PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Developed 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 1,243 records · Page 69Linked to original sources
PubMed1999

Late diagnosis of retinoblastoma in a developing country.

OBJECTIVES: To assess the diagnostic process of retinoblastoma in a developing country. STUDY DESIGN: Prospective survey of 95 consecutive parents of patients with retinoblastoma. RESULTS: Fifty six parents consulted initially with a paediatrician. Their children tended to be younger, with a significantly higher frequency of advanced disease. Only half of the patients who consulted with a paediatrician were appropriately referred to an ophthalmologist; the paediatrician underestimated the complaints in the remainder. Children taken to an ophthalmologist were older and had less advanced disease. In about three quarters of these children, a diagnosis of retinoblastoma was suspected by the ophthalmologist on the first visit. Parents of patients with more advanced disease consulted significantly later. Poor parental education correlated significantly with late consultation. Lack of health insurance and living outside Buenos Aires City correlated significantly with an increased risk of extraocular disease. CONCLUSIONS: Paediatricians are the first health professional seen by most children with retinoblastoma. However, the diagnosis is not readily established. There is also a delay in consultation by parents, which is significantly longer in cases with advanced extraocular disease. Socioeconomic factors and access to health care might play a role in delayed diagnosis.

Argentina↗
PubMed1990

Prevention of excess mortality in refugee and displaced populations in developing countries.

More than 30 million refugees and internally displaced persons in developing countries are currently dependent on international relief assistance for their survival. Most of this assistance is provided by Western nations such as the United States. Mortality rates in these populations during the acute phase of displacement have been extremely high, up to 60 times the expected rates. Displaced populations in northern Ethiopia (1985) and southern Sudan (1988) have suffered the highest crude mortality rates. Although mortality rates have risen in all age groups, excess mortality has been the greatest in 1- through 14-year-old children. The major causes of death have been measles, diarrheal diseases, acute respiratory tract infections, and malaria. Case-fatality ratios for these diseases have risen due to the prevalence of both protein-energy malnutrition and certain micronutrient deficiencies. Despite current technical knowledge and resources, several recent relief programs have failed to promptly implement essential public health programs such as provision of adequate food rations, clean water and sanitation, measles immunization, and control of communicable diseases. Basic structural changes in the way international agencies implement and coordinate assistance to displaced populations are urgently needed.

Africa↗
PubMed2004

The use of CRP for diagnosing infections in young infants < 3 months of age in developing countries.

The diagnosis of severe bacterial infection in young infants in developing countries is difficult because of the lack of sensitivity and specificity of the presenting symptoms and signs. Whether C-reactive protein (CRP) might help with the early detection of neonatal sepsis was investigated in a prospective study in The Gambia, Ethiopia and The Philippines. Infants < 3 months of age with symptoms or signs of possible sepsis were evaluated; CRP was measured and assessed for its ability to predict proven invasive bacterial infection. Of 966 children < 3 months of age, 54 had a positive blood culture, 13 a positive CSF culture, 15 a positive blood and CSF culture and 884 had negative cultures. Median (interquartile range) CRP values were 42 (9-173), 14 (6-36), 209 (135-286) and 8 (3-27) mg/L in the four groups, respectively. Taking a CRP cut-off of 10 mg/L, the sensitivity and specificity of an elevated CRP to predict a positive blood or CSF culture were 77% and 55%, respectively, and 55% and 82%, respectively, for a cut-off of 40 mg/L. CRP lacks the sensitivity and specificity to be used alone as a predictor of serious infections in young infants.

Bacteremia↗
PubMed1997

Predictors of hypoxaemia in hospital admissions with acute lower respiratory tract infection in a developing country.

Since oxygen has to be given to most children in developing countries on the basis of clinical signs without performing blood gas analyses, possible clinical predictors of hypoxaemia were studied. Sixty nine children between the ages of 2 months and 5 years admitted to hospital with acute lower respiratory tract infection and an oxygen saturation (Sao2) < 90% were compared with 67 children matched for age and diagnosis from the same referral hospital with an Sao2 of 90% or above (control group 1), and 44 unreferred children admitted to a secondary care hospital with acute lower respiratory infection (control group 2). Using multiple logistic regression analysis, sleepiness, arousal, quality of cry, cyanosis, head nodding, decreased air entry, nasal flaring, and upper arm circumference were found to be independent predictors of hypoxaemia on comparison of the cases with control group 1. Using a simple model of cyanosis or head nodding or not crying, the sensitivity to predict hypoxaemia was 59%, and the specificity 94% and 93% compared to control groups 1 and 2, respectively; 80% of the children with an Sao2 < 80% were identified by the combination of these signs. Over half of the children with hypoxaemia could be identified with a combination of three signs: extreme respiratory distress, cyanosis, and severely compromised general status. Further prospective validation of this model with other datasets is warranted. No other signs improved the sensitivity without compromising specificity. If a higher sensitivity is required, pulse oximetry has to be used.

