scholarly journals Gender-Related Barriers and Delays in Accessing Tuberculosis Diagnostic and Treatment Services: A Systematic Review of Qualitative Studies

2014 ◽  
Vol 2014 ◽  
pp. 1-14 ◽  
Author(s):  
Lakshmi Krishnan ◽  
Tokunbo Akande ◽  
Anita V. Shankar ◽  
Katherine N. McIntire ◽  
Celine R. Gounder ◽  
...  
Keyword(s):  
Developing Countries ◽  
Physical Dependence ◽  
Public Health Problem ◽  
Qualitative Studies ◽  
System Level ◽  
Service Access ◽  
Global Public Health ◽  
Coding System ◽  
Treatment Services ◽  
Variable Nature

Background. Tuberculosis (TB) remains a significant global public health problem with known gender-related (male versus female) disparities. We reviewed the qualitative evidence (written/spoken narrative) for gender-related differences limiting TB service access from symptom onset to treatment initiation.Methods. Following a systematic process, we searched 12 electronic databases, included qualitative studies that assessed gender differences in accessing TB diagnostic and treatment services, abstracted data, and assessed study validity. Using a modified “inductive coding” system, we synthesized emergent themes within defined barriers and delays limiting access at the individual and provider/system levels and examined gender-related differences.Results. Among 13,448 studies, 28 studies were included. All were conducted in developing countries and assessed individual-level barriers; 11 (39%) assessed provider/system-level barriers, 18 (64%) surveyed persons with suspected or diagnosed TB, and 7 (25%) exclusively surveyed randomly sampled community members or health care workers. Each barrier affected both genders but had gender-variable nature and impact reflecting sociodemographic themes. Women experienced financial and physical dependence, lower general literacy, and household stigma, whereas men faced work-related financial and physical barriers and community-based stigma.Conclusions. In developing countries, barriers limiting access to TB care have context-specific gender-related differences that can inform integrated interventions to optimize TB services.

scholarly journals Barriers and Delays in Tuberculosis Diagnosis and Treatment Services: Does Gender Matter?

2014 ◽  
Vol 2014 ◽  
pp. 1-15 ◽  
Author(s):  
Wei-Teng Yang ◽  
Celine R. Gounder ◽  
Tokunbo Akande ◽  
Jan-Walter De Neve ◽  
Katherine N. McIntire ◽  
...  
Keyword(s):  
Gender Differences ◽  
Public Health Problem ◽  
System Level ◽  
Global Public Health ◽  
Community Members ◽  
Quantitative Evidence ◽  
Individual Level ◽  
Treatment Services ◽  
Quantitative Studies ◽  
The Individual

Background. Tuberculosis (TB) remains a global public health problem with known gender-related disparities. We reviewed the quantitative evidence for gender-related differences in accessing TB services from symptom onset to treatment initiation.Methods. Following a systematic review process, we: searched 12 electronic databases; included quantitative studies assessing gender differences in accessing TB diagnostic and treatment services; abstracted data; and assessed study validity. We defined barriers and delays at the individual and provider/system levels using a conceptual framework of the TB care continuum and examined gender-related differences.Results. Among 13,448 articles, 137 were included: many assessed individual-level barriers (52%) and delays (42%), 76% surveyed persons presenting for care with diagnosed or suspected TB, 24% surveyed community members, and two-thirds were from African and Asian regions. Many studies reported no gender differences. Among studies reporting disparities, women faced greater barriers (financial: 64% versus 36%; physical: 100% versus 0%; stigma: 85% versus 15%; health literacy: 67% versus 33%; and provider-/system-level: 100% versus 0%) and longer delays (presentation to diagnosis: 45% versus 0%) than men.Conclusions. Many studies found no quantitative gender-related differences in barriers and delays limiting access to TB services. When differences were identified, women experienced greater barriers and longer delays than men.

