Risk Factors For Communicable Diseases Research Articles

Präventionspolitik – Nicht nur ein Themenfeld für das Gesundheitsressort

Zusammenfassung Effektive Gesundheitsförderungs- und Präventionsmaßnahmen adressieren übergeordnete, strukturelle Risikofaktoren übertragbarer wie nichtübertragbarer Krankheiten. Diese sind zumeist außerhalb des Gesundheitssektors verortet und erfordern einen Health in All Policies (HiAP) Ansatz. Die weltweite Ausbreitung des SARS-CoV-2-Virus verdeutlicht die Notwendigkeit einer ressortübergreifenden Präventionspolitik mit klarer HiAP-Perspektive und politisch institutioneller Verankerung.

A Study on Dental Caries and Risk Factors for Non Communicable Diseases among Undergraduate Medical Students of Palakkad District, Kerala

Background: Dental caries is the most widespread oral disease worldwide and constitutes a major global public health challenge. The modifiable risk factors for dental caries and non communicable diseases are obesity, unhealthy diet, tobacco use, alcohol consumption. Aims: To find out the association between dental caries and risk factors for non communicable diseases among medical students. Methods: A cross sectional study was done among undergraduate medical students of our institution and total 554 students were included. They were asked to visit dental clinic for dental examination and their risk factors for non communicable diseases like body mass index, waist hip ratio, and family history of diabetes mellitus, regular exercises and type of personality were recorded using a self administered questionnaire. Statistical analysis used: SPSS version 20 was used for analysis. Results: The dental caries was present among 428 (77.3%) of undergraduate medical students. Out of 554 students 144 (26%) of them were overweight and 92(16.6%) were obese. There was statistically significant association between BMI, waist hip ratio and dental caries. Conclusions: The present study concludes that those students with higher BMI and high risk of waist hip ratio had higher prevalence of dental caries. Since the risk factors are common for dental caries and non communicable diseases s a healthy eating habits and lifestyle modification need to be started in all medical colleges

Household studies provide key insights on the transmission of, and susceptibility to, SARS-CoV-2

Studies of household members and close contacts of individuals infected with a communicable disease such as COVID-19 are a key source of information for infectious disease epidemiologists. Exposure to an infectious individual is the most important risk factor for communicable diseases. In household studies, only individuals who have been exposed are included, allowing for careful examination of other individual-level risk factors and quantification of transmission probabilities. The study by Qin-Long Jing and colleagues1 published in The Lancet Infectious Diseases provides important insights into factors affecting transmission from COVID-19 primary cases and susceptibility of their close contacts.

Associations between early childhood caries, malnutrition and anemia: a global perspective

BackgroundMalnutrition is the main risk factor for most common communicable diseases. The aim of this study is to determine the relationship between country-level prevalence of early childhood caries (ECC), malnutrition and anemia in infants and preschool children.MethodsMatched country-level ECC, malnutrition and anemia prevalence were generated from databases covering the period 2000 to 2017. Multivariate general linear models were developed to assess the relationship between outcome variables (prevalence of stunting, wasting, overweight, and anemia) and the explanatory variable (ECC prevalence) adjusted for gross national income per capita. Adjusted regression coefficients (B) and partial eta squared were computed.ResultsThe mean (standard deviation (SD)) ECC prevalence was 23.8 (14.8)% for 0–2 year-olds and 57.3 (22.4)% for 3–5-year-olds. The mean (SD) prevalence of wasting was 6.3 (4.8)%, overweight 7.2 (4.9)%, stunting 24.3 (13.5)%, and anemia 37.8 (18.1)%. For 0–2-year-olds, the strongest and only significant association was between the prevalence of ECC and overweight (η2 = 0.21): 1 % higher ECC prevalence was associated with 0.12% higher prevalence of overweight (B = 0.12, P = 0.03). In 3–5-year-olds, the strongest and only significant association was between the prevalence of ECC and anemia (η2 = 0.08): 1 % higher prevalence of ECC was associated with 0.14% lower prevalence of anemia (B = − 0.14, P = 0.048).ConclusionCountry-level prevalence of ECC was associated with malnutrition in 0–2-year-olds and with anemia in 3–5-year-olds. The pathway for the direct relationship between ECC and overweight may be diet related. The pathway for the inverse relationship between ECC and anemia is less clear and needs further investigations.

