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 685 records · Page 38Linked to original sources

PubMed1987

Well child clinics and mass vaccination campaigns: an evaluation of strategies for improving the coverage of primary health care in a developing country.

Millions of children in developing countries are dying from diseases that could be prevented or treated by simple interventions. To examine ways to improve the delivery of these basic services, we evaluated well child clinics and mass vaccination campaigns under operational conditions in a rural area of Nicaragua. We found that mass vaccination campaigns using volunteers reached 77.1 per cent of the population under age six. At stationary well child clinics in which villages were invited to a health center and a small food ration was used as an incentive, attendance improved to 94.1 per cent. Similar attendance levels (99.2 per cent) were attained by mobile well child clinics also using a food incentive. Attendance at stationary clinics decreased with the distance of the village from the health center. However, stationary clinics took up only half as much health workers' time as mobile clinics. Our results suggest that stationary clinics employing food as an incentive could be used for villages or neighborhoods close to a health center while mobile clinics offering food should be reserved for more isolated villages.

Ambulatory Care Facilities↗

PubMed2001

Occupational health and safety in the least developed countries--a simple case of neglect.

In many of the least developed countries, working people are significantly exposed to a number of occupational problems that may result in a deterioration of their health, safety and well being. These work-related problems are untenable, not only because of the occupational problems itself but also because of the simultaneous exposure to heat, dusts, noise, organo-chemicals, and biological and environmental pollution. This situation has existed for a long time due to various socio economic,geographical, cultural and local factors. The deteriorating situation of health and safety in the workplace may perhaps exist due to the inadequate resource facilities, economic constraints and lack of opportunity to conduct research and studies on the assessment of exposure-diseases associations. Officials, who are employed by the state, are not able to implement work regulations and labour legislation easily. Generally, they are not professionally trained and expert in the occupational health, industrial hygiene and/or safety fields, and thus, successful application and implementation of control measures are lacking. Steps to control work exposure limits have been ineffective, since national policies have been rare, owing to the multiple obstacles in preventing occupational problems. However, the major focus is on practical solutions to differing workers' needs, consideration of which is very important, depending on the what the industrial entrepreneurs could reasonably to be expected to afford. Why there is a lack of motivation and effort regarding the development of health and safety-this paper explores some important issues, aiming to focus public attention on the legacy of national and international efforts. Examples are likewise given to show the real situation of health and safety in the least developed countries.

Developing Countries↗

PubMed1997

Is asthma treatment affordable in developing countries?

BACKGROUND: A study was undertaken to assess whether the therapeutic aspects of published international asthma management guidelines are practically applicable in developing countries. METHODS: Questionnaires were sent to expatriate doctors working in developing countries. RESULTS: Forty one replies were received from 24 countries in Africa and Asia. Oral salbutamol was prescribed "usually" or "often" by 35 of the 41 respondents, theophyllines by 30, inhaled bronchodilators by 12, inhaled steroids by two, and cromoglycate by two. Theophyllines were locally available in all 41 cases, oral salbutamol in 40, inhaled bronchodilators in 34, and inhaled steroids (usually beclomethasone 50 micrograms) in only 15. Where they were available, the median (range) coat of a beclomethasone 50 micrograms inhaler was 20% (6.8-100%) of average local monthly income, salbutamol inhaler 13% (3.3-250%), 90 salbutamol 4 mg tablets 3.8% (0.8-75%), and 90 aminophylline 100 mg tablets 4.5% (0.5-70%). If they were available locally at a cheaper price, 34 (83%) respondents would prescribe more inhaled steroids and 37 (90%) would prescribe more inhaled bronchodilators. CONCLUSIONS: Many asthma patients in developing countries are not receiving adequate treatment because the required drugs are not available in their area or are prohibitively expensive.

Africa↗

PubMed2004

A view on antimicrobial resistance in developing countries and responsible risk factors.

