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PubMed2000

Mental health economic studies from developing countries reviewed in the context of those from developed countries.

OBJECTIVE: Mental health economic studies from developing countries were reviewed in the context of such studies from developed countries. METHOD: Mental health economic studies were ascertained through a systematic Medline search, chasing references at the end of papers acquired from the initial medline search and details of studies furnished by members of the WHO collaborating centre. RESULTS: Only a small number of mental health economic studies from developing countries were identified. They were mainly cost-of-illness and cost-effectiveness studies. CONCLUSION: Psychiatric disorders impose a significant burden in developing countries. It is not always possible to extrapolate findings from developed countries to developing countries. Potential avenues for future research and development are discussed.

Clinical Trials as Topic↗
PubMed2004

Tropical diseases, pathogens, and vectors biodiversity in developing countries: need for development of genomics and bioinformatics approaches.

The world's biodiversity, including many infectious, parasitic disease agents and their vectors whose impact on both human and animal health is significant, is largely retained in the developing countries of the tropics. Owing to the number of species involved and the relatively low-level exploration of pathogens and vectors biodiversity, several organisms are still waiting to be discovered and consequently explored in terms of genomics. Although some parasitic species of humans and animals have been studied through genomics and bioinformatics approaches, a significant number of relevant species are still to be addressed. Through the use of modern technologies, such as genomics and bioinformatics, for assessment of biodiversity and targeting tropical diseases, other relevant advantages of these initiatives for developing countries would be technology transfer and capacity building. Consequently, these initiatives could be critical to the development of the respective countries. Moreover, intra- and interhemispheric scientific collaboration should be encouraged and supported to increase the chances for success. In Brazil, the Ministry of Science and Technology has stepped forward to further such initiatives, co-supporting collaborative genomics and bioinformatics projects. The need for the establishment of working groups on genomics and bioinformatics in developing countries as well as the improvement and strengthening of collaborative research projects between developed and developing countries is discussed from our point of view. As these discussions remain open to debate, we encourage colleagues to promote further discussion on the subject.

Animal Diseases↗
PubMed1998

Access to treatment for HIV in developing countries; statement from international seminar on access to treatment for HIV in developing countries, London, June 5 and 6, 1998. UK NGO AIDS Consortium Working Group on Access to Treatment for HIV in Developing Countries.

Compared with those in industrialised countries, people in developing countries have little access to treatment for HIV infection, or for many other diseases including cancer, tuberculosis, and malaria. Although attention has been paid to areas such as provision of essential drugs, strengthening of infrastructures and service delivery, human rights, and appropriate health technologies, great inequalities remain. The HIV epidemic has highlighted these differences, because technological advances and the response of people infected with HIV have enabled the sharing of experiences across regions and brought the contrast into focus.

Anti-HIV Agents↗
PubMed2002

Cross-sectional study of morbidity, morbidity-associated factors and cost of treatment in Ngaoundere, Cameroon, with implications for health policy in developing countries and development assistance policy.

BACKGROUND: In a population-based epidemiological study in Ngaoundere, Cameroon, we studied cross-sectional child morbidity and the cost of necessary investigation and treatment. METHODS: Three teams of two to three health workers visited haphazardly selected households in all major housing quarters. We asked permission to enter for a health survey. Children with cough, fever or weight loss as well as sick adults were offered free-of-charge local hospital examination and treatment. RESULTS: From 177 households with 1777 persons, 51 (2.9%) persons were referred. Thirty-five of them had an undiagnosed disease threatening individual health and in many cases also public health. Seven were hospitalised, including three adults with tuberculosis. Malnutrition was diagnosed in nine small children. Four patients had AIDS, seven had malaria. Average total cost for ambulant patients was 15 USD, for hospitalised patients 110 USD.In the households, almost half of the women 16-50 years of age had no schooling. Two per cent of women and nine per cent of men were daily smokers. Coughing children were more likely than non-coughing children to live in a household with at least one smoker (OR = 3.58, 95% CI 1.72 to 7.46), and they generally lived in more poor households (P = 0.018). Twelve of 16 children with weight loss were referred from households with a high poverty score. CONCLUSIONS: Adult smoking and poverty affect children's health. The cost of hospitalisation or long-lasting therapy is beyond the means of most ordinary families. Diseases with severe consequences for public health, like tuberculosis, AIDS and malaria should have national programs with free, decentralised examination and treatment. Access to generic drugs is important. A major educational effort is needed to improve public health.

Journal Article↗
PubMed1989

Quality assurance in toxicology studies in developing countries.

