National Health Organizations Research Articles

Incidence rates of dysentery among humans in Lemghaier province, Algeria.

Dysentery is an infectious clinical syndrome which can cause high morbidity and mortality, especially in developing countries. This research highlights the epidemiological features of dysentery in Lemghaier province, Algeria. A retrospective study of the incidence rates of dysentery in Lemghaier province, Algeria and overall for the whole country for the period from January 2001 to December 2018 was carried out. On a local level data were provided by the Directorate of Health and Population of El-Oued province, Algeria. At the national level data were provided by the National Public Health Institute, Algeria. An overall number of 1,786 cases of dysentery were notified, with an incidence rate of 58.5 cases per 100,000 population (mean±SD: 58.54±47.20; 95% CI: 36.73-80.35). The high incidence rate was reported in autumn and summer, respectively, with 23.4 and 20.1 cases per 100,000 population. The high incidence rate observed in the persons aged 20-44 years with 76.4 cases per 100,000 population. Females were more likely to have dysentery than males, respectively, with 63.6 against 53.7 cases per 100,000 population. The highest incidence rate was reported in Lemghaier municipality (capital of the province) with 176.9 cases per 100,000 population. The results from this research showed high incidence rates of dysentery in Lemghaier province, Algeria. Тhis fact is a serious reason for national public health organizations to take adequate and timely measures to reduce the incidence rates of dysentery in this part of the country.

Greenhouse Gas Emission Savings in Relation to Telemedicine and Associated Patient Benefits: A Systematic Review.

Introduction: Telemedicine is a rapidly expanding service in the digitization of health care systems. Recently emphasis has been placed on the decarbonization of health care systems with National and World Health Organization initiatives aimed at carbon neutrality toward the mid-21st century. This study investigates greenhouse gas emissions related to telemedicine, its potential role in achieving carbon neutrality and its role in determining policy. We further investigate patient benefits related to telemedicine. Methods: A systematic review was conducted of the PubMed, Medline, EMBASE, EMCARE, CINAHL, and HMIC databases. Eligibility of studies was determined by predefined criteria. Results: A total of 31 studies were identified totaling over 57,000 patients. Carbon savings ranged from 0.69 kg CO2e (carbon dioxide equivalent) to 893 kg CO2e per encounter. Distances saved also ranged from 6.1 to 3,386 km. Further analysis of 18 included studies was conducted for cost savings that ranged from €1.73 in fuel costs to over U.S. $900 in travel related expenses. Similarly, 15 included studies were analyzed for time savings, which ranged from 38 min to 24 h. Conclusions: There are substantial carbon savings to be made with telemedicine systems. Furthermore, there are substantial benefits to patients in terms of both time savings and cost savings. Rural and isolated communities or patients needing tertiary or quaternary care may be a particular cohort that might benefit disproportionally from telemedicine and is an area where the largest per capita emission savings can potentially be made.

Global Surgery: advent of a new discipline

Global surgery is a rapidly developing multidisciplinary field, aiming to provide equitable and improved surgical care across international health systems often with a focus on underserved populations of low- and middle-income countries1. History is witness that Christian Missionaries, International Committee of the Red Cross, Aga Khan Foundation and Islamic Association of North America have been offering humanitarian health support, including Surgery, to the needy since long. These were joined by League of Nations Health Organization (since 1920; later became the World Health Organization in 1946) and Médecins Sans Frontières (since 1971)2. However, Surgery remained ‘The neglected stepchild of global health’3. Main reason for this was lack of data leading to knowledge gap about the magnitude of the problem. The much needed catalyst for development of Global Surgery was the launch of Lancet Commission on Global Surgery report in January 20144. This report provided the much needed data about unmet needs of Surgery which grabbed the World’s attention: 5 billion people not having access to safe, timely affordable surgery and anaesthesia; leading to 18.6 million preventable early deaths each year - more than the number of people who die from HIV/AIDS, malaria and tuberculosis combined; millions of patients facing catastrophic expenditures when faced with surgical costs and many low- and middle-income countries likely to lose up to 2% of GDP due to loss of proper surgical care leading to loss of productivity. They also predicted that to reach the necessary levels of access to surgery by 2030 would require an investment of $420 billion, which would save an estimated $12 trillion in lost GDP over the same period, making it a very sound investment. And global burden of surgical disease was estimated to be ~ 30%5.

