scholarly journals Histopathologic spectrum of childhood tumours in a Tertiary Hospital: a ten-year review

2021 ◽  
Vol 21 (1) ◽  
pp. 54-9
Author(s):  
Said M Amin ◽  
Vincent E Nwatah ◽  
Emmanuel A Ameh ◽  
Abdurasaq R Oyesegun ◽  
Adewumi B Oyesakin
Keyword(s):  
Malignant Tumour ◽  
Tertiary Hospital ◽  
Middle Income ◽  
Public Health Burden ◽  
Middle Income Countries ◽  
Comprehensive Information ◽  
Mesenchymal Neoplasm ◽  
Group 2 ◽  
Benign Tumours ◽  
Childhood Tumours

Background: There has been a growing public health burden of childhood tumours in low and middle income countries (LMICs) as the trend in epidemiological transition continues to vary. Objective: The objective of this report is to determine the spectrum of childhood tumours at a tertiary hospital in Nigeria. Methods: A retrospective review of the histopathology register over the period January 2006 to December 2015. Results: The total paediatric tumour cases was 248, including 143 (57.7%) females and 105 (42.3%) males, aged 0 – 12 years (mean 6.1years ± 3.97 SD). The age group 2 - 5 year cohort had the highest prevalence of tumour. The predominant tumour based on tissue of origin was epithelial neoplasms 88 (35.5%), vascular neoplasms 56 (22.6%), neural neoplasm 42 (16.9%), mesenchymal neoplasm 37 (14.9%), germ cell neoplasm 13 (5.2%) and haematopoietic neoplasms 12 (4.8%). Majority of the tumours were benign, 148 (59.7%) and malignant 100 (40.3%). The most predominant benign tumour was haemangioma 33 (13.3%) and predominant malignant tumour was lymphoma 22 (8.9%). Conclusion: Benign tumours remain the commonest neoplasm of children in this hospital-based data. Development and implementation of a tumour registry would provide a more comprehensive information. Keywords: Childhood tumours; spectrum; haemangioma; lymphoma.

scholarly journals Interventional nephrology and vascular access practice: A perspective from South and Southeast Asia

2021 ◽  
pp. 112972982110113
Author(s):  
Raja Ramachandran ◽  
Vinant Bhargava ◽  
Sanjiv Jasuja ◽  
Maurizio Gallieni ◽  
Vivekanand Jha ◽  
...  
Keyword(s):  
Southeast Asia ◽  
Vascular Access ◽  
Central Catheter ◽  
Middle Income ◽  
Middle Income Countries ◽  
South And Southeast Asia ◽  
Group 2 ◽  
Venous Fistula ◽  
Economic Constraints ◽  
Group 1

South and Southeast Asia is the most populated, heterogeneous part of the world. The Association of Vascular Access and InTerventionAl Renal physicians (AVATAR Foundation), India, gathered trends on epidemiology and Interventional Nephrology (IN) for this region. The countries were divided as upper-middle- and higher-income countries as Group-1 and lower and lower-middle-income countries as Group-2. Forty-three percent and 70% patients in the Group 1 and 2 countries had unplanned hemodialysis (HD) initiation. Among the incident HD patients, the dominant Vascular Access (VA) was non-tunneled central catheter (non-TCC) in 70% of Group 2 and tunneled central catheter (TCC) in 32.5% in Group 1 countries. Arterio-Venous Fistula (AVF) in the incident HD patients was observed in 24.5% and 35% of patients in Group-2 and Group-1, respectively. Eight percent and 68.7% of the prevalent HD patients in Group-2 and Group-1 received HD through an AVF respectively. Nephrologists performing any IN procedure were 90% and 60% in Group-2 and Group 1, respectively. The common procedures performed by nephrologists include renal biopsy (93.3%), peritoneal dialysis (PD) catheter insertion (80%), TCC (66.7%) and non-TCC (100%). Constraints for IN include lack of time (73.3%), lack of back-up (40%), lack of training (73.3%), economic issues (33.3%), medico-legal problems (46.6%), no incentive (20%), other interests (46.6%) and institution not supportive (26%). Routine VA surveillance is performed in 12.5% and 83.3% of Group-2 and Group-1, respectively. To conclude, non-TCC and TCC are the most common vascular access in incident HD patients in Group-2 and Group-1, respectively. Lack of training, back-up support and economic constraints were main constraints for IN growth in Group-2 countries.

