Abstract:
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.
