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Background and Objectives: Ischemic stroke (IS) in young is increasingly recognized as an important health problem in low- and middle-income countries (LMICs). Limited data is available from LMICs about the predictors of outcome and recurrence of IS in young. The study aims to assess the predictors of short-term and long-term functional outcome and the recurrence of the first-ever IS and transient ischemic attack in young. Methods: The clinical, radiological data, functional outcome, and recurrence of 569 IS patients aged 18-50 years were recorded. The etiological classification was done. The functional outcome was assessed using the modified Rankin scale (mRS), with a good outcome being mRS 0-2. Logistic regression was used to analyze the predictors of recurrence and outcome. Results: The most common risk factors were hypertension (40.3%) and diabetes mellitus (34.3%). Stroke of undetermined etiology (33.6%) was the most common etiological subtype. Among the cardioembolic subtypes, rheumatic heart disease constituted 47.4%. A good functional outcome at 1 year was seen in 76.3%. While baseline stroke severity predicted both the 3-month and 1-year functional outcome, age ≥40 years and male gender predicted poor outcome at 1 year. The risk of recurrent strokes at 1 year was 2.5%. On multiple logistic regression analysis, diabetes mellitus independently predicted recurrent vascular events at 1 year (odds ratio = 2.43, 95% confidence interval 1.07-5.50). Conclusions: We found a good functional outcome with a relatively low recurrence at 1 year among young IS patients. Baseline stroke severity, age, and male gender predicted a poor 1-year functional outcome. Keywords: Young stroke, ischemic, recurrence, outcome, Author(s): Balaswamy Reddy [1]; Arun Kathuveetil [2]; Sapna Erat Sreedharan [1]; VT Jissa [3]; PN Sylaja (corresponding author) [1] Introduction In developing countries, the epidemiologic trends of young ischemic stroke [...]

Byline: A. Raza, R. A. Gul, H. Anjum, M. A. Raza, K. Mehmood, M. T. Ghori, M. Altaf, A. I. Malik, K. Li, E. M. Al Olayan, M. K. Okla, [...]

Hepatitis E virus (HEV) is a nonenveloped, single-stranded, positive-sense RNA virus within the family Hepeviridae, subfamily Orthohepevirinae, which is divided into 4 genera: Paslahepevirus, Rocahepevirus, Chirohepevirus, and Avihepevirus (1). Human [...]

Background Enteropathogenic E. coli (EPEC) causes acute infantile diarrhea accounting for significant morbidity and mortality in developing countries. EPEC uses a type three secretion system to translocate more than twenty effectors into the host intestinal cells. At least four of these effectors, namely EspF, Map, EspG1/G2 and NleA, are reported to disrupt the intestinal tight junction barrier. We have reported earlier that the expression of EspF and Map in MDCK cells causes the depletion of the TJ membrane proteins and compromises the integrity of the intestinal barrier. In the present study, we have examined the role of the proline-rich repeats (PRRs) within the C-terminus of EspF in the depletion of the tight junction membrane proteins and identified key endocytosis markers that interact with EspF via these repeats. Results We generated mutant EspF proteins which lacked one or more proline-rich repeats (PRRs) from the N-terminus of EspF and examined the effect of their expression on the cellular localization of tight junction membrane proteins. In lysates derived from cells expressing the mutant EspF proteins, we found that the C-terminal PRRs of EspF are sufficient to cause the depletion of TJ membrane proteins. Pull-down assays revealed that the PRRs mediate interactions with the TJ adaptor proteins ZO-1 and ZO-2 as well as with the proteins involved in endocytosis such as caveolin-1, Rab5A and Rab11. Conclusions Our study demonstrates the direct role of the proline-rich repeats of EspF in the depletion of the TJ membrane proteins and a possible involvement of the PRRs in the endocytosis of host proteins. New therapeutic strategies can target these PRR domains to prevent intestinal barrier dysfunction in EPEC infections. Keywords: Enteropathogenic E. Coli, EspF, Intestinal barrier, Proline rich repeats, Tight Junctions, Endocytosis, Author(s): Imran Ansari[sup.1], Anupam Mandal[sup.1], Kritika Kansal[sup.1], Pangertoshi Walling[sup.1], Sumbul Khan[sup.1] and Saima Aijaz[sup.1] Background Infections by EPEC are one of the leading causes of infantile diarrhea in the developing [...]