Acute Disease↗
PubMed2002

Clinical features of HIV disease in developing countries.

HIV disease progresses from an asymptomatic period of variable duration, through mild symptoms, to severe disease characteristic of cellular immunodeficiency. The rate of progression from infection to severe disease is probably similar world-wide. However, individuals in developing countries have more symptomatic disease, in keeping with the high incidence of morbidity in the general population, and poor survival with advanced disease. The clinical manifestations of severe HIV-related immunosuppression vary with geographical region. Tuberculosis (TB) is the most important severe opportunistic disease in developing countries: the clinical presentation may differ from TB in the immunocompetent. Bacterial infections, particularly due to Streptococcus pneumoniae and non-typhoid Salmonella spp., are also important causes of morbidity and mortality. Fungal diseases such as Pneumocystis carinii pneumonia (PCP), cryptococcosis, histoplasmosis and penicilliosis vary in prevalence in different geographical regions. A high index of suspicion of HIV infection and knowledge of the local spectrum of HIV disease are important for early diagnosis and appropriate management of HIV-related disease.

AIDS-Related Opportunistic Infections↗
PubMed1999

Necrotising enterocolitis: a management protocol for developing countries.

28 cases of necrotising enterocolitis (NEC) comprising 11 term and 17 preterm patients were diagnosed between January 1990 and December 1995 at the University Hospital of the West Indies (UHWI). Treatment was in accordance with a management protocol which emphasised aggressive screening of potential cases, early laparotomy for bowel perforation and primary anastomosis after small bowel resection. There were three deaths among the 13 cases of bowel perforation. Centres in developing countries can achieve rates of survival comparable to those in the developed world in babies with NEC weighing over 1000 grams by adopting the UHWI management protocol.

Anastomosis, Surgical↗
PubMed2000

NHS reforms in the United Kingdom and learning from developing country experience.

The NHS has been the object of much international interest from its inception and through its periodic reforms. However, UK policy-makers have expressed only limited and selective concern for health sector reforms in other countries. This paper seeks to identify key elements of the present process and content of reforms to the UK NHS and examine the extent to which international learning would be important in developing these reforms. Particular emphasis is placed on learning from developing country experience. The paper therefore considers the policy process in the UK, the focus on primary care, the shift from competitive to collaborative strategies in addition to prioritising and planning. Each is considered in relation to developing country experience and the opportunities for learning. The paper concludes by setting out four areas leading to an international opening in NHS policy processes: developing political space in policy making, developing mechanisms for international exchanges, understanding policy context, and broadening international experience and changing values. The notion of a one-way process in international policy learning is rejected: while the South can learn from the North, so too can the North from the South.

Cooperative Behavior↗
PubMed1998

Service development to meet the needs of 'people with communication disabilities' in developing countries.

PURPOSE: In spite of the catastrophic consequences of impaired communication skills on the quality of human life, development of services for people with communication disabilities have low priority in health care and rehabilitation. Nowhere is this more apparent than in developing countries. The low coverage levels of the limited services which do exist in these countries, indicate a need to develop new and innovative service structures. It is to this end, given the limited literature available, that this review looks mainly at articles of a descriptive nature based on clinical experience. The review seeks to identify ideology which could be used to under-pin alternative service delivery and structures. METHOD: Three collections of literature relevant to the topic under discussion are identified, one collection relates to impairment categories, one to disability perspectives and one to speech and language therapy provision. It is recognized that all three collections are needed to form a basis for innovative change, but this review aims to examine the latter collection only, referring the reader to items in the other collections, when relevant. RESULTS: The information reviewed is analysed for recurring themes and the results are seen to concur with many of the disability perspectives expressed in present day literature.

Communication Disorders↗
PubMed2000

Maternal mortality in the past and its relevance to developing countries today.

High maternal mortality was a feature of the Western world from the mid-19th century, when reliable record keeping commenced, to the mid-1930s. During this time, maternal mortality rates tended to remain on a high plateau, although there was wide disparity between countries in the height of the plateau. From approximately 1937, maternal mortality rates began to decline everywhere, and within 20 y, the intercountry differences had almost disappeared. The decline in maternal mortality rates was so dramatic that current rates for developed countries are between one-fortieth and one-fiftieth of the rates that prevailed 60 y ago. In this paper, the reasons for the high mortality before 1937 and its decline since that date are discussed. It is suggested that the main determinant of maternal mortality was the overall standard of maternal care provided by birth attendants. Poverty and associated malnutrition played little part in determining the rate of maternal mortality. This view is supported by much evidence, including the fact that, unlike for infant mortality rates, maternal mortality rates tended to be higher in the upper than in the lower social classes. The potential relevance of these findings to developing countries is discussed.

