SEARCH · PubMed Health

Results for “Developing Countries”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 379 records · Page 21Linked to original sources

PubMed1990

[Modern health care systems in industrially developed countries].

The present paper characterizes the health care systems in several chosen capitalistic countries with developed industries. The health care systems are referred to in USA, Sweden, Japan and Great Britain. Mentioned countries are now able to subsidize their public health care with 6.5 to 11% gross national products and about 1,000 dollars for 1 citizen a year in average. The health care tends to be provided generally from governmental sources, though in lesser extent in USA, being still covered there with almost 50% from national budget. Nowadays a certain trend is manifested in providing better health care as well as health status of population without rising costs. This was notably achieved in Sweden. In industrially developed countries, no straight relation has been found between the cost-expenditure of the health care and the level of health status achieved as measured with the use of population health characteristics. The extent of health investments is directly dependent of country's economical level and that of national budget which is created there.

Delivery of Health Care↗

PubMed2000

Early onset of endocrine abnormalities in beta-thalassemia major in a developing country.

Endocrine complications in patients with thalassemia major in developing countries may be frequent due to suboptimal iron chelation. Data from developing countries are scant. We prospectively evaluated growth, growth hormone (GH), insulin-like growth factor I, thyroid hormone, cortisol and glucose tolerance in 84 patients over one year. Height standard deviation (SD) score of patients > 8 years (-2.2 +/- 1.5 against National Center for Health Statistics references) was significantly lower than that of normal controls (-1.0 +/- 0.7, p < 0.001). 51% of patients had GH deficiency, 13% hypocortisolism and 7.9% diabetes/impaired glucose tolerance. Ten of 11 adolescents/young adults had hypogonadism. Of 54 preadolescent children who underwent dynamic testing, 18 (33%) had at least one endocrine deficiency other than short stature. We conclude that hypogonadism and hypocortisolism form important causes for morbidity in our thalassemic children. Thalassemic patients in developing countries may be at risk for endocrine deficiencies at younger ages.

Adolescent↗

PubMed2003

Biomedical research in developing countries: the case of Morocco in the 1990s.

Moroccan biomedical research occupies the third place among African or Arab countries, and its outputs considerably increased during the last decade. The quality of publications from developing countries should be improved as suggested by the comparison with developed countries. The gap between developed and developing countries is very large considering the number of publications and their quality, the number of edited journals, and the number of patented inventions, thus making developing countries more as consumers then producers. Accordingly, there is a large gap between developing and developed countries when considering the human and financial resources devoted to scientific research.

Bibliometrics↗

PubMed2005

Community-based interventions for improving perinatal and neonatal health outcomes in developing countries: a review of the evidence.

BACKGROUND: Infant and under-5 childhood mortality rates in developing countries have declined significantly in the past 2 to 3 decades. However, 2 critical indicators, maternal and newborn mortality, have hardly changed. World leaders at the United Nations Millennium Summit in September 2000 agreed on a critical goal to reduce deaths of children <5 years by two thirds, but this may be unattainable without halving newborn deaths, which now comprise 40% of all under-5 deaths. Greater emphasis on wide-scale implementation of proven, cost-effective measures is required to save women's and newborns' lives. Approximately 99% of neonatal deaths take place in developing countries, mostly in homes and communities. A comprehensive review of the evidence base for impact of interventions on neonatal health and survival in developing-country communities has not been reported. OBJECTIVE: This review of community-based antenatal, intrapartum, and postnatal intervention trials in developing countries aimed to identify (1) key behaviors and interventions for which the weight of evidence is sufficient to recommend their inclusion in community-based neonatal care programs and (2) key gaps in knowledge and priority areas for future research and program learning. METHODS: Available published and unpublished data on the impact of community-based strategies and interventions on perinatal and neonatal health status outcomes were reviewed. Evidence was summarized systematically and categorized into 4 levels of evidence based on study size, location, design, and reported impact, particularly on perinatal or neonatal mortality. The evidence was placed in the context of biological plausibility of the intervention; evidence from relevant developed-country studies; health care program experience in implementation; and recommendations from the World Health Organization and other leading agencies. RESULTS: A paucity of community-based data was found from developing-country studies on health status impact for many interventions currently being considered for inclusion in neonatal health programs. However, review of the evidence and consideration of the broader context of knowledge, experience, and recommendations regarding these interventions enabled us to categorize them according to the strength of the evidence base and confidence regarding their inclusion now in programs. This article identifies a package of priority interventions to include in programs and formulates research priorities for advancing the state of the art in neonatal health care. CONCLUSIONS: This review emphasizes some new findings while recommending an integrated approach to safe motherhood and newborn health. The results of this study provide a foundation for policies and programs related to maternal and newborn health and emphasizes the importance of health systems research and evaluation of interventions. The review offers compelling support for using research to identify the most effective measures to save newborn lives. It also may facilitate dialogue with policy makers about the importance of investing in neonatal health.