Abstract Background: Subacute sclerosing panencephalitis (SSPE) is a progressive neurological disorder in children and young adults due to persistent infection caused by the defective measles virus. It is still common in developing countries such as India. Aim: The aim of this study was to describe the clinical and demographic neuroimaging features, and outcomes of SSPE. Materials and Methods: A retrospective chart review of children diagnosed with SSPE during 2016-2020 was performed and the data were analyzed. Results: Of the 32 patients, 28 (87.5%) were men and four (12.5%) were women. The mean age of onset was 7.28 ± 2.19 years. The initial symptom was myoclonic and generalized seizures in eight (25%) each, behavioral problems in seven (21.9%), frequent falls in six (18.8%), and poor scholastic performance in three (9.4%). One-half of the cohorts had measles in the past and 91% had received the vaccine. Atypical presentations such as akinetic rigid syndrome, and acute disseminated encephalomyelitis (ADEM) like presentations can occur. Magnetic resonance imaging (MRI) brain showed abnormalities in 14 (43.8%) and was normal in 10 (31.3%). The most common abnormality noted was hyperintensities in the frontoparietal region in six (18.8%). Electroencephalogram showed long interval periodic complexes in 21 (65.6%), burst suppression pattern in 7 (22%), and was normal in 4 (12.5%). At the time of diagnosis, 25 (78%) patients were in stage II, 5 (15.6%) in stage III, and 1 (3.1%) child in stage IV and stage I each. Five patients (15.6%) died, 10 (31.3%) lost follow-up, 12 (37.5%) were bedridden, and the disease was static in 5 children (15.6%). Conclusion: Myoclonic seizures and cognitive decline are the most common symptoms in children with SSPE. Knowledge about atypical presentations is essential to avoid unnecessary investigations. Keywords: Cognitive decline, myoclonic seizures, subacute sclerosing panencephalitis, Author(s): Leema P. Cornelius [1]; K. J. Venkateswaran [1]; K. Jered Livinston [1]; E. Neeraj [1]; S. Surya Kumar [1] Introduction Subacute sclerosing panencephalitis (SSPE) is a rare progressive demyelinating [...]

Objectives A conflicting body of evidence suggests localized periodontal inflammation spreads systemically during pregnancy inducing adverse pregnancy outcomes. This systematic review and meta-analysis aim to specifically evaluate the relationship between periodontitis and preeclampsia. Methods Electronic searches were carried out in Medline, Pubmed, Embase, Lilacs, Cochrane Controlled Clinical Trial Register, CINAHL, ClinicalTrials.gov, and Google Scholar with no restrictions on the year of publication. We identified and selected observational case-control and cohort studies that analyzed the association between periodontal disease and preeclampsia. This meta-analysis was conducted following the PRISMA checklist and MOOSE checklist. Pooled odds ratios, mean difference, and 95% confidence intervals were calculated using the random effect model. Heterogeneity was tested with Cochran's Q statistic. Results Thirty studies including six cohort- and twenty-four case-control studies were selected. Periodontitis was significantly associated with increased risk for preeclampsia (OR 3.18, 95% CI 2.26 - 4.48, p < 0.00001), especially in a subgroup analysis including cohort studies (OR 4.19, 95% CI 2.23 - 7.87, p < 0.00001). The association was even stronger in a subgroup analysis with lower-middle-income countries (OR 6.70, 95% CI 2.61 - 17.19, p < 0.0001). Conclusions Periodontitis appears as a significant risk factor for preeclampsia, which might be even more pronounced in lower-middle-income countries. Future studies to investigate if maternal amelioration of periodontitis prevents preeclampsia might be warranted., Author(s): Quynh-Anh Le [sup.1] [sup.3] , Rahena Akhter [sup.1] , Kimberly Mathieu Coulton [sup.1] , Ngoc Truong Nhu Vo [sup.2] , Le Thi Yen Duong [sup.3] , Hoang Viet Nong [...]

