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PubMed1994

Options for provision of occupational health services in developing countries.

Different models of occupational health care are available for developing countries to consider in developing their provisions for occupational health services. Even in developed countries there are differences between legal requirements for personnel and services, and voluntary provision of services. The range of activities covered by occupational health services can be extensive. Developing countries often focus on the provision of clinical care and treatment facilities at the workplace with less emphasis on preventive services. This may be related to the perceived value of the clinical skills of the doctor and nurse available at the workplace, plus the lack of other occupational health personnel, and the limited access to occupational hygiene and laboratory facilities. For future occupational health provisions, developing countries have to consider the balance between preventive services versus other clinical and non-clinical services. There will be benefits in reviewing the experience of developed countries in terms of the essential skills and training of occupational health personnel, and the contribution this would make to the health of the workforce in developing countries.

Developing Countries↗
PubMed1991

Chemicals and environmentally caused diseases in developing countries.

This chapter discusses international aspects of diseases resulting from exposure to chemical pollutants in the environment, with an emphasis on developing countries. These countries share many of the same problems of air, water, and pesticide pollution that face the more industrialized countries. In developing countries, however, the problems are compounded by a number of unique situations, viz., economic priorities, high burden of infectious diseases, impoverishment, and absence of a regulatory framework for the disposal of toxic chemicals. This discussion emphasizes the importance of interactions among toxicants, malnutrition, and infectious diseases for both urban and rural populations insofar as these interactions contribute to disease. Toxicants not only produce disease directly but also exacerbate diseases with other causes. Specific examples from developing countries demonstrate how human health effects from exposures to environmental chemicals can be assessed. While they do not strictly fall under the rubric of "developing countries," the public health consequences of inadequate control of environmental pollution in the East European countries should demonstrate the magnitude of the problem, except that in developing countries the public health consequence of environmental chemicals will be aggravated by the widespread malnutrition and high prevalence of infectious diseases. Much needs to be done before we can adequately quantify the contribution of environmental chemicals to morbidity and mortality in developing countries with the level of sophistication now evident in the charting of infectious diseases in these countries.

Air Pollution↗
PubMed1980

[Cardiovascular mortality in industrial and developing countries (author's transl)].

In developing countries when causes of death are registered cardiovascular mortality levels revealed themselves surprising. For instance, they appear to be more important in Tebessa (Algeria) during 1974-1975, Mauritius (1973-1976) or Egypt (1971-1973) than in france, United States or Sweden before the age of 45 and very near after this age. These results are consistent with the mortality patterns by causes of death proposed by Preston according to life expectancy at birth. Before the age of 45, rheumatic heart diseases can explain this overmortality. After this age the recent observations in the Third-World, especially in Africa, show that cardiomyopathy, cardiomegaly and principally hypertension are widely spread to-day. On the other hand, ischemic heart diseases are still rare. For many authors, cardiovascular diseases are increasing in Africa because ways of life in developing and developed countries are becoming identical. In fact, this trend could be a little artificial. Formerly indeed, disparity in population age structures and mortality differences for all other causes were not enough taken into account.

Adolescent↗
PubMed1972

Concept of a paediatric emergency ward for the cities of a developing country.

Children's hospitals in developing countries carry an enormous patient load. Available facilities must be organized to provide essential care for all. At the Red Cross Children's Hospital in Cape Town this has been achieved by the development of an emergency ward attached to the outpatient department. It is suggested that this concept should be applied in large hospitals of other developing countries.

Bronchiolitis, Viral↗
PubMed1990

Reproductive epidemiologic research in developing countries.

This paper discusses the scientific rationale for carrying out reproductive epidemiologic research in developing countries, and the generalizability of results of research done in developed countries to developing countries. Practical problems encountered in doing research in developing countries include limited resources, overcommitted researchers, cost, and study monitoring. Cultural differences that affect the design and conduct of research activities in developing countries are also discussed.

Anemia, Sickle Cell↗
PubMed1990

A study of financial resources devoted to research on health problems of developing countries.

The Commission on Health Research for Development is an independent, international commission composed of 12 leaders from the fields of health research, social science research and development policy. Chaired by John Evans, the other Commissioners are Gelia Castillo, vice-chair, F. H. Abed, Sune Bergstrom, Doris Calloway, Esmat Ezzat, Demissie Habte, Walter Kamba, Adetokumbo Lucas, Adolfo Martinez-Palomo, Saburo Okita and V. Ramalingaswami. The Commission began its work in November 1987, charged with analysing the strengths, weaknesses and gaps in current research on health problems of developing countries, and making proposals and promoting action for improvement. The Commission is sponsored by a variety of foundations, bilateral donor agencies, and international organizations. The Commission's report was published in the spring of 1990. As part of the work of the Commission Secretariat, we have undertaken a study of financial resources devoted to research on the health problems of developing countries. The study which began in May 1988 has three objectives: (i) To describe the current pattern of funding for research on the health problems of developing countries. (ii) To provide a baseline against which future trends and/or new programmes can be measured. (iii) To explore the possibility of an ongoing information system on research on health problems of developing countries.

