Rise In Non-communicable Diseases Research Articles

Population health status and green urban areas: impact on health outcomes in two Italian regions

Abstract Background Living in urban areas has been linked to a rise in noncommunicable diseases. Nevertheless, there is scarcity of evidence emphasizing the combined impacts of certain urban attributes (e.g. pollution, excessive soil sealing, urban temperatures) and the existence of green spaces on health outcomes. Further studies are imperative to evaluate the association between chronic illnesses such as dementia and ischemic heart disease, and the presence of urban green areas. Methods We conducted an ecological study in two Italian regions. Prevalence of chronic diseases in Tuscany and Latium were obtained at the municipality level from public health databases available online and Normalized Difference Vegetation Index (NDVI) was calculated for 2023. Descriptive analyses and Poisson regression models were run to assess the association between green space and chronic diseases prevalence, adjusting for age, sex, education, employment, foreign residents, income, urbanicity and spatial correlation. Results Preliminary analyses were conducted on 273 municipalities in Tuscany. Mean prevalence per 1000 inhabitants of dementia and ischemic heart disease were 15.75 (SD = 5.3) and 48.25 (SD = 11.06), respectively. Mean NDVI across municipalities was 0.37 (SD = 0.04). Higher green exposure is associated with lower prevalence of ischemic heart disease (β= -0.21; p < 0.05) and dementia (β=-0.3, p < 0.05). Analyses will be executed for the Latium region and complete results will be available by mid-June. Conclusions The presence of urban greenery appears to be associated with a reduction in chronic illnesses. While further studies are warranted, it is crucial to adopt urban policies focused on green spaces and citizens’ health outcomes. Generating evidence for decision-makers is essential for shaping urban environments in ways that promote both health and overall human wellbeing. Key messages • Living in green urban areas appears to positively impact human health, reducing chronic disease prevalence. • Greenery serve as a tool for mitigating and adapting to the climate crisis, promoting health.

Prevalence and associated factors of chronic kidney disease among Truká Indigenous adults in Cabrobó, Brazil: a population-based study

The prevalence of chronic kidney disease (CKD) is increasing worldwide, especially in developing countries, due to factors such as lifestyle changes and the rise of non-communicable diseases. Populations living in socioeconomically disadvantaged areas are subject to a higher burden of CKD. However, the burden of CKD on Brazilian Indigenous people, especially those undergoing an advanced urbanisation process, has not yet been described. This cross-sectional study included 1715 Truká Indigenous adults from Cabrobó, Brazil. CKD was defined according to the Kidney Disease Improving Global Outcomes guidelines classification as a urinary albumin/creatinine ratio ≥30mg/g and/or an estimated glomerular filtration rate <60mL/min/1.73m2. Univariate and multiple logistic regression models were used to evaluate factors associated with CKD. Odds ratio (OR) with a 95% confidence interval (CI) was used to measure association. Out of the 1654 participants analysed (61 excluded due to missing data), the prevalence of CKD was 10% (95% CI, 8.6%-11.5%), with a higher prevalence in women compared to men (12.4% versus 6.9%, p<0.001). The mean age was 40.5 years, with 55.6% being women. In univariate analysis, female sex (OR, 1.9; 95% CI, 1.3-2.7), age ≥60 years (OR, 4.6; 95% CI, 3.2-6.6), cardiovascular disease (OR, 2.1; 95% CI, 1.1-4.1), and dyslipidemia (OR, 1.6; 95% CI, 1.1-2.4) were identified as associated factors with CKD. Multiple logistic regression analysis identified age ≥60 years, female sex, and dyslipidemia as independently associated factors with CKD. The prevalence of CKD among Truká Indigenous adults analysed is high and affects a higher proportion of women. Our study found no association between hypertension, diabetes, obesity, and CKD risk, despite their high prevalence. These findings assist in developing early CKD detection strategies in Brazilian Indigenous communities, supporting disease treatment and prevention. National Council for Scientific and Technological Development (CNPq)-Ministry of Science, Technology, and Innovation of Brazil, and the Maria Emília Foundation.

Extrinsic goals benefit capitalism but not well-being. Rethinking the economy's goal for a healthier future.