Byline: Deepjyoti. Kalita, Madhab. Rajbangshi, Sumi. Deka, Ridip. Sarma, Sangeeta. Deka In the developing world, surgical-site infection (SSI)-associated pathogens are becoming more drug resistant implicating higher morbidity and management cost. [...]

Vitamin A deficiency (VAD) threatens public health especially among children in developing countries. Various interventions and their efficacy have been much discussed at a global level to alleviate VAD. Yet, studies indicate individual countries afflicted with VAD may be running relevant programs without adequately updated data or evidence from situational analyses. This study takes Uganda as a case to examine the status of its existing VAD mitigation programs, focusing on food-based interventions. To review the VAD mitigation programs, nationally representative data from the Ugandan public institutions, policy documents from the government and VAD-relevant data from the United Nations agencies were mainly examined. Also analyzed in detail were published studies and working papers directly or indirectly related to Uganda's VAD and/or VA issues. The results from the review pointed to some evidence on the existing issues with the country's VAD mitigation strategies. First, gauging a temporal trend of VAD prevalence in the target population was not possible due to changes and inconsistencies in the survey formats and methodologies. This implies the present VAD interventions might rely on unsynchronized VAD assessments in the first place. Second, of the ongoing food-based VAD interventions, effectiveness of food fortification with VA seemed constrained by questionable food vehicle choices, reluctant food industries, low stakeholder engagement, and weak public supervision. Third, for biofortification, wide adoption/utilization of the VA-biofortified orange sweet potato appeared to be complicated by farmer and consumer preferences, social factors, and immature value chains of the crop. But adoption/utilization of the genetically modified VA-biofortified banana seems to have been even more complicated by additional issues around the relevant biotechnology law of the country and public concerns about the genetic modification. Collectively, these VAD interventions in Uganda appeared to be continued without sufficiently updated documents and monitoring frameworks. This suggests that Uganda should review its current VAD interventions for more effective and efficient VAD mitigation. Key words: Biofortification, Food fortification, Public health, Vitamin A deficiency, Uganda, INTRODUCTION Vitamin A deficiency (VAD) threatens public health especially in preschool-aged children in developing countries. In 2013, the estimated prevalence of VAD was 29% among children aged 6 to 59 [...]

During pandemics, in which harm is universal, states find themselves under an obligation to cooperate within a global solidarity framework. However, because they do not have the same set of capabilities, their obligations should be differentiated and based on equity and distributive justice. As an effective tool of States' foreign policy, health diplomacy is being used by developing countries according to different priorities and interests. After a few months of relative calm, COVID-19 still poses a major challenge for African and Middle Eastern economies and societies where the vaccination rates are low across the board with healthcare systems in poor shape. If some Gulf countries can be considered exceptions due to active lockdowns, mobility restrictions, and considerable testing, their engagement abroad to help contain the pandemic, especially in North Africa, shows that, if the spirit of cooperation and justice is well taken care of at the regional level, this is not the case at the international level, where global health cooperation would clearly benefit from the application of a type of differentiated treatment such as the one provided by the Common but Differentiated Responsibilities (CBDR) principle. Keywords: Health diplomacy, Vaccines, CBDR, Principle, Cooperation, Introduction Contrary to a global public good (2), a so-called 'global public harm (3)' is linked to a damage and not to the consumption of a good. To constitute a [...]

