scholarly journals C�te d�Ivoire Dual Burden of Disease (CoDuBu): Study Protocol to Investigate the Co-occurrence of Chronic Infections and Noncommunicable Diseases in Rural Settings of Epidemiological Transition (Preprint)

2017 ◽  
Author(s):  
Ikenna C Eze ◽  
Clémence Esse ◽  
Fidèle K Bassa ◽  
Siaka Koné ◽  
Felix Acka ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Risk Factors ◽  
Blood Pressure ◽  
Health Care ◽  
Infectious Diseases ◽  
Noncommunicable Diseases ◽  
Epidemiological Transition ◽  
Middle Income ◽  
Middle Income Countries ◽  
Dual Burden

BACKGROUND Individual-level concomitance of infectious diseases and noncommunicable diseases (NCDs) is poorly studied, despite the reality of this dual disease burden for many low- and middle-income countries (LMICs). OBJECTIVE This study protocol describes the implementation of a cohort and biobank aiming for a better understanding of interrelation of helminth and Plasmodium infections with NCD phenotypes like metabolic syndrome, hypertension, and diabetes. METHODS A baseline cross-sectional population-based survey was conducted over one year, in the Taabo health and demographic surveillance system (HDSS) in south-central Côte d’Ivoire. We randomly identified 1020 consenting participants aged ≥18 years in three communities (Taabo-Cité, Amani-Ménou, and Tokohiri) reflecting varying stages of epidemiological transition. Participants underwent health examinations consisting of NCD phenotyping (anthropometry, blood pressure, renal function, glycemia, and lipids) and infectious disease testing (infections with soil-transmitted helminths, schistosomes, and Plasmodium). Individuals identified to have elevated blood pressure, glucose, lipids, or with infections were referred to the central/national health center for diagnostic confirmation and treatment. Aliquots of urine, stool, and venous blood were stored in a biobank for future exposome/phenome research. In-person interviews on sociodemographic attributes, risk factors for infectious diseases and NCDs, medication, vaccinations, and health care were also conducted. Appropriate statistical techniques will be applied in exploring the concomitance of infectious diseases and NCDs and their determinants. Participants’ consent for follow-up contact was obtained. RESULTS Key results from this baseline study, which will be published in peer-reviewed literature, will provide information on the prevalence and co-occurrence of infectious diseases, NCDs, and their risk factors. The Taabo HDSS consists of rural and somewhat more urbanized areas, allowing for comparative studies at different levels of epidemiological transition. An HDSS setting is ideal as a basis for longitudinal studies since their sustainable field work teams hold close contact with the local population. CONCLUSIONS The collaboration between research institutions, public health organizations, health care providers, and staff from the Taabo HDSS in this study assures that the synthesized evidence will feed into health policy towards integrated infectious disease-NCD management. The preparation of health systems for the dual burden of disease is pressing in low- and middle-income countries. The established biobank will strengthen the local research capacity and offer opportunities for biomarker studies to deepen the understanding of the cross-talk between infectious diseases and NCDs. CLINICALTRIAL International Standard Randomized Controlled Trials Number (ISRCTN): 87099939; http://www.isrctn.com/ISRCTN87099939 (Archived by WebCite at http://www.webcitation.org/6uLEs1EsX)

scholarly journals The winding road to health: A systematic scoping review on the effect of geographical accessibility to health care on infectious diseases in low- and middle-income countries

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0244921
Author(s):  
Fleur Hierink ◽  
Emelda A. Okiro ◽  
Antoine Flahault ◽  
Nicolas Ray
Keyword(s):  
Infectious Disease ◽  
Health Care ◽  
Infectious Diseases ◽  
Disease Burden ◽  
Disease Risk ◽  
Surveillance Systems ◽  
Middle Income ◽  
Middle Income Countries ◽  
Geographical Accessibility ◽  
Physical Accessibility

