scholarly journals The Inequities of Motherhood: The Challenges of Obstetric Anesthesia in Low-Income Countries

2018 ◽  
Author(s):  
Mary Ricci
Keyword(s):  
Low Income ◽  
Well Being ◽  
Obstetric Anesthesia ◽  
World Health ◽  
Low Income Countries ◽  
Extensive Literature ◽  
Anesthetic Care ◽  
Middle Income ◽  
The World ◽  
Health Organization

The maternal mortality rate (MMR) is unconscionably high around the world, with women in low to middle income countries (LMICs) disproportionately passing away from potentially preventable causes. While this is a complicated and multifaceted problem, anesthesia has been identified as a contributing cause of death. From the moment the parturient enters the operating room, the anesthetist is responsible for their well-being. This integrative review was designed to further explore relationship between anesthesia and the MMR in LMICs. Twelve articles published within the last 15 years were selected through an extensive literature search using Medline and CINAHL. Each article was examined using the Polit and Beck (2017) assessment criteria followed by a cross table analysis. The results identified common themes across the studies including lack of infrastructure such as access to reliable power, water and oxygen, resources such as medications and basic anesthesia equipment, training focusing on maternal care and anesthesia and continuing education for providers. Knowing these deficiencies in anesthetic care, nurse anesthetists can assist in implementing changes to help reduce the MMR. Recommendations include encouraging hospitals and governments to make updating hospital infrastructure a priority, reaching out to groups such as the World Health Organization who help fund basic equipment such as pulse oximeters, establishing relationships with medical institutions in other regions to provide training and guidance, and focusing on the development of non-physician anesthetist programs to increase the number of proficient providers.

scholarly journals Mitotic Poisons in Research and Medicine

Molecules ◽  
2020 ◽  
Vol 25 (20) ◽  
pp. 4632 ◽  
Author(s):  
Jan Škubník ◽  
Michal Jurášek ◽  
Tomáš Ruml ◽  
Silvie Rimpelová
Keyword(s):  
Low Income ◽  
Cancer Therapeutics ◽  
Modern Medicine ◽  
World Health ◽  
Low Income Countries ◽  
Cancer Therapies ◽  
Middle Income ◽  
Treatment Services ◽  
The World ◽  
Health Organization

Cancer is one of the greatest challenges of the modern medicine. Although much effort has been made in the development of novel cancer therapeutics, it still remains one of the most common causes of human death in the world, mainly in low and middle-income countries. According to the World Health Organization (WHO), cancer treatment services are not available in more then 70% of low-income countries (90% of high-income countries have them available), and also approximately 70% of cancer deaths are reported in low-income countries. Various approaches on how to combat cancer diseases have since been described, targeting cell division being among them. The so-called mitotic poisons are one of the cornerstones in cancer therapies. The idea that cancer cells usually divide almost uncontrolled and far more rapidly than normal cells have led us to think about such compounds that would take advantage of this difference and target the division of such cells. Many groups of such compounds with different modes of action have been reported so far. In this review article, the main approaches on how to target cancer cell mitosis are described, involving microtubule inhibition, targeting aurora and polo-like kinases and kinesins inhibition. The main representatives of all groups of compounds are discussed and attention has also been paid to the presence and future of the clinical use of these compounds as well as their novel derivatives, reviewing the finished and ongoing clinical trials.

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 The burden of serious health-related suffering among cancer decedents: Global projections study to 2060

2020 ◽  
pp. 026921632095756
Author(s):  
Katherine E Sleeman ◽  
Barbara Gomes ◽  
Maja de Brito ◽  
Omar Shamieh ◽  
Richard Harding
Keyword(s):  
Palliative Care ◽  
Low Income ◽  
Population Based ◽  
World Health ◽  
Low Income Countries ◽  
Cancer Type ◽  
Middle Income ◽  
Middle Income Countries ◽  
Health Related ◽  
Health Organization

