Increase In Non-communicable Diseases Research Articles

The Physical Activity Patterns among Rural Chinese Adults: Data from China National Nutrition and Health Survey in 2010⁻2012.

China has experienced a rapid increase in non-communicable diseases (NCDs), especially in rural China. In addition to a dramatic increase in energy intake, the decrease in physical activity (PA) may be a reason. The study described the patterns and factors of physical activity and sedentary behaviors of 70,038 adults in rural China, based on data from the Chinese Nutrition and Health Survey (CNNHS) in 2010–2012. The mean working time of the employed subjects was 6.04 ± 1.3 day/week, 8.38 ± 2.2 h/day, of which 3.37 ± 2.8 h was sitting time. The occupational PA intensity was significantly relevant with occupation. The average transportation time of the rural Chinese adults was 57.9 ± 45.4 min, and 60.0% took the active transportation mode. The leisure-time PA (LTPA) participation rate was 3.8%, the LTPA time of those who had LTPA was 234.9 ± 231.3 min/week, lower participation was found in farmers and those in younger age groups, and those with lower educational and economic levels. The average domestic PA time, sedentary leisure-time, and sleeping time was 93.0 ± 72.7 min, 2.5 ± 1.4 h, and 7.9 ± 1.1 h, respectively. PA programs should be implemented in rural China, and the PA guidelines for farmers should be developed separately for the farming and non-farming seasons.

Practices of Future Foresight in Management of Non-Communicable Diseases -An Early Attempt towards Focusing on ‘Foresight Economy’ Labs.

Future foresight have been more linked with technological changes and innovative disruptions than socio-economic challenges. With the development of foresight, science efforts should be directed towards tackling humanity chronic problems than just focusing most of the efforts on future technological developments and advancements only. Focusing the foresight analysis on the increase of Non-Communicable Diseases (NCD’s) doesn’t only help us to tackle current and future health community issues, but in fact direct the focus of the efforts on mitigating the progressive development of future socio-economic and quality of life challenges. The world need more work in utilising strategic foresight in dealing with Socio-Economic challenges. The holistic approach of SF studies targeted to overcome the usual challenges that face the future socio-economic change where NCD’s are expected to become more of epidemic problem in many countries and specially in the Arab and Asian emerging economy countries. The future carries a catastrophic result where 90% of the population in a country like Bahrain might be at risk of NCD during their life in the next 50 years, unless radical lifestyle changes are done. Utilising a technique called ‘foresight economy’ lab (FEL) the problem statement is shifted from solutions of increasing the NCD’s clinics in Community Health Centre (CHC’s) to more challenging the CHC’s staff towards better explore early NCD’s risks, i.e. focusing in increasing their capacity through collaboration of all the community services. This paper concludes with what FEL’s bring in as opportunities that would help in drastically reducing the percentage of population at NCD’s risk, from having 90% to 50% at risk in 20 years from now and with minimal resources.

Role of chronobiology in determining the distribution of non-communicable diseases across geographies-thinking beyond diet

Background: Over the last few years, it is being realised that the increasing burden of non-communicable diseases (NCDs) may be linked to some macro-level determinants. Material and Methods: The present systematic review uses data distributed across geographies to explore the role played by chronobiology. Results: The paper is based on the role of these factors in affecting the prevalence of diabetes, hypertension and dementia. The paper uses extensive empirical scrutiny, covering areas across a state and applying the outcome of these to generate a hypothesis. Conclusion: Our results though initial indicate that change in chronotype appears to contribute to an increase in NCDs.

A review on Noncommunicable Diseases (NCDs) burden, its socio-economic impact and the strategies for prevention and control of NCDs in India.

