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PubMed1996

Hypertension control in developing countries: generic issues.

Epidemics of Cardiovascular Disease (CVD) are presently occuring or accelerating in developing countries, as epidemiologic transition accompanies socio-economic and demographic changes. Hypertension, a major risk factor for coronary and cerebrovascular disease, needs effective programmes for prevention, recognition and control. Strategically, hypertension control is ideally suited to be the initial component of an integrated CVD control programme which has to be implemented in the developing countries. Primary prevention, through a population based lifestyle linked programme, as well as cost-effective methods of detection and management are synergestically complementary approaches. The existing health care infrastructure needs to be reoriented to meet the emerging challenge of CVD, while empowering the community through health education.

Developing Countries↗
PubMed2002

Surgical services for children in developing countries.

There is growing evidence that childhood surgical conditions, especially injuries, are common in developing countries and that poor care results in significant numbers of deaths and cases of disability. Unfortunately, however, surgical care is not considered an essential component of most child health programmes. Strategies for improving paediatric surgical care should be evidence-based and cost-effective and should aim to benefit the largest possible number of children. The most likely way of achieving policy change is to demonstrate that childhood surgical conditions are a significant public health problem. For paediatric purposes, special attention should also be given to defining a cost-effective package of surgical services, improving surgical care at the community level, and strengthening surgical education. Surgical care should be an essential component of child health programmes in developing countries.

Africa South of the Sahara↗
PubMed2006

Analysis and applicability of the Dutch EMS system into countries developing EMS systems.

Development of an Emergency Medical Services (EMS) system is a challenging task for administrators, government agencies, and politicians. Factors such as the political climate, governmental support, and monetary resources heavily influence and shape the development of an EMS system. There are various systems in place to meet the functional needs and abilities of different regions while maintaining the basic principle of providing fast attention to those in need, and transportation to a definitive care facility. In this report, we describe the current Dutch EMS system in Amsterdam and the methods of daily pre-hospital health care delivery used, while exploring its potential applicability in developing nations. The Dutch EMS system is a nurse-driven triage system, both at the dispatch level and at the treatment level. Of the approximate yearly 165,000 calls received at the dispatch center, 40% of the requests were triaged based on national protocols such that no emergency ambulance dispatching was necessary. Furthermore, 30% of patients were treated at the scene, and did not subsequently require emergency transport to a definitive care facility.

Ambulances↗
PubMed1993

Adult health: a legitimate concern for developing countries.

Adults, defined here as people between 15 and 59 years of age, in developing countries have a high risk of premature death and suffer from frequent morbidity and high rates of chronic impairment. Their ill health imposes a major burden on health services and large negative consequences on families, communities, and societies. This paper describes the level and impact of adult mortality and morbidity, and highlights some of its characteristics and causes, which in some cases contradict commonly held beliefs. It concludes that "adult health" is a legitimate public health concern for developing countries that is not being addressed. An agenda for remedial research and action is proposed.

Adolescent↗
PubMed2002

Top ten biotechnologies for improving health in developing countries.

Most research into genomics and other related biotechnologies is concerned with the priorities of industrialized nations, and yet a limited number of projects have shown that these technologies could help improve health in developing countries. To encourage the successful application of biotechnology to global health, we carried out a study in which we asked an international group of eminent scientists with expertise in global health issues to identify the top ten biotechnologies for improving health in developing countries. The results offer concrete guidance to those in a position to influence the direction of research and development, and challenge common assumptions about the relevance and affordability of biotechnology for developing countries.

Biotechnology↗
PubMed2006

Blood transfusion and caesarean section in a developing country.

