The American Jornal of Tropical Medicine and Hygiene, vol. 105, no.6, pp.1772-1781.
Schistosomiasis, which is the second most important parasitic infection after malaria in terms of its socioeconomic impact, is responsible for the loss of an estimated 4.5 million disability-adjusted life years (DA...LYs) worldwide. Schistosomiasis, including both intestinal and urinary forms of the disease, occurs in 78 countries across the globe. An estimated 240 million people are infected, with more than 779 million living at risk globally. The majority of those infected and those at risk for infection live in low-income countries, and approximately 80% of the morbidity occurs in impoverished communities and households in sub-Saharan Africa. Within Uganda, 91 of the 134 districts are endemic for intestinal schistosomiasis caused by Schistosoma mansoni, and the eastern region, especially along Lake Victoria, has one of the highest S. mansoni burdens worldwide. Schistosoma haematobium is only endemic in the five districts of the Lango region in northern Uganda.
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Recommendations to develop guidelines on community-based rehabilitation (CBR) were made during the International Consultation to Review Community-based Rehabilitation which was held in Helsinki, Finland in 2003. WHO; the International Labour Organization; the United Nations Educational, Scientific ...and Cultural Organization; and the International Disability and Development Consortium – notably CBM, Handicap International, the Italian Association Amici di Raoul Follereau, Light for the World, the Norwegian Association of Disabled and Sightsavers – have worked closely together to develop the Community-based rehabilitation guidelines. More than 180 individuals and representatives of nearly 300 organizations, mostly from low-income and middle-income countries around the world, have been involved in their development.
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The results of the report clearly show that in 2020, a year dominated by the emergence of COVID-19 and its associated health and economic crises, governments around the world rose to the challenge. Sharp increases in government spending on health at all country income levels underpinned the rise in ...health spending to a new high of US $9 trillion (approximately 11% of global GDP). Government health spending generally increased and offset declines in out-of-pocket spending. Importantly, the rise in government health spending was part of a much broader fiscal response to the pandemic. In high income and upper-middle income countries social protection spending also increased sharply in as governments attempted to cushion populations from the economic impacts of COVID-19. In contrast to health and social protection, growth in education spending was relatively subdued. Countries face the further challenge of sustaining increased public spending on health and other social sectors in the face of deteriorating macroeconomic conditions and rising debt servicing. This also includes the challenge of sustaining external support for low income countries, which is essential for reducing ensuring poverty, ensuring access to health services and strengthening pandemic preparedness.
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Noncommunicable diseases (NCDs) – chief among them, cardiovascular diseases (heart disease and stroke), cancer, diabetes and chronic respiratory diseases – along with mental health, cause nearly three quarters of deaths in the world. Their drivers are social, environmental, commercial and geneti...c, and their presence is global. Every year 17 million people under the age of 70 die of NCDs, and 86% of them live in low- and middle-income countries (LMICs).
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As we approach World Asthma Day on the May 2, 2023, we reflect on the theme “ Asthma Care for All”. Prevalence of Asthma is increasing amongst children, adolescents and adults. Under-diagnosis, underutilization of inhaled corticosteroids, inaccessibility of treatment, and unaffordability of medi...cines are amongst the challenges that low-middle income countries are faced with. This commentary seeks to highlight the challenges, the resources available and to suggest recommendations that can be implemented to improve asthma care for all and reduce burden of asthma in Africa.
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Recommendations to develop guidelines on community-based rehabilitation (CBR) were made during the International Consultation to Review Community-based Rehabilitation which was held in Helsinki, Finland in 2003. WHO; the International Labour Organization; the United Nations Educational, Scientific ...and Cultural Organization; and the International Disability and Development Consortium – notably CBM, Handicap International, the Italian Association Amici di Raoul Follereau, Light for the World, the Norwegian Association of Disabled and Sightsavers – have worked closely together to develop the Community-based rehabilitation guidelines. More than 180 individuals and representatives of nearly 300 organizations, mostly from low-income and middle-income countries around the world, have been involved in their development.
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This is the first global report on epilepsy summarizing the available evidence on the burden of epilepsy and the public health response required at global, regional and national levels.
The reports highlights major gaps in awareness, diagnosis, treatment, and health policies through a series of a...ppalling numbers. With around 50 million people affected worldwide, epilepsy is one of the most common and serious brain disorders. Nearly 80% of people with epilepsy live in low-income and middle-income countries
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The report is geared towards mayors, local government officials and city policy planners.It highlights key areas where city leaders can tackle the drivers of NCDs, including tobacco use, air pollution, poor diets and lack of exercise, and improve road safety.