New blueprint created to address youth suicide prevention

Increasing rates of attempted suicide and suicidal thoughts among youth have prompted national health and suicide prevention organizations to produce a comprehensive document released March 2 to support pediatric health clinicians to identify and support adolescents and young adults at risk for suicide in any type of clinical setting.

Central and territorial governmental institutions involved in health promotion for older people in European Union countries


 Defining, planning and achieving health goals including health promotion and health promotion for older people (HP4OP) are always the responsibility of the public authority. In European countries the public health and health promotion strategic framework, including HP4OP is provided by the ministry of health or others national public health organisations, which are responsible for defining of legal regulations on the different aspects of health promotion.
 The goal of this article is the analysis of the central and territorial government (CTG) sector’s involvement in the issue of HP4OP, their functions, activities and responsibilities in this area. The analysis is focused on the main differences and similarities between CTG’s institutions.
 The authors triangulated data collected using varied methods: literature review, questionnaire research (conducted in European Pro-Health 65+ project’s countries) and in-depth interviews with national experts from selected countries.
 In the majority of analysed countries, the central government and municipalities are the main stakeholders responsible for providing funding for these programs. The operational level for the implementation of majority HP4OP is the local level. Research countries have been identified as strongly varying in institutional, legal and political specificity. The analysis shows the increasing position of HP4OP in public health policy. Many of the identified problems come from the implementation of a fragmented approach, the duplication of efforts undertaken by different stakeholders and the lack of a co-ordinated strategy and dedicated legal regulations at both the national and regional/local levels.

Malariology and decolonization: Eastern European experts from the League of Nations to the World Health Organization

AbstractThe article de-centres the global history of disease by examining the agency of Eastern European expertise at international organizations and during decolonization. It challenges accounts of anti-malaria policies at the League of Nations Health Organization and at the World Health Organization written from a Western, particularly North American perspective, or on the basis of local reactions to Western interventions. The contribution proposes an analysis of circulations and ideas across multiple cultural, social and political spaces: post-imperial European states, (post)colonial territories and bureaucracies of international organizations. From the 1920s to the 1960s, Eastern European experts played a crucial role in the transformation of malaria from an imperial disease that tested governance over ‘tropical’ peoples into an issue of global health and nation-state building. However, regional representatives reproduced civilizational hierarchies intrinsic to North–South biomedical relations. The global entanglements of Eastern European malariology show that liberation from disease was less about communism or liberalism, and more about national renewal, statehood and world hierarchies.

An Uneasy, Challenging, Yet Meaningful Experience: A Reflection on a Face-to-Face to Online Synchronous COVID-19 Course Transition

During the 2020 spring semester, as COVID-19 infection rates increased, universities and colleges closed campuses and moved courses online. All of these responses occurred as the Center for Disease Control (CDC), World Health Organization (WHO), and other national and global health organizations attempted to understand this new and deadly illness. Library and Information Science (LIS) schools were, in particular, ready for this unexpected education shift with their long history of online learning and online engagement. This article is both a reflection on and analysis of the teaching experiences of the author during this period of crisis.

Perceived impact of formulating, implementing and enacting national mental health policies recommendations in practice: An exploratory qualitative study within child and adolescent mental health services in Scotland.

Objective:To understand the process of formulating, implementing and enacting national recommendations into practice, by exploring the interactions between government policymakers and national and local organisations supporting and delivering policy implementation within a Child and Adolescent Mental Health Service (CAMHS) context in Scotland.Methods:Data collection involved 16 semi-structured individual and four focus group interviews with a purposeful sample of policymakers, national health and social care stakeholders and local outpatient and inpatient CAMHS teams representing three NHS health boards in Scotland. Results:Study participants highlighted the challenges of navigating through evolving and often conflicting policy agendas, seen to not acknowledging the current evidence base or experiential learning from services and prior evaluations. Accounts of transformation fatigue often emerged from increased expectations for staff to adopt new approaches to accommodate constantly changing recommendations. Participants also reported a lack of integration and implementation support from national health and social care organisations, leading to duplication of effort and gaps in provision or waste. Policy recommendations were perceived as sometimes vague, lacking clarity about how to deliver service transformation using a whole-system approach. The collective narratives reflected increased tension between the need for local autonomy to innovate and the limitations created vertically by the relative inflexibility of policy recommendations, and horizontally by the proliferation of national organisations delivering the same transformation aims using different approaches in a resource-constrained environment.Conclusion:The findings contribute to the wider literature by offering an exploration of importance of evaluation and evidence uptake in policy formulation; the roles and remits in supporting the implementation of policy recommendations; and how the dynamics of central control and local autonomy might impact on the local enactment of policy recommendations.

