Disease Management Approach Research Articles

Identifying metabolic shifts in Crohn's disease using 'omics-driven contextualized computational metabolic network models

Crohn's disease (CD) is a chronic inflammatory disease of the gastrointestinal tract. A clear gap in our existing CD diagnostics and current disease management approaches is the lack of highly specific biomarkers that can be used to streamline or personalize disease management. Comprehensive profiling of metabolites holds promise; however, these high-dimensional profiles need to be reduced to have relevance in the context of CD. Machine learning approaches are optimally suited to bridge this gap in knowledge by contextualizing the metabolic alterations in CD using genome-scale metabolic network reconstructions. Our work presents a framework for studying altered metabolic reactions between patients with CD and controls using publicly available transcriptomic data and existing gene-driven metabolic network reconstructions. Additionally, we apply the same methods to patient-derived ileal enteroids to explore the utility of using this experimental in vitro platform for studying CD. Furthermore, we have piloted an untargeted metabolomics approach as a proof-of-concept validation strategy in human ileal mucosal tissue. These findings suggest that in silico metabolic modeling can potentially identify pathways of clinical relevance in CD, paving the way for the future discovery of novel diagnostic biomarkers and therapeutic targets.

PER2 integrates circadian disruption and pituitary tumorigenesis.

Rationale: The role of circadian clock in pituitary tumorigenesis remains elusive. Here we investigate whether and how circadian clock modulates the development of pituitary adenomas. Methods and Results: We found altered expression of pituitary clock genes in patients with pituitary adenomas. In particular, PER2 is prominently upregulated. Further, jetlagged mice with PER2 upregulation have accelerated growth of GH3 xenograft tumor. Conversely, loss of Per2 protects mice against developing estrogen-induced pituitary adenoma. Similar antitumor effect is observed for SR8278, a chemical that can decrease pituitary PER2 expression. RNA-seq analysis suggests involvement of cell cycle disturbance in PER2 regulation of pituitary adenoma. Subsequent in vivo and cell-based experiments validate that PER2 induces pituitary expression of Ccnb2, Cdc20 and Espl1 (three cell cycle genes) to facilitate cell cycle progression and inhibit apoptosis, thereby promoting pituitary tumorigenesis. Mechanistically, PER2 regulates the transcription of Ccnb2, Cdc20 and Espl1 through enhancing the transcriptional activity of HIF-1α. HIF-1α trans-activates Ccnb2, Cdc20 and Espl1 via direct binding to its specific response element in the gene promoters. Conclusion: PER2 integrates circadian disruption and pituitary tumorigenesis. These findings advance our understanding of crosstalk between circadian clock and pituitary adenomas and highlight the relevance of clock-based approaches in disease management.

Celiac disease: experience of general practitioners in Brianza Area- Monza- Milan-Italy.

The purpose of the study was to better investigate the degree of knowledge and the diagnostic approach concerning celiac disease and its extra-intestinal manifestations by general practitioners in Italy. Celiac Disease is a common chronic disease, but often goes undiagnosed because of atypical symptoms or silent disease. Currently there are non-definitive data about the disease management approach concerning celiac disease by general practitioners. To better investigate the degree of knowledge and the diagnostic approach concerning celiac disease and its extra-intestinal manifestations, questionnaire was used to assess the daily practice of diagnosis, treatment, and follow-up of this condition by general practitioners in two densely populated area in Italy: Monza-Brianza Area and Milan City. The questionnaire was composed of 18 questions that explored 3 precise domains: diagnosis criteria, correct management of celiac disease and availability for training. The frequencies of the domains explored were analyzed, analyzes were carried out to identify differences between the groups of general practitioners interviewed. Analysis of the questionnaires showed a degree of knowledge and preparation comparable to that of other countries, even though not sufficient to guarantee access to early diagnosis for all patients with celiac disease. The knowledge was not influenced by the years of experience or specific curriculum of health professionals. General practitioners under 40 were much more in favor of continuous training and were aware of its importance (OR=10.55; CI95%: 1.62-445.39), although this need was a high priority in the whole group interviewed (84.7%). Continuous specific training aimed at primary care physicians and general practitioners is the first tool to improve early diagnosis. A second opportunity is represented by the continuous dialogue between general practitioners and tertiary level hospitals and universities.