Debility due to malaria remains a major constraint to economic growth in many Agrarian economies. In the case of Ethiopia, nearly 70% of the population reside in malaria prone areas with focal and multifocal malaria epidemics, presenting a major challenge to subsistence farmers who rely on family labor supply for agricultural production. Various studies have analysed the economic burden of malaria in developing countries, proposing various interventions to reduce its prevalence. These studies have, however, paid little attention to the role of gender in shaping the impact of malaria infections on agricultural labor supply and productivity. There is evidence of existence of complex and diverse gender norms that shape decision making and gender roles in households in many African countries and may influence the risks of malaria infections within households, and access to services for malaria prevention and control. In this study, we examine the direct and indirect effects of malaria risk on agricultural productivity among smallholder farmers. We deviate from previous research in two main aspects: we examine productivity effects of the disease by sex and age of the infected member of the household and estimate the malaria equations using the fractional response model to overcome the limitations of linear and non-linear econometric estimators for bounded data. We find that malaria significantly reduces crop yields and labor productivity. For instance, a 50% increase in malaria prevalence in a household can reduce the per capita land productivity by US$13.4/year, which is about 7.8% reduction in annual per capita income. The estimated loss in labor productivity is about US$1.38/person-day given a 50% rise in malaria prevalence in a household. The results further reveal differential productivity effects of the disease with respect to gender of the household member infected; the effect is greatest when women and children below 14 years in the household fall sick compared to men. The results highlight the need to strengthen women and children's access to malaria control and prevention services to enhance human health and agricultural productivity. Furthermore, rural development projects may achieve greater health benefits by integrating malaria control interventions with the existing agricultural interventions. JEL Classifications: M1, M2, O1 and O2 Keywords: Malaria risk, Agriculture productivity, Gender, Ethiopia Contact author's email address: diirog@yahoo.co.uk, INTRODUCTION Malaria remains a major health and economic burden in Sub-Saharan Africa (SSA), accounting for 10% of the overall disease burden, and 40% of the public health expenditure in the [...]

Background For community-living older people, the ability to estimate total daily energy expenditure (TDEE) with validated predictive equations based on anthropometry is limited. To our knowledge no studies exist for non-Caucasian populations Objective To design and validate an anthropometry-based equation to estimate TDEE using doubly-labelled water (DLW) as the criterion measure, and to assess the performance of three other published equations in community-living older people from rural and urban areas of Brazil, Chile, Guatemala, Senegal, Cuba, and Mexico Methods This cross-sectional study measured anthropometry and TDEE using DLW in 69 men and 43 women aged 60-89 years. TDEE was also estimated with an anthropometry-based equation derived from the sub-sample of Mexico (n = 38) and with three other published equations. Predictive accuracy of the equations was tested by an external validation procedure Results TDEE by DLW in the six country sample was 2411 [plus or minus] 41 kcal/day (mean [plus or minus] SE) in men and 1939 [plus or minus] 51 kcal/day in women. The best new Mexican equation was TDEE, kcal/d = [223.4 + (27.9 × weight, kg) + (239.7 × sex)]; where sex: Man = 1 and Woman = 0; having high precision; R.sup.2 = 0.89, lowest RMSE = 149.2, and Cp value of 2.0. This new Mexican equation estimated TDEE accurately in the five country sample and at country level after correction for Guatemalan older men, while the published equations performed poorly Conclusions The Mexican equation performed better that other published equations and is recommended to accurately estimate energy requirements for community-living older people in five Latin American and one African country., Author(s): Heliodoro Alemán-Mateo [sup.1] , Lesley Evelyn Antúnez-Roman [sup.1] , Julián Esparza-Romero [sup.1] , Mauro E. Valencia [sup.1] , Julissa J. Salguero [sup.2] , Manuel Ramirez-Zea [sup.2] , Eduardo Ferriolli [...]

Byline: Mrinalini. Verma, Deep. Chakrabarti, Shiv. Rajan, Naseem. Akhtar Head and neck squamous cell cancers (HNSCC) are the seventh most common cancer by incidence accounting for 3% of global cancer [...]