Suicide in Developing Countries (1)

Crisis ◽  
2005 ◽  
Vol 26 (3) ◽  
pp. 104-111 ◽  
Author(s):  
Lakshmi Vijayakumar ◽  
K. Nagaraj ◽  
Jane Pirkis ◽  
Harvey Whiteford
Keyword(s):  
Developing Countries ◽  
Public Health Problem ◽  
Data Availability ◽  
World Health ◽  
Global Public Health ◽  
Socioeconomic Indicators ◽  
Suicide Rates ◽  
Country Level ◽  
Education Levels ◽  
Health Organization

Abstract. Objective. Suicide is a global public health problem, but relatively little epidemiological investigation of the phenomenon has occurred in developing countries. This paper aims to (1) examine the availability of rate data in developing countries, (2) provide a description of the frequency and distribution of suicide in those countries for which data are available, and (3) explore the relationship between country-level socioeconomic factors and suicide rates. It is accompanied by two companion papers that consider risk factors and preventive efforts associated with suicide in developing countries, respectively. Method. Using World Health Organization data, we calculated the average annual male, female, and total suicide rates during the 1990s for individual countries and regions (classified according to the Human Development Index [HDI]), and examined the association between a range of socioeconomic indicators and suicide rates. Results. For reasons of data availability, we concentrated on medium HDI countries. Suicide rates in these countries were variable. They were generally comparable with those in high HDI countries from the same region, with some exceptions. High education levels, high telephone density, and high per capita levels of cigarette consumption were associated with high suicide rates; high levels of inequality were associated with low suicide rates. Conclusion. Epidemiological investigations of this kind have the potential to inform suicide prevention efforts in developing countries, and should be encouraged.

scholarly journals A practical approach for the compassionate use of convalescent plasma in patients with severe COVID-19 in developing countries

2020 ◽  
Vol 14 (07) ◽  
pp. 737-741
Author(s):  
Brenner Elías Sabando Vélez ◽  
Carlos Plaza Meneses ◽  
Miguel Felix ◽  
Emanuel Vanegas ◽  
Valeria L Mata ◽  
...  
Keyword(s):  
Developing Countries ◽  
Neutralizing Antibodies ◽  
Severe Disease ◽  
Case Series ◽  
Public Health Problem ◽  
Practical Approach ◽  
Current Evidence ◽  
Global Public Health ◽  
Compassionate Use

The COVID-19 pandemic has affected 187 countries, representing a global public health problem. The increasing number of critically ill patients and deaths have fueled a desperate search for treatments that can halt the course of the disease. Currently, there are several experimental therapies with demonstrated in vitro activity against COVID-19 used in clinical practice, including hydroxychloroquine, remdesivir, interleukin-6 pathway inhibitors, and convalescent plasma; however, to date no agent has proven efficacy against COVID-19. In the case of convalescent plasma, this therapy consists in obtaining neutralizing antibodies from previously infected individuals by plasmapheresis and administering them to patients with severe disease. Recently, the use of convalescent plasma has shown promising results in preliminary studies, with case series reporting a decrease in temperature, and viral load, as well as improvement in clinical parameters among patients receiving this treatment. However, there are still unmet needs regarding the safety profile, tolerability, dosage, and timing this therapy should be given. Based on this, the objective of our study was to develop and propose a practical approach for the compassionate use of convalescent plasma for the treatment of patients with severe COVID-19, given the constrains and limitations of developing countries. We encourage health professionals in developing countries to use the current evidence and approaches to experimental treatments for patients with COVID-19, adapting them to their conditions, and always based on a thorough risk-benefit evaluation for each patient, and whenever possible to design and promote the much needed research in this field.

