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 433 records · Page 24Linked to original sources

PubMed1998

Inhibitor development and substitution therapy in a developing country: Turkey.

Prevalence of inhibitor in developing countries, such as Turkey, where fresh frozen plasma (FFP) is still in use due to high cost of concentrates, is unknown. To determine the frequency of inhibitors in Turkish haemophiliacs exposed to blood products, 53 haemophilia A patients (age range 1-20; median: 11 years) and 12 haemophilia B patients (age range 3-20; median: 10 years), were evaluated; 31 haemophilia A patients (23 severe) received plasma-derived concentrates and 22 patients (10 severe) only FFP. No haemophilia B patients developed inhibitor, compared with seven of 53 (13%) haemophilia A patients, all with a severe defect (7/33; 21%) and treated with concentrates (7/23; 30%), whereas severe patients treated with FFP showed a lower risk to develop inhibitors (0/10, P = 0.07). Inhibitors were detected after 8-125 exposure days (median: 52). Intermediate-purity concentrates and pasteurization seemed to be linked with a higher risk of inhibitor compared to high-purity concentrates and solvent-detergent inactivation for seven patients with inhibitor. In four of seven inhibitor patients low-dose concentrate was administered at 25 IU kg-1 twice weekly and inhibitor disappeared in 1-4 months. This regimen might be recommended for immune tolerance in developing countries for its lower cost.

Adolescent↗

PubMed1991

[Epidemiology of sexually transmissible diseases in developing countries in the era of AIDS].

Recent developments in the epidemiology of sexual transmitted diseases (STD) in developing countries are reviewed. STD are very frequent in the tropics, particularly in large urban areas. They put a heavy burden on public health because they affect the economically most important age groups and because their sequellae may be fatal. Pelvic inflammatory disease and its consequences, and morbidity during pregnancy and the neonatal period are among the most important causes of mother and child morbidity. STD favour sexual transmission of HIV and may therefore explain the explosive AIDS epidemics in many developing countries. Antimicrobial resistance has made treatment of gonorrhoea and chancroid more difficult and more expensive. STD and HIV infection may be responsible for up to 17% of productive years lost to disease in certain regions. Strategies to control STD should be developed and linked with the AIDS programs. Both should be integrated in the primary health care system.

Developing Countries↗

PubMed1998

Trends in the global healthcare environment: the developed countries.

The purpose of this paper is to examine trends in the global healthcare environment, especially the developed countries. The developed countries are examined in detail as they have influenced the changes that have occurred in the delivery of healthcare in Australia. The countries discussed include the United States, Canada, Europe and Australia. The most concerning trend is the increase in healthcare spending. There has been a marked rise in the cost of hospital and other institutionalised care and health insurance. The ageing population and the increased use of sophisticated and expensive equipment have also increased costs. Other issues identified are, the declining number of hospitals beds, the shift from care in the hospitals or institutions to care in the home or community, the increase in continuum of care programs, the establishment of health care networks, focus on service quality, the lack of security about gaining health insurance and the focus on treatment rather than prevention.

Australia↗

PubMed2002

[Epidemiological research on dementia in developing countries].

As the world population is ageing, dementia becomes an important public health problem, particularly in developing countries. Epidemiological research in these settings is scarce and present additional methodological difficulties, mainly regarding the socio-cultural adequacy of instruments used to identify cases of dementia. As a result of these concerns the 10/66 Dementia Research Group was founded to fill this gap. This is an international network of investigators, mostly from developing countries, and the group's name was based on the paradox that less than 10% of the population-based studies on dementia are directed to 2/3 or more cases of people with dementia living in developing countries. The aim of the paper is to update data in the literature regarding the differences in dementia prevalence and incidence seen in developed and developing countries.

Dementia↗

PubMed1998

Maternal carriage of group B streptococci in developing countries.