Noncommunicable diseases (NCDs) have become a major public health problem in India accounting for 62% of the total burden of foregone DALYs and 53% of total deaths. Out-of-pocket expenditure associated with the acute and long-term effects of NCDs is high resulting in catastrophic health expenditure for the households. A large national survey in India found that spending on NCDs accounted for 5.17% of household expenditure. According to a macroeconomic analysis, it is estimated that each 10% increase in NCDs is associated with a 0.5% lower rate of annual economic growth. The income loss due to hypertension is the highest, followed by diabetes and cardiovascular diseases. The macroeconomic impact of NCDs is profound as they cause loss of productivity and decrease in gross domestic product. Since the health sector alone cannot deal with the "chronic emergency" of NCDs, a multisectoral action addressing the social determinants and strengthening of health systems for universal coverage to population and individual services is required.

China's Efforts on Management, Surveillance, and Research of Noncommunicable Diseases: NCD Scorecard Project

BackgroundThe incidence of noncommunicable diseases (NCDs) is rising dramatically throughout the world. Aspects of researches concerned with the improvement and development of prevention and control of NCDs have been conducted. Furthermore, the influence of most determinants of the major NCDs has showed that a broad and deep response involving stakeholders in different sectors is required in the prevention and control of NCDs. ObjectiveChina has experienced an increase in NCDs in a short period compared with many countries. To address the burden of NCDs in China, it is important to learn about the progress that has been made in prevention and control of NCDs in China and worldwide, informed by opinions of stakeholders in different areas. MethodsIn 2014, GRAND South developed the NCD Scorecard instrument to evaluate progress of NCD prevention and control in 23 countries through a 2-round Delphi process. The scorecard included 51 indicators in 4 domains: governance, surveillance and research, prevention and risk factors, and health system response. Stakeholders were then selected in the areas of government, nongovernmental organizations, private sectors, and academia to join the NCD Scorecard survey. Indicators of progress were scored by stakeholders from 0 (no activity), 1 (present but not adequate), and 2 (adequate) to 3 (highly adequate) and then the percentage of progress in each domain was calculated, representing the current situation in each country. FindingsThere were 14 indicators in the domains of governance and surveillance and research. Of 429 stakeholders worldwide, 41 in China participated in the survey. China scored in the top 5 out of all participating countries in those 2 domains, scoring 67% in governance and 64% in surveillance and research. Indicators on which China scored particularly well included having a well-resourced unit or department responsible for NCDs, having a strong national system for recording the cause of all deaths, and having a system of NCD surveillance. Areas where China had the greatest need for improvement included increasing taxes on tobacco and addressing the needs of the population older than age 70 dying from major NCDs. ConclusionIn China the burden of disease of NCDs and disabilities remains serious, although China has put significant efforts into its governance and surveillance and research. To improve, further action is needed on reducing tobacco consumption, increasing investment in the national health budget, and increasing the focus on system construction.

Cause-specific mortality for 249 causes in Brazil and states during 1990\u20132015: a systematic analysis for the global burden of disease study 2015

BackgroundReliable data on cause of death (COD) are fundamental for planning and resource allocation priorities. We used GBD 2015 estimates to examine levels and trends for the leading causes of death in Brazil from 1990 to 2015.MethodsWe describe the main analytical approaches focused on both overall and specific causes of death for Brazil and Brazilian states.ResultsThere was an overall improvement in life expectancy at birth from 1990 to 2015, but with important heterogeneity among states. Reduced mortality due to diarrhea, lower respiratory infections, and other infectious diseases contributed the most for increasing life expectancy in most states from the North and Northeast regions. Reduced mortality due to cardiovascular diseases was the highest contributor in the South, Southeast, and Center West regions. However, among men, intentional injuries reduced life expectancy in 17 out of 27 states. Although age-standardized rates due to ischemic heart disease (IHD) and cerebrovascular disease declined over time, these remained the leading CODs in the country and states. In contrast, leading causes of premature mortality changed substantially - e.g., diarrheal diseases moved from 1st to 13th and then the 36th position in 1990, 2005, and 2015, respectively, while violence moved from 7th to 1st and to 2nd. Overall, the total age-standardized years of life lost (YLL) rate was reduced from 1990 to 2015, bringing the burden of premature deaths closer to expected rates given the country’s Socio-demographic Index (SDI). In 1990, IHD, stroke, diarrhea, neonatal preterm birth complications, road injury, and violence had ratios higher than the expected, while in 2015 only violence was higher, overall and in all states, according to the SDI.ConclusionsA widespread reduction of mortality levels occurred in Brazil from 1990 to 2015, particularly among children under 5 years old. Major shifts in mortality rates took place among communicable, maternal, neonatal, and nutritional disorders. The mortality profile has shifted to older ages with increases in non-communicable diseases as well as premature deaths due to violence. Policymakers should address health interventions accordingly.

