Noncommunicable Diseases Research Papers - Academia.edu (original) (raw)

BACKGROUND Timely initiating antenatal care (ANC) is crucial in the countries that have high maternal morbidity and mortality. However, in developing countries including Ethiopia, pregnant mother's time to initiate antenatal care was not well-studied. Therefore, this study aimed to assess time to first ANC and its predictors among pregnant women in Ethiopia. METHODS A community-based cross-sectional study was conducted among 7,543 pregnant women in Ethiopia using the Ethiopian Demographic Health Survey (EDHS), 2016 data. A two-stage stratified cluster sampling was employed. The Kaplan-Meier (KM) method was used to estimate time to first antenatal care visit. Cox-gamma shared frailty model was applied to determine predictors. Adjusted Hazard Ratio (AHR) with 95% confidence interval was reported as the effect size. Model adequacy was assessed by using the Cox-Snell residual plot. Statistical significance was considered at p value <0.05. For data management and analysis Stata 14...

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- Health Sciences, Infectious disease epidemiology, Medicine, Multidisciplinary

The prevalence of non-communicable diseases (NCDs) is rising in low- and middle-income countries, including Kenya, disproportionately to the rest of the world. Our objective was to quantify patient payments to obtain NCD screening, diagnosis, and treatment services in the public and private sector in Kenya and evaluate patients' ability to pay for the services. We collected payment data on cardiovascular diseases, diabetes, breast and cervical cancer, and respiratory diseases from Kenyatta National Hospital, the main tertiary public hospital, and the Kibera South Health Center-a public outpatient facility, and private sector practitioners and hospitals. We developed detailed treatment frameworks for each NCD and used an itemization cost approach to estimate payments. Patient affordability metrics were derived from Kenyan government surveys and national datasets. Results compare public and private costs in U.S. dollars. NCD screening costs ranged from 4to4 to 4to36, while diagnostic ...

- by Gerald Yonga
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- Public sector, Kenya, Multidisciplinary, Humans

This paper is aimed at critically assessing the extent to which Non-Communicable Disease NCD-related policies introduced in Bangladesh align with the World Health Organization's (WHO) 2013-2020 Action Plan for the Global Strategy for the Prevention and Control of NCDs. The authors reviewed all relevant policy documents introduced by the Government of Bangladesh since its independence in 1971. The literature review targeted scientific and grey literature documents involving internet-based search, and expert consultation and snowballing to identify relevant policy documents. Information was extracted from the documents using a specific matrix, mapping each document against the six objectives of the WHO 2013-2020 Action Plan for the Global Strategy for the Prevention and Control of NCDs. A total of 51 documents were identified. Seven (14%) were research and/or surveys, nine were on established policies (17%), while seventeen (33%) were on action programmes. Five (10%) were related ...

- by Anwar Islam
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- Health Planning, Health Policy, Bangladesh, Policy making

This essay investigates social determinants of health, specifically looking at non-communicable diseases, and argues that structural interventions in the economy and society are necessary to reduce the prevalence of non-communicable diseases (NCDs). Sociologists study health demographics because patterns of health change across classes, cultures, genders and countries. Disease does not have solely biological causes, but is also determined by factors such as the socio-cultural environment, economic status, living and working conditions and government legislation. Many NCDs, defined as diseases which cannot be passed from person to person, have such characteristics. Cardiovascular diseases, chronic respiratory diseases, cancers and diabetes are the four most prevalent NCDs, and the four biggest risk factors are alcohol use, tobacco use, unhealthy diets and a less active lifestyle. When looking at the causes of NCDs, this essay argues that people engage in unhealthy activities not because they lack the willpower to abstain, but because they are placed in a social and economic construct which constrains the choices that they are able to make, encourages unhealthy behaviour and prevents them from disengaging from those activities. Governmental and civil society organisations are therefore placed with the responsibility to intervene.

