scholarly journals Field Evaluation of Xpert HPV Point-of-Care Test for Detection of Human Papillomavirus Infection by Use of Self-Collected Vaginal and Clinician-Collected Cervical Specimens

2016 ◽  
Vol 54 (7) ◽  
pp. 1734-1737 ◽  
Author(s):  
P. Toliman ◽  
S. G. Badman ◽  
J. Gabuzzi ◽  
S. Silim ◽  
L. Forereme ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Low Income ◽  
Point Of Care ◽  
Cervical Screening ◽  
Field Evaluation ◽  
World Health ◽  
Low Income Countries ◽  
High Burden ◽  
Screening Programs ◽  
Hpv Test

The World Health Organization has recommended that testing for high-risk human papillomavirus (HPV) (hrHPV) infection be incorporated into cervical screening programs in all settings worldwide. In many high-burden, low-income countries, it will not be feasible to achieve high cervical screening coverage using hrHPV assays that require clinician-collected samples. We conducted the first evaluation of self-collected vaginal specimens compared with clinician-collected cervical specimens for the detection of hrHPV infection using the Xpert HPV test. Women aged 30 to 54 years attending two well-woman clinics in Papua New Guinea were invited to participate and provided self-collected vaginal and clinician-collected cervical cytobrush specimens. Both specimen types were tested at the point of care by using the Xpert HPV test. Women were given their cervical test result the same day. Those with a positive hrHPV test and positive examination upon visual inspection of the cervix with acetic acid were offered same-day cervical cryotherapy. A total of 1,005 women were enrolled, with 124 (12.3%; 95% confidence interval [CI], 10.3%, 14.4%) being positive for any hrHPV infection. There was a 99.4% overall percent agreement (OPA) between vaginal and cervical tests for HPV-16 (95% CI, 98.9%, 99.9%), a 98.5% OPA for HPV-18/45 (95% CI, 97.7%, 99.3%), a 94.4% OPA for other hrHPV infections (95% CI, 92.9%, 95.9%), and a 93.4% OPA for all hrHPV types combined (95% CI, 91.8%, 95.0%). Self-collected vaginal specimens had excellent agreement with clinician-collected cervical specimens for the detection of hrHPV infection using the Xpert HPV test. This approach provides for the first time an opportunity to incorporate point-of-care hrHPV testing into clinical cervical screening algorithms in high-burden, low-income settings.

scholarly journals Assessment of a new low-cost, PCR-based strategy for high-risk human papillomavirus DNA detection for cervical cancer prevention

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Pedro Surriabre ◽  
Andrea Torrico ◽  
Tania Vargas ◽  
Fuantina Ugarte ◽  
Patricia Rodriguez ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Human Papillomavirus ◽  
High Risk ◽  
Low Income ◽  
Low Cost ◽  
Low Income Countries ◽  
Hybrid Capture ◽  
Hpv Test ◽  
Novel Strategy ◽  
Level Of Agreement

Abstract Background HPV test implementation as a primary screening tool has the potential to decrease cervical cancer incidence as shown by several studies around the world. However, in many low-resource settings, the HPV test introduction has been backed down mainly due to its price. In this study, we present a novel low-cost strategy involving simple devices and techniques for high-risk human papillomavirus (HR-HPV) detection. The analytical performance to detect HR-HPV infections of this novel strategy was assessed by comparing it with the Hybrid Capture 2 system (HC2), which is used as gold standard. Methods Paired-cervical samples were collected from 541 women assisting to gynecological services in an outpatient clinic. One sample was transported in the Hybrid Capture Standard Transport Medium for HR-HPV detection by the HC2. The second sample was transported on glass slide for detection by PCR-based techniques (GP-EIA, BSGP-EIA and pU 1 M-L/2R). Results The level of agreement between the PCR-based techniques and HC2 system was determined with the Cohen’s kappa value. The kappa values between HC2 and GP-EIA, BSGP-EIA and pU 1 M-L/2R were 0.71 (CI 95% 0.63–0.78), 0.78 (CI 95% 0.71–0.84) and 0.63 (CI 95% 0.55–0.72), respectively. However, when the results from both BSGP-EIA and pU 1 M-L/2R were combined, the level of agreement with HC2 was increased to 0.82 (CI 95% 0.76–0.88), reflecting a very good agreement between the two HR-HPV detection strategies. Furthermore, the sensitivity of both techniques combined was also increased compared to the BSGP-EIA (88.7% vs 77.4%) and the pU (88.7 vs 60.9%) without penalizing the specificity obtained with the BSGP-EIA (95.1% vs 96.9%) and the pU (95.1% vs 96.5%). Conclusions This novel strategy, combining two PCR-based techniques for HR-HPV detection, could be useful for cervical cancer screening in self-collected samples in low-income countries.

