People In Low-income Countries Research Articles

Age-Dependent Effects of Copper Toxicity on Connective Tissue Structural Stability in Wistar Rats Skin.

Over the last three decades, there has been increasing global concern over the public health impacts attributed to direct and indirect environmental pollution, in particular, the global burden of disease. The World Health Organization estimates that, about a quarter of the diseases facing mankind today occur due to prolonged exposure to environmental pollution; the health of 200 million people in lower-income countries is at risk from toxins such as lead and copper or mercury, more than from AIDS, tuberculosis and malaria combined and that, nearly a quarter of deaths in developing countries including Nigeria and Ghana, are linked to pollution. The purpose of the study was to investigate the effects of the ingestion of large dose of copper on the structural stability of collagen molecules, as well as reveal age-dependent differences in the phenomena. The content of de novo synthesized collagen was determined by hydroxyproline concentration using Stegmann-Staeder's method as modified by Utevskaya and Persky; the nature of intra- and inter-molecular covalent cross-links in collagen matrix was estimated by electrophoretic separation of products of partial thermal denaturation of collagen in polyacrylamide gel. There was intensification of synthesis over degradation in young rats, and that administration of copper led to a decrease in collagen solubility. Effects of copper on the structural stability of collagen appeared mostly in young rats.

Editorial

Since the publication of our last issue, which included special sections on The Stakes of Sanctuary and Religion and Refugees, COVID-19 has continued to disrupt peoples’ lives and rhythms in multiple ways around the world. Vaccination programs have enabled many people in Europe and North America to start traveling again for work, to visit family, or for pleasure, yet long-standing global inequalities and inequities have persisted, with deadly effect. At the time of writing (end of February 2022), while 79 percent of the populations of high- and middle-income countries have received at least one vaccine dose, only 13 percent of people in low-income countries have been able to access the vaccine (Holder 2022), reflecting what Tedros Adhanom Ghebreyesu (Director-General of the World Health Organization) calls global “vaccine apartheid.”

Constructing ‘others’ and a wider ‘we’ as emotional processes: A case of South Korea in times of crisis

This article examines how growing fears, insecurities and uncertainties during the COVID-19 pandemic have prompted an emotional distance from others. The aim is to explore how global solidarity and nationalism are challenged and constructed as collective emotional processes concerning ‘others’. Drawing on social theories of emotions during crises and emotions towards others, this study looks at policy decisions around vaccines and health services and their associated emotions in the context of Korea, which has a relatively small migrant population and a short history of supporting people in lower-income countries. The study finds that the COVID-19 pandemic has strengthened nationalism, both ethnic nationalism and cosmopolitan nationalism. This points to the need to highlight global norms such as human rights and justice and cultivate foundational emotions such as empathy and compassion. This article suggests paying attention to the role of emotions in generating othering practices and developing global solidarity.

Addressing malnutrition and food insecurity with breadfruit in a rural, developing country: a case study and lessons learned in Thomassique, Haiti

Haiti’s Central Plateau region suffers from significant malnutrition, economic hardship, and a crisis level of food insecurity. Already the poorest country in the Western Hemisphere in terms of gross domestic product (GDP) per capita, Haiti has pervasively high malnutrition rates, but the Central Plateau is among the most severely affected areas. One in five children of the Central Plateau suffers from malnutrition, and the region exhibits a devastating 30% rate of child stunting. Our US-based team affiliated with Klinik Sen Jozèf, a community-respected medical clinic in the Central Plateau city of Thomassique. We partnered with local Haitian leadership, a local agronomist, and Trees That Feed Foundation to introduce breadfruit (Artocarpus altilis) and an innovative development model to combat local malnutrition. Five years into the program, we have partnered with 152 farmers, and we have enhanced our malnutrition program with breadfruit derivatives. This report addresses the lessons we learned to assist others looking to introduce models or crops in a similar manner. Our experience is particularly significant in light of the COVID-19 pandemic, as supply chain disruptions have worsened food insecurity for more than 800 million people in low-income countries.

