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PubMedDate not supplied

Ongoing research in occupational health and environmental epidemiology in developing countries.

Research in occupational health and environmental epidemiology can play an important role in furthering our understanding of occupational and environmental health problems. Research guides us in the recognition, management, and prevention of health problems. However, in developing countries, where rates of occupational and environmental illnesses and injuries are higher and where these problems are often more severe than in developed countries, research capabilities are less developed. In mid-1990, a project was undertaken to (a) document ongoing research in occupational health and environmental epidemiology in developing countries, (b) facilitate the exchange of information among researchers in this field, (c) stimulate research, and (d) avoid unnecessary duplication among researchers in this field. A questionnaire was mailed, the purpose of which was to learn the current status of research in developing countries and to develop a directory of such ongoing research. The questionnaire was sent to 1,528 individuals. Of the 500 research projects identified, 77% were investigating chemical hazards; 26%, physical hazards; 10%, biological hazards; and 10%, psychosocial hazards (some projects addressed multiple hazards). The chemical hazards studied most frequently were dusts, pesticides, and lead. The greatest number of research projects were identified in China, India, Brazil, Korea, and Thailand. Most projects were descriptive or cross-sectional epidemiologic studies or industrial hygiene or exposure-assessment studies. The World Health Organization has published a directory of the specific research projects that were identified in this survey.

Developing Countries↗
PubMed1978

[Problems in production, control and utilization of veterinary vaccines in the developing countries].

For a whole series of reasons, most of which are political, the developing countries are following a policy of national self-sufficiency in veterinary vaccines. They are faced with problems at various levels: (1) at the level of logistic distribution, the developing countries suffer from a shortage of trained personnel, frequently lacking in enthusiasm, an often chronic shortage of funds; poorly equipped premises; poor maintenance of sophisticated but indispensable equipment (e.g. freeze-driers); a lack of facilities for cold storage and of distribution channels; field personnel with limited experience; (2) at the level of production, they must contend with difficulties in obtaining supplies of flasks and glassware; irregular supplies of water and electricity; difficulties in obtaining susceptible animals for quality control. The developing countries have found basically pragmatic solutions to these problems, such as the strict separation of the sites, materials and personnel involved in routine diagnosis and those involved in production; temporary foreign technical assistance, with or without financial aid; the use of simple, unsophisticated techniques, which are known to be reliable, even if somewhat outdated; manufacturing in bulk in multiple-dose bottles; research into the thermostabilisation of vaccine strains and the development of thermoprotective diluents for freeze-drying and reconstitution; the extensive use of combined vaccines; the establishment of production and control standards under the auspices of the WHO/FAO/OIE. In spite of these obstacles, the cost price is particularly low (from 0.20 to 0.35 francs per dose), which compares favourably with that of foreign private industry.

Africa↗
PubMed1988

The information needs of health care professionals and consumers in developing countries.

The health information needs of health care professionals and consumers in less-developed countries, although somewhat similar to those of their U.S. counterparts, have a number of unique differences. Health care professionals in developing countries are more diverse in their backgrounds, training, experience, and work settings. These differences, combined with cultural variables, a lack of resources and trained information professionals, contribute to the complexity of health information delivery. Consumers in developing countries, due to a lower literacy rate and a higher rate of commercial health information, face different problems when attempting to make health-related decisions.

Delivery of Health Care↗
PubMed1991

[Dentistry in developing countries].

The author presents different approaches to dental activities in developing countries. The general prevalence of dental caries and periodontitis in developing countries is low. The limited resources for health programmes, and for oral health in particular, underscore the need to make priorities in order to improve the health of the inhabitants. To promote oral health, it is necessary to focus on improving knowledge about the major oral diseases and the possibility of developing community-based programmes of intervention and prevention. The integration of oral health into general health programmes is a major goal in the prevention and combat of oral diseases. Knowledge and research in fields of oral medicine, preventive oral programmes as well as in fluoride toxicology as part of water programmes is important.

Dental Care↗
PubMed1988

Measles in developing countries. Part I. Epidemiological parameters and patterns.

This paper presents a review of published data concerning the epidemiology of measles in developing countries. Simple mathematical models provide a framework for data analysis and interpretation. The analyses highlight differences and similarities in the patterns of transmission of the measles virus in developed and developing countries. Whilst the rate of loss of maternally derived immunity to measles is broadly similar, the average age at infection is much lower, and case fatality rates are much higher in developing countries. Data analysis also serves to illustrate inter-relationships between different kinds of epidemiological data. Thus, for example, in order to correctly interpret an age stratified serological profile from a developing country it is necessary to have information on the rate of decay of maternal antibodies and age specific case fatality rates. To determine the probable impact of a given vaccination programme, information on the birth rate in the community concerned is also required. A discussion is given of the epidemiological data required in order to effectively design a community based vaccination programme aimed at the eradication of measles.

Adolescent↗
PubMed1992

Psychiatric morbidity in developing countries and American psychiatry's role in international health.