- by Aidan J Horn
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- Sociology, Health Promotion, Health Policy, Noncommunicable Diseases
- by Gamze Aktuna
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- Public Health, Noncommunicable Diseases, Halk Sağlığı

A b s t r a c t Obesity is the accumulation of abnormal or excessive fat that may interfere with the maintenance of an optimal state of health. The excess of macronu-trients in the adipose tissues stimulates them to release inflammatory mediators such as tumor necrosis factor α and interleukin 6, and reduces production of adiponectin, predisposing to a pro-inflammatory state and oxidative stress. The increased level of interleukin 6 stimulates the liver to synthesize and secrete C-reactive protein. As a risk factor, inflammation is an imbedded mechanism of developed cardiovascular diseases including coagulation, ath-erosclerosis, metabolic syndrome, insulin resistance, and diabetes mellitus. It is also associated with development of non-cardiovascular diseases such as psoriasis, depression, cancer, and renal diseases. On the other hand, a reduced level of adiponectin, a significant predictor of cardiovascular mortality, is associated with impaired fasting glucose, leading to type-2 diabetes development , metabolic abnormalities, coronary artery calcification, and stroke. Finally, managing obesity can help reduce the risks of cardiovascular diseases and poor outcome via inhibiting inflammatory mechanisms.

- by Yehia Abed and +1
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- Epidemiology, Nutrition, Noncommunicable Diseases

Full author list: Reeve Kako, Po-Hao Hsu, Adrienne Kinman, Julia Mcgarry, Marina Djurdjevic, Emily Xing, Vanessa Skubic, Vivian Wang, Yann Ilboudo, Rachel Chan, Jahanara Rajwani and Marieme Dembele

- by Adrienne Kinman
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- Public Health, World Health Organization, Noncommunicable Diseases

Background: In Nepal, the burden of noncommunicable, chronic diseases is rapidly rising, and disproportionately affecting low and middle-income countries. Integrated interventions are essential in strengthening primary care systems and addressing the burden of multiple comorbidities. A growing body of literature supports the involvement of frontline providers, namely mid-level practitioners and community health workers, in chronic care management. Important operational questions remain, however, around the digital, training, and supervisory structures to support the implementation of effective, affordable, and equitable chronic care management programs.

- by David Citrin and +3
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- Global Health, Implementation Science, Decision Support Systems, Nepal
- by Azizallah Dehghan
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- Preventive medicine, Noncommunicable Diseases

Elderly people suffer from different morbidities as the increase in prevalence of disease is proportionate to increasing age. In Bangladesh, the number of the elderly person is increasing with time. This study aims to determine the morbidity pattern and health seeking behavior among the urban senior citizens of Bangladesh. A cross-sectional study was carried out from January 2014 to December 2014 in different areas of Dhaka City. Information was collected from 384 respondents, aged 60 years and above by purposive sampling technique. The mean age of the study population was 64.7 (SD±5.7) years and majority (74.74%) belonged to 60-69 years age group. More than half (52.6%) of the respondents were female. Most of the respondents (71.61%) received institutional education; 51.82% of the elderly were still working; 63% of the respondents were totally independent; 11.74% were totally dependent; and 53.65% respondents belonged to joint family. Most of the respondents (96.8%) were suffering from at least one medical problem; the commonest was musculoskeletal problems (84.11%) followed by eye problems (81.25%). Majority of male (78.8%) and females (89.60%) were suffering from eye problems and musculoskeletal problems respectively. All the respondents sought treatment for their health problems. Majority (33%) respondents went to government hospitals for medical help. Most of the male (68.70%) and female (71.26%) can do their daily physical activities without any problem. Approximately 30% respondents did health checkup once in one year. Majority respondents took prescribed medications (69.27%) and were satisfied with their treatment (56.77%). The study findings showed that urban geriatric population had one or more morbidities and their health seeking behavior was poor, more among females. The study concludes with further emphasis of primary health care for the urban elderly people of Bangladesh. The health care service should be accessible and affordable to the elderly people.