The dramatic rise in non-communicable diseases around the world but notably in high-income countries like the UK is a manifestation of a global economic system-capitalism-that prioritizes wealth over health. A decade ago, the former WHO Director-General, Margaret Chan highlighted how 'efforts to prevent non-communicable diseases go against the business interests of powerful economic operators' [United Nations. (2013) Take Action for the Sustainable Development Goals. https://www.un.org/sustainabledevelopment/sustainable-development-goals/ (last accessed 16 February 2024)]. While there is a growing literature on how politics and economics influence population health-for better or worse-less attention has been given to exploring how economic systems like capitalism influence people's psychological well-being. To fill this gap, the following article examines how the continued pursuit of economic growth under capitalism (neoliberal free-market forms especially) impacts well-being through challenging basic psychological needs for security, autonomy, competence and relatedness. In doing so, I hope to shed important light on the sources and possible solutions to our growing health and social problems, and stimulate a conversation on how to achieve a healthier future for us all.

Predictors and health outcomes of cigarette and shisha smoking among men in Gaza: a cross-sectional study

Tobacco smoking, a significant public health concern globally, is associated with a rise in noncommunicable diseases (NCDs) and preventable deaths, with pronounced impacts in conflict zones like Gaza. A cross-sectional study, conducted in 2020, in Gaza focused on individuals over 40 years of age, aiming to identify predictors of tobacco use and its links to diseases like coronary artery disease (CAD), chronic lung disease (CLD), and stroke using regression analysis. The research, based on the Gaza NCD study data with 4576 participants and a 96.6% response rate, found an overall tobacco smoking prevalence of 19.4%, with higher rates among men. After adjusting for various factors, the study identified significant associations between cigarette smoking in men and adverse health outcomes, such as CAD and CLD, with adjusted odds ratios (OR) of 1.67, 95% CI (1.22–2.29) and 1.68, 95% CI (1.21–2.33) respectively. However, after adjusting for independent variables, shisha smoking in men showed no association with these health outcomes. The findings of this study could assist other researchers in designing interventions aimed at reducing smoking prevalence by utilizing the associated factors identified in our analysis, such as age, education level, physical activity, and body mass index among men in Gaza.

The Impact of Caregiver Support on Symptom Improvement in Post-Stroke Patients

The Impact of Caregiver Support on Symptom Improvement in Post-Stroke Patients

Spatial distribution of non-communicable diseases; a case of Ischaemic Heart Diseases, Cancer and Diabetes in Sri Lanka

The abstract provides a comprehensive overview of the global prevalence of non-communicable diseases (NCDs) and their impact on public health, emphasizing their leading role in morbidity and mortality worldwide. It highlights the specific burden of Ischaemic heart diseases, cancers, and diabetes, with a significant portion of premature deaths occurring in low- and middle-income countries. Transitioning to Sri Lanka, the abstract underscores the country's shift towards NCDs as the primary health concern, attributing over 80% of premature deaths to these diseases. The narrative emphasizes the influence of rapid lifestyle changes and socio-economic development on the rise of NCDs in Sri Lanka and emphasizes the urgent need for comprehensive research to understand trends, patterns, and contributing factors for effective preventive measures.

Diet changes due to urbanization in South Africa are linked to microbiome and metabolome signatures of Westernization and colorectal cancer

Transition from traditional high-fiber to Western diets in urbanizing communities of Sub-Saharan Africa is associated with increased risk of non-communicable diseases (NCD), exemplified by colorectal cancer (CRC) risk. To investigate how urbanization gives rise to microbial patterns that may be amenable by dietary intervention, we analyzed diet intake, fecal 16 S bacteriome, virome, and metabolome in a cross-sectional study in healthy rural and urban Xhosa people (South Africa). Urban Xhosa individuals had higher intakes of energy (urban: 3,578 ± 455; rural: 2,185 ± 179 kcal/d), fat and animal protein. This was associated with lower fecal bacteriome diversity and a shift from genera favoring degradation of complex carbohydrates (e.g., Prevotella) to taxa previously shown to be associated with bile acid metabolism and CRC. Urban Xhosa individuals had higher fecal levels of deoxycholic acid, shown to be associated with higher CRC risk, but similar short-chain fatty acid concentrations compared with rural individuals. Fecal virome composition was associated with distinct gut bacterial communities across urbanization, characterized by different dominant host bacteria (urban: Bacteriodota; rural: unassigned taxa) and variable correlation with fecal metabolites and dietary nutrients. Food and skin microbiota samples showed compositional differences along the urbanization gradient. Rural-urban dietary transition in South Africa is linked to major changes in the gut microbiome and metabolome. Further studies are needed to prove cause and identify whether restoration of specific components of the traditional diet will arrest the accelerating rise in NCDs in Sub-Saharan Africa.

