scholarly journals Global Vitamin C Status and Prevalence of Deficiency: A Cause for Concern?

Nutrients ◽  
2020 ◽  
Vol 12 (7) ◽  
pp. 2008 ◽  
Author(s):  
Sam Rowe ◽  
Anitra C. Carr
Keyword(s):  
Vitamin C ◽  
Communicable Disease ◽  
Risk Groups ◽  
Epidemiological Studies ◽  
Deficiency Disease ◽  
Middle Income ◽  
Global Literature ◽  
Middle Income Countries ◽  
Essential Nutrient ◽  
Low And Middle Income

Vitamin C is an essential nutrient that must be obtained through the diet in adequate amounts to prevent hypovitaminosis C, deficiency and its consequences—including the potentially fatal deficiency disease scurvy. Global vitamin C status and prevalence of deficiency has not previously been reported, despite vitamin C’s pleiotropic roles in both non-communicable and communicable disease. This review highlights the global literature on vitamin C status and the prevalence of hypovitaminosis C and deficiency. Related dietary intake is reported if assessed in the studies. Overall, the review illustrates the shortage of high quality epidemiological studies of vitamin C status in many countries, particularly low- and middle-income countries. The available evidence indicates that vitamin C hypovitaminosis and deficiency is common in low- and middle-income countries and not uncommon in high income settings. Further epidemiological studies are required to confirm these findings, to fully assess the extent of global vitamin C insufficiency, and to understand associations with a range of disease processes. Our findings suggest a need for interventions to prevent deficiency in a range of at risk groups and regions of the world.

scholarly journals Finding Children with High Risk of Non-Vaccination in 92 Low- and Middle-Income Countries: A Decision Tree Approach

Vaccines ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 646
Author(s):  
Thiago M. Santos ◽  
Bianca O. Cata-Preta ◽  
Cesar G. Victora ◽  
Aluisio J. D. Barros
Keyword(s):  
High Risk ◽  
Decision Tree ◽  
Immunization Coverage ◽  
Risk Groups ◽  
Demographic And Health Surveys ◽  
Middle Income ◽  
Agenda 2030 ◽  
Middle Income Countries ◽  
Tree Approach ◽  
Low And Middle Income

Reducing vaccination inequalities is a key goal of the Immunization Agenda 2030. Our main objective was to identify high-risk groups of children who received no vaccines (zero-dose children). A decision tree approach was used for 92 low- and middle-income countries using data from Demographic and Health Surveys and Multiple Indicator Cluster Surveys, allowing the identification of groups of children aged 12–23 months at high risk of being zero dose (no doses of the four basic vaccines—BCG, polio, DPT and measles). Three high-risk groups were identified in the analysis combining all countries. The group with the highest zero-dose prevalence (42%) included 4% of all children, but almost one in every four zero-dose children in the sample. It included children whose mothers did not receive the tetanus vaccine during and before the pregnancy, who had no antenatal care visits and who did not deliver in a health facility. Separate analyses by country presented similar results. Children who have been missed by vaccination services were also left out by other primary health care interventions, especially those related to antenatal and delivery care. There is an opportunity for better integration among services in order to achieve high and equitable immunization coverage.

Strengthening Noncommunicable Disease Research Capacity and Chronic Disease Outcomes in Low- and Middle-Income Countries in South Asia: Implementation and Evaluation of the ASCEND Program

2019 ◽  
Vol 31 (6) ◽  
pp. 536-547
Author(s):  
Allison Byrnes ◽  
Tilahun Nigatu Haregu ◽  
Naanki Pasricha ◽  
Kavita Singh ◽  
Sathish Thirunavukkarasu ◽  
...  
Keyword(s):  
Online Learning ◽  
Communicable Disease ◽  
Research Capacity ◽  
Lessons Learned ◽  
Early Career ◽  
Noncommunicable Disease ◽  
Middle Income ◽  
Face To Face ◽  
Middle Income Countries ◽  
Low And Middle Income