Modulation of the drug resistance by Platonia insignis Mart. extract, ethyl acetate fraction and Morelloflavone/Volkensiflavone (biflavonoids) in Staphylococcus aureus strains overexpressing efflux pump genes

2020 ◽  
Vol 21 ◽  
Author(s):  
Andressa Kelly Ferreira e Silva ◽  
Antonielly Campinho dos Reis ◽  
Emanuelly Elanny Andrade Pinheiroc ◽  
Jonas Nascimento de Sousa ◽  
Felipe Araújo de Alcântara Oliveira ◽  
...  
Keyword(s):  
Natural Products ◽  
Ethyl Acetate ◽  
Native Species ◽  
Efflux Pump ◽  
Public Health Problem ◽  
Ethyl Acetate Fraction ◽  
Multidrug Resistant ◽  
Global Public Health ◽  
Minimal Inhibitory Concentrations ◽  
Subinhibitory Concentrations

Background: Microbial resistance to antibiotics is a global public health problem, which requires urgent attention. Platonia insignis is a native species from the eastern Brazilian Amazon, used in the treatment of burns and wounds. Objectives: To evaluate the antimicrobial activity of the hydroalcoholic extract of P. insignis (PIHA), the ethyl acetate fraction (PIAE), and its subfraction containing a mixture of biflavonoids (BF). Moreover, the effect of these natural products on the antibiotic activity against S. aureus strains overexpressing efflux pump genes was also evaluated. Methods: Minimal inhibitory concentrations were determined against different species of microorganisms. To evaluate the modulatory effect on the Norfloxacin-resistance, the MIC of this antibiotic was determined in the absence and presence of the natural products at subinhibitory concentrations. Inhibition of the EtBr efflux assays were conducted in the absence or presence of the natural products. Results: PIHA showed a microbicidal effect against S. aureus and C. albicans, while PIAE was bacteriosctatic for S. aureus. PIAE and BF at subinhibitory concentrations were able to reduce the MIC of Norfloxacin acting as modulating agents. BF was able to inhibit the efflux of EtBr efflux in S. aureus strains overexpressing specific efflux pump genes. Conclusion: P. inignisis a source of efflux pump inhibitors, including volkensiflavone and morelloflavone which were able to potentiate the Norfloxacin activity by NorA inhibition, being also able to inhibit QacA/B, TetK and MsrA. Volkensiflavone and morelloflavone could be used as adjuvant in the antibiotic therapy of multidrug resistant S. aureus strains overexpressing efflux pumps.

4H-1,3-Benzothiazin-4-one a Promising Class Against MDR/XDR-TB

2019 ◽  
Vol 19 (8) ◽  
pp. 567-578 ◽  
Author(s):  
Marcus Vinicius Nora de Souza ◽  
Thais Cristina Mendonça Nogueira
Keyword(s):  
Treatment Time ◽  
Public Health Problem ◽  
New Drugs ◽  
Global Public Health ◽  
Synthesis Mechanism ◽  
Highly Active ◽  
Latent Disease ◽  
Resistant Strains ◽  
Chemical Class ◽  
Global Public Health Problem

Nowadays, tuberculosis (TB) is an important global public health problem, being responsible for millions of TB-related deaths worldwide. Due to the increased number of cases and resistance of Mycobacterium tuberculosis to all drugs used for the treatment of this disease, we desperately need new drugs and strategies that could reduce treatment time with fewer side effects, reduced cost and highly active drugs against resistant strains and latent disease. Considering that, 4H-1,3-benzothiazin-4-one is a promising class of antimycobacterial agents in special against TB-resistant strains being the aim of this review the discussion of different aspects of this chemical class such as synthesis, mechanism of action, medicinal chemistry and combination with other drugs.

Application of Inherent Risk of Contagion (IRC) framework & modelling to aid local Covid-19 response & mitigation: Viewpoint (Preprint)

2020 ◽  
Author(s):  
Helmi Zakariah ◽  
Fadzilah bt Kamaluddin ◽  
Choo-Yee Ting ◽  
Hui-Jia Yee ◽  
Shereen Allaham ◽  
...  
Keyword(s):  
Public Health ◽  
Public Health Problem ◽  
Analytical Framework ◽  
Vulnerable Population ◽  
Contact Tracing ◽  
Global Public Health ◽  
Inherent Risk ◽  
Transmission Area ◽  
Current Outbreak ◽  
Novel Coronavirus