AbstrAct Objective The first is to estimate the prevalence of dyslipidaemia (hypercholesterolaemia, hypertriglyceridaemia, high low-density lipoprotein (LDL) level and low high-density lipoprotein (HDL) level), as well as the mean levels of total cholesterol, triglyceride, LDL and HDL, in the urban and rural Yangon Region, Myanmar. The second is to investigate the association between urban-rural location and total cholesterol. Design Two cross-sectional studies using the WHO STEPS methodology. setting Both the urban and rural areas of the Yangon Region, Myanmar. Participants A total of 1370 men and women aged 25–74 years participated based on a multistage cluster sampling. Physically and mentally ill people, monks, nuns, soldiers and institutionalised people were excluded. results Compared with rural counterparts, urban dwellers had a significantly higher age-standardised prevalence of hypercholesterolaemia (50.7% vs 41.6%; p=0.042) and a low HDL level (60.6% vs 44.4%; p=0.001). No urban-rural differences were found in the prevalence of hypertriglyceridaemia and high LDL. Men had a higher age-standardised prevalence of hypertriglyceridaemia than women (25.1% vs 14.8%; p<0.001), while the opposite pattern was found in the prevalence of a high LDL (11.3% vs 16.3%; p=0.018) and low HDL level (35.3% vs 70.1%; p<0.001). Compared with rural inhabitants, urban dwellers had higher age-standardised mean levels of total cholesterol (5.31 mmol/L, SE: 0.044 vs 5.05 mmol/L, 0.068; p=0.009), triglyceride (1.65 mmol/L, 0.049 vs 1.38 mmol/L, 0.078; p=0.017), LDL (3.44 mmol/L, 0.019 vs 3.16 mmol/L, 0.058; p=0.001) and lower age-standardised mean levels of HDL (1.11 mmol/L, 0.010 vs 1.25 mmol/L, 0.012; p<0.001). In linear regression, the total cholesterol was significantly associated with an urban location among men, but not among women. conclusion The mean level of total cholesterol and the prevalence of hypercholesterolaemia were alarmingly high in men and women in both the urban and rural areas of Yangon Region, Myanmar. Preventive measures to reduce cholesterol levels in the population are therefore needed.

Hypertension (HTN) and Type 2 diabetes (T2D) are lifestyle interrelated diseases of global significance. Interestingly, the prevalence of these diseases in Africa and indeed Nigeria seems to be on the increase. This study, therefore, investigated the socioeconomic status (based on income, education and occupational activity) of 400 subjects (52% female and 48% male) aged 20 years and above who were sampled randomly among the newly diagnosed HTN and/or T2D cases at the Ahmadu Bello University Teaching Hospital, Zaria, NorthWest Nigeria. A semi-structured questionnaire was used to collect information from the subjects. From the result obtained, most of the respondents who live in towns or city suffer from either HTN or T2D while more town dwellers (28%) suffer from a combination of both diseases. It was also discovered that most respondents who suffer from HTN and from a combination of HTN and T2D belong to the old generation (60-79 years). There is higher prevalence rate of diabetes among the respondents who had no formal education or attended only basic Arabic schools. Most respondents who earn good income (₦50,000-₦100,000 and above ₦100,000) suffer HTN, T2D and a combination of both diseases. Those engaged in heavy occupational activities had the lowest prevalence of the disease compared with those of light or moderate occupational activities. These data will be found useful in planning intervention healthcare preventive programs especially on public enlightenment workshops and seminars to educate the populace on the importance of lifestyle modification, healthy diet and regular exercises.

- by S.I.R. Okoduwa
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- Diabetes, Socio-Economic Status, Hypertension, Noncommunicable Diseases

IMPORTANCE Cancer and other noncommunicable diseases (NCDs) are now widely
recognized as a threat to global development. The latest United Nations high-level meeting
on NCDs reaffirmed this observation and also highlighted the slow progress in meeting the
2011 Political Declaration on the Prevention and Control of Noncommunicable Diseases and
the third Sustainable Development Goal. Lack of situational analyses, priority setting, and
budgeting have been identified as major obstacles in achieving these goals. All of these have
in common that they require information on the local cancer epidemiology. The Global
Burden of Disease (GBD) study is uniquely poised to provide these crucial data.
OBJECTIVE To describe cancer burden for 29 cancer groups in 195 countries from 1990
through 2017 to provide data needed for cancer control planning.
EVIDENCE REVIEW We used the GBD study estimation methods to describe cancer incidence,
mortality, years lived with disability, years of life lost, and disability-adjusted life-years
(DALYs). Results are presented at the national level as well as by Socio-demographic Index
(SDI), a composite indicator of income, educational attainment, and total fertility rate.We
also analyzed the influence of the epidemiological vs the demographic transition on cancer
incidence.
FINDINGS In 2017, there were 24.5 million incident cancer cases worldwide (16.8 million
without nonmelanoma skin cancer [NMSC]) and 9.6 million cancer deaths. The majority of
cancer DALYs came from years of life lost (97%), and only 3%came from years lived with
disability. The odds of developing cancer were the lowest in the low SDI quintile (1 in 7) and
the highest in the high SDI quintile (1 in 2) for both sexes. In 2017, the most common incident
cancers in men were NMSC (4.3 million incident cases); tracheal, bronchus, and lung (TBL)
cancer (1.5 million incident cases); and prostate cancer (1.3 million incident cases). The most
common causes of cancer deaths and DALYs for men were TBL cancer (1.3 million deaths and
28.4 million DALYs), liver cancer (572 000 deaths and 15.2 million DALYs), and stomach
cancer (542 000 deaths and 12.2 million DALYs). For women in 2017, the most common
incident cancers were NMSC (3.3 million incident cases), breast cancer (1.9 million incident
cases), and colorectal cancer (819 000 incident cases). The leading causes of cancer deaths
and DALYs for women were breast cancer (601 000 deaths and 17.4 million DALYs), TBL
cancer (596 000 deaths and 12.6 million DALYs), and colorectal cancer (414 000 deaths
and 8.3 million DALYs).
CONCLUSIONS AND RELEVANCE The national epidemiological profiles of cancer burden in the
GBD study show large heterogeneities, which are a reflection of different exposures to risk
factors, economic settings, lifestyles, and access to care and screening. The GBD study can be
used by policy makers and other stakeholders to develop and improve national and local
cancer control in order to achieve the global targets and improve equity in cancer care.