What is the current and expected evolution of prevalence, geographical spread and impact of ticks and tick-borne diseases, and what strategies are needed to improve management, testing, diagnosis and treatment of these diseases amongst patients and animal populations?

Tick-borne pathogens are a growing threat with increasing negative impact on species diversity, food security and human health. Ticks, as a group, are second only to mosquitoes as vectors of pathogens to humans and are the primary vector for pathogens of livestock, companion animals, and wildlife (Mansfield et al., 2017). There are many tick species in Europe that carry human pathogens, and there are many more in North and South America and Asia. Changes in climate and land usage are leading to changes in the tick populations and therefore pathogen spread (Gandy et al., 2023).1 To mitigate the impact of these tick-borne pathogens, we need to better understand the complex relationships between vector, pathogen and host. Disease management approaches (including preventative measures and treatment protocols) vary significantly from country to country, partly due to resource challenges, but also due to knowledge siloes. Testing and treatment protocols for many tick-borne diseases are an acknowledged area of research need, and there is a growing patient, political and clinical voice calling for improvement. Effective multidisciplinary and international collaboration has the potential to yield significant improvements in scientific understanding, disease management and treatment strategies.

An Extensive Review of Strawberry (Fragaria×ananassa) Diseases and Integrated Management Approaches: Current Understanding and Future Directions

Strawberry production has increased by more than double in the past two decades. Meanwhile, it is also susceptible to various diseases which have become a limiting factor in its yield increment. Indiscriminate use of chemicals in the management of diseases has brought several adverse effects to the environment and human health. Thus, this review aims to present the different diseases of strawberries including their epidemiology, disease cycle, and symptoms. Moreover, the focus has been given to Integrated Management. More than ten dozen of literature including journal articles, books, websites, and organizational reports were thoroughly reviewed to get the related information. Botrytis grey mold rot, anthracnose, strawberry leaf spot, powdery mildew, and red stele are the major fungal diseases whereas angular leaf spot is the serious bacterial disease of strawberries. It is severely infected by viruses such as strawberry mottle virus and crinkling and vein banding virus. In addition to this nematode causes ring spots, root-knot, and root lesions on strawberries. Integrated disease management approaches should be adopted for effective and sustainable management. It may include cultural methods, physical methods, use of bio-control agents, botanical fungicides, and at last chemicals if the disease is severe.

Molecular Identification of Podosphaera xanthii and the Susceptibility of Vigna Species Genotypes to Natural Infection of Powdery Mildew

Powdery mildew was observed on 20 genotypes of Vigna unguiculata subsp. sesquipedalis (yardlong beans) and 33 genotypes of V. radiata (mungbean) in Los Baños, Laguna, Philippines. Powdery mildew was collected and then subjected to molecular characterization to identify the species associated with the disease. Based on combined microscopic observations and molecular identification, the species causing powdery mildew to yardlong bean and mungbean was Podosphaera xanthii (Castagne) U. Braun & S. Takam. 2000 (Bas.: Erysiphe xanthii 1845). None of the yardlong beans and mungbean genotypes were resistant to powdery mildew, with disease incidence reaching up to 100% and with fungal colonies present on plant vines and both sides of leaves. This is the first report of powdery mildew disease caused by P. xanthii on yardlong bean and mungbean in the country. Both legume plant species are important food crops in the Philippines. The information from this study will be valuable in formulating other disease management approaches. The lack of resistant plants warrants further screening in legume germplasm collection to identify sources of resistance or tolerance.

Huanglongbing Pandemic: Current Challenges and Emerging Management Strategies.

Huanglongbing (HLB, aka citrus greening), one of the most devastating diseases of citrus, has wreaked havoc on the global citrus industry in recent decades. The culprit behind such a gloomy scenario is the phloem-limited bacteria "Candidatus Liberibacter asiaticus" (CLas), which are transmitted via psyllid. To date, there are no effective long-termcommercialized control measures for HLB, making it increasingly difficult to prevent the disease spread. To combat HLB effectively, introduction of multipronged management strategies towards controlling CLas population within the phloem system is deemed necessary. This article presents a comprehensive review of up-to-date scientific information about HLB, including currently available management practices and unprecedented challenges associated with the disease control. Additionally, a triangular disease management approach has been introduced targeting pathogen, host, and vector. Pathogen-targeting approaches include (i) inhibition of important proteins of CLas, (ii) use of the most efficient antimicrobial or immunity-inducing compounds to suppress the growth of CLas, and (iii) use of tools to suppress or kill the CLas. Approaches for targeting the host include (i) improvement of the host immune system, (ii) effective use of transgenic variety to build the host's resistance against CLas, and (iii) induction of systemic acquired resistance. Strategies for targeting the vector include (i) chemical and biological control and (ii) eradication of HLB-affected trees. Finally, a hypothetical model for integrated disease management has been discussed to mitigate the HLB pandemic.