Evaluating compliance with local and International Food Labelling Standards in urban Tanzania: a cross-sectional study of pre-packaged snacks in Dar Es Salaam

BackgroundUrbanization influences food culture, particularly in low- and middle-income countries where there is an increasing consumption of processed and pre-packaged foods. This shift is contributing to a rise in non-communicable diseases. Food labelling standards are crucial for regulating manufacturing practices and helping consumers make healthy food choices. We aimed to assess the compliance of local and imported pre-packaged snacks with Tanzanian and international labelling standards in Dar es Salaam, Tanzania.MethodologyA cross-sectional study was conducted on 180 snack products. A checklist based on Tanzanian and Codex labelling standards was used to evaluate adherence. We also examined factors influencing adherence, such as product origin, price, category, purchase location, and package size.ResultsThe majority of the snacks demonstrated partial adherence to Tanzania (n = 97; 54%) and International (Codex) (n = 120; 67%) labelling standards. Imported products showed significantly better adherence to both Tanzanian (n = 46; 53%) and international (n = 42; 48%) standards. Notably, more than half (n = 110; 66.7%) of the products used English for labelling, and infrequently (n = 74; 41.4%) used the recommended World Health Organization Front-of-Pack Nutrition Labelling. Product category, origin, and package size were significantly associated with higher levels of international standard adherence (p < 0.05).ConclusionThe inadequate adherence to mandatory labelling standards and the scarce use of Swahili and FoPL highlight the need to strengthen labelling practices and potential challenges faced by consumers in understanding nutritional information. Thus, strengthening and emphasizing good labelling practices are urgently needed as we seek to address diet-related noncommunicable diseases.

Transforming Public Health in Samoa: Battling Non-Communicable Diseases through Dietary Interventions and Government Initiatives

Non-communicable diseases (NCDs) have become a major health concern worldwide, with Samoa being no exception(1). This presentation delves into the intricate dynamics of NCDs in Samoa, from the historical perspective before colonization to the contemporary challenges and initiatives taken by the government to address this pressing issue. Samoa, before colonization, maintained traditional diets that were largely plant-based and rich in local fruits and vegetables(2). The evolution of these diets over time has played a significant role in the rise of NCDs. The incorporation of imported processed foods, high in sugars and unhealthy fats, has led to a shift in dietary patterns. Recognizing the urgency of the situation, the Samoan government has initiated a series of policies aimed at addressing NCDs. These include the NCD Policy and Nutrition Policy, which focus on promoting healthier lifestyles through dietary changes and increased physical activity(3). The Samoa Health System Strengthening Program for Results is a crucial component of the government’s approach to combat NCDs. It encompasses several key areas, including the “First 1000 Days” initiative, emphasizing the importance of proper nutrition during pregnancy and early childhood, and breastfeeding promotion, vital for the health and development of infants(4). Furthermore, the School Nutrition program is designed to instill healthy eating habits from a young age(5). Nutrition guidelines, monitored quarterly, are in place to ensure the quality of school meals, with a strong focus on reducing the consumption of instant noodles and sugary drinks among schoolchildren. For adults, the “Healthy eating for Adults” program is pivotal. It introduces Food-Based Dietary Guidelines in Samoa that categorize foods into carbohydrates (energy foods), proteins (body-building foods), and fruits and vegetables (protective foods)(6). These guidelines also recommend reducing the intake of sugary foods, salt, and foods high in fats and oils. An intriguing approach to improving dietary habits is the “Grow the Colors of the Rainbow” initiative, which encourages the consumption of a diverse range of colorful fruits and vegetables(7). By emphasizing the importance of a balanced diet, this initiative aims to address the imbalance that has contributed to the NCD epidemic. Through this presentation, attendees will gain a comprehensive understanding of the historical, dietary, and governmental aspects surrounding NCDs in Samoa. It highlights the urgency of addressing NCDs in the region and underscores the importance of ongoing efforts to promote healthier eating habits and lifestyle choices. By examining government policies and initiatives, as well as the challenges faced, we aim to shed light on the path toward a healthier, NCD-free Samoa.

