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Publication Years
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Keeping communities at the centre of efforts to eliminate lymphatic filariasis: learning from the past to reach a future free of lymphatic filariasis
Krentel, A.; Gyapong, M.; McFarland, D.A.; Ogundahunsi, O.; Titaley, C.R.; Addiss, D.G.
Oxford Academic - International Health
(2021)
CC
Since the launch of the Global Programme to Eliminate Lymphatic Filariasis (GPELF) in 2000, more than 910 million people have received preventive chemotherapy for lymphatic filariasis (LF) and many thousands have received care for chronic manifestations of the disease. To achieve this, millions of c
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ommunity drug distributors (CDDs), community members and health personnel have worked together each year to ensure that at-risk communities receive preventive chemotherapy through mass drug administration (MDA). The successes of 20 y of partnership with communities is celebrated, including the application of community-directed treatment, the use of CDDs and integration with other platforms to improve community access to healthcare. Important challenges facing the GPELF moving forward towards 2030 relate to global demographic, financing and programmatic changes. New innovations in research and practice present opportunities to encourage further community partnership to achieve the elimination of LF as a public health problem. We stress the critical need for community ownership in the current Covid-19 pandemic, to counter concerns in relaunching MDA programmes for LF.
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Background: The human helminth infections include ascariasis, trichuriasis, hookworm infections, schistosomiasis, lymphatic filariasis (LF) and onchocerciasis. It is estimated that almost 2 billion people worldwide are infected with helminths. Whilst the WHO treatment guidelines for helminth infecti
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ons are mostly aimed at controlling morbidity, there has been a recent shift with some countries moving towards goals of disease elimination through mass drug administration, especially for LF and onchocerciasis. However, as prevalence is driven lower, treating entire populations may no longer be the most efficient or cost-effective strategy. Instead, it may be beneficial to identify individuals or demographic groups who are persistently infected, often termed as being “predisposed” to infection, and target treatment at them.
Methods: The authors searched Embase, MEDLINE, Global Health, and Web of Science for all English language, humanbased papers investigating predisposition to helminth infections published up to October 31st, 2017. The varying definitions used to describe predisposition, and the statistical tests used to determine its presence, are summarised. Evidence for predisposition is presented, stratified by helminth species, and risk factors for predisposition to infection are identified and discussed.
Results: In total, 43 papers were identified, summarising results from 34 different studies in 23 countries. Consistent evidence of predisposition to infection with certain species of human helminth was identified. Children were regularly found to experience greater predisposition to Ascaris lumbricoides, Schistosoma mansoni and S. haematobium than adults. Females were found to be more predisposed to A. lumbricoides infection than were males. Household clustering of infection was identified for A. lumbricoides, T. trichiura and S. japonicum. Ascaris lumbricoides and T. trichiura also showed evidence of familial predisposition. Whilst strong evidence for predisposition to hookworm infection was identified, findings with regards to which groups were affected were considerably more varied than for other helminth species.
Conclusion: This review has found consistent evidence of predisposition to heavy (and light) infection for certain human helminth species. However, further research is needed to identify reasons for the reported differences between demographic groups. Molecular epidemiological methods associated with whole genome sequencing to determine ‘who infects whom’ may shed more light on the factors generating predisposition.
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This report aims to outline the current available knowledge on the health and wellbeing of older persons in the Region of the Americas during the United Nations Decade of Healthy Ageing (2021-2030). It also seeks to guide political actions towards ensuring the human rights of older persons, and desc
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ribes the negotiation and drafting process behind the Inter-American Convention on Protecting the Human Rights of Older Persons. It reports on the doctrinal and legal developments that led the Region of the Americas to draft the Convention and describes its action areas and guaranteed rights, as well as the obligations assumed by the States Parties. The Convention is an essential tool to advance the strategies of the Decade of Healthy Ageing. This publication reflects on the importance of having a major legal instrument for this purpose at the international level. The demographic transition in Latin America and the Caribbean will continue to shape the ability of countries and health systems to respond to the needs of the population. Given this reality, international instruments will be needed to guarantee the full enjoyment of the human rights of older persons. In order to design inclusive and sustainable systems, accurate, updated, and effective information is required. The Decade of Healthy Ageing––the initiative that constitutes the framework for this document––is a strategic period in which to focus on data generation and monitoring.