scholarly journals Medical Education and Training: Building In-Country Capacity at All Levels

2016 ◽  
Vol 34 (1) ◽  
pp. 36-42 ◽  
Author(s):  
Fredrick Chite Asirwa ◽  
Anne Greist ◽  
Naftali Busakhala ◽  
Barry Rosen ◽  
Patrick J. Loehrer
Keyword(s):  
Health Care ◽  
Access To Health Care ◽  
National Level ◽  
Cancer Control ◽  
Tertiary Hospital ◽  
Middle Income ◽  
Middle Income Countries ◽  
High Resource ◽  
Medical Education And Training ◽  
Representative Model

Poorly trained workers and limited workforce capacity contribute immensely to barriers in cancer control in low- and middle-income countries (LMICs). Because of an increasing disease burden and the gap in trained personnel, it is critical that LMICs must develop appropriate in-country training programs at all levels to adequately address their cancer-related outcomes. The training in LMICs of cancer health personnel should address priority cancer diseases in the specific country by developing caregivers, trainers, researchers, and administrators at all levels of health care and all cadres of staff, from the community level to the national level. The Academic Model of Providing Access to Health care is a representative model of how a public tertiary hospital like the Moi Teaching and Referral Hospital in an LMIC setting can leverage its resources, collaborate with partners from high-resource countries, and assist in the development of a training center to spearhead a sustainable education program.

Incidence of respiratory pathogens in persons hospitalized with pneumonia in two provinces in Thailand

2010 ◽  
Vol 138 (12) ◽  
pp. 1811-1822 ◽  
Author(s):  
S. J. OLSEN ◽  
S. THAMTHITIWAT ◽  
S. CHANTRA ◽  
M. CHITTAGANPITCH ◽  
A. M. FRY ◽  
...  
Keyword(s):  
Nasopharyngeal Swab ◽  
Respiratory Pathogens ◽  
Middle Income ◽  
Viral Pathogen ◽  
Effective Prevention ◽  
Middle Income Countries ◽  
Viral Culture ◽  
Comprehensive Information ◽  
Rsv Infection ◽  
Syncytial Virus

SUMMARYAlthough pneumonia is a leading cause of death from infectious disease worldwide, comprehensive information about its causes and incidence in low- and middle-income countries is lacking. Active surveillance of hospitalized patients with pneumonia is ongoing in Thailand. Consenting patients are tested for seven bacterial and 14 viral respiratory pathogens by PCR and viral culture on nasopharyngeal swab specimens, serology on acute/convalescent sera, sputum smears and antigen detection tests on urine. Between September 2003 and December 2005, there were 1730 episodes of radiographically confirmed pneumonia (34·6% in children aged <5 years); 66 patients (3·8%) died. A recognized pathogen was identified in 42·5% of episodes. Respiratory syncytial virus (RSV) infection was associated with 16·7% of all pneumonias, 41·2% in children. The viral pathogen with the highest incidence in children aged <5 years was RSV (417·1/100 000 per year) and in persons aged ⩾50 years, influenza virus A (38·8/100 000 per year). These data can help guide health policy towards effective prevention strategies.

scholarly journals Towards better diagnostic tools for liver injury in low-income and middle-income countries

2019 ◽  
Vol 4 (4) ◽  
pp. e001704 ◽  
Author(s):  
Saundria Moed ◽  
Muhammad H Zaman
Keyword(s):  
Chronic Hepatitis ◽  
Liver Injury ◽  
Low Income ◽  
Liver Diseases ◽  
Diagnostic Methods ◽  
Low Income Countries ◽  
Diagnostic Tools ◽  
Middle Income ◽  
Public Health Burden ◽  
Middle Income Countries