Background Geographical accessibility to healthcare is an important component of infectious disease dynamics. Timely access to health facilities can prevent disease progression and enables disease notification through surveillance systems. The importance of accounting for physical accessibility in response to infectious diseases is increasingly recognized. Yet, there is no comprehensive review of the literature available on infectious diseases in relation to geographical accessibility to care. Therefore, we aimed at evaluating the current state of knowledge on the effect of geographical accessibility to health care on infectious diseases in low- and middle-income countries. Methods and findings A search strategy was developed and conducted on Web of Science and PubMed on 4 March 2019. New publications were checked until May 28, 2020. All publication dates were eligible. Data was charted into a tabular format and descriptive data analyses were carried out to identify geographical regions, infectious diseases, and measures of physical accessibility among other factors. Search queries in PubMed and Web of Science yielded 560 unique publications. After title and abstract screening 99 articles were read in full detail, from which 64 articles were selected, including 10 manually. Results of the included publications could be broadly categorized into three groups: (1) decreased spatial accessibility to health care was associated with a higher infectious disease burden, (2) decreased accessibility was associated to lower disease reporting, minimizing true understanding of disease distribution, and (3) the occurrence of an infectious disease outbreak negatively impacted health care accessibility in affected regions. In the majority of studies, poor geographical accessibility to health care was associated with higher disease incidence, more severe health outcomes, higher mortality, and lower disease reporting. No difference was seen between countries or infectious diseases. Conclusions Currently, policy-makers and scientists rely on data collected through passive surveillance systems, introducing uncertainty on disease estimates for remote communities. Our results highlight the need for increasing integration of geographical accessibility measures in disease risk modelling, allowing more realistic disease estimates and enhancing our understanding of true disease burden. Additionally, disease risk estimates could be used in turn to optimize the allocation of health services in the prevention and detection of infectious diseases.

scholarly journals Hypertension in Low- and Middle-Income Countries

2021 ◽  
Vol 128 (7) ◽  
pp. 808-826
Author(s):  
Aletta E. Schutte ◽  
Nikhil Srinivasapura Venkateshmurthy ◽  
Sailesh Mohan ◽  
Dorairaj Prabhakaran
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Health Care ◽  
Cost Effective ◽  
Care Staff ◽  
Health Care Staff ◽  
Significant Shift ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

In recent decades low- and middle-income countries (LMICs) have been witnessing a significant shift toward raised blood pressure; yet in LMICs, only 1 in 3 are aware of their hypertension status, and ≈8% have their blood pressure controlled. This rising burden widens the inequality gap, contributes to massive economic hardships of patients and carers, and increases costs to the health system, facing challenges such as low physician-to-patient ratios and lack of access to medicines. Established risk factors include unhealthy diet (high salt and low fruit and vegetable intake), physical inactivity, tobacco and alcohol use, and obesity. Emerging risk factors include pollution (air, water, noise, and light), urbanization, and a loss of green space. Risk factors that require further in-depth research are low birth weight and social and commercial determinants of health. Global actions include the HEARTS technical package and the push for universal health care. Promising research efforts highlight that successful interventions are feasible in LMICs. These include creation of health-promoting environments by introducing salt-reduction policies and sugar and alcohol tax; implementing cost-effective screening and simplified treatment protocols to mitigate treatment inertia; pooled procurement of low-cost single-pill combination therapy to improve adherence; increasing access to telehealth and mHealth (mobile health); and training health care staff, including community health workers, to strengthen team-based care. As the blood pressure trajectory continues creeping upward in LMICs, contextual research on effective, safe, and cost-effective interventions is urgent. New emergent risk factors require novel solutions. Lowering blood pressure in LMICs requires urgent global political and scientific priority and action.

scholarly journals Prevalence of Hyperhomocysteinaemia and Associated Factors among Ethiopian Adult Population in a 2015 National Survey

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Feyissa Challa ◽  
Tigist Getahun ◽  
Meron Sileshi ◽  
Bikila Nigassie ◽  
Zeleke Geto ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Vegetable Consumption ◽  
Adult Population ◽  
Noncommunicable Diseases ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Middle Income ◽  
Steps Survey ◽  
Associated Risk Factors

Hyperhomocysteinaemia (HHcy) is an independent risk factor for major cardiovascular diseases, but data on the prevalence and predictors of HHcy in low- and middle-income countries like Ethiopia are scant. The aim of this study was to estimate the prevalence of HHcy and associated risk factors in the Ethiopian adult population. A cross-sectional survey on risks of noncommunicable diseases (NCDs) using the STEPwise approach to surveillance (STEPS) survey was conducted between April and June 2015. A total of 4,175 study participants were surveyed. Serum homocysteine (Hcy) and metabolic profile were determined using Cobas Integra 400 Plus and CardioChek PA analyzer, respectively. Factors associated with HHcy were determined using logistic regression. The mean serum tHcy concentration was 14.6 μmol/L, with 16.4 μmol/L in males and 13.4 μmol/L in females. Overall, 38% had HHcy, with figures in males (49%) higher than females (30%). Increased age, being male, and high blood pressure and/or taking blood pressure medication, as well as low consumption of fruit and/or vegetables, were independent risk factors for HHcy. In conclusion, the prevalence of HHcy among the adult Ethiopian population is alarmingly high. Improving diets through the promotion of fruit and vegetable consumption is needed to reduce the risk of NCDs.

scholarly journals The Impact of COVID-19 on the Care of Patients With Noncommunicable Diseases in Low- and Middle-Income Countries: An Online Survey of Patient Perspectives

