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1
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 and 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.
more
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 diseases (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.
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The global burden of disease due to mental disorders continues to rise, especially in low- and middle-income countries (LMIC). In addition to causing a large proportion of morbidity, mental disorder
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s – especially severe mental disorders (SMD) – are linked with poorer health outcomes and increased mortality. SMD are defined as a group of conditions that include moderate to severe depression, bipolar disorder, and schizophrenia and other psychotic disorders. People with SMD have a two to three times higher average mortality compared to the general population, which translates to a 10-20 year reduction in life expectancy. While people with SMD do have higher rates of death due to unnatural causes (accidents, homicide, or suicide) than the general population, the
majority of deaths amongst people with SMD are attributable to physical health conditions, both
non-communicable and communicable.
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In the WHO South-East Asia Region, epidemiological knowledge of mental health conditions remains
a relative unknown, given the sparsity of data and information on (a) the total burden associated
with each disorder; (b) the degree of met and unmet
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needs for treatment and interventions; and
(c) the patterns and costs of treatment. This is a common situation in other regions of the world,
where the global descriptive epidemiology of the Global Burden of Disease (GBD) study is mainly
used in association with the WHO Global Health Estimates (GHE) to quantify, at the very least, the
total burden associated with mental health conditions.
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Cardiovascular diseases remain the leading cause of morbidity and mortality worldwide. There are significant differences in the burden of cardiovascular disease and associated risk factors, across h
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igh-income countries and low- and middle-income countries. Cardiac imaging by echocardiography, cardiac computed tomography, cardiac magnetic resonance imaging, single-photon emission computed tomography, and positron emission tomography myocardial perfusion imaging are well-established non-invasive tests that aid in the diagnosis, risk stratification, and management of various cardiac diseases. However, there are significant inequalities in availability and access to imaging modalities in low- and middle-income countries attributed to financial constraints, disparities in healthcare and technical infrastructure. In the post-COVID-19 pandemic era, these disparities are exaggerated by the continued technological advancements driving innovations in the field of cardiovascular (CV) imaging in high-income countries, while there is an urgent need to provide sustainable access to diagnostic imaging for patients in economically strained healthcare systems in regions like Africa. This review aims to highlight the inequalities in the burden of cardiac disease, associated risk factors, and access to diagnostic CV imaging tests, while also exploring the need for sustainable solutions to implementing CV imaging all over the world.
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Diabetes mellitus is one of the most common noncommunicable diseases worldwide. In the Eastern Mediterranean Region there has been a rapid increase in the incidence of diabetes mellitus and it is now the fourth leading cause of death. The increasing prevalence of diabetes mellitus, the emergence of
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diabetes complications as a cause of early morbidity and mortality, and the enormous and mounting burden on health care systems make diabetes a priority health concern. These guidelines provide up-to-date, reliable and balanced information for the prevention and care of diabetes mellitus in the Region. The information is evidence-based and clearly stated to facilitate the use of the guidelines in daily practice. They are intended to benefit physicians at primary, secondary and tertiary level, general practitioners, internists and family medicine specialists, clinical dieticians and nurses as well as policy-makers at ministries of health. They provide the information necessary for decision-making by health care providers and patients themselves about disease management in the most commonly encountered situations.
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Chronic obstructive pulmonary disease (COPD) represents an increasing burden throughout the world. COPD-related mortality is probably underestimated because of the difficulties associated with ident
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ifying the precise cause of death. Respiratory failure is considered the major cause of death in advanced COPD. Comorbidities such as cardiovascular disease and lung cancer are also major causes and, in mild-to-moderate COPD, are the leading causes of mortality.
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Existing data on chronic obstructive pulmonary disease (COPD) prevalence are irregularly distributed around the world, and in many geographic regions data are scarce or even nonexistent. This fact hinders the implementation of adequate preventive an
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d therapeutic interventions to reduce the high burden and costs of COPD. In the current study, we have used the Geographic Information System (GIS) inverse distance weighted (IDW) interpolation technique with the objective of visualising spatial data of COPD prevalence in the world and obtaining a visual impression of the magnitude of this global health problem. GIS has been recognised as an effective tool to display the geographical distribution of data, even when they are few and widely separated, as is the case with the prevalence of COPD.
