication adherence was cost-effective.
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Background
Low- and middle-income countries now experience the highest prevalence and mortality rates of cardiovascular disease.
Main text
While improving the availability and delivery of prove
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n, effective therapies will no doubt mitigate this burden, we posit that studies evaluating cardiovascular disease risk factors, management strategies and service delivery, in diverse settings and diverse populations, are equally critical to improving outcomes in low- and middle-income countries. Focusing on examples drawn from four cardiovascular diseases — coronary artery disease, stroke, diabetes and kidney disease — we argue that ethnicity, culture and context matter in determining the risk factors for disease as well as the comparative effectiveness of medications and other interventions, particularly diet and lifestyle interventions.
Conclusion
We believe that a host of cohort studies and randomized control trials currently being conducted or planned in low- and middle-income countries, focusing on previously understudied race/ethnic groups, have the potential to increase knowledge about the cause(s) and management of cardiovascular diseases across the world.
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The Economic Costs of Exclusion and Gains of Inclusion of People with Disabilities
Lena Morgon Banks and Sarah Polack
International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine
(2015)
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Evidence from Low and Middle Income Countries
Robust clinical research capacity in low- and middle-income countries is key to stemming the spread of epidemics, according to a new report from the International Vaccines Task Force (IVTF). The rep
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ort lays out how to develop the political support, financing and coordination required to build this capacity as a crucial component of global epidemic preparedness. The IVTF was convened by the World Bank Group (WBG) and the Coalition for Epidemic Preparedness Innovations (CEPI) in October 2017.
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People with mental disorders in low-income countries are at risk of being left behind during efforts to expand universal health coverage. Aim is to propose context-relevant strategies for moving tow
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ards universal health coverage for people with mental disorders in Ethiopia.
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Donor financing to low- and middle-income countries for reproductive, maternal, newborn, and child health increased substantially from 2008 to 2013. However, increased spending by donors might not i
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mprove outcomes, if funds are delivered in ways that undermine countries’ public financial management systems and incur high transaction costs for project implementation
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Research Methods for Promotion of Lung Health
D. A. Enarson, S. M. Kennedy, D. L. Miller, et al.
International Union Against Tuberculosis and Lung Disease
(2001)
A guide to protocol development for low-income countries
It is of utmost importance to low-income countries and some lower-middle income nations in the time of the SDG period that they are not on course t
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o accomplish the health-related SDG 3 and its targets until 2030. If we honestly intend to support this goal and realize it for the people living in the regions that are facing the lowest survival chances, we also need to recognize that these countries are far from being in a position to raise the necessary resources solely with their own means.
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Overcoming barriers in low- and middle-income countries
For the first time, this year’s report includes information on hepatitis C diagnostics. With a focus on selected countries with diverse HCV
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epidemics, the report provides updates on the various dimensions of access to HCV diagnostics and pharmaceutical products, including product pricing, the regulatory environment and patent status, which together shape the national hepatitis response in different settings. It highlights key areas for action by ministries of health and other government decision-makers, pharmaceutical manufacturers and technical partners.
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The Republic of the Union of Myanmar is at a historic moment, with a new civilian government assuming power in 2016. The country graduated to lower-middle-income status in 2015, and has made significant progress in reducing poverty, improving food s
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ecurity and addressing malnutrition.
The remaining challenges to food and nutrition security and achievement of Sustainable Development Goal 2 targets include continued population displacements resulting from conflict, vulnerability to extreme weather events, poverty, limited social protection coverage, high malnutrition and persistent gender inequalities. more
The remaining challenges to food and nutrition security and achievement of Sustainable Development Goal 2 targets include continued population displacements resulting from conflict, vulnerability to extreme weather events, poverty, limited social protection coverage, high malnutrition and persistent gender inequalities. more
Injection practices worldwide and especially in low- and middle-income countries (LMICs) include multiple, avoidable unsafe practices that ultimately lead to the large-scale transmission of bloodbor
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ne viruses among patients, health care providers and the community at large.
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Globally, in low-income countries, the average newborn mortality rate is 27 deaths per 1,000 births, the report says. In high-income countries, tha
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t rate is 3 deaths per 1,000. Newborns from the riskiest places to give birth are up to 50 times more likely to die than those from the safest places.
The report also notes that 8 of the 10 most dangerous places to be born are in sub-Saharan Africa, where pregnant women are much less likely to receive assistance during delivery due to poverty, conflict and weak institutions. If every country brought its newborn mortality rate down to the high-income average by 2030, 16 million lives could be saved.
More than 80 per cent of newborn deaths are due to prematurity, complications during birth or infections such as pneumonia and sepsis, the report says. These deaths can be prevented with access to well-trained midwives, along with proven solutions like clean water, disinfectants, breastfeeding within the first hour, skin-to-skin contact and good nutrition. more
The report also notes that 8 of the 10 most dangerous places to be born are in sub-Saharan Africa, where pregnant women are much less likely to receive assistance during delivery due to poverty, conflict and weak institutions. If every country brought its newborn mortality rate down to the high-income average by 2030, 16 million lives could be saved.
More than 80 per cent of newborn deaths are due to prematurity, complications during birth or infections such as pneumonia and sepsis, the report says. These deaths can be prevented with access to well-trained midwives, along with proven solutions like clean water, disinfectants, breastfeeding within the first hour, skin-to-skin contact and good nutrition. more
Most of the global burden of sepsis occurs in low- and middle-income countries (LMICs), but the prevalence and etiology of sepsis in LMICs are not well understood. In particular, the lack of laborat
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ory infrastructure in many LMICs has historically precluded an assessment of the pathogens leading to sepsis. A recent systematic review found that data describing antimicrobial resistance were absent for 43% of countries in Africa, and only two countries have national antimicrobial resistance plans. In addition, small studies have identified indiscriminate antibiotic use both in and out of hospital settings in sub-Saharan Africa. The absence of microbiological data and lack of antibiotic stewardship complicate sepsis management and almost certainly worsens outcomes, particularly in low-resource systems. The purpose of this study was to examine the prevalence, etiology, and outcomes of sepsis among a cohort of critically ill patients in a referral hospital of Malawi, with a focus on the prevalence of culture-confirmed bacteremia and urinary tract infections.
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Tuberculosis (TB) is the deadliest infectious disease in most low- and middle-income countries, claiming more than 4,000 lives each day. The unprecedented COVID-19 pandemic has seriously impacted pe
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ople with pre-existing health conditions. People with TB are usually more vulnerable to other infections, including the novel coronavirus, due to pre-existing lung damage. They are also at higher risk of developing complications from COVID-19.
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Best Practice for the Care of Patients with Tuberculosis: a Guide for Low-Income CountriesThe practical aspects of TB patient care from the onset of symptoms to the completion of treatment are cover
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ed in this guide.
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