Background: Cardiovascular disease (CVD), mainly heart attack and stroke, is the
leading cause of premature mortality in low and middle income countries (LMICs).
Identifying and managing individuals at high risk of CVD is an important strategy to prevent and control CVD, in addition to multisector...al population-based interventions to reduce CVD risk factors in the entire population.
Methods: We describe key public health considerations in identifying and managing individuals at high risk of CVD in LMICs.
Results: A main objective of any strategy to identify individuals at high CVD risk is to maximize the number of CVD events averted while minimizing the numbers of
individuals needing treatment. Scores estimating the total risk of CVD (e.g. ten-year risk of fatal and non-fatal CVD) are available for LMICs, and are based on the main CVD risk factors (history of CVD, age, sex, tobacco use, blood pressure, blood cholesterol and diabetes status). Opportunistic screening of CVD risk factors enables identification of persons with high CVD risk, but this strategy can be widely applied in low resource settings only if cost effective interventions are used (e.g. the WHO Package of Essential NCD interventions for primary health care in low resource settings package) and if treatment (generally for years) can be sustained, including continued availability ofaffordable medications and funding mechanisms that allow people to purchase medications without impoverishing them (e.g. universal access to health care). Thisalso emphasises the need to re-orient health systems in LMICs towards chronic diseases management.
Conclusion: The large burden of CVD in LMICs and the fact that persons with high
CVD can be identified and managed along cost-effective interventions mean that
health systems need to be structured in a way that encourages patient registration, opportunistic screening of CVD risk factors, efficient procedures for the management of chronic conditions (e.g. task sharing) and provision of affordable treatment for those with high CVD risk. The focus needs to be in primary care because that is where most of the population can access health care and because CVD programmes can be run effectively at this level.
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Neurological, Psychiatric, and Developmental Disorders: Meeting the Challenge in the Developing World
Institute of Medicine (US) Committee on Nervous System Disorders in Developing Countries.
Washington (DC): National Academies Press (US); 2001.
Update 2021; Immunization, Vaccines and Biologicals
Annals of Global Health, 87(1), p.43. DOI: http://doi.org/10.5334/aogh.3269;
The aim of this study was to examine the prevalence of mental health symptoms (anxiety, depression, and stress) in Bangladesh and the factors associated with these symptoms during the COVID-19 pandemic.
They found that ...about 64%, 87%, and 61% of the respondents in Bangladesh reported high levels of depression, anxiety, and stress, respectively and this varied between divisions (regions), more in women, those who self-quarantined, and those that experienced classical symptoms of COVID-19. We think there is a need for mental health support in this population to minimise the long term effects.
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Financing Global Health 2016: Development Assistance, Public and Private Health Spending for the Pursuit of Universal Health Coverage presents a complete analysis of the resources available for health in 184 countries, with a particular focus on development assistance for health (DAH). DAH was estim...ated to total $37.6 billion in 2016, up 0.1% from 2015. After a decade of rapid growth from 2000 to 2010 (up 11.4% annually), DAH grew at only 1.8% annually between 2010 and 2016. In low-income countries, where much DAH is targeted, DAH made up 34.6% of total health spending in 2016. In upper-middle- and high-income countries, which generally do not receive DAH, DAH accounted for only 0.5% of total health spending. The other 99.5% of health spending – government, prepaid private, and out-of-pocket spending – is the subject of our further analysis.
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The Lancet Regional Health - Americas 2024;30: 100681
Published Online 3 February 2024 https://doi.org/10.1016/j.lana.2024.100681
This country snapshot provides an overview of national data relating to sexual and reproductive health and rights (SRHR) throughout the life course. Realization of SRHR requires provision of comprehensive, people-centred services, that address the different elements of SRHR, and which are supported ...by an enabling environment, quality health systems, and meaningful community engagement. Multiple, synergistic cross-linkages exist within and between the different SRHR elements, leading to sequential outcome benefits throughout the life course.
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Reference Manual for Programme Managers on Accreditation Process
A Reference Guide for Program Managers and Policy Makers. Recently, a renewed interest in large-scale community health worker (CHW) programs has been seen globally. This renewal provides an opportune moment to take stock of issues and challenges such programs face and what can be done to make them a...s effective as possible. With this in mind, this manual is intended to be used a practical guide for policymakers and program managers wishing to develop or strengthen a CHW program, drawing lessons from other countries that have implemented CHW programs at-scale
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This manual describes methods for investigating clusters or outbreaks that may be of chemical origin and describes the importance of a structured, coordinated, collaborative multidisciplinary, multi-agency approach at local, regional, national and international levels.
Resumo: o que é esta orientação dinâmica?
Pergunta clínica: qual é o papel dos medicamentos na prevenção da COVID-19?
Público-alvo: o público-alvo são os médicos e os tomadores de decisão na área da saúde.
Prática atual: o uso atual de medicamentos para prevenção da COVID-19 é ...variável, refletindo uma incerteza em grande escala. Numerosos estudos clínicos randomizados de muitos medicamentos estão em andamento para orientar melhor a prática. Esta primeira versão de Medicamentos para prevenção da COVID-19: Orientação dinâmica da OMS contém novas
informações e uma recomendação sobre a hidroxicloroquina. (1) Segue-se a publicação de seis estudos sintetizados em uma meta-análise dinâmica de rede (NMA).
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Cardiovascular diseases (CVDs) are a growing public health problem in Ghana and other African countries. Strokes and other CVDs have become a leading cause of death due to increasing risk factors such as hypertension. According to the Global Burden of Disease study (GBD), ischaemic heart disease was... the fourth leading cause of death in Ghana in 2016. The prevalence of hyper-
tension, a major risk factor for CVDs, is increasing rapidly and ranges from 19% to 48%, according to the Ghana Health Service Annual Report, 2017, due to rising life expectancy and the increasing prevalence of contributing factors such as overweight/obesity. Early diagnosis and adequate management of the risk factors can reduce the fatal consequences of CVDs.
At the heart of improving risk assessment and management of CVDs are nationally approved guidelines, which facilitate standardisation of care approaches.
These guidelines developed by experts from all levels of health care and stakeholders capture all recommended approaches and necessary information for clinicians and other healthcare workers on CVDs. They also serve as a practical guide for assessing and managing the most important CVDs prevalent in Ghana and can be used at all levels of care namely health facilities without a doctor; with a general practitioner and with a physician specialist.
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Special Report
This report of the European Centre for Disease Prevention and Control (ECDC) was coordinated by Teymur Noori, with technical support from Andrew J. Amato-Gauci, Anastasia Pharris, Jan C. Semenza, Denis Coulombier and Piotr Kramarz.