Antimicrobial resistance is one of the biggest challenges facing global public health. Although antimicrobial drugs have saved many lives and eased the suffering of many millions, poverty, ignorance, poor sanitation, hunger and malnutrition, inadequate access to drugs, poor and inadequate health care systems, civil conflicts and bad governance in developing countries have tremendously limited the benefits of these drugs in controlling infectious diseases. The development of resistance in the responsible pathogens has worsened the situation often with very little resource to investigate and provide reliable susceptibility data on which rational treatments can be based as well as means to optimise the use of antimicrobial agents. The emergence of multi-drug-resistant isolates in tuberculosis, acute respiratory infections and diarrhoea, often referred to as diseases of poverty, has had its greatest toll in developing countries. The epidemic of HIV/AIDS, with over 30 million cases in developing countries, has greatly enlarged the population of immunocompromised patients. The disease has left these patients at great risk of numerous infections and even greater risks of acquiring highly resistant organisms during long periods of hospitalisation. This review discusses antimicrobial resistance in developing countries and the risk factors responsible.

Animals↗

PubMed2004

Prospective case review of a global e-health system for doctors in developing countries.

The Swinfen Charitable Trust has managed email consultations for doctors in developing countries since 1999. The process was handled manually for the first three years and then subsequently using an automatic message-handling system. We conducted a prospective review of email consultations between referring doctors and consulting specialists during six months of automatic operation (December 2003 to May 2004). During the study period 125 consultations took place. These concerned a wide range of specialties (e.g. orthopaedics 17%, dermatology 16%, obstetrics and gynaecology 11%, radiology 10%). Of these referrals, 33% (41) were for paediatric cases. Consulting specialists, who were based in five countries, were volunteers. Referring doctors were from 24 hospitals in 12 developing countries. The median time from referral to definitive reply was 1.5 days (interquartile range 0.6-4.9). There was an 85% response rate (n = 106) to a survey concerning the value of the consultation to the referring doctor. All the referring doctors who responded made positive comments about the service and half said that it improved their management of the case. The second-opinion consultation system operated by the Swinfen Charitable Trust represents an example of a global e-health system operated for altruistic, rather than commercial, reasons.

Developing Countries↗

PubMedDate not supplied

Pediatric nursing health care delivery plan for humanitarian missions in developing countries.

In today's health care environment, pediatric nurses are being called upon to perform humanitarian missions in tropical developing countries. During these missions, pediatric nurses often are faced with providing short-term health care to children in the villages of the developing countries visited. These efforts involve a group of pediatric health care personnel traveling to a poor, medically underserved area; establishing provisional clinics; and seeing a large number of children over several days. Usually only the most necessary resources are taken along, including varying amounts of medications and supplies and possibly minimal laboratory capabilities. To date, health care delivery plans for pediatric nurses as part of an interdisciplinary team on these missions are unavailable. This article provides literature and experience-based guidance for pediatric nurses performing humanitarian missions around the world in tropical developing countries to provide care in a manner that is safe, appropriate, and offers the greatest likelihood of benefit to the children in these countries.

Child↗

PubMed2003

Income, education, and blood pressure in adults in Jamaica, a middle-income developing country.

BACKGROUND: At present, little is known about how socioeconomic status (SES) is related to blood pressure (BP) and hypertension in developing countries. This cross-sectional study examined associations between SES and BP in 2082 adults from a peri-urban area of Jamaica, a middle-income developing country. METHODS: Hypertension (systolic BP >/=140 mmHg, diastolic BP >/=90 mmHg or current hypertensive medication use) was estimated based on self-reported medication use and the mean of the second and third of three manual BP measurements. Income and education were self-reported. Linear or logistic regressions were used to estimate multivariate associations between BP or hypertension and SES. RESULTS: Hypertension prevalence was 20% in men and 28% in women. In both men and women, the income distributions of BP and hypertension were non-linear, indicating elevated levels in low as well as in high-income groups. In contrast to the negative relationships typical for industrialized countries, multivariate-adjusted BP and hypertension were highest in the wealthiest women. In men with some high school education, income was positively associated with BP, while there were negative associations in men with lesser education. Unlike women, mean BP were highest in poor men with limited education. Low SES men were also least likely to receive diagnosis and treatment. CONCLUSIONS: Socioeconomic status is related to BP and hypertension in Jamaica, although relationships are non-linear. Behavioural and environmental factors that explain elevated BP among both low and high SES adults in developing countries must be identified to develop effective prevention strategies.

Adult↗

PubMed2004

New roles for poison control centres in the developing countries.