Background: Palliative care improves outcomes for people with cancer, but in many countries access remains poor. Understanding future needs is essential for effective health system planning in response to global policy. Aim: To project the burden of serious health-related suffering associated with death from cancer to 2060 by age, gender, cancer type and World Bank income region. Design: Population-based projections study. Global projections of palliative care need were derived by combining World Health Organization cancer mortality projections (2016–2060) with estimates of serious health-related suffering among cancer decedents. Results: By 2060, serious health-related suffering will be experienced by 16.3 million people dying with cancer each year (compared to 7.8 million in 2016). Serious health-related suffering among cancer decedents will increase more quickly in low income countries (407% increase 2016–2060) compared to lower-middle, upper-middle and high income countries (168%, 96% and 39% increase 2016-2060, respectively). By 2060, 67% of people who die with cancer and experience serious health-related suffering will be over 70 years old, compared to 47% in 2016. In high and upper-middle income countries, lung cancer will be the single greatest contributor to the burden of serious health-related suffering among cancer decedents. In low and lower-middle income countries, breast cancer will be the single greatest contributor. Conclusions: Many people with cancer will die with unnecessary suffering unless there is expansion of palliative care integration into cancer programmes. Failure to do this will be damaging for the individuals affected and the health systems within which they are treated.

Overview of chemistry and therapeutic potential of non-nitrogen heterocyclics as anticonvulsant agents

2021 ◽  
Vol 19 ◽  
Author(s):  
Rohit Pal ◽  
Karanvir Singh ◽  
Joyson Paul ◽  
Shah Alam Khan ◽  
Mohd. Javed Naim ◽  
...  
Keyword(s):  
Low Income ◽  
Therapeutic Potential ◽  
Neurological Diseases ◽  
Well Being ◽  
Pharmacokinetic Profile ◽  
Heterocyclic Ring ◽  
World Health ◽  
Low Income Countries ◽  
Health Organization ◽  
Nitrogen Heterocyclic

: Epilepsy is a chronic neurological disorder, characterized by predisposition of unprovoked seizures affecting the neurobiological, psychological, cognitive, economic, and social well-being of patient. As per the 2019 report by World Health Organization, it affects nearly 80% of the population which comes from the middle to low-income countries. It has been suggested that 70% of such cases can be treated effectively if properly diagnosed. It is one of the most common neurological diseases affecting 50 million people globally. Most of the antiepileptic drugs used in clinical practice are only 60-80% effective in controlling the disease. These drugs suffer from serious drawbacks of non-selectivity and toxicity that limit their clinical usefulness. Hence, there is a need to search for the safe, potent, and effective anti-epileptic drugs. One of the emerging strategies to discover and develop selective and non-toxic anticonvulsant molecule focuses on design of non-nitrogen heterocyclic compounds (NNHC). Drugs such as valproic acid, gabapentin, viagabatrin, fluorofelbamate, tiagabine, progabide, pregabalin, gamma amino butyric acid (GABA) etc., do not contain a nitrogen heterocyclic ring but are as effective anticonvulsants as conventional heterocyclic nitrogen compounds. This review covers the various classes of NNHC which have been developed in the recent past as anticonvulsants along with their chemistry, percentage yield, structure activity relationship and biological activity. The most potent compound in each series has been identified for the comparative studies, for further structural modification and to improve the pharmacokinetic profile. Various optimized synthetic pathways and diverse functionalities other than nitrogen-containing rings discussed in the article may help medicinal chemists to design safe and effective anticonvulsant drugs in near future.

scholarly journals COVID-19 Vaccine and Psychosocial Challenges

2021 ◽  
Vol 22 (3) ◽  
pp. 185-191
Author(s):  
Dae Jung Kim ◽  
Jung Yeon Heo ◽  
Hyun Soo Kim
Keyword(s):  
Low Income ◽  
Vaccination Rate ◽  
World Health ◽  
Low Income Countries ◽  
The Past ◽  
The World ◽  
Psychosocial Challenges ◽  
Health Organization ◽  
The Uk ◽  
Fourth Wave