Epidemiology of obesity and overweight in sub-Saharan Africa: a protocol for a systematic review and meta-analysis

IntroductionGlobally, overweight and obesity were estimated to cause 3.4 million deaths, 3.9% of years of life lost and 3.8% of disability-adjusted life years in 2010. Despite the fact that obesity...

Universal Coverage of Hypertension Treatment Services in Malaysia Is Still an Elusive Goal

An analysis of population coverage of hypertension treatment services can be used to make inferences about the performance of primary care services within health systems. Malaysia, an upper middle-income country, has a well-established primary care system but one that favors rural populations and provision of services for maternal and child health and infectious diseases. Demographic factors including rapid aging, urbanization, as well as lifestyle changes characteristic of a modernizing society have led to an increase in noncommunicable diseases, including hypertension. In this article, we used data from a nationally representative household health survey to develop service coverage indicators for hypertension screening and treatment services. The age-standardized prevalence of hypertension was estimated to be 33.9% (95% confidence interval [CI], 33.9, 33.9). Only 39.0% (95% CI, 37.5, 40.6) of adults with hypertension had been diagnosed by a medical practitioner, 35.7% had been on treatment, and 9.6% had blood pressure controlled under treatment. The diagnosis, treatment, and controlled treatment coverage were higher for older persons compared to younger persons. There were no differences in the diagnosis and treatment coverage between urban and rural areas and between ethnic groups. However, controlled treatment coverage was higher among Chinese and those living in urban areas. Our findings suggest that primary care services in Malaysia may need to intensify health education activities to promote screening services. There is also a need to reprioritize activities to provide regular community health screening of adults and increase access to affordable primary care services, especially in the urban areas.

GERIATRIC HEALTHCARE IN DEVELOPING NATIONS: A REVIEW FROM INDIA

In the highly populous India, the population above 60 were at 96 million in 2011 or 117 million in 2015, with a rapidly increasing trend. Alongside the demographic transition, there is also an epidemiological transition with increase in non-communicable diseases (NCDs) such as diabetes, hypertension, stroke and heart disease. Lower respiratory infections and diarrhoeal diseases decreased almost 80%, but ischaemic heart disease increased over 20%. For the large number of sick elderly though, geriatric healthcare, research, infrastructure, programs, policy and implementation present big gaps. Geriatrics as a medical specialty too is in its infancy, with only a handful of MD seats and very few geriatric departments across the nation. Thus, common age-related medical conditions such as stroke and dementia are undiagnosed or underdiagnosed. There is no universal social security such as medicare for the elderly and very few are insured, that too only for acute or in-patient care. Elderly healthcare and its access thus is dismal, especially with disintegration of the traditional joint family system. For the non-working 60 plus, rationing of healthcare and finances has been the norm. This talk will address the lacunae in geriatric diagnoses, policy and implementing healthcare.

Prevalence of non-communicable disease risk factors in three sites across Papua New Guinea: a cross-sectional study

Papua New Guinea (PNG) is a culturally, environmentally and ethnically diverse country of 7.3 million people experiencing rapid economic development and social change. Such development is typically associated with an...

Tobacco smoking trends in Samoa over four decades: can continued globalization rectify that which it has wrought?