This article describes the design, outcomes, challenges, and lessons learned from the ASian Collaboration for Excellence in Non-Communicable Disease (ASCEND) program, implemented between 2011 and 2015 in India, Sri Lanka, and Malaysia. The program involved a blended-delivery model, incorporating online and face-to-face training, mentoring, and supervision of trainees’ research projects. Evaluation data were collected at baseline, 6, 12, 18, and 24 months. Intended outcomes, lessons, and challenges were summarized using a logic model. During the program period, 48 participants were trained over 2 cohorts in June 2011 and 2012. The trainees published 83 peer-reviewed articles between 2011 and 2015. Additionally, 154 presentations were given by trainees at national and international conferences. Underutilization of the online learning management system was an important challenge. Utilizing a combination of intensive face-to-face and online learning and mentoring of early career researchers in low- and middle-income countries has great potential to enhance the research capacity, performance, and outputs.

scholarly journals Early Intervention for Children at High Risk of Developmental Disability in Low- and Middle-Income Countries: A Narrative Review

2019 ◽  
Vol 16 (22) ◽  
pp. 4449 ◽  
Author(s):  
Maya Kohli-Lynch ◽  
Cally J. Tann ◽  
Matthew E. Ellis
Keyword(s):  
High Risk ◽  
Developmental Disability ◽  
Best Practice ◽  
Risk Groups ◽  
Community Based ◽  
Middle Income ◽  
Critical Window ◽  
Middle Income Countries ◽  
High Risk Infants ◽  
Low And Middle Income

In low- and middle-income countries (LMICs), while neonatal mortality has fallen, the number of children under five with developmental disability remains unchanged. The first thousand days are a critical window for brain development, when interventions are particularly effective. Early Childhood Interventions (ECI) are supported by scientific, human rights, human capital and programmatic rationales. In high-income countries, it is recommended that ECI for high-risk infants start in the neonatal period, and specialised interventions for children with developmental disabilities as early as three months of age; more data is needed on the timing of ECI in LMICs. Emerging evidence supports community-based ECI which focus on peer support, responsive caregiving and preventing secondary morbidities. A combination of individual home visits and community-based groups are likely the best strategy for the delivery of ECI, but more evidence is needed to form strong recommendations, particularly on the dosage of interventions. More data on content, impact and implementation of ECI in LMICs for high-risk infants are urgently needed. The development of ECI for high-risk groups will build on universal early child development best practice but will likely require tailoring to local contexts.

scholarly journals Implementation barriers for mHealth for non-communicable diseases management in low and middle income countries: a scoping review and field-based views from implementers

2020 ◽  
Vol 5 ◽  
pp. 7 ◽  
Author(s):  
Josefien van Olmen ◽  
Erica Erwin ◽  
Ana Cristina García-Ulloa ◽  
Bruno Meessen ◽  
J. Jaime Miranda ◽  
...  
Keyword(s):  
Scoping Review ◽  
Text Messaging ◽  
Communicable Disease ◽  
Scale Up ◽  
Research Network ◽  
Implementation Barriers ◽  
Middle Income ◽  
Middle Income Countries ◽  
Technical Requirements ◽  
Low And Middle Income

Background: Mobile health (mHealth) has been hailed as a potential gamechanger for non-communicable disease (NCD) management, especially in low- and middle-income countries (LMIC). Individual studies illustrate barriers to implementation and scale-up, but an overview of implementation issues for NCD mHealth interventions in LMIC is lacking. This paper explores implementation issues from two perspectives: information in published papers and field-based knowledge by people working in this field. Methods: Through a scoping review publications on mHealth interventions for NCDs in LMIC were identified and assessed with the WHO mHealth Evidence Reporting and Assessment (mERA) tool. A two-stage web-based survey on implementation barriers was performed within a NCD research network and through two online platforms on mHealth targeting researchers and implementors. Results: 16 studies were included in the scoping review. Short Message Service (SMS) messaging was the main implementation tool. Most studies focused on patient-centered outcomes. Most studies did not report on process measures and on contextual conditions influencing implementation decisions. Few publications reported on implementation barriers. The websurvey included twelve projects and the responses revealed additional information, especially on practical barriers related to the patients’ characteristics, low demand, technical requirements, integration with health services and with the wider context. Many interventions used low-cost software and devices with limited capacity that not allowed linkage with routine data or patient records, which incurred fragmented delivery and increased workload. Conclusion: Text messaging is a dominant mHealth tool for patient-directed of quality improvement interventions in LMIC. Publications report little on implementation barriers, while a questionnaire among implementors reveals significant barriers and strategies to address them. This information is relevant for decisions on scale-up of mHealth in the domain of NCD. Further knowledge should be gathered on implementation issues, and the conditions that allow universal coverage.