Context.--Most cancers occur in lower and middle income countries, where pathologists are scarce. Despite this, few pathology training programs offer global health electives, and trainees are not exposed to challenges associated with practicing in resource-restricted settings. Objective.--To implement a global health elective model aimed at exposing trainees to global health while alleviating overburdened pathologists in resource-restricted settings. Design.--For 1 year, trainees at 2 US institutions reviewed cases shipped weekly from a pathology lab serving Trinidad and Tobago and Guyana. Turnaround time, specimen type, and trainee and clinician satisfaction were assessed. Results.--Trainees reviewed an average of 16 cases per week. Average turnaround time was 6 days. There was no significant difference between the turnaround time for the US trainees and the pathologist based in the lab in Trinidad. Trainees and clinicians reported a high level of satisfaction, and the collaboration was fruitful, resulting in the publication of a case report. Conclusions.--We demonstrate that collaboration between US trainees and laboratories in resource-restricted settings, in the form of a global health elective, is mutually beneficial. doi: 10.5858/arpa.2020-0353-OA, There is a need for anatomic pathology in lower- and middle-income countries (LMICs). One-third of cancers can be prevented and another third cured if diagnosed early and accurately, and treated [...]

Cereal-based diets of the people in developing countries are qualitatively deficient in micronutrients--vitamins and minerals--due to low intake of vegetables, fruits, legumes and foods of animal origin. Consumption of nutritious millets has also come down in India. Calorie sufficiency may ensure protein sufficiency (though not protein quality), but it does not ensure adequacy of micronutrients. Studies in several countries in Asia, and India show that with education and advocacy even farmers with small and marginal land holdings can be persuaded to raise homestead vegetables and fruits gardens and increase household vegetables consumption. Backyard poultry also has good acceptance and impact on household egg consumption. For best results, the community, especially the mothers have to be educated about the importance of nutrition for health and wellbeing. Studies done by the authors in the villages of Medak district, of the South Indian state of Telangana, show remarkable improvement in the knowledge of food, nutrition, hygiene and health of mothers with children under 3 years of age, with education-behavioural change communication. Impact of nutrition gardens and backyard poultry with high egg-yielding breeds had positive impact on the household consumption of vegetables and eggs., Author(s): Mahtab S. Bamji [sup.1] , P. V. V. S. Murty [sup.1] , Parimala Diana Sudhir [sup.2] Author Affiliations: (1) Dangoria Charitable Trust (DCT), Hyderabad, India (2) Department of statistics, [...]

All countries worldwide have signed up to the United Nations Sustainable Development Goals and have committed to the objective of achieving 'universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all'. During the COVID-19 pandemic and beyond, advancement toward universal health coverage (UHC) will become more difficult for many countries, demonstrating that locally led priority setting is urgently needed to provide health services with appropriate financial protection to all. Because resources are limited and no national constituency can provide an unlimited number of services to their whole population in a sustainable manner, rationing and setting priorities for the selection of interventions to be included in a defined package of services is critical. In this Perspective, we discuss how packages of essential health services can be developed in resource-constrained settings, and detail how experts and the public can decide on principles and criteria, use a comprehensive array of analytical methods and choose which services to be provided free of charge. We illustrate these main steps while drawing on a recently conducted exercise of revising the national essential health services package in Ethiopia, which we compare with examples from other countries that have defined their essential benefits packages. This Perspective also provides recommendations for other low- and middle-income countries on their pathway to UHC. All countries worldwide have signed up to the United Nations Sustainable Development Goals and committed to the objective of achieving universal health coverage. Getting there will require understanding how packages of essential health services can be developed in resource-constrained settings and how experts and the public can make decisions about which health services should be provided free of charge., Author(s): Stéphane Verguet [sup.1] , Alemayehu Hailu [sup.2] [sup.3] , Getachew Teshome Eregata [sup.2] [sup.3] , Solomon Tessema Memirie [sup.4] , Kjell Arne Johansson [sup.3] , Ole Frithjof Norheim [sup.1] [...]