Risk factors for non communicable diseases among transport and security personnel of a health sciences university in coastal Karnataka

Background: Non communicable diseases (NCDs) are on the rise among workers in various occupations resulting in morbidity and mortality. This study was conducted to assess the various risk factors and associated socio-demographic factors among the security and transport personnel working in a health sciences university in Mangaluru.Methods: It was a cross-sectional study conducted among all the security and transport personnel. Questionnaire based on WHO-STEPS approach was used. Blood pressure (BP) measurements were recorded.Results: Total 167 study participants were enrolled; 57.5% were security and rest were transport personnel. Physical activity was perceived as light by 63.5% participants. Current smokers constituted to 26% and 33.5% consumed alcohol in past 12 months. Eighteen percent of them top salted their food. Among participants who were apparently healthy, 12.5% and 23.4% had raised systolic and diastolic BP. Associations between the areas of residence (p=0.004) and type of occupation (p<0.001) were found to be significant.Conclusions: Prevalence of risk factors of NCDs was high among study participants. Only few study subjects were physically active and majority of them felt that their routine work provided them with light physical activity. Around one third of the participants consumed tobacco and alcohol. Around 1/4th of the study participants who were not known hypertensive, were found with increased levels of blood pressure.

National, regional, and global burdens of disease from 2000 to 2016 attributable to alcohol use: a comparative risk assessment study

Alcohol use has increased globally, with varying trends in different parts of the world. This study investigates gender, age, and geographical differences in the alcohol-attributable burden of disease from 2000 to 2016. This comparative risk assessment study estimated the alcohol-attributable burden of disease. Population-attributable fractions (PAFs) were estimated by combining alcohol exposure data obtained from production and taxation statistics and from national surveys with corresponding relative risks obtained from meta-analyses and cohort studies. Mortality and morbidity data were obtained from the WHO Global Health Estimates, population data were obtained from the UN Population Division, and human development index (HDI) data were obtained from the UN Development Programme. Uncertainty intervals (UIs) were estimated using a Monte Carlo-like approach. Globally, we estimated that there were 3·0 million (95% UI 2·6-3·6) alcohol-attributable deaths and 131·4 million (119·4-154·4) disability-adjusted life-years (DALYs) in 2016, corresponding to 5·3% (4·6-6·3) of all deaths and 5·0% (4·6-5·9) of all DALYs. Alcohol use was a major risk factor for communicable, maternal, perinatal, and nutritional diseases (PAF of 3·3% [1·9-5·6]), non-communicable diseases (4·3% [3·6-5·1]), and injury (17·7% [14·3-23·0]) deaths. The alcohol-attributable burden of disease was higher among men than among women, and the alcohol-attributable age-standardised burden of disease was highest in the eastern Europe and western, southern, and central sub-Saharan Africa regions, and in countries with low HDIs. 52·4% of all alcohol-attributable deaths occurred in people younger than 60 years. As a leading risk factor for the burden of disease, alcohol use disproportionately affects people in low HDI countries and young people. Given the variations in the alcohol-attributable burden of disease, cost-effective local and national policy measures that can reduce alcohol use and the resulting burden of disease are needed, especially in low-income and middle-income countries. None.

