Acceptance of a Smartphone-based Visual Field Screening Platform for Glaucoma: Pre-Post Study (Preprint)

2020 ◽  
Author(s):  
Esmael Kedir Nida ◽  
Sisay Bekele ◽  
Luc Geurts ◽  
Vero Vanden Abeele
Keyword(s):  
Visual Field ◽  
Low Income ◽  
Rural Areas ◽  
Low Cost ◽  
Screening Tests ◽  
Low Income Countries ◽  
Structured Interviews ◽  
Field Screening ◽  
Glaucoma Screening ◽  
Screening Platform

BACKGROUND Glaucoma, the “silent thief of sight”, is a major cause of blindness worldwide. It is a burden for people in low-income countries specifically, where it accounts for 15% of the total blindness. More than half of the people living with glaucoma in low-income countries, are unaware of their disease until it progresses to an advanced stage, resulting in permanent visual impairment. OBJECTIVE To evaluate the acceptability of the Glaucoma Easy Screener (GES), a low-cost and portable visual field screening platform comprising of a smartphone, a stereoscopic VR headset and a gaming joystick. METHODS A mixed-method study was conducted to evaluate the acceptability of GES, including 24 eye care professionals from four hospitals in Southwest Ethiopia. A pre-post design was employed to collect perspectives before and after using GES, using questionnaires and semi-structured interviews. The questionnaire and interview questions were guided by the Unified Theory of Acceptance and Use of Technology (UTAUT). RESULTS Positive results were obtained both pre-use and post-use, suggesting acceptance of mHealth solutions for glaucoma screening, using a low-cost headset through a smartphone and a game controller. Ophthalmic professionals perceived GES as easy-to-use, enabling the screening of glaucoma screening tests, especially during outreach to rural areas. However, positive evaluations are contingent on adequate accuracy of the tool. Moroever, ophtalmic professionals voiced the need to limit the tool to screening only, and not for diagnosis. CONCLUSIONS The study supports the feasibility of using a mobile device in combination with a low-cost VR headset and classic controller for glaucoma screening in rural areas. GES has the potential to reduce the burden of irreversible blindness due to glaucoma. Yet, a further assessment of its sensitivity and specificity is needed.

scholarly journals Assessment of cardiovascular risk among adults in a rural area of Kancheepuram district, Tamil Nadu

2018 ◽  
Vol 5 (2) ◽  
pp. 698
Author(s):  
Velavan A. ◽  
Jyothi Vasudevan ◽  
Arun S. ◽  
Anil J. Purty ◽  
Vincent A.
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Diseases ◽  
Low Income ◽  
Rural Areas ◽  
Tamil Nadu ◽  
Low Cost ◽  
Low Income Countries ◽  
Cross Sectional ◽  
Cooking Oils

Background: Increasing longevity of the world’s population has resulted in a shift in the disease patterns prevalent hitherto. The worst affected are the middle and low- income countries including India. The genetic make-up of Indians render them highly susceptible to cardiovascular diseases and diabetes at a much earlier age with resultant higher mortality rates. Thus, low- cost early detection, and innovative, customized preventive strategies are the need of the hour. Methods: In this cross- sectional study, we have used the WHO/ISH risk prediction charts tailor – made for the SEAR D region, to assess the cardiovascular risk of a rural population aged above 40 years. Data regarding multiple cardiovascular risk factors were collected using a pre- defined and pre-tested questionnaire, from 400 participants, including other variables like BP and anthropometric measurements. The data were entered in Microsoft excel and analysed using SPSS- ver16. Results: We found that 14.5% of the population had more than 10% risk of cardiovascular diseases and 41.5% were in stage I or II hypertension. People who belonged to the class II SES, use of oral tobacco, saturated cooking oils and sedentary lifestyle was found to be associated with high CV risk. However the association of CV risk with other risk factors like smoking and BMI was inconsistent. Conclusions: There is an increasing trend of cardiovascular risk in rural areas of Tamil Nadu and risk factors like higher socio economic class, use of oral tobacco, saturated cooking oils and sedentary occupation were found to be associated with high CV risk.