Paediatric pneumonia is a respiratory infection that affects infants and young children under the age of 3. This disease is the leading cause of infant and child mortality in developing countries because of the weak immune system of young children. The difficulty and length of time required to identify the pathogen and causative agent are the main reasons for this high mortality rate. In addition, the identification of certain causative agents is particularly important for the treatment of paediatric pneumonia. In this study, we explored the possible mechanisms by which pathogenic Enterococcus faecalis induced pneumonia in vivo. The potential virulence factors of bacteria isolated from the intestines of paediatric pneumonia patients were determined. Taken together, the results suggested that lysophosphatidic acid (LTA) from pathogenic E. faecalis decreases the expression of platelet-activating factor receptor (PAFR), which in turn disrupts the function of intestinal tight junctions (Occ and Ccldn1), leading to the entry of LE-LTA into the bloodstream because of the disruption of the intestinal barrier. Although LTA can enter circulation, it cannot directly infiltrate the lungs, which indicates that lung inflammation in mice is not caused by the direct entry of LE-LTA into the lungs. We further found that LTA activates immune cells, such as CD8 + T cells and type 2 innate lymphocytes, in vivo. Interleukin-6 and interleukin-17 can produce large amounts of inflammatory factors and thus promote the development of pneumonia. In conclusion, our findings demonstrate that the LTA of pathogenic E. faecalis in the intestine is a virulence factor that can cause paediatric pneumonia. This study found that intestinal bacterial virulence factors can induce immune responses in the lungs and blood. These findings could provide further insight into the mechanism of infectious diseases in the lung that are caused by bacteria in the intestine. Keywords: Enterococcus faecalis, Type 2 innate lymphocyte, Lipoteichoic acid, Paediatric pneumonia, Virulence factor, Author(s): Zhiying Tian[sup.1], Asif Iqbal Khan[sup.1], Ata Ur Rehman[sup.1], Ting Deng[sup.1], Chao Ma[sup.1] and Liang Wang[sup.2] Introduction Bacteria in the intestinal tract have evolved over a long period of coexistence [...]

The safe, highly effective measles vaccine has been recommended globally since 1974, yet in 2017 there were more than 17 million cases of measles and 83,400 deaths in children under 5 years old, and more than 99% of both occurred in low- and middle-income countries (LMICs).sup.1-4. Globally comparable, annual, local estimates of routine first-dose measles-containing vaccine (MCV1) coverage are critical for understanding geographically precise immunity patterns, progress towards the targets of the Global Vaccine Action Plan (GVAP), and high-risk areas amid disruptions to vaccination programmes caused by coronavirus disease 2019 (COVID-19).sup.5-8. Here we generated annual estimates of routine childhood MCV1 coverage at 5 × 5-km.sup.2 pixel and second administrative levels from 2000 to 2019 in 101 LMICs, quantified geographical inequality and assessed vaccination status by geographical remoteness. After widespread MCV1 gains from 2000 to 2010, coverage regressed in more than half of the districts between 2010 and 2019, leaving many LMICs far from the GVAP goal of 80% coverage in all districts by 2019. MCV1 coverage was lower in rural than in urban locations, although a larger proportion of unvaccinated children overall lived in urban locations; strategies to provide essential vaccination services should address both geographical contexts. These results provide a tool for decision-makers to strengthen routine MCV1 immunization programmes and provide equitable disease protection for all children. Although progress in the coverage of routine measles vaccination in children in low- and middle-income countries was made during 2000-2019, many countries remain far from the goal of 80% coverage in all districts by 2019., Author(s): Alyssa N. Sbarra [sup.1] [sup.1] , Sam Rolfe [sup.1] , Jason Q. Nguyen [sup.1] , Lucas Earl [sup.1] , Natalie C. Galles [sup.1] , Ashley Marks [sup.1] , Kaja [...]

Infant and maternal mortality remain significant problems throughout the developing world. The United Nations' third sustainable development goal (good health and wellbeing) includes the reduction of the global maternal mortality [...]