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Background: Achieving universal health coverage (UHC) requires health financing systems that provide prepaid pooled resources for key health services without placing undue financial stress on households. Understanding current and future trajectories of health financing is vital for progress towards
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UHC. We used historical health financing data for 188 countries from 1995 to 2015 to estimate future scenarios of health spending and pooled health spending through to 2040. Methods: We extracted historical data on gross domestic product (GDP) and health spending for 188 countries from 1995 to 2015, and projected annual GDP, development assistance for health, and government, out-of-pocket, and prepaid private health spending from 2015 through to 2040 as a reference scenario. These estimates were generated using an ensemble of models that varied key demographic and socioeconomic determinants. We generated better and worse alternative future scenarios based on the global distribution of historic health spending growth rates. Last, we used stochastic frontier analysis to investigate the association between pooled health resources and UHC index, a measure of a country’s UHC service coverage. Finally, we estimated future UHC performance and the number of people covered under the three future scenarios.
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Background: Worldwide, maternal hypertensive disorders complicate one in ten pregnancies. As a result of changes in the life styles of society, currently, it is becoming a common public life encounter. However, Ethiopia lacks comprehensive and comparable maternal hypertensive disorders, causing burd
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en and health loss to inform policy and practice.
Objective: To describe the incidence and prevalence of maternal hypertensive disorders and deaths, Disability Adjusted Life Years, and Years Life Lost attributable to maternal hypertensive disorders in Ethiopia and its regional distributions from 1990 to 2019 as part of a collaborative Global Burden of Diseases, (2019) Study.
Methods: The data for this study were collected from surveys, demographic surveillances, medical record reviews, health facility observations and interviews socio-demographic, health care service utilization, and other data sources such as case notifications, scientific literature, and unpublished data as per the Global Burden of Disease protocol and analysis techniques to produce national and regional estimates of maternal hypertensive disorders in Ethiopia. Cause of death ensemble modeling and Bayesian meta-regression disease modeling was employed to ascertain cause of death and morbidity. Each metric was estimated per 100,000 populations with a 95% uncertainty interval (UI).
Results: In the last thirty years, in Ethiopia, , the incidence of maternal hypertensive disorders among young women was raised by 52,596 cases per 100,000 population [199,707 (95% UI 150,261-267,221) to 252,303 (95% UI 191,335-332,524)], while decreased among adolescent women from 67,206 (95% UI 46,887-90,883) to 64, 622 (95% UI; 47,587-84,664) per 100,000 population. The prevalence among women of reproductive age had increased from 94, 818 (95% UI 59,434-135,332) in 1990 to 138, 263 (95% UI 88,447-196,029) in 2019. Between 1990 and 2019, deaths attributable to maternal hypertensive disorders among adolescents and young women had increased by 1.5 and 1.17 times, respectively. In 2019, disability adjusted life years among adolescent, young women and women of reproductive age due to maternal hypertensive disorders was 8,493 (UI 95% 5,370-12,849), 21,812 (UI 95% 14,682-32,139) and 57,867 (UI 95% 41,751-79,165) respectively. The highest daily adjusted life years due to maternal hypertensive disorders had occurred among young women, 13,319 (UI 95% 8,592-19,931) which was higher than 1990 whereas the young women years of life lost had increased.
Conclusions: Based on the finding, increasingly high new cases, prevalence and burden of maternal hypertensive disorders and significant health loss were observed in the last three decades in Ethiopia. Hence, prevention of cases, disabilities, deaths and health losses caused by maternal hypertensive disorders can be prevented by properly advocating lifestyle modifications with specifically designed age-specific interventions. On the top of continuing prevention efforts with newly devised magnesium sulphate administration in the new ANC initiative of the ministry, contextualized, need based, localized, and targeted interventions could be reconstituted. [Ethiop. J. Health Dev. 2023;37 (SI-2)]
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Global cardiovascular disease (CVD) burden is high and rising, especially in low-income and middle-income countries (LMICs). Focussing on 45 LMICs, we aimed to determine (1) the adult population’s median 10-year predicted CVD risk, including its variation within countries by socio-
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demographic characteristics, and (2) the prevalence of self-reported blood pressure (BP) medication use among those with and without an indication for such medication as per World Health Organization (WHO) guidelines.
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Non-communicable diseases (NCDs) are of increasing concern for society and national governments, as well as globally due to their high mortality rate. The main risk factors of NCDs can be classified into the categories of self-management, genetic factors, environmental factors, factors of medical co
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nditions, and socio-demographic factors.
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troke, a major Non-Communicable Disease (NCD), is responsible for 3.5% of disabilityadjusted life year (DALY) in India.Apart from risk factors like hypertension, diabetes, heart diseases and positive family history, other lifestyle related factors such as unhealthy diet, obesity, lack of physical ac
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tivity, stress and tobacco use account for its occurrence. Changes in lifestyles, behavioural patterns, demographic profile (aging population), socio-cultural and technological advancements are leading to sharp increases in the prevalence of stroke. The disease by and large can be prevented by making simple changes in the way people live their lives or simply by changing our lifestyle.