2021 ◽  
Vol 8 ◽  
pp. 237437352110340
Author(s):  
Ratna Devi ◽  
Felicity Goodyear-Smith ◽  
Kannan Subramaniam ◽  
Jessica McCormack ◽  
Amanda Calder ◽  
...  
Keyword(s):  
Health Care ◽  
Online Survey ◽  
Well Being ◽  
Control Measures ◽  
Noncommunicable Diseases ◽  
Middle Income ◽  
Middle Income Countries ◽  
The Impact ◽  
Mental Well Being ◽  
Low And Middle Income

We sought to gain insights into the impacts of COVID-19 and associated control measures on health and health care of patients from low- and middle-income countries with cardiovascular disease, diabetes, and mental health conditions, using an online survey during the COVID-19 pandemic. The most common concern for the 1487 patients who took part was contracting COVID-19 when they accessed health care. Of those infected with COVID-19, half said that their health had been worse since being infected. Collectively, most people reported an increase in feelings of stress and loneliness. The COVID-19 pandemic has led to a range of health care impacts on patients with noncommunicable diseases, including constraints on access to care and health effects, particularly mental well-being.

scholarly journals Price, Tax and Income Elasticity Effects on Smoking Intensities Among Urban Cigarette Smokers in Kenya: Double-Hurdle Approach

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 195s-195s
Author(s):  
P. Kipkorir
Keyword(s):  
Risk Factors ◽  
Tobacco Use ◽  
Respiratory Diseases ◽  
Income Elasticity ◽  
Noncommunicable Diseases ◽  
Cigarette Smokers ◽  
Middle Income ◽  
Chronic Respiratory Diseases ◽  
Middle Income Countries ◽  
Elasticity Effects

Background: Rationally, tobacco use is enemy number one among risk factors for noncommunicable diseases. It is a widely and broadly established cause of cancer and also responsible for cardiovascular and chronic respiratory diseases. It has been estimated that there are >1.3 billion smokers worldwide, with ∼80% residing in low- and middle-income countries. More than 10% of all deaths resulting from noncommunicable diseases including cancer, cardiovascular, chronic respiratory diseases and diabetes are related to tobacco and most of these occur in these low- and middle-income countries. In Kenya, >2.5 million of the population are adult smokers. Aim: Objectively, this abstract analyzed the price, tax and income elasticity effects on smoking intensities among the urban cigarette smokers for effective tobacco control in Kenya. Methods: The data used was sourced form the household and individual survey questionnaires from the Kenya Global Adult Tobacco Survey 2014. Double-hurdle model was used where the first part of the technique was to distinguish between the urban smokers and urban nonsmokers. The second part was to determine the smoking intensities among those who smoke and also to analyze the effect of price, tax and income elasticity on the individual consumption. Results: The study revealed that price of cigarette had a reducing (β = −2.2343) and very significant ( P < 0.001) elastic effect on smoking intensities among urban smokers while disposable income had a significant ( P < 0.010) but positive (β = −0.0366) inelastic effect on smoking levels of the urban cigarette smokers. Particularly, tax on cigarette has also been depicted to have a significant ( P < 0.001) yet positive and elastic (β = 1.7044) effect on smoking intensities on the urban cigarette smokers. Time spent in education has a significant ( P < 0.001) and negative (β = −3.2240) elastic effect on the smoking intensities of urban smokers. Notably, those who are married (β = −0.6320, P < 0.001) and employed (β = −0.5498, P < 0.010) have significant and negative though inelastic effect on their smoking intensities as compared with the unmarried and unemployed. Conclusion: Summarily, this implies that urban smokers have more income where the proportion spent on smoking is very small. Also, since tax is a function of income, it thus calls for the need to increase the rate of excise tax on cigarette so as to discourage consumption of cigarettes among the urban smokers and thus ultimately realizing and sustaining the health policy goals of reducing and averting the cancer risk factors. Furthermore, continuous use of cost-effective sensitization methods to create awareness and educate people on economic, social and health effects and impacts of tobacco use.

scholarly journals Noncommunicable Diseases Prevention In Low- and Middle-Income Countries: An Overview of Health in All Policies (HiAP)

2021 ◽  
Vol 58 ◽  
pp. 004695802092788
Author(s):  
Nweke Ebele Ndubuisi
Keyword(s):  
Risk Factors ◽  
Physical Inactivity ◽  
Health Sector ◽  
Noncommunicable Disease ◽  
Noncommunicable Diseases ◽  
Middle Income ◽  
Middle Income Countries ◽  
Unhealthy Diet ◽  
Tobacco Usage ◽  
Low And Middle Income