Introduction: HIV-1 transmitted drug resistance (TDR) prevalence increased during the initial years of the antiretroviral therapy (ART) global scale-up. Few studies have examined recent trends in TDR prevalence using published genetic sequences and described the characteristics of ART-naive persons from whom these published sequences have been obtained. Methods: We identified 125 studies published between 2014 and 2019 for which HIV-1 reverse transcriptase (RT) with or without protease from [greater than or equal to]50 ART-naive adult persons were submitted to the GenBank sequence database. The population characteristics and TDR prevalence were compared to those in 122 studies published in the preceding five years between 2009 and 2013. TDR prevalence was analysed using median study-level and person-level data. Results and discussion: The 2009 to 2013 and 2014 to 2019 studies reported sequence data from 32,866 and 41,724 ART-naive persons respectively. Studies from the low- and middle-income country (LMIC) regions in sub-Saharan Africa, South/Southeast Asia and Latin America/Caribbean accounted for approximately two-thirds of the studies during each period. Between the two periods, the proportion of studies from sub-Saharan Africa and from South/Southeast Asia countries other than China decreased from 43% to 32% and the proportion of studies performed at sentinel sites for recent HIV-1 infection decreased from 33% to 22%. Between 2014 and 2019, median study-level TDR prevalence was 4.1% in South/Southeast Asia, 6.0% in sub-Saharan Africa, 9.1% in Latin America/Caribbean, 8.5% in Europe and 14.2% in North America. In the person-level analysis, there was an increase in overall, NNRTI and two-class NRTI/NNRTI resistance in sub-Saharan Africa; an increase in NNRTI resistance in Latin America/Caribbean, and an increase in overall, NNRTI and PI resistance in North America. Conclusions: Overall, NNRTI and dual NRTI/NNRTI-associated TDR prevalence was significantly higher in sub-Saharan Africa studies published between 2014 and 2019 compared with those published between 2009 and 2013. The decreasing proportion of studies from the hardest hit LMIC regions and the shift away from sentinel sites for recent infection suggests that global TDR surveillance efforts and publication of findings require renewed emphasis. Keywords: HIV-1; antiretroviral therapy; drug resistance; surveillance; reverse transcriptase; protease Additional information may be found under the Supporting Information tab for this article., 1 | INTRODUCTION HIV-1 drug resistance (HIVDR) testing is not routinely available for clinical management in most low- and middle-income countries (LMICs), which shoulder the largest global burden of HIV-1 [...]

Objective: This study aims to identify factors that have a substantial impact on the fertility performance of the human population in developing countries. Methods: We have used 16 different countries' demographic and health survey data to complete the study. To address the study objective, binary logistic regression random effect meta-analysis and random effect meta-regression are used. Results: At the end of the analysis, it is found that Odds Ratio (OR) for variable women's age is 0.06 [0.06; 0.07] for the event high fertility which is least among all other results. OR for education of women and partner be respectively 0.31 [0.25; 0.39] and 0.44 [0.35; 0.56]. OR for age at first marriage was found to be 0.47 [0.40; 0.56] for the event high fertility. On the other hand, per-capita-health-expenditure can explain 57.14% of the total amount of variation for the variable age at first marriage. Additionally, 49.17% of the heterogeneity can be explained by annual population growth for the variable type of place of residence. Conclusion: In a developing country, women's age is the most important factor to explain fertility performance. After women's age, an increase in education for both partners and women lead to fertility decline. Another unusual factor that influences fertility behavior is the per capita health expenditure of a country. A rise in per capita health expenditure ultimately leads to fertility decline. Keywords: Fertility, Factors, Developing countries, Meta-analysis, Introduction Fertility behavior or human population is largely dependent on the complex web of socio-economic, biological and behavioral factors. So to obtain the impact of one particular factor we need [...]

