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Challenges in management and prevention of ischemic heart disease in low socioeconomic status people in LLMICs

Gupta, R.; Yusuf, S. BMC Medicine (2019) CC

Cardiovascular diseases, principally ischemic heart disease (IHD), are the most important cause of death and disability in the majority of low- and lower-middle-income countries (LLMICs). In these countries, IHD mortality rates are significantly greater in individuals of a low socioeconomic status (... more

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Screening for cardiovascular disease risk and subsequent management in low and middle income countries: challenges and opportunities

Bovet, P.; Chiolero, A.; Paccaud, F. et al. Public Health Reviews (2015) CC

Background: Cardiovascular disease (CVD), mainly heart attack and stroke, is the leading cause of premature mortality in low and middle income countries (LMICs). Identifying and managing individuals at high risk of CVD is an important strategy to prevent and control CVD, in addition to multisector... more

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Trend analysis of cardiovascular disease mortality, incidence, and mortality-to-incidence ratio: results from global burden of disease study 2017

Amini, M.; Zayeri, F.; Salehi, M. BioMed Central (2021) CC

Background Cardiovascular diseases (CVDs) are one of the global leading causes of concern due to the rising prevalence and consequence of mortality and disability with a heavy economic burden. The objective of the current study was to analyze the trend in CVD incidence, mortality, and mortality-to-... 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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Prevention and management of CVD in LMICs: why do ethnicity, culture, and context matter?

Anand, S.; Bradshaw, C.; Prabhakaran, D. BMC Medicine (2020) CC

Background Low- and middle-income countries now experience the highest prevalence and mortality rates of cardiovascular disease. Main text While improving the availability and delivery of proven, effective therapies will no doubt mitigate this burden, we posit that studies evaluating cardiovasc... more

Pharmacological Primary Prevention of Diabetes Mellitus Type II: A Narrative Review

Naveed, A.; Farrukh, L.; Khawar Sana, M.; et al. National Library of Medicine (2020) CC2

The evolving epidemic of type 2 diabetes mellitus has challenged health-care professionals. It stands among the leading causes of mortality in the present world. It warrants new and versatile approaches to improve mortality and the associated huge quality-adjusted life years lost to it once diagnose... more

Air pollution and the noncommunicable disease prevention agenda: opportunities for public health and environmental science

Howse, E.; Crane, M.; Hanigan, I. et al. Environmental Research Letters (2021) CC

Air pollution is a major environmental risk factor and contributor to chronic, noncommunicable diseases (NCDs). However, most public health approaches to NCD prevention focus on behavioural and biomedical risk factors, rather than environmental risk factors such as air pollution. This article discus... more

Qualitative assessment of community health workers’ perspective on their motivation in community-based primary health care in rural Malawi

Ndambo, M.K.; Munyaneza, F.; Aron, M.B. et al. BMC Health Services Research (2022) CC

Background: Community Health Workers (CHWs) have a positive impact on the provision of community-based primary health care through screening, treatment, referral, psychosocial support, and accompaniment. With a broad scope of work, CHW programs must balance the breadth and depth of tasks to mainta...in CHW motivation for high-quality care delivery. Few studies have described the CHW perspective on intrinsic and extrinsic motivation to enhance their programmatic activities. Methods: We utilized an exploratory qualitative study design with CHWs employed in the household model in Neno District, Malawi, to explore their perspectives on intrinsic and extrinsic motivators and dissatisfiers in their work. Data was collected in 8 focus group discussions with 90 CHWs in October 2018 and March–April 2019 in seven purposively selected catchment areas. All interviews were audiotaped, transcribed verbatim, coded, and analyzed using Dedoose. Results: Themes of complex intrinsic and extrinsic factors were generated from the perspectives of the CHWs in the focus group discussions. Study results indicate that enabling factors are primarily intrinsic factors such as positive patient outcomes, community respect, and recognition by the formal health care system but can lead to the chal- lenge of increased scope and workload. Extrinsic factors can provide challenges, including an increased scope and workload from original expectations, lack of resources to utilize in their work, and rugged geography. However, a posi- tive work environment through supportive relationships between CHWs and supervisors enables the CHWs. Conclusion: This study demonstrated enabling factors and challenges for CHW performance from their perspec- tive within the dual-factor theory. We can mitigate challenges through focused efforts to limit geographical distance, manage workload, and strengthen CHW support to reinforce their recognition and trust. Such programmatic empha- sis can focus on enhancing motivational factors found in this study to improve the CHWs’ experience in their role. The engagement of CHWs, the communities, and the formal health care system is critical to improving the care provided to the patients and communities, along with building supportive systems to recognize the work done by CHWs for the primary health care systems. more

Access to health care for people with disabilities in rural Malawi: what are the barriers?