BACKGROUND: Group B streptococcus (GBS) is a leading cause of neonatal sepsis in many industrialized countries, but reports from the developing world infrequently identify this pathogen among newborns with sepsis. Studies of GBS colonization among women living in developing countries were reviewed to determine whether lower colonization rates might account for these findings. METHODS: Literature was reviewed with the use of Medline Express (1980 to 1996) and Abstracts on Tropical Agriculture and Rural Development in the Tropics (1975 to 1995). The methods of each report were considered adequate if specimens were collected from the vagina and if selective broth media were used. RESULTS: Thirty-four studies reported results of cultures from 7730 women; overall colonization was 12.7%. Among only those studies in which methods were adequate, 17.8% (675 of 3801) women were identified as colonized. Studies with adequate methods found significantly higher colonization rates (relative risk, 2.3; 95% confidence interval, 2.0 to 2.6) than those using inadequate methods. When analysis was restricted to reports with adequate methods, the prevalence of colonization by region was as follows: Middle East/North Africa, 22%; Asia/Pacific, 19%; Sub-Saharan Africa, 19%; India/Pakistan, 12%; and Americas, 14%. CONCLUSION: Although there is significant geographic variation in the proportion of women colonized with GBS, the range of colonization reported from developing countries is similar to that identified in populations studied in the United States. Specimen collection and microbiologic methods are important factors in identification of women colonized with GBS.

Adult↗

PubMedDate not supplied

Gender and adult undernutrition in developing countries.

BACKGROUND: Information on the prevalence of undernutrition in adults in developing countries is mainly restricted to data on women. Literature reporting on the occurrence of female deprivation in developing countries, in particular in South Asia, suggests that differences between undernutrition prevalence in adult men and adult women might occur, but systematic information on the subject is lacking. AIM: The study compares undernutrition prevalence rates, based on prevalence of low body mass index (BMI < 18.5), in adult men and adult women in developing countries. Regional comparison is made between the main developing regions: Sub-Saharan Africa, South/Southeast Asia and Latin America. SUBJECTS AND METHODS: The study uses data as reported in 75 samples from 31 countries(divided over the three developing regions), in which anthropometric information has been collected in adult men and women within one and the same community. RESULTS: Results indicate that, in general, prevalence rates of undernutrition are rather similar in adult men and women. However, there are regional differences. In communities in Sub-Saharan Africa, prevalence of low BMI is, on average, a few percent higher in men than in women; in South/Southeast Asia the reverse is the case. In some communities differences in undernutrition prevalence between men and women are exceptionally large. CONCLUSIONS: It can be concluded that, in general, information on undernutrition prevalence in women can be considered a proxy for undernutrition prevalence in all adults, men and women together. However, the finding that in South/Southeast Asia women's nutritional status relative to men's nutritional status compares unfavourably with results from other developing regions, in particular Sub-Saharan Africa, provides some support for the concept of female deprivation in South/Southeast Asia. Where large differences between prevalence of low BMI in men and women occur, gender-specific policies aimed at reducing under-nutrition should be considered.

Adult↗

PubMed2006

Specific caries index: A new system for describing untreated dental caries experience in developing countries.

OBJECTIVES: To develop a reproducible surface-specific caries index that provided qualitative and quantitative information about untreated dental caries, that could be used in conjunction with the DMFS index and would provide information on not only the caries prevalence but also the location and type of caries lesion in an individual based on clinical examination. METHODS: Untreated carious lesions were divided into six types based on the location of the lesions. 339 rural school children in the age group of 12-15 years were examined for dental caries using both the DMFS index and the Specific Caries Index. RESULTS: Type 1 and 2 were found to be the most common type of caries lesions. The reproducibility of the Specific Caries Index was also found to be good. CONCLUSIONS: Encouraging indications about the validity and reproducibility of this new caries index was found, suggesting the need for further studies to test its applicability in larger and different populations.

Adolescent↗

PubMed2006

Issues in the design and implementation of vaccine trials in less developed countries.

There is a growing need for vaccine trials in developing countries. This need arises from the fact that some vaccines do not perform as well in developing as in industrialized country populations and because some newly developed candidates target diseases found only in less-developed countries. Here we discuss several key issues in the design and implementation of vaccine trials in less-developed countries. These include the phasing of vaccine trials on safety, immunogenicity and efficacy to achieve licensure; the recent use of trials to obtain other information crucial to the ultimate deployment of vaccines (such as immunological correlates of protection, indirect vaccine effects, and practical information on the feasibility, costs and acceptability of vaccine introduction); and several ethical issues that have arisen in connection with trials done in developing countries.