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Considerable energy has been expended over the last two decades in developing methods for identifying the presence of asthma among participants in population studies. The objective of this endeavour has commonly been to enable epidemiological research on risk factors for asthma, with the ultimate ai
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m of preventing the disease. However, there are other reasons for measuring the prevalence of asthma in populations, including the desire to assess the burden of disease attributable to asthma, to track changes over time, and to compare the prevalence among population groups defined by geographical, demographic or social factors. Two major international collaborative studies arising from this work have made major contributions to our knowledge about asthma
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Asthma is the most common noncommunicable disease in children, and among the most common in adults. According to the most recent estimates from the Global Asthma Network Phase I study, around one in 10 children and adults have symptoms of asthma and one in 20 school-aged children have severe asthma
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symptoms, with marked variations in prevalence and in prevalence trends between countries and regions of the world. The Global Burden of Disease Study estimated that asthma caused the loss of 21.6 million healthy years of life (disability-adjusted life years) and 461 069 deaths in 2019. Approximately 90% of the asthma burden of disease is borne by people living low and middle income countries (LMICs). Some countries report very high (up to 90%) rates of uncontrolled asthma. While the prevalence of asthma is highest in countries with a high Socio-Demographic Index (SDI), death rates from asthma are highest in countries with low and lower middle incomes.
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In 2022, Namibia had an estimated population of 2.6 million people, where 51 per cent per cent are females and 52.5 per cent of households in urban areas, with fast-growing urban informal settlements which lack access to basic services. Namibia has a young population; 42 per cent are children (0-17
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years), 13 per cent are under-five, per cent and 19 per cent are aged 15 to 24 years. With the right investment on children and youth, this represents an opportunity for a demographic dividend.
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The World Heart Federation (WHF) Roadmap series covers a large range of cardiovascular conditions. These Roadmaps identify potential roadblocks and their solutions to improve the prevention, detection and management of cardiovascular diseases and provide a generic global framework available for loca
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l adaptation. A first Roadmap on raised blood pressure was published in 2015. Since then, advances in hypertension have included the publication of new clinical guidelines (AHA/ACC; ESC; ESH/ISH); the launch of the WHO Global HEARTS Initiative in 2016 and the associated Resolve to Save Lives (RTSL) initiative in 2017; the inclusion of single-pill combinations on the WHO Essential
Medicines’ list as well as various advances in technology, in particular telemedicine and mobile health. Given the substantial benefit accrued from effective interventions in the management of hypertension and their potential for scalability in low and middle-income countries (LMICs), the WHF has now revisited and updated the ‘Roadmap for raised BP’ as ‘Roadmap for hypertension’
by incorporating new developments in science and policy. Even though cost-effective lifestyle and medical interventions to prevent and manage hypertension exist, uptake is still low, particularly in resource-poor areas. This Roadmap examined the roadblocks pertaining to both the demand side (demographic and socio-economic factors, knowledge and beliefs, social relations, norms, and
traditions) and the supply side (health systems resources and processes) along the patient pathway to propose a range of possible solutions to overcoming them. Those include the development of population-wide prevention and control programmes; the implementation of opportunistic screening and of out-of-office blood pressure measurements; the strengthening of primary care and a greater focus on task sharing and team-based care; the delivery of people-centred care and stronger patient and carer education; and the facilitation of adherence to treatment. All of the above are dependent upon the availability and effective distribution of good quality, evidencebased, inexpensive BP-lowering agents.
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Background: Data on burden of peripheral artery disease (PAD) and its attributable risk factors are valuable for policymaking. We aimed to estimate the burden and risk factors for PAD from 1990 to 2019.
Methods: We extracted the data on prevalence, incidence, death, years lived with disability (YLD
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s), and years of life lost (YLLs) from the Global Burden of Disease Study 2019 to measure PAD burden. Moreover, the attributable burden to PAD risk factors was also estimated.
Results: Globally, in 2019, 113,443,017 people lived with PAD and 10,504,092 new cases occurred, resulting in 74,063 deaths, 500,893 YLDs, and 1,035,487 YLLs. The absolute numbers of PAD prevalent and incident cases significantly increased between 1990 and 2019, contrasting with the decline trends in age-standardized prevalence and incidence rates. However, no statistically significant changes were detected in the global age-standardized death or YLL rates. The burden of PAD and its temporal trends varied significantly by location, gender, age group, and social-demographic status. Among all potentially modifiable risk factors, age-standardized PAD deaths worldwide were primarily attributable to high fasting plasma glucose, followed by high systolic blood pressure, tobacco, kidney dysfunction, diet high in sodium, and lead exposure.
Conclusion: PAD remained a serious public health problem worldwide. More strategies aimed at implementing cost-effective interventions and addressing modifiable risk factors should be carried out, especially in regions with high or increasing burden.
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DHS Analytical Studies No. 41