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PubMed2001

Infection control in developing countries.

Infection control activities in developing countries have increased substantially during the last decade, particularly in certain regions of the world. Pressure to improve hospital care cost-effectiveness, the emergence of highly resistant microorganisms, the perception of healthcare worker occupational hazards, and public claims for improved health assistance quality have been important factors responsible for this development. A major challenge for infection control personnel in developing countries is to sustain this development.

Cost of Illness↗
PubMed1980

[Cardiovascular mortality in industrial and developing countries (author's transl)].

In developing countries when causes of death are registered cardiovascular mortality levels revealed themselves surprising. For instance, they appear to be more important in Tebessa (Algeria) during 1974-1975, Mauritius (1973-1976) or Egypt (1971-1973) than in france, United States or Sweden before the age of 45 and very near after this age. These results are consistent with the mortality patterns by causes of death proposed by Preston according to life expectancy at birth. Before the age of 45, rheumatic heart diseases can explain this overmortality. After this age the recent observations in the Third-World, especially in Africa, show that cardiomyopathy, cardiomegaly and principally hypertension are widely spread to-day. On the other hand, ischemic heart diseases are still rare. For many authors, cardiovascular diseases are increasing in Africa because ways of life in developing and developed countries are becoming identical. In fact, this trend could be a little artificial. Formerly indeed, disparity in population age structures and mortality differences for all other causes were not enough taken into account.

Adolescent↗
PubMed2004

Asbestos in developing countries: magnitude of risk and its practical implications.

In developing countries, aggressive marketing of chrysotile asbestos continues as a result of restrictions on its use being imposed by the developed countries. In the Asian continent, China and India are emerging as the major users of asbestos. There is enough evidence to link chrysotile with pulmonary fibrosis and lung cancer in humans, even at low levels of exposure, hence the need to apply the Precautionary Principle for phasing out its use globally. Due to poor occupational health and safety systems in developing countries and difficulties in early detection of pulmonary malignancy related to asbestos, the statistics remain sketchy. This is hampering efforts to create pressure on policy makers and to counter the propaganda of the asbestos industry. The International Labour Office believes that more than 100,000 deaths a year occur from asbestos-related disease. In the view of studies published in Europe and Australia, the number of deaths due to such malignancies will peak around the year 2020 and could be anywhere between half a million to a million. That means more than a million deaths will occur in developing countries. At about the same time when asbestos-related deaths start to decrease in developed countries, their number will begin to rise in developing countries. This presents a major challenge to the international scientific community.

Asbestos↗
PubMed2005

Suicide in developing countries (2): risk factors.

The majority of studies on risk factors for suicide have been conducted in developed countries, and less work has been done to systematically profile risk factors in developing countries. The current paper presents a selective review of sociodemographic, clinical, and environmental/situational risk factors in developing countries. Taken together, the evidence suggests that the profiles of risk factors in developing countries demonstrate some differences from those in developed countries. In some developing countries, at least, being female, living in a rural area, and holding religious beliefs that sanction suicide may be of more relevance to suicide risk than these factors are in developed countries. Conversely, being single or having a history of mental illness may be of less relevance. Risk factors that appear to be universal include youth or old age, low socioeconomic standing, substance use, and previous suicide attempts. Recent stressful life events play a role in both developing and developed countries, although their nature may differ (e.g., social change may have more of an influence in the former). Likewise, access to means heightens risk in both, but the specific means may vary (e.g., access to pesticides is of more relevance in developing countries). These findings have clear implications for suicide prevention, suggesting that preventive efforts that have shown promise in developed countries may need to be tailored differently to address the risk factor profile of developing countries.

Adolescent↗
PubMed2001

Effective screening programmes for cervical cancer in low- and middle-income developing countries.