Native endophytes from maize as potential biocontrol agents against bacterial top rot caused by cross-kingdom pathogen Klebsiella pneumoniae

Maize crop has been suffering huge economic loss due to bacterial top rot disease caused by emerging plant pathogen Klebsiella pneumoniae, which is most concerning and highly contagious to both humans and animals. At present, chemical control is considered as an important disease management approach, however biological control through native endophytes has not been reported yet. Here, initially we isolated 120 native endophytes from maize plants, and screened 12 endophytes with potential antagonistic effect in coculture assay against maize bacterial top rot pathogen. Based on strong antibacterial activity, three endophytes (MZ-4, YN-23, and F14) were selected to evaluate their plant growth-promoting traits and biocontrol efficiency through in-vitro and in-vivo antagonistic assays. The three strains could produce IAA with a maximum yield of 2.54 µg/ml, 2.96 µg/ml, 2.07 µg/ml, respectively and also inhibit the growth of 10 common plant pathogenic bacteria. In planta assay suggested that three endophytes enhanced maize growth and significantly suppressed the incidence of K. pneumoniae with control effect of about 81.2 %, 74.7 %, and 66.7 %, respectively. Lastly, selected isolates MZ-4, YN-23, and F14 were molecularly characterized and identified as Bacillus velezensis. To our knowledge, this is the first study reporting the application of maize endophyte B. velezensis as a biocontrol agent against emerging pathogen of maize bacterial top rot disease.

Development of a multi-year white-nose syndrome mitigation strategy using antifungal volatile organic compounds.

Pseudogymnoascus destructans is a fungal pathogen responsible for a deadly disease among North American bats known as white-nose syndrome (WNS). Since detection of WNS in the United States in 2006, its rapid spread and high mortality has challenged development of treatment and prevention methods, a significant objective for wildlife management agencies. In an effort to mitigate precipitous declines in bat populations due to WNS, we have developed and implemented a multi-year mitigation strategy at Black Diamond Tunnel (BDT), Georgia, singly known as one of the most substantial winter colony sites for tricolored bats (Perimyotis subflavus), with pre-WNS abundance exceeding 5000 individuals. Our mitigation approach involved in situ treatment of bats at the colony level through aerosol distribution of antifungal volatile organic compounds (VOCs) that demonstrated an in vitro ability to inhibit P. destructans conidia germination and mycelial growth through contact-independent exposure. The VOCs evaluated have been identified from microbes inhabiting naturally-occurring fungistatic soils and endophytic fungi. These VOCs are of low toxicity to mammals and have been observed to elicit antagonism of P. destructans at low gaseous concentrations. Cumulatively, our observations resolved no detrimental impact on bat behavior or health, yet indicated a potential for attenuation of WNS related declines at BDT and demonstrated the feasibility of this novel disease management approach.

Occupational medicine and ergonomics: a new paradigm for improved management of ergonomic risks

Abstract Despite the existence of numerous initiatives and methods to prevent occupational risks and improve workplace well-being, musculoskeletal disorders (MSDs) remain a major health concern in European countries. Without doubt, the cause of this worrying situation is multifactorial, and various disease management approaches have been proposed in the scientific literature. However, the authors of this article identified a gap that should be considered: collaboration between occupational health professionals and ergonomists would lead to more efficient ergonomic interventions and proper implementation of proactive measures for occupational health and safety. The paper presents a brief literature review and proposes a methodological framework that englobes the cooperation of occupational health professionals and ergonomists for implementation of ergonomic interventions.

Focusing COVID-19-associated mucormycosis: a major threat to immunocompromised COVID-19.