DNA vaccines join the fight against COVID-19

DNA vaccines join the fight against COVID-19

Cross-Reactivity between Half Doses of Pfizer and AstraZeneca Vaccines—A Preliminary Study

Media reports have caused a significant drop in confidence in the AstraZeneca ChAdOx1 nCoV-19 COVID-19 vector vaccine (Vaxzevria, AstraZeneca Södertälje, Sweden). This has caused many people, already vaccinated with the first dose of AstraZeneca, to refuse vaccination with this product. On the other hand, the increased demand for mRNA vaccines has resulted in a greater shortage of mRNA vaccines and cases of people being vaccinated with the AstraZeneca vaccine after the first dose of the Pfizer/BioNTech BNT162b2 COVID-19 vaccine (Comirnaty, Pfizer/BioNTech, Mainz, Germany). Moreover, currently, 60.9% of the global population have received at least one dose of a COVID-19 vaccine, while only 10% of people in low-income countries have received at least one dose. Even less people are fully vaccinated. The present pilot study evaluated the administration of half doses of AstraZeneca and Pfizer vaccines and included the enrollment of 26 subjects who were vaccinated with a different vaccine the first and second time. The reference group included individuals undergoing vaccination with two full doses of the Pfizer vaccine (21-day interval) monitored for their antibody levels as part of a parallel study. The distribution of antibody levels was not significantly different between those who received the Pfizer vaccine alone and those receiving the AstraZeneca vaccine plus Pfizer or Pfizer and AstraZeneca. To prepare for the next pandemic waves, solving the problem of the matching of booster vaccine to the previously received doses would be advisable. The topic is important and emerging as most of the population in low-income countries is still not vaccinated. We strongly believe that vaccine equity is the most important aspect of vaccination strategies.

Ensemble Machine Learning Model to Predict the Waterborne Syndrome

The COVID-19 epidemic has highlighted the significance of sanitization and maintaining hygienic access to clean water to reduce mortality and morbidity cases worldwide. Diarrhea is one of the prevalent waterborne diseases caused due to contaminated water in many low-income countries with similar living conditions. According to the latest statistics from the World Health Organization (WHO), diarrhea is among the top five primary causes of death worldwide in low-income nations. The condition affects people in every age group due to a lack of proper water used for daily living. In this study, a stacking ensemble machine learning model was employed against traditional models to extract clinical knowledge for better understanding patients’ characteristics; disease prevalence; hygienic conditions; quality of water used for cooking, bathing, and toiletries; chemicals used; therapist’s medications; and symptoms that are reflected in the field study data. Results revealed that the ensemble model provides higher accuracy with 98.90% as part of training and testing phases when experimented against frequently used J48, Naïve Bayes, SVM, NN, PART, Random Forest, and Logistic Regression models. Managing outcomes of this research in the early stages could assist people in low-income countries to have a better lifestyle, fewer infections, and minimize expensive hospital visits.

Determinants of blood donation among selected tertiary college students in Homa Bay County Kenya

Background: Globally blood donation rate is low. 31.5 donations per 1000 people in high income countries and 5.0 donations per 1000 people in low-income countries. Donors aged 16-25 years are ideal target for recruitment efforts. The study aimed to assess determinants of blood donation among students of selected tertiary institutions of Homa Bay County Kenya.Methods: Cross-sectional study using both quantitative and qualitative methods was used to collect data from 424 study participants, three focused group discussions and three key informants between April 2021 and July 2021.Data collection tools included structured questionnaire and interview guide. Data analysed using statistical package for social sciences version 21.0, Pearson’s correlation calculated for reliability. Percentage agreement calculated with values>75% being acceptable. Chi square (X2) test and Logistic regression were used to determine association and strength, while qualitative data coded thematically.Results: Most respondents were male 221 (60.5%) and 159 (43.6%) of respondents were of 19-21 years age group. Majority were blood donors 199 (54.5%). Reliability result was significant, r (39)=(.82), p=(.000) with simple percentage agreement of 78%. The study revealed that sex OR=0.493 p=0.013 and rare blood type, A (OR) 8.597 p=0.0.009, and O+ (OR) 2.189 p=0.012 of the students were significant socio- characteristics factors associated with blood donation.Conclusions: Sex and blood type were significant socio-demographic characteristics associated with blood donation.

Vaccine apartheid: global cooperation and equity

Vaccine apartheid: global cooperation and equity

Motivations and barriers for clinical mental health help-seeking in Bangladeshi university students: a cross-sectional study.