An Examination of the Sex-Specific Nature of Nutrition Assessment within the Nutrition Care Process: Considerations for Nutrition and Dietetics Practitioners Working with Transgender and Gender Diverse Clients

An Examination of the Sex-Specific Nature of Nutrition Assessment within the Nutrition Care Process: Considerations for Nutrition and Dietetics Practitioners Working with Transgender and Gender Diverse Clients

C&EN talks with Simon Smith, respirator filter expert

Simon Smith has a long history of developing personal protective equipment (PPE) for industrial, health-care, military, emergency response, and other applications. He specializes in respirator filters and says he finds great satisfaction in the opportunity to apply “dry” science to products that improve health and safety and sometimes save lives. Smith, 60, earned a bachelor’s degree in chemistry from what is now Imperial College London, then a doctorate in chemistry from the University of Manchester Institute of Science and Technology in 1985. After a postdoctoral fellowship at the Royal Military College of Canada, he joined Racal Health and Safety. The company was purchased by 3M in 1998. Smith retired from 3M in late 2019 but remains active in standards development with the International Organization for Standardization, the CSA Group (formerly the Canadian Standards Association), and other national and international health and safety organizations. Jeff Johnson spoke with Smith about developing

Local Partnerships for Health on National Forests

The USDA Forest Service has recently piloted health partnerships that facilitate therapeutic outdoor experiences on national forests, building on the growing evidence of the multiple health benefits of activities and time spent in nature. This article presents brief case studies of three pilot partnerships between national forests and health organizations in California, Indiana, and Georgia (USA). These partnerships deliver nature-based programming for the general public as well as those who are in recovery from major surgeries, have been diagnosed with cancer, and face chronic health challenges. To help recreation managers and policy makers understand the potential for such local health partnerships in a federal context, we describe the programs’ enabling conditions, their incorporation of service and stewardship activities, and the challenges and successes they have faced. Insights inform an expanding variety of health partnership models that advance the interconnectedness of human and ecosystem health on public lands as a fundamental dimension of sustainable recreation management.

Peripheral Nerve: Health and Medicine in Cold War Latin America

Peripheral Nerve: Health and Medicine in Cold War Latin America

Practice of Health Care Governance among South Wollo Department Heads and Managers of Public Health Institutions, Northeast Ethiopia.

Governance in health care generally means strengthening leadership and governance functions, improving systems, and having both central and local governments jointly take responsibility for overall health system performance. More than half of the world's population has expressed distrust of state institutions including the health sector. Ethiopia, like other African countries, faces many challenges in the process of good governance building. The aim of this study was to assess the practices health care governance in the South Wollo Zone health sectors, Northeast Ethiopia. A facility-based cross-sectional study design was conducted in the South Wollo from 15 May to 15 June 2021. A simple random sampling technique was used, and the data were collected using a structured survey. The data were entered into Epi data version 4.6 for cleaning and exported to SPSS v.25 for further analysis. We performed binary and multivariable logistic regression analysis to identify factors of governance practices. Variables with p values less than 0.05 during multivariable logistic regression analysis were declared statistically significant. A 96.75% (387) of the study participants completed the study questionnaires. Out of these, 37.98% (95% confidence interval: 33.1%, 42.9%) have been found practicing good governance in the health sector. Having had training (adjusted odds ratio = 7.92, 95% confidence interval: 4.04, 15.51), having job descriptions (adjusted odds ratio = 2.05, 95% confidence interval: 1.03, 4.09), opportunity to share with peers (adjusted odds ratio = 6.64, 95% confidence interval: 3.02, 14.62), political interference (adjusted odds ratio = 0.40, 95% confidence interval: 0.22, 0.71), and age < 25 years (adjusted odds ratio = 0.13, 95% confidence interval: 0.02, 0.77) were found to have a statistically significant association with the governance practice of managers. The overall practice of governance was found poor in light of the national and World Health Organization standards for health sector Governance. Having had training, having job descriptions and the opportunity to share with peers significantly increased the odds of good governance while political interference and young age significantly decreased the odds of good governance. Managers could implement training, write job descriptions, and encourage sharing with peers to improve governance.