Developing Countries↗
PubMed1984

A simple kit system for rapid diagnosis of cerebrospinal meningitis in rural areas of developing countries.

A simple, easily operated, portable diagnostic kit, employing coagglutination reagents, has been developed for the rapid, bedside diagnosis of cerebrospinal meningitis. Field trials using this kit were conducted in a rural area of sub-Saharan Africa for identifying the etiological agents of meningitis outbreaks. West African village medical attendants were taught to use this kit and succeeded in making rapid specific diagnoses of meningitis cases. Other acute infections such as cholera and typhoid fever can also be rapidly diagnosed in a similar manner. This rapid diagnostic system offers appropriate technology in support of primary health care delivery in the rural areas of developing countries.

Burkina Faso↗
PubMed1986

An assessment of burst strength distribution data for monitoring quality of condom stocks in developing countries.

Laboratory tests were conducted on condoms to examine the changes that occur over time in indicators of condom burst strength, and to determine the relationship between laboratory-assessed condom burst strength and breakage during use in a developing country setting. Three groups of unaged condoms purchased directly from the manufacturer were used: one group exposed to UV light for 10 hours; one group exposed for five hours; and one group unexposed. A sample of each of these groups was tested according to ISO condom air burst test protocols. The remaining condoms were individually packaged in coded polyethylene bags for shipment to the developing country study site. Also used in the study was a group of condoms that had been aged for over 40 months under field conditions in a tropical climate; a sample from this group was tested by the ISO air burst test protocol and the remainder distributed to the study site. One-hundred-thirty Indonesian urban males participated in the double-blind study. Volunteers were not relying on the condom for contraceptive purposes. Each volunteer was given one individually packaged untreated condom, one condom from each treatment group, and four condoms aged in the field. Study participants were instructed to return all used condoms. Each condom that was returned after use was examined for breakage, and the unbroken condoms were subjected to an air inflation test to determine volume and pressure at burst. A comparison of the air burst volume data for a sample of unused and used condoms from the same treatment group indicates that most of the condoms that broke during use had air burst volumes below 11 liters. Therefore, a significant downward shift in the burst strength distribution as measured in the laboratory is likely to result in an increased breakage rate during use. A Condom Deterioration Index calculated from regular periodic testing of stored condom stocks is a convenient and sensitive means of monitoring trends in the distribution and deterioration of condom strength.

Air↗
PubMed2000

Organization of ambulatory care provision: a critical determinant of health system performance in developing countries.

Success in the provision of ambulatory personal health services, i.e. providing individuals with treatment for acute illness and preventive health care on an ambulatory basis, is the most significant contributor to the health care system's performance in most developing countries. Ambulatory personal health care has the potential to contribute the largest immediate gains in health status in populations, especially for the poor. At present, such health care accounts for the largest share of the total health expenditure in most lower income countries. It frequently comprises the largest share of the financial burden on households associated with health care consumption, which is typically regressively distributed. The "organization" of ambulatory personal health services is a critical determinant of the health system's performance which, at present, is poorly understood and insufficiently considered in policies and programmes for reforming health care systems. This article begins with a brief analysis of the importance of ambulatory care in the overall health system performance and this is followed by a summary of the inadequate global data on ambulatory care organization. It then defines the concept of "macro organization of health care" at a system level. Outlined also is a framework for analysing the organization of health care services and the major pathways through which the organization of ambulatory personal health care services can affect system performance. Examples of recent policy interventions to influence primary care organization--both government and nongovernmental providers and market structure--are reviewed. It is argued that the characteristics of health care markets in developing countries and of most primary care goods result in relatively diverse and competitive environments for ambulatory care services, compared with other types of health care. Therefore, governments will be required to use a variety of approaches beyond direct public provision of services to improve performance. To do this wisely, much better information on ambulatory care organization is needed, as well as more experience with diverse approaches to improve performance.

Adult↗
PubMed1997

Long-term results of intramedullary pinning of forearm fractures in a developing country.