Clinical Trials as Topic↗

PubMed2000

Obesity in women from developing countries.

OBJECTIVES: The key objective was to estimate obesity (>/=30 kg/m2) in women 15-49 y from developing countries. A second objective was to study how obesity varies by educational level and by residence in urban and rural areas. A third objective was to investigate how national incomes shape the relationship between obesity and eduction or residence. DESIGN: The analyses use cross-sectional data from nationally representative surveys from developing countries carried out in the last decade. Most of the surveys were Demographic Health Surveys (DHS). Data from a survey from the USA are used for comparison. SETTING: The 39 surveys used come from 38 developing countries and the USA. SUBJECTS: A total of 147,938 non-pregnant women 15-49 y were included in the analyses. RESULTS: The percentage of obese women was 0.1% in South Asia, 2.5% in Sub-Saharan Africa, 9. 6% in Latin America and the Caribbean, 15.4% in Central Eastern Europe/Commonwealth of Independent States (CEE/CIS), 17.2% in the Middle East and North Africa, and 20.7% in the USA. Levels of obesity in countries increased sharply until a gross national product of US$1500 per capita (1992 values) was reached and changed little thereafter. In very poor countries, such as in Sub-Saharan Africa, obesity levels were greatly concentrated among urban and higher educated women. In more developed countries, such as those in Latin America and the CEE/CIS regions, obesity levels were more equally distributed in the general population. CONCLUSIONS: Based on the analyses presented and on a review of the literature, it is concluded that obesity among women is a serious problem in Latin America and the Caribbean, the Middle East and North Africa, and the CEE/CIS region. Obesity is less of a concern in Sub-Saharan Africa, China and South Asia. Obesity levels increased over time in most of the limited number of countries with data, but at varying rates. Rising national incomes in developing countries and increased 'Westernization' will most likely lead to increased levels of obesity in the future. SPONSORSHIP: Financial support was provided by the Food and Nutrition Program of the Pan American Health Organization and by the World Bank.

Adolescent↗

PubMed1978

Patterns of fertility decline in developing countries, 1950-75.

Since 1965 there have been substantial declines in the crude birth rates of many countries in the developing world, particularly the largest countries. This auspicious trend is shown clearly in an analysis of population figures for the last 25 years, despite the fact that there are deficiencies in the data. In 1950 the average crude birth rate for developing countries was 42 per thousand per year. Over the next 15 years, declines in the crude birth rate were limited to a relatively few, and for the most part small, countries. After 1965, however, for the 13 developing countries with a population numbering 35 million and over, there have been declines in the crude birth rate averaging 13 percent, with declines of over 12 percent in 9 of them. The effects of a number of sociodemographic factors on crude birth rates are examined, and the analysis shows that increases in the age at marriage and decreases in marital fertility were the principal factors affecting declines since 1965.

Adolescent↗

PubMed2004

Environmental engineering education for developing countries: framework for the future.

This paper presents the existing philosophy, approach, criteria and delivery of environmental engineering education (E3) for developing countries. In general, environmental engineering is being taught in almost all major universities in developing countries, mostly under civil engineering degree programmes. There is an urgent need to address specific inputs that are particularly important for developing countries with respect to the reality of urbanisation and industrialisation. The main component of E3 in the near future will remain on basic sanitation in most developing countries, with special emphasis on the consumer-demand approach. In order to substantially overcome environmental problems in developing countries, E3 should include integrated urban water management, sustainable sanitation, appropriate technology, cleaner production, wastewater minimisation and financial framework.

Cities↗

PubMedDate not supplied

Childhood cancer in developing countries.

The problem of childhood cancer cannot be evaluated separately from developmental levels and states of health of the countries. Rapid increase in population, poverty, poor hygiene, lack of education, and multitude health problems impede the development of pediatric oncology and success of the management of childhood cancer in developing countries. More than 85% pediatric cancer cases occur in developing countries that use less than 5% of world resources. The rate will exceed 90% in the next two decades, due to the increase of youth population in favor of developing countries. Incidence rates, pathology, and clinical characteristics of various cancers seem different in developing and developed countries. Different environments, life styles, dietary habits, and hygienic conditions are the main reasons for those differences. Unprecedented changes in diagnostic techniques, treatment methods and supportive care have occurred during the last decades. Consequently, management has improved and the mortality rates have decreased. Most of the children with cancer living in developing countries could not profit from those advances in pediatric oncology because of the cost.