- by Adnan Kisa
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- Epistemology, Poverty, Global Health, Cancer

- by Rina Swart
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- Business, Food Science, Public Health Policy, Food and Nutrition

This paper considers challenges for Australia's role in effectively implementing global non-communicable disease (NCD) strategy, and its influence on NCD related strategy in the Asia-Pacific region. It explores the relationship between 1) Australian foreign policy and health policies related to NCDs and 2) Australian government positions taken in health and trade fora associated with NCDs. Research included a review of Australian health, diplomacy and development policies as they relate to NCDs; interviews (n=18) with participants from governments, international organisations, academics and civil society actors working across health and trade; discussions with key informants (n=7); a review of policy on NCDs in Asia-Pacific forums; and observations at the 68 th World Health Assembly. Australia played a key global health diplomacy role on tobacco control measures and has engaged in capacity building on trade and health issues, however there was policy incoherence in other areas. Positions taken in trade policy fora conflicted with commitment to global NCD strategy, and aligned with Australia's trade interests. There was a lack of bipartisanship support for NCD prevention efforts within Australia. Policy networks on trade/health and NCDs were also fragmented. There is greater scope for 1 This paper is based on the conference presentation 'Battams, S. The impact of neoliberalism on Australia's rollout of global non-communicable disease strategy nationally and health diplomacy role for the Asia-Pacific region, The Australian Sociological Association conference – Neoliberalism and Contemporary Challenges for the Asia-Pacific, Cairns, Australia. It is based upon sabbatical research supported by Torrens University Australia. Suggested reference: Battams, S. (2017). Challenges for Australia's role in effectively implementing global non-communicable disease (NCD) strategy, unpublished research paper. 2 Contact details: sam.battams@flinders.edu.au capacity building and mobilisation on NCDs in Australia and the Asia-Pacific region and much to be learnt from the tobacco control area where there is greater policy coherence, political commitment and bipartisanship support. Results are discussed in terms of key challenges for NCD strategy and the 'multiple streams' approach to policy agenda setting.

Chronic diseases contribute a large share of disease burden in low- and middle-income countries (LMICs). Chronic diseases have a tendency to occur simultaneously and where there are two or more such conditions, this is termed as ‘multimorbidity’. Multimorbidity is associated with adverse health outcomes, but
limited research has been undertaken in LMICs. Therefore, this study examines the prevalence and correlates of multimorbidity as well as the associations between multimorbidity and self-rated health, activities of daily living (ADLs), quality of life, and depression across six LMICs.
Data was obtained from the WHO’s Study on global AGEing and adult health (SAGE) Wave-1 (2007/10). This was a cross-sectional population based survey performed in LMICs, namely China, Ghana, India, Mexico, Russia, and South Africa, including 42,236 adults aged 18 years and older. Multimorbidity was measured as the simultaneous presence of two or more of eight chronic conditions including angina pectoris, arthritis, asthma, chronic lung disease, diabetes mellitus, hypertension, stroke, and vision impairment. Associations with four health outcomes were examined, namely ADL limitation, self-rated health, depression, and a quality of life index. Random-intercept multilevel regression models were used on pooled data from the six countries.
The prevalence of morbidity and multimorbidity was 54.2 % and 21.9 %, respectively, in the pooled sample of six countries. Russia had the highest prevalence of multimorbidity (34.7 %) whereas China had the lowest (20.3 %). The likelihood of multimorbidity was higher in older age groups and was lower in those with higher socioeconomic status. In the pooled sample, the prevalence of 1+ ADL limitation was 14 %, depression 5.7 %, self-rated poor health 11.6 %, and mean quality of life score was 54.4. Substantial cross-country variations were seen in the four health outcome measures. The prevalence of 1+ ADL limitation, poor self-rated health, and depression increased whereas quality of life declined markedly with an increase in number of diseases.
Findings highlight the challenge of multimorbidity in LMICs, particularly among the lower socioeconomic groups, and the pressing need for reorientation of health care resources considering the distribution of multimorbidity and its adverse effect on health outcomes.