Our objective was to review blood transfusion practices during caesarean section in a developing country. An audit of 463 consecutive caesarean sections and blood transfusions over a 3-year period (2000 - 2002) was undertaken. The data were collected from the records department in a pre-designed proforma and analysed, using EPI - info Statistical Software version 6. A total of 117 out of 463 (25.2%) caesarean section cases were transfused. The rate of blood transfusion for the various indications were as follows: malpresentation (excluding breech), four out of six (66.7%); placenta praevia, 28 out of 49 (59.1%); uterine rupture, five out of nine (55.6%); breech delivery, eight out of 25 (32%); obstructed labour, 35 out of 124 (28.2%); precious baby, one out of four (25%); previous caesarean section, 24 out of 141 (17.0%); severe pre-eclampsia, five out of 45 (11.1%); fetal distress, three out of 28 (10.7%); and others, three out of 29 (10.3%). A total of 78 (67.2%) of caesarean section cases were emergency. A blood transfusion rate of 25.2% during caesarean section is high. The indications for the caesarean section, preoperative anaemia and quantity of blood loss during caesarean section were significant risk factor for blood transfusion. Efforts should be made to reduce the blood transfusion without increasing maternal morbidity and mortality. This is very important because of rising HIV infection in developing country and blood-borne disease.

Adult↗
PubMed2002

Determinants of cervical cancer rates in developing countries.

Although cervical cancer (CC) is a leading cause of cancer-related deaths in developing countries, incidence rates vary considerably, ranging from 3 to 61 per 10(5) females. Identifying determinants of high vs. low rates may suggest population-level prevention strategies. CC rates for 175 countries were obtained from the IARC. Country-specific behavioral, health, economic and demographic measures were obtained from United Nations agencies and other international organizations. Regression analyses performed for 127 low or medium developed countries identified both geography and religion as independently associated with high CC rates. Among behavioral measures, high fertility rates, early age at birth of first child and high teenage birth rates were significantly associated with high CC rates. Countries with high CC rates had fewer doctors per capita, less immunization coverage, more HIV infections and shorter life expectancies. CC rates also tended to be higher in countries with more spending on health and younger, less educated populations. Patterns of CC rates suggest that programmatic approaches, such as promoting delayed childbearing and sexual monogamy, may be appropriate interventions. For countries with high CC rates and some flexibility in their health-care budgets, a once-in-a-lifetime screen of women 30-50 years of age, using Pap smears, direct visual inspection and/or HPV DNA testing, may be cost-effective. Finally, relatively low immunization rates and a shortage of health-care workers in countries with high CC rates suggest potential challenges for introducing prophylactic HPV vaccines.

Adolescent↗
PubMed1991

Points of action in the campaign against blindness in developing countries.

This article provides a survey of the problems of prevention of blindness in developing countries. The World Health Organization estimates that 31 million people are blind and 15 million people partially-sighted. The main cause of blindness is cataract. Other causes are trachoma, glaucoma, xerophthalmia, river blindness, corneal scars and leprosy. Prevention or treatment of these causes is possible in more than 80% of cases. The number of blind persons, however, is still increasing due to the increase in population and the immense shortage of all kinds of ophthalmological equipment and personnel. An effective strategy for the prevention of blindness in developing countries should focus on: more cheap cataract operations, increasing teaching facilities for ophthalmic personnel, integration of ophthalmic care into the general health system and the promotion of blindness prevention in political organizations.

Blindness↗
PubMed1998

Sources of Deforestation in Tropical Developing Countries

/ Key causes of tropical deforestation are investigated using cross-sectional data for 90 developing countries for the period 1981-1990. Regression results reveal that deforestation is associated with both development and scarcity. Deforestation accelerates with expanding infrastructure, trade, debt, investment in the human capital base, and resource-based economic expansion. On the other hand, absolute and relative scarcities-manifested by growing population pressures, food and land shortages, fuelwood dependency, and inequalities in access to land-are also key factors explaining forest loss. Thus, results point to a fundamental environmental conundrum: Development is required if countries are to alleviate scarcity-driven forms of forest exploitation but is itself a major cause of deforestation. Can countries balance development goals with forest protection? Setting aside the issue of its practical realization, the paper concludes that forest sustainable development cannot be achieved by implementing simple technical improvements in land-use practices alone. Securing the foundations for the sustainability of the forest base will require that countries address the underlying social processes driving tropical forest loss as well.KEY WORDS: Tropical deforestation; Developing countries; Rural land-use practices; Development; Scarcity.