Age Distribution↗

PubMed2000

Mutual benefits from epilepsy surgery in developed and developing countries.

The last three decades have seen tremendous progress in the surgical management of patients with intractable epilepsy involving all facets of diagnosis, localization, operative technique, and research. Unfortunately, such progress has taken place and is in operation only in the developed countries of North America, Europe, and Japan. Epilepsy surgery programs in the developing countries of South America, Asia, and particularly Africa, if they exist at all, are the result of the individual efforts of physicians who were fortunate enough to receive their training abroad. These physicians face difficulties in financing their programs and in obtaining the necessary equipment, and they work without the assistance of trained personnel or technicians. The exchange of experience between physicians in developed and developing countries may be mutually beneficial. In the face of the high cost of health care in developed countries, it is unrealistic to expect patients with intractable epilepsy to continue to undergo elaborate investigative procedures indefinitely. On the other hand, physicians in developing countries need to keep updated on the latest technology and research and have to receive the necessary support from developed countries to slowly build up their programs. The global perspective of physicians dealing with epilepsy patients may be broadened by exposure to the experience from the "other side of the fence" and will ultimately lead to better patient education and more focused patient care.

Delivery of Health Care↗

PubMed2006

A review and analysis of intensive care medicine in the least developed countries.

OBJECTIVE: To give critical care clinicians in Western nations a general overview of intensive care medicine in less developed countries and to stimulate institutional or personal initiatives to improve critical care services in the least developed countries. DATA SOURCE: In-depth PubMed search and personal experience of the authors. DATA SYNTHESIS: In view of the eminent burden of disease, prevalence of critically ill patients in the least developed countries is disproportionately high. Despite fundamental logistic (water, electricity, oxygen supply, medical technical equipment, drugs) and financial limitations, intensive care medicine has become a discipline of its own in most nations. Today, many district and regional hospitals have units where severely ill patients are separately cared for, although major intensive care units are only found in large hospitals of urban or metropolitan areas. High workload, low wages, and a high risk of occupational infections with either the human immunodeficiency virus or a hepatitis virus explain burnout syndromes and low motivation in some health care workers. The four most common admission criteria to intensive care units in least developed countries are postsurgical treatment, infectious diseases, trauma, and peripartum maternal or neonatal complications. Logistic and financial limitations, as well as insufficiencies of supporting disciplines (e.g., laboratories, radiology, surgery), poor general health status of patients, and in many cases delayed presentation of severely sick patients to the intensive care unit, contribute to comparably high mortality rates. CONCLUSION: More studies on the current state of intensive care medicine in least developed countries are needed to provide reasonable aid to improve care of the most severely ill patients in the poorest countries of the world.

Critical Care↗

PubMed1995

Quality, cost and utilization of health services in developing countries. A longitudinal study in Zaïre.

Many developing countries, particularly in Africa, have recently introduced payment schedules based on the selling of essential drugs. This is one of the main elements of the Bamako Initiative according to which the income generated would ensure a reliable supply of drugs and would improve other aspects of the quality of the services offered. Thus, quality improvements would compensate for the financial barrier and as a result the utilization of public health services would be increased or at least maintained. These hypotheses have proven to be partially valid, since there have been cases where the utilization of health services has increased and others where it has decreased; these inconclusive results have fuelled criticisms concerning the inequitable nature of these measures. This longitudinal study in a rural community of Zaïre shows that the utilization of health services had diminished by close to 40% over 5 yr (1987-1991) and that 18-32% of this decrease is explained by cost. The regular supply of drugs and the improvement in the technical quality of the services--technical qualification of the staff, allocation of microscopes, and renovation of the infrastructures--was not enough to compensate for the additional financial barriers created by the increased cost of services. However, on a local level, the interpersonal qualities displayed by some of the nurses sometimes helped to compensate for the negative effects of the costs, and even to increase the level of utilization of some health centres. The quality of public services has often been neglected in developing countries. While some attention is given to technical qualities, the interpersonal components of the quality of the services are generally ignored or underestimated by planners and they are the very components which are most resistant to change. It will be a major challenge for health systems to address this issue of quality of care in order to minimize the negative impact of the introduction of user payment schemes. Therefore, now is the time to place quality next to coverage in planners' agendas.