The primary mission of poison control centres has always been an improvement in the poisoned patients' care and poison prevention. The need to reach this mission implies that many functions and roles must be accomplished. Many centres, even in developing countries, are multifunctional and provide a broad toxicological information service. However, the main challenges of poison centres in developing countries are still treatment information, formal training, laboratory services accessibility and availability of antidotes. At the same time poison centres from developing countries need to accomplish their public health mission through strengthening and expansion of some well-defined roles like toxico-surveillance and environmental health monitoring according to the prevailing and future toxicological problems. Poison control centres from developing countries continue to face old challenges but cannot ignore the new ones that appear in the globalised world. Poison centres have a vital role for environmental exposure surveillance systems for sentinel event detection. Poison centres offer real-time and continuous data needed for preparation and response during such events and also offer a means to report health concerns. Centres from South America were involved in some of the most important environmental health problems of the region e.g., lead contamination (children), children 'occupational' poisoning, and flour contamination with fusarium toxins. Furthermore, poison centres can be the markers of risk factors or identifiers of vulnerable population e.g., changes in drugs prescription patterns, unusual patterns of addiction, unexpected product uses, children abuse scenarios or undetected sources of environmental contamination. In an era of evidence-based medicine and research, toxico-vigilance based on the millions of cases registered by poison centres everyday acquires more and more importance. A new approach of the toxico-vigilance and preventive roles of poison information centres lies in their ability to contribute to risk assessment methodologies with their human data. The data routinely collected by poisons centres could contribute to risk assessment documentation and to define priorities for risk assessment of the harmful chemicals. Although there is some scepticism about the value of poison centres data, the shared volume of human data could validate this information. The international effort of the IPCS/INTOX program, on harmonisation of data collection and terminology for comparable recording of observational human data, has been a great advancement towards handling this problem.

Child↗

PubMed1998

[Data on birthweight in developing countries: are surveys useful?].

The main source of data on birth weight in developing countries is statistics from health facilities, although most developing countries do not produce annual estimates of the incidence of low birth weight from these data. Such estimates would be subject to selection bias as the data are usually limited to babies born within health facilities, and therefore are representative of a subgroup that is markedly different from the overall population of neonates. Since 1990 the Demographic and Health Surveys programme has included questions on recalled birth weight and relative size at birth in 15 national surveys. In this article, we show that these cross-sectional surveys can provide a useful data source for making national estimates of mean birth weight and the incidence of low birth weight. The extent of misclassification of birth weight is, however, too large to use the data on relative size as birth as an indicator of low birth weight at the individual level.

Birth Weight↗

PubMed1996

Data on birth weight in developing countries: can surveys help?

The main source of data on birth weight in developing countries is statistics from health facilities, although most developing countries do not produce annual estimates of the incidence of low birth weight from these data. Such estimates would be subject to selection bias as the data are usually limited to babies born within health facilities, and therefore are representative of a subgroup that is markedly different from the overall population of neonates. Since 1990 the Demographic and Health Surveys programme has included questions on recalled birth weight and relative size at birth in 15 national surveys. In this article, we show that these cross-sectional surveys can provide a useful data source for making national estimates of mean birth weight and the incidence of low birth weight. The extent of misclassification of birth weight is, however, too large to use the data on relative size at birth as an indicator of low birth weight at the individual level.

Bias↗

PubMed2002

Health interventions for the metal working industry: which is the most cost-effective? A study from a developing country.

This study ranked the cost-effectiveness of health interventions in the metal working industry in a developing country. Data were based on 82 034 workers of the Northern region of Mexico. Effectiveness was measured through 'healthy life years' (HeaLYs) gained. Costs were estimated per worker according to type and appropriate inputs from selected health interventions. 'Hand' was the anatomical region that yielded the most gain of HeaLYs and amputation was the injury that yielded the most gain of HeaLYs. The most effective health intervention corresponded to training, followed by medical care, education, helmets, safety shoes, lumbar supports, safety goggles, gloves and safety aprons. In dollar terms, education presented the best cost-effectiveness ratio (US$637) and safety aprons presented the worst cost-effectiveness ratio (US$1 147 770). Training proved to be a very expensive intervention, but presented the best effectiveness outcome and the second best cost-effectiveness ratio (US$2084). Cost-effectiveness analyses in developing countries are critical. Corporations might not have the same funds and technology as those in developed countries or multinational companies.

Accidents, Occupational↗

PubMed2006

Can the ubiquitous power of mobile phones be used to improve health outcomes in developing countries?