Developing Countries↗
PubMed1985

Socioeconomic and health effects on mortality declines in developing countries.

It has been argued that mortality declines in developing countries have not been associated with social and economic factors because of the diffusion from the developed countries to the developing countries of health and medical techniques. This paper examines the relationship between socioeconomic development and health and mortality declines in developing countries which are in two different stages of the demographic transition. A path model linking socioeconomic and health variables and mortality is developed and tested for early and late transition nations. The empirical findings indicated that the network of socioeconomic variables and their effects on mortality were much more significant in late transition countries than in early transition countries. While the impact of health services on crude death rates is large in the early transition nations, its impact declines considerably as countries reach a more transitionally 'mature' stage.

Cross-Cultural Comparison↗
PubMed1996

Prospects, problems, and prerequisites for national health examination surveys in developing countries.

Design options for the development of health information systems are evaluated. The health examination survey is found to be an appropriate method for meeting data needs for health planning, program design, and evaluation activities in developing countries. The model proposed is a national cross-sectional prevalence survey employing both interviews and physical examinations to produce a health status profile of a countries population. Examination data are objective, internationally comparable, and not dependent upon reports of clinical encounters in the population. Limitations inherent to health examination surveys are reviewed in reference to their potential in developing countries. Not all countries may be able to conduct health examination surveys; criteria are presented to assist in evaluation of the feasibility of application in specific countries.

Cross-Sectional Studies↗
PubMedDate not supplied

[Organ transplantation as a health priority in developing countries].

The epidemiology profile of developing countries is in transition. While the prevalence of infectious and preventable diseases, malnutrition, and in general the health problems traditionally associated to the poor, is still high, the characteristic health profile of industrialized countries (i.e. chronic and degenerative diseases, accidents, violence, social pathology) is beginning to surface. This paper focuses on the need to consider organ transplantation as a health priority in developing countries, as an important element in the global strategy to cover both aspects of the health care demand.

Developing Countries↗
PubMedDate not supplied

[Artificial crystalline lens in developing countries (author's transl)].

In developing countries, cataract affects many young but also poor patients. They have difficulties to get operated and generally cannot afford to buy spectacles. Implanting artificial crystalline lens is, then, theorically the best solution. This skillfull technique, nevertheless, requires a high level sanitary environment. Recent advances in the surgical treatment of cataract and postoperative correction of aphakia minimized its risks. Improvements in plastics technology give new possibilities. A study of the various techniques available and of the changes required in the sanitary environment of developing countries give some hope for a possibility of using artificial crystalline lens in these countries.

Cataract↗
PubMed1991

Public and private donor financing for health in developing countries.

Among the many variables that influence the outcome of national health status in both developed and developing countries, the availability and efficiency of financing is critical. For 148 developing countries, annual public and private expenditures from domestic sources (1983) were estimated to be approximately $100 billion. For the United States alone, annual public and private costs for medical care are almost five times larger ($478 billion, 1988). In contrast to domestic expenditures, the total flow of donor assistance for health in 1986 was estimated to be $4 billion, approximately 5% of total current domestic expenditures by developing countries. Direct donor assistance for development purposes by the United States Government approximates 0.5% of the US federal budget (1988). Approximately 10% of all United States development assistance is allocated for health, nutrition, and population planning purposes. While the total health sector contribution is on the order of $500 million annually, the US contribution represents about 13% of health contributions by all external donors. In sub-Saharan Africa, all donor health allocations only reach 3.4% of total development assistance. While available data suggest that private and voluntary organizations contribute approximately 20% of total global health assistance, data reporting methods from private agencies are not sufficiently specific to provide accurate global estimates. Clearly, developing countries as a whole are dependent on the efficient use of their own resources because external financing remains a small fraction of total domestic financing. Nevertheless, improvement in health sector performance often depends on the sharing of western experience and technology, services available through external donor cooperation. In this effort, the available supply of donor financing for health is not restricted entirely by donor policy, but also by the official demand for external financing as submitted by developing countries. In perspective, the supply of financing for health greatly exceeds the receipt of well-articulated and officially approved proposals from developing countries. The major constraints that produce this imbalance are unfamiliarity of ministries of health with potential donor sources; passive approaches to external financing; unfamiliarity with proposal preparation; increasing competition within developing countries by competing sectors, such as industry and agriculture; limited numbers of trained personnel; and absence of an international system which is able to support developing countries in mobilizing external financing. Tested solutions to these issues have been applied in one geographic region.(ABSTRACT TRUNCATED AT 400 WORDS)

Delivery of Health Care↗
PubMed1994

Reversibility of stunting: epidemiological findings in children from developing countries.

The growth literature from developing countries is reviewed to assess the extent to which stunting, a phenomenon of early childhood, can be reversed in later childhood and adolescence. The potential for catch-up growth increases as maturation is delayed and the growth period is prolonged. However, maturational delays in developing countries are usually less than two years, only enough to compensate for a small fraction of the growth retardation of early childhood. Follow-up studies find that subjects who remain in the setting in which they became stunted experience little or no catch-up in growth later in life. Improvements in living conditions, as through food supplementation or through adoption, trigger catch-up growth but do so more effectively in the very young. One study cautions that in older adopted subjects, accelerated growth may accelerate maturation, shorten the growth period and lead to short adult stature.