- by Richard Biritwum and +1
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- Epidemiology, Global Health, Public Health Policy, Public Health

On June 11 and June 12, 2019, the National Academies convened a workshop to explore the growing understanding of how the interplay between humans and microbes affects host physiology and causes noncommunicable diseases. Discussions included an overview of colliding epidemics, emerging research on associations between infectious and noncommunicable diseases, risks posed by chronic diseases to the development and severity of infectious diseases, and the influence of the microbiome. Workshop participants also examined the challenges and opportunities of convergence, the integration of health care delivery models and interventions, potential approaches for research, policy, and practice in the immediate-term, and potential directions for the long-term. This publication summarizes the presentations and discussions from the workshop.

- by Anna Nicholson
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- Infectious Diseases, Noncommunicable Diseases

Non-communicable diseases (NCDs) are the leading cause of death globally and they are on the rise both in low- and middle-income countries, with South Africa being no exception. Implicated in this upward trend in the country is an observed change in diet – a transition from traditional foods, to what has come to be known as the ‘western’ diet, i.e. more energy-dense, processed foods, more foods of animal origin, and more added sugar, salt and fat. Increasingly, international research links rapidly changing food environment with escalating chronic disease, i.e. it implicates population-level dietary change over individual factors such as knowledge, attitudes and behaviours. Environmental and/or policy interventions can be some of the most effective strategies for creating healthier food environments.
This chapter explores the link between the rise in diet-related NCDs, their proximal determinants (specifically an observed change in diet patterns), contributing environmental factors, what is currently being done or recommended to address this internationally, and the most relevant national-level policies for South Africa.
The authors conclude that to improve dietary patterns and reduce chronic diseases in South Africa will require a sustained public health effort that addresses environmental factors and the conditions in which people live and make choices. Overall, positive policies have been made at national level; however, many initiatives have suffered from a lack of concerted action. Key actions will be to reduce the intake of unhealthy foods and make healthy foods more available, affordable and acceptable in South Africa.

- by Peter Delobelle
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- Food Science, Food and Nutrition, Public Health, South Africa
- by Mihai Gafencu
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- Geography, Demography, Medicine, BMI

Advances in Clustered Regularly Interspaced Short Palindromic Repeats/CRISPR associated system (CRISPR/Cas9) has dramatically reshaped our ability to edit genomes. The scientific community is using CRISPR/Cas9 for various biotechnological and medical purposes. One of its most important uses is developing potential therapeutic strategies against diseases. CRISPR/Cas9 based approaches have been increasingly applied to the treatment of human diseases like cancer, genetic, immunological and neurological disorders and viral diseases. These strategies using CRISPR/Cas9 are not only therapy oriented but can also be used for disease modeling as well, which in turn can lead to the improved understanding of mechanisms of various infectious and genetic diseases. In addition, CRISPR/Cas9 system can also be used as programmable antibiotics to kill the bacteria sequence specifically and therefore can bypass multidrug resistance. Furthermore, CRISPR/Cas9 based gene drive may also hold the potentia...

- by Hassan Zafar
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- Biological Sciences, Humans, Biomedical science, Noncommunicable Diseases
- by Molla Mesele Wassie
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- Global Health, Communicable Diseases, Adolescent, Pregnancy
- by Kyaw Mya
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- Diet, Linear models, Myanmar, Humans
- by Srinivasan Kannan
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- Geography, Demography, Medicine, BMI