BACKGROUND: The ongoing policy debate about the value of communications technology in promoting development objectives is diverse. Some view computer/web/phone communications technology as insufficient to solve development problems while others view communications technology as assisting all sections of the population. This paper looks at evidence to support or refute the idea that fixed and mobile telephones is, or could be, an effective healthcare intervention in developing countries. METHODS: A Web-based and library database search was undertaken including the following databases: MEDLINE, CINAHL, (nursing & allied health), Evidence Based Medicine (EBM), POPLINE, BIOSIS, and Web of Science, AIDSearch (MEDLINE AIDS/HIV Subset, AIDSTRIALS & AIDSDRUGS) databases. RESULTS: Evidence can be found to both support and refute the proposition that fixed and mobile telephones is, or could be, an effective healthcare intervention in developing countries. It is difficult to generalize because of the different outcome measurements and the small number of controlled studies. There is almost no literature on using mobile telephones as a healthcare intervention for HIV, TB, malaria, and chronic conditions in developing countries. Clinical outcomes are rarely measured. Convincing evidence regarding the overall cost-effectiveness of mobile phone " telemedicine" is still limited and good-quality studies are rare. Evidence of the cost effectiveness of such interventions to improve adherence to medicines is also quite weak. CONCLUSION: The developed world model of personal ownership of a phone may not be appropriate to the developing world in which shared mobile telephone use is important. Sharing may be a serious drawback to use of mobile telephones as a healthcare intervention in terms of stigma and privacy, but its magnitude is unknown. One advantage, however, of telephones with respect to adherence to medicine in chronic care models is its ability to create a multi-way interaction between patient and provider(s) and thus facilitate the dynamic nature of this relationship. Regulatory reforms required for proper operation of basic and value-added telecommunications services are a priority if mobile telecommunications are to be used for healthcare initiatives.

Journal Article↗

PubMed2005

Epidemiology of von Willebrand disease in developing countries.

There is limited information on von Willebrand disease (vWD) in developing countries. A questionnaire survey in 1998 showed that overall, less than one third of the expected number of patients with vWD in the population had been detected. Among those registered, the proportion with the severe form of the disease was relatively higher, forming up to 50% of the total, particularly in those countries with high prevalence of consanguineous marriages. Diagnosis was based on von Willebrand factor antigen (vWF:Ag) assays, vWF ristocetin cofactor (vWF:Rco) activity, and ristocetin-induced platelet aggregation (RIPA) at the reporting centers, but vWF multimer analysis was not widely available. Responsiveness to desmopressin acetate (DDAVP), which could be very significant clinically, was not often assessed. An attempt was made to assess accuracy of reporting of the prevalence of vWD by conducting a second survey aimed at normalizing the reported numbers with that of severe hemophilia A in a defined population on the presumption that the latter is less likely to be missed. These data showed that in most countries, the ratio of patients with vWD to severe hemophilia varied between 0.1 to 0.6 with a mean of approximately 0.4, as opposed to an expected ratio of approximately 1 (based on population-based data from Italy), confirming the underdiagnosis of vWD even within the same health-care system. A system for collecting more extensive and detailed data on vWD from developing countries (where 80% of the world's population lives) is required. Efforts are needed to develop national registries and make at least basic services for diagnosis and treatment widely available.

Delivery of Health Care↗

PubMed2003

Maternal mortality in developing countries.

Of all health statistics mentioned by the World Health Organization (WHO), maternal mortality is unique in showing the largest discrepancy between developed and developing countries. Approximately 90% of maternal deaths (more than 0.5 million each year) occur in developing countries. Over the last century, almost all countries have accepted antenatal care principles. However, insufficiency of resources and lack of women's compliance were the main handicaps in developing countries and compelled these countries to apply various standard programs. Unfortunately, these programs are not sufficiently effective in the prevention and treatment of maternal mortality. Fixing the number (quantity) of antenatal visits and the static approach affect the "quality" of antenatal care. Bleeding, chronic anemia, hypertensive disorders, obstructed labor, unsafe abortions and infections are the main factors leading to maternal mortality. The majority of these factors are preventable. It is important to suspect the presence of any of these factors and to intervene promptly both during antenatal care and immediately after delivery. The evidence-based approach is a way of reaching this solution. Antenatal care is a concept that extends from pre-pregnancy to postpartum, leading to effective emergency care for unpredictable and predictable complications during pregnancy and childbirth. Worldwide policies are not always applicable to each country, coercing national policies. There is still a need for prospective randomized trials to clarify this concept and the relevant policies.

