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The publication conveys the quantitative surveillance results focusing on tobacco use and noncommunicable disease (NCD) related behaviours among youth (13–15 years) in Member States of the WHO South-East Asia Region, namely, the Global School-based Student Health Survey (GSHS) and the Global Youth
...
Tobacco Survey (GYTS). This publication contains selected indicators relating to tobacco use and other related risk behaviours of youth (aged 13–15 years) in Member States of the WHO South-East Asia Region. The tobacco indicators are mainly taken from GYTS and other indicators relating to risk behaviours (dietary behaviours, physical activity, alcohol use, drug use, mental health, violence and unintentional injury, sexual behaviours, protective factors and hygiene) are taken from GSHS. The latest findings from surveys conducted in Member States are presented in the publication.
more
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 multisectoral 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.
more
The Global Burden of Cardiovascular Diseases and Risk: A Compass for Future Health
Vaduganathan, M.; Mensah, G.A.; Turco, J.V. et al.
Journal of the American College of Cardiology
(2022)
CC
Cardiovascular diseases (CVDs) have collectively remained the leading causes of death worldwide and substantially contribute to loss of health and excess health system costs. The Global Burden of Diseases, Injuries, and Risk
...
Factors (GBD) Study has tracked trends in death and disability since 1990 and has provided an updated perspective on the status of cardiovascular health globally, regionally, and nationally.
more
The article "Asthma in South African adolescents: a time trend and risk factor analysis over two decades" investigates the prevalence and risk factors
...
for asthma in Cape Town adolescents from 2002 to 2017. The study finds that while the overall prevalence of asthma remained similar, the severity of the condition increased significantly. Risk factors for asthma and severe cases include smoking, pet exposure, outdoor pollution, and living in informal housing. Despite these trends, underdiagnosis remains a concern, as only one-third of adolescents with current or severe asthma had been formally diagnosed. The article emphasizes the need for better public health strategies to address environmental exposures and improve asthma diagnosis and treatment.
more
Heliyon 2023 Oct 20;9(11):e21286. doi: 10.1016/heliyon.2023.e21286. This study conducted a systematic review of observational, community-based studies from 2013 to 2022, aiming to estimate the prevalence of prediabetes and its associated risk
...
factors within the adult East African population. Twenty-one studies were analysed, revealing an overall prediabetes prevalence of 12.58%.
more
Cardiovascular disease is a major cause of disability and premature death throughout the world, and contributes substantially to the escalating costs of health care. The underlying pathology is atherosclerosis, which develops over many years and is usually advanced by the time symptoms occur, genera
...
lly in middle age. Acute coronary and cerebrovascular events frequently occur suddenly, and are often fatal before medical care can be given. Modification of risk factors has been shown to reduce mortality and morbidity in people with diagnosed or undiagnosed cardiovascular disease.
This publication provides guidance on reducing disability and premature deaths from coronary heart disease, cerebrovascular disease and peripheral vascular disease in people at high risk, who have not yet experienced a cardiovascular event. People with established cardiovascular disease are at very high risk of recurrent events and are not the subject of these guidelines. They have been addressed in previous WHO guidelines.
Several forms of therapy can prevent coronary, cerebral and peripheral vascular events. Decisions about whether to initiate specific preventive action, and with what degree of intensity, should be guided by estimation of the risk of any such vascular event. The risk prediction charts that accompany these guidelinesb allow treatment to be targeted accord-
ing to simple predictions of absolute cardiovascular risk.
Recommendations are made for management of major cardiovascular risk factors through changes in lifestyle and prophylactic drug therapies. The guidelines provide a framework for the development of national guidance on prevention of cardiovascular disease that takes into account the particular political, economic, social and medical circumstances.
more
Women, the elderly, adolescents, youth, and children,
persons with disabilities, indigenous populations, refugees,
migrants, and minorities experience the highest degree
of socio-economic marginalization. Marginalized people
become even more vulnerable in emergencies.1 This is due
to
...
factors such as their lack of access to effective surveillance
and early-warning systems, and health services. The
COVID-19 outbreak is predicted to have significant impacts
on various sectors.
The populations most at risk are those that:
• depend heavily on the informal economy;
• occupy areas prone to shocks;
• have inadequate access to social services or political
influence;
• have limited capacities and opportunities to cope and
adapt and;
• limited or no access to technologies.