Since after World War II, the world has been grappling with the grumbling rising prevalence and economic burden of non-communicable diseases (NCDs). The rise of these chronic diseases has reached an epidemic proportion and a melting point in many communities of the world. This has been made worse by the recent COVID-19 pandemic. While the world is still battling this debilitating reality, a more gruesome scenario is evolving in low-income and Middle-Income Countries (LMICs). Although these countries account for the highest poverty index in the world, they also account for a disproportionately higher burden of NCDs. More than 80% of NCD-related deaths are presently recorded among the LMICs. Ironically, although most sub-Saharan Africa (SSA) countries can be categorized as LMICs, yet communicable diseases (CDs) still constitute the highest disease burden in this region. However, based on global projections, SSA may soon lose this 'advantage' and may become the region with the highest burden of NCDs by the year 2030. If the present trajectory is left unshattered, the resulting heavy double burden of CDs and NCDs will likely crumble the already fragile economy of most SSA countries and tilt the region into an unprecedented recession. A critical review of the present disease-centered healthcare management approach and adoption of a more evidence-based health promotion-centered management approach may be vital in salvaging the situation. This article briefly reviewed the global epidemiologic transition, compared the disease-and health promotion-centered healthcare models, and made a case for a change in health management strategy in SSA.

Cancer is the second leading cause of death worldwide. Current estimates on the burden of cancer are needed for cancer control planning. To estimate mortality, incidence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs) for 32 cancers in 195 countries and territories from 1990 to 2015. Cancer mortality was estimated using vital registration system data, cancer registry incidence data (transformed to mortality estimates using separately estimated mortality to incidence [MI] ratios), and verbal autopsy data. Cancer incidence was calculated by dividing mortality estimates through the modeled MI ratios. To calculate cancer prevalence, MI ratios were used to model survival. To calculate YLDs, prevalence estimates were multiplied by disability weights. The YLLs were estimated by multiplying age-specific cancer deaths by the reference life expectancy. DALYs were estimated as the sum of YLDs and YLLs. A sociodemographic index (SDI) wa...

- by Gulfaraz Khan
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- Neuroscience, Epistemology, Global Health, Cancer

Background: Cardiovascular disease (CVD) is mainly attributable to a combination of risk factors (RFs): tobacco use, alcohol use, high blood pressure, diabetes, unhealthy diet, and obesity which are amenable to interventions. Building construction workers are poor and vulnerable. They are also the victims of adverse working environmental conditions and subjected to health hazards of occupational origin. Objective: The aim was to study the RFs and associated sociodemographics for CVD among construction site workers. Materials and Methods: This cross-sectional study was conducted among construction site workers. A total of 172 male workers over the age of 18 years were included in the study. Modified World Health Organization Step-wise approach to chronic disease RF surveillance was used to collect data. The data were analyzed in SPSS version 17 and the Chi-square test was applied to analyze the qualitative data. Results: At least one RF for CVD was present in all the subjects, with majority (93.6%) of them having at least two RFs. The presence of the RFs (moderate to high, 3–11) was found to be significantly associated with lower income group, unskilled workers, migration year <1, alcoholics, personal tobacco use, family history of tobacco use, and the low knowledge score regarding tobacco use (0–2). Conclusions: Community-based comprehensive behavioral and life style communication package should be established for workers to reduce the modifiable RFs of CVD.

- by Zakirhusain Shaikh
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- Cardiology, Cancer, Tobacco, Migrant workers

Noncommunicable diseases (NCDs) impose a growing burden on the health, economy, and development of South Africa. According to the World Health Organization, four risk factors, tobacco use, alcohol consumption, unhealthy diets, and physical inactivity, account for a significant proportion of major NCDs. We analyze the role of tobacco, alcohol, and food corporations in promoting NCD risk and unhealthy lifestyles in South Africa and in exacerbating inequities in NCD distribution among populations. Through their business practices such as product design, marketing, retail distribution, and pricing and their business practices such as lobbying, public relations, philanthropy, and sponsored research, national and transnational corporations in South Africa shape the social and physical environments that structure opportunities for NCD risk behavior. Since the election of a democratic government in 1994, the South African government and civil society groups have used regulation, public education, health services, and community mobilization to modify corporate practices that increase NCD risk. By expanding the practice of health education to include activities that seek to modify the practices of corporations as well as individuals, South Africa can reduce the growing burden of NCDs.