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The infectious disease burden in India is among the highest in the world. A large amount of antibiot-ics are consumed in fighting infections, some of them saving lives, but every use adding to antib
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iotic resistance in bacteria. Antibiotic use is increasing steadily (table 1), particularly certain antibiotic classes (beta-lactam antibacterials), most notably in the more prosperous states. Resistance follows in lock-step.
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Cardiovascular diseases (CVD) represent the highest burden of disease globally. Medicines are a critical intervention used to prevent and treat CVD. This review describes access to medication for CV
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D from a health system perspective and strategies that have been used to promote access, including providing medicines at lower cost, improving medication supply, ensuring medicine quality, promoting appropriate use, and managing intellectual property issues. Using key evidence in published and gray literature and systematic reviews, we summarize advances in access to cardiovascular medicines using the 5 health system dimensions of access: availability, affordability, accessibility, acceptability, and quality of medicines. There are multiple barriers to access of CVD medicines, particularly in low- and middle-income countries. Low availability of CVD medicines has been reported in public and private healthcare facilities. When patients lack insurance and pay out of pocket to purchase medicines, medicines can be unaffordable. Accessibility and acceptability are low for medicines used in secondary prevention; increasing use is positively related to country income. Fixed-dose combinations have shown a positive effect on adherence and intermediate outcome measures such as blood pressure and cholesterol. We have a new opportunity to improve access to CVD medicines by using strategies such as efficient procurement of low-cost, quality-assured generic medicines, development of fixed-dose combination medicines, and promotion of adherence through insurance schemes that waive copayment for long-term medications. Monitoring progress at all levels, institutional, regional, national, and international, is vital to identifying gaps in access and implementing adequate policies.
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Stunting as a Risk Factor of Soil-Transmitted Helminthiasis in Children: A Literature Review
Fauziah, N.; Ar-Rizqi, M.A.; Hana, S. et al.
Interdisciplinary Perspectives on Infectious Diseases
(2022)
CC
As a high-burden neglected tropical disease, soil-transmitted helminth (STH) infections remain a major problem in the world, especially among children under five years of age. Since young children a
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re at high risk of being infected, STH infection can have a long-term negative impact on their life, including impaired growth and development. Stunting, a form of malnutrition in young children, has been long assumed as one of the risk factors in acquiring the STH infections. However, the studies on STH infection in children under five with stunting have been lacking, resulting in poor identification of the risk. Accordingly, we collected and reviewed existing related research articles to provide an overview of STH infection in a susceptible population of stunted children under five years of age in terms of prevalence and risk factors. There were 17 studies included in this review related to infection with Ascaris lumbricoides, Trichuris trichiura, hookworm, and Strongyloides stercoralis from various countries. The prevalence of STH infection in stunted children ranged from 12.5% to 56.5%. Increased inflammatory markers and intestinal microbiota dysbiosis might have increased the intensity of STH infection in stunted children that caused impairment in the immune system. While the age from 2 to 5 years along with poor hygiene and sanitation has shown to be the most common risk factors of STH infections in stunted children; currently there are no studies that show direct results of stunting as a risk factor for STH infection. While stunting itself may affect the pathogenesis of STH infection, further research on stunting as a risk factor for STH infection is encouraged.
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The WHO Global Burden of Disease (GBD) study measures the burden of
disease using the disabilit
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y-adjusted life year metric (DALY). The DALY metric
was developed to assess the burden of disease consistently across diseases,
risk factors and regions. A consistent and comparative description of the burden
of diseases and injuries and the risk factors that cause them is important as it
can inform health decision-making and health care planning.
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There is paucity of data on the burden and specific drivers operative in the pathogenesis of chronic obstructive pulmonary disease (COPD) in the African setting and populations. Lack of awareness an
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d inadequate knowledge on the aetio-pathogenesis of the disease together with inadequate capacity for COPD care contributes to preventive and management challenges. Thus, the majority of patients with COPD are misdiagnosed, misclassified and mismanaged or undertreated. With the struggling improvement in the quality of healthcare in Africa, studies conducted over the last 10 years indicates the rising trends in both the risk factors and the burden of COPD. The role of new risk factors such as indoor pollution, infections with human immunodeficiency virus (HIV) and pulmonary tuberculosis (TB), in the pathogenesis of COPD in Africa is increasingly being recognized. This literature review attempts to collect and synthesize information that could be useful in improving COPD care and informing the governments to take appropriate actions for prevention, diagnosis and management of COPD in Africa.