COVID-19 disease has been identified to cause remarkable increase of mucormycosis infection cases in India, with the majority of cases being observed in individuals recovering from COVID-19. Mucormycosis has emanated as an outcome of the recent COVID-19 pandemic outbreak as rapidly developing fatal illness which was acquired by Mucorales fungus which is a subcategory of molds known as mucormycetes. Mucormycosis is one of the serious, sporadic mycotic illnesses which is a great threat to immunocompromised COVID-19 patients and affects people of all ages, including children with COVID-19 infections. This is associated with tissue damaging property and, therefore, causes serious clinical complications and elevated death rate. The COVID-19-associated mucormycosis or "black fungus" are the terms used interchangeably. The rapid growth of tissue necrosis presenting as "rhino-orbital-cerebral, pulmonary, cutaneous, gastrointestinal, and disseminated disease" are various clinical forms of mucormycosis. The patient's prognosis and survival can be improved with proper surgeries using an endoscopic approach for local tissue protection in conjunction with course of appropriate conventional antifungal drug like Amphotericin-B and novel drugs like Rezafungin, encochleated Amphotericin B, Orolofim, and SCY-078 which have been explored in last few years. This review provides an overview of mucormycosis including its epidemiology, pathophysiology, risk factors, its clinical forms, and therapeutic approaches for disease management like antifungal therapy, surgical debridement, and iron chelators. The published patents and ongoing clinical trials related to mucormycosis have also been mentioned in this review.

Effect of marigold (Tagetes erecta L.) on soil microbial communities in continuously cropped tobacco fields

Root-knot nematode disease is a catastrophic soil-borne disease in tobacco production. The regulation of natural microbial communities is considered a good disease management approach to suppress the incidence of soilborne diseases. In this study, the effects of tobacco (Nicotiana tabacum L.)-marigold (Tagetes erecta L.) rotation on the diversity and structure of soil microbial communities in continuously cropped tobacco fields were analyzed to manage this devastating pathogen. The results showed that the soil bacterial OTUs increased after marigold rotation and that the bacterial Shannon, ACE, Chao1 index, and fungal Shannon index were higher in the tobacco-marigold rotation fields than in the continuously cropped tobacco fields by 3.98%, 10.37%, 5.46%, and 3.43%, respectively. After marigold rotation, the relative abundances of Actinobacteria, Acidobacteria, and Ascomycota increased by 28.62%, 107.50%, and 57.44%, respectively, and the proportion of beneficial bacterial genera such as Nocardioides, Gemmatimonas, and Bradyrhizobium increased. In addition, our results also showed that rotation of marigold could effectively reduce the incidence of root-knot nematodes in the next crop of tobacco. These results indicate that marigold rotation had a positive effect on the soil microecological environment of continuously cropped tobacco fields, reducing the obstacles to continuous cropping of tobacco.

Exploring the Efficacy of Biocontrol Microbes against the Fungal Pathogen Botryosphaeria dothidea JNHT01 Isolated from Fresh Walnut Fruit.

Biological control by antagonistic microorganisms are an effective and environmentally friendly approach in postharvest disease management. In order to develop a biocontrol agent for fresh walnut fruit preservation, the potential biocontrol effects of Bacillus amyloliquefaciens RD.006 and Hanseniaspora uvarum FA.006 against the main fungal pathogen of walnuts were evaluated. Botryosphaeria species showed the highest detection, and the JNHT01 strain showed the strongest pathogenicity. Bot. dothidea JNHT01 caused gray mold and brown rot on fresh walnuts, and its incidence rate reached 100% after an 8 days incubation. The growth of this fungal strain can be promoted by lighting, with a maximum growth rate achieved at a pH of 7 and at 28 °C. B. amyloliquefaciens RD.006 and H. uvarum FA.006 supernatants at a concentration of 1-15% v/v showed antifungal activity. The mycelial growth inhibition rates of Bot. dothidea JNHT01 were 23.67-82.61% for B. amyloliquefaciens RD.006 and 1.45-21.74% for H. uvarum FA.006. During Bot. dothidea JNHT01 growth, the biomass, nucleic acid leakage, and malondialdehyde content gradually increased, while the DPPH scavenging capacity and SOD activity decreased. The B. amyloliquefaciens RD.006 and H. uvarum FA.006 strains showed antifungal activity by damaging fungal cell membranes and reducing fungal antioxidant activity. Moreover, the antifungal effect of B. amyloliquefaciens RD.006 was higher than that of H. uvarum FA.006. Hence, the RD.006 strain of B. amyloliquefaciens can be considered a potential biocontrol agent for the management of postharvest walnut diseases caused by Bot. dothidea.

Transcriptome Profiling of the Resistance Response of Musa acuminata subsp. burmannicoides, var. Calcutta 4 to Pseudocercospora musae.

