Bioengineering and World HealthSlide 2Review of Lecture 1Overview of Lecture 2Economic DataSlide 6Slide 7Human Development IndexOne View of The WorldLeast Developed CountriesSlide 11Health and Other Data in LDCsSlide 13Slide 14Ratio of Mortality RateChild MortalitySlide 17Leading Causes of Mortality: Ages 0-4Slide 191. Perinatal ConditionsBurden of Perinatal ConditionsCommon Perinatal ConditionsSlide 23Preventing Perinatal ConditionsSlide 25Slide 26Maternal Morbidity and MortalityObstetric Fistula2. Lower Respiratory InfectionsBurden of Lower Respiratory InfectionsPathophysiology of PneumoniaSlide 32Slide 33Diagnosis of PneumoniaDirect Fluorescence AssayVaccines for Lower Respiratory Infections3. Diarrheal DiseaseBurden of Diarrheal DiseaseNormal Gastrointestinal PhysiologyCauses of DiarrheaSlide 41Slide 42“Malnutrition is an Infectious Disease”Oral Rehydration TherapyHow Does ORT Work?Slide 46Slide 47Vaccines to Prevent Diarrhea4. MalariaBurden of MalariaSlide 51Malaria PathogenesisDiagnosis of MalariaPreventing MalariaPreventing MalariaSlide 56Slide 57Slide 58Slide 592. Congenital AnomaliesBurden of Congenital AnomaliesCommon Congenital Anomalies4. Unintentional InjuriesSummary of Lecture TwoBioengineering and World HealthLecture Two:Defining “Developing vs Developed” CountriesLeading Causes of Mortality, Ages 0-4Geoff PreidisMD/PhD candidateBaylor College of [email protected] of Lecture 1Course organizationFour questions we will answerTechnology assessment – The big pictureHealth data and its usesQuantitative measures of healthIncidencePrevalenceMortality RateInfant Mortality RateQALY, DALYOverview of Lecture 2What are the major health problems worldwide?Defining “Developing vs Developed” CountriesLeading Causes of Mortality, Ages 0-4A Tale of Two WomenSierra LeoneJapanEconomic DataPer capita GDPPer capita health spendingEconomic DataPer capita GDPPer capita health spendingPurchasing power parityTake into account true costs of goods and servicesHow much does a loaf of bread cost?Human Development Index Average achievements in health, education and income.Human Development IndexGreen = High developmentYellow & Orange = Medium developmentRed: Low DevelopmentUN Human Development Report, 2006One View of The WorldDeveloped vs. Developing CountriesThere is no universally accepted definition of what a developing country isUsually categorized by a per capita income criterionLow income developing countries: <$400Middle income developing countries: $400-$4,000WTO members decide for themselves if they are a developing country; brings certain rightsLeast Developed CountriesIn 1971, the UN created a Least Developed Country member categoryCountries apply for this statusLow national income (<$900 per capita GDP)Low levels of human capital developmentEconomic vulnerabilityOriginally 25 LDCsAs of 2005, 637 million people live in world’s 50 least developed countries Population growth expected to triple by 2050www.unctad.orgLeast Developed CountriesHealth and Other Data in LDCsAverage per capita GDP:LDCs: $235All other developed countries: $24,522Average life expectancy:LDCs: 51 yearsBotswana – expected to be only 27 years by 2010Industrialized nations: 78 years1 child in 10 dies before his or her 1st Bday in LDCs40% of all children under 5 are underweight or suffering from stunted growth in LDCsHalf the population in LDCs is illiterateHealth and Other Data in LDCsMortality rate for children under five:LDCs: 151/1,000 live birthsHigh income countries: 6/1,000 live birthsAverage annual health care expenditures:LDCs: $16/personHigh income countries: $1,800/personA child born today in an LDC is more than 1,000 times more likely to die of measles than one born in an industrialized country.Group 1Group 1 Communicable diseases, maternal/perinatal conditions, nutritional deficienciesGroup 2Group 2 Non-communicable diseases (cardiovascular, cancer, mental disorders)Group 3Group 3 InjuriesRatio of Mortality Rate0.01.02.03.04.05.06.07.00-4 5-14 15-29 30-44 45-59 60-69 70-79 80+Age GroupMortality Rate in Developing Countries / Mortality Rate in Developed Countries WHO, 2002Child Mortality10 million children under the age of 5 die every year98% of these deaths occur in developing countriesNumber of children who die each year in developing countries is more than two times the number of children born each year in the US and Canada2/3 of deaths could be prevented today with available technology feasible for low income countries40% of deaths in this age group occur in first month of life (neonatal period)25% of deaths occur in childbirth and first week of life (perinatal period)http://globalis.gvu.unu.edu/Leading Causes of Mortality: Ages 0-4Developing world1. Perinatal conditions2. Lower respiratory infections3. Diarrheal diseases4. MalariaDeveloped world1. Perinatal conditions2. Congenital anomalies3. Lower respiratory infections4. Unintentional injuries1. Perinatal ConditionsBurden of Perinatal ConditionsCommon Perinatal ConditionsPreventing Perinatal MortalityMaternal Morbidity and MortalityObstetric FistulaBurden of Perinatal Conditions2.5 million children each year die in perinatal period (birth through first week of life)Most perinatal deaths are a result of inadequate access to healthcarePoor maternal health and nutritionNo health care during pregnancy and deliveryLow birth weightMany cultures…Don’t celebrate child’s birth until weeks have passedMother and child isolated during this periodCan reduce incidence of infectionCan result in delays in seeking healthcareCommon Perinatal ConditionsInfections Acquired during exposure to the maternal genital tractAcquired using non-sterile technique to cut the umbilical cord“ToRCHeS”Common Perinatal ConditionsBirth AsphyxiaBaby does not breathe at birthUmbilical cord wrapped around baby’s neckBirth TraumaMechanical forces in obstructed labor prevent descent through birth canal (e.g. cephalopelvic disproportion)Can result in intracranial hemmorhage, blunt trauma to internal organs, injury to spinal cord or peripheral nervesPreventing Perinatal ConditionsNo good screening tests to indicate who will need emergency careAll births should be attended by a
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