- by Peter Delobelle
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- Public Health Policy, Public Health, Tobacco control policy, South Africa

Hypertension is a leading attributable risk factor for mortality in South Asia. However, a systematic review on prevalence and risk factors for hypertension in the region of the South Asian Association for Regional Cooperation (SAARC) has not carried out before.The study was conducted according to the Meta-Analysis of Observational Studies in Epidemiology Guideline. A literature search was performed with a combination of medical subject headings terms, "hypertension" and "Epidemiology/EP". The search was supplemented by cross-references. Thirty-three publications that met the inclusion criteria were included in the synthesis and meta-analyses. Hypertension is defined when an individual had a systolic blood pressure (SBP) ≥140 mm Hg and/or diastolic blood pressure (DBP) ≥90 mm Hg, was taking antihypertensive drugs, or had previously been diagnosed as hypertensive by health care professionals. Prehypertension is defined as SBP 120-139 mm Hg and DBP 80-89 mm Hg.The overall prevalence of hypertension and prehypertension from the studies was found to be 27% and 29.6%, respectively. Hypertension varied between the studies, which ranged from 13.6% to 47.9% and was found to be higher in the studies conducted in urban areas than in rural areas. The prevalence of hypertension from the latest studies was: Bangladesh: 17.9%; Bhutan: 23.9%; India: 31.4%; Maldives: 31.5%; Nepal: 33.8%; Pakistan: 25%; and Sri Lanka: 20.9%. Eight out of 19 studies with information about prevalence of hypertension in both sexes showed that the prevalence was higher among women than men. Meta-analyses showed that sex (men: odds ratio [OR] 1.19; 95% confidence interval [CI]: 1.02, 1.37), obesity (OR 2.33; 95% CI: 1.87, 2.78), and central obesity (OR 2.16; 95% CI: 1.37, 2.95) were associated with hypertension.Our study found a variable prevalence of hypertension across SAARC countries, with a number of countries with blood pressure above the global average. We also noted that studies are not consistent in their data collection about hypertension and related modifiable risk factors.

- by Dinesh Neupane and +3
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- South Asian Studies, Public Health, Nepal, Hypertension

Objective: To estimate the prevalence of clustering of behavioral risk factors for chronic noncommunicable diseases, as well as the associated factors in climacteric women. Methods: This is a cross-sectional, analytical study, with random selection of climacteric women, aged between 40 and 65 years, and registered in Family Health Strategy units. The dependent variable was clustering of three or more behavioral risk factors for chronic non-communicable diseases. The definition of associated variables was made after Poisson multiple regression analysis with robust variance. Results: We evaluated 810 women, and 259 (32.0%) had a clustering of risk factors. The main risk behaviors were physical inactivity and low fruit consumption. The variables associated with clustering of behavioral factors were age group 52-65-years, marital status without a partner, overweight/obesity, moderate to severe anxiety and depression symptoms. Conclusion: There was a considerable prevalence of women with three or more behavioral risk factors for chronic non-communicable diseases. Demographic variables and those related to health conditions were shown to be associated. Considering the results recorded, health services must provide differentiated care policies to climacteric women, seeking to alleviate high morbidity and mortality of chronic non-communicable diseases.

- by Journal einstein (São Paulo)
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- Health Behavior, Obesity, Women's Health, Women
- by Daniel Forman
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- Political Science, Public Health, Conflict of Interest, Health Policy

- by Per Kallestrup
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- South Asian Studies, Public Health, Nepal, Medicine

The increasing burden of non-communicable diseases (NCDs) in sub-Saharan Africa is causing further burden to the health care systems that are least equipped to deal with the challenge. Countries are developing policies to address major NCD risk factors including tobacco use, unhealthy diets, harmful alcohol consumption and physical inactivity. This paper describes NCD prevention policy development process in five African countries (Kenya, South Africa, Cameroon, Nigeria, Malawi), including the extent to which WHO "best buy" interventions for NCD prevention have been implemented. The study applied a multiple case study design, with each country as a separate case study. Data were collected through document reviews and key informant interviews with national-level decision-makers in various sectors. Data were coded and analyzed thematically, guided by Walt and Gilson policy analysis framework that examines the context, content, processes and actors in policy development. Coun...

- by Shukri Mohamed
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- Africa, Policy, Cameroon, Qualitative Research

