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The cardiovascular disease continuum begins with risk factors such as diabetes mellitus (DM), progresses to vasculopathy and myocardial dysfunction, and finally ends with cardiovascular death. Diabetes is associated with a 2- to 4-fold increased risk for heart failure (HF). Moreover, HF patients wit... more
Chapter 2 in "Latest Findings in Intellectual and Developmental Disabilities Research" Edited by Üner Tan, ISBN 978-953-307-865-6, 404 pages, Publisher: InTech, Chapters published February 15, 2012 under CC BY 3.0 license | Intellectual and Developmental Disabilities presents reports on a wide rang... more
Externalizing disorders Chapter D.1 Attention deficit hyperactivity disorder
The prevalence of chronic non-communicable diseases such as diabetes, cardiovascular diseases and cancers has been on the increase in Kenya in the recent past. This has been occasioned by changes in social and demogr... more
This publication was developed in response to the need for a reference list of priority medical devices required for management of noncommunicable diseases (NCDs), focusing on cardiovascular disease... more
Hypertension is referred to as a “silent killer”. Most people with hypertension are unaware of their condition as in most cases, they experience no warning signs or symptoms hence they are not identified or treated. Hypertention is associated wi... more
N Engl J Med 2019;380:2429-39.DOI: 10.1056/NEJMoa1901113
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 ... medical societies and contacted international organizations. Country-specific guidelines on care and control of stroke in any language published from 2010 to 2020 were eligible for inclusion. We reviewed each included guideline for coverage of four key components of stroke services (surveillance, prevention, acute care and rehabilitation). We also assessed compliance with the eight Institute of Medicine standards for clinical practice guidelines, the ease of implementation of guidelines and plans for dissemination to target audiences. Findings: We reviewed 108 eligible guidelines from 47 countries, including four low-income, 24 middle-income and 19 high-income countries. Globally, fewer of the guidelines covered primary stroke prevention compared with other components of care, with none recommending surveillance. Guidelines on stroke in low- and middle-income countries fell short of the required standards for guideline development; breadth of target audience; coverage of the four components of stroke services; and adaptation to socioeconomic context. Fewer low- and middle-income country guidelines demonstrated transparency than those from high-income countries. Less than a quarter of guidelines encompassed detailed implementation plans and socioeconomic considerations. Conclusion: Guidelines on stroke in low- and middle-income countries need to be developed in conjunction with a wider category of health-care providers and stakeholders, with a full spectrum of translatable, context-appropriate interventions. more
Update, 23 de junio de 2022
This publication is based on the list of clinical interventions selected from clinical guidelines on prevention, screening, diagnosis, treatment, palliative care, monitoring and end of life care. Th... more
In 2014, the World Heart Federation (WHF) launched an initiative to develop a series of Roadmaps [1e6]. Their aim is to identify potential roadblocks on the pathway to effective prevention, detection, and management ... cardiovascular disease (CVD), along with evidence-based solutions to overcome them. The resulting documents provide a framework to translate strategic intent into action on integrating epidemiology, population, and cardiovascular outcome trial data into national plans for optimal CVD management. more
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 ... more
Hypertension is the number one health related risk factor in India, with the largest contribution to burden of disease and mortality. It contributes to an estimated 1.6 million deaths, due to ischemic heart disease and stroke, out ... a total of about 10 million deaths annually in India. Fifty seven percent of deaths related to stroke and 24% of deaths related to coronary heart disease are related to hypertension. Hypertension is one of the commonest non-communicable diseases in India, with an overall prevalence of 29.8% among the adult population, and a higher prevalence in urban areas (33.8% vs. 27.6%) according to recent estimates. Awareness of hypertension in India is low while appropriate treatment and control among those with hypertension is even lower: Hypertension is a chronic, persistent, largely asymptomatic disease. A majority of the patients with hypertension in India are unaware of their condition. This is because of low levels of awareness and the lack of screening for hypertension in adults-either as a systematic programme or as an opportunistic exercise during visits to healthcare providers. more
BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m3026 (Published 11 August 2020) The BMJ "practice pointer" inlcudes a one-page visual summary of assessment and initial management of patients with p... more
Afr J Thoracic Crit Care Med 2021;27(4):Published online 22 October 2021. https://doi.org/10.7196/AJTCCM.2021.v27i4.173
Regional Network for Equity in Health in east and southern Africa (EQUINET): Disussion Paper 111
The health services delivery system in Zambia is pyramid in structure, with primary healthcare (PHC) services at community level, at the base, followed by first and second level hospitals at distric... more