As developing countries become more involved in the international chemical trade, they must adhere to certain requirements for importation of their chemicals into foreign countries. These developing countries will be required to provide basic safety information on their chemical products, including data developed from chemical and toxicologic testing. These data must be developed in accordance with the national requirements of the importing country. Many importing countries have adopted the OECD Test Guidelines and the OECD Principles of Good Laboratory Practice (GLP) as primary guidance to assure the quality of laboratory data. These procedures provide a basis for internationally acceptable data. Several countries have incorporated many of these provisions into their national laws or administrative procedures. These procedures describe the process of documenting the conduct of laboratory studies, including recording of data, reporting of study results, and storage of data gathered. This process is intended to assure the quality and integrity of the data so that, if required, the study can be reconstructed by an auditor or an inspector. Details of these procedures and their applicability to the international chemical trade are discussed.

Developing Countries↗
PubMed1997

Physical assessment: a vital nursing tool in both developing and developed countries.

In developed countries such as the United States and Great Britain, the use of technology to assess and diagnose a patient's health status is often taken for granted. In developing countries, however, the lack of available technology, replacement parts, and ability to maintain the machinery is severely limited. More often than not, diagnosis and consequent treatment are decided through physical assessment findings alone. It is therefore imperative that critical care nurses in developing countries acquire and utilize good physical assessment skills to enhance quality nursing care. This article focuses on physical assessment skills from a global perspective, emphasizing the value of this knowledge and its application to clinical practice for critical care nurses in both developing and developed countries.

Critical Care↗
PubMed2006

International standards for services activities relating to drinking water supply systems and wastewater systems: implications for developing countries.

In developing countries, the PPP (Public-Private-Partnerships) programs have been unsatisfied during the last decade. This study analyzed one of the main causes is low quality of the system. That is, no matter what supports developing countries may get through PPP, reforming water systems can be hardly successful without appropriate system quality. With this background, this study introduces service standards of ISO/TC 224 as an option to improve system quality of developing countries. To analyze its effects, system dynamic modeling was conducted. The results indicated that service standards, working with the PPP programs, can benefit all the stakeholders involved in the water systems in developing countries. Also this indicates further that this approach with service standards deserves more detailed study for improving the ailing water systems in developing countries.

Developing Countries↗
PubMed1991

Urbanization and health in developing countries.

In developing countries the level of urbanization is expected to increase to 39.5% by the end of this century and to 56.9% by 2025. The number of people living in slums and shanty towns represent about one-third of the people living in cities in developing countries. This article focuses upon these poor urban populations and comments upon their lifestyle and their exposure to hazardous environmental conditions which are associated with particular patterns of morbidity and mortality. The concept of marginality has been used to describe the lifestyle of the urban poor in developing countries. This concept is critically examined and it is argued that any concept of the urban poor in developing countries being socially, economically or politically marginal is a myth. However, it can certainly be claimed that in health terms the urban poor are marginal as demonstrated by some of the studies reviewed in this article. Most studies of the health of the urban poor in developing countries concentrate on the environmental conditions in which they live. The environmental conditions of the urban poor are one of the main hazards of the lifestyle of poor urban residents. However, other aspects of their way of life, or lifestyle, have implications for their health. Issues such as smoking, diet, alcohol and drug abuse, and exposure to occupational hazards, have received much less attention in the literature and there is an urgent need for more research in these areas.

Developing Countries↗
PubMed1996

Cervical dysplasia treatment: key issues for developing countries.

Many developing countries face serious obstacles that have hindered establishment of successful cervical cancer control programs. Various countries are now seeking to strengthen cytology services and identify simple low-cost screening strategies; but any real gains in reducing cervical cancer incidence and mortality will also require effective treatment of women with preinvasive disease. Despite a trend toward conservative outpatient approaches for treating cervical dysplasia in industrialized countries, clinicians in many developing countries still rely primarily on invasive inpatient methods such as cone biopsy and hysterectomy. For women who could be treated with less invasive methods, these procedures tend to pose unnecessary risks and entail high costs that put them beyond the reach of many patients. Outpatient therapy, employing methods such as cryotherapy and the loop electrosurgical excision procedure (LEEP), combined with proper follow-up, is appropriate for dealing with visible lesions on the ectocervix when invasive cancer and endocervical involvement have been ruled out. Cryotherapy and LEEP hold out particular promise for developing countries because of their effectiveness, lack of side-effects, simplicity, and low cost. Cure rates range from 80% to 95%, depending on the method used and the severity of the lesions. However, each method has advantages and disadvantages that demand consideration. Various ways of reducing the number of follow-up visits, including the two-visit "see and treat" approach, are also available for use in areas where women's access to health services may be limited. A recent survey by the Program for Appropriate Technology in Health (PATH) affirmed the tendency to rely on cone biopsy and hysterectomy. It also found that in many places all degrees of preinvasive disease were treated, rather than only high-grade or severe conditions; that respondents in Latin America, the Caribbean, and Asia tended to use cryotherapy and LEEP more widely than other low-cost methods; that LEEP was preferred over cryotherapy in Latin America; and that colposcopes and other basic equipment needed to provide treatment were not consistently or widely available in some settings.