By understanding these issues, we can support the capacity
of vulnerable populations in emergencies. We can give
them priority assistance, and engage them in decision-making
processes for response, recovery, preparedness, and
risk reduction.
more
Halving snakebite morbidity and mortality by 2030 requires countries to develop both prevention and treatment strategies. The paucity of data on the global incidence and severity of snakebite envenoming causes challenges in prioritizing and mobilising resources for snakebite prevention and treatment
...
. In line with the World Health Organisation’s 2019 Snakebite Strategy, this study sought to investigate Eswatini’s snakebite epidemiology and outcomes, and identify the socio-geographical factors associated with snakebite risk.
more
Risk factors for noncommunicable diseases in Ukraine in 2019. This document summarizes the findings of the STEPS survey in Ukraine and compares them with the results of STEPS surveys carried out in
...
other countries in the WHO European Region, as well as with selected other surveys in Ukraine. The survey is designed to be repeated approximately every five years in each country to allow assessment of trends.
The study revealed very high prevalence of NCDs and their behavioural and biological risk factors in Ukraine. Data on behavioural risk factors include tobacco and alcohol use, diet, and physical activity. Data on biological risk factors include overweight and obesity, blood pressure, blood glucose, and blood lipid levels.
more
Background
Noncommunicable diseases are major contributors to morbidity and mortality worldwide. Modifying the risk factors for these conditions, such as physical inactivity, is thus essential. Add
...
ressing the context or circumstances in which physical activity occurs may promote physical activity at a population level. We assessed the effects of infrastructure, policy or regulatory interventions for increasing physical activity.
Methods
We searched PubMed, Embase and clinicaltrials.gov to identify randomised controlled trials (RCTs), controlled before-after (CBAs) studies, and interrupted time series (ITS) studies assessing population-level infrastructure or policy and regulatory interventions to increase physical activity. We were interested in the effects of these interventions on physical activity, body weight and related measures, blood pressure, and CVD and type 2 diabetes morbidity and mortality, and on other secondary outcomes. Screening and data extraction was done in duplicate, with risk of bias was using an adapted Cochrane risk of bias tool. Due to high levels of heterogeneity, we synthesised the evidence based on effect direction.
Results
We included 33 studies, mostly conducted in high-income countries. Of these, 13 assessed infrastructure changes to green or other spaces to promote physical activity and 18 infrastructure changes to promote active transport. The effects of identified interventions on physical activity, body weight and blood pressure varied across studies (very low certainty evidence); thus, we remain very uncertain about the effects of these interventions. Two studies assessed the effects of policy and regulatory interventions; one provided free access to physical activity facilities and showed that it may have beneficial effects on physical activity (low certainty evidence). The other provided free bus travel for youth, with intervention effects varying across studies (very low certainty evidence).
Conclusions
Evidence from 33 studies assessing infrastructure, policy and regulatory interventions for increasing physical activity showed varying results. The certainty of the evidence was mostly very low, due to study designs included and inconsistent findings between studies. Despite this drawback, the evidence indicates that providing access to physical activity facilities may be beneficial; however this finding is based on only one study. Implementation of these interventions requires full consideration of contextual factors, especially in low resource settings.
more
The risk factors for CVD include behavioural factors, such as tobacco use, an unhealthy diet, harmful use of alcohol and inadequate physical activi
...
ty, and physiological (metabolic) factors, including high blood pressure (hypertension), high blood cholesterol and high blood sugar or glucose. Both kinds of factor are linked to underlying social determinants and drivers. This module focuses on the behavioural risk factors and provides information on: • tobacco use, unhealthy diet, insufficient physical activity and harmful use of alcohol as important contributors to CVDs • behavioural change, brief interventions for counselling and key points for motivational interviewing • the theory of the 5As for brief interventions, as well as sample brief interventions for each risk factor, using the 5As. Target users of this module This module is intended for trainers of primary health care workers, including physicians, nurses, and other health workers. Primary care workers should be trained on the risk factors and counselling approaches, adapting to local customs, culture and context. NCD programme managers may also use it for planning purposes.
more
Stroke happens either when the blood supply to part of your brain is cut off because of a blood clot, or when a brain
artery ruptures and leads to a haemorrhage. Stroke is a leading cause of death and disability worldwide, but most strokes can
be prevented by addressing a small number of key
...
risk factors.
more
Addressing comorbidities and risk factors for TB is a crucial component of Pillar one of the End TB Strategy, which focuses on integrated patient-centred care and prevention, including action on TB
...