scholarly journals HPV Testing from Dried Urine Spots as a Tool for Cervical Cancer Screening in Low-Income Countries

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Elena Rosanna Frati ◽  
Marianna Martinelli ◽  
Ester Fasoli ◽  
Daniela Colzani ◽  
Silvia Bianchi ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Low Income ◽  
Urine Samples ◽  
Low Income Countries ◽  
Hpv Testing ◽  
Hpv Dna ◽  
Screening Programs ◽  
Hpv Test ◽  
Fresh Urine ◽  
Sociocultural Barriers

Nowadays, several screening strategies are available to prevent cervical cancer, but inadequate resources, sociocultural barriers, and sampling issues impede their success in low-income countries. To overcome these issues, this study aimed to evaluate the performance of human papillomavirus (HPV) testing from dried urine spots (DUS). Eighty-eight urine samples (including 56 HPV DNA positive specimens) were spotted on filter paper, dried, and stored in paper-bags. HPV DNA was detected from the DUS after 1 week and 4 weeks of storage using a polymerase chain reaction (PCR) assay. The sensitivity, specificity, and concordance of the DUS-based HPV test were evaluated by comparing the results with those of HPV testing on fresh urine samples as the gold standard. The sensitivity of the test was 98.21% (95% CI: 90.56–99.68) for DUS stored for 1 week and 96.42% (95% CI: 87.88–99.01) for DUS stored for 4 weeks. The specificity was 100% (95% CI: 89.28–100) at both time points. The concordance between DUS and fresh urine HPV testing was “almost perfect” using theκstatistic. These preliminary data suggest that a DUS-based assay could bypass sociocultural barriers and sampling issues and therefore could be a suitable, effective tool for epidemiological surveillance and screening programs, especially in low-income countries.

scholarly journals Newborn and Infant Hearing Screening Facing Globally Growing Numbers of People Suffering from Disabling Hearing Loss

2019 ◽  
Vol 5 (1) ◽  
pp. 7 ◽  
Author(s):  
Katrin Neumann ◽  
Shelly Chadha ◽  
George Tavartkiladze ◽  
Xingkuan Bu ◽  
Karl White
Keyword(s):  
Hearing Loss ◽  
Low Income ◽  
Data Transfer ◽  
Hearing Screening ◽  
World Health ◽  
Low Income Countries ◽  
National Committee ◽  
High Quality ◽  
Screening Programs ◽  
The World

Recent prevalence estimates indicate that in 2015 almost half a billion people—about 6.8% of the world’s population—had disabling hearing loss and that prevalence numbers will further increase. The World Health Organization (WHO) currently estimates that at least 34 million children under the age of 15 have disabling hearing loss. Based on a 2012 WHO report, approximately 7.5 million of these children were under the age of 5 years. This review article focuses on the importance of high-quality newborn and infant hearing screening (NIHS) programs as one strategy to ameliorate disabling hearing loss as a global health problem. Two WHO resolutions regarding the prevention of deafness and hearing loss have been adopted urging member states to implement screening programs for early identification of ear diseases and hearing loss in babies and young children. The effectiveness of these programs depends on factors such as governmental mandates and guidance; presence of a national committee with involvement of professionals, industries, and stakeholders; central oversight of hearing screening; clear definition of target parameters; presence of tracking systems with bi-directional data transfer from screening devices to screening centers; accessibility of pediatric audiological services and rehabilitation programs; using telemedicine where connectivity is available; and the opportunity for case discussions in professional excellence circles with boards of experts. There is a lack of such programs in middle- and low-income countries, but even in high-income countries there is potential for improvement. Facing the still growing burden of disabling hearing loss around the world, there is a need to invest in national, high-quality NIHS programs.

scholarly journals Aptamer-Based Diagnostic Systems for the Rapid Screening of TB at the Point-of-Care

Diagnostics ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 1352
Author(s):  
Darius Riziki Martin ◽  
Nicole Remaliah Sibuyi ◽  
Phumuzile Dube ◽  
Adewale Oluwaseun Fadaka ◽  
Ruben Cloete ◽  
...  
Keyword(s):  
Low Income ◽  
Point Of Care ◽  
Health Care Systems ◽  
Cost Effective ◽  
Rapid Screening ◽  
Low Income Countries ◽  
Sputum Smear ◽  
Diagnostic Systems ◽  
Molecular Tests ◽  
Rapid Tests