BackgroundThe island country of Samoa (population 188,000 in 2011) forms part of Polynesia in the South Pacific. Over the past several decades Samoa has experienced exceptional modernization and globalization of many sectors of society, with noncommunicable diseases (NCD) now the leading cause of morbidity and mortality. The evolution of risk factor prevalence underpinning the increase in NCDs, however, has not been well described, including tobacco smoking which is related to cardiovascular disease, lung cancer, and chronic obstructive pulmonary disease.MethodsThe present study examines tobacco smoking in relation to different forms and effects of globalization in Samoa using 7 population-based surveys (n = 9223) over 1978–2013.ResultsThe prevalence of daily tobacco smoking steadily decreased over 1978–2013 from 76% to 36% in men, and from 27% to 15% in women (p < 0.0001 both sexes). During 1991–2013, current tobacco smoking also steadily decreased from 64% to 40% in men (p < 0.0001), and from 21% to 17% in women (p < 0.05). Declines were similar in younger (25–44 years) and older (45–64 years) men and women. Colonial globalization facilitated the introduction and prolific spread of tobacco trade and consumption in the Pacific Islands from the sixteenth century, with many populations inexorably pulled into trade relations and links to the global economy. It has also been a different globalization which may have led to the decline in smoking prevalence in Samoa in recent decades, through global dissemination since the 1950s of information on the harmful effects of tobacco smoking derived from research studies in the USA and Europe.ConclusionsOver the past 35 years tobacco smoking has steadily declined among Samoan adults; the only NCD risk factor to demonstrate marked declines during this period. By 2013 tobacco smoking in women had decreased to levels similar to Australia and New Zealand (ANZ), however in men smoking prevalence remained more than three times higher than ANZ. The impact on smoking prevalence of the variety of tobacco control interventions that have been implemented so far in Samoa need to be evaluated in order to determine the most effective initiatives that should be prioritized and strengthened.

Shared decision making in Argentina in 2017

Argentina is a high-middle income country located in Southern South America with an estimated population of 44 million inhabitants. The epidemiological profile of the population is characterised by an increase of non-communicable diseases. The health system is heterogeneous, fragmented and loosely integrated. There are no unified research agenda or government initiatives encouraging the implementation of and research on shared decision making (SDM). Progress has been made lately to respect patient autonomy through the enactment of the ‘Patients’ Rights Act’, which expressly enshrines the right of patients to get information as a key element of decision-making.To our knowledge, the team at the Department of Family and Community Medicine of the Hospital Italiano de Buenos Aires is the only one working on shared decision making in Argentina. This department carries out research, medical undergraduate and graduate training, and clinical practice implementation activities through strategies aimed at professionals and patients alike.We face some challenges regarding SDM, such as: 1) the fragmentation and the heterogeneity of the local health system; 2) we are a small group of people working on this topic who, simultaneously, have care, management, teaching and research responsibilities; 3) we have no government support and project funding is scarce; 4) due to the geographic location of the country, we must make a great effort in order to attend events on the state of the art in SDM.Given the current state of our health system, we believe the government is not likely to encourage, implement or research on SDM in the short term. Our group will continue to work on the local initiative and also to instil it in other interested groups.

Distributing development assistance for health: simulating the implications of 11 criteria.

After years of unprecedented growth in development assistance for health (DAH), the DAH system is challenged on several fronts: by the economic downturn and stagnation of DAH, by the epidemiological transition and increase in non-communicable diseases and by the economic transition and rise of the middle-income countries. Central to any potent response is a fair and effective allocation of DAH across countries. A myriad of criteria has been proposed or is currently used, but there have been no comprehensive assessment of their distributional implications. We simulated the implications of 11 quantitative allocation criteria across countries and country categories. We found that the distributions varied profoundly. The group of low-income countries received most DAH from needs-based criteria linked to domestic capacity, while the group of upper-middle-income countries was most favoured by an income-inequality criterion. Compared to a baseline distribution guided by gross national income per capita, low-income countries received less DAH by almost all criteria. The findings can inform funders when examining and revising the criteria they use, and provide input to the broader debate about what criteria should be used.