Child Health Services↗

PubMed2004

Overcoming ethical barriers to childhood tuberculosis research in developing countries.

In 2002, an international Workshop on Tuberculosis in Children was held to determine priority areas for basic, clinical and programmatic research to improve paediatric TB practice. During the workshop, issues related to the ethical treatment of children as research subjects, particularly in resource-poor settings, were identified as major constraints to the goal of expanding paediatric TB research. Based on participation in the workshop discussions, this article proposes concrete activities that can begin to address the ethical barriers. The time and costs associated with creating collaborative scientific and ethical research projects between high and low-income countries should be supported in grants for paediatric TB research studies in developing countries. Paediatric TB researchers in developing countries should be given opportunities to participate in international programmes that develop bioethics expertise. Relevant case studies of paediatric research in developing countries can assist ethical review committees in industrialised countries in understanding the special issues related to paediatric research in resource-limited settings. Paediatricians in developing countries need to be included in childhood TB research studies and ethical review committees.

Age Factors↗

PubMed1996

Gram negative bacillary meningitis in infants and children in developing countries.

Gram negative bacillary meningitis (GNBM) in postneonatal infants and children is two to three times more common in developed compared to developing countries. Other major differences are in the pattern of pathogens (mainly Klebsiella spp and Salmonella spp in developing versus E. coli in developed countries) and associated conditions (diarrhoeal diseases and malnutrition in developing versus neurosurgical and urinary tract abnormalities in developed countries). 12 (11.5%) of 104 cases of bacterial meningitis were due to GNB, including Klebsiella spp seven, E. coli, two and untyped Coliform spp, three; the age range of patients with GNBM was 3-24 months. Among seven completely evaluable patients, six presented after seven days of illness, five convulsed on or before admission, and six had accompanying respiratory or gastro-enteritic illnesses but none was severely malnourished or had associated neurosurgical or urinary tract abnormalities. Three patients died, three were discharged with sequelae and one without sequelae. The only significant difference between patients with GNBM and those with meningitis due to "usual" pathogens was the greater tendency to delayed presentation among the former (6/7 patients with GNBM versus 11/36 "usual" pathogens; p = 0.011); this was also the only striking difference in presentation when compared with patients from developed countries. The need for further studies, preferably multicentred, and for a revision of the traditional combination of gentamicin and ampicillin or chloramphenicol and ampicillin for the treatment of GNBM in developing countries is discussed.

Adolescent↗

PubMed1999

The burden of pneumococcal disease among adults in developed and developing countries: what is and is not known.