Pixels to precision: Remote thoracic and pediatric cardiac surgery mentorship with Rods&amp;Cones® Technology in Kigali, Rwanda

Surgery is the final frontier in global medicine; yet, access to essential surgical services in low- and middle-income countries remains a significant barrier to equitable care. With a rise in non-communicable diseases and a shortage of skilled surgeons, the need for mentorship becomes crucial to capacity building. The COVID-19 pandemic acted as a catalyst for remote mentorship, leading to the development of innovative solutions such as Rods&amp;Cones&amp;reg;. Herein, we describe one example of remote mentorship conducted across a distance of more than 7,700 miles between King Faisal Hospital in Rwanda and the University of Wisconsin Hospital in the US. This paper aims to demonstrate how advances in remote mentorship technology can overcome existing barriers and aid in expanding the global surgical workforce in thoracic surgery.

Integrating rehabilitation into health systems: A comparative study of nine middle-income countries using WHO's Systematic Assessment of Rehabilitation Situation (STARS).

The need for rehabilitation is growing due to health and demographic trends, especially the rise of non-communicable diseases and the rapid ageing of the global population. However, the extent to which rehabilitation is integrated into health systems is mostly unclear. Our objective is to describe and compare the nature and extent of integration of rehabilitation within health systems across nine middle-income countries using available Systematic Assessment of Rehabilitation Situation (STARS) reports. Cross-country comparative study with variable-oriented design using available rehabilitation health system assessment reports from nine middle income countries. The integration of rehabilitation into health systems is limited across countries. Governance and financing for rehabilitation are mostly established within health ministries but weakly so, while health information systems are characterized by no available data or data that is insufficient or not routinely generated. The overall numbers of rehabilitation workforce per capita are low, with frequent reports of workforce challenges. In most countries the availability of longer-stay, high-intensity rehabilitation is extremely low, the availability of rehabilitation in tertiary hospitals is modest and in government supported primary care its almost non-existent. Multiple concerns about rehabilitation quality arose but the lack of empirical data hinders formal appraisal. The study sheds light on the limited integration of rehabilitation in health systems and common areas of difficulty and challenge across nine middle income countries. All countries were found to have a basis on which to strengthen rehabilitation and there were often multiple areas within each health system building block that required action in order to improve the situation. Findings can inform governments, regional and global agencies to support future efforts to strengthen rehabilitation. Additionally, our study demonstrates the value of STARS reports for health policy and systems research and can serve as a model for further comparative studies.

The Role of Nurses in Rehabilitation in Primary Health Care for Ageing Populations: A Secondary Analysis from a Scoping Review.

With the ageing of the global population and the rise in noncommunicable diseases, there is an increased need for rehabilitation services, especially those that address the specific needs of ageing populations. Through their proximity to patients, nurses play a critical role in providing rehabilitation interventions for older adults in primary health care. However, they are not yet established as typical rehabilitation providers and further research is needed to clarify their role and competencies to optimize rehabilitation interventions for ageing populations. Therefore, this secondary analysis of a scoping review aims to describe the role of nurses in the provision of rehabilitation interventions to ageing populations in primary health care. This review was carried out following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. It is built on all inclusion and exclusion criteria from the primary analysis and focused on studies including nurses and taking place in primary health care. Data analysis included descriptive statistics, as well as qualitative analysis on the role of nurses. A total of 68 studies from high- and upper-middle income countries were included. Nurses typically had a managerial and clinical role (76%) and worked in multidisciplinary teams (54%), most often with physical therapists. Nurses provided 355 interventions, with assessments (n = 106; 30%), and coordination and management of the rehabilitation process (n = 105; 30%) being the most frequent ones. They had 117 different job titles and little information was available about their educational background. This paper contributes to a better understanding of the key role nurses play in providing rehabilitation interventions to ageing populations in primary health care. Matching nurses' competencies with their level of proficiency is essential to ensure quality care in rehabilitation.