Development assistance for health: what criteria do multi- and bilateral funders use?

After years of unprecedented growth in development assistance for health (DAH), the system is challenged on several fronts: by the economic downturn and stagnation of DAH, by the epidemiological transition and increase in non-communicable diseases, and by the economic transition and rise of the middle-income countries. This raises questions about which countries should receive DAH and how much, and, fundamentally, what criteria that promote fair and effective allocation. Yet, no broad comparative assessment exists of the criteria used today. We reviewed the allocation criteria stated by five multilateral and nine bilateral funders of DAH. We found that several funders had only limited information about concrete criteria publicly available. Moreover, many funders not devoted to health lacked specific criteria for DAH or criteria directly related to health, and no funder had criteria directly related to inequality. National income per capita was emphasised by many funders, but the associated eligibility thresholds varied considerably. These findings and the broad overview of criteria can assist funders in critically examining and revising the criteria they use, and inform the wider debate about what the optimal criteria are.

Indirect maternal deaths: UK and global perspectives.

Indirect maternal deaths outnumber direct deaths due to obstetric causes in many high-income countries, and there has been a significant increase in the proportion of maternal deaths due to indirect medical causes in low- to middle-income countries. This review presents a detailed analysis of indirect maternal deaths in the UK and a perspective on the causes and trends in indirect maternal deaths and issues related to care in low- to middle-income countries. There has been no significant decrease in the rate of indirect maternal deaths in the UK since 2003. In 2011-2013, 68% of all maternal deaths were due to indirect causes, and cardiac disease was the single largest cause. The major issues identified in care of women who died from an indirect cause was a lack of clarity about which medical professional should take responsibility for care and overall management. Under-reporting and misclassification result in underestimation of the rate of indirect maternal deaths in low- to middle-income countries. Causes of indirect death include a range of communicable diseases, non-communicable diseases and nutritional disorders. There has been evidence of a shift in incidence from direct to indirect maternal deaths in many low- to middle-income countries due to an increase in non-communicable diseases among women in the reproductive age. The gaps in care identified include poor access to health services, lack of healthcare providers, delay in diagnosis or misdiagnosis and inadequate follow-up during the postnatal period. Irrespective of the significant gains made in reducing maternal mortality in many countries worldwide, there is evidence of a steady increase in the rate of indirect deaths due to pre-existing medical conditions. This heightens the need for research to generate evidence about the risk factors, management and outcomes of specific medical comorbidities during pregnancy in order to provide appropriate evidence-based multidisciplinary care across the entire pathway: pre-pregnancy, during pregnancy and delivery, and postpartum.

Cancer and palliative care in Africa.

Cancer and palliative care in Africa.

Mortality among 5-17 year old children in Kenya.

IntroductionGlobal mortality trends have changed over time and are expected to continue changing with a reduction in communicable diseases and an increase of non-communicable disease. Increased survival of children beyond five years may change mortality patterns for these children. There are few studies in Africa that explore the causes of mortality in children over five years. The objective of this study was to determine the mortality rate and clinical profiles of children aged 5-17 years who died in six Kenyan hospitals in 2013.MethodsRetrospective review of patients’ medical records to abstract data on diagnosis for those who died in year 2013. Data was analysed to provide descriptive statistics and explored differences in mortality rates between age groups and gender.ResultsWe retrieved 4,520 patient records. The in-hospital mortality rate was 3.5% (95%CI 3.0-4.1) with variations in deaths between the ages and gender. Among the deaths, 60% suffered from communicable diseases, maternal and nutritional causes; 41.3% suffered from non-communicable diseases. A further 11.9% succumbed to traumatic injuries. The predominant clinical diagnoses among patients who died were HIV/AIDS, respiratory tract infections and malaria.ConclusionInfectious causes had the highest proportion of diagnoses among children aged 5-17 years who died.

