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2.
Yale J Biol Med ; 93(4): 579-585, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-33005122

RESUMO

Not only do epidemics such as HIV/AIDS, Ebola Virus Disease (EVD), and the current Coronavirus Disease (COVID-19) cause the loss of millions of lives, but they also cost the global economy billions of dollars. Consequently, there is an urgent need to formulate interventions that will help control their spread and impact when they emerge. The education of young girls and women is one such historical approach. They are usually the vulnerable targets of disease outbreaks - they are most likely to be vehicles for the spread of epidemics due to their assigned traditional roles in resource-limited countries. Based on our work and the work of others on educational interventions, we propose six critical components of a cost-effective and sustainable response to promote girl-child education in resource-limited settings.


Assuntos
Doenças Transmissíveis Emergentes , Infecções por Coronavirus , Identidade de Gênero , Saúde Global , Educação em Saúde , Pandemias , Pneumonia Viral , Betacoronavirus , Criança , Doenças Transmissíveis Emergentes/epidemiologia , Doenças Transmissíveis Emergentes/prevenção & controle , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Países em Desenvolvimento , Feminino , Saúde Global/economia , Saúde Global/educação , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Educação em Saúde/métodos , Educação em Saúde/organização & administração , Doença pelo Vírus Ebola/epidemiologia , Doença pelo Vírus Ebola/prevenção & controle , Humanos , Determinação de Necessidades de Cuidados de Saúde , Pandemias/economia , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle
5.
PLoS One ; 15(10): e0240503, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33035244

RESUMO

BACKGROUND: In this paper, we predict the health and economic consequences of immediate investment in personal protective equipment (PPE) for health care workers (HCWs) in low- and middle-income countries (LMICs). METHODS: To account for health consequences, we estimated mortality for HCWs and present a cost-effectiveness and return on investment (ROI) analysis using a decision-analytic model with Bayesian multivariate sensitivity analysis and Monte Carlo simulation. Data sources included inputs from the World Health Organization Essential Supplies Forecasting Tool and the Imperial College of London epidemiologic model. RESULTS: An investment of $9.6 billion USD would adequately protect HCWs in all LMICs. This intervention would save 2,299,543 lives across LMICs, costing $59 USD per HCW case averted and $4,309 USD per HCW life saved. The societal ROI would be $755.3 billion USD, the equivalent of a 7,932% return. Regional and national estimates are also presented. DISCUSSION: In scenarios where PPE remains scarce, 70-100% of HCWs will get infected, irrespective of nationwide social distancing policies. Maintaining HCW infection rates below 10% and mortality below 1% requires inclusion of a PPE scale-up strategy as part of the pandemic response. In conclusion, wide-scale procurement and distribution of PPE for LMICs is an essential strategy to prevent widespread HCW morbidity and mortality. It is cost-effective and yields a large downstream return on investment.


Assuntos
Infecções por Coronavirus/patologia , Análise Custo-Benefício , Mão de Obra em Saúde/economia , Equipamento de Proteção Individual/economia , Pneumonia Viral/patologia , Teorema de Bayes , Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/economia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Países em Desenvolvimento , Pessoal de Saúde/estatística & dados numéricos , Humanos , Método de Monte Carlo , Pandemias/economia , Equipamento de Proteção Individual/provisão & distribução , Pneumonia Viral/economia , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia
6.
Int J Equity Health ; 19(1): 182, 2020 10 15.
Artigo em Inglês | MEDLINE | ID: mdl-33059674

RESUMO

COVID-19 which started in Wuhan, China and swiftly expanded geographically worldwide, including to Low to Middle Income Countries (LMICs). This in turn raised numerous ethical concerns in preparedness, knowledge sharing, intellectual property rights, environmental health together with the serious constraints regarding readiness of health care systems in LMICs to respond to this enormous public health crisis. From the restrictions on public freedom and burgeoning socio-economic impacts to the rationing of scarce medical resources, the spread of COVID-19 is an extraordinary ethical dilemma for resource constrained nations with less developed health and research systems. In the current crisis, scientific knowledge and technology has an important role to play in effective response. Emergency preparedness is a shared responsibility of all countries with a moral obligation to support each other. This review discusses the ethical concerns regarding the national capacities and response strategies in LMICs to deal with the COVID-19 pandemic as well as the deep link between the environment and the increasing risk of pandemics.