BACKGROUND: Patients with fractured forearms who were treated with intramedullary Rush pins/nails at Port Moresby General Hospital (Papua New Guinea) were studied. METHODS: Sixteen patients were reviewed 24 months after insertion of the pins/nails. RESULTS: The results indicate that good outcomes could be achieved by the use of intramedullary pins in developing countries. There were no major specific short- or long-term complications (re-fracture or non-union). Disability in terms of pain and stiffness was noted in only three out of six patients with pins in situ. These were considered temporary disabilities. CONCLUSIONS: The pins are much cheaper than plates and screws, require minimal expertise for insertion, and removal was performed under local anesthetic as outpatient cases. They remain a valuable method for managing patients with forearm fractures in developing countries.

Adolescent↗
PubMed2003

[What did the campaigns against childhood vaccination accomplish in developed countries?].

An overview is given on the literature on the campaigns against vaccination of children. Such campaigns were organized in the developed countries of the Western Europe and they have occurred recently also in the Czech Republic. From these actions and namely from the consequence of the limited vaccination it is possible to get an important lesson and to use them as arguments for our own vaccination program. There is no doubt that vaccination can bring some side effects, however, restrictions of vaccination have shown that even in the developed countries the disease of an unvaccinated child brings much higher risk of complications than the vaccination itself. Vaccination belongs to the basic prevention in the primary care and our paediatricians have to be fully informed about the program in order to outreason the devious arguments of parents. In the risk cases (children with serious preceding reaction, reaction in the history, etc.) it is possible to consult www pages www.ockovanideti.cz or a specialized clinic for vaccination in the Motol hospital. In selected cases it is possible to use for the risk patients also those vaccines, which are not listed in the present routine vaccination programs. Professional societies have to prepare projects of the nomenclature of side effects (namely their grading) in the nearest term and in co-operation with legislative to introduce principles for measures and action in cases of serious side effects of vaccination in children. Though the www pages on vaccination for parents already exist www.ockovanideti.cz/rodice it would be useful to publish a booklet for laymen. Paediatricians can contribute to their actualisation and actively participate on reediting of such thematic booklets.

Child↗
PubMed2006

The International Atomic Energy Agency (IAEA) program on radiation and tissue banking: a successful program for developing countries.

Since its inception the IAEA program in radiation and tissue banking supported the establishment of twenty five tissue banks in different countries. Now more than 103 tissue banks are now operating in these countries. The production of sterilized tissues has grown in an exponential mode within the IAEA program. From 1988 until the end of 2000 the production of sterilized tissues was 224,706 grafts, with an estimated value of at least $51,768,553 million dollars at the mean current charge rate in non-commercial banks in Europe and USA. During the period 1997-2002 several countries from Asia and the Pacific region produced more than 155,000 grafts, with an estimated value of about $36.7 million dollars. Training was considered to be one of the most important tasks to be supported. A total of 192 students were registered in the training program and 146 students graduated with a University Diploma. For many developing countries an additional benefit is not having to import expensive sterilized tissues from developed countries, but the exposure of orthopedic and plastic surgeons working, to new methods of using allografts in specific surgical treatments.

Developing Countries↗
PubMedDate not supplied

[Starting points for the Italian actualization derived from the experience of community medicine in developing countries].

The Authors have studied the salient features of Community Medicine from three different aspects: 1) the theory of primary health care, as defined by the WHO, as a fundamental element in Community Medicine; 2) the characteristics it assumes in health planning in developing countries, where it is designed to meet the special local requirements; 3) the situation in Italy, where local medical care is regarded as a favoured sphere for projects, but where different planning and policies are required. From this study we have selected a number of ideas gathered during our experience in developing countries, which are suitable for adoption in Italy: the setting up of health care systems on global, capillary and participatory lines, aimed jointly at prevention, diagnosis and therapy: the use of scientific methodologies which are both thorough and accurate, and which are available for user countries; adequate personnel training; coordination between medical care and the working world; all this with the aim of enabling each and every individual to lead a socially and economically productive life, by ensuring the greatest possible physical and mental well being.

Community Medicine↗
PubMed1981

A profile of heart disease in children in a developing country.

Experience is presented of paediatric cardiology in a well-equipped and staffed centre during a six-year period in a developing country. Despite the success of the programme in offering first class medical investigation and surgical care to a large number of children, it is estimated that only about 2% of the existing cases in the country were operated upon. The main problems were the large numbers of cases, creating long waiting lists, and the lack of adequately trained paramedical personnel. Although paediatric cardiology in other developing countries is by no means a first priority, thousands of children suffering from heart disease should not be ignored. It appears that establishing similar centres for the care of children with heart disease in those countries is necessary; that they would contribute to patient care and medical education, would uncover the magnitude of the problem and would open ways to its future solution. The possibility of utilization of the facilities in the Western countries must also be considered.

Adolescent↗