scholarly journals Protocol for a Multi-Level Policy Analysis of Non-Communicable Disease Determinants of Diet and Physical Activity: Implications for Low- and Middle-Income Countries in Africa and the Caribbean

2021 ◽  
Vol 18 (24) ◽  
pp. 13061
Author(s):  
Maylene Shung-King ◽  
Amy Weimann ◽  
Nicole McCreedy ◽  
Lambed Tatah ◽  
Clarisse Mapa-Tassou ◽  
...  
Keyword(s):  
Physical Activity ◽  
South Africa ◽  
Policy Development ◽  
Salt Intake ◽  
Communicable Disease ◽  
Middle Income ◽  
Middle Income Countries ◽  
Country Level ◽  
Promotion Of Physical Activity ◽  
Low And Middle Income

Non-communicable diseases (NCDs) are the leading cause of death globally. Despite significant global policy development for addressing NCDs, the extent to which global policies find expression in low-and-middle income countries’ (LMIC) policies, designed to mitigate against NCDs, is unclear. This protocol is part of a portfolio of projects within the Global Diet and Activity Research (GDAR) Network, which aims to support the prevention of NCDs in LMICs, with a specific focus on Kenya, Cameroon, South Africa and Jamaica. This paper outlines the protocol for a study that seeks to explore the current policy environment in relation to the reduction of key factors influencing the growing epidemic of NCDs. The study proposes to examine policies at the global, regional and country level, related to the reduction of sugar and salt intake, and the promotion of physical activity (as one dimension of healthy placemaking). The overall study will comprise several sub-studies conducted at a global, regional and country level in Cameroon, Kenya and South Africa. In combination with evidence generated from other GDAR workstreams, results from the policy analyses will contribute to identifying opportunities for action in the reduction of NCDs in LMICs.

scholarly journals Implementation barriers for mHealth for non-communicable diseases prevention and management in low and middle income countries: a scoping review and field-based views from implementers

2020 ◽  
Vol 5 ◽  
pp. 7
Author(s):  
Josefien van Olmen ◽  
Erica Erwin ◽  
Ana Cristina García-Ulloa ◽  
Bruno Meessen ◽  
J. Jaime Miranda ◽  
...  
Keyword(s):  
Scoping Review ◽  
Text Messaging ◽  
Communicable Disease ◽  
Scale Up ◽  
Research Network ◽  
Implementation Barriers ◽  
Middle Income ◽  
Middle Income Countries ◽  
Technical Requirements ◽  
Low And Middle Income

Background: Mobile health (mHealth) has been hailed as a potential gamechanger for non-communicable disease (NCD) management, especially in low- and middle-income countries (LMICs). Individual studies illustrate barriers to implementation and scale-up, but an overview of implementation issues for NCD mHealth interventions in LMICs is lacking. This paper explores implementation issues from two perspectives: information in published papers and field-based knowledge by people working in this field. Methods: Through a scoping review publications on mHealth interventions for NCDs in LMICs were identified and assessed with the WHO mHealth Evidence Reporting and Assessment (mERA) tool. A two-stage web-based survey on implementation barriers was performed within a NCD research network and through two online platforms on mHealth targeting researchers and implementors. Results: 18 studies were included in the scoping review. Short Message Service (SMS) messaging was the main implementation tool. Most studies focused on patient-centered outcomes. Most studies do not report on process measures and on contextual conditions influencing implementation decisions. Few publications reported on implementation barriers. The websurvey included twelve projects and the responses revealed additional information, especially on practical barriers related to the patients’ characteristics, low demand, technical requirements, integration with health services and with the wider context. Many interventions used low-cost software and devices with limited capacity that not allowing linkage with routine data or patient records, which incurred fragmented delivery and increased workload. Conclusion: Text messaging is a dominant mHealth tool for patient-directed of quality improvement interventions in LMICs. Publications report little on implementation barriers, while a questionnaire among implementors reveals significant barriers and strategies to address them. This information is relevant for decisions on scale-up of mHealth in the domain of NCD. Further knowledge should be gathered on implementation issues, and the conditions that allow universal coverage.

scholarly journals Towards a global framework for capacity building for non-communicable disease advocacy in low- and middle-income countries