The transmission of Tuberculosis (TB) is very rapid and the burden it places on health care systems is felt globally. The effective management and prevention of this disease requires that it is detected early. Current TB diagnostic approaches, such as the culture, sputum smear, skin tuberculin, and molecular tests are time-consuming, and some are unaffordable for low-income countries. Rapid tests for disease biomarker detection are mostly based on immunological assays that use antibodies which are costly to produce, have low sensitivity and stability. Aptamers can replace antibodies in these diagnostic tests for the development of new rapid tests that are more cost effective; more stable at high temperatures and therefore have a better shelf life; do not have batch-to-batch variations, and thus more consistently bind to a specific target with similar or higher specificity and selectivity and are therefore more reliable. Advancements in TB research, in particular the application of proteomics to identify TB specific biomarkers, led to the identification of a number of biomarker proteins, that can be used to develop aptamer-based diagnostic assays able to screen individuals at the point-of-care (POC) more efficiently in resource-limited settings.

scholarly journals Tuberculosis and Non-Communicable Disease Multimorbidity: An Analysis of the World Health Survey in 48 Low- and Middle-Income Countries

2021 ◽  
Vol 18 (5) ◽  
pp. 2439
Author(s):  
Brendon Stubbs ◽  
Kamran Siddiqi ◽  
Helen Elsey ◽  
Najma Siddiqi ◽  
Ruimin Ma ◽  
...  
Keyword(s):  
Health Survey ◽  
Low Income ◽  
World Health ◽  
Low Income Countries ◽  
Multivariable Logistic Regression Analysis ◽  
World Health Survey ◽  
Middle Income ◽  
Middle Income Countries ◽  
The World ◽  
Low And Middle Income

Tuberculosis (TB) is a leading cause of mortality in low- and middle-income countries (LMICs). TB multimorbidity [TB and ≥1 non-communicable diseases (NCDs)] is common, but studies are sparse. Cross-sectional, community-based data including adults from 21 low-income countries and 27 middle-income countries were utilized from the World Health Survey. Associations between 9 NCDs and TB were assessed with multivariable logistic regression analysis. Years lived with disability (YLDs) were calculated using disability weights provided by the 2017 Global Burden of Disease Study. Eight out of 9 NCDs (all except visual impairment) were associated with TB (odds ratio (OR) ranging from 1.38–4.0). Prevalence of self-reported TB increased linearly with increasing numbers of NCDs. Compared to those with no NCDs, those who had 1, 2, 3, 4, and ≥5 NCDs had 2.61 (95% confidence interval (CI) = 2.14–3.22), 4.71 (95%CI = 3.67–6.11), 6.96 (95%CI = 4.95–9.87), 10.59 (95%CI = 7.10–15.80), and 19.89 (95%CI = 11.13–35.52) times higher odds for TB. Among those with TB, the most prevalent combinations of NCDs were angina and depression, followed by angina and arthritis. For people with TB, the YLDs were three times higher than in people without multimorbidity or TB, and a third of the YLDs were attributable to NCDs. Urgent research to understand, prevent and manage NCDs in people with TB in LMICs is needed.

scholarly journals Examination of WHO/INRUD Core Drug Use Indicators at Public Primary Healthcare Centers in Kisii County, Kenya

2020 ◽  
Author(s):  
Faith A. Okalebo ◽  
Eric M. Guantai ◽  
Aggrey O. Nyabuti
Keyword(s):  
Drug Use ◽  
Low Income ◽  
Primary Healthcare ◽  
Essential Medicines ◽  
World Health ◽  
Low Income Countries ◽  
Rational Use ◽  
Health Organization ◽  
Consultation Time ◽  
Primary Healthcare Centers

ABSTRACTBackgroundIrrational drug use is a global problem. However, the extent of the problem is higher in low-income countries. This study set out to assess and characterize drug use at the public primary healthcare centers (PPHCCs) in a rural county in Kenya, using the World Health Organization/ International Network for the Rational Use of Drugs (WHO/INRUD) core drug use indicators methodology.MethodsTen PPHCCs were randomly selected. From each PPHCC, ninety prescriptions from October to December 2018 were sampled and data extracted. Three-hundred (30 per PPHCC) patients and ten (1 per PPHCC) dispensers were also observed and interviewed. The WHO/INRUD core drug use indicators were used to assess the patterns of drug use.ResultsThe average number of drugs per prescription was 2.9 (SD 0.5) (recommended: 1.6– 1.8), percentage of drugs prescribed by generic names was 27.7% (recommended: 100%); the percentage of prescriptions with an antibiotic was 84.8% (recommended: 20.0–26.8%), and with an injection prescribed was 24.9% (recommended: 13.4–24.1%). The percentage of prescribed drugs from the Kenya Essential Medicines List was 96.7% (recommended: 100%). The average consultation time was 4.1 min (SD 1.7) (recommended: ≥10 min), the average dispensing time was 131.5 sec (SD 41.5) (recommended: ≥90 sec), the percentage of drugs actually dispensed was 76.3% (recommended: 100%), the percentage of drugs adequately labeled was 22.6% (recommended: 100%) and percentage of patients with correct knowledge of dispensed drugs was 54.7% (recommended: 100%). Only 20% of the PPHCCs had a copy of KEML available, and 80% of the selected essential drugs assessed were available.ConclusionThe survey shows irrational drug use practices, particularly polypharmacy, non-generic prescribing, overuse of antibiotics, short consultation time and inadequacy of drug labeling. Effective programs and activities promoting the rational use of drugs are the key interventions suggested at all the health facilities.