HEALTH STATUS AND LIFESTYLE RELATED RISK FACTORS AMONG MIGRANT WORKERS IN SHAH ALAM, MALAYSIA

Introduction: In Malaysia, it’s about 4-5 million of the migrant’s workers that involve in occupation that seriously give and effect to their health, which is in construction, manufacturing, agriculture, services, and domestic work. Thus, study is conducted to identify the non- communicable disease (NCDs) risk factor among the migrant workers in migrant workers in Shah Alam of both genders. Methods: A cross- sectional study was conducted among 50 migrant workers in Shah Alam using convenience sampling method. Both questionnaires and measurement were used in data collection. The questionnaire included sociodemographic data, behavioral and lifestyle data and medical history. Results: A total of 32% of migrant workers either oversight or obese. 56% of them are involve in vigorous activity. most of them are not a smoker person which is about 86%. 20(40%) of them have history of hypertension only 6(12%) of them have diabetes Conclusion: The main findings of our study that, 32% of the migrant workers either overweight or obese. More health promotion and regular screening are required especially, for people with high risk or having hypertension and diabetes history.

Study of Prevalence of Non Communicable disease risk factors using WHO-STEPs approach in a Slum locality of Bhopal city, Madhya Pradesh

Background: Non-communicable diseases (NCDs) are chronic conditions that progress slowly and are rarely completely curable .These diseases such as diabetes and cardiovascular diseases, pose an increasing public health challenge in India, especially due to changes in lifestyles, behaviors and the physical and social environments in cities1.They are mainly caused by preventable behavioral risk factors, such as tobacco and alcohol consumption, unhealthy diet, and insufficient physical exercise3.It is well known that a lot of diseases can be prevented by altering the life style and habits of people. This study was undertaken with the objective of studying the prevalence of risk factors for NCDs in the Anna Nagar slum locality of Bhopal city, Madhya Pradesh. Material & Methods: The study was conducted on the population of Anna nagar slums. The sample size was 180(calculated using the prevalence data of ICMR on NCDs) but 260 was covered. The household were selected using systematic random sampling and individuals from the houses were selected using KISH method as used in WHO STEPS approach. WHO STEPS questionnaire was used to collect data. Physical measurements were taken as per standard WHO protocol. Data were entered in MS-EXCEL and analysis was done using EPI INFO. Results: In the population, male members were 53% and females were 47% respectively. Mean age was 43.67±11.3 yrs.80% had not received any formal education.31% people had history of alcohol consumption and 16% of tobacco consumption. Only 36.2% participants had normal BMI. 35.8% were obese, 17.3% were overweight and 10.8% were underweight. Obesity was more in females as compared to males. Blood pressure was found to be elevated in 18.1% participants, HTN1 in 10.4% and HTN2 in 31.5% participants. 40% participants had normal blood pressure.Conclusion: The major population was illiterate. The risk factors like alcohol consumption and smoking was very prevalent and is largely attributed to the low awareness of people regarding risk factors

School related factors affecting non communicable diseases risk factors among 13-15 years old adolescents from two schools in Delhi

Background: Children and adolescents are more vulnerable to developing NCD (non communicable diseases) risk factors due to changing lifestyles. Hence it is essential to recognize NCD risk factors among adolescents. School plays an important role in imparting knowledge and shaping the behaviours and practices among children. This study focusses on the school related factors that may be influencing the NCD risk factors among adolescents.Methods: The study was conducted among 438 students, 13 to 15 years old of two central government schools in Delhi. A self-administered modified STEPS questionnaire, an observation checklist for assessing facilities at schools and an interview schedule for school staff were used to collect data.Results: The statistically significant determinants of inadequate fruits and vegetable intake and excess fast food intake were consumption of fast food from vendors selling food outside the school (OR=4.36), inadequate physical activity at school (OR=2.56) and feeling stressed at school (OR=2.93). Physical activity at school was an important determinant for overall physical activity of students (OR=2.38). Current tobacco use and current alcohol use was determined by feeling stressed at school (OR=3.12). Health education classes at school had a protective effect on the NCD risk factors.Conclusions: Many school related factors such as absence of playground at school, stressed life at school and vendors selling fast food outside school were seen to influence lifestyle risk factors amongst adolescents. Hence an active involvement of school by increasing health education classes and providing adequate facilities for physical activities may help in reducing the NCD risk factors among students.