Cervical cancer is an important public health problem among adult women in developing countries in South and Central America, sub-Saharan Africa, and south and south-east Asia. Frequently repeated cytology screening programmes--either organized or opportunistic--have led to a large decline in cervical cancer incidence and mortality in developed countries. In contrast, cervical cancer remains largely uncontrolled in high-risk developing countries because of ineffective or no screening. This article briefly reviews the experience from existing screening and research initiatives in developing countries. Substantial costs are involved in providing the infrastructure, manpower, consumables, follow-up and surveillance for both organized and opportunistic screening programmes for cervical cancer. Owing to their limited health care resources, developing countries cannot afford the models of frequently repeated screening of women over a wide age range that are used in developed countries. Many low-income developing countries, including most in sub-Saharan Africa, have neither the resources nor the capacity for their health services to organize and sustain any kind of screening programme. Middle-income developing countries, which currently provide inefficient screening, should reorganize their programmes in the light of experiences from other countries and lessons from their past failures. Middle-income countries intending to organize a new screening programme should start first in a limited geographical area, before considering any expansion. It is also more realistic and effective to target the screening on high-risk women once or twice in their lifetime using a highly sensitive test, with an emphasis on high coverage (>80%) of the targeted population. Efforts to organize an effective screening programme in these developing countries will have to find adequate financial resources, develop the infrastructure, train the needed manpower, and elaborate surveillance mechanisms for screening, investigating, treating, and following up the targeted women. The findings from the large body of research on various screening approaches carried out in developing countries and from the available managerial guidelines should be taken into account when reorganizing existing programmes and when considering new screening initiatives.

Adult↗
PubMed2005

Alternatives for the treatment and disposal of healthcare wastes in developing countries.

Waste production in healthcare facilities in developing countries has brought about a variety of concerns due to the use of inappropriate methods of managing the wastes. Inappropriate treatment and final disposal of the wastes can lead to adverse impacts to public health, to occupational health and safety, and to the environment. Unfortunately, most economically developing countries suffer a variety of constraints to adequately managing these wastes. Generally in developing countries, few individuals in the staff of the healthcare facility are familiar with the procedures required for a proper waste management program. Furthermore, the management of wastes usually is delegated to poorly educated laborers who perform most activities without proper guidance and insufficient protection. This paper presents some of the most common treatment and disposal methods utilized in the management of infectious healthcare wastes in developing countries. The methods discussed include: autoclave; microwave; chemical disinfection; combustion (low-, medium-, and high-technology); and disposal on the ground (dump site, controlled landfill, pits, and sanitary landfill). Each alternative for treatment and disposal is explained, including a description of the types of wastes that can and cannot be treated. Background information on the technologies also is included in order to provide information to those who may not be familiar with the details of each alternative. In addition, a brief presentation of some of the emissions from each of the treatment and disposal alternatives is presented.

Developing Countries↗
PubMed1972

Concept of a paediatric emergency ward for the cities of a developing country.

Children's hospitals in developing countries carry an enormous patient load. Available facilities must be organized to provide essential care for all. At the Red Cross Children's Hospital in Cape Town this has been achieved by the development of an emergency ward attached to the outpatient department. It is suggested that this concept should be applied in large hospitals of other developing countries.

Bronchiolitis, Viral↗
PubMed1990

Reproductive epidemiologic research in developing countries.

This paper discusses the scientific rationale for carrying out reproductive epidemiologic research in developing countries, and the generalizability of results of research done in developed countries to developing countries. Practical problems encountered in doing research in developing countries include limited resources, overcommitted researchers, cost, and study monitoring. Cultural differences that affect the design and conduct of research activities in developing countries are also discussed.

Anemia, Sickle Cell↗
PubMed2002

Human campylobacteriosis in developing countries.