The burden of pneumococcal disease among adults in developed countries is neither widely known nor appreciated. The incidence of pneumococcal pneumonia is uncertain because a precise diagnosis cannot be obtained for most patients. Population-based data on invasive pneumococcal disease (e.g., bacteraemia and meningitis) suggest an annual incidence in all developed countries of > or =15-20 cases per 100,000 persons of all ages and > or =50 cases per 100,000 elderly adults (> or =65 years). In developing countries there are no population-based data on the burden of pneumococcal disease among adults. Studies of high risk groups, hospital-based studies, vaccine efficacy trials, extrapolations from surveillance of "native populations" in developed countries, and demographic studies in developing regions all suggest a high burden of disease. The broad variation in these estimates, however, indicates that better studies are needed. Increased use of pneumococcal vaccines among adults in all countries will depend on better scientific and public understanding of the burden of pneumococcal disease. In developing countries, intensive community-based studies of the impact of pneumococcal disease, or, alternatively, a "vaccine probe" approach, in which a population is vaccinated and the reduction in pneumonia is compared with that in a control population, could give more accurate estimates of the burden of disease and of the potential effectiveness of pneumococcal vaccination among adults.

Adult↗

PubMedDate not supplied

Cancer in developing countries.

Cancer is a major cause of mortality in developing countries, accounting for 13 percent of the annual deaths in adults. As the population increases and ages, the number of new cases of cancer is expected to increase dramatically. This article presents epidemiologic information on the principal cancers in developing countries and outlines the increasing challenge for the control of cancer in developing countries.

Age Factors↗

PubMed2004

Promotion of smoking cessation in developing countries: a framework for urgent public health interventions.

The rapid rise in smoking in many developing countries will have devastating consequences; by 2030 the developing world is expected to have 7 million deaths annually from tobacco use. Many smokers express a desire to quit, but they often fail because they are addicted to tobacco. Although a number of cessation aids are now available in the developed world, their applicability and affordability in developing countries is less clear. Successful interventions will require many stakeholder groups to take action at the local, national, and international levels. We discuss smoking cessation as a means of reducing disease burden, examine factors that may limit the promotion of smoking cessation in developing countries, and propose a framework for public health action. This framework should comprise intervention with healthcare professionals, strengthening national commitment, development of a model for developing countries, changing the social acceptability of smoking, strengthening community participation, integration of smoking cessation with other healthcare services, specifying the role of healthcare professionals, development of guidelines, mobilisation of the business community, provision of financial incentives, establishing population specific smoking cessation services, increased collaboration between countries, and development of international initiatives.

Commerce↗

PubMed1979

Treatment of epilepsy: with special reference to developing countries.

1. Epilepsy, a common chronic neurological disorder, constitutes an important medical problem especially as in the developing countries there is a great dearth and shortage of health personnel, especially trained ones, in clinical neurosciences. The prevalence of epilepsy in developing countries is probably higher than in the Caucasians although accurate epidemiological data are lacking. 2. Epilepsy is discussed with special regard to the need for accurate diagnosis, and the difficulties encountered in developing countries. 3. Pharmacotherapy should be as simple as possible and suggestions are made on the essential drugs useful in the control of epilepsy with special reference to developing countries and in the context of economics and ready availability. Grand mal and focal epilepsies could be controlled by phenobarbitone, with phenytoin, sulthiame and carbamazepine kept as reserves or adjuncts. Minor (generalised) epilepsies could be controlled by ethosuximide, with clonazepam and sodium valproate (sodium dipropylacetate) as reserve drugs and adjuncts. For status epilepticus, diazepam is effective and readily available, with clonazepam and phenytoin as alternatives. 4. The problems in the management of epilepsy in the developing countries include lack of facilities and personnel to ensure accurate diagnosis and treatment, inadequate supply or non-availability of drugs, high defaulting rate of patients, the adverse and often pernicious social stigmatisation of the epileptic. 5. Possible solutions to some of these problems include integration of management (in simple terms) of convulsive disorders into the basic health system of delivery of health care in developing countries, aggressive pursuit of health education of the public by governmental and non-governmental agencies, active, intensive and sustained promotion of training of health personnel in clinical neurosciences and research aimed at producing long-acting anticonvulsants.

Africa↗

PubMed2005

Management of hemophilia with minimal factor replacement in developing countries: role of ancillary therapy.