University and college students are vulnerable to developing depressive symptoms. People in low-income countries are disproportionately impacted by mental health problems, yet few studies examine routes to accessing clinical services. Examining motivation and barriers toward seeking clinical mental health services in university students in Bangladesh is important. Using a cross-sectional survey (n = 350), we assess the relationship between the constructs of autonomy, relatedness, and competency toward using clinical mental health practices (i.e. using professional resources, taking medication) with (1) positive views, (2) perceived need, and (3) use of clinical mental health services among Bangladeshi university students. Results showed that the perceived need for mental health support was the predictor of the largest magnitude (aOR = 4.99, p = 0.005) for using clinical services. Having a positive view of clinical services was predictive of clinical service use (aOR = 2.87, p = 0.033); however, that association became insignificant (p = 0.054) when adjusting for the perceived need for mental health care. Of the SDT constructs, social influences were predictive of perceiving a need for mental health support, and mental health knowledge was predictive (aOR = 1.10, p = 0.001) of having a positive view of clinical mental health care. Our findings show that knowledge of mental health is associated with positive views of mental health services, and that higher levels of stress and the presence of people with mental health problems are associated with the perception of a need for mental health care, which is ultimately responsible for using the services.

Social and temporal dynamics mediate the distribution of ecosystem service benefits from a small-scale fishery

ABSTRACT Small-scale fisheries are important for the livelihoods and food security of millions of people in low-income countries. Sustainably managing these dynamic social-ecological systems requires understanding links between ecosystems and human well-being: the focus of ecosystem service approaches. However, in-depth exploration of how co-production and temporal dynamics shape ecosystem benefits in small-scale fisheries remain nascent. There is thus an opportunity to better investigate pathways through which small-scale fisheries support food security. To address this gap, we ask how households allocate seafood landings across different uses, depending on supply and season. Using a daily survey, we collected panel data on landings from 15 households on Atauro Island, Timor-Leste, over six 1-week periods across three seasons, representing 630 survey days and 179 fishing trips. We found households mediate the pathways through which seafood contributes to food security. Specifically, the proportion of landings eaten, sold or shared changed with the amount landed and across seasons. As landings increased, households ate a smaller proportion and sold a greater proportion. The greatest proportion of landings were sold in the preparation season, when households save money to buy staple foods. Landings were shared with family and kin, reflecting the importance of seafood for social capital and community food security. Put broadly, households shaped a dynamic and non-linear (not directly proportional) relationship between service supply and benefits. Our findings demonstrate that seasonal context and livelihood priorities shape seafood provisioning benefits in small-scale fisheries. Careful consideration of temporal scale in ecosystem service assessments is critical for sustainable management of small-scale fisheries.

Can a Multi-Epitope Vaccine be a solution for COVID-19 pandemic?

COVID-19 virus, SARS-CoV-2 first reported from Wuhan City of Hubei Province of China became pandemic infectious disease of severe respiratory disorder. Globally 17.8 Cr population was effected within a short span of period leading to 38.6 L deaths. Coronoviruses are large enveloped RNA viruses of Coronaviridae. Coronavirus employs a complex gene expression and pathway system unique among RNA viruses. SARA-CoV-2 is reported to mutate and variants reported to have one specific mutation, D614G which is makes to spread faster. WHO is monitoring and assessing the evolution of SARS-CoV-2 and notified Variants of Concern (VOCs) and Variants of Interest (VOIs), in order to prioritise the activities globally on containing COVID-19 pandemic. Currently genetic lineages by GISAID, Nextstrain and Pango are in use to code variants detected and being labeled using letters of the Greek Alphabet, i.e., Alpha, Beta, Gamma and Delta etc. Presently 15 vaccines were developed based on the SARS-CoV-2 spike protein, of original Wuhan-hu-1 and being administered in different countries. Surveillance and monitoring of the genomic sequence of SARS-CoV-2 is being done on a priority as virus is mutating for development of effective vaccine or therapeutic measures. Only 0.8% of people in low-income countries have received a single dose out of 20.8% of the world population which is a big concern for vulnerable groups.

3D-printed prostheses in developing countries: A systematic review.