Campylobacteriosis is a collective description for infectious diseases caused by members of the bacterial genus Campylobacter. The only form of campylobacteriosis of major public health importance is Campylobacter enteritis due to C. jejuni and C. coli. Research and control efforts on the disease have been conducted more often in developed countries than developing countries. However, because of the increasing incidence, expanding spectrum of infections, potential of HIV-related deaths due to Campylobacter, and the availability of the complete genome sequence of C. jejuni NCTC 11168, interest in campylobacteriosis research and control in developing countries is growing. We present the distinguishing epidemiologic and clinical features of Campylobacter enteritis in developing countries relative to developed countries. National surveillance programs and international collaborations are needed to address the substantial gaps in the knowledge about the epidemiology of campylobacteriosis in developing countries.

Campylobacter Infections↗
PubMed1990

A study of financial resources devoted to research on health problems of developing countries.

The Commission on Health Research for Development is an independent, international commission composed of 12 leaders from the fields of health research, social science research and development policy. Chaired by John Evans, the other Commissioners are Gelia Castillo, vice-chair, F. H. Abed, Sune Bergstrom, Doris Calloway, Esmat Ezzat, Demissie Habte, Walter Kamba, Adetokumbo Lucas, Adolfo Martinez-Palomo, Saburo Okita and V. Ramalingaswami. The Commission began its work in November 1987, charged with analysing the strengths, weaknesses and gaps in current research on health problems of developing countries, and making proposals and promoting action for improvement. The Commission is sponsored by a variety of foundations, bilateral donor agencies, and international organizations. The Commission's report was published in the spring of 1990. As part of the work of the Commission Secretariat, we have undertaken a study of financial resources devoted to research on the health problems of developing countries. The study which began in May 1988 has three objectives: (i) To describe the current pattern of funding for research on the health problems of developing countries. (ii) To provide a baseline against which future trends and/or new programmes can be measured. (iii) To explore the possibility of an ongoing information system on research on health problems of developing countries.

Developing Countries↗
PubMed1985

Socioeconomic and health effects on mortality declines in developing countries.

It has been argued that mortality declines in developing countries have not been associated with social and economic factors because of the diffusion from the developed countries to the developing countries of health and medical techniques. This paper examines the relationship between socioeconomic development and health and mortality declines in developing countries which are in two different stages of the demographic transition. A path model linking socioeconomic and health variables and mortality is developed and tested for early and late transition nations. The empirical findings indicated that the network of socioeconomic variables and their effects on mortality were much more significant in late transition countries than in early transition countries. While the impact of health services on crude death rates is large in the early transition nations, its impact declines considerably as countries reach a more transitionally 'mature' stage.

Cross-Cultural Comparison↗
PubMed2002

Problems of modern urban drainage in developing countries.

Socio-economic factors in developing countries make it more difficult to solve problems of urban drainage than in countries that are more advanced. Factors inhibiting the adoption of modern solutions include: (1) in matters of urban drainage, 19th-century sanitary philosophy still dominates; (2) both legal and clandestine land settlement limits the space that modern solutions require; (3) contamination of storm runoff by foul sewage, sediment and garbage prevents adoption of developed-country practices; (4) climatic and socio-economic factors favour the growth of epidemics where runoff is retained for flood-avoidance and to increase infiltration; (5) lack of a technological basis for adequate drainage management and design; (6) lack of the interaction between community and city administration that is needed to obtain modern solutions to urban drainage problems. Awareness of these difficulties is fundamental to the search for modern and viable solutions appropriate for developing countries.

Brazil↗
PubMed1996

Prospects, problems, and prerequisites for national health examination surveys in developing countries.

Design options for the development of health information systems are evaluated. The health examination survey is found to be an appropriate method for meeting data needs for health planning, program design, and evaluation activities in developing countries. The model proposed is a national cross-sectional prevalence survey employing both interviews and physical examinations to produce a health status profile of a countries population. Examination data are objective, internationally comparable, and not dependent upon reports of clinical encounters in the population. Limitations inherent to health examination surveys are reviewed in reference to their potential in developing countries. Not all countries may be able to conduct health examination surveys; criteria are presented to assist in evaluation of the feasibility of application in specific countries.