Assuntos
Infecções por Coronavirus/prevenção & controle , Países em Desenvolvimento , Meio Ambiente , Ética , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Infecções por Coronavirus/epidemiologia , Previsões , Humanos , Pneumonia Viral/epidemiologia
10.
Environ Monit Assess ; 192(10): 633, 2020 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-32902741

RESUMO

The Tarai region of Nepal is regarded as the food bowl of Nepal, and yet urban areas have increased in size at an average annual rate of 12% for the 30 years since 1988/1989, largely at the expense of prime agricultural land. Nepal is recognized internationally as highly sensitive to food security with 40% of its population undernourished. To aid future planning and reduce potential further loss of agricultural land and consequent increased food insecurity, we here investigated the previously unknown factors underlying this rapid urban expansion. We achieved this through analyses of land use and land cover (LULC) data, population, and climatic data, in association with focus group discussions and questionnaire surveys. We found that socioeconomic factors were perceived to have made the highest (62%) contribution to urbanization, particularly migration-led population growth and the economic opportunities offered by urban areas, followed by political factors (14.5%), physical factors (12%), and planning and policy factors (11.5%). In addition, climate and physiographic features make the area attractive for urban development along with favorable government plans and policies. Accelerated urban expansion during this period was particularly driven by mass migration due to political upheaval in the country resulting in rapid population and urban center growth. Of the total 293 urban centers in the country, the Tarai region includes 150 (51.2%) of which 77 (26.3%) are located in province 2 alone and accommodate 17.2% of Nepal's households. This increasing urbanization trend is expected to continue in the future due to current socioeconomic and demographic factors. We hope our results which show what has driven past urbanization will aid future urban planning and management of the Tarai as well as other similar regions elsewhere in the world. We also identified that such rapid urban growth is largely at the cost of populations in rural areas with rural depopulation resulting in agriculture being abandoned in some areas. Given Nepal's sensitivity to food security and lower food production, this will be an increasing problem for the future.


Assuntos
Emigração e Imigração , Política Pública , Agricultura , Demografia , Países em Desenvolvimento , Monitoramento Ambiental , Nepal , Dinâmica Populacional , População Urbana , Urbanização
11.
Medicine (Baltimore) ; 99(35): e21767, 2020 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-32871897

RESUMO

Risk factors such as smoking and sugar intake threaten the health of human being at an individual national level as well as at a global level. The globalization affect health indirectly through macro and micro-level factors. This study aimed to identify the global trend of dental caries according to countries national income level, and to examine the role of globalization, health services, obesity, and sugar consumption on dental caries. Data for 160 countries were collected for the time period of the 1990s to 2010s. The final sample included 46 countries with complete data (21 high income countries (HIC) and 25 middle and low income countries (MLIC)). The main dependent variable was the mean decayed, missing, and filled teeth (DMFT) index of 12-year-olds as an indicator of dental caries. Globalization was a main independent variable which was measured by economic growth, urbanization and economic freedom. Other independent variables were health services, obesity and sugar consumption. The data were analyzed first using repeated measures analysis of variance to compare dental caries trends in HIC and MLIC. Then, using multiple linear regression and partial least squares structural equation modeling (PLS-SEM), the relationships between globalization, health services, obesity, sugar consumption, and dental caries were examined. The results of PLS-SEM revealed that globalization was associated with lower DMFT in HIC. The global dental caries trend had a declined pattern, but this pattern has been attenuated in MLIC after the new millennium. There is a need for policy change and regulations on sugar trade especially in MLIC to diminish the adverse consequences of globalization, and to improve population dental health.


Assuntos
Índice CPO , Cárie Dentária/epidemiologia , Países Desenvolvidos/estatística & dados numéricos , Países em Desenvolvimento/estatística & dados numéricos , Internacionalidade , Criança , Açúcares da Dieta , Desenvolvimento Econômico , Acesso aos Serviços de Saúde/estatística & dados numéricos , Humanos , Análise de Classes Latentes , Modelos Lineares , Obesidade/epidemiologia , Urbanização
13.
Indian J Med Microbiol ; 38(2): 139-143, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32883925

RESUMO

COVID-19 as a pandemic has spanned across all continents. With the increasing numbers in cases worldwide, even the countries with the best of healthcare facilities are reeling under the burden of the disease. Therefore, in countries with limited access to resources and poor healthcare infrastructure, the low and middle-income countries (LMICs), limiting spread becomes even more challenging. Low- and middle-income countries (LMICs) are severely hit by any outbreak and pandemics and face the lack of infrastructure and problem of overcrowding. Health facilities are compromised and almost exhausted at the time of emergency. There is disruption of normal supply chain, and consumables are not in sufficient quantity. In the current situation, rationalized use of available supplies is important. This paper presents the perspective on the basis of current literature on gaps in various infection prevention and control (IPC) strategies that are being followed currently in LMICs and suggestions for bridging these gaps.


Assuntos
Betacoronavirus/patogenicidade , Controle de Doenças Transmissíveis/organização & administração , Infecções por Coronavirus/epidemiologia , Higiene das Mãos/organização & administração , Pandemias , Pneumonia Viral/epidemiologia , Controle de Doenças Transmissíveis/métodos , Infecções Comunitárias Adquiridas , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/prevenção & controle , Países em Desenvolvimento , Desinfecção/métodos , Instalações de Saúde/provisão & distribução , Humanos , Pandemias/prevenção & controle , Equipamento de Proteção Individual/provisão & distribução , Pneumonia Viral/diagnóstico , Pneumonia Viral/prevenção & controle , Guias de Prática Clínica como Assunto
14.
BMC Public Health ; 20(1): 1466, 2020 Sep 29.
Artigo em Inglês | MEDLINE | ID: mdl-32993570