Design and Development of a Ubiquitous Healthcare Monitoring System Based on Android Platform

With the rapid aging populations in developed and developing countries and the increase of non-communicable disease, the contradiction between increasing healthcare demands and the lack of medical specialists have become more and more serious. Wearable personal health devices (PHDs) provide a good solution of this problem. But due to the proprietary interface and protocol, the compatibility and extensibility problem among different PHD manufacturers strongly influenced the spread application of the wearable PHDs. So we design and develop a ubiquitous healthcare system for Android tablet, which can not only acquire and process the physiological signals from non-standard laboratory developed multifunction wearable sensors, but also acquire and process the physiological signals from standard PHDs comply with Continua Alliance or ISO/IEEE 11073 standards. The preliminary results demonstrate that this system can not only receive data from standard and non-standard PHDs, but also do the arrhythmia classification and heart rate analysis in real time.

Challenges of Multimorbidities in the Era of an Aging Population.

The health care system introduced a reimbursement system based on the existing care when the prevalence rate of acute diseases was still. However, the types of diseases in developed countries are mostly noncommunicable diseases such as cancer or vascular disease, and thus, it impossible to fully recover from these chronic diseases. The increase in noncommunicable diseases is related to unhealthy lifestyle habits such as smoking, heavy drinking, and lack of exercise. Thus, the health care system is changing by improving the prevention of diseases and promoting healthy lifestyles. However, multimorbidities have emerged as an important concept in this process. In countries where the population is rapidly aging, those who have multimorbidities have become a burden to the health care system's revenue, manpower, and service quality. Therefore, health care reform to cope with those who are aging and have multimorbidities is necessary to establish. Reform measures can consist of the following suggestions. First, proper medical guidelines for multiple diseases need to be developed. Second, professional manpower should be trained. Third, the reimbursement system should be improved to relieve those with multimorbidities. Fourth, disease prevention services should be improved. Finally, instruments to measure health care service quality for chronic disease need to be developed.

Burden of stroke attributable to selected lifestyle risk factors in rural South Africa.

BackgroundRural South Africa (SA) is undergoing a rapid health transition characterized by increases in non-communicable diseases; stroke in particular. Knowledge of the relative contribution of modifiable risk factors on disease occurrence is needed for public health prevention efforts and community-oriented health promotion. Our aim was to estimate the burden of stroke in rural SA that is attributable to high blood pressure, excess weight and high blood glucose using World Health Organization’s comparative risk assessment (CRA) framework.MethodsWe estimated current exposure distributions of the risk factors in rural SA using 2010 data from the Agincourt health and demographic surveillance system (HDSS). Relative risks of stroke per unit of exposure were obtained from the Global Burden of Disease Study 2010. We used data from the Agincourt HDSS to estimate age-, sex-, and stroke specific deaths and disability adjusted life years (DALYs). We estimated the proportion of the years of life lost (YLL) and DALY loss attributable to the risk factors and incorporate uncertainty intervals into these estimates.ResultsOverall, 38 % of the documented stroke burden was due to high blood pressure (12 % males; 26 % females). This translated to 520 YLL per year (95 % CI: 325-678) and 540 DALYs (CI: 343-717). Excess Body Mass Index (BMI) was calculated as responsible for 20 % of the stroke burden (3.5 % males; 16 % females). This translated to 260 YLLs (CI: 199-330) and 277 DALYs (CI: 211-350). Burden was disproportionately higher in young females when BMI was assessed.ConclusionsHigh blood pressure and excess weight, which both have effective interventions, are responsible for a significant proportion of the stroke burden in rural SA; the burden varies across age and sex sub-groups. The most effective way forward to reduce the stroke burden requires both population wide policies that have an impact across the age spectra and targeted (health promotion/disease prevention) interventions on women and young people.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-016-2805-7) contains supplementary material, which is available to authorized users.