Banana (Musa spp.), which is one of the world's most popular and most traded fruits, is highly susceptible to pests and diseases. Pseudocercospora musae, responsible for Sigatoka leaf spot disease, is a principal fungal pathogen of Musa spp., resulting in serious economic damage to cultivars in the Cavendish subgroup. The aim of this study was to characterize genetic components of the early immune response to P. musae in Musa acuminata subsp. burmannicoides, var. Calcutta 4, a resistant wild diploid. Leaf RNA samples were extracted from Calcutta 4 three days after inoculation with fungal conidiospores, with paired-end sequencing conducted in inoculated and non-inoculated controls using lllumina HiSeq 4000 technology. Following mapping to the reference M. acuminata ssp. malaccensis var. Pahang genome, differentially expressed genes (DEGs) were identified and expression representation analyzed on the basis of gene ontology enrichment, Kyoto Encyclopedia of Genes and Genomes orthology and MapMan pathway analysis. Sequence data mapped to 29,757 gene transcript models in the reference Musa genome. A total of 1073 DEGs were identified in pathogen-inoculated cDNA libraries, in comparison to non-inoculated controls, with 32% overexpressed. GO enrichment analysis revealed common assignment to terms that included chitin binding, chitinase activity, pattern binding, oxidoreductase activity and transcription factor (TF) activity. Allocation to KEGG pathways revealed DEGs associated with environmental information processing, signaling, biosynthesis of secondary metabolites, and metabolism of terpenoids and polyketides. With 144 up-regulated DEGs potentially involved in biotic stress response pathways, including genes involved in cell wall reinforcement, PTI responses, TF regulation, phytohormone signaling and secondary metabolism, data demonstrated diverse early-stage defense responses to P. musae. With increased understanding of the defense responses occurring during the incompatible interaction in resistant Calcutta 4, these data are appropriate for the development of effective disease management approaches based on genetic improvement through introgression of candidate genes in superior cultivars.

Psychological services to extend public health and disease management approaches in criminal justice settings: An introduction.

COVID-19 has brought renewed attention to the physical and mental health needs of underserved populations and the settings that assist them in receiving services. This introduction presents six articles of a special section on disease management approaches used within criminal justice settings to address such needs. Articles span a range of settings, including prisons, jails, mental health courts, forensic settings, and crisis units. Collectively, the articles in this special section discuss medical conditions, substance use, and mental health. They provide information on the diverse approaches taken across various settings in managing the physical and mental health challenges of those involved in the criminal justice system. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Bacterial cellulose adhesive patches designed for soft mucosal interfaces

The wet environment in the oral cavity is challenging for topical disease management approaches. The compromised material properties leading to weak adhesion and short retention (<8 h) in such environment result in frequent reapplication of the therapeutics. Composites of bacterial cellulose (BC) and carbene-based bioadhesives attempt to address these shortcomings. Previous designs comprised of aqueous formulations. The current design, for the first time, presents dry, shelf-stable cellulose patches for convenient ready-to-use application. The dry patches simultaneously remove tissue surface hydration while retaining carbene-based photocuring and offers on-demand adhesion. The dry patch prototypes are optimized by controlling BC/adhesive mole ratios and dehydration technique. The adhesion strength is higher than commercial denture adhesives on soft mucosal tissues. The structural integrity is maintained for a minimum of 7 days in aqueous environment. The patches act as selective nanoporous barrier against bacteria while allowing permeation of proteins. The results support the application of BC-based adhesive patches as a flexible platform for wound dressings, drug depots, or combination thereof.

Integrated Pest and Disease Management (IPDM) Approach in Mulberry Sericulture of Jammu &amp; Kashmir

Jammu and Kashmir is one of the traditional sericultural states of India, produces 735 MT of cocoons which is converted into 98 MT of raw silk. Spring is the major silkworm rearing season of J&amp;K when fresh mulberry leaf is available for rearing the silkworm, Bombyx mori L. The food plant of silkworm, mulberry is affected by various insect pests viz., Glyphodes pyloalis, Spilosoma oblique, Amsacta lactinea, Hemerophilla atrilineata etc., and diseases like leaf spot and powdery mildew. In integrated pest and disease management of mulberry various factors such as cultural, mechanical, biological and bio-pesticides management practices have been adopted to control the pests as well as the diseases of mulberry. The major diseases are powdery mildew and leaf spot which affect the foliage of the mulberry plant thereby reducing the quality and quantity of the silkworm feed. The present study was conducted to identify the suitable IPDM approach to manage pest and diseases in mulberry sericulture of Jammu &amp; Kashmir. Results showed that the impact of IPDM the incidence of insect pest to an extent of 43.66% and 48.82% by leaf Webber and semilooper respectively. Leaf spot and powdery mildew disease of mulberry was also reduced up to 39.56% and 49.92% respectively. By adopting 100% IPDM module cocoon yield was increased up to 4 kg 100 disease free laying (dfl).