Adolescent↗
PubMed1989

State monopoly systems and alcohol prevention in developing countries: report on a collaborative international study.

In many countries, state alcohol monopoly systems have been adopted as a means of public control over alcohol availability. These countries include industrialized as well as developing countries. In this paper, an analysis is presented on the present state and potentials of state alcohol monopoly systems in preventing alcohol abuse. Special reference is given to the specificity of alcoholic beverages supply in developing countries and the potential contributions of existing state monopoly systems in developed countries to assist developing countries willing to adopt and implement preventive national alcohol policies.

Alcoholic Beverages↗
PubMed1996

A review of successful transport and home injury interventions to guide developing countries.

Injury is recognized as an increasing public health problem in developing countries. Extensive research on injury control has been conducted in the U.S. and other industrialized countries in the past several decades, but research is still in its infancy in developing countries. In this paper, successful interventions for transport and home injuries are reviewed in the context of the developing country setting. The aim is to evaluate injury interventions developed in the industrialized countries and identify those likely to be usable in developing countries. The evaluation criteria used include the efficacy of the interventions, as well as their affordability, feasibility and sustainability. The review demonstrates that while several interventions are available in the field of injury prevention for developing countries to import, caution should be taken in doing this. The use of automobile safety seat belts, bicyclist and motorcyclist helmets, speed limits, laws banning the sale of alcohol at lorry parks, pedestrian crossing signs, adequate roadway lighting, separation of pedestrians from vehicles, conspicuity-enhancement measures, simple safety equipment, and poison prevention packaging should be seriously considered by developing countries to reduce the morbidity and mortality from transport and home injuries. Since injury prevention may often require a blend of several interventions due to the multifactorial nature of the causes of injury, interventions that appear to be most effective are those with multidimensional strategies including education, legislation and environmental modification. This review should serve as a useful guide to injury control efforts in developing countries which must grapple with limited resources and low levels of education.

Accidents, Home↗
PubMed1984

Prosthetics and orthotics in developing countries.

Principles of orthoses and prostheses in developing countries are discussed. Appropriate technological adaptations to suit cultural needs in developing countries have been identified and illustrative examples have been given. In view of the importance of the problem of leprosy in many developing countries, a separate description to cover prosthetic and orthotic appliances including footwear has been attempted. The material is a summary of the excellent publication from Alert in Addis Ababa.

Amputation, Surgical↗
PubMed1981

Sexually transmitted diseases in Ethiopia. Social factors contributing to their spread and implications for developing countries.

Sexually transmitted diseases in developing countries are causing concern to those responsible for their control and eradication. To gain a better understanding of the problems involved in a country struggling with development, the economic and psychosocial factors influencing the spread of STD in Ethiopia have been studied. Increased migration and urbanisation and the changing role of women have led to a rise in prostitution. Thus changes in the social structure--particularly in relation to the education and employment of women--and improved medical services are essential for the long-term control of STD.

Delivery of Health Care↗
PubMed1996

Serological response to specific Helicobacter pylori antigens: antibody against CagA antigen is not predictive of gastric cancer in a developing country.

OBJECTIVES: In symptomatic patients resident in developed countries, a high prevalence of antibody to the cytotoxin-associated antigen (CagA) of Helicobacter pylori has been linked to the development of peptic ulcer disease and gastric cancer. This association has not been examined in developing countries, nor in asymptomatic subjects resident in either developed or developing countries. The aim of this study was to examine the seroprevalence of antibody to the CagA antigen; as well as other specific H. pylori antigens in symptomatic and asymptomatic individuals resident in Australia and China. METHODS: The Helico-blot 2.0 Western blot system was used for the detection of antibodies to specific antigens of H. pylori in sera obtained from the following H. pylori-positive groups: 19 Australian blood donors, 96 Australian nonulcer dyspepsia patients, 29 Australian duodenal ulcer patients, 35 asymptomatic Chinese subjects, and 48 Chinese gastric cancer patients. RESULTS: Nine antigens were commonly recognized by sera from Australian and Chinese subjects. These antigens were of molecular mass 19.5 kDa, 26.5 kDa, 35 kDa, 45 kDa, 60 kDa, 89 kDa (VacA), 116 kDa (CagA), and 180 kDA. A significant association between the prevalence of antibody to the CagA antigen and duodenal ulcer disease was observed in Australian subjects; however, no association between the prevalence of antibody to the CagA antigen and gastric cancer was found in Chinese subjects. In subjects from both countries, a significant association was found between antibody to the 30-kDa and 45-kDa antigens and more serious gastroduodenal disease. CONCLUSION: The results of this study suggest that the cagA gene is not associated with the development of more serious gastroduodenal disease; however, it cannot be ruled out that this gene may be an important but insufficient factor in some disease processes.

Adult↗