According to the World Health Organization, only 5%-15% of people in lower-income countries have access to prostheses. This is largely due to low availability of materials and high costs of prostheses. 3D-printing techniques have become easily accessible and can offer functional patient-specific components at relatively low costs, reducing or bypassing the current manufacturing and postprocessing steps. However, it is not yet clear how 3D-printing can provide a sustainable solution to the low availability of limb prostheses for patients with amputations in lower-income countries. To evaluate 3D-printing for the production of limb prostheses in lower-income countries and lower-middle-income countries (LLMICs). Systematic Review. Literature searches, completed in April 2020, were performed in PubMed, Embase, Web of Science, and Cochrane Library. The search results were independently screened and reviewed by four reviewers. Only studies that examined interventions using prostheses in LLMICs for patients with limb amputations were selected for data extraction and synthesis. The web was also searched using Google for projects that did not publish in a scientific journal. Eighteen studies were included. Results were reported regarding country of use, cost and weight, 3D-printing technology, satisfaction, and failure rate. Low material costs, aesthetic appearance, and the possibility of personalized fitting make 3D-printed prostheses a potential solution for patients with limb amputations in LLMICs. However, the lack of (homogeneous) data shows the need for more published (scientific) research to enable a broader availability of knowledge about 3D-printed prostheses for LLMICs.

Science, Innovation, and Society in the Age of Pandemics: Reflections From the Inaugural Sir Alasdair Breckenridge Lecture.

Science, Innovation, and Society in the Age of Pandemics: Reflections From the Inaugural Sir Alasdair Breckenridge Lecture.

Extracellular pH, osmolarity, temperature and humidity could discourage SARS-CoV-2 cell docking and propagation via intercellular signaling pathways.

The COVID-19 pandemic and its virus variants continue to pose a serious and long-lasting threat worldwide. To combat the pandemic, the world’s largest COVID-19 vaccination campaign is currently ongoing. As of July 19th 2021, 26.2% of the world population has received at least one dose of a COVID-19 vaccine (1.04 billion), and one billion has been fully vaccinated, with very high vaccination rates in countries like Israel, Malta, and the UEA. Conversely, only 1% of people in low-income countries have received at least one dose with examples of vaccination frequency as low as 0.07% in the Democratic Republic of Congo. It is thus of paramount importance that more research on alternate methods to counter cell infection and propagation is undertaken that could be implemented in low-income countries. Moreover, an adjunctive therapeutic intervention would help to avoid disease exacerbation in high-rate vaccinated countries too. Based on experimental biochemical evidence on viral cell fusion and propagation, herein we identify (i) extracellular pH (epH), (ii) temperature, and (iii) humidity and osmolarity as critical factors. These factors are here in discussed along with their implications on mucus thick layer, proteases, abundance of sialic acid, vascular permeability and exudate/edema. Heated, humidified air containing sodium bicarbonate has long been used in the treatment of certain diseases, and here we argue that warm inhalation of sodium bicarbonate might successfully target these endpoints. Although we highlight the molecular/cellular basis and the signalling pathways to support this intervention, we underscore the need for clinical investigations to encourage further research and clinical trials. In addition, we think that such an approach is also important in light of the high mutation rate of this virus originating from a rapid increase.

Acceptance of a Smartphone-Based Visual Field Screening Platform for Glaucoma: Pre-Post Study.

BackgroundGlaucoma, the silent thief of sight, is a major cause of blindness worldwide. It is a burden for people in low-income countries, specifically countries where glaucoma-induced blindness accounts for 15% of the total incidence of blindness. More than half the people living with glaucoma in low-income countries are unaware of the disease until it progresses to an advanced stage, resulting in permanent visual impairment.ObjectiveThis study aims to evaluate the acceptability of the Glaucoma Easy Screener (GES), a low-cost and portable visual field screening platform comprising a smartphone, a stereoscopic virtual reality headset, and a gaming joystick.MethodsA mixed methods study that included 24 eye care professionals from 4 hospitals in Southwest Ethiopia was conducted to evaluate the acceptability of GES. A pre-post design was used to collect perspectives before and after using the GES by using questionnaires and semistructured interviews. A Wilcoxon signed-rank test was used to determine the significance of any change in the scores of the questionnaire items (two-tailed, 95% CI; α=.05). The questionnaire and interview questions were guided by the Unified Theory of Acceptance and Use of Technology.ResultsPositive results were obtained both before and after use, suggesting the acceptance of mobile health solutions for conducting glaucoma screening by using a low-cost headset with a smartphone and a game controller. There was a significant increase (two-tailed, 95% CI; α=.05) in the average scores of 86% (19/22) of postuse questionnaire items compared with those of preuse questionnaire items. Ophthalmic professionals perceived GES as easy to use and as a tool that enabled the conduct of glaucoma screening tests, especially during outreach to rural areas. However, positive evaluations are contingent on the accuracy of the tool. Moreover, ophthalmologists voiced the need to limit the tool to screening only (ie, not for making diagnoses).ConclusionsThis study supports the feasibility of using a mobile device in combination with a low-cost virtual reality headset and classic controller for glaucoma screening in rural areas. GES has the potential to reduce the burden of irreversible blindness caused by glaucoma. However, further assessment of its sensitivity and specificity is required.