Liver disease is a significant public health burden in both high-income and low-income countries, accounting for over 2 million annual, global deaths. Despite the significant mortality burden, liver diseases are historically a neglected problem due to a lack of accurate incidence and prevalence statistics, as well as national and international programmes targeting these diseases. A large portion of deaths due to liver diseases can be treated (eg, chronic hepatitis B), cured (eg, chronic hepatitis C) or prevented (eg, acute liver failure due to medications) if prompt diagnosis is made, but currently diagnostic methods fall short. Therefore, there is a critical need to fund the development of prompt, effective diagnostics for liver function, specifically in low-income and middle-income countries where the landscape for this testing is sparse. Here, we review and compare available and currently emerging diagnostic methods for liver injury in low-income and middle-income settings, while highlighting the opportunities and challenges that exist in the field.

scholarly journals Knowledge on tuberculosis and utilization of DOTS service by tuberculosis patients in Lalitpur District, Nepal

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0245686
Author(s):  
Nirmal Gautam ◽  
Rewati Raj Karki ◽  
Rasheda Khanam
Keyword(s):  
Rural Areas ◽  
Age Groups ◽  
Directly Observed Therapy ◽  
Middle Income ◽  
Public Health Burden ◽  
The Public ◽  
Middle Income Countries ◽  
Adequate Knowledge ◽  
Short Course ◽  
Younger Age

Background Tuberculosis is one of the major infectious diseases and is both complex and serious. It is spread from person to person through the air, causing a public health burden, especially in low- and middle-income countries. This study aims to assess the knowledge on tuberculosis and the utilization of Directly-Observed Therapy, Short Course (DOTS) service from the public DOTS centers in Lalitpur district of Nepal. Method A structured questionnaire was used to collect data from 23 DOTS centers in Lalitpur district. Univariate and multivariate logistic regression was applied to assess the knowledge on tuberculosis and utilization of DOTS among people living with tuberculosis. Results Among 390 respondents, 80% of patients had knowledge of tuberculosis and 76.92% utilized the DOTS service from the DOTS center. People of higher age (50–60 years) [aOR; 13.96, 95% CI 4.79,40.68], [aOR; 10.84,95% CI 4.09,28.76] had significantly more knowledge on TB and utilization of the DOTS service compared to the younger group. Additionally, those who completed twelfth class [aOR; 2.25, 95% CI 0.46,11.07] and [aOR;2.47, 95% CI 0.51,11.28] had greater knowledge of Tuberculosis and utilization of DOTS compared to those who had not completed twelfth class. Likewise, compared to urban residents, respondents in rural areas (aOR; 0.51, 95% CI 0.27,0.97) had less knowledge of tuberculosis, (aOR; 0.57, 95% CI 0.32,1) and less chance of utilization of the DOTS service from the DOTS center. Conclusion Approximately one quarter of patients did not have adequate knowledge of tuberculosis and were not utilizing the DOTS service, particularly in younger age groups, people living in a combined family, with no education, poor economic position, and from rural areas. Findings of this study revealed that some specific programs are needed for enhancing the knowledge and utilization of DOTS, particularly for those patients whose economic situations extended from low to mid range.

Cervical Cancer Screening and HPV Vaccination

2021 ◽  
pp. 61-67
Author(s):  
Richard Fielding ◽  
Samara Perez ◽  
Zeev Rosberger ◽  
Ovidiu Tatar ◽  
Linda D. L. Wang
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Hpv Vaccination ◽  
Psychological Impact ◽  
Middle Income ◽  
Public Health Burden ◽  
Middle Income Countries ◽  
Screening Strategies ◽  
Successes And Challenges