UNSTRUCTURED The current outbreak of coronavirus disease 2019 (COVID-19) caused by the novel coronavirus named SARS-CoV-2 has been a major global public health problem threatening many countries and territories. Mathematical modelling is one of the non-pharmaceutical public health measures that plays a crucial role for mitigating the risk and impact of the pandemic. A group of researchers and epidemiologists have developed a machine learning-powered inherent risk of contagion (IRC) analytical framework to georeference the COVID-19 with an operational platform to plan response & execute mitigation activities. This framework dataset provides a coherent picture to track and predict the COVID-19 epidemic post lockdown by piecing together preliminary data on publicly available health statistic metrics alongside the area of reported cases, drivers, vulnerable population, and number of premises that are suspected to become a transmission area between drivers and vulnerable population. The main aim of this new analytical framework is to measure the IRC and provide georeferenced data to protect the health system, aid contact tracing, and prioritise the vulnerable.

Perceived Experiences of Community Violence Among Adolescents: A School Survey From Rio de Janeiro, Brazil

2021 ◽  
pp. 088626052110051
Author(s):  
Claudia L. de Moraes ◽  
Érika B. dos Santos ◽  
Michael E. Reichenheim ◽  
Stella R. Taquette ◽  
Luciane Stochero ◽  
...  
Keyword(s):  
Public Schools ◽  
Community Violence ◽  
Rio De Janeiro ◽  
Public Health Problem ◽  
Cross Sectional Study ◽  
Global Public Health ◽  
Cross Sectional ◽  
Interpersonal Aggression ◽  
Adolescent Students ◽  
Management Actions

Community violence (CV) is a global public health problem due to its high frequency and severe consequences. Although CV is one of the leading causes of death among adolescents, little is known about the everyday CV situations that do not lead to death. This study aimed to estimate the frequency of exposure to and involvement in CV situations among adolescent students from public and private schools in the city of Rio de Janeiro, Brazil. This was a cross-sectional study of 693 individuals in their second year of high school selected through stratified multistage random sampling. Information about their exposure to and involvement in CV was collected through a self-completed multidimensional questionnaire in the classrooms. For approximately 30% of the adolescents, someone close to them had been murdered, and 40% had already seen the corpse of a victim of homicide. Seventeen percent reported having been directly involved in CV situations. Approximately 38%, 13%, and 25% had been victims of robberies, interpersonal aggression, and death threats to either themselves or their relatives, respectively. Many of these situations occurred more than once. In general, CV was more frequently reported by boys and by those who did not live with both parents. Adolescents from higher economic classes experienced more interpersonal aggression and felt a greater need to carry a gun. Those who belonged to the lower economic classes and studied in public schools were more exposed to lethal violence than other students. The results call attention to the very high percentage of adolescent students that are involved in CV situations as well as to the differences in violence rates among population subgroups. Such findings should be considered when planning CV prevention and management actions in schools and other socialization spaces for adolescents.

scholarly journals Associations between gestational diabetes mellitus and the neurodevelopment of offspring from 1 month to 72 months: study protocol for a cohort study

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e040305
Author(s):  
Chao Li ◽  
Ping Zhou ◽  
Yixi Cai ◽  
Bin Peng ◽  
Yongfang Liu ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Cohort Study ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Public Health Problem ◽  
Multiple Linear Regression Model ◽  
Preschool Age ◽  
Control Group ◽  
Global Public Health ◽  
Open Access Journals

IntroductionGestational diabetes mellitus (GDM) is a common gestational disease and an important global public health problem. GDM may affect the short-term and long-term health of offspring, but the associations between GDM and the neurodevelopment of offspring of mothers with GDM (OGDM) are still unclear, and studies based on the Chinese population are lacking. We aim to determine the associations between GDM and the neurodevelopment of OGDM by studying a cohort of OGDM and offspring of non-GDM mothers.Methods and analysisThe single-centre prospective cohort study is being conducted in China over 7 years. A total of 490 OGDM (GDM group) and 490 fromof healthy mothers (control group) will be enrolled during the same period. Baseline characteristics, neuropsychological development scores and clinical data at specific time points (at 0, 1, 3, 6, 12, 24, 36, 48, 60 and 72 months old) will be collected from the children in both groups until the age of 6 years. The associations between GDM and the neurodevelopment of OGDM from infancy to preschool age will be analysed using a multiple linear regression model adjusted for confounders. In addition, we will compare longitudinal data to further assess the effects of GDM on neurodevelopmental trajectories.Ethics and disseminationThe study has been approved by the Ethics Committee of the Children’s Hospital of Chongqing Medical University (Approval Number: (2019) Institutional Review Board (IRB) (STUDY) No. 85). The findings of this study will be disseminated through open access journals, peer-reviewed journals and scientific meetings.Trial registration numberNCT03997396.