scholarly journals Manual Borehole Drilling as a Cost-Effective Solution for Drinking Water Access in Low-Income Contexts

Water ◽  
2020 ◽  
Vol 12 (7) ◽  
pp. 1981
Author(s):  
Pedro Martínez-Santos ◽  
Miguel Martín-Loeches ◽  
Silvia Díaz-Alcaide ◽  
Kerstin Danert
Keyword(s):  
Drinking Water ◽  
Low Income ◽  
Rural Areas ◽  
Low Cost ◽  
Cost Effective ◽  
Unconsolidated Sediments ◽  
Low Income Countries ◽  
Water Access ◽  
Middle Income ◽  
Advantages And Disadvantages

Water access remains a challenge in rural areas of low-income countries. Manual drilling technologies have the potential to enhance water access by providing a low cost drinking water alternative for communities in low and middle income countries. This paper provides an overview of the main successes and challenges experienced by manual boreholes in the last two decades. A review of the existing methods is provided, discussing their advantages and disadvantages and comparing their potential against alternatives such as excavated wells and mechanized boreholes. Manual boreholes are found to be a competitive solution in relatively soft rocks, such as unconsolidated sediments and weathered materials, as well as and in hydrogeological settings characterized by moderately shallow water tables. Ensuring professional workmanship, the development of regulatory frameworks, protection against groundwater pollution and standards for quality assurance rank among the main challenges for the future.

scholarly journals Evaluation of a Low-Cost Commercial Actigraph and Its Potential Use in Detecting Cultural Variations in Physical Activity and Sleep

Sensors ◽  
2021 ◽  
Vol 21 (11) ◽  
pp. 3774
Author(s):  
Pavlos Topalidis ◽  
Cristina Florea ◽  
Esther-Sevil Eigl ◽  
Anton Kurapov ◽  
Carlos Alberto Beltran Leon ◽  
...  
Keyword(s):  
Physical Activity ◽  
Low Income ◽  
Large Scale ◽  
Low Cost ◽  
Low Income Countries ◽  
Time Data ◽  
Cultural Variations ◽  
Step Counts ◽  
Scale Step ◽  
Potential Use

The purpose of the present study was to evaluate the performance of a low-cost commercial smartwatch, the Xiaomi Mi Band (MB), in extracting physical activity and sleep-related measures and show its potential use in addressing questions that require large-scale real-time data and/or intercultural data including low-income countries. We evaluated physical activity and sleep-related measures and discussed the potential application of such devices for large-scale step and sleep data acquisition. To that end, we conducted two separate studies. In Study 1, we evaluated the performance of MB by comparing it to the GT3X (ActiGraph, wGT3X-BT), a scientific actigraph used in research, as well as subjective sleep reports. In Study 2, we distributed the MB across four countries (Austria, Germany, Cuba, and Ukraine) and investigated physical activity and sleep among these countries. The results of Study 1 indicated that MB step counts correlated highly with the scientific GT3X device, but did display biases. In addition, the MB-derived wake-up and total-sleep-times showed high agreement with subjective reports, but partly deviated from GT3X predictions. Study 2 revealed similar MB step counts across countries, but significant later wake-up and bedtimes for Ukraine than the other countries. We hope that our studies will stimulate future large-scale sensor-based physical activity and sleep research studies, including various cultures.

scholarly journals Birth companionship in a government health system: a pilot study in Kigoma, Tanzania

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Paul Chaote ◽  
Nguke Mwakatundu ◽  
Sunday Dominico ◽  
Alex Mputa ◽  
Agnes Mbanza ◽  
...  
Keyword(s):  
Low Income ◽  
Pilot Project ◽  
Low Income Countries ◽  
Respectful Maternity Care ◽  
Health Providers ◽  
Structured Interviews ◽  
Government Officials ◽  
Government Health ◽  
Project Data ◽  
Birth Companion