Natural farming

Due to the increasing global population, advancement in farming techniques to meet the global food demand is the need of the hour. Conventional farming techniques have increased the yield over the past few decades, but those techniques also have adverse effects on natural resources. In this scenario, many other alternatives have emerged as a solution, natural farming being one among them. The presented article delivers crucial information regarding the targeted farming technique i.e., natural farming. Multiple scientifically-proven natural techniques and ecological approaches are discussed for different aspects of farming. In addition, criticisms related to Natural Farming are illustrated along with a basic introduction to zero budget natural farming (ZBNF). Furthermore, the article describes multiple proven technologies for weed, pest and disease management approaches through natural practices. Lastly, the article gives recommendations on implementing and introducing natural farming to the farming community.

Comparative Proteomic Analysis of Potato Roots from Resistant and Susceptible Cultivars to Spongospora subterranea Zoospore Root Attachment In Vitro.

Potato (Solanum tuberosum L.) exhibits broad variations in cultivar resistance to tuber and root infections by the soilborne, obligate biotrophic pathogen Spongospora subterranea. Host resistance has been recognised as an important approach in potato disease management, whereas zoospore root attachment has been identified as an effective indicator for the host resistance to Spongospora root infection. However, the mechanism of host resistance to zoospore root attachment is currently not well understood. To identify the potential basis for host resistance to S. subterranea at the molecular level, twelve potato cultivars differing in host resistance to zoospore root attachment were used for comparative proteomic analysis. In total, 3723 proteins were quantified from root samples across the twelve cultivars using a data-independent acquisition mass spectrometry approach. Statistical analysis identified 454 proteins that were significantly more abundant in the resistant cultivars; 626 proteins were more abundant in the susceptible cultivars. In resistant cultivars, functional annotation of the proteomic data indicated that Gene Ontology terms related to the oxidative stress and metabolic processes were significantly over-represented. KEGG pathway analysis identified that the phenylpropanoid biosynthesis pathway was associated with the resistant cultivars, suggesting the potential role of lignin biosynthesis in the host resistance to S. subterranea. Several enzymes involved in pectin biosynthesis and remodelling, such as pectinesterase and pectin acetylesterase, were more abundant in the resistant cultivars. Further investigation of the potential role of root cell wall pectin revealed that the pectinase treatment of roots resulted in a significant reduction in zoospore root attachment in both resistant and susceptible cultivars. This study provides a comprehensive proteome-level overview of resistance to S. subterranea zoospore root attachment across twelve potato cultivars and has identified a potential role for cell wall pectin in regulating zoospore root attachment.

Integrated approach for noncommunicable disease management in the Americas.

ABSTRACTAn overview of an integrated approach to improve noncommunicable disease (NCD) management is presented, along with tools on integrating NCD management as part of health system strengthening in the Americas. The study is based on an analysis of Pan American Health Organization/World Health Organization (PAHO/WHO) data and publicly available information on NCD care and capacity, disruptions in NCD services, and guidance on NCD management. Gaps in NCD care are highlighted, in which an estimated 43.0% of men and 28.0% of women with hypertension in Latin America remain undiagnosed; and for those with diabetes, 32.8% in Central and South America are undiagnosed. Yet, only 17/35 countries (49%) in the Americas report having evidence-based national guidelines for NCD management through a primary care approach and only 7/35 countries (20%) report provision of drug therapy, including glycaemic control for eligible persons. To improve NCD management, an integrated approach is needed to coordinate and deliver care across the levels of the health system. This includes increasing primary care capacity and competencies to address multiple chronic conditions, and integration with other complementary programs to avoid missing opportunities for NCD diagnosis and management. An integrated approach to NCD management, and implementation of available tools, should be part of rebuilding health systems after the COVID-19 pandemic.