Noncommunicable disease (NCD) causes about 35 million deaths and accounts for 60% of all deaths, of which 80% is in low- and middle-income countries (LMIC). NCDs will account for 80% of the global burden of disease by 2020 and account for 7 out of every 10 deaths in LMIC. NCD is no longer an emerging problem in developing countries, it’s assuming an alarming dimension, and taking on the proportion of an epidemic. Several literatures document the known risk factors for significant NCDs. The critical risk factors are tobacco usage, unhealthy diet, physical inactivity, and detrimental usage of alcohol. To reverse the trend that leads to an increase in poor dietary patterns, sedentary lifestyle, tobacco use, and harmful alcohol use will need policies that transcend the health sector and policy change in different areas such as finance, urban planning, education, agriculture, and transportation.

scholarly journals Noncommunicable diseases prevention in low- and middle-income countries: an overview of Health in All Policies (HiAP)

2019 ◽  
Author(s):  
Ndubuisi Ebele
Keyword(s):  
Risk Factors ◽  
Tobacco Use ◽  
Current Trend ◽  
Health Sector ◽  
Noncommunicable Diseases ◽  
Middle Income ◽  
Middle Income Countries ◽  
Harmful Use ◽  
Unhealthy Diet ◽  
Low And Middle Income

NCD causes an estimated 35 million deaths annually and accounts for 60% of all deaths globally, of which 80% is in low-and-middle-income countries (LMIC). NCDs will account for 80% of the global burden of disease by 2020. And will be responsible for seven out of every ten deaths in LMIC, more than double the current trend today. NCD is no longer an emerging problem in developing countries, it is assuming an alarming dimension, and it's taking on the proportion of an epidemic. The known risk factors for significant NCDs are well documented. The critical risk factors are tobacco use, unhealthy diet, physical inactivity, and harmful use of alcohol. To reverse the current trend that leads to an increase in poor dietary pattern, sedentary lifestyle, tobacco use, and harmful alcohol use- will require policies that transcend the health sector and policy change in different areas such as finance, urban planning, education, agriculture, and transportation.

scholarly journals "Big" Food, Tobacco, and Alcohol: Reducing Industry Influence on Noncommunicable Disease Prevention Laws and Policies Comment on "Addressing NCDs: Challenges From Industry Market Promotion and Interferences"

2019 ◽  
Vol 8 (7) ◽  
pp. 450-454 ◽  
Author(s):  
Belinda Reeve ◽  
Lawrence O. Gostin
Keyword(s):  
Risk Factors ◽  
Conflicts Of Interest ◽  
Noncommunicable Disease ◽  
Noncommunicable Diseases ◽  
Unhealthy Food ◽  
Middle Income ◽  
Middle Income Countries ◽  
Growing Body ◽  
Laws And Policies ◽  
Market Promotion

The food, tobacco and alcohol industries have penetrated markets in low- and middle-income countries (LMICs), with a significant impact on these countries’ burden of noncommunicable diseases (NCDs). Tangcharoensathien and colleagues describe the aggressive marketing of unhealthy food, alcohol and tobacco in LMICs, as well as key tactics used by these industries to resist laws and policies designed to reduce behavioural risk factors for NCDs. This commentary expands on the recommendations made by Tangcharoensathien and colleagues for preventing or managing conflicts of interest and reducing undue industry influence on NCD prevention policies and laws, focusing on the needs of LMICs. A growing body of research proposes ways to design voluntary industry initiatives to make them more effective, transparent and accountable, but governments should also consider whether collaboration with health-harming industries is ever appropriate. More fundamentally, mechanisms for identifying, managing and mitigating conflicts of interest and reducing industry influence must be woven into – and supported by – broader governance and regulatory structures at both national and international levels.

scholarly journals Noncommunicable diseases prevention in low- and middle-income countries: an overview of Health in All Policies (HiAP)

2019 ◽  
Author(s):  
Ndubuisi Ebele
Keyword(s):  
Risk Factors ◽  
Tobacco Use ◽  
Current Trend ◽  
Health Sector ◽  
Noncommunicable Diseases ◽  
Middle Income ◽  
Middle Income Countries ◽  
Harmful Use ◽  
Unhealthy Diet ◽  
Low And Middle Income

NCD causes an estimated 35 million deaths annually and accounts for 60% of all deaths globally, of which 80% is in low-and-middle-income countries (LMIC). NCDs will account for 80% of the global burden of disease by 2020. And will be responsible for seven out of every ten deaths in LMIC, more than double the current trend today. NCD is no longer an emerging problem in developing countries, it is assuming an alarming dimension, and it's taking on the proportion of an epidemic. The known risk factors for significant NCDs are well documented. The critical risk factors are tobacco use, unhealthy diet, physical inactivity, and harmful use of alcohol. To reverse the current trend that leads to an increase in poor dietary pattern, sedentary lifestyle, tobacco use, and harmful alcohol use- will require policies that transcend the health sector and policy change in different areas such as finance, urban planning, education, agriculture, and transportation.

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