HIV Seroprevalence in Mogadishu, Somalia: a Retrospective Study between 2015 and 2019.

Acquired immunodeficiency syndrome (AIDS) remains a major global public health problem. This study aimed to obtain current epidemiological data on the Human immunodeficiency virus (HIV) infections in Mogadishu, Somalia. This study included 92,270 anti-HIV test results reported for 82,954 different individuals between 2015 and 2019. HIV tests were performed using the Architect HIV Ag/Ab Combo assay and retested with the Elecsys HIV combi PT assay. HIV seropositivity was found to be 0.32% (269/82,954) in all individuals over a period of four years. Anti-HIV seropositivity in the 0 - 14, 15 - 19, 15 - 24, 15 - 49, and > 15 age groups were as follows: 0.17% (11/6,441), 0.17% (12/7,131), 0.15% (35/24,132), 0.37% (212/56,895), and 0.34% (258/76,513), respectively. In HIV-infected patients, anti-HBs, HBsAg, anti-HCV, and anti-TP (syphilis) seropositivity was found to be 30.3% (56/185), 9.54% (23/241), 1.24% (3/242), and 3.45% (2/58), respectively. The findings from this study provide comprehensive data on the HIV epidemiology in Somalia. We believe that the results presented in this study will contribute to the risk analysis and planning of preventive policies of national and global health organizations.

Optimizing pathological assessment of breast cancer in Brazil: recommendations from a multidisciplinary working group on the tumor-tissue journey

Timely and correct assessment of histopathological, immunohistochemical and molecular features of biopsy and surgical specimens is of paramount importance in the provision of care to patients with breast cancer, particularly in the current era of precision oncology. In order to ensure that tissue samples are obtained, processed, analyzed and reported in an optimal way, a concerted effort is required by institutions and individuals, taking into account state-of-the-art scientific and technical knowledge and circumventing logistic and operational constraints. This may be particularly challenging in some settings due to several sources of economic, structural, organizational and communication inefficiencies. In the current article, we present a brief review of breast cancer epidemiology and challenges in the disease diagnosis, especially in Brazil, and report the results of a multidisciplinary working group convened in May 2020 in an expert panel to identify and discuss the barriers and challenges related to the journey of breast cancer samples in Brazil. Following the identification of the issues, the working group also discussed and proposed recommendations for improving the journey and quality of breast cancer samples based on their professional experience and the current scientific literature, including guidelines of national and international health organizations (e.g. World Health Organization), consensus of medical societies and other published literature on the topic. We outline the most salient issues related to that journey in Brazilian public and private medical institutions, based on the experts’ clinical experience, since all of them are actively working at both sectors, and discuss current recommendations to address these issues aiming at mitigating and preventing preanalytical and analytical issues affecting diagnostic and therapeutic decisions. Such issues are grouped under four headings pertaining to education, communication, procedures in the operating room and sample transportation, and procedures in the pathology laboratory. Selected recommendations based on the current literature and discussed by the group of Brazilian experts are reviewed, which may mitigate the issues identified and optimize diagnostic and therapeutic decisions for patients with breast cancer, currently the most frequent malignant tumor worldwide and in Brazil. This paper has been submitted and published jointly, upon invitation and consent, in both the Surgical and Experimental Pathology and the Mastology journals.

Preconception exposures and adverse pregnancy, birth and postpartum outcomes: Umbrella review of systematic reviews.

Preconception exposures have been associated with adverse pregnancy, birth and postpartum outcomes. However, the reports, statements and guidelines of national and international health organisations vary in what they recommend individuals should monitor, avoid, reduce or practise in the preconception period. To synthesise and evaluate the evidence across systematic reviews for associations between exposures before conception and adverse pregnancy, birth and postpartum outcomes. MEDLINE, Embase, Epistemonikos (to May 2020) and reference lists of included reviews, without language or date restrictions. Systematic literature reviews of observational and/or interventional studies reporting associations between preconception exposures in women and/or men of reproductive age and pregnancy, birth or postpartum health outcomes were included. The methodological quality of reviews and the certainty of the evidence underlying each exposure-outcome association were assessed using AMSTAR 2 and the GRADE approach. We identified 53 eligible reviews reporting 205 unique exposure-outcome associations. Methodological quality was generally low with only two reviews rated as 'high' quality and two as 'moderate'. We found high-certainty, randomised trial evidence that maternal folate supplementation reduces the risk of neural tube defects and anomaly-related terminations. Moderate-certainty, observational evidence was found that maternal physical activity is associated with reduced risk of pre-eclampsia and gestational diabetes, and that paternal age of ≥40years and maternal body mass index (BMI) and interpregnancy weight gain are associated with increased risk of various adverse pregnancy and birth outcomes. Low- and very low-certainty evidence was found for other associations. Clinicians and policymakers can be confident that maternal folate supplementation should be encouraged during the preconception period. There is moderate certainty in the evidence base that maternal physical activity, BMI and interpregnancy weight gain and advanced paternal age are important preconception considerations. High-quality research is required to better understand other exposure-outcome associations.