It has been a year and half since the World Health Organization declared the coronavirus disease 2019 (COVID-19) pandemic. As of July 23, 2021, more than 193 million people worldwide have been confirmed to contract the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), with more than 4.15 million deaths. In Korea, about 185,000 people have been confirmed and 2,066 have died of COVID-19. Korea is in the middle of the fourth wave of trends, and the metropolitan area is in the top stage of social distancing. Since the SARS-CoV-2 vaccination began in the UK in December 2020, the number of people who complete vaccination is only 13.3% around the world, and many low-income countries have less than 5%. In Korea, the first vaccination rate was 32.27%, but only 13% completed the vaccination until July 23. As expected, there has been a lot of confusion, controversy, and even fake news and rumors over the past five months since the vaccination against COVID-19 began in Korea on February 26, 2021. People’s views on vaccination are bound to vary depending on their experience, perspective, and even political stance. In this article, we wanted to introduce the arguments and conflicts that could arise during vaccinations and suggest what we should think about so that many people can get vaccinated without hesitation.

scholarly journals Recruitment of consultant psychiatrists from low- and middle-income countries

2004 ◽  
Vol 1 (6) ◽  
pp. 15-18 ◽  
Author(s):  
David Ndetei ◽  
Salman Karim ◽  
Malik Mubbashar
Keyword(s):  
Low Income ◽  
Health Sector ◽  
World Health ◽  
Low Income Countries ◽  
Middle Income ◽  
Middle Income Countries ◽  
Fellowship Programme ◽  
Health Organization ◽  
Rich Countries ◽  
Low And Middle Income

The UK's 2-year International Fellowship Programme for consultant doctors has inadvertently highlighted the long-standing issues of the costs and benefits of such recruitment for the countries of origin, and of whether it is ethical for rich countries to recruit health personnel not only from other rich countries but also from low- and middle-income countries. The ‘brain drain’ from poor to rich countries has been recognised for decades; it occurs in the health sector as well as other sectors, such as education, science and engineering. It has had serious ramifications for the health service infrastructure in low-income countries, where poverty, morbidity, disability and mortality are increasing rather than decreasing, and it is a matter of serious concern for both the World Health Organization and the International Monetary Fund (Carrington & Detragiache, 1998; Lee, 2003).

scholarly journals AMR Surveillance in low and middle-income settings - A roadmap for participation in the Global Antimicrobial Surveillance System (GLASS)

2017 ◽  
Vol 2 ◽  
pp. 92 ◽  
Author(s):  
Anna C. Seale ◽  
N. Claire Gordon ◽  
Jasmin Islam ◽  
Sharon J. Peacock ◽  
J. Anthony G. Scott
Keyword(s):  
Low Income ◽  
Surveillance System ◽  
World Health ◽  
Low Income Countries ◽  
Drug Resistant ◽  
Middle Income ◽  
Surveillance Programme ◽  
Antimicrobial Surveillance ◽  
Life Threatening ◽  
Health Organization

Drug-resistant infections caused by bacteria with increasing antimicrobial resistance (AMR) threaten our ability to treat life-threatening conditions. Tackling AMR requires international collaboration and partnership. An early and leading priority to do this is to strengthen AMR surveillance, particularly in low-income countries where the burden of infectious diseases is highest and where data are most limited. The World Health Organization (WHO) has developed the Global AMR Surveillance System (GLASS) as one of a number of measures designed to tackle the problem of AMR, and WHO member states have been encouraged to produce National Action Plans for AMR by 2017. However, low-income countries are unlikely to have the resources or capacity to implement all the components in the GLASS manual. To facilitate their efforts, we developed a guideline that is aligned to the GLASS procedures, but written specifically for implementation in low-income countries. The guideline allows for flexibility across different systems, but has sufficient standardisation of core protocols to ensure that, if followed, data will be valid and comparable. This will ensure that the surveillance programme can provide health intelligence data to inform evidence-based interventions at local, national and international levels.

scholarly journals The State of Stroke Services across the Globe: Report of World Stroke Organization-World Health Organization Surveys

2021 ◽  
pp. 174749302110195
Author(s):  
Mayowa Owolabi ◽  
Amanda G Thrift ◽  
Sheila Cristina Ouriques Martins ◽  
Walter Johnson ◽  
Jeyaraj Durai Pandian ◽  
...  
Keyword(s):  
Acute Stroke ◽  
Low Income ◽  
Stroke Care ◽  
World Health Organisation ◽  
World Health ◽  
Low Income Countries ◽  
Acute Stroke Care ◽  
Middle Income ◽  
Stroke Services ◽  
Health Organization