Adult↗

PubMed1993

Cancer in developing countries: opportunity and challenge.

Epidemiologic observations indicate that environment and lifestyle are the major determinants of the geographical patterns of cancer. The developing countries, which account for 75% of the world's population, have lower incidence rates of cancer compared with the industrialized nations but bear more than half the global cancer burden. Demographic trends resulting from economic progress (decreasing incidence of infectious diseases, population growth, aging, and urbanization), coupled with increased tobacco consumption and dietary changes, indicate that developing countries will bear a continually increasing proportion of the world's cancer burden and its accompanying demand for the provision of costly treatment programs. Yet the developing countries command only 5% of the world's economic resources, and health care programs are already fully extended and frequently inadequate. Thus, cancer control in the developing countries, including preemptive prevention of the anticipated increases in cancers presently more common in the industrialized nations (e.g., lung, breast, and colon), should include much greater emphasis on cancer prevention than is presently the case. But there is another perspective. The developing countries, with their dramatic contrasts in lifestyles and environments and equally diverse patterns of cancer, provide an unparalleled, and often neglected, opportunity for studies directed toward understanding the mechanisms of environmental carcinogenesis. Such an understanding should eventually lead to the development of novel intervention approaches. Unfortunately, cancer research is much more difficult to conduct in the developing countries because of the lack of population-based registries, poor communication and transportation systems, and deficiencies in infrastructure, financial support, and the training of health professionals. These difficulties could be overcome, to the benefit of all, if the extent of collaboration in cancer research between the developing and industrialized nations were to be greatly expanded.

Developing Countries↗

PubMed2006

Road traffic injuries: hidden epidemic in less developed countries.

Road traffic injuries (RTIs) are a leading cause of morbidity, disability and mortality in less developed countries. Globally in 2002, 1.2 million deaths resulted from RTIs, and about 10 times that were injured. RTIs are often preventable, and the technology and knowledge to achieve success in this area exist. In spite of this, it is projected that given the current trend and without adequate intervention, RTIs will rank third of all major causes of morbidity and mortality globally by 2020. Although > 85% of the global deaths and injuries from road traffic crashes occur in less developed countries, traffic safety attracts little public health attention in these nations, due in part to a plethora of other equally important problems, including infectious diseases. Unfortunately, the public health and economic impact of traffic-related injuries and disabilities can be incalculable in these countries, owing to their poorly developed trauma care systems and nonexistent social welfare infrastructures to accommodate the needs of the injured and the disabled. In this paper, we highlight the problem posed to public health in less developed countries by RTIs and examine contributing factors. To engender debate and action to address the problem, we reviewed interventions that have proven effective in industrialized nations and discussed potential barriers to their replication in less developed countries.

Accident Prevention↗

PubMed2002

Basic requirements for the transfer of fermentation technologies to developing countries.

Traditional small-scale fermentation technologies offer considerable potential for stimulating development in the food industry of developing countries in light of their low cost, scalability, minimal energy and infrastructural requirements and the wide consumer acceptance of fermented products in these countries. Efficient transfer and adaptation of these technologies is, however, often limited by inadequate basic scientific knowledge of the processes involved and the lack of appropriate biological inoculants and process controls for these technologies. Basic infrastructures, such as suitably equipped laboratories with consistent working conditions, a constant supply of good quality water and reliable power supplies, are critical elements of a minimal technology base for transfer and adaptation of these technologies. Building the institutional capacity in developing countries to facilitate research and development geared toward a better understanding of the technologies applied in small-scale traditional fermentations is essential, as is the encouragement of governments to formulate supportive national policies, which promote small-scale agro-industrial development. Socioeconomic considerations play a critical role in the successful and sustainable transfer and adoption of technologies and their products in developing countries.

Developing Countries↗