Harrison, J.A.K.; Thomson, R.; Banda, H.T. et al. BMC Public Health (2020) CC

People with disabilities experience significant health inequalities. In Malawi, where most individuals live in low-income rural settings, many of these inequalities are exacerbated by restricted access to health care services. This qualitative study explores the barriers to health care access experi... more

Exploring equity and inclusion in Malawi’s National Disability Mainstreaming Strategy and Implementation Plan

Ebuenyi, I.D.; Smith, E.M.; Munthali, A. et al. International Journal for Equity in Health (2021) CC

Background Equity and inclusion are important principles in policy development and implementation. The aim of this study is to explore the extent to which equity and inclusion were considered in the development of Malawi’s National Disability Mainstreaming Strategy and Implementation Plan. Met... more

Effectiveness of a diabetes program based on digital health on capacity building and quality of care in type 2 diabetes: a pragmatic quasi-experimental study

Moreas Morelli, D.; Rubinstein, F.; Santero, M.; et al. BMC Health Services Research, part of Springer Nature (2023) CC2

Health systems in Latin America face many challenges in controlling the increasing burden of diabetes. Digital health interventions are a promise for the provision of care, especially in developing countries where mobile technology has a high penetration. This study evaluated the effectiveness of th... more

Asbestos-related diseases in mineworkers: a clinicopathological study

Ndlovu, N.; Rees, D.; Murray, J.; et al. ERJ Open Research, part of the European Respiratory Society (ERS) (2017) CC

This study compared clinical and autopsy findings for three asbestos-related diseases (asbestosis, mesothelioma and lung cancer) in former asbestos mineworkers, and explored factors that influenced agreement between clinical and autopsy findings using data from two compensation systems. In South Afr... more

Challenges in the diagnosis of asthma in children, what are the solutions? A scoping review of 3 countries in sub Saharan Africa

Magwenzi, P.; Rusakaniko, S.; Sibanda, E.N. et al. Respiratory Research (2022) CC

The article is a scoping review that explores the challenges in diagnosing asthma in children in three sub-Saharan African countries: Nigeria, South Africa, and Uganda. It identifies key barriers, such as a lack of community awareness, inadequate healthcare access, limited diagnostic tools like spir... more

Medical device donations: considerations for solicitation and provision. Second edition

World Health Organization WHO (2024) CC

Medical devices are used for the prevention, diagnosis and treatment of illness and diseases and for rehabilitation. WHO developed guidance on medical device donation in 2011, which has been now reviewed, with new evidence, new references on considerations for medical device solicitation and provisi... more

Task-shifting to improve asthma education for Malawian children: a qualitative analysis

Nkhalamba, L.; Rylance, S.; Muula, S. A. et al. Human Resources for Health (2021) CC

Background Asthma education, a key component of long-term asthma management, is challenging in resource-limited settings with shortages of clinical staff. Task-shifting educational roles to lay (non-clinical) staff is a potential solution. We conducted a randomised controlled trial of an enhanced a... more

A summary of the new GINA strategy: a roadmap to asthma control

Reddel, H. K.; Bateman, E. D.; Becker, A.; et al. (2015) CC2

Over the past 20 years, the Global Initiative for Asthma (GINA) has regularly published and annually updated a global strategy for asthma management and prevention that has formed the basis for many national guidelines. However, uptake of existing guidelines is poor. A major revision of the GINA r... more

Asthma morbidity in Africa: Is it time to act to achieve asthma care for all?

Thembelihle Hlophe, S.; Stolbrink, M.; Govender, K.; et al. (2023) CC2

As we approach World Asthma Day on the May 2, 2023, we reflect on the theme “ Asthma Care for All”. Prevalence of Asthma is increasing amongst children, adolescents and adults. Under-diagnosis, underutilization of inhaled corticosteroids, inaccessibility of treatment, and unaffordability of medi... more

Understanding and controlling asthma in Latin America: A review of recent research informed by the SCAALA programme

Cooper, P. J.; Figueiredo, C. A.; Rodriguez, A.; et al. (2023) CC2

Asthma is the most common chronic respiratory disease (CRD) worldwide and is estimated to affect 262 million causing significant mortality and morbidity, and has emerged as an important public health problem in many Latin American (LA) countries over the last 30 or so years. LA is a highly diverse r... more

The reality of managing asthma in sub-Saharan Africa – Priorities and strategies for improving care

Mortimer, K.; Masekela, R.; Ozoh, O.; et al. (2022) CC2

Asthma is the most common non-communicable disease in children and remains one of the most common throughout the life course. The great majority of the burden of this disease is seen in low-income and middle-income countries (LMICs), which have disproportionately high asthma-related mortality relati... more