From anti-tobacco actions in Beijing a...nd Bogor, to road safety initiatives in Accra and Bangkok, a bike sharing scheme in Fortaleza, and actions to create walkable streets for seniors that have reduced elderly pedestrian deaths by 16% in New York City, the report aims to share knowledge between urban policy planners.
Of the 19 case studies cited, 15 are from developing countries, where 85% of premature adult deaths through NCDs take place, and over 90% of road traffic fatalities are recorded. You can download the case studieson the website https://www.who.int/ncds/publications/tackling-ncds-in-cities/en/.
Over 90% of future urban population growth will be in low or middle-income countries, and seven of the world’s 10 largest cities are in developing countries.
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The internationally recognized criteria for diagnosis of neurocysticercosis include a requirement for neuroimaging techniques, such as computerized tomography (CT) and/or magnetic resonance imaging (MRI), ideally supported by serology. These facilities are not available in all settings, especially i...n rural areas of low-income countries, making it difficult to identify and treat patients. Additionally, there is controversy about the role, type and duration of anthelmintic, antiinflammatory and antiepileptic drug (AED) treatments for different forms of neurocysticercosis.
These guidelines were developed to assist health-care providers in appropriate, evidence-based management of parenchymal neurocysticercosis. The guidelines do not address other forms of neurocysticercosis and do not include management of extraparenchymal disease (including cysticerci in the cerebral ventricles or subarachnoid space). The aim of the guidance is to improve decision-making to ensure appropriate patient care and to avoid misdiagnoses and inappropriate treatment of patients with neurocysticercosis.
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The Global Asthma Report (GAR) 2022, prepared by the Global Asthma Network (GAN), is the fourth such report (others 2011, 2014, 2018). GAN builds upon the work of the International Study of Asthma and Allergies in Childhood (ISAAC) and The International Union Against Tuberculosis and Lung Disease (T...he Union) to monitor asthma and improve asthma care, particularly in low- and middle-income countries (LMICs).
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Preventing tuberculosis infection from progressing to tuberculosis disease is a crucial component of the goal to eliminate tuberculosis. When deciding on the use of tuberculosis preventive therapy among household contacts, policy makers regularly ask questions, such as whether tuberculosis preventiv...e therapy is effective, safe, and feasible in a programme setting and what it will cost. For contact management and tuberculosis preventive therapy for multidrug-resistant and rifampicin-resistant tuberculosis, studies from high-income and low-income countries have shown feasibility, safety, and effectiveness.
However, there is scarce information on the cost of tuberculosis preventive therapy for multidrug-resistant and rifampicin-resistant tuberculosis. In The Lancet Global Health, Peter Dodd and colleagues show that household contact management strategies are cost-effective even in low-income and middle-income countries, which has important policy implications for achieving the END TB Strategy goals.
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The document, "Progress on the Prevention and Control of Non-Communicable Diseases," reports on global efforts to reduce the impact of NCDs, such as heart disease, cancer, diabetes, and chronic respiratory diseases, following the commitments made at high-level United Nations meetings. It highlights ...the inadequate progress in meeting the targets set under the Sustainable Development Goal 3.4 to reduce premature NCD mortality by one-third by 2030. Key challenges include insufficient funding, limited implementation of effective interventions, and political and economic barriers, especially in low-income countries. The report calls for strengthened international cooperation, policy reform, and innovative approaches to meet global health targets.
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This comprehensive book has established itself as the most useful text for the medical practitioner in poor-resource settings who is obliged to manage surgical cases. It is particularly adapted for those whose surgical experience is basic or minimal. Importantly, it has extensive advice about pitfal...ls to avoid, and what to do if things go wrong. It is written in simple style, particularly for those whose mother tongue is not English. It is not a text which discusses the latest up-to-date technology, but it is not out-of-date being a synthesis of the best advice from a myriad of surgeons practicing for many years in low- and middle-income countries.