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WHO alcohol brief intervention training manual for primary care
World Health Organization (Europe)
(2017)
C_WHO
Alcohol contributes significantly to the disease and mortality burden in the WHO European Region, and primary health care systems play an important role in reducing the impact of harmful alcohol use
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. Screening and brief interventions (SBIs) for alcohol are an evidence-informed approach to addressing the needs of the many patients presenting in primary care who may benefit from reducing their alcohol consumption. This manual provides information to plan training and support for primary care practitioners to confidently deliver SBI for alcohol problems to their patients. The manual outlines the background and evidence base for SBI, and gives practical advice on establishing an implementation programme as well as detailed educational materials to develop the knowledge and skills of participants in organized training sessions.
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Skin prick reactivity among asthmatics in East Africa
Kwizera, R.; Wadda, V.; Mugenyi, L.; et al.
World Allergy Organization Jornal Volume 13, Issue 6100130June 2020
(2020)
CC2
The burden of asthma in Africa is high, and yet the disease is not universally prioritised. Data on allergic asthma and its impact on asthma morbidity are limited in Africa. Our aim was to describe
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the distribution of skin prick positivity among asthmatics in Eastern Africa.
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A systematic analysis for the Global Burden of Disease Study 2019. The Lancet Vol.399 Issue 10341 p.2129-2154
Human resources for health (HRH) include a range of occupations that aim to promote or
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improve human health. The UN Sustainable Development Goals (SDGs) and the WHO Health Workforce 2030 strategy have drawn attention to the importance of HRH for achieving policy priorities such as universal health coverage (UHC). Although previous research has found substantial global disparities in HRH, the absence of comparable cross-national estimates of existing workforces has hindered efforts to quantify workforce requirements to meet health system goals. We aimed to use comparable and standardised data sources to estimate HRH densities globally, and to examine the relationship between a subset of HRH cadres and UHC effective coverage performance.
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Child and adolescent mental health policy in South Africa: history, current policy development and implementation, and policy analysis
S. Mokitimi; M. Schneider; P. J. de Vries
International Journal of Mental Health Systems; BioMed Central
(2018)
CC
Mental health problems represent the greatest global burden of disease among children and adolescents. There is, however, lack of policy development and implementation for child and adolescent menta
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l health (CAMH), particularly in low- and middle-income countries (LMICs) where children and adolescents represent up to 50% of populations. South Africa, an upper-middle income country is often regarded as advanced in health and social policy-making and implementation in comparison to other LMICs. It is, however, not clear whether this is the case for CAMH.
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Rabies is a neglected zoonotic disease with a global burden of approximately 59,000 human deaths a year. Once clinical symptoms appear, rabies is almost invariably fatal; however, with timely and ap
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propriate post-exposure prophylaxis (PEP) consisting of wound washing, vaccine, and in some cases rabies immunoglobulin (RIG), the disease is almost entirely preventable. Access to PEP is limited in many countries, and when available, is often very expensive.
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The Mexico Declaration for Circulatory Health brings together global health
organizations committed to improving circulatory health and reducing deaths and disability from heart disease and stroke around the world. These diseases presently represen
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t the biggest health burden world-wide, accounting for over 17 million deaths every year. We are united around existing global strategies and targets to reduce the burden of heart disease and stroke. We are committed to achieving the World Health Organization (WHO) “25 by 25” non-communicable disease (NCD) targets, and the United Nations’ NCDrelated Sustainable Development Goals, based on known, effective and affordable
interventions for secondary prevention, primary prevention and primordial prevention in populations. As heart disease and stroke make up half of all NCD deaths, our efforts, working together as the international cardiovascular community, are central to achieving these global goals.
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Background: Asthma and chronic obstructive pulmonary disease (COPD) cause a considerable burden of morbidity
and mortality in low-income and middle-income countries (LMICs). Access to safe, effecti
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ve, quality-assured, and
affordable essential medicines is variable. We aimed to review the existing literature relating to the availability, cost,
and affordability of WHO’s essential medicines for asthma and COPD in LMICs.
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