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Medicine for Global Health

Improvements to medical practice and delivery of treatment has been the focus of many international collaborations aiming to address the global burden of disease. Delivering appropriate health care, as well as implementation of research in low-and-middle-income countries, is compounded by resource allocation issues. Vulnerable populations continue to be seriously affected by non-communicable and infectious diseases including neglected tropical diseases, while complications during pregnancy and childbirth in these regions leave mothers and infants at risk of severe disability or death. These are ethical as well as medical problems, as many of these outcomes are preventable. To focus on the public health initiatives, the development of health care policies and evidence-based guidelines, in addition to research into the control and treatment of diseases, BMC Medicine has launched an article collection on Medicine for Global Health.

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  1. Debate

    The need for pragmatic clinical trials in low and middle income settings – taking essential neonatal interventions delivered as part of inpatient care as an illustrative example

    Pragmatic randomized trials aim to examine the effects of interventions in the full spectrum of patients seen by clinicians who receive routine care. Such trials should be employed in parallel with efforts to ...

    Mike English, Jamlick Karumbi, Michuki Maina, Jalemba Aluvaala, Archna Gupta, Merrick Zwarenstein and Newton Opiyo

    BMC Medicine 2016 14:5

    Published on: 18 January 2016

  2. Review

    Improving health outcomes through concurrent HIV program scale-up and health system development in Rwanda: 20 years of experience

    The 1994 genocide against the Tutsi destroyed the health system in Rwanda. It is impressive that a small country like Rwanda has advanced its health system to the point of now offering near universal health in...

    Sabin Nsanzimana, Krishna Prabhu, Haley McDermott, Etienne Karita, Jamie I. Forrest, Peter Drobac, Paul Farmer, Edward J. Mills and Agnes Binagwaho

    BMC Medicine 2015 13:216

    Published on: 9 September 2015

  3. Research article

    The impact of multimorbidity on adult physical and mental health in low- and middle-income countries: what does the study on global ageing and adult health (SAGE) reveal?

    Chronic diseases contribute a large share of disease burden in low- and middle-income countries (LMICs). Chronic diseases have a tendency to occur simultaneously and where there are two or more such conditions...

    Perianayagam Arokiasamy, Uttamacharya Uttamacharya, Kshipra Jain, Richard Berko Biritwum, Alfred Edwin Yawson, Fan Wu, Yanfei Guo, Tamara Maximova, Betty Manrique Espinoza, Aarón Salinas Rodríguez, Sara Afshar, Sanghamitra Pati, Gillian Ice, Sube Banerjee, Melissa A. Liebert, James Josh Snodgrass…

    BMC Medicine 2015 13:178

    Published on: 3 August 2015

  4. Research article

    Predicting mortality in sick African children: the FEAST Paediatric Emergency Triage (PET) Score

    Mortality in paediatric emergency care units in Africa often occurs within the first 24 h of admission and remains high. Alongside effective triage systems, a practical clinical bedside risk score to identify ...

    Elizabeth C. George, A. Sarah Walker, Sarah Kiguli, Peter Olupot-Olupot, Robert O. Opoka, Charles Engoru, Samuel O. Akech, Richard Nyeko, George Mtove, Hugh Reyburn, James A. Berkley, Ayub Mpoya, Michael Levin, Jane Crawley, Diana M. Gibb, Kathryn Maitland…

    BMC Medicine 2015 13:174

    Published on: 31 July 2015

  5. Research article

    A meta-analysis of the performance of the PimaTM CD4 for point of care testing

    The Alere point-of-care (POC) Pima™ CD4 analyzer allows for decentralized testing and expansion to testing antiretroviral therapy (ART) eligibility. A consortium conducted a pooled multi-data technical perform...

    Lesley E. Scott, Jennifer Campbell, Larry Westerman, Luc Kestens, Lara Vojnov, Luciana Kohastsu, John Nkengasong, Trevor Peter and Wendy Stevens

    BMC Medicine 2015 13:168

    Published on: 25 July 2015

  6. Research article

    Health and wealth in Mesoamerica: findings from Salud Mesomérica 2015

    Individual income and poverty are associated with poor health outcomes. The poor face unique challenges related to access, education, financial capacity, environmental effects, and other factors that threaten ...