Cervical cancer kills 300,000 women annually, despite being among the most preventable of all cancers, with a well-known cause (human papilloma virus [HPV]), established and successful screening strategies, and effective vaccination and treatments. This chapter examines the reasons for this inconsistency and begins by outlining the epidemiology and public health burden of cervical cancers. It describes HPV vaccine–related successes and challenges in low- and middle-income countries contrasted with high-income countries, with emphasis on the two most populous countries of India and China, before examining issues around strategies for cervical cancer screening in high- and low-resource settings. Following discussion of screening recommendations, the chapter describes barriers and facilitators to vaccination, screening, and testing. It then addresses screening and vaccination messaging and the psychological impact of testing and concludes with future directions.

scholarly journals The Monetary Value of Human Lives Lost to Suicide in the African Continent: Beating the African War Drums

Healthcare ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. 84
Author(s):  
Joses M. Kirigia ◽  
Rosenabi D.K. Muthuri ◽  
Newton G. Muthuri
Keyword(s):  
Discount Rate ◽  
Economic Burden ◽  
Years Of Life Lost ◽  
African Continent ◽  
Middle Income ◽  
Middle Income Countries ◽  
Monetary Value ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Background: Suicide is an important public health problem in the African continent whose economic burden remains largely unknown. This study estimated the monetary value of human lives lost due to suicide in the African continent in 2017. Methods: The human capital approach was applied to monetarily value the years of life lost due to premature mortality from suicide deaths (SD) among 54 African countries. A 3% discount rate was used to convert future losses into their present values. The sensitivity of monetary value of human lives lost to changes in discount rate and average life expectancy was tested. Results: The 75,505 human lives lost from suicide had a grand total monetary value of International Dollars (Int$) 6,989,963,325; and an average present value of Int$ 92,576 per SD. About 31.1% of the total monetary value of SD was borne by high-income and upper-middle-income countries (Group 1); 54.4% by lower-middle-income countries (Group 2); and 14.5% by low-income countries (Group 3). The average monetary value per human life lost from SD was Int$ 234,244 for Group 1, Int$ 109,545 for Group 2 and Int$ 32,223 for Group 3. Conclusions: Evidence shows that suicide imposes a substantive economic burden on African economies. The evidence reinforces the case for increased investments to ensure universal coverage of promotive, preventive, curative and rehabilitative mental health services.

scholarly journals Building capacity in mental health care in low- and middle-income countries by training primary care physicians using the mhGAP: a randomized controlled trial

2019 ◽  
Vol 35 (2) ◽  
pp. 186-198 ◽  
Author(s):  
Jessica Spagnolo ◽  
François Champagne ◽  
Nicole Leduc ◽  
Michèle Rivard ◽  
Wahid Melki ◽  
...  
Keyword(s):  
Mental Health ◽  
Self Efficacy ◽  
Primary Care Physicians ◽  
Health Knowledge ◽  
Control Group ◽  
Middle Income ◽  
Middle Income Countries ◽  
Group 2 ◽  
Mental Health Knowledge ◽  
Group 1

Abstract To address the rise in mental health conditions in Tunisia, a training based on the Mental Health Gap Action Programme (mhGAP) Intervention Guide (IG) was offered to primary care physicians (PCPs) working in the Greater Tunis area. Non-specialists (such as PCPs)’ training is an internationally supported way to target untreated mental health symptoms. We aimed to evaluate the programme’s impact on PCPs’ mental health knowledge, attitudes, self-efficacy and self-reported practice, immediately following and 18 months after training. We conducted an exploratory trial with a combination of designs: a pretest–posttest control group design and a one-group pretest–posttest design were used to assess the training’s short-term impact; and a repeated measures design was used to assess the training’s long-term impact. The former relied on a delayed-intervention strategy: participants assigned to the control group (Group 2) received the training after the intervention group (Group 1). The intervention consisted of a weekly mhGAP-based training session (totalling 6 weeks), comprising lectures, discussions, role plays and a support session offered by trainers. Data were collected at baseline, following Group 1’s training, following Group 2’s training and 18 months after training. Descriptive, bivariate and ANOVA analyses were conducted. Overall, 112 PCPs were randomized to either Group 1 (n = 52) or Group 2 (n = 60). The training had a statistically significant short-term impact on mental health knowledge, attitudes and self-efficacy scores but not on self-reported practice. When comparing pre-training results and results 18 months after training, these changes were maintained. PCPs reported a decrease in referral rates to specialized services 18 months after training in comparison to pre-training. The mhGAP-based training might be useful to increase mental health knowledge and self-efficacy, and decrease reported referral rates and negative mental health attitudes among PCPs in Tunisia and other low- and middle-income countries. Future studies should examine relationships among these outcome variables.