THE RISE OF NON-COMMUNICABLE DISEASES: A GLOBAL HEALTH REVIEW OF CHALLENGES AND PREVENTION STRATEGIES

Non-communicable diseases (NCDs) have emerged as a major global health concern, posing significant challenges to healthcare systems worldwide. This paper provides a succinct overview of the rising prevalence of NCDs, examining the key challenges faced and outlining preventive strategies adopted on a global scale. The escalation of NCDs, including cardiovascular diseases, diabetes, cancer, and respiratory conditions, is intricately linked to lifestyle factors, urbanization, and demographic transitions. This paper explores the multifaceted challenges posed by the growing burden of NCDs, encompassing economic implications, disparities in healthcare access, and the complex interplay of genetic and environmental factors. Addressing NCDs necessitates a comprehensive and multi-sectoral approach. Prevention strategies are crucial components of global health initiatives, encompassing lifestyle modifications, public health interventions, and policy frameworks. This paper outlines successful preventive measures adopted globally, including tobacco control initiatives, promotion of healthy diets and physical activity, and the integration of early screening and detection programs. Despite notable progress, several challenges persist, requiring sustained efforts to curb the NCD epidemic. Issues such as limited resources, inadequate healthcare infrastructure, and the need for cross-sectoral collaboration are explored in this paper. Additionally, the role of education, awareness campaigns, and technological innovations in shaping preventive strategies is emphasized. This paper provides a concise yet comprehensive overview of the global challenges posed by the rise of NCDs and highlights effective prevention strategies. It underscores the urgency for continued collaborative efforts to mitigate the impact of NCDs on global health, with a focus on fostering healthier lifestyles, improving healthcare access, and implementing evidence-based policies.&#x0D; Keywords: Non-communicable Diseases, Global Health, Prevention, Disease, Review, NCD.

The Burden of Cardiovascular Disease from Air Pollution in Rwanda.

Rwanda, like many countries in sub-Saharan Africa, is still relatively early in development. Industrialization and urbanization are major drivers of the county's economic growth. Rwanda is also undergoing an epidemiological transition, from a pattern of morbidity and mortality dominated by infectious diseases to a pattern shaped by non-communicable diseases (NCDs). The rise in NCDs is due, in part, to increasing exposures to environmental hazards. These include emissions from the growing number of motor vehicles and toxic occupational exposures. Cardiovascular disease (CVD) is now an increasingly important cause of death in Rwanda, and ambient air pollution is a CVD risk factor of growing importance. To quantify the burden of CVD attributable to air pollution in Rwanda and identify opportunities for prevention and control of air pollution and pollution-related disease. We relied on the 2019 Global Burden of Disease (GBD) study for information on levels, sources, and trends in household and ambient air pollution and the burden of pollution-related disease in Rwanda. Information on pollution sources was obtained from the Health Effects Institute State of Global Air 2019 report. An estimated 3,477 deaths (95% Uncertainty Interval [UI]: 2,500-4,600) in Rwanda in 2019 were attributable to air pollution-related CVD. Of these, 689 (UI: 283-1,300) deaths were from ambient air pollution-related CVD, while 2,788 (UI: 1,800-3,800) deaths were from household air pollution-related CVD. Rwanda is experiencing increased rates of disease and premature death from NCDs, including CVD, as the country grows economically. While household air pollution is still the top pollution-related cause of disease and premature death, rising levels of ambient air pollution are an increasingly important CVD risk factor. Actions taken now to curb rising levels of ambient air pollution will improve health, reduce CVD, increase longevity, and produce great economic benefit for Rwanda. The single most effective intervention against air pollution will be a rapid nationwide transition to renewable energy. We recommend additionally that Rwanda prioritize air pollution prevention and control, establish a robust, nationwide air monitoring network, support research on the health effects of air pollutants, and build national research capacity. The allocation of increased resources for rural and urban public health and health care will complement air pollution control measures and further reduce CVD. To incentivize a rapid transition to renewable energy in Rwanda and other nations, we recommend the creation of a new Global Green Development Fund.

Peritoneal Dialysis of Three-Cuff Catheter Experience in Qassim Province, Saudi Arabia.

Background: The global rise in noncommunicable diseases, including chronic kidney diseases (CKDs), has led to a significant increase in the use of dialysis units to enhance patient longevity and quality of life. Over time, two-cuff catheters have been replaced by three-cuff catheters, with their usage expanding in nephrology centers across Saudi Arabia. This study aimed to evaluate the benefits, complications, and duration of therapy associated with three-cuff catheters in peritoneal dialysis (PD) patients. Methodology: To ensure the reliability of our results, we conducted a comprehensive cross-sectional study involving 257 patients who underwent three-cuff PD catheter (PDC) insertion and omentopexy. Data were retrospectively collected from 2016 to 2023 at King Fahad Specialist Hospital, Buraidah. The questionnaire was designed based on available variables in the records section and validated by subject experts and experienced research faculty. Data were then entered and analyzed using SPSS version 21.0. Descriptive statistics were employed for inferential statistics, while the chi-square test and logistic regression analysis were used to identify predictors of PD outcomes. Results: The average duration of therapy was 27.84 months, with a standard deviation of 27.23 months. Early complications were minimal, with just 5.1% (n = 13) experiencing peritonitis, 0.8% (n = 2) facing catheter migration, and 0.4% (n = 1 each) encountering omental wrap and exit site infection (ESI) within 30 days of catheter insertion. Remarkably, only 7.8% (n = 20) required catheter reinsertion. In addition, catheter removal due to catheter-related issues was low, affecting only 3.8% of patients. Conclusions: According to the study findings, three-cuff catheters exhibited fewer complications, superior performance, and longer therapy duration. These outcomes may be attributed to the thorough design of the three-cuff catheters, the dedication of the staff, and the implementation of strict policies. To maintain these positive results, it is crucial for the Ministry of Health and the Health Cluster to adopt long-term supportive measures.