Zinc Biofortification in Food Crops Could Alleviate the Zinc Malnutrition in Human Health.

Micronutrient malnutrition is a global health issue and needs immediate attention. Over two billion people across the globe suffer from micronutrient malnutrition. The widespread zinc (Zn) deficiency in soils, poor zinc intake by humans in their diet, low bioavailability, and health consequences has led the research community to think of an economic as well as sustainable strategy for the alleviation of zinc deficiency. Strategies like fortification and diet supplements, though effective, are not economical and most people in low-income countries cannot afford them, and they are the most vulnerable to Zn deficiency. In this regard, the biofortification of staple food crops with Zn has been considered a useful strategy. An agronomic biofortification approach that uses crop fertilization with Zn-based fertilizers at the appropriate time to ensure grain Zn enrichment has been found to be cost-effective, easy to practice, and efficient. Genetic biofortification, though time-consuming, is also highly effective. Moreover, a Zn-rich genotype once developed can also be used for many years without any recurring cost. Hence, both agronomic and genetic biofortification can be a very useful tool in alleviating Zn deficiency.

Online Blood Bank

Out of 118.5 million blood donations collected globally, 40% are collected in high income countries which compromises 16% of the world’s population. The median annual donations per blood centre are very low in low-income countries as compared to high-income countries. In high-income countries, the median blood donation rate is 31.5 donations per 1000 people, 15.9 per 1000 people in upper-middle-income countries and five donations per 1000 people in low-income countries, which is very low when compared. This indicates there is a huge gap between demand and supply. Most of the patients, due to the lack of communication between the donor and the recipient do not receive the blood in time and this may cost them their lives. The necessity for synchronisation between blood donors, hospitals, and blood banks is critical. The usage of online web portals has made it easy for the public to access and connect to other people and organizations. Using a portal we will be able to make blood donors easily available for the receivers. An online web portal where the hospitals and blood banks are integrated will make it easy for the receivers to get access to blood.

Against the odds: Young people’s high aspirations and societal contributions amid a decent work shortage

Insufficient decent work in lower income countries is one of the most pressing global challenges facing young people today and is captured by SDG 8: decent work for all. Specific concerns include high levels of working poverty and informality, underemployment, and a lack of demand for youth labour. The vast majority of research into this subject focuses upon wealthier countries, and there is a need for greater engagement with young people’s experiences and aspirations. Here we draw upon an international survey in lower income countries, alongside focus groups and interviews in Uganda, to challenge dominant conceptual and empirical understandings. Though our sample is limited to a relatively privileged group, by accessing young people’s own perspectives on the employment challenge we contribute to an essential and ongoing disruption of the narrative that young people are the root of the youth employment problem. We do this by demonstrating that (1) unemployed young people tend to make positive social contributions, (2) while youth aspirations for work are tailored to their context they are nevertheless ambitious, and (3) lack of demand for youth labour needs to be directly addressed alongside the current focus on skills development. Our novel contribution to the literature on youth geographies is that young people in lower income countries tend to be dynamic and committed to contributing to their communities on a voluntary basis despite – and at times because of - the context in which they live limiting their chance of finding decent work.

Photoplethysmography Heart Rate Monitoring

Research conducted by the World Health Organisation (WHO) in 2018 demonstrated that the worldwide threat of cardiovascular diseases (CVDs) has increased compared to previous years. CVDs are very dangerous: if timely treatment is not performed, these conditions could become irreversible and lead to sudden death. Prescriptive measures include physical exercises and monitoring of the heart rate (HR). Despite the existence of various HR monitoring devices (or HMDs), a major challenge remains their availability, particularly to people in lower-income countries. Unfortunately, it is also this segment of the population that is the most vulnerable to CVDs. Accordingly, this led the authors to propose the design for an easily constructible state-of-the-art HMD that attempts to provide a highly accessible, lower-cost, and long-lasting solution that would be more affordable and accessible to these low-income communities.