2013 ◽  
Vol 20 (4_suppl) ◽  
pp. 6-19 ◽  
Author(s):  
Trevor Shilton ◽  
Beatriz Champagne ◽  
Claire Blanchard ◽  
Lorena Ibarra ◽  
Vijj Kasesmup
Keyword(s):  
Capacity Building ◽  
Communicable Disease ◽  
Middle Income ◽  
Middle Income Countries ◽  
Disease Advocacy ◽  
Non Communicable Disease ◽  
Low And Middle Income

scholarly journals A Bibliometric Analysis of Published Literature in Postoperative Pain in Elderly Patients in Low- and Middle-Income Countries

2021 ◽  
Vol 10 (11) ◽  
pp. 2334
Author(s):  
João Batista Santos Garcia ◽  
Érica Brandão de Moraes ◽  
José Osvaldo Barbosa Neto
Keyword(s):  
Postoperative Pain ◽  
Elderly Patients ◽  
Bibliometric Analysis ◽  
Low Income ◽  
The Elderly ◽  
Epidemiological Studies ◽  
Middle Income ◽  
Middle Income Countries ◽  
Citation Indexes ◽  
Low And Middle Income

Postoperative pain (POP) remains a major challenge for surgeons and anesthesiologists worldwide, especially in low- and middle-income countries. Elderly patients are at higher risk for undertreatment of pain. Despite that, there is a paucity of papers addressing POP among this population in developing countries. This study aimed to provide a bibliometric analysis of the literature concerning postoperative pain in elderly patients from low- and middle-income countries. It was performed an extensive search of papers on this subject through the Web of Science and Scopus database using a series of uniterms and, including publications from 2001 to 2021. Publication quality was assessed by using total citation frequency, average citations per item and other citation indexes. Citation indexes were low, with the highest reaching 15 citations. In conclusion, few studies of postoperative pain in the elderly in countries with medium and low income, indicating a need that has not yet been met for this population and in these areas of the world. The published studies were not specifically aimed at the elderly, had limited impact, low international visibility. They were not epidemiological studies and are not robust, weakening knowledge and decision-making towards policies directed at this vulnerable population.

scholarly journals Can Improved Legume Varieties Optimize Iron Status in Low- and Middle-Income Countries? A Systematic Review

2020 ◽  
Vol 11 (5) ◽  
pp. 1315-1324
Author(s):  
Linet N Mutwiri ◽  
Florence Kyallo ◽  
Beatrice Kiage ◽  
Bart Van der Schueren ◽  
Christophe Matthys
Keyword(s):  
Health Outcomes ◽  
Nutrition Education ◽  
Iron Status ◽  
Fold Increase ◽  
Risk Groups ◽  
Micronutrient Deficiencies ◽  
Middle Income ◽  
Middle Income Countries ◽  
Iron And Zinc ◽  
Low And Middle Income

ABSTRACT Iron and zinc deficiencies are some of the most widespread micronutrient deficiencies in low- and middle-income countries (LMIC). Dietary diversification, food fortification, nutrition education, and supplementation can be used to control micronutrient deficiencies. Legumes are important staple foods in most households in LMIC. Legumes are highly nutritious (good sources of essential minerals, fiber, and low glycemic index) and offer potential benefits in addressing nutrition insecurity in LMIC. Several efforts have been made to increase micronutrient intake by use of improved legumes. Improved legumes have a higher nutrient bioavailability, lower phytate, or reduced hard-to-cook (HTC) defect. We hypothesize that consumption of improved legumes leads to optimization of zinc and iron status and associated health outcomes. Therefore, the objective of this review is to examine the evidence on the efficacy of interventions using improved legumes. Nine relevant studies are included in the review. Consumption of improved legumes resulted in a ≥1.5-fold increase in iron intake. Several studies noted modest improvements in biomarkers of iron status [hemoglobin (Hb), serum ferritin (SF), and transferrin receptor] associated with consumption of improved legumes. Currently, no efficacy studies assessing the relation between consumption of improved legumes and zinc status are available in the literature. Evidence shows that, in addition to repletion of biomarkers of iron status, consumption of improved legumes is associated with both clinical and functional outcomes. The prevalence of iron deficiency (ID) decreases with consumption of improved legumes, with increases of ≤3.0 g/L in Hb concentrations. Improvement in cognition and brain function in women has been reported as well. However, further research is necessary in more at-risk groups and also to show if the reported improvements in status markers translate to improved health outcomes. Evidence from the included studies shows potential from consumption of improved legumes suggesting them to be a sustainable solution to improve iron status.

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