Economic and social change in the developing countries of Asia, Africa, Latin America, and the Pacific Islands is associated with increased rates of behavior-related illnesses, including psychiatric disorders, alcoholism, and substance abuse. Between 10 and 20 percent of the presenting problems in primary care settings in those countries are psychosocial. The authors provide an overview of the epidemiology of psychiatric and psychosocial morbidity in developing countries and summarize its effect on medical care systems in those settings. They suggest that American psychiatry increase its involvement in improving mental health care in developing countries. Consultation should be directed toward priorities determined locally in those countries, including assessment of current clinical practices, applied epidemiologic research, and training of indigenous researchers.

Adolescent↗
PubMed1989

Alcohol advertising in developing countries.

Alcohol consumption appears to be increasing in some developing countries. Groups who previously did not drink alcohol, such as young people and women, are now increasingly beginning to drink. Recent anecdotal observations by researchers in Lesotho suggest that aggressive advertising may play a part in encouraging drinking among the young. This commentary suggests that surveys of alcohol advertising and youthful drinking in developing countries would be particularly useful in monitoring the influence of alcohol advertising in rapidly expanding markets. Recent studies have described simple measures of awareness and appreciation of alcohol advertising which discriminate between under-age drinkers and non-drinkers. These measures could be readily adapted by researchers responsible for the design of surveys of youthful drinking.

Advertising↗
PubMedDate not supplied

General internal medicine and technologically less developed countries.

OBJECTIVE: To assess the international health activities of departments of medicine, divisions of general medicine, and general medicine faculty and the interest among departments of medicine in joint international health ventures. DESIGN: 15-item, mailed questionnaire. PARTICIPANTS: 100 chiefs of divisions of general medicine associated with training programs in internal medicine. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Completed questionnaires were returned by 87 division chiefs representing 1,355 general medicine faculty. 49% of division had faculty with six weeks' experience in less developed countries. 8.5% of general medicine faculty had six weeks' experience in less developed countries. 7.6% of general medicine faculty were interested in spending extended time in less developed countries. 19% of departments had formal collaborations with schools in less developed countries. 45% of departments were interested in affiliations with U.S. institutions for the purpose of joint international health ventures. CONCLUSIONS: The international health interests of current general medicine faculty may not be satisfied. Departmental and divisional encouragement of international interests would increase the number of U.S. general internists participating in less developed countries. The authors discuss the potential for greater involvement of general medicine faculty in international health.

Attitude of Health Personnel↗
PubMedDate not supplied

Rapid diagnosis of tuberculosis: laboratory techniques applicable in developing countries.

New technologies for the rapid diagnosis of tuberculosis that can be applied in developing countries where the prevalence of tuberculosis is high are based on methods that permit recognition of either mycobacterial products in clinical specimens or specific host responses to mycobacteria. Mycobacterial antigens can be identified by immunoassays based on the enzyme-linked immunosorbent assay (ELISA). Mycobacterial DNA or rRNA can be identified with the use of single-stranded DNA probes. Both techniques are potentially suitable for use in developing countries, although there remain technical problems associated with the use of sputum samples. Serodiagnosis by ELISA is a promising technique based on recognition of the IgG antibody response of the host. The technique is ready for early application and can be used in developing countries. However, high specificity depends on the use of antigens that are not now generally available. The predictive accuracy of any newly proposed diagnostic technique must be compared with that of direct microscopic examination of sputum.

DNA Probes↗
PubMed1991

Epidemiology of traumatic brain injury in Johannesburg--I. Methodological issues in a developing country context.

Incidence studies in the developing countries present epidemiologists with unique methodological challenges for which novel solutions must be found. These challenges arise from archival inadequacies, hospital overcrowding, high violence rates, and limited research funding that necessitates low cost epidemiology. This paper describes the methods devised in Johannesburg, South Africa, in order to develop incidence estimates of determinable reliability of the morbidity and mortality arising from traumatic brain injury, and its etiology. Results are reported in Part II of the paper (p. 289).

Age Factors↗
PubMed1983

[Status and perspectives of agrarian production and food supply in developing countries].

In the early 1980s the agrarian-economic situation and the food supply of most developing countries is characterized by serious complications and vast contradictions. Contrary to the predictions made at the world food conferences in 1970 and 1974, a general retardation has taken place in the rates of increase of food production, and the nutrient crisis has extended. The FAO prognosis 'Agriculture: Toward 2000'- based on annual growth rates of 4%--outlines the enormous problems to be solved in the struggle against hunger and malnutrition in the developing countries. Because of its inadequacies and contradictions this document of the FA cannot, however, be considered as a complex strategy for the fight against hunger, poverty, and underdevelopment, or as a general orientation for shaping the agrarian and nutritional policy in the developing countries.

Agriculture↗
PubMed1990

Problems of drug therapy of epilepsy in developing countries.