Many researchers worldwide report that health behaviours tend to be highly clustered, and can be addressed simultaneously. Yet, more remains unknown than known about how to optimize multiple preventive health behaviour change to mitigate health risks associated with noncommunicable diseases, which currently presents major public health concerns, and represents the greatest global health security threats in the future. There are emerging shifts in epidemiology of these chronic diseases, not only by gender, socioeconomic status, disability, ethnicity, but most recently by age-albeit subject characteristics, as they are increasingly causing premature deaths. Nevertheless, the problem remains a neglected public health issue in Uganda, and at Makerere University in particular. A cross-sectional sample of 381 undergraduate female students completed the self-administered questionnaire, whose results were subjected to binary logistic regression modeling to determine extents to which subject characteristics influenced adoption of preventive health behaviours. Multivariate regression models suggest that course of study significantly (p=.013) influenced physician visits, with adjusted odds ratio of 0.32. Pentecostal (p=.018) and Anglican (p=.002) affiliations significantly influenced screening behaviour, with corresponding odd ratios of 0.37 and 0.34. Pentecostal (p= .021), like Science course (p=.030) significantly influenced physical activity, with corresponding odds ratios of 0.34 and 0.44. With respect to multiple preventive health behaviours, only course of study showed significant (p=.036) influence on adoption of all three desired behaviours, with adjusted odds ratio of 3.15. The study contributes to body of knowledge on multiple health behavioral change and the healthy Universities concept. Future health promotions should consider issues around equitable access to essential information, and take advantage of religious places of worship and leaders to channel messaging.

- by Texila International Journal and +1
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- Public Health, Noncommunicable Diseases, subject characteristics, multiple preventive health behavior
- by Stanley Okoduwa
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- Diabetes, Life Style, Public Health, Nigeria
- by kyaw khant
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- Diet, Medicine, Linear models, Myanmar
- by Paul-Andre ROSENTAL
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- Sociology, Global Health, Communicable Diseases, Medicine
- by Rosario Cárdenas
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- Global Health, Communicable Diseases, Adolescent, Pregnancy

Successful prevention and control of the epidemic of noncommunicable diseases (NCDs) cannot be achieved by the health sector alone: a wide range of organisations from multiple sectors and across government must also be involved. This requires a new, inclusive approach to advocacy and to coordinating, convening and catalysing action across civil society, best achieved by a broad-based network. This comment maps the experience of the NCD Alliance (NCDA) on to Shiffman's challenges for global health networks – framing (problem definition and positioning), coalition-building and governance – and highlights some further areas overlooked in his analysis.

- by International Journal of Health Policy and Management IJHPM and +1
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- Governance, Sustainable Human Development, Advocacy, Noncommunicable Diseases

The “building blocks” of the ICCC Framework can be used to create or redesign healthcare systems. It also provides a global framework to harmonise initiatives aimed at improving chronic patient care.
Key characteristics of the framework are that it incorporates a health policy perspective and can be used as a reference for the comparative analysis of systems and identification of examples of good practice. It also puts an emphasis on optimising the use of available health resources in specific populations/geographical contexts. In line with this, it indicates that the development of integrated care strategies and creation of health service networks are crucial for systems to successfully address the challenge of chronicity.
These characteristics are reflected in the guiding principles on which the ICCC is based, and which should be followed at all levels of the health system. To enable successful change towards a better response to needs arising from chronic pathologies, the WHO proposed the following eight elements as essential areas for action for decision-makers:
Guiding principles of the ICCC framework.
Evidence-based decision making.
Population health approach.
Focus on prevention.
Emphasis on quality of care and systemic quality.
Flexibility/adaptability.
Integration as a core and fractal of the framework.

- by Adnan Kisa
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- Mental Health, Depression, Diabetes, HIV/AIDS

Rodriguez-Martinez, Andrea et al. NCD Risk Factor Collaboration (NCD-RisC) Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories: a pooled analysis of 2181... more

- by Andre Guimaraes
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- Geography, Medicine, BMI, Noncommunicable Diseases

- by hassan zafar
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- Biological Sciences, Humans, Biomedical science, Noncommunicable Diseases

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.

Background In Nepal, the burden of non-communicable, chronic diseases is rapidly rising, and disproportionately affecting low- and middle-income countries. Integrated interventions are essential in strengthening primary care systems and addressing the burden of multiple comorbidities. A growing body of literature supports the involvement of frontline providers, namely mid-level practitioners and community health workers, in chronic care management. Important operational questions remain, however, around the digital, training, and supervisory structures to support the implementation of effective, affordable, and equitable chronic care management programs. Methods A twelve-month, population-level, type 2 hybrid effectiveness-implementation study will be conducted in rural Nepal to evaluate an integrated non-communicable disease care management intervention within Nepal’s new municipal governance structure. The intervention will leverage the government’s planned roll-out of the World H...

- by Anu Aryal
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- Global Health, Implementation Science, Decision Support Systems, Nepal

- by Jonah Musa
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- Neuroscience, Epistemology, Global Health, Cancer