Journal Article↗
PubMed1985

[Developing countries. Health education in the primary prevention of alcoholism].

In most developing countries alcoholism hampers economic development in the same way as illiteracy or disease. Several studies reveal the extent of the problem in Latin America where the consumption of alcoholic beverages is rooted in national traditions. In Chile, the population includes 5% of alcoholics and 15% of people who drink excessively. The authors have developed a programme to control alcoholism in Pudahuel, a district of Santiago where there is much poverty. The programme includes four stages. The first consists in informing community leaders, teachers and parents of how to carry out primary prevention. During the second stage, teachers are shown how to use the didactic material available. The third stage concerns programmed activities for students and parents. The last stage is devoted to preventive activities in the community. The evaluation of this ambitious programme has not yet taken place.

Adolescent↗
PubMed1981

Problems of occupational carcinogenesis in developing countries.

An overview of published information on occupational cancer and recorded ongoing occupational cancer research in developing countries is presented. The main cancers reported, of possible occupational origin, are skin carcinoma, leukemia due to exposure to benzene, asbestos-caused mesothelioma, vinyl chloride-induced hepatic angiosarcoma, carcinoma of bilharzial urinary bladder, stomach cancer reportedly associated with nitrogen fertilizers, lung cancer of nickel smelters, and nasopharyngeal and pulmonary carcinoma in workers exposed to the dust of hard wood. The difficulties of developing efficient occupational cancer prevention are discussed. Some options are analyzed regarding legislative, technological, environmental, medical, administrative, and educational cancer control applicable under conditions of developing countries.

Carcinogens, Environmental↗
PubMed1996

[A non-specific, beneficial effect of measles vaccination. Analysis of mortality studies from developing countries].

The study examined whether the reduction in mortality after standard titre measles immunization in developing countries can be explained by the prevention of acute measles and its long-term consequences. All studies comparing mortality of unimmunised children and children immunised with standard titre measles vaccine in developing countries were included; ten cohort and two case-control studies from Bangladesh, Benin, Burundi, Guinea-Bissau, Haiti, Senegal, and Zaire. We examined the protective efficacy of standard titre measles immunization against all cause mortality. Furthermore, by restricting the analysis to children who had not developed measles, we examined how much of the difference in mortality between immunised and unimmunised children could be explained by prevention of measles disease. In the ten cohort studies, protective efficacy against death after measles immunization was found to be in the range of 30-86%. Efficacy was highest in the studies with short follow-up and where children were immunised in infancy (range: 44-100%). Vaccine efficacy against death was much greater than the proportion of deaths attributed to acute measles disease. In four studies from Guinea-Bissau, Senegal and Burundi, vaccine efficacy against death remained almost unchanged when measles cases were excluded from the analysis. Hence, the reduction in mortality among immunized children cannot be explained by the prevention of acute and long-term consequences of measles. In contrast to the effect of measles vaccine, studies from Guinea-Bissau, Senegal and Benin suggest that diphtheria-tetanus-pertussis and polio vaccinations are not associated with reduction in mortality. These observations suggest that standard titre measles vaccine may confer a beneficial effect which is unrelated to the specific protection against measles disease.

Cohort Studies↗
PubMedDate not supplied

Expanding access to emergency contraception in developing countries.

Emergency contraception has been called the best-kept contraceptive secret. Previous research shows that several regimens of postcoital contraception offer safe and effective ways for women to avoid pregnancy. Yet the methods are typically unavailable to women in developing countries. In this article, the authors review the main methods of emergency contraception and describe experience with them to date. The prevalence and urgency of the need for making these methods available to women in developing countries are assessed. The necessary elements for creating such access are described. In several developing countries, conditions for introducing the methods may be more favorable than in industrialized countries. These advantages are reviewed. Finally, the authors describe the challenges anticipated for broadening the availability of postcoital methods in the developing world. They conclude with a brief series of recommendations for policymakers.

Contraceptives, Postcoital↗
PubMed2006

Incentive-based conservation programs in developing countries: a review of some key issues and suggestions for improvements.