The Rehabilitation Landscape in a Low-to-Middle-Income Country: Stakeholder Perspectives and Policy Implications-A Qualitative Study.

The need for rehabilitation is increasing on a global level due to a rise in non-communicable diseases, aging and medical advances, and in South Africa (SA), due to the quadruple burden of disease. More information is required regarding rehabilitation scope and practices in SA to optimize the provision of rehabilitation interventions in the context of the transforming health care sector in SA, a low-to-middle-income country (LMIC). The purpose of this study is to explore the perspectives of South African rehabilitation stakeholders on the landscape of rehabilitation in SA. A descriptive qualitative study, with an interpretive approach, was used to explore stakeholder perspectives on rehabilitation practices in the public health care sector of SA. Semi-structured interviews were conducted with 12 rehabilitation stakeholders. Data were analyzed using a combination of deductive and inductive processes to generate themes and categories. We identified 5 main themes, with subsequent categories and sub-categories. The themes include a composite definition of rehabilitation, core elements of rehabilitation provision, challenges affecting rehabilitation practices, the importance of policy implementation, and the progress of rehabilitation in SA. Despite a common understanding of rehabilitation practices in SA amongst stakeholders, many persistent challenges hamper the delivery of effective rehabilitation services. We recommend that further research explore the rehabilitation needs of end-users, together with collaborative research for priority setting on the translation of policy to practice ensuring equitable and quality rehabilitation service delivery.

Nyakaza-Move-for-Health: A Culturally Tailored Physical Activity Intervention for Adolescents in South Africa Using the Intervention Mapping Protocol.

The Nyakaza-Move-for-Health intervention program was developed in response to the alarming rise in non-communicable diseases (NCDs) globally, in sub-Saharan Africa and South Africa. The rise in NCDs is attributed to the low levels of participation in physical activity (PA) among adolescents. Therefore, this study aimed to design a culturally tailored PA intervention for adolescents, guided by the Intervention Mapping (IM) protocol. The intervention program aims to address the multifaceted determinants of physical activity behavior, promote healthy lifestyles and improve adolescent fitness levels. The Intervention Mapping protocol was applied to design the intervention program. The IM has 6 steps: (1) Needs assessment, (2) developing a logic model of the problem (LMP), (3) Formulating program outcomes and objectives, (4) Program design and production, (5) Generating implementation plan, and (6) Generating intervention evaluation plan. Participants included (n = 48) adolescent learners recruited from 8 (n = 8) participating schools. Adolescent learners participated in focus group discussions (FGD) to identify personal, interpersonal and environmental determinants of physical inactivity. Twenty-six (n = 26) key informant stakeholders participated in a stakeholder engagement workshop (SEW) to determine the motivators and constraints in implementing physical activity interventions. The Nyakaza intervention program's process development involved extensive stakeholder engagement, capacity development training, and integration of community feedback into the design. The intervention included a social marketing campaign and structured after-school physical activity sessions based on the Health Belief Model (HBM) and Transtheoretical Model (TTM). Implementation and evaluation plans were created, emphasizing real-time monitoring and adaptations. Strategies to enhance parental and community support were developed to address participation barriers. Although not tested in this study, these plans laid a robust foundation for fostering sustainable behavior change and improving physical activity among adolescents in resource-constrained settings. The Nyakaza-Move-for-Health intervention demonstrates a promising framework for promoting adolescent physical activity and addressing Non-Communicable Diseases in a culturally relevant manner. The systematic approach, grounded in the intervention mapping protocol, ensured a robust and replicable intervention design. Future research should focus on long-term follow-up, integrating objective physical activity measures, and expanding the program to include nutrition education. Addressing identified barriers, such as parental involvement, is crucial for enhancing the intervention's effectiveness and sustainability.

Facilitators and barriers to integration of noncommunicable diseases with HIV care at primary health care in Ethiopia: a qualitative analysis using CFIR.

The rise in non-communicable diseases (NