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Cardiovascular diseases in Africa in the twenty-first century: Gaps and priorities going forward

Minja, N.W.; Nakagaayi, D.; Aliku, T. et al. Frontiers in Cardiovascular Medicine (2022) CC

In 2015, the United Nations set important targets to reduce premature cardiovascular disease (CVD) deaths by 33% by 2030. Africa disproportionately bears the brunt of CVD burden and has one of the highest risks of dying from non-communicable dise...ases (NCDs) worldwide. There is currently an epidemiological transition on the continent, where NCDs is projected to outpace communicable diseases within the current decade. Unchecked increases in CVD risk factors have contributed to the growing burden of three major CVDs—hypertension, cardiomyopathies, and atherosclerotic diseasesleading to devastating rates of stroke and heart failure. The highest age standardized disability-adjusted life years (DALYs) due to hypertensive heart disease (HHD) were recorded in Africa. The contributory causes of heart failure are changing—whilst HHD and cardiomyopathies still dominate, ischemic heart disease is rapidly becoming a significant contributor, whilst rheumatic heart disease (RHD) has shown a gradual decline. In a continent where health systems are traditionally geared toward addressing communicable diseases, several gaps exist to adequately meet the growing demand imposed by CVDs. Among these, high-quality research to inform interventions, underfunded health systems with high out-of-pocket costs, limited accessibility and affordability of essential medicines, CVD preventive services, and skill shortages. Overall, the African continent progress toward a third reduction in premature mortality come 2030 is lagging behind. More can be done in the arena of effective policy implementation for risk factor reduction and CVD prevention, increasing health financing and focusing on strengthening primary health care services for prevention and treatment of CVDs, whilst ensuring availability and affordability of quality medicines. Further, investing in systematic country data collection and research outputs will improve the accuracy of the burden of disease data and inform policy adoption on interventions. This review summarizes the current CVD burden, important gaps in cardiovascular medicine in Africa, and further highlights priority areas where efforts could be intensified in the next decade with potential to improve the current rate of progress toward achieving a 33% reduction in CVD mortality. more

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Cardiac arrhythmias in low- and middle-income countries

Mkoko, P.; Bahiru, E.; Ajijola, O.A. et al. Cardiovascular Diagnosis and Therapy (2019) CC

Many low- and middle-income countries (LMICs) are undergoing an epidemiological transition. With an improvement in socioeconomic conditions and an aging population, cardiovascular diseases (CVDs), like cardiac arrhythmias, are expected to increase in these countries. However, there are limited studi... more

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Management of a cholera epidemic - Practical guide for doctors, nurses, laboratory technicians, medical auxiliaries, water and sanitation specialists and logisticians
recommended

Médecins Sans Frontières MFS (2023) CC

Cholera is a transmissible diarrhoeal infection caused by Vibrio cholerae. Endemic and/or epidemic in over 40 countries (mainly in Africa and Asia), cholera continues to be a major global public health issue. The World Health Organization (WHO) estimates that the number of cases reported worldwid...e represents in reality only 5 to 10% of actual cases. This guide is intended for medical and non-medical staff responding to a cholera outbreak. It attempts to provide concrete answers to the questions and problems faced by staff, based on the recommendations of reference organisations, such as WHO and UNICEF, as well as Médecins Sans Frontières’ experience in the field. It is divided into 8 chapters. Chapter 1, Cholera overview, outlines the epidemiological and clinical features of cholera. Chapter 2, Outbreak investigation, explains the method and stages of a field investigation, from the alert to implementation of initial activities. Chapter 3, Cholera control measures, details measures and tools to prevent and/or control cholera transmission and mortality in populations affected, or at risk of being affected, by an epidemic (curative care, prevention means and health promotion activities). Chapter 4, Strategies for epidemic response, addresses the roll-out strategies of the measures described in Chapter 3 which depend on context (e.g. urban, rural, endemic, non-endemic setting, etc.), resources and particular constraints. Chapter 5, Cholera case management, details the different stages of cholera treatment, from diagnosis through to cure. Chapter 6, Setting up cholera treatment facilities, focuses on the installation of treatment facilities that vary in size and complexity according to operational requirements (treatment centres and units and oral rehydration points). Chapter 7, Organisation of cholera treatment facilities, describes the organisation of these specialized facilities in terms of human resources, supply, water, hygiene and sanitation, etc. Chapter 8, Monitoring and evaluation, presents the key data to be collected and analysed during an epidemic to facilitate a tailored response and evaluate its quality and effectiveness. The guide includes various practical tools in the appendices to facilitate activities (e.g. water quality tests, job descriptions, documents, etc.). Moreover, the toolbox also contains additional tools in editable formats (individual patient file, cholera case register, pictograms). Despite all efforts, it is possible that certain errors may have been overlooked in this guide. Please inform the authors of any errors detected. To ensure that this guide continues to evolve while remaining adapted to field realities, please send any comments or suggestions. more

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Infrastructure, policy and regulatory interventions to increase physical activity to prevent cardiovascular diseases and diabetes: a systematic review

Durão, S.; Burns, J.; Schmidt, B. et al. BMC Public Health (2023) CC

Background Noncommunicable diseases are major contributors to morbidity and mortality worldwide. Modifying the risk factors for these conditions, such as physical inactivity, is thus essential. Addressing the context or circumstances in which physical activity occurs may promote physical activity a...t a population level. We assessed the effects of infrastructure, policy or regulatory interventions for increasing physical activity. Methods We searched PubMed, Embase and clinicaltrials.gov to identify randomised controlled trials (RCTs), controlled before-after (CBAs) studies, and interrupted time series (ITS) studies assessing population-level infrastructure or policy and regulatory interventions to increase physical activity. We were interested in the effects of these interventions on physical activity, body weight and related measures, blood pressure, and CVD and type 2 diabetes morbidity and mortality, and on other secondary outcomes. Screening and data extraction was done in duplicate, with risk of bias was using an adapted Cochrane risk of bias tool. Due to high levels of heterogeneity, we synthesised the evidence based on effect direction. Results We included 33 studies, mostly conducted in high-income countries. Of these, 13 assessed infrastructure changes to green or other spaces to promote physical activity and 18 infrastructure changes to promote active transport. The effects of identified interventions on physical activity, body weight and blood pressure varied across studies (very low certainty evidence); thus, we remain very uncertain about the effects of these interventions. Two studies assessed the effects of policy and regulatory interventions; one provided free access to physical activity facilities and showed that it may have beneficial effects on physical activity (low certainty evidence). The other provided free bus travel for youth, with intervention effects varying across studies (very low certainty evidence). Conclusions Evidence from 33 studies assessing infrastructure, policy and regulatory interventions for increasing physical activity showed varying results. The certainty of the evidence was mostly very low, due to study designs included and inconsistent findings between studies. Despite this drawback, the evidence indicates that providing access to physical activity facilities may be beneficial; however this finding is based on only one study. Implementation of these interventions requires full consideration of contextual factors, especially in low resource settings. more

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Selection of essential medicines for the prevention and treatment of cardiovascular diseases in low and middle income countries

Bazargani, Y.T.; Ugurlu, M.; Leufkens, H.G.M. et al. BMC Cardiovascular Disorders (2018) CC

The incidence and mortality of cardiovascular diseases (CVDs) in low and middle income countries (LMICs) have been increasing, while access to CVDs medicines is suboptimal. We assessed selection of essential medicines for the prevention and treatment of CVDs on national essential medicines lists (NE... more

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Quality of stroke guidelines in low- and middle-income countries: a systematic review

Yaria, J.; Gil, A.; Makanjuola, A. et al. Bulletin of the World Health Organization (2021) C_WHO

Objective: To identify gaps in national stroke guidelines that could be bridged to enhance the quality of stroke care services in low- and middle-income countries. Methods: We systematically searched medical databases and websites of medical societies and contacted international organizations. Co... more

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Management and Prevention Strategies for Non-communicable Diseases (NCDs) and Their Risk Factors

Budreviciute, A.; Damiati, S.; Khdr Sabir, D. et al. (2020) CC

Non-communicable diseases (NCDs) are of increasing concern for society and national governments, as well as globally due to their high mortality rate. The main risk factors of NCDs can be classified into the categories of self-management, genetic factors, environmental factors, factors of medical co... more

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Building better immunity: A life course approach to healthy longevity

Pan American Health Organization PAHO (2023) C_WHO

As the Americas undergo profound demographic change and there are more persons aged 65 years or older than children younger than 5 years, it is crucial to recognize that national immunization programs must be redesigned to ensure comprehensive protection for individuals across the lifespan. By adopt... more

Ethiopia Health Cluster Strategy 2024-2025

World Health Organization WHO; Health Cluster (2024) CC

Ethiopia has been repeatedly affected by conflict, flooding, drought, and disease outbreaks in the past years. As of January 2024, the country is actively responding to the longest recorded cholera outbreak which started in August 2022, recurrent measles outbreaks which started in August 2021, and t... more

primary prevention of diabetes (WHO Collaborating Centre for Research, Education & Training in Diabetes