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Project Drawdown (2022) provides evidence of how climate solutions can also be win-win opportunities for meeting development and human well-being needs while boosting prosperity for rural communities in sub-Saharan Africa and South Asia. The report summarizes the co-benefits of five groups of a subs...et of Project Drawdown climate solutions (28 total solutions) for advancing human well-being in rural areas of low- and middle-income countries
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The World Health Organization (WHO) defines mental health as ‘a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community’. Mental illn...ess refers to all of the diagnosable mental disorders, which are characterised by abnormalities in thinking, feelings or behaviours. Mental illness is closely related to vulnerability, both in its causes and in its effects. Globally, 14 per cent of the global burden of disease is attributed to mental illness – with 75 per cent of those affected being found in low-income countries – which includes a broad spectrum of diagnoses, from common mental illnesses such as anxiety and
substance abuse, to severe illnesses like psychosis.
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Direct acting antivirals (DAAs) have revolutionized treatment for hepatitis C. Combi-
nations of DAAs can cure infection with HCV in 12 weeks, are highly effective and
have limited side-effects. Affordability of DAAs has improved significantly, but access remains lim-
i...ted. Initially, due to their high prices, affordability of DAAs was limited in high-, middle- and low-
income countries alike. Now there is a divide between those countries where, because of intellectual
property barriers, prices have remained (very) high and other countries where generics are, or can be,
available at much lower prices. The result is a dual market
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In October 2022, President Biden signed the Global Malnutrition Prevention and Treatment Act (GMPTA) into law, which directs USAID to prevent and treat malnutrition globally. The GMPTA further codifies USAID’s leadership on nutrition, with a focus on evidence-based interventions across health syst...ems and food systems, in both development and humanitarian settings.
Realizing the potential of good nutrition to save lives and ensure a brighter future for generations to come is central to U.S. Government priorities. For over 60 years, USAID has been a leader in the fight to end global malnutrition. Nutrition affects every aspect of human development: from the ability to fight disease, to children’s performance in school, to a nation’s health and economic advancement. There is overwhelming evidence of the power of good nutrition but, due to challenges in accessing safe, nutritious foods and health and sanitation services, many people in low- and middle-income countries remain undernourished.
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Background
Noncommunicable diseases are major contributors to morbidity and mortality worldwide. Modifying the risk factors for these conditions, such as physical inactivity, is thus essential. Addressing the context or circumstances in which physical activity occurs may promote physical activity a...t a population level. We assessed the effects of infrastructure, policy or regulatory interventions for increasing physical activity.
Methods
We searched PubMed, Embase and clinicaltrials.gov to identify randomised controlled trials (RCTs), controlled before-after (CBAs) studies, and interrupted time series (ITS) studies assessing population-level infrastructure or policy and regulatory interventions to increase physical activity. We were interested in the effects of these interventions on physical activity, body weight and related measures, blood pressure, and CVD and type 2 diabetes morbidity and mortality, and on other secondary outcomes. Screening and data extraction was done in duplicate, with risk of bias was using an adapted Cochrane risk of bias tool. Due to high levels of heterogeneity, we synthesised the evidence based on effect direction.
Results
We included 33 studies, mostly conducted in high-income countries. Of these, 13 assessed infrastructure changes to green or other spaces to promote physical activity and 18 infrastructure changes to promote active transport. The effects of identified interventions on physical activity, body weight and blood pressure varied across studies (very low certainty evidence); thus, we remain very uncertain about the effects of these interventions. Two studies assessed the effects of policy and regulatory interventions; one provided free access to physical activity facilities and showed that it may have beneficial effects on physical activity (low certainty evidence). The other provided free bus travel for youth, with intervention effects varying across studies (very low certainty evidence).
Conclusions
Evidence from 33 studies assessing infrastructure, policy and regulatory interventions for increasing physical activity showed varying results. The certainty of the evidence was mostly very low, due to study designs included and inconsistent findings between studies. Despite this drawback, the evidence indicates that providing access to physical activity facilities may be beneficial; however this finding is based on only one study. Implementation of these interventions requires full consideration of contextual factors, especially in low resource settings.
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Chronic respiratory diseases, such as asthma and
chronic obstructive pulmonary disease, kill more than
four million people every year and affect hundreds
of millions more. These diseases erode the health
and well-being of the patients and have a negative
impact on families and societies. Women ...and
children are particularly vulnerable, especially those
in low and middle income countries, where they are
exposed on a daily basis to indoor air pollution from
solid fuels for cooking and heating. In high income
countries, tobacco is the most important risk factor
for chronic respiratory diseases, and in some of
these countries, tobacco use among women and
young people is still increasing.
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