Unavailability of drug therapy to patients with epilepsy in developing countries is probably the most important obstacle to effective primary care of epilepsy in these countries. At the recent international Merritt-Putnam Symposium in New Delhi, poor availability of drug supply and poor access to drug therapy were identified as major constraints to availability of drug therapy. The extent and magnitude of the problems are examined in this communication and methods of improving drug therapy of epilepsy in developing countries are suggested.

Anticonvulsants↗
PubMedDate not supplied

Contraceptive use during lactation in developing countries.

Contraceptive use by breastfeeding women in developing countries has led to concern about potentially harmful effects of steroid contraceptives on the health of breastfed children. In this paper, breastfeeding women's use of the pill and hormonal injections is investigated using survey data from 17 Latin American, Asian, and African countries. The results indicate that while the proportions of breastfeeding women who use these methods were small in most countries at the time of the surveys, the proportion using the pill was not inconsequential. In general, younger lactating women with higher education and more live births who live in urban areas are more likely to use the pill than other breastfeeding women.

Breast Feeding↗
PubMed1979

Nutritional problems in developing countries.

Nutritional problems in children constitute the major health problem in developing countries. Impact of a factors leading to different kinds of nutritional problems in developing countries are reviewed. Prevention and treatment of some special disease states are discussed. Outlines for some solutions to the greatest nutritional problems are presented.

Bottle Feeding↗
PubMed1992

Advertising for all by the year 2000: public health implications for less developed countries.

This paper argues that the development of global advertising has significant implications for the public health of less developed countries. These implications can be seen in three areas. First, it is clear that advertising and marketing of lethal or health-compromising products like alcohol and tobacco not only can increase the level of death and disease, but can also produce serious indirect effects upon families, communities, and entire societies. Second, advertising promotes a consumption ethic which can have far-reaching effects that go beyond individual behavior, significantly altering social relationships, and influencing public policies and allocation of scarce resources. Third, advertising can restrict the public's knowledge about health issues by substituting distorted and manipulative sales messages for vital, accurate health information. In addition, revenues from advertising are a primary support for many mass media systems and this further limits the presentation of critical information.

Advertising↗
PubMed2026

Long-acting reversible contraception, condom use and sexually transmitted infections in developing countries: a multi-country serial cross-sectional analysis using demographic and health surveys.

INTRODUCTION: Unintended pregnancy and sexually transmitted infections (STIs) are major public health issues in developing countries. While long-acting reversible contraception (LARC) effectively prevents unintended pregnancy, there is limited evidence from large multinational studies on its association with condom use and STI-related outcomes. This study aimed to investigate the association between LARC use, condom use and STIs among women in developing countries. METHODS: This serial cross-sectional study extracted data from Demographic and Health Surveys (DHS), a series of nationally representative household surveys conducted in developing countries. The analysis included women aged 15 to 49 years, with data on contraceptive methods and demographics. Generalised linear mixed effect models (GLMMs) were used to estimate adjusted prevalence ratios (aPRs) for condom use and self-reported STI-related outcomes, comparing LARC users with both non-LARC users and oral contraceptive users. Subgroup analyses were conducted at the individual level and at the country level. RESULTS: Data from 2 171 884 women across 31 countries were analysed. Overall, the prevalence of self-reported STI-related outcomes was 7.4%, 3.9% of participants used LARC, and 7.5% of participants reported consistent condom use. LARC users were significantly less likely to use condoms compared with non-LARC users (aPR=0.40, 95% CI 0.30 to 0.53) and compared with oral contraceptive users (aPR=0.61, 95% CI 0.48 to 0.78). LARC use was associated with a higher prevalence of STI-related outcomes compared with non-LARC users (aPR=1.19, 95% CI 1.10 to 1.28) and compared with oral contraceptives users (aPR=1.14, 95% CI 1.05 to 1.24). Associations were stronger in low-Human Development Index (HDI) countries, especially among younger women (15-19 years), but were not significant in high-HDI countries. Country-level heterogeneity was observed. CONCLUSIONS: LARC use is associated with reduced condom use and higher self-reported STI prevalence, particularly among younger women and in lower HDI developing countries. These findings support integrating STI prevention into LARC services and promoting dual-method use to prevent both unintended pregnancies and STIs.

Humans↗
PubMed1991

Nursing aspects of infection control in developing countries.

The quality of the infection control programme in developing countries is determined by the resource allocation to the health sector and the health care delivery system. These depend to a great extent on the socio-economic development of the country. Morbidity and mortality from communicable infections, such as diarrhoeal diseases and malaria are high. There is often an irregular water and electricity supply. Essential material resources, e.g. paper towels, gowns, gloves, masks and disinfectants may not be available and some disposable materials have to be re-used. Most hospitals have no infection control programme due to the lack of awareness of the problem or absence of trained personnel in infection control practices. Developing countries differ in many ways from each other, often having dissimilar cultures and languages and state of socio-economic development. Solutions will emerge only if there is co-operation between countries and provision of assistance, where appropriate, from wealthier countries.

Cross Infection↗