Delivering urgent oral healthcare in Sub-Saharan Africa: supporting sustainable local development

2021 ◽  
Vol 10 (3) ◽  
pp. 69-74
Author(s):  
Rachael England ◽  
Andrew Paterson ◽  
Adam Jones
Keyword(s):  
Oral Health ◽  
Local Development ◽  
Sub Saharan Africa ◽  
Oral Disease ◽  
Care Needs ◽  
Middle Income ◽  
Public Health Burden ◽  
Middle Income Countries ◽  
Sub Saharan ◽  
High Level

Oral disease continues to be a public health burden, affecting almost half of the global population, and disproportionately affecting the most vulnerable communities.1 Development organisations use different approaches to tackle this through short-term volunteering programmes in low- and middle-income countries, to address oral health needs in a variety of ways. There is evidence that volunteering requires a high level of cultural competence to avoid negatively impacting on local healthcare systems.2-4 The oral health care needs of communities in Sub-Saharan Africa (SSA) differ markedly from those in the developed world, posing challenges for volunteering organisations to provide effective programmes in circumstances where there is a lack of resources, equipment and infrastructure.

scholarly journals The Indirect cost of illness in Africa

10.3823/2568 ◽  
2018 ◽  
Vol 11 ◽  
Author(s):  
Joses Muthuri Kirigia ◽  
Germano Mwiga Mwabu
Keyword(s):  
Indirect Cost ◽  
Cost Of Illness ◽  
Health System Strengthening ◽  
Age Group ◽  
Health Targets ◽  
Middle Income ◽  
Middle Income Countries ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Background: The current study estimated (a) the indirect costs associated with non-fatal disability and premature death across a wide range of diseases and health conditions in Africa in 2015 and (b) the potential savings that could be accrued if countries were to meet the 3 health targets of the substainable development goal (SDG) compared to the costs under the status quo. Methods: This study used the lost output or human capital approach to quantify the gross domestic product (GDP) losses associated with the disability-adjusted-life-years (DALYs) lost due to all causes by age group as well as by country economic classification (Group 1: 10 high/upper-middle income countries; Group 2: 17 lower-middle income countries; and Group 3: 27 low income countries). Results: The expected indirect cost of the 704,765,879 DALYs lost in Africa in 2015 was Int$ 2,983,187,560,197. Of this amount, 25.17%, 57.84% and 16.99% were incurred by the economies of the countries comprising Group 1, Group 2 and Group 3, respectively. Of the total continental indirect cost, 36.9%, 10.5%, 13.7%, 17.0%, 7.6%, 6.8% and 7.5% were associated with people aged 0-4, 5-14, 15-29, 30-49, 50-59, 60-69 and 70 years or older, respectively. Most of the total indirect cost (56.61%) was attributable to maternal conditions, AIDS, tuberculosis (TB), malaria, neglected tropicald diseases (NTDs), non-communicable diseases and traffic injuries. Approximately half (47%) of this cost could be avoided (or saved) every year if the 3 (health) targets of the SDG were fully met. Conclusion: The study estimated the total indirect cost of illness due to all causes by age group and country economic classification. The annual indirect cost is substantial. The findings contained in this paper suggest that health system strengthening should focus on both rich and poor countries, people of all ages and specific disease categories.  

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