Compared with developed countries, the care of hemophiliacs in still relatively poor in developing countries. There are three major factors that influence this problem: inadequate knowledge, lack of laboratories to diagnose the disorder, and inadequate supply of factor concentrates. It is important that healthcare providers and family members of these patients be adequately educated about all of the aspects of hemophilia. Basic laboratories could be established at a reasonable price, technical personnel could be trained, and quality-assurance programs could be initiated. Even in the absence of high-quality factor concentrates, which are expensive, there are affordable means to manage these patients, although certainly not optimally. To overcome these problems, hemophilia care services need to be established and integrated to facilitate the basic needs for these patients.

Blood Coagulation Factors↗

PubMed2005

Effluent standards for developing countries: combining the technology- and water quality-based approach.

It is a challenge for developing countries to realize socio-economical development without impairing water resources in an unacceptable way. A possible means for controlling water pollution is through defining, applying and enforcing effluent standards for wastewater discharges. However, in many developing countries the definition of effluent standards is still poor. They are either too stringent because they are based on standards from developed countries, or too relaxed and therefore they do not guarantee the safe intended uses of water. In order to define an approach for setting effluent standards that suits the needs and means of developing counties, water quality management practices in the USA, the EU, the New Independent States (NIS) and the Philippines were analyzed and compared. Four criteria (protection of the environment, technical viability, economic feasibility and institutional capacity requirements) were used to assess the suitability of these practices for developing countries. It is concluded that a combined approach that is based on best available technology not entailing excessive costs and environmental quality standards is the best way to define effluent standards that restrict water pollution against affordable costs.

Conservation of Natural Resources↗

PubMed1993

Measles control in developing and developed countries: the case for a two-dose policy.

Despite major reductions in the incidence of measles and its complications, measles control with a single dose of the currently used. Schwarz strain vaccine has failed to eradicate the disease in the developed countries. In developing countries an enormous toll of measles deaths and disability continues, despite considerable efforts and increasing immunization coverage. Empirical evidence from a number of countries suggests that a two-dose measles vaccination programme, by improving individual protection and heard immunity can make a major contribution to measles control and elimination of local circulation of the disease. Cost-benefit analysis also supports the two-dose schedule in terms of savings in health costs, and total costs to society. A two-dose measles vaccination programme is therefore an essential component of preventive health care in developing, as well as developed countries for the 1990s.

Cost-Benefit Analysis↗

PubMed2002

Salmonellosis in children in developing and developed countries and populations.

PURPOSE OF REVIEW: The present review addresses recent developments that relate to the clinical management and prevention of childhood salmonellosis in developed and developing countries. RECENT FINDINGS: Invasive disease due to serovar Typhi as well as nontyphoidal salmonellae (NTS) is common in children younger than 5 years old in developing countries, and multidrug resistance is an increasingly difficult problem to manage. A new conjugate vaccine was found to be very effective in preventing typhoid fever in young Vietnamese children and was well tolerated, showing great promise for the future. Antibiotic use in the food animal industry is an important source of disease with multidrug resistant NTS strains in the developed world. Efforts for prevention are aimed at immunization of animals, control of antibiotic use in the food animal industry and careful monitoring of food-borne outbreaks. On the other hand, although the burden of NTS disease in children is far greater in developing countries, especially in tropical Africa, knowledge of even basic epidemiology is lacking. Importantly, it may be that, as spp. acquire increasing resistance, they also acquire increasing virulence that will lead to even greater morbidity and mortality. SUMMARY: Recent developments include a better knowledge of clinical aspects of invasive salmonellosis, an increasing response to the problem of multiple antibiotic resistance (including quinolones), and excellent results from the use of a recently developed conjugate vaccine for typhoid fever in children as young as 2 years old.

Anti-Bacterial Agents↗

PubMed1986

In-hospital maternal mortality risk by cesarean and vaginal deliveries in two less developed countries--a descriptive study.