A NLP Pipeline for the Automatic Extraction of Microorganisms Names from Microbiological Notes.

According to the "Istituto Superiore di Sanita'" (ISS), hospital infections are the most frequent and serious complication of health care. This constitutes a real health emergency which requires incisive and joint action at all levels of the local and national health organization. Most of the valuable information related to the presence of a specific microorganism in the blood are written into the notes field of the laboratory exams results. The main objective of this work is to build a Natural Language Processing (NLP) pipeline for the automatic extraction of the names of microorganisms present in the clinical texts. A sample of 499 microbiological notes have been analysed with the developed system and all the microorganisms names have been extracted correctly, according to the labels given by the expert.

The Nordic Nutrition Recommendations 2022 - prioritisation of topics for de novo systematic reviews.

BackgroundAs part of the process of updating national dietary reference values (DRVs) and food-based dietary guidelines (FBDGs), the Nordic Nutrition Recommendations 2022 project (NNR2022) will select a limited number of topics for systematic reviews (SRs).ObjectiveTo develop and transparently describe the results of a procedure for prioritisation of topics that may be submitted for SRs in the NNR2022 project.DesignIn an open call, scientists, health professionals, national food and health authorities, food manufacturers, other stakeholders and the general population in the Nordic and Baltic countries were invited to suggest SR topics. The NNR2022 Committee developed scoping reviews (ScRs) for 51 nutrients and food groups aimed at identifying potential SR topics. These ScRs included the relevant nominations from the open call. SR topics were categorised, ranked and prioritised by the NNR2022 Committee in a modified Delphi process. Existing qualified SRs were identified to omit duplication.ResultsA total of 45 nominations with suggestion for more than 200 exposure–outcome pairs were received in the public call. A number of additional topics were identified in ScRs. In order to omit duplication with recently qualified SRs, we defined criteria and identified 76 qualified SRs. The NNR2022 Committee subsequently shortlisted 52 PI/ECOTSS statements, none of which overlapped with the qualified SRs. The PI/ECOTSS statements were then graded ‘High’ (n = 21), ‘Medium’ (n = 9) or ‘Low’ (n = 22) importance, and the PI/ECOTSS statements with ‘High’ were ranked in a Delphi process. The nine top prioritised PI/ECOTSS included the following exposure–outcome pairs: 1) plant protein intake in children and body growth, 2) pulses/legumes intake, and cardiovascular disease and type 2 diabetes, 3) plant protein intake in adults, and atherosclerotic/cardiovascular disease and type 2 diabetes, 4) fat quality and mental health, 5) vitamin B12 and vitamin B12 status, 6) intake of white meat (no consumption vs. high consumption and white meat replaced with red meat), and all-cause mortality, type 2 diabetes and risk factors, 7) intake of n-3 LPUFAs from supplements during pregnancy, and asthma and allergies in the offspring, 8) nuts intake and cardiovascular disease (CVD) and type 2 diabetes in adults, 9) dietary fibre intake (high vs. low) in children and bowel function.DiscussionThe selection of topics for de novo SRs is central in the NNR2022 project, as the results of these SRs may cause adjustment of existing DRVs and FBDGs. That is why we have developed this extensive process for the prioritisation of SR topics. For transparency, the results of the process are reported in this publication.ConclusionThe principles and methodologies developed in the NNR2022 project may serve as a framework for national health authorities or organisations when developing national DRVs and FBDGs. This collaboration between the food and health authorities in Denmark, Estonia, Finland, Iceland, Latvia, Lithuania, Norway and Sweden represents an international effort for harmonisation and sharing of resources and competence when developing national DRVs and FBDGs.