    Ali H. Mokdad, Marielle C. Gagnier, K. Ellicott Colson, Paola Zúñiga-Brenes, Diego Ríos-Zertuche, Annie Haakenstad, Erin B. Palmisano, Brent W. Anderson, Sima S. Desai, Catherine W. Gillespie, Tasha Murphy, Paria Naghavi, Jennifer Nelson, Dharani Ranganathan, Alexandra Schaefer, Gulnoza Usmanova…

    BMC Medicine 2015 13:164

    Published on: 14 July 2015

  7. Research article

    A combination SMS and transportation reimbursement intervention to improve HIV care following abnormal CD4 test results in rural Uganda: a prospective observational cohort study

    Up to 50 % of HIV-infected persons in sub-Saharan Africa are lost from care between HIV diagnosis and antiretroviral therapy (ART) initiation. Structural barriers, including cost of transportation to clinic an...

    Mark J. Siedner, Data Santorino, Alexander J. Lankowski, Michael Kanyesigye, Mwebesa B. Bwana, Jessica E. Haberer and David R. Bangsberg

    BMC Medicine 2015 13:160

    Published on: 6 July 2015

  8. Research article

    Prevalence, risk factors and disability associated with fall-related injury in older adults in low- and middle-incomecountries: results from the WHO Study on global AGEing and adult health (SAGE)

    In 2010 falls were responsible for approximately 80 % of disability stemming from unintentional injuries excluding traffic accidents in adults 50 years and over. Falls are becoming a major public health proble...

    Jennifer Stewart Williams, Paul Kowal, Heather Hestekin, Tristan O’Driscoll, Karl Peltzer, Alfred Yawson, Richard Biritwum, Tamara Maximova, Aarón Salinas Rodríguez, Betty Manrique Espinoza, Fan Wu, Perianayagam Arokiasamy and Somnath Chatterji

    BMC Medicine 2015 13:147

    Published on: 23 June 2015

  9. Research article

    Frailty and the prediction of dependence and mortality in low- and middle-income countries: a 10/66 population-based cohort study

    In countries with high incomes, frailty indicators predict adverse outcomes in older people, despite a lack of consensus on definition or measurement. We tested the predictive validity of physical and multidim...

    Jotheeswaran AT, Renata Bryce, Matthew Prina, Daisy Acosta, Cleusa P Ferri, Mariella Guerra, Yueqin Huang, Juan J. Llibre Rodriguez, Aquiles Salas, Ana Luisa Sosa, Joseph D. Williams, Michael E. Dewey, Isaac Acosta, Zhaorui Liu, John Beard and Martin Prince

    BMC Medicine 2015 13:138

    Published on: 10 June 2015

  10. Research article

    Potential for international spread of wild poliovirus via travelers

    The endgame of polio eradication is hampered by the international spread of poliovirus via travelers. In response to ongoing importations of poliovirus into polio-free countries, on 5 May 2014, WHO’s Director-...

    Annelies Wilder-Smith, Wei-Yee Leong, Luis Fernandez Lopez, Marcos Amaku, Mikkel Quam, Kamran Khan and Eduardo Massad

    BMC Medicine 2015 13:133

    Published on: 4 June 2015

  11. Research article

    High prevalence of hypertension and of risk factors for non-communicable diseases (NCDs): a population based cross-sectional survey of NCDS and HIV infection in Northwestern Tanzania and Southern Uganda

    The burden of non-communicable diseases (NCDs) is increasing in sub-Saharan Africa, but data available for intervention planning are inadequate. We determined the prevalence of selected NCDs and HIV infection,...