Risk factors for communicable diseases in humanitarian emergencies and disasters: Results from a three-stage expert elicitation

Background: Humanitarian emergencies including disasters associated with natural hazards, conflict, complex emergencies and famines can pose significant risks to public health, especially when they lead to population displacement into inadequate conditions. To reduce the risk of communicable disease outbreaks in such situations it is necessary to know the key risk factors, their thresholds (quantitative risk factors only) and their relative importance in different types of emergencies. Methods: We conducted a three-stage structured expert elicitation. Experts from the fields of health protection and humanitarian assistance were invited to complete three successive online questionnaires. Experts were asked to choose the 20 most critical risk factors and in subsequent rounds to determine thresholds for urgent (yellow threshold level) and critical action (red threshold level). Additionally, experts were asked to assign weights for the risk factors in different emergency types. Results: We identified 20 key risk factors, which include factors related to water, sanitation and hygiene, access to health care, vaccination, nutrition, political will and others. Nine out of the 20 risk factors were quantifiable, for those risk factors yellow and red thresholds are given. 11 risk factors were qualitative. All risk factors scored highly when weighted in different emergency types and differences between risk factor weights in different types of emergencies were limited. Conclusion: Communicable disease risks in humanitarian emergencies are a nexus of complex and often interrelated individual issues. Knowing key risk factors and their thresholds and weight in different types of emergencies can help guide emergency response and risk reduction efforts.

Low consumption of fruits and vegetables among adults in Uganda: findings from a countrywide cross-sectional survey

IntroductionAdequate consumption of fruits and vegetables has protective benefits against development of coronary heart disease, hypertension and chronic obstructive pulmonary disease. However, approximately 2.7 million deaths annually can be attributed to inadequate fruit and vegetable consumption. We analyzed data from a countrywide survey in Uganda, to estimate the prevalence of adequate fruit and/ or vegetable consumption, and identify associated factors.MethodsData were collected using the World Health Organization STEPwise approach to surveillance, a standard approach to surveillance of risk factors for Non Communicable Diseases. Fruit and vegetable consumption was assessed by asking participants the number of days in a typical week they eat fruits or vegetables and the number of servings eaten in one of those days. Adequate fruit and/ or vegetable consumption was defined as consuming 5 or more servings of fruits and/ or vegetables per day in a typical week. We used modified Poisson regression analysis to estimate prevalence risk ratios (PRRs) and identify factors associated with eating 5 or more servings of fruits and/ or vegetables per day, per week.ResultsOf 3962 participants, 484 (12.2%) consumed 5 or more servings of fruits and/ or vegetables per day in a typical week. Participants who were married or cohabiting were more likely to consume at least 5 servings of fruits and/ or vegetables per day in a typical week compared with those who had never been married PRR = 1.51 [95% CI 1.07–2.14]. Compared with participants from Western region, those from Central region were more likely to consume 5 or more servings of fruits and/ or vegetables per day in a typical week, PRR = 3.54 [95% CI 2.46–5.10] as were those from Northern, PRR = 2.90 [95% CI 2.00–4.23] and Eastern regions PRR = 1.60 [95% CI 1.04–2.47].ConclusionsFruit and vegetable consumption in Uganda is low and does not differ significantly across social and demographic characteristics, except marital status and geographical region of residence. There is a need to develop and strengthen policies that promote adequate consumption of fruits and vegetables in the Ugandan population.