RESUMO

BACKGROUND: Lung cancer is the most diagnosed cancer worldwide. In low- and middle-income countries (LMICs), lung cancer is often diagnosed at a late stage due to poor knowledge and awareness of its signs and symptoms. Increasing lung cancer awareness is likely to reduce the diagnosis and treatment delays. The implementation of early palliative care has also been reported to improve a patient's quality of life, and even survival. The aim of this scoping review was to map evidence on lung cancer awareness and palliative care interventions implemented in sub-Saharan Africa (SSA) and other LMICs. METHODS: This scoping review was guided by Arksey and O'Malley's framework. Databases such as the EBSCOhost, PubMed, Science Direct, Google Scholar, World Health Organization (WHO) library and grey literature were used to perform systematic searches of relevant articles. The methodological quality assessment of included primary studies was assessed using the Mixed Method Appraisal Tool (MMAT). NVivo version 10 software was used to perform the thematic content analysis of the included studies. RESULTS: A total number of screened articles was 2886, with 236 meeting the eligibility criteria and 167 further excluded following abstract screening. Sixty-nine (69) articles qualified for full-article screening and 9 were selected for detailed data extraction and methodological quality assessment. Of the included nine studies, eight described at least one lung cancer warning signs and symptoms, while one described the effectiveness of palliative care for lung cancer. Eight articles recognized the level of lung cancer knowledge, risk factors awareness of warning signs and symptoms in LMICs, mostly Africa and Asia. CONCLUSIONS: Most of the participants were aware of tobacco use as the major risk factor for lung cancer but lacked knowledge on the other pre-disposing risk factors. Evidence on palliative care is scarce, therefore, awareness interventions packaged with evidence on the value of timely access to palliative care services in improving the quality of life of the lung cancer patients and their families, are required.


Assuntos
Países em Desenvolvimento , Disparidades em Assistência à Saúde/estatística & dados numéricos , Neoplasias Pulmonares/terapia , Cuidados Paliativos/estatística & dados numéricos , Pobreza/estatística & dados numéricos , Adulto , África ao Sul do Saara , Ásia , Feminino , Humanos , Neoplasias Pulmonares/economia , Qualidade de Vida , Fatores de Risco
16.
Clin J Oncol Nurs ; 24(5): 586-590, 2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-32945791

RESUMO

As the coronavirus spread from Asia to Western Europe and North America, healthcare institutions in the Middle East, Africa, South Asia, and Latin America prepared for the COVID-19 pandemic. Interprofessional task forces were established to coordinate institutions' responses, inventory supplies of personal protective equipment, educate staff and patients, develop procedures for triaging patients and prioritizing care, and provide support to nurses to mitigate their stress. Despite challenges, nurses continued to deliver quality care to patients with cancer.


Assuntos
Infecções por Coronavirus/epidemiologia , Países em Desenvolvimento , Neoplasias/enfermagem , Pandemias , Pneumonia Viral/epidemiologia , Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/virologia , Educação em Enfermagem/organização & administração , Humanos , Equipamento de Proteção Individual , Pneumonia Viral/virologia , Qualidade da Assistência à Saúde
17.
Respir Care ; 65(9): 1378-1381, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32879035

RESUMO

COVID-19 is devastating health systems globally and causing severe ventilator shortages. Since the beginning of the outbreak, the provision and use of ventilators has been a key focus of public discourse. Scientists and engineers from leading universities and companies have rushed to develop low-cost ventilators in hopes of supporting critically ill patients in developing countries. Philanthropists have invested millions in shipping ventilators to low-resource settings, and agencies such as the World Health Organization and the World Bank are prioritizing the purchase of ventilators. While we recognize the humanitarian nature of these efforts, merely shipping ventilators to low-resource environments may not improve outcomes of patients and could potentially cause harm. An ecosystem of considerable technological and human resources is required to support the usage of ventilators within intensive care settings. Medical-grade oxygen supplies, reliable electricity, bioengineering support, and consumables are all needed for ventilators to save lives. However, most ICUs in resource-poor settings do not have access to these resources. Patients on ventilators require continuous monitoring from physicians, nurses, and respiratory therapists skilled in critical care. Health care workers in many low-resource settings are already exceedingly overburdened, and pulling these essential human resources away from other critical patient needs could reduce the overall quality of patient care. When deploying medical devices, it is vital to align the technological intervention with the clinical reality. Low-income settings often will not benefit from resource-intensive equipment, but rather from contextually appropriate devices that meet the unique needs of their health systems.


Assuntos
Infecções por Coronavirus/epidemiologia , Disparidades em Assistência à Saúde/economia , Pandemias/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Pobreza/estatística & dados numéricos , Ventiladores Mecânicos/estatística & dados numéricos , Infecções por Coronavirus/terapia , Cuidados Críticos/organização & administração , Países em Desenvolvimento , Feminino , Recursos em Saúde/economia , Humanos , Unidades de Terapia Intensiva/organização & administração , Masculino , Nigéria , Pneumonia Viral/terapia , Nações Unidas , Ventiladores Mecânicos/economia , Organização Mundial da Saúde
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