Economic Profile of Iranian Rehabilitation Services: 2002-2017

Objective: The role of the service sector in general and healthcare services in particular have been promoting in Iran’s economy. The implementation of the Health System Transformation Plan and the injection of new financial resources into this sector have raised concerns about the health system function. Thus, this is the first attempt to estimate and evaluate the share of rehabilitation services in the Iranian economic and health systems. Materials &amp; Methods: The study utilized longitudinal trend analysis using the National Health Accounts data during 2002-2015. National Health Accounts, through input-output tables, breaks down the share of different sources of financing for different functions of the health system. According to this method, both the share of rehabilitation services in Iran’s economy and the financing sources of these activities have been calculated and compared to other countries. Data on Iran's National Health Accounts has been collected from the Statistical Center of Iran. International data is collected from the World Health Organization's National Health Accounts and the databases of the Organization for Economic Cooperation and Development member countries. Results: Expenditures related to rehabilitation services in Iran increased from 884 billion rials in 2002 to more than 2967 billion rials in 1396, equivalent to 0.02% of Iran's GDP in that year. The share of rehabilitation expenditures in total health expenditures in 2007 was at its highest level (0.3%). In the following years, it has always had a decreasing trend. In 1396 it reached about 22.0%, the lowest amount during 16 Last year. Comparing the economic share of rehabilitation of the country's economic activities with different countries shows that the position of this sector is in no way comparable to developed countries and is even lower than many developing countries. Tunisia, Tonga, and Moldova have a similar situation to Iran's economy, with rehabilitation services accounting for about 0.05 to 0.1 percent of their total economic activity. Comparison of the prevalence of disability in these countries with Iran shows that these countries had a lower prevalence than Iran. Examination of the share of various sources shows that out-of-pocket payments with households with 6.37 percent, the most, and the government with 7.18 percent had the least role in financing rehabilitation services. It is noteworthy that this figure was about 65% before implementing the health system transformation plan. Social insurance in 2017 also covered only 6.24% of rehabilitation costs. Conclusion: Inaccessibility of people with disabilities to healthcare services is a very serious issue in the world. The rehabilitation services expenditures have always been mentioned as one of the most important barriers of accessing to these services. Following the implementation of the Health Transformation Plan, the share of rehabilitation activities in Iran’s health market has been shrunk.

Estimating the health and economic effects of the voluntary sodium reduction targets in Brazil: microsimulation analysis

BackgroundExcessive sodium consumption is one of the leading dietary risk factors for non-communicable diseases, including cardiovascular disease (CVD), mediated by high blood pressure. Brazil has implemented voluntary sodium reduction targets with food industries since 2011. This study aimed to analyse the potential health and economic impact of these sodium reduction targets in Brazil from 2013 to 2032.MethodsWe developed a microsimulation of a close-to-reality synthetic population (IMPACTNCD-BR) to evaluate the potential health benefits of setting voluntary upper limits for sodium content as part of the Brazilian government strategy. The model estimates CVD deaths and cases prevented or postponed, and disease treatment costs. Model inputs were informed by the 2013 National Health Survey, the 2008–2009 Household Budget Survey, and high-quality meta-analyses, assuming that all individuals were exposed to the policy proportionally to their sodium intake from processed food. Costs included costs of the National Health System on CVD treatment and informal care costs. The primary outcome measures of the model are cardiovascular disease cases and deaths prevented or postponed over 20 years (2013–2032), stratified by age and sex.ResultsThe study found that the application of the Brazilian voluntary sodium targets for packaged foods between 2013 and 2032 could prevent or postpone approximately 110,000 CVD cases (95% uncertainty intervals (UI): 28,000 to 260,000) among men and 70,000 cases among women (95% UI: 16,000 to 170,000), and also prevent or postpone approximately 2600 CVD deaths (95% UI: − 1000 to 11,000), 55% in men. The policy could also produce a net cost saving of approximately US$ 220 million (95% UI: US$ 54 to 520 million) in medical costs to the Brazilian National Health System for the treatment of CHD and stroke and save approximately US$ 71 million (95% UI: US$ 17 to170 million) in informal costs.ConclusionBrazilian voluntary sodium targets could generate substantial health and economic impacts. The reduction in sodium intake that was likely achieved from the voluntary targets indicates that sodium reduction in Brazil must go further and faster to achieve the national and World Health Organization goals for sodium intake.