Prevalence of non communicable disease risk factors among male to female transgenders: a cross sectional study

Background: Non communicable diseases are responsible for a high proportion of deaths and disabilities. The major risk factors attributed to this are smoking, heavy alcohol drinking, inadequate fruit, and vegetable consumptions, and physical inactivity. While there are data available to understand the prevalence of non-communicable risk factors among men and women, there is no data among transgender community. Hence this study was conducted to assess the prevalence of NCD risk factors among the male-to-female transgender community.Methods: This cross sectional study was conducted among 54 transwomen who had been registered with two social welfare organizations for transgender community in Chennai. The risk factor was assessed using WHO STEPS instrument.Results: Among the transwomen, 16.7% were currently smoking tobacco, while 18.5% were using smokeless forms of tobacco. Alcohol consumption was observed in 44.4% of the population. 62.9% of them were not involved in any kind of exerting physical activity for recreation. 25.9% had undergone hormone supplementation for gender affirmation. Prevalence of obesity was 20.4% in the study population. The prevalence of hypertension, diabetes and hypercholesterolemia was 11.1%, 5.6% and 7.4% respectively.Conclusions: High Prevalence of certain risk factors such as smokeless tobacco usage, alcohol consumption and hormone supplementation were seen among the male-to-female transgender community compared to the general population. Targeted interventions must be made so that specific attention is given to the transgender community in various NCD programs by the government. They must also be supported and accepted by every member of this society.

Obesity, hypertension, and dyslipidemia among human immunodeficiency virus patients in Abeokuta Ogun State, Nigeria

Context: The coexistence of human immunodeficiency virus (HIV) with non communicable disease risk factors is an emerging public health problem in sub-Saharan Africa. Aims: We investigated the prevalence and risk factors of obesity, hypertension, and dyslipidemia among HIV-positive patients in Abeokuta. Settings and Design: This was a cross-sectional study done using 206 persons living with HIV in three hospitals at Abeokuta, South Western Nigeria. Subjects and Methods: The WHO stepwise interviewer-administered questionnaire was used for data collection. Specific clinical information on HIV treatment status and traditional cardiovascular risk factors were assessed. Data were analyzed using descriptive statistics, Chi-square, and multivariate logistic regression at P Results: The prevalence of overweight/obesity was 34.0% (95% confidence interval [CI]: 27.5–40.5); 20.9% (95% CI: 15.3–26.4) for hypertension; and 40.2% (95% CI: 33.5–47.0) for dyslipidemia. Risk factors for obesity were sedentary time (odds ratio [OR] 1.2; 95% CI: 1.0–1.3), hypertension (OR 3.0; 95% CI: 1.1–6.0), and increasing duration of HIV (OR for 2–5 years = 2.0; 95% CI: 1.0–4.1 and OR for >5 years = 3.0; 95% CI: 1.0–6.3). Age >40 years (OR 7.9; CI: 2.7–23) and CD4 level ≥ 350/μl (OR 3.9; 95% CI: 1.0–14.6) were risk factors for hypertension while female sex protected against hypertension (OR 0.2; 95% CI: 0.1–0.6). None of the measured covariates predicted dyslipidemia. Conclusion: Obesity, hypertension, and dyslipidemia are common in HIV patients in Nigeria. HIV patients would benefit from cardiovascular diseases screening programs just like the general adult population if the gains of HIV care are not to be reversed.

Predictive factors for preventing hookah smoking and health promotion among young people based on the protection motivation theory.

BACKGROUND:Smoking hookahs is one of the most preventable risk factors for non communicable diseases. It is also considered as the gateway to youth addiction. Planning and training to prevent this health problem is considered an important priority. The aim of this study was to determine the predictive factors for preventing hookah smoking (PHS) in the youth of Sirjan city, based on the protection motivation theory (PMT).MATERIALS AND METHODS:This research was a cross-sectional study conducted in 2018, and participants were chosen by simple random sampling. Data were collected by a researcher-made questionnaire which was valid and reliable and was designed based on the PMT constructs. This questionnaire was completed by 280 young people in Sirjan, Iran. Data were analyzed through descriptive statistics, Pearson correlation coefficients, and linear regression.RESULTS:Pearson correlation coefficients showed that there was a significant correlation between protection motivation and the structures of the PMT, except for the response cost structure. The strongest correlation was between protection motivation and self-efficacy (r = 0.502) and fear (r = 0.470). The structures of the PMT predicted 36.5% of PHS, and fear (β =0.27) was the strongest predictor of PHS.CONCLUSION:The results of this study show that the constructs of the PMT can partially predict PHS. This theory can be used as a tool for designing and implementing educational interventions to prevent hookah smoking among the youth.