Cross-Sectional Studies↗
PubMed2001

Antenatal care in developing countries. What should be done?

Development of antenatal care from the beginning of the 20th century and its relation to perinatal mortality in developed countries is presented. The role of socioeconomic factors, new diagnostic and therapeutic procedures, extended indications for cesarean section and of neonatal intensive care is also stressed. In the West- and Middle-European countries by the introduction of antenatal care the perinatal mortality (PNM) rate decreased from about 60.0@1000 in the years 1920-1930 to about 40.0@1000 in 1950s. Further decrease to about 25.0@1000 in the 1970s was conditioned by an increase of number of antenatal visits and by extended indications for cesarean section. New technologies (amnioscopy, pH.metry, cardiotocography and ultrasound examinations) decreased the PNM rate to about 13.0@1000 in the year 1980. Regional organization with neonatal intensive care units decreased PNM rate to low values of 5.0-9.0@1000. The echo of the number of antenatal visits to PNM rate is illustrated on 36,855 deliveries at the University Clinic in Zagreb. In developing countries maternal and perinatal mortality is very high. The reason for that is a bad socioeconomic background and a lack of organized antenatal and perinatal health care system. The policy to decrease maternal and perinatal mortality is presented: the improvement of antenatal booking and of the number of prenatal visits of pregnant women; their childbearing under professional assistance. The organizing of maternity health care should be different from country to country, from region to region, respectively.

Developing Countries↗
PubMedDate not supplied

[Organ transplantation as a health priority in developing countries].

The epidemiology profile of developing countries is in transition. While the prevalence of infectious and preventable diseases, malnutrition, and in general the health problems traditionally associated to the poor, is still high, the characteristic health profile of industrialized countries (i.e. chronic and degenerative diseases, accidents, violence, social pathology) is beginning to surface. This paper focuses on the need to consider organ transplantation as a health priority in developing countries, as an important element in the global strategy to cover both aspects of the health care demand.

Developing Countries↗
PubMedDate not supplied

[Artificial crystalline lens in developing countries (author's transl)].

In developing countries, cataract affects many young but also poor patients. They have difficulties to get operated and generally cannot afford to buy spectacles. Implanting artificial crystalline lens is, then, theorically the best solution. This skillfull technique, nevertheless, requires a high level sanitary environment. Recent advances in the surgical treatment of cataract and postoperative correction of aphakia minimized its risks. Improvements in plastics technology give new possibilities. A study of the various techniques available and of the changes required in the sanitary environment of developing countries give some hope for a possibility of using artificial crystalline lens in these countries.

Cataract↗
PubMed2005

Does pleural tuberculosis disease pattern differ among developed and developing countries.

BACKGROUND: A number of reports from developed countries have documented a rising age at which pleural tuberculosis occurs and increase in the frequency of reactivation disease being as the main cause of pleural involvement. OBJECTIVE: To determine the age at which pleural tuberculosis occurs, study its clinical pattern, and to determine whether pleural tuberculosis is a result of reactivation of pulmonary tuberculosis or it is a primary one comparing our findings with results from developed countries. METHOD: Retrospective study of 100 cases discharged from Hamad General Hospital with the diagnosis of pleural tuberculosis from January 1996 to December 2002. RESULTS: Pleural tuberculosis tends to affect younger age groups (84% are below the age of 45 years, with mean age of 31.5). The disease tends to be mostly a primary infection. Fever is the most common symptom (90%) and the disease is usually an acute or sub acute one. Weight loss precedes other symptoms. Exudative pleural effusion with predominant lymphocytosis is characteristic. Majority of patients have no predisposing conditions for the disease. CONCLUSION: In contrast to what has been reported in some developed countries, Pleural tuberculosis tends to be a primary disease in the present study. Younger age groups are particularly affected.

AIDS-Related Opportunistic Infections↗