and comorbidities. The Framework for collaborative action on TB and comorbidities aims to support countries in the evidence-informed introduction and scale-up of holistic people-centred services for TB, comorbidities and health-related risk factors, with the goal of comprehensively addressing TB and other co-existing health conditions. It should be used in conjunction with relevant WHO guidelines. The Framework is intended for use by people working in ministries of health, other relevant line-ministries, policymakers, international technical and funding organizations, researchers, nongovernmental and civil society organizations, as well as primary care workers, specialist health practitioners, and community health workers who support the response to TB and comorbidities in both the public and private sectors.
more
Addressing comorbidities and risk factors for tuberculosis (TB) is a crucial component of the World Health Organization (WHO)’s End TB Strategy. This WHO operational handbook on tuberculosis. Modu
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le 6: tuberculosis and comorbidities aims to support countries in scaling up people-centred care, based on the latest WHO recommendations on TB and key comorbidities, and drawing upon additional evidence, best practices and inputs from various experts and stakeholders obtained during WHO processes. It is intended for use by people working in ministries of health, particularly TB programmes and the relevant departments or programmes responsible for comorbidities and health-related risk factors for TB such as HIV, diabetes, undernutrition, substance use, and tobacco use, as well as programmes addressing mental health and lung health. This operational handbook is a living document and will include a separate section for each of the key TB comorbidities or health-related risk factors. The third edition includes guidance for HIV-associated TB, mental health conditions and diabetes, which are three conditions strongly associated with TB and which result in higher mortality, poorer TB treatment outcomes and negatively impact health-related quality of life. The operational handbook aims to facilitate early detection, proper assessment and adequate management of people affected by TB and comorbidities. Full implementation of this guidance is expected to have a significant impact on TB treatment outcomes and health-related quality of life for people affected by TB.
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WHO consolidated guidelines on tuberculosis: Module 6: tuberculosis and comorbidities, 2nd ed
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Addressing TB comorbidities and risk factors is central to the World Health Organization (WHO) End TB Strategy. These guidelines consolidate the latest WHO recommendations on TB and key comorbiditie
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s. The guidelines are a living document and will include dedicated sections for each key TB comorbidity or health-related risk factor. The first edition focused on HIV-associated TB, updating the WHO policy on collaborative TB/HIV activities. This second edition expands on the previous edition and consolidates new and existing recommendations on interventions to address undernutrition in people with TB, to provide food assistance to households of people with TB in food-insecure settings, and to screen for TB among those who are undernourished or food insecure.
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The STEPS survey of noncommunicable disease (NCD) risk factors in Zambia was carried out from July to September 2017. Zambia carried out Step 1, Step 2 and Step 3. Socio demographic and behavioural
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information was collected in Step 1. Physical measurements such as height, weight and blood pressure were collected in Step 2. Biochemical measurements were collected to assess blood glucose and cholesterol levels in Step 3. The survey was a population-based survey of adults aged 18-69. A multi-stage cluster sample design was used to produce representative data for that age range in Zambia. A total of 4,302 adults participated in the survey. The overall response rate was 74% for Step 1 and 2 and 65% for Step 3. A repeat survey is planned for 2022 if funds permit.
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The document provides Information on alcohol use (risk factors, evaluation alcohol use etc.) in a descriptive way.
The cardiovascular disease continuum begins with risk factors such as diabetes mellitus (DM), progresses to vasculopathy and myocardial dysfunction, and finally ends with cardiovascular death. Diabe
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tes is associated with a 2- to 4-fold increased risk for heart failure (HF). Moreover, HF patients with DM have a worse prognosis than those without DM. Diabetes can cause myocardial ischemia via micro- and macrovasculopathy and can directly exert deleterious effects on the myocardium. Hyperglycemia, hyperinsulinemia, and insulin resistance can cause alterations in vascular homeostasis. Then, reduced nitric oxide and increased reactive oxygen species levels favor inflammation leading to atherothrombotic progression and myocardial dysfunction. The classification, diagnosis, and treatment of HF for a patient with and without DM remain the same. Until now, drugs targeting neurohumoral and metabolic pathways improved mortality and morbidity in HF with reduced ejection fraction (HFrEF). Therefore, all HFrEF patients should receive guideline-directed medical therapy. By contrast, drugs modulating neurohumoral activity did not improve survival in HF with preserved ejection fraction (HFpEF) patients. Trials investigating whether sodium-glucose cotransporter-2 inhibitors are effective in HFpEF are on-going. This review will summarize the epidemiology, pathophysiology, and treatment of HF in diabetes.
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