Developing Countries↗

PubMed2003

Global epidemic of type 2 diabetes: implications for developing countries.

Diabetes has reached epidemic proportions in many populations. Current estimates suggest that the number of persons with diabetes will reach 250 million by 2010 and 300 million by 2025. The majority of these patients will have type 2 diabetes and reside in developing countries. Type 2 diabetes and its associated long-term complications continue to accelerate among patients who reside in developing countries. Apart from microscopic complications, cardiovascular disease, with its attending morbidity and mortality, is on the rise in the developing countries. Current evidence suggests that environmental factors are major determinants of the increasing rates of diabetes. Addressing these environmental factors offers a unique opportunity for preventing diabetes; health programs that aim to encourage physical activity and discourage (or limit) overweight and obesity deserve significant attention. Prevention must be the cornerstone for international health organizations and ministries of health in developing countries as they plan diabetes management programs.

Africa↗

PubMed2005

Challenges and opportunities for enhancing biotechnology and technology transfer in developing countries.

Biotechnological innovation is gaining increased recognition as an important tool for improving global health. The challenge, however, lies in defining the role of technology transfer to develop therapies for diseases prevalent in developing countries. During the past decade, a large disparity emerged between the developed and developing world in accessing affordable medicines because of the pharmaceutical industry's focus on health areas bearing greatest profits. Discussed herein are several mechanisms that provide partial solutions to this challenge. The Office of Technology Transfer of the US National Institutes of Health has increased its technology licensing pertaining to neglected diseases to partners in developing regions. Establishing partnerships through the transfer of technologies and assisting indigenous institutions build R and D capacity may positively impact policies on protection of intellectual property rights and increase multinational company investments in lesser-developed countries. This will most probably result in the development of more accessible therapies for those in need.

Biotechnology↗

PubMed2000

Effectiveness of HIV prevention interventions in developing countries.

OBJECTIVE: To review the effectiveness of projects and programs in developing countries that aim to reduce sexual transmission of HIV infection or transmission related to injection drug use. DESIGN: We identified 34 published studies undertaken in 18 developing countries that met rigorous inclusion criteria. These criteria included the length of follow-up, use of statistical analysis, the inclusion of a comparison group, and type of outcomes measured. RESULTS: We found that behavioral change interventions are effective when targeted to populations at high risk, particularly female sex workers and their clients. Few studies have evaluated harm reduction interventions in injecting drug users (IDUs). Evidence on the effectiveness of voluntary counseling and testing programs was promising, and VCT was most effective when directed at discordant couples. Treatment of sexually transmitted diseases (STD) appears highly effective in reducing HIV/STD transmission, particularly in the earlier stages of the epidemic. CONCLUSIONS: This review demonstrates that HIV prevention interventions can be effective in changing risk behaviors and preventing transmission in low and middle-income countries. When the appropriate mix of interventions is applied, they can lead to significant reductions in the prevalence of HIV at the national level. Additional research is needed to identify effective interventions, particularly in men who have sex with men, youth, IDUs and HIV-infected persons. Structural and environmental interventions show great promise, although more evaluation is needed.

Developing Countries↗

PubMed2005

Analysis of information and communication needs in rural primary health care in developing countries.

This article presents three studies dealing with information and communication needs in rural primary health care from Peru and Nicaragua. Results show that primary health-care systems in rural areas of developing countries are very inefficient. Among the main reasons we found factors related to communication infrastructure, information sharing, and continuous training of health professionals. We conclude that telemedicine systems can improve this situation, but the lack of infrastructures, low income levels, and other conditions, impose strong limits to the introduction of new technologies. The main conclusion is that differences in needs and conditions between developing countries and industrialized ones force to use different solutions and approaches. This article presents some proposals on technology requirements and how to deal with the use of telemedicine in rural areas of developing countries. These proposals can be useful to all kind of actors (national public administrations, multilateral institutions, industry, academy, civil society, etc.) in order to promote really relevant and sustainable proposals in telemedicine for rural regions of developing countries.

Developing Countries↗