Vaccines may reduce the burden of antimicrobial resistance, in part by preventing infections for which treatment often includes the use of antibiotics.sup.1-4. However, the effects of vaccination on antibiotic consumption remain poorly understood--especially in low- and middle-income countries (LMICs), where the burden of antimicrobial resistance is greatest.sup.5. Here we show that vaccines that have recently been implemented in the World Health Organization's Expanded Programme on Immunization reduce antibiotic consumption substantially among children under five years of age in LMICs. By analysing data from large-scale studies of households, we estimate that pneumococcal conjugate vaccines and live attenuated rotavirus vaccines confer 19.7% (95% confidence interval, 3.4-43.4%) and 11.4% (4.0-18.6%) protection against antibiotic-treated episodes of acute respiratory infection and diarrhoea, respectively, in age groups that experience the greatest disease burden attributable to the vaccine-targeted pathogens.sup.6,7. Under current coverage levels, pneumococcal and rotavirus vaccines prevent 23.8 million and 13.6 million episodes of antibiotic-treated illness, respectively, among children under five years of age in LMICs each year. Direct protection resulting from the achievement of universal coverage targets for these vaccines could prevent an additional 40.0 million episodes of antibiotic-treated illness. This evidence supports the prioritization of vaccines within the global strategy to combat antimicrobial resistance.sup.8. Pneumococcal and rotavirus vaccines have reduced antibiotic consumption substantially among children under five years old in low- and middle-income countries; however, this effect could be doubled if all countries were to implement vaccination programmes and meet universal vaccine coverage targets., Author(s): Joseph A. Lewnard [sup.1] [sup.2] [sup.3] , Nathan C. Lo [sup.4] , Nimalan Arinaminpathy [sup.5] , Isabel Frost [sup.5] [sup.6] , Ramanan Laxminarayan [sup.6] [sup.7] Author Affiliations: (1) Division [...]

Health workforce challenges hinder progress towards universal health coverage, improved health outcomes (1) and health security. The global health workforce shortage is declining, (2) but progress is slower in the [...]

Byline: M. Naeem, Z. Iqbal and N. Roohi Keywords: Haemonchus; Sheep; Neem; Shahtra; Kalonji. INTRODUCTION The livestock sector is a vital segment of the economy throughout the world particularly in [...]

Author(s): Beryne Odeny *, Raffaella Bosurgi Colonial science, also known as parachute or parasitic science, is an extractive practice whereby researchers-typically from highly resourced countries-do research and extract data and [...]

Drug companies and wealthy countries are facing increased pressure to partner with firms in the global south but are reluctant to relinquish control. Drug companies and wealthy countries are facing increased pressure to partner with firms in the global south but are reluctant to relinquish control., Author(s): Amy Maxmen Author Affiliations: The fight to manufacture COVID vaccines in lower-income countries In Mumbai, India, people stand in queue to receive the COVID-19 vaccine. Credit: Divyakant Solanki/EPA-EFE/Shutterstock A [...]

Byline: Alvee. Saluja, Rajinder. Dhamija Introduction Disability is the loss of functional capacity due to organ impairment resulting in an inability to perform activities considered normal for human beings.[1] This [...]

Background Providing balanced energy-protein (BEP) supplements is a promising intervention to improve birth outcomes in low- and middle-income countries (LMICs); however, evidence is limited. We aimed to assess the efficacy of fortified BEP supplementation during pregnancy to improve birth outcomes, as compared to iron-folic acid (IFA) tablets, the standard of care. Methods and findings We conducted an individually randomized controlled efficacy trial (MIcronutriments pour la SAnté de la Mère et de l'Enfant [MISAME]-III) in 6 health center catchment areas in rural Burkina Faso. Pregnant women, aged 15 to 40 years with gestational age (GA) Conclusions The MISAME-III trial did not provide evidence that fortified BEP supplementation is efficacious in reducing SGA prevalence. However, the intervention had a small positive effect on other birth outcomes. Additional maternal and biochemical outcomes need to be investigated to provide further evidence on the overall clinical relevance of BEP supplementation. Trial registration ClinicalTrials.gov NCT03533712., Author(s): Brenda de Kok 1, Laeticia Celine Toe 1,2, Giles Hanley-Cook 1, Alemayehu Argaw 1,3, Moctar Ouédraogo 4, Anderson Compaoré 4, Katrien Vanslambrouck 1, Trenton Dailey-Chwalibóg 1, Rasmané Ganaba 4, [...]