Biodiversity conservation in developing countries has been a challenge because of the combination of rising human populations, rapid technological advances, severe social hardships, and extreme poverty. To address the social, economic, and ecological limitations of people-free parks and reserves, incentives have been incorporated into conservation programs in the hopes of making conservation meaningful to local people. However, such incentive-based programs have been implemented with little consideration for their ability to fulfill promises of greater protection of biodiversity. Evaluations of incentive-based conservation programs indicate that the approach continually falls short of the rhetoric. This article provides an overview of the problems associated with incentive-based conservation approaches in developing countries. It argues that existing incentive-based programs (IBPs) have yet to realize that benefits vary greatly at different "community" scales and that a holistic conceptualization of a community is essential to incorporate the complexities of a heterogeneous community when designing and implementing the IBPs. The spatial complexities involved in correctly identifying the beneficiaries in a community and the short-term focus of IBPs are two major challenges for sustaining conservation efforts. The article suggests improvements in three key areas: accurate identification of "target" beneficiaries, greater inclusion of marginal communities, and efforts to enhance community aptitudes.

Biodiversity↗
PubMed2003

[Changes in the prevalence of intestinal parasites among Japanese expatriates in developing countries].

In order to study the prevalence of intestinal parasites among Japanese expatriates of developing countries, we conducted fecal specimen examinations annually from 1995 to 2000. Fecal specimens were collected from Japanese expatriates of each area: Asia, the Middle East, East Europe, Africa and Latin America. The specimens were fixed with 10% formalin in the local area, and then examined in Japan. We used the formalin-ether sedimentation method to find protozoan cysts or helminth eggs. In 1995, the infection ratio was 3.0% (N = 981), decreasing to 2.4% (N = 1,275) in 1996, 2.3% (N = 1,620) in 1997 and 1.6% (N = 1,574) in 1998. However, the ratio began to increase in 1999 (2.0%, N = 1,713) and 2000 (2.5%, N = 1,806). The ratio in Africa was the highest in each year, followed by Asia and Latin America. Heterophyidae (51 cases), Giardia lamblia (42) and Trichuris trichiura (30) were detected most frequently. In Egypt, the ratio of Heterophyidae rose by 28.8% in 2000. This was the prime reason for the increase in the overall ratio of infections worldwide. Most of the Japanese infected with Heterophyidae in Egypt had ingested dried mullet roe. This may explain the reason for the increase in the infection ratio there. Although the prevalence of intestinal parasites among Japanese expatriates in developing countries is decreasing, those who eat fish in these areas are still at risk. In order to eradicate intestinal parasitosis from this group, we must continue preventive measures such as health education.

Adult↗
PubMed2006

[Regulations, conflicts and ethics of medical research in developing countries].

The patient is the subject who may meet the needs and interests of medical investigators for their research. This intrinsic conflict becomes more evident and shows particularities in the context of research projects involving clinical trials in developing countries. Target populations in these countries have inadequate access to health services, little understanding of risks involved in a study and also less capacity to claim judicially in the event of damage. In general, the discussions on ethics in research in industrialized countries are characterized by a biomedical approach of disease, and a neoliberal vision of economy and trade. In fact, most biomedical research has been directed to benefit already privileged communities. Therefore, it is necessary to minimize the risk of exploitation of developing countries populations. The present study provides an outlook of ethical protection for human research in developing countries.

Biomedical Research↗
PubMed2006

Economic impact of transgenic crops in developing countries.

Transgenic crops are being adopted rapidly at the global level, but only a few developing countries are growing them in significant quantities. Why are these crops so successful in some countries but not in others? Farm level profitability ultimately determines whether farmers adopt and retain a new technology, but this depends on much more than technical performance. Recent economic studies in developing countries find positive, but highly variable, economic returns to adopting transgenic crops. These studies confirm that institutional factors such as national agricultural research capacity, environmental and food safety regulations, intellectual property rights and agricultural input markets matter at least as much as the technology itself in determining the level and distribution of economic benefits.

Crops, Agricultural↗