Background: Improving stroke services is critical for reducing the global stroke burden. The World Stroke Organization (WSO)-World Health Organisation (WHO)-Lancet Neurology Commission on Stroke conducted a survey of the status of stroke services in low and middle income countries (LMICs) compared to high income countries (HICs). Methods: Using a validated WSO comprehensive questionnaire, we collected and compared data on stroke services along four pillars of the stroke quadrangle (surveillance, prevention, acute stroke, and rehabilitation) in 84 countries across WHO regions and economic strata. The WHO also conducted a survey of non-communicable diseases in 194 countries in 2019. Results: Fewer surveillance activities (including presence of registries, presence of recent risk factors surveys and participation in research) were reported in low-income countries (LICs) than HICs. The overall global score for prevention was 40.2%. Stroke units were present in 91% of HICs in contrast to 18% of LICs (p<0.001). Acute stroke treatments were offered in ~60% of HICs compared to 26% of LICs (p=0.009). Compared to HICs, LMICs provided less rehabilitation services including in-patient rehabilitation, home assessment, community rehabilitation, education, early hospital discharge program, and presence of rehabilitation protocol. Conclusions: There is an urgent need to improve stroke services globally especially in LMICs. Countries with less stroke services can adapt strategies from those with better services. This could include establishment of a framework for regular monitoring of stroke burden and services, implementation of integrated prevention activities and essential acute stroke care services, and provision of interdisciplinary care for stroke rehabilitation.

scholarly journals Is cholera disease associated with poverty?

2009 ◽  
Vol 3 (06) ◽  
pp. 408-411 ◽  
Author(s):  
Arturo Talavera ◽  
Ela M. Perez
Keyword(s):  
World Health Organization ◽  
Low Income ◽  
Disease Incidence ◽  
World Health ◽  
Low Income Countries ◽  
Intrinsic Factors ◽  
The World ◽  
Health Organization ◽  
Global Threat ◽  
Key Indicators

Background: Cholera remains a global threat and is one of the key indicators of social development. While the disease no longer poses a menace to countries with minimum standards of hygiene, it remains a serious challenge to countries where access to safe drinking water and adequate sanitation cannot be guaranteed. The objective of this work was to analyse the results obtained when contrasting the reports of the World Health Organization (WHO) about cholera disease with those of the World Bank List of economies (countries). Methodology: Data were obtained from reports of two international organizations, the report on cholera disease incidence of the World Health Organization and the World Bank’s classification of countries attending to their income. Results: We determined that low-income countries are more affected by cholera disease than countries with middle or high income. This difference was reflected in the percent of countries, the total number of reported cases, the number of cases per 100,000 habitants, as well as in the reported mortality. These results support the phrase “cholera disease is a disease of poverty.” Conclusions: We consider that economic development is an important factor in the morbidity and mortality of cholera, together with environment, climate, culture, medical management, political intention, and the intrinsic factors of the system.

scholarly journals Cultural psychiatry, diversity and political correctness in a shrinking world

2008 ◽  
Vol 5 (2) ◽  
pp. 27-28 ◽  
Author(s):  
John L. Cox
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Low Income ◽  
Global Mental Health ◽  
World Health ◽  
Low Income Countries ◽  
Middle Income ◽  
Middle Income Countries ◽  
The World

It is perhaps unusual for an academic journal like the Lancet to spearhead a ‘movement’ to advocate the scaling up of mental health services in low-income countries. Yet at the movement's launch in London in November 2007, attended by representatives from World Health Organization (WHO), the World Bank, donor agencies, as well as the World Psychiatric Association (WPA) and the Royal College of Psychiatrists, it was clear that a seminal series of papers, published in September of last year, was of the utmost importance for world psychiatry and for our planet. The five papers in the series ‘Global Mental Health’ had the following titles: ‘No health without mental health’; ‘Resources for mental health: scarcity, equity, and inefficiency’; ‘Treatment and prevention of mental disorders in low-income and middle-income countries’; ‘Mental health systems in countries: where are we now?’; and ‘Barriers to improvement of mental health services in low-income and middle-income countries’ (Lancet, September 2007, vol. 370, nos 9590–9593).

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