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Background: Cardiovascular disease (CVD), mainly heart attack and stroke, is the
leading cause of premature mortality in low and middle income countries (LMICs).
Identifying ... managing individuals at high risk of CVD is an important strategy to prevent and control CVD, in addition to multisectoral population-based interventions to reduce CVD risk factors in the entire population.
Methods: We describe key public health considerations in identifying and managing individuals at high risk of CVD in LMICs.
Results: A main objective of any strategy to identify individuals at high CVD risk is to maximize the number of CVD events averted while minimizing the numbers of
individuals needing treatment. Scores estimating the total risk of CVD (e.g. ten-year risk of fatal and non-fatal CVD) are available for LMICs, and are based on the main CVD risk factors (history of CVD, age, sex, tobacco use, blood pressure, blood cholesterol and diabetes status). Opportunistic screening of CVD risk factors enables identification of persons with high CVD risk, but this strategy can be widely applied in low resource settings only if cost effective interventions are used (e.g. the WHO Package of Essential NCD interventions for primary health care in low resource settings package) and if treatment (generally for years) can be sustained, including continued availability ofaffordable medications and funding mechanisms that allow people to purchase medications without impoverishing them (e.g. universal access to health care). Thisalso emphasises the need to re-orient health systems in LMICs towards chronic diseases management.
Conclusion: The large burden of CVD in LMICs and the fact that persons with high
CVD can be identified and managed along cost-effective interventions mean that
health systems need to be structured in a way that encourages patient registration, opportunistic screening of CVD risk factors, efficient procedures for the management of chronic conditions (e.g. task sharing) and provision of affordable treatment for those with high CVD risk. The focus needs to be in primary care because that is where most of the population can access health care and because CVD programmes can be run effectively at this level.
The "Primary Healthcare Standard Treatment Guidelines and Essential Medicines List" by the South African National Department of Health provides evidence-based guidelines for diagnosing ... managing common medical conditions at the primary healthcare level. This document includes treatment protocols for various health issues, such as infections, chronic diseases, maternal and child health, mental health, and emergency care. It aims to standardize care, promote rational medicine use, and ensure equitable access to essential medications across South Africa. The guidelines emphasize prevention, accurate diagnosis, and efficient treatment strategies to improve patient outcomes.
This guidance note developed by UNICEF is intended to help WASH staff in their preparedness and response to the current COVID-19 pandemic. It provides an overview of Infection Prevention ... Control (IPC) and its intersection with water, sanitation and hygiene (WASH), and how staff can help prevent infection and its spread in schools, whether through human-to-human or by touching surfaces contaminated with the virus. WASH services, including waste management and environmental cleaning, are all important for IPC. This brief is available in English, Spanish, and French here.
Evidence-based guidelines are one of the most useful tools for improving public health and clinical practice. Their purpose is to formulate interventions based on strong evidence of efficacy, avoid unnecessary risks, use resources efficiently, reduc...
Worldwide, there are about 17 million deaths due to cardiovascular disease (CVD) each year and at least two or three times as many non-fatal events. Raised cholesterol greatly increases the risks of stroke ... heart disease, causing a large
health burden across the world. The World Health Organization has identified control of cholesterol as part of a Total Risk Approach to the prevention of CVD as a public health priority.
This is an update (third edition) of the BACPR Standards & Core Components and represents current evidence-based best practice and a pragmatic overview of the structure ... function of Cardiovascular Prevention and Rehabilitation Programmes (CPRPs) in the UK. The previously described seven standards have now been reduced to six but without sacrificing any of the key elements and with a greater emphasis placed on measurable clinical outcomes, audit and certification. Similarly, the second edition provided an overview of seven core components felt to be essential for the delivery of quality prevention and rehabilitation, and this too has been reduced to six. The interplay between cardio-protective therapies and medical risk factors is almost impossible to disentangle for the vast majority of patients and even if specific drug therapies are deployed exclusively for risk factor modulation, the indirect effect will also be cardio-protective. Thus, these have been combined into a single core component – medical risk management.
This document provides guidance on the implementation of the shielding approach in camps and camp-like settings for refugees and internally displaced persons. It is intended f...
No country can claim to be free from health-care associated infections, therefore, improvement of infection prevention and control (IPC) strategies is essential. WHO recommends the use of multimodal...
Clinical guideline, Methods, Evidence and Recommendations
In this guideline the following is covered: information needs of people with chronic hep
titis B and their carers; where children, young p...
. Interim Guidelines. This interim guideline lays out some basic principles of optimal nutritional care for adults and paediatric patients during treatment ... convalescence in Ebola treatment units, community care centres or to other centres where Ebola patients are receiving care and support. It highlights the key clinical problems in patients affected by Ebola virus disease (EVD) that may interfere with their nutritional status and overall clinical support in the context of the current Ebola crisis, and summarizes their nutritional needs. It does not provide specific advice on fluid management in cases of vomiting, diarrhoea and dehydration or parenteral nutrition
This Plan envisions a future with the elimination of cervical cancer as a public health problem as a result of universal access to sexual health and STI prevention services, HPV vaccines, effective ...
The core of the strategy is the goal for all patients to have better overall care, so that the numbers of deaths and cases of disability are reduced by 50% before 2030. For this to be achieved, four strategic aims will be pursued.
Empower ... engage communities,
Ensure safe, effective treatment,
Strengthen health systems, and
Increase partnerships, coordination and resources Strong collaboration
1PEP GUIDELINES | 2019 EDITION. The prevalence of both HIV and Hepatitis B is high in South Africa therefore there is a significant risk of acquiring these infections following exposure to infected material. Studies suggest that post- exposure proph...
The NICE guideline "Hypertension in Adults: Diagnosis and Management" outlines recommendations for diagnosing and managing hypertension in adults o...
The aims of these guidelines are to provide guidance to health-care providers (i.e. the end-users of these guidelines: physicians, nurses, pharmacists and caregivers) on the adequate relief of pain associated with cancer. They also assist policy-mak...
This guidance note is for UNICEF Regional and Country Office WASH staff to help them in their preparedness and response to the current COVID-19 global pandemic. It provides an overview of Infection ...
The Regional Action Framework for Noncommunicable Disease Prevention and Control provides a unified vision of objectives and recommended actions to...
To assess national-level responses to NCDs, WHO has implemented NCD country capacity surveys periodically since 2001. This report is the latest in that series. Since the first survey round, the NCD Country Capacity Survey (NCD CCS) has been conducted a further seven times, most recently in 2021. In ...
The "Assessing National Capacity for the Prevention and Control of Noncommunicable Diseases: Report of the 2021 Global Survey" by WHO examines the global state of readiness ... infrastructure for managing noncommunicable diseases (NCDs) across countries. Based on the 2021 survey, it analyzes national capabilities in public health infrastructure, policies, health systems, and the impact of the COVID-19 pandemic on NCD-related resources. The report highlights gaps and strengths in NCD prevention, treatment, and health policy integration, offering insights for improving NCD care worldwide. It emphasizes the need for multisectoral collaboration and targeted actions to meet global health goals.
A module from the suite of health service capacity assessments in the context of the COVID-19 pandemic, Interim Guidance 20 October 2020.
This self-assessment tool is designed for acute health-care facilities (i.e. tertiary and secondary) but can b...