scholarly journals A Systematic Review and Meta-Analysis of Pharmacogenetic Studies in Patients with Chronic Kidney Disease

2021 ◽  
Vol 22 (9) ◽  
pp. 4480
Author(s):  
Maria Tziastoudi ◽  
Georgios Pissas ◽  
Georgios Raptis ◽  
Christos Cholevas ◽  
Theodoros Eleftheriadis ◽  
...  
Keyword(s):  
Systematic Review ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Meta Analysis ◽  
Public Health Problem ◽  
Response To Treatment ◽  
Genotype Distribution ◽  
Global Public Health ◽  
High Prevalence ◽  
Additive Inheritance

Chronic kidney disease (CKD) is an important global public health problem due to its high prevalence and morbidity. Although the treatment of nephrology patients has changed considerably, ineffectiveness and side effects of medications represent a major issue. In an effort to elucidate the contribution of genetic variants located in several genes in the response to treatment of patients with CKD, we performed a systematic review and meta-analysis of all available pharmacogenetics studies. The association between genotype distribution and response to medication was examined using the dominant, recessive, and additive inheritance models. Subgroup analysis based on ethnicity was also performed. In total, 29 studies were included in the meta-analysis, which examined the association of 11 genes (16 polymorphisms) with the response to treatment regarding CKD. Among the 29 studies, 18 studies included patients with renal transplantation, 8 involved patients with nephrotic syndrome, and 3 studies included patients with lupus nephritis. The present meta-analysis provides strong evidence for the contribution of variants harbored in the ABCB1, IL-10, ITPA, MIF, and TNF genes that creates some genetic predisposition that reduces effectiveness or is associated with adverse events of medications used in CKD.

scholarly journals Prevalence and Associated Factors of Anemia among Muslim Students, Nakhon Si Thammarat, Thailand: A Cross-Sectional Study

2021 ◽  
Vol 58 ◽  
pp. 004695802110134
Author(s):  
Chutima Rattanawan ◽  
Suraiya Cheloh ◽  
Asma Maimahad ◽  
Malatee Tayeh
Keyword(s):  
Public Health ◽  
Associated Factors ◽  
Public Health Problem ◽  
Economic Factor ◽  
Cross Sectional Study ◽  
School Age ◽  
Global Public Health ◽  
Related Factors ◽  
Cross Sectional ◽  
Prevalence Of Anemia

Anemia is a global public health problem. The prevalence of anemia among different ages, genders or ethnic groups must be clarified in order to solve problems. This study proposed to determine the prevalence and factors related to anemia among the Muslim school-age population in Nakhon Si Thammarat, Thailand. Socio-demographic and anthropometric data were collected by a structured questionnaire. Blood samples were collected from 200 school-age subjects. The thalassemia screening was performed with KKU-OF and KKU-DCIP reagents. The prevalence of anemia in this study was 36.5%, divided into males and females, 33.3% and 39.1%, respectively. The means of Hb, Hct, MCV, MCH, and MCHC in the anemic group were significantly lower. The positive results for KKU-OF or KKU-DCIP or both were 15.0%, 2.5%, and 1.0%, respectively. The result of positive OF test was a significantly independent factor for anemia. The number of family members was 5 to 7 and more than 7 persons are related factors for anemia in this study. In summary, the contribution of thalassemia and socio-economic factor are associated factors to anemia in this population. These findings should be addressed in public health strategies for the control of anemia of school-aged Muslims in the region.

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