Cesarean deliveries are increasing in both developed countries and less developed countries (LDCs). Recent studies in the U.S. have revealed a significantly higher mortality risk for women who delivered abdominally than for those who delivered vaginally, even when the effect of the conditions which necessitated cesarean delivery was taken into account. We chose for study from an international maternity monitoring network, five centers from two LDCs that reported an in-hospital maternal mortality rate (MMR) of around 10 per 1000 parturient women. The pooled data revealed an MMR of 5.1 per 1000 women with vaginal deliveries. For women with cesarean delivery, the total MMR was 36.2 and the MMR attributable to cesarean section was estimated to be 12.8; both rates were per 1000 procedures. The leading cause of death was eclampsia for the vaginal deliveries and sepsis for the cesarean deliveries. The risk of maternal mortality inherent with the cesarean section procedure per se (not counting the risk associated with the labor and delivery complications that necessitated cesarean section) as well as the practical avoidability of maternal deaths for either mode of delivery in these LDC hospitals are discussed.

Anesthesia, Obstetrical↗

PubMed1993

Developing and maintaining of hemophilia programs in developing countries.

There are elements key to the success of developing and maintaining hemophilia programs in developing countries. Health care providers who are dedicated champions of hemophilia care are essential. Their training through the WFH International Hemophilia Training Centers brings them in contact with modern comprehensive care as well as establishes collegial linkages with treaters in developed centers. Affordable, safe, viral free coagulation products are essential for an effective hemophilia program. Developing essential for an effective hemophilia program. Developing countries may have to use intermediate purity products because of economic considerations, but technologies must be used which reduce the risk of viral contamination. Successful programs also result from linking to hemophilia programs with national health care initiatives. Hemophilia health care must be recognized as a priority within the developing country's health care system.

Developing Countries↗

PubMed2004

Prevalence of hyperuricemia and relation of serum uric acid with cardiovascular risk factors in a developing country.

BACKGROUND: The prevalence of hyperuricemia has rarely been investigated in developing countries. The purpose of the present study was to investigate the prevalence of hyperuricemia and the association between uric acid levels and the various cardiovascular risk factors in a developing country with high average blood pressures (the Seychelles, Indian Ocean, population mainly of African origin). METHODS: This cross-sectional health examination survey was based on a population random sample from the Seychelles. It included 1011 subjects aged 25 to 64 years. Blood pressure (BP), body mass index (BMI), waist circumference, waist-to-hip ratio, total and HDL cholesterol, serum triglycerides and serum uric acid were measured. Data were analyzed using scatterplot smoothing techniques and gender-specific linear regression models. RESULTS: The prevalence of a serum uric acid level >420 micromol/L in men was 35.2% and the prevalence of a serum uric acid level >360 micromol/L was 8.7% in women. Serum uric acid was strongly related to serum triglycerides in men as well as in women (r = 0.73 in men and r = 0.59 in women, p < 0.001). Uric acid levels were also significantly associated but to a lesser degree with age, BMI, blood pressure, alcohol and the use of antihypertensive therapy. In a regression model, triglycerides, age, BMI, antihypertensive therapy and alcohol consumption accounted for about 50% (R2) of the serum uric acid variations in men as well as in women. CONCLUSIONS: This study shows that the prevalence of hyperuricemia can be high in a developing country such as the Seychelles. Besides alcohol consumption and the use of antihypertensive therapy, mainly diuretics, serum uric acid is markedly associated with parameters of the metabolic syndrome, in particular serum triglycerides. Considering the growing incidence of obesity and metabolic syndrome worldwide and the potential link between hyperuricemia and cardiovascular complications, more emphasis should be put on the evolving prevalence of hyperuricemia in developing countries.

Adult↗

PubMed1995

Reproductive technologies in developing countries.

Are there any ethical concerns about reproductive technologies that are specific or unique to developing countries? Three ethical concerns often mentioned specifically in regard to developing countries are (1), the "overpopulation argument"; (2) the limited resources argument; and (3) the ethical problem of poorly trained practitioners offering their services to unsuspecting and uninformed infertile individuals or couples. Each argument is explored in some detail, with the conclusion that ethical problems do, in fact, exist but are not unique to developing countries. Nevertheless, the difficulties relating to reproductive technologies are likely to be greater in developing countries than in developed ones because of limited resources and a larger number of poor people residing there.

Delivery of Health Care↗