Tharker, S.; Nandhini, Mrs.; Satyavani, K.; et al. M. V. Hospital for Diabetes & Diabetes Research Centre (WHO Collaborating Centre for Research, Education & Training in Diabetes) (2023) CC

It is now well known that there is a pandemic of Type 2 Diabetes in the world particularly in developing countries. This fact has several implications for the health care system in the developing countries because this condition is associated with metabolic and vascular complications which in turn i... more

1 Global Heart & Circulatory Diseases Factsheet

British Heart Foundation (2024) CC

Heart and circulatory diseases is an umbrella term for all diseases of the heart and circulation. It includes everything from conditions that are inherited or that a person is born with, to those that develop later, such as coronary heart disease, atrial fibrillation, heart failure, stroke and vascu... more

HEARTS in the Americas. Compendium of essential clinical tools 2023

Pan American Health Organisation PAHO (2024) CC

Since 2016, the Pan American Health Organization (PAHO) has been promoting the implementation of the HEARTS Initiative in the Americas as a regional adaptation of the World Health Organization's Global HEARTS Initiative. During this time, 33 countries in the Region of the Americas have committed to ... more

Guidelines for the management of asthma in adults and adolescents: Position statement of the South African Thoracic Society – 2021 update

Lalloo, U.G.; Kalla, I.S.; Abdool-Gaffar, S. et al. African Journal of Thoracic and Critical Care Medicine (2021) CC

sthma prevalence is increasing worldwide, and surveys indicate that most patients in developed and developing countries, including South Africa, do not receive optimal care and are therefore not well controlled. Standard management guidelines adapted to in-country realities are important to support ... more

Kenya National Guidelines for Cardiovascular Diseases Management

Ministry of Health Kenya Republic of Kenya (2018) CC

The Kenya Health Policy 2014-2030 aims at attaining the highest possible standard of health in a manner responsive to the health needs of our population. One of the major policy directions towards realizing the intentions of this policy is to halt and reverse the rising burden of non-communicable d... more

National Essential Medicines List - Tertiary/Quaternary Medication Review Process

Republic of South Africa (2017) CC

Long Acting Muscarinic Antagonists (LAMA) such as tiotropium and glycopyrronium are used in the management of COPD1. They have been shown to improve lung function, quality of life and exercise tolerance. They have also been associated with reduced COPD-related exacerbations, associated hospitalisati... more

CVD and the Development Agenda: Advocacy Toolkit

World Heart Federation (2017) CC

Global Development: Where Are We Now? Today, we are facing a vital opportunity to change the profile of cardiovascular disease around the world. The Millennium Development Goals (MDGs) are due to expire at the end of 2015, placing the cardiovascular health community in a unique position to shape t... more

Global air pollution exposure and poverty

Rentschler, J.; Leonova, N. Nature Communications (2023) CC

Air pollution is one of the leading causes of health complications and mortality worldwide, especially affecting lower-income groups, who tend to be more exposed and vulnerable. This study documents the relationship between ambient air pollution exposure and poverty in 211 countries and territories.... more

Regional capacity-building workshop for management and care of substance use disorders

World Health Organization (WHO) World Health Organization (WHO) (2019) C_WHO

The document is a summary report by the World Health Organization (WHO) Regional Office for the Eastern Mediterranean, focusing on a capacity-building workshop held in Abu Dhabi in 2019. The workshop addressed the management and care of substance use disorders, aiming to improve technical and manage... more

Secondhand Smoke Exposure and the Impact of Smokefree Policies

Centers for Disease Control and Prevention (2021) CC

The Public Health Burden of Secondhand Exposure to Commercial Tobacco Smoke Secondhand smoke, the combination of smoke from burning commercial tobacco* products and the smoke breathed out by a person who is smoking, is deadly.

Interim Guidlines for the clinical management of diabetes in Jamaica

Ministry of Health and Wellness (2020) CC2

Diabetes mellitus, also called diabetes, is a chronic metabolic condition in which the hormone insulin is not produced by the pancreas in sufficient quantities or is not utilized effectively by the body to control blood glucose levels. As a result, blood glucose levels are abnormally high (hypergl... more

Management of a cholera epidemic - Practical guide for doctors, nurses, laboratory technicians, medical auxiliaries, water and sanitation specialists and logisticians recommended

Management of a cholera epidemic - Practical guide for doctors, nurses, laboratory technicians, medical auxiliaries, water and sanitation specialists and logisticians
recommended