Abstract MP043: Awareness of Hypertension and Determinants of Treatment in a Community-Based Observational Sample in Da Nang, Viet Nam

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Zachary P Boas ◽  
Annette L Fitzpatrick ◽  
Quang V Ngo ◽  
James P Logerfo
Keyword(s):  
Blood Pressure ◽  
Low Income ◽  
World Health ◽  
Viet Nam ◽  
Behavioral Modification ◽  
Community Based ◽  
Major Health Problem ◽  
Screening Programs ◽  
Urban Regions ◽  
Undiagnosed Hypertension

Introduction: Hypertension in Viet Nam is becoming an increasing source of mortality and morbidity. While data collection on hypertension in resource poor environments has been improving through the use of standardized surveys, little is known about how well treatments are being applied. Knowledge of gaps in diagnosis and treatment is necessary if appropriate public health programs are to developed. Using a community based observational sample in the Da Nang province of Viet Nam, we studied both the prevalence of undiagnosed hypertension, as well as the types of treatment those with hypertension received. Methods: Randomized cluster sampling methods were used to identify adults age 35 years and older in six communes of Da Nang province, Viet Nam. Using World Health Organization guidelines, data were collected on subject’s demographics, medical history, blood pressure and health behaviors. Subjects were also instructed to bring all medications they take regularly which were then recorded. Separate multivariate logistic regressions were used to identify both factors associated with awareness of hypertension as well as factors influencing whether one received medical therapy. Results: The initial survey examined 1,621 adults with 557 (34.5%) having hypertension. Of those, only 232 (41.7%) were aware of the diagnosis. Being male (OR 0.52, 95% CI: 0.36–0.75), older (OR 1.03, 95% CI: 1.02–1.05 per year) and having a low income (OR 1.11, 95% CI: 1.05–1.16 per million dong/month) were each independently associated with being unaware of one’s hypertension. Of those who were aware of their hypertension, 212 (91.4%) had been recommended some behavioral modification (exercise, decreased sodium intake, smoking cessation, or weight loss). Two-thirds (152/229) reported having taken antihypertensives in the past two weeks. Reported use of medication differed by region, 109/150 (72.7%) in urban regions versus 43/79 (54.4%) in rural/mixed-urban regions (p<0.05), but was not associated with any other demographic. Eighty-nine (38.9%) of those aware of their hypertension had adequately controlled blood pressure when evaluated, and this did not differ based on reported medication use. We were able to determine the actual medications used in 91 of the 152 (59.9%). Seven people were on dual therapy, the remainder were on monotherapy. Calcium channel blockers (54, 59.3%) and ACE inhibitors (36, 39.6%) were the most common therapies. Conclusions: Undiagnosed hypertension remains a major health problem in the Da Nang province of Viet Nam. The vast majority of those aware of their hypertension were receiving at least some level of behavioral modification with a smaller, but substantial, majority receiving medications. Screening programs focused on young and poor men may be a rich target for improving hypertension control in Viet Nam.

INTERNATIONAL DEVELOPMENT ISSUES

PEDIATRICS ◽  
1982 ◽  
Vol 70 (3) ◽  
pp. 395-395
Author(s):  
Keyword(s):  
International Development ◽  
Low Income ◽  
Development Aid ◽  
Military Expenditure ◽  
World Health ◽  
Low Income Countries ◽  
River Blindness ◽  
Eradication Programme ◽  
Set Up ◽  
Health Organization

The annual military bill is now approaching 450 billion US dollars, while official development aid accounts for less than 5 per cent of this figure. Four examples: 1. The military expenditure of only half a day would suffice to finance the whole malaria eradication programme of the World Health Organization, and less would be needed to conquer river-blindness, which is still the scourge of millions. 2. A modern tank costs about one million dollars; that amount could improve storage facilities for 100,000 tons of rice and thus save 4000 tons or more annually; one person can live on just over a pound of rice a day. The same sum of money could provide 1000 classrooms for 30,000 children. 3. For the price of one jet fighter (20 million dollars) one could set up about 40,000 village pharmacies. 4. One-half of one per cent of one year's world military expenditure would pay for all the farm equipment needed to increase food production and approach self-sufficiency in food-deficit low-income countries by 1990.

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