Colposcopy↗
PubMed1984

Costs of training and maintenance of expert man-power vs costs of drugs. Priorities in the field of helminthic diseases in developing countries.

In developing countries, prevention and treatment of parasitic diseases present not only a challenge to the health services but also a test case to the efficiency of health education in general. In these countries, medical schools have started and continue to function on a Western pattern of medical education. This may have well served the provision of hospital-based services on a well-tested scientific and professional tradition. The system is, however, inappropriate when it comes to the provision of preventive care and mass treatment, and to the introduction of adaptational and developmental changes which are constantly needed in developing countries as well on the health service as on the educational side. As a consequence the whole enterprise is in danger of becoming increasingly irrelevant and insufficient. The fact that both health services and medical curricula are at present seriously questioned in developed countries as well, lends an even greater importance to their re-assessment and adaptation in developing countries.

Anthelmintics↗
PubMed1990

[AIDS: risk for tourists and assistants in developing countries?].

In developing countries, AIDS is transmitted in essentially the same way as other sexually transmitted diseases. Therefore the spread of AIDS is also associated with travel. Unfortunately, it is still very difficult to assess the distribution of the infection, especially in developing countries, because in these countries often only 10% of the cases are identified and registered. It can, however, be stated that the highest infection rates are found in Central Africa, in some South American cities, and in the Caribbean. Moderately high rates are found in Western Europe, the USA, Canada and Australia. In the Eastern bloc, in Asiatic countries and in the Pacific area, and in considerable parts of North Africa and South America, the pandemic is only just beginning. Sexual intercourse has been found to be the main means of transmission of HIV infection in developing countries. In addition, further risk factors have been identified; venereal disease, and ulcers on the sexual organs. The risk of parenteral transfer is also considerable, because of inadequate testing of blood for transfusion, and the lack of satisfactory facilities for sterilisation. For tourists and development workers, the risk of infection depends very much on their own behaviour when they are overseas. Though the risk of infection is somewhat higher in developing countries, it can clearly be greatly reduced if travellers are adequately informed and are thus equipped to take the necessary precautions.

Acquired Immunodeficiency Syndrome↗
PubMed2000

Cervical cancer screening in developing countries.

In developing countries, cervical cancer remains a clinical problem of public health proportions. Eighty percent of the approximately 400,000 new cases of cervical cancer each year occur in such settings. Primarily as a result of the introduction and success of screening programs, cervical cancer rates in developed countries have dropped remarkably. However, in most developing countries, screening programs are virtually nonexistent. Reasons for this relate primarily to lack of public awareness and the fact that screening via cytology is an untenable proposition for mass screening in such low-resource settings. Matching the resources available to provide cervical cancer screening in such settings requires alternative means of providing testing and treatment. Recent evidence indicates that, depending on local conditions and locally-made decisions, visual inspection of the cervix with acetic acid wash, coupled with a benign form of therapy, such as cryotherapy, could hold promise as a means of testing and treatment. By adapting resource-appropriate technologies and building local consensus regarding clinically driven public health approaches that are safe and feasible, the challenge of reducing the mortality from cervical cancer in developing countries can yet be met.

Journal Article↗
PubMed1985

1984 and occupational health in developing countries.

The developing countries constitute a large and important sector of the world. Their needs and aspirations require serious consideration by the international scientific community. When considering the countries of the developing world, it must be appreciated that they do not constitute a homogeneous entity but are a disparate group with different cultural backgrounds and at varying stages of economic and industrial development. But in spite of such diversity, it is possible to establish at least two issues of common interest to these nations. The first is in relation to the setting of environmental standards in the workplace. In the setting of such standards cultural, political, social, economic, and administrative factors must be taken into consideration. In some situations, for economic reasons, the standards may have to be less stringent than the prevailing standards in the industrialized world. On the other hand, because of administrative and health reasons, they may have to be more stringent. Finally, the issue of scientific research relevant to developing countries is considered in the paper.

Developing Countries↗