Prevalence of Risk Factors of Major NonCommunicable Diseases among Adolescents of Higher Secondary Schools of Kaski, District

The main aim of this study is to determine the prevalence of major non communicable disease risk factors among higher secondary school students. A cross-sectional study was conducted among higher secondary students of grade 11 and 12 of Kaski district in Nepal. The study period was from July 2016 to June 2017. Total sample 640 higher secondary students were recruited through two-stage cluster sampling. Self-administrated questionnaire was used for the data collection tool along with other tools which were used such as UNICEF electronic weighing scale, stature meter and mechanical aneroid sphygmomanometer. Ethical approval was obtained from IRC, Pokhara University. Data were entered intoEpiData software and analysis was performed with the help of the Statistical Package for Social Science (SPSS). The prevalence of smoking was 6.1% which was high in male (11.9%) than female (0.6%). Alcohol consumption practice among the adolescents was 18.9%. Family history of hypertension was seen higher than family history of diabetes.The prevalence of hypertension was 11.7%. High prevalence of abnormal values of systolic and diastolic BP was found in male than female students. Overweight was seen in 6.1% students. Prevalence of obesity was almost equal in both groups. There is high prevalence of smoking, alcoholism among adolescents. Hypertension was more common than overwieght among adolescents.

Prevalence of Risk Factors of Major Non-Communicable Diseases among Adolescents of Higher Secondary Schools of Kaski District

Background: The main aim of this study is to determine the prevalence of major non communicable disease risk factors among higher secondary school students.Methods: A cross-sectional study was conducted among higher secondary students of grade 11 and 12 of Kaski district in Nepal. The study period was from July 2016 to June 2017. Total sample 640 higher secondary students were recruited through two-stage cluster sampling. Self-administrated questionnaire was used for the data collection tool along with other tools which were used such as UNICEF electronic weighing scale, stature meter and mechanical aneroid sphygmomanometer. Ethical approval was obtained from IRC, Pokhara University. Data were entered intoEpiData software and analysis was performed with the help of the Statistical Package for Social Science (SPSS).Results: The prevalence of smoking was 6.1% which was high in male (11.9%) than female (0.6%). Alcohol consumption practice among the adolescents was 18.9%. Family history of hypertension was seen higher than family history of diabetes.The prevalence of hypertension was 11.7%. High prevalence of abnormal values of systolic and diastolic BP was found in male than female students. Overweight was seen in 6.1% students. Prevalence of obesity was almost equal in both groups.Conclusions: There is high prevalence of smoking, alcoholism among adolescents. Hypertension was more common than overwieght among adolescents.Keywords: Adolescent; college students; non-communicable diseases; risk factors.

A8942 Detection of Hypertension in People Working at Tertiary Level Cardiac Hospital in Bangladesh According to 2017 ACC/AHA Guideline on High Blood Pressure and Its Impact