    Bazil Kavishe, Samuel Biraro, Kathy Baisley, Fiona Vanobberghen, Saidi Kapiga, Paula Munderi, Liam Smeeth, Robert Peck, Janneth Mghamba, Gerald Mutungi, Eric Ikoona, Jonathan Levin, Maria Assumpció Bou Monclús, David Katende, Edmund Kisanga, Richard Hayes…

    BMC Medicine 2015 13:126

    Published on: 29 May 2015

  12. Commentary

    Balancing omega-6 and omega-3 fatty acids in ready-to-use therapeutic foods (RUTF)

    Ready-to-use therapeutic foods (RUTFs) are a key component of a life-saving treatment for young children who present with uncomplicated severe acute malnutrition in resource limited settings. Increasing recogn...

    J Thomas Brenna, Peter Akomo, Paluku Bahwere, James A Berkley, Philip C Calder, Kelsey D Jones, Lei Liu, Mark Manary, Indi Trehan and André Briend

    BMC Medicine 2015 13:117

    Published on: 15 May 2015

  13. Research article

    Ready-to-use therapeutic food with elevated n-3 polyunsaturated fatty acid content, with or without fish oil, to treat severe acute malnutrition: a randomized controlled trial

    Ready-to-use therapeutic foods (RUTF) are lipid-based pastes widely used in the treatment of acute malnutrition. Current specifications for RUTF permit a high n-6 polyunsaturated fatty acid (PUFA) content and ...

    Kelsey DJ Jones, Rehema Ali, Maureen A Khasira, Dennis Odera, Annette L West, Grielof Koster, Peter Akomo, Alison WA Talbert, Victoria M Goss, Moses Ngari, Johnstone Thitiri, Said Ndoro, Miguel A Garcia Knight, Kenneth Omollo, Anne Ndungu, Musa M Mulongo…

    BMC Medicine 2015 13:93

    Published on: 23 April 2015

  14. Correspondence

    Strengthening mental health systems in low- and middle-income countries: the Emerald programme

    There is a large treatment gap for mental health care in low- and middle-income countries (LMICs), with the majority of people with mental, neurological, and substance use (MNS) disorders receiving no or inade...

    Maya Semrau, Sara Evans-Lacko, Atalay Alem, Jose Luis Ayuso-Mateos, Dan Chisholm, Oye Gureje, Charlotte Hanlon, Mark Jordans, Fred Kigozi, Heidi Lempp, Crick Lund, Inge Petersen, Rahul Shidhaye and Graham Thornicroft

    BMC Medicine 2015 13:79

    Published on: 10 April 2015

  15. Research article

    The predictive value of current haemoglobin levels for incident tuberculosis and/or mortality during long-term antiretroviral therapy in South Africa: a cohort study

    Low haemoglobin concentrations may be predictive of incident tuberculosis (TB) and death in HIV-infected patients receiving antiretroviral therapy (ART), but data are limited and inconsistent. We examined thes...

    Andrew D Kerkhoff, Robin Wood, Frank G Cobelens, Ankur Gupta-Wright, Linda-Gail Bekker and Stephen D Lawn

    BMC Medicine 2015 13:70

    Published on: 2 April 2015

  16. Review

    Maternal undernutrition and cardiometabolic disease: a latin american perspective

    The current epidemic of obesity and cardiometabolic diseases in developing countries is described as being driven by socioeconomic inequalities. These populations have a greater vulnerability to cardiometaboli...

    Patricio Lopez-Jaramillo, Diego Gomez-Arbelaez, Aristides Sotomayor-Rubio, Daniel Mantilla-Garcia and Jose Lopez-Lopez

    BMC Medicine 2015 13:41

    Published on: 2 March 2015

  17. Research article

    Proxy markers of serum retinol concentration, used alone and in combination, to assess population vitamin A status in Kenyan children: a cross-sectional study

    Serum retinol concentration determined by high-performance liquid chromatography (HPLC) is recommended by the World Health Organization to assess population vitamin A status. This assay is expensive, technical...

    Elise F Talsma, Hans Verhoef, Inge D Brouwer, Anne S Mburu-de Wagt, Paul JM Hulshof and Alida Melse-Boonstra

    BMC Medicine 2015 13:30

    Published on: 11 February 2015

  18. Research article

    Effects on mortality of a nutritional intervention for malnourished HIV-infected adults referred for antiretroviral therapy: a randomised controlled trial

    Malnourished HIV-infected African adults are at high risk of early mortality after starting antiretroviral therapy (ART). We hypothesized that short-course, high-dose vitamin and mineral supplementation in lip...

    Suzanne Filteau, George PrayGod, Lackson Kasonka, Susannah Woodd, Andrea M Rehman, Molly Chisenga, Joshua Siame, John R Koethe, John Changalucha, Denna Michael, Jeremiah Kidola, Daniela Manno, Natasha Larke, Daniel Yilma, Douglas C Heimburger, Henrik Friis…

    BMC Medicine 2015 13:17

    Published on: 28 January 2015

  19. Research article

    The burden of disease in Spain: results from the global burden of disease study 2010

    We herein evaluate the Spanish population’s trends in health burden by comparing results of two Global Burden of Diseases, Injuries, and Risk Factors Studies (the GBD studies) performed 20 years apart.

    Josep Maria Haro, Stefanos Tyrovolas, Noe Garin, Cesar Diaz-Torne, Loreto Carmona, Lidia Sanchez-Riera, Fernando Perez-Ruiz and Christopher JL Murray

    BMC Medicine 2014 12:236

    Published on: 5 December 2014

  20. Research article

    Diagnostic utility of zinc protoporphyrin to detect iron deficiency in Kenyan pregnant women

    Iron-deficient erythropoiesis results in excess formation of zinc protoporphyrin (ZPP), which can be measured instantly and at low assay cost using portable haematofluorometers. ZPP is used as a screening mark...

    Martin N Mwangi, Sumi Maskey, Pauline EA Andang’o, Noel K Shinali, Johanna M Roth, Laura Trijsburg, Alice M Mwangi, Han Zuilhof, Barend van Lagen, Huub FJ Savelkoul, Ayşe Y Demir and Hans Verhoef

    BMC Medicine 2014 12:229

    Published on: 26 November 2014

  21. Research article

    Mental, neurological, and substance use problems among refugees in primary health care: analysis of the Health Information System in 90 refugee camps

    Population-based epidemiological research has established that refugees in low- and middle-income countries (LMIC) are at increased risk for a range of mental, neurological and substance use (MNS) problems. Im...

    Jeremy C Kane, Peter Ventevogel, Paul Spiegel, Judith K Bass, Mark van Ommeren and Wietse A Tol

    BMC Medicine 2014 12:228

    Published on: 24 November 2014

  22. Research article

    Epidemiology of multimorbidity in China and implications for the healthcare system: cross-sectional survey among 162,464 community household residents in southern China

    China, like other countries, is facing a growing burden of chronic disease but the prevalence of multimorbidity and implications for the healthcare system have been little researched. We examined the epidemiol...

    Harry HX Wang, Jia Ji Wang, Samuel YS Wong, Martin CS Wong, Fang Jian Li, Pei Xi Wang, Zhi Heng Zhou, Chun Yan Zhu, Sian M Griffiths and Stewart W Mercer

    BMC Medicine 2014 12:188

    Published on: 23 October 2014

  23. Forum

    Remembering the forgotten non-communicable diseases

    The forthcoming post-Millennium Development Goals era will bring about new challenges in global health. Low- and middle-income countries will have to contend with a dual burden of infectious and non-communicab...

    Alan D Lopez, Thomas N Williams, Adeera Levin, Marcello Tonelli, Jasvinder A Singh, Peter GJ Burney, Jürgen Rehm, Nora D Volkow, George Koob and Cleusa P Ferri

    BMC Medicine 2014 12:200

    Published on: 22 October 2014

  24. Research article

    Alcohol consumption, drinking patterns, and ischemic heart disease: a narrative review of meta-analyses and a systematic review and meta-analysis of the impact of heavy drinking occasions on risk for moderate drinkers

    Alcohol consumption is a major global risk factor for mortality and morbidity. Much discussion has revolved around the diverse findings on the complex relationship between alcohol consumption and the leading c...

    Michael Roerecke and Jürgen Rehm

    BMC Medicine 2014 12:182

    Published on: 21 October 2014

  25. Commentary

    How do you circumcise a nation? The Rwandan case study

    Voluntary medical male circumcision has been conclusively demonstrated to reduce the lifetime risk of male acquisition of HIV. The strategy has been adopted as a component of a comprehensive strategy towards a...

    Vincent Mutabazi, Jamie I Forrest, Nathan Ford and Edward J Mills

    BMC Medicine 2014 12:184

    Published on: 6 October 2014

  26. Research article

    Liver cirrhosis mortality in 187 countries between 1980 and 2010: a systematic analysis

    Liver cirrhosis is a major yet largely preventable and underappreciated cause of global health loss. Variations in cirrhosis mortality at the country level reflect differences in prevalence of risk factors suc...

    Ali A Mokdad, Alan D Lopez, Saied Shahraz, Rafael Lozano, Ali H Mokdad, Jeff Stanaway, Christopher JL Murray and Mohsen Naghavi

    BMC Medicine 2014 12:145

    Published on: 18 September 2014

  27. Research article

    Predictors and correlates of adherence to combination antiretroviral therapy (ART) for chronic HIV infection: a meta-analysis

    Adherence to combination antiretroviral therapy (ART) is a key predictor of the success of human immunodeficiency virus (HIV) treatment, and is potentially amenable to intervention. Insight into predictors or ...

    Nienke Langebeek, Elizabeth H Gisolf, Peter Reiss, Sigrid C Vervoort, Thóra B Hafsteinsdóttir, Clemens Richter, Mirjam AG Sprangers and Pythia T Nieuwkerk

    BMC Medicine 2014 12:142

    Published on: 21 August 2014

  28. Research article

    Burden of mental disorders and unmet needs among street homeless people in Addis Ababa, Ethiopia

    The impact of mental disorders among homeless people is likely to be substantial in low income countries because of underdeveloped social welfare and health systems. As a first step towards advocacy and provis...

    Abebaw Fekadu, Charlotte Hanlon, Emebet Gebre-Eyesus, Melkamu Agedew, Haddis Solomon, Solomon Teferra, Tsehaysina Gebre-Eyesus, Yonas Baheretibeb, Girmay Medhin, Teshome Shibre, Abraham Workneh, Teketel Tegegn, Alehegn Ketema, Philip Timms, Graham Thornicroft and Martin Prince

    BMC Medicine 2014 12:138

    Published on: 20 August 2014

  29. Research article

    Mesalazine in the initial management of severely acutely malnourished children with environmental enteric dysfunction: a pilot randomized controlled trial

    Environmental enteric dysfunction (EED) is an acquired syndrome of impaired gastrointestinal mucosal barrier function that is thought to play a key role in the pathogenesis of stunting in early life. It has be...

    Kelsey DJ Jones, Barbara Hünten-Kirsch, Ahmed MR Laving, Caroline W Munyi, Moses Ngari, Jenifer Mikusa, Musa M Mulongo, Dennis Odera, H Samira Nassir, Molline Timbwa, Moses Owino, Greg Fegan, Simon H Murch, Peter B Sullivan, John O Warner and James A Berkley

    BMC Medicine 2014 12:133

    Published on: 14 August 2014

  30. Research article

    Findings from the SASA! Study: a cluster randomized controlled trial to assess the impact of a community mobilization intervention to prevent violence against women and reduce HIV risk in Kampala, Uganda

    Intimate partner violence (IPV) and HIV are important and interconnected public health concerns. While it is recognized that they share common social drivers, there is limited evidence surrounding the potentia...

    Tanya Abramsky, Karen Devries, Ligia Kiss, Janet Nakuti, Nambusi Kyegombe, Elizabeth Starmann, Bonnie Cundill, Leilani Francisco, Dan Kaye, Tina Musuya, Lori Michau and Charlotte Watts

    BMC Medicine 2014 12:122

    Published on: 31 July 2014

  31. Research article

    Hypertension, kidney disease, HIV and antiretroviral therapy among Tanzanian adults: a cross-sectional study

    The epidemics of HIV and hypertension are converging in sub-Saharan Africa. Due to antiretroviral therapy (ART), more HIV-infected adults are living longer and gaining weight, putting them at greater risk for ...

    Robert N Peck, Rehema Shedafa, Samuel Kalluvya, Jennifer A Downs, Jim Todd, Manikkam Suthanthiran, Daniel W Fitzgerald and Johannes B Kataraihya

    BMC Medicine 2014 12:125

    Published on: 29 July 2014

  32. Research article

    The association between the ratio of monocytes:lymphocytes at age 3 months and risk of tuberculosis (TB) in the first two years of life

    Recent transcriptomic studies revived a hypothesis suggested by historical studies in rabbits that the ratio of peripheral blood monocytes to lymphocytes (ML) is associated with risk of tuberculosis (TB) disea...

    Vivek Naranbhai, Soyeon Kim, Helen Fletcher, Mark F Cotton, Avy Violari, Charles Mitchell, Sharon Nachman, George McSherry, Helen McShane, Adrian VS Hill and Shabir A Madhi

    BMC Medicine 2014 12:120

    Published on: 17 July 2014

  33. Research article

    A combined analysis of immunogenicity, antibody kinetics and vaccine efficacy from phase 2 trials of the RTS,S malaria vaccine

    The RTS,S malaria vaccine is currently undergoing phase 3 trials. High vaccine-induced antibody titres to the circumsporozoite protein (CSP) antigen have been associated with protection from infection and epis...

    Michael T White, Philip Bejon, Ally Olotu, Jamie T Griffin, Kalifa Bojang, John Lusingu, Nahya Salim, Salim Abdulla, Nekoye Otsyula, Selidji T Agnandji, Bertrand Lell, Kwaku Poku Asante, Seth Owusu-Agyei, Emmanuel Mahama, Tsiri Agbenyega, Daniel Ansong…

    BMC Medicine 2014 12:117

    Published on: 10 July 2014

  34. Commentary

    Achieving a polio free world

    Recently, the World Health Organization (WHO) declared that the spread of polio is an international public health emergency, and a coordinated international response is sought. Although the importance of such ...

    Mohammad Ali and David A Sack

    BMC Medicine 2014 12:116

    Published on: 3 July 2014

  35. Research article

    Opsonic phagocytosis of Plasmodium falciparummerozoites: mechanism in human immunity and a correlate of protection against malaria

    An understanding of the mechanisms mediating protective immunity against malaria in humans is currently lacking, but critically important to advance the development of highly efficacious vaccines. Antibodies p...

    Faith HA Osier, Gaoqian Feng, Michelle J Boyle, Christine Langer, Jingling Zhou, Jack S Richards, Fiona J McCallum, Linda Reiling, Anthony Jaworowski, Robin F Anders, Kevin Marsh and James G Beeson

    BMC Medicine 2014 12:108

    Published on: 1 July 2014

  36. Research article

    Diagnostic accuracy of quantitative PCR (Xpert MTB/RIF) for tuberculous pericarditis compared to adenosine deaminase and unstimulated interferon-γ in a high burden setting: a prospective study

    Tuberculous pericarditis (TBP) is associated with high morbidity and mortality, and is an important treatable cause of heart failure in developing countries. Tuberculous aetiology of pericarditis is difficult ...

    Shaheen Pandie, Jonathan G Peter, Zita S Kerbelker, Richard Meldau, Grant Theron, Ureshnie Govender, Mpiko Ntsekhe, Keertan Dheda and Bongani M Mayosi

    BMC Medicine 2014 12:101

    Published on: 18 June 2014

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