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Clinical emergency care research in low-income and middle-income countries: opportunities and challenges

Disease processes that frequently require emergency care constitute approximately 50% of the total disease burden in low-income and middle-income countries (LMICs). Many LMICs continue to deal with emergencies caused by communicable disease states such as pneumonia, diarrhoea, malaria and meningitis...

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Autores principales: Aluisio, Adam R, Waheed, Shahan, Cameron, Peter, Hess, Jermey, Jacob, Shevin T, Kissoon, Niranjan, Levine, Adam C, Mian, Asad, Ramlakhan, Shammi, Sawe, Hendry R, Razzak, Junaid
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6666826/
https://www.ncbi.nlm.nih.gov/pubmed/31406600
http://dx.doi.org/10.1136/bmjgh-2018-001289
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author Aluisio, Adam R
Waheed, Shahan
Cameron, Peter
Hess, Jermey
Jacob, Shevin T
Kissoon, Niranjan
Levine, Adam C
Mian, Asad
Ramlakhan, Shammi
Sawe, Hendry R
Razzak, Junaid
author_facet Aluisio, Adam R
Waheed, Shahan
Cameron, Peter
Hess, Jermey
Jacob, Shevin T
Kissoon, Niranjan
Levine, Adam C
Mian, Asad
Ramlakhan, Shammi
Sawe, Hendry R
Razzak, Junaid
author_sort Aluisio, Adam R
collection PubMed
description Disease processes that frequently require emergency care constitute approximately 50% of the total disease burden in low-income and middle-income countries (LMICs). Many LMICs continue to deal with emergencies caused by communicable disease states such as pneumonia, diarrhoea, malaria and meningitis, while also experiencing a marked increase in non-communicable diseases, such as cardiovascular diseases, diabetes mellitus and trauma. For many of these states, emergency care interventions have been developed through research in high-income countries (HICs) and advances in care have been achieved. However, in LMICs, clinical research, especially interventional trials, in emergency care are rare. Furthermore, there exists minimal research on the emergency management of diseases, which are rarely encountered in HICs but impact the majority of LMIC populations. This paper explores challenges in conducting clinical research in patients with emergency conditions in LMICs, identifies examples of successful clinical research and highlights the system, individual and study design characteristics that made such research possible in LMICs. Derived from the available literature, a focused list of high impact research considerations are put forth.
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spelling pubmed-66668262019-08-12 Clinical emergency care research in low-income and middle-income countries: opportunities and challenges Aluisio, Adam R Waheed, Shahan Cameron, Peter Hess, Jermey Jacob, Shevin T Kissoon, Niranjan Levine, Adam C Mian, Asad Ramlakhan, Shammi Sawe, Hendry R Razzak, Junaid BMJ Glob Health Analysis Disease processes that frequently require emergency care constitute approximately 50% of the total disease burden in low-income and middle-income countries (LMICs). Many LMICs continue to deal with emergencies caused by communicable disease states such as pneumonia, diarrhoea, malaria and meningitis, while also experiencing a marked increase in non-communicable diseases, such as cardiovascular diseases, diabetes mellitus and trauma. For many of these states, emergency care interventions have been developed through research in high-income countries (HICs) and advances in care have been achieved. However, in LMICs, clinical research, especially interventional trials, in emergency care are rare. Furthermore, there exists minimal research on the emergency management of diseases, which are rarely encountered in HICs but impact the majority of LMIC populations. This paper explores challenges in conducting clinical research in patients with emergency conditions in LMICs, identifies examples of successful clinical research and highlights the system, individual and study design characteristics that made such research possible in LMICs. Derived from the available literature, a focused list of high impact research considerations are put forth. BMJ Publishing Group 2019-07-29 /pmc/articles/PMC6666826/ /pubmed/31406600 http://dx.doi.org/10.1136/bmjgh-2018-001289 Text en © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0
spellingShingle Analysis
Aluisio, Adam R
Waheed, Shahan
Cameron, Peter
Hess, Jermey
Jacob, Shevin T
Kissoon, Niranjan
Levine, Adam C
Mian, Asad
Ramlakhan, Shammi
Sawe, Hendry R
Razzak, Junaid
Clinical emergency care research in low-income and middle-income countries: opportunities and challenges
title Clinical emergency care research in low-income and middle-income countries: opportunities and challenges
title_full Clinical emergency care research in low-income and middle-income countries: opportunities and challenges
title_fullStr Clinical emergency care research in low-income and middle-income countries: opportunities and challenges
title_full_unstemmed Clinical emergency care research in low-income and middle-income countries: opportunities and challenges
title_short Clinical emergency care research in low-income and middle-income countries: opportunities and challenges
title_sort clinical emergency care research in low-income and middle-income countries: opportunities and challenges
topic Analysis
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6666826/
https://www.ncbi.nlm.nih.gov/pubmed/31406600
http://dx.doi.org/10.1136/bmjgh-2018-001289
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