Objectives: Hypertension is the most common cardiovascular disorder affecting about 20% of adult population worldwide. Non communicable disease risk factor survey 2010 in Bangladesh has shown that the prevalence of hypertension in adult aged more than 25 years is 17.9% (more in urban (19.9%) than in rural areas (15.9%). Present study conducted to detect hypertension among the staff of a tertiary care cardiac hospital in Dhaka, Bangladesh, according to new 2017 ACC/AHA guideline on Hypertension and compared with previous guideline Methods: National Heart Foundation Hospital & Research Institute in collaboration with International Society of Hypertension (ISH) participated in the international event of May Measurement Month (MMM17) 2017 for screening program for hypertension in Bangladesh. As a part of this program all staff of this tertiary care hospital were requested to measure their blood pressure, height and weight. Data were recorded in a predesigned questionnaire. Total 786 data were analyzed. Results: Mean age ± Std. deviation was 33.0 ± 10.0 years. Among them 305 (38.8%) were male and 481 (61.2%) were female. 4.3% were diabetic, 5.5% were smoker and 0.4% had history of heart attack. Mean ± Std. deviation of systolic blood pressure was 109.7 ± 14.8 with the range of 80 to 170 mm Of Hg and that of diastolic blood pressure was 73.4 ± 10.0 with the range of 40 to 100 mm of Hg. Among them 17.2% were hypertensive according to previous guidelines (on medication or SBP ≥ 140 and/or DBP ≥90 mm of Hg) and 43.8% were hypertensive according to current guidelines (on medication or SBP ≥ 130 and/or DBP ≥80 mm of Hg). Conclusion: The prevalence of Hypertension became significantly higher as per new guideline. So, further consensus among the clinicians and the health planners is required before adopting new guideline in Bangladesh.

Awareness of Risk Factors for Non Communicable Diseases among Adolescent girls aged 15-17 years in Koti, Hyderabad

Awareness of Risk Factors for Non Communicable Diseases among Adolescent girls aged 15-17 years in Koti, Hyderabad

Antibiotic resistance and One Health: a mapping project

Abstract Background The One Health approach is a global strategy that encourages interdisciplinary collaboration on health at the human–animal–environmental interface. Antibiotic resistance is a direct consequence of the selection pressure from antibiotic use in humans, animals, and the environment, requiring a One Health approach towards its containment. The high HIV/AIDS burden and other risk factors for communicable diseases in South Africa results in a high incidence of infectious diseases, engendering extensive antibiotic use and subsequent resistance. Two-thirds of the antimicrobials sold for animal use are used in growth promotion. Although the burden of antibiotic resistance has not been quantified, available evidence indicates that it is escalating in humans, animals, and the environment. There is thus a need to quantify the burden of antibiotic resistance with a view to implementing measures for its containment on biomedical, clinical, sociobehavioural, drug discovery/diagnostics, and policy grounds. Methods This project delineates the molecular epidemiology, nature, and extent of antibiotic resistance in the One Health context in the uMgungundlovu District in KwaZulu-Natal, South Africa. The aim is to map the fluidity of antibiotic-resistant bacterial clones, antibiotic resistance genes, and their associated mobile genetic elements within and between the human, animal, and environmental health sectors by (1) instituting surveillance programmes on antibiotic use and resistance in human, animal, and environmental health; (2) demonstrating the phenotypic and genotypic mechanisms of antibiotic resistance by sensitivity testing and appropriate screening tests and whole-genome sequencing; and (3) establishing the clonality and genetic determinants of resistance by multi-locus sequence typing and whole-genome sequencing. Findings This project began in 2017. Isolates have been collected from patients, chicken, water, and soil. The molecular epidemiology of their antibiotic resistance profiles will be determined. The project will (1) provide a proxy surveillance system for antibiotic resistance in humans and food animals and (2) unambiguously give credence to the One Health approach for the containment of antibiotic resistance mooted in the UN General Assembly Political Declaration on Antimicrobial Resistance and by the tripartite alliance of the WHO, the Food and Agriculture Organization, and the World Organisation for Animal Health using a specific conceptual framework. Interpretation Successful proof of concept will require validation of the conceptual framework in different countries and health systems with different levels of antibiotic resistance and will thus be tested in high-income, middle-income, and low-income countries with different antibiotic resistance burdens. Funding South African National Research Foundation, South African Medical Research Council.

Assessing tobacco marketing regulation implementation level in Georgia: evidence from Non Communicable Disease Risk Factors STEPS Survey Georgia 2016

Assessing tobacco marketing regulation implementation level in Georgia: evidence from Non Communicable Disease Risk Factors STEPS Survey Georgia 2016