Abstract Background Having a companion of choice throughout childbirth is an important component of good quality and respectful maternity care for women and has become standard in many countries. However, there are only a few examples of birth companionship being implemented in government health systems in low-income countries. To learn if birth companionship was feasible, acceptable and led to improved quality of care in these settings, we implemented a pilot project using 9 intervention and 6 comparison sites (all government health facilities) in a rural region of Tanzania. Methods The pilot was developed and implemented in Kigoma, Tanzania between July 2016 and December 2018. Women delivering at intervention sites were given the choice of having a birth companion with them during childbirth. We evaluated the pilot with: (a) project data; (b) focus group discussions; (c) structured and semi-structured interviews; and (d) service statistics. Results More than 80% of women delivering at intervention sites had a birth companion who provided support during childbirth, including comforting women and staying by their side. Most women interviewed at intervention sites were very satisfied with having a companion during childbirth (96–99%). Most women at the intervention sites also reported that the presence of a companion improved their labor, delivery and postpartum experience (82–97%). Health providers also found companions very helpful because they assisted with their workload, alerted the provider about changes in the woman’s status, and provided emotional support to the woman. When comparing intervention and comparison sites, providers at intervention sites were significantly more likely to: respond to women who called for help (p = 0.003), interact in a friendly way (p < 0.001), greet women respectfully (p < 0.001), and try to make them more comfortable (p = 0.003). Higher proportions of women who gave birth at intervention sites reported being “very satisfied” with the care they received (p < 0.001), and that the staff were “very kind” (p < 0.001) and “very encouraging” (p < 0.001). Conclusion Birth companionship was feasible and well accepted by health providers, government officials and most importantly, women who delivered at intervention facilities. The introduction of birth companionship improved women’s experience of birth and the maternity ward environment overall.

scholarly journals Global Nursing - A Qualitative Case Study of Tanzanian Nursing Students' Experiences of Student Exchange in Sweden

2020 ◽  
Author(s):  
Tara Alden-Joyce ◽  
Elina Scheers-Andersson ◽  
Jane Rogathi ◽  
Paulo Kidayi ◽  
Jenny Cadstedt ◽  
...  
Keyword(s):  
Nursing Education ◽  
Nursing Students ◽  
Low Income ◽  
Qualitative Content Analysis ◽  
Inductive Reasoning ◽  
Low Income Countries ◽  
Structured Interviews ◽  
Global Perspectives ◽  
Purposeful Sampling ◽  
Student Exchange

Abstract Background: Due to globalization and a shift in population demographics, needs within healthcare are changing and nurses require new skills and knowledge. Nursing education needs to facilitate these new demands and student exchange programmes provide an opportunity to develop necessary skills.Aim: The aim of this study was to explore Tanzanian nursing students' experiences of student exchange in Sweden. Method: A qualitative design was used for this empirical study. Semi-structured interviews were conducted with six Tanzanian nursing students who had participated in student exchange in Sweden. The participants were recruited by purposeful sampling. Inductive reasoning and qualitative content analysis were applied.Results: The findings revealed that the students experienced new approaches in Sweden, allowing them to develop skills and competences. Furthermore, they increased their global perspectives on nursing and interest in working with global health issues. However, they also experienced challenges in the new environment.Conclusion: The present study showed that the Tanzanian nursing students benefitted from their student exchange, both personally, as well as for their future careers as nurses. More research is needed examining nursing students from low-income countries participating in student exchange in high-income countries.

scholarly journals Adaptation and validation for Colombia of the WHO safe childbirth checklist

2018 ◽  
Vol 49 (3) ◽  
pp. 201-212
Author(s):  
Ana Carolina Amaya Arias ◽  
Óscar Zuluaga ◽  
Douglas Idárraga ◽  
Javier Hernando Eslava Schmalbach
Keyword(s):  
Low Income ◽  
Health Workers ◽  
Low Cost ◽  
Neonatal Morbidity ◽  
Neonatal Care ◽  
World Health ◽  
Low Income Countries ◽  
Safe Childbirth Checklist ◽  
Health Organization ◽  
Safe Childbirth

Introduction: Most maternal deaths that occur in developing countries are considered unfair and can be avoided. In 2008, The World Health Organization (WHO) proposed a checklist for childbirth care, in order to assess whether a simple, low-cost intervention had an impact on maternal and neonatal mortality in low-income countries. Objective: To translate, adapt and validate the content of the WHO Safe Childbirth Checklist (SCC) for its use in Colombia Methods: The checklist was translated and adapted to the Colombian context. It was subsequently validated by a panel of experts composed of 17 health workers with experience in maternal and neonatal care and safety. Reliability among judges was estimated (Rwg) and items were modified or added to each section of the list according to the results. Results: Modifications were made to 28 items, while 19 new items were added, and none was removed. The most important modifications were made to the management guidelines included in each item, and the items added refer to risks inherent to our environment. Conclusion: The Colombian version of the SCC will be a useful tool to improve maternal and neonatal care and thereby contribute to reducing maternal and neonatal morbidity and mortality in our country.

scholarly journals A Garden-Based Intervention to Improve Dietary Diversity in Kenyan School Children: Results from a Natural Experiment

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 810-810 ◽  
Author(s):  
Sara Benjamin-Neelon ◽  
Tiange Liu ◽  
Eve S Puffer ◽  
Liz Turner ◽  
Daniel Zaltz ◽  
...  
Keyword(s):  
Low Income ◽  
Rural Areas ◽  
Primary Schools ◽  
Dietary Diversity ◽  
Food Group ◽  
Low Income Countries ◽  
Severe Drought ◽  
School Gardens ◽  
Post Intervention

Abstract Objectives School gardens may improve child diet, but little is known about their effectiveness in rural areas in low-income countries. We evaluated the ability of school gardens to improve child diet in rural Kenya. We hypothesized that children in intervention schools would improve their dietary diversity and specifically their produce intake. Methods An non-government organization installed gardens in 2 primary schools. We selected 2 geographically proximal additional schools as comparisons. We conducted baseline assessments in 2013, prior to garden installation, and follow-up assessments a year later in 2014 in all 4 schools. We measured child dietary intake via a single 24-hour recall. We calculated dietary diversity using the women's dietary diversity score (WDDS) (continuous) and also examined each of the 10 food group components defined as adequate ≥15 g (binary). We conducted marginal linear or logistic regression models using a generalized estimating equation and included an exposure x time interaction to assess differences in outcomes between intervention and comparison schools from baseline to follow up. We controlled for child age, gender, and orphan status. Results We assessed 855 children (n = 438 intervention; n = 417 comparison) at baseline and 688 children (n = 383 intervention; n = 305 comparison) at follow up. Children in intervention schools were 51.8% male, compared to 56.5% in comparison schools. Mean (standard deviation) age was 11.6 (2.1) years in intervention and 11.8 (2.3) years in comparison schools. All children's WDDS worsened post-intervention. In adjusted difference in difference analyses, WDDS did not differ in intervention vs. comparison schools pre- to post-intervention (β 0.04, CI −0.19, 0.27). However, we observed less of a decrease in meeting adequate intake for pulses (OR 2.18, CI 1.18, 4.01) and other fruits (OR 1.55, CI 1.00, 2.40) in intervention versus comparison schools. Conversely, children in comparison schools had less of a decrease in meat, poultry, and fish compared to children in intervention schools (OR 0.67, CI 0.45, 0.99). Conclusions Children's WDDS worsened in all 4 schools, likely due to a severe drought that affected the region in 2014. We observed some differences in intervention vs. comparison children, but cannot attribute these improvements to school gardens. Funding Sources Duke Global Health Institute.

scholarly journals Fe0/H2O Filtration Systems for Decentralized Safe Drinking Water: Where to from Here?

Water ◽  
2019 ◽  
Vol 11 (3) ◽  
pp. 429 ◽  
Author(s):  
Charles Nanseu-Njiki ◽  
Willis Gwenzi ◽  
Martin Pengou ◽  
Mohammad Rahman ◽  
Chicgoua Noubactep
Keyword(s):  
Drinking Water ◽  
Low Income ◽  
Universal Access ◽  
Low Cost ◽  
Low Income Countries ◽  
Future Research ◽  
Systematic Research ◽  
Safe Drinking Water ◽  
Iron Corrosion ◽  
Small Communities

Inadequate access to safe drinking water is one of the most pervasive problems currently afflicting the developing world. Scientists and engineers are called to present affordable but efficient solutions, particularly applicable to small communities. Filtration systems based on metallic iron (Fe0) are discussed in the literature as one such viable solution, whether as a stand-alone system or as a complement to slow sand filters (SSFs). Fe0 filters can also be improved by incorporating biochar to form Fe0-biochar filtration systems with potentially higher contaminant removal efficiencies than those based on Fe0 or biochar alone. These three low-cost and chemical-free systems (Fe0, biochar, SSFs) have the potential to provide universal access to safe drinking water. However, a well-structured systematic research is needed to design robust and efficient water treatment systems based on these affordable filter materials. This communication highlights the technology being developed to use Fe0-based systems for decentralized safe drinking water provision. Future research directions for the design of the next generation Fe0-based systems are highlighted. It is shown that Fe0 enhances the efficiency of SSFs, while biochar has the potential to alleviate the loss of porosity and uncertainties arising from the non-linear kinetics of iron corrosion. Fe0-based systems are an affordable and applicable technology for small communities in low-income countries, which could contribute to attaining self-reliance in clean water supply and universal public health.

The chance of conception during lactation

1977 ◽  
Vol 9 (S4) ◽  
pp. 41-54 ◽  
Author(s):  
Jeroen K. van Ginneken
Keyword(s):  
Menstrual Cycle ◽  
Milk Production ◽  
Breast Feeding ◽  
Low Income ◽  
Rural Areas ◽  
Spacing Effect ◽  
Birth Spacing ◽  
Low Income Countries ◽  
Newborn Child

Many mothers in low-income countries, particularly in rural areas, nurse their children for 1–2 years on the average. The main purpose of this practice is, of course, to provide the newborn child with the nutrition necessary for its survival. Prolonged breast-feeding, however, also has a birth-spacing effect and postpones the next pregnancy by inhibiting ovulation and by delaying resumption of the menstrual cycle. Suckling of the infant is important for this suppression of the menstrual cycle because it leads to the release of prolactin, which not only plays an important role in milk production but also inhibits the release of gonadotrophins which initiate resumption of the menstrual cycle. For further details about these endocrinological aspects of lactation see, for example, Rolland et al. (1975); Thomson, Hytten & Black (1975) and Buchanan (1975).

Development of improved low-cost ceramic water filters for viral removal in the Haitian context

2014 ◽  
Vol 5 (1) ◽  
pp. 28-38 ◽  
Author(s):  
L. Guerrero-Latorre ◽  
M. Rusiñol ◽  
A. Hundesa ◽  
M. Garcia-Valles ◽  
S. Martinez ◽  
...  
Keyword(s):  
Low Income ◽  
Low Cost ◽  
World Health ◽  
Low Income Countries ◽  
Virus Removal ◽  
Ceramic Water Filters ◽  
Removal Efficiencies ◽  
Reductive Atmosphere ◽  
Health Organization ◽  
Water Filters

Household-based water treatment (HWT) is increasingly being promoted to improve water quality and, therefore, health status in low-income countries. Ceramic water filters (CWFs) are used in many regions as sustainable HWT and have been proven to meet World Health Organization (WHO) microbiological performance targets for bacterial removal (2–4 log); however, the described viral removal efficiencies are insufficient to significantly reduce the associated risk of viral infection. With the objective of improving the viral removal efficiencies of ceramic water filters, new prototypes with different oxide compositions and firing atmospheres have been developed and evaluated. For removal efficiencies human adenoviruses, MS2 bacteriophage and Escherichia coli were quantified in all prototypes. A new model of CWF that was fired in a reductive atmosphere presented virus and bacteria removal efficiencies greater than 3.0 log and 2.5 log, respectively, which would fulfill the viral targets that are recommended by the WHO. Ceramic characterization of the selected filters, which were fired in a reductive atmosphere, showed that a larger specific surface area than those of control filters and higher fraction of a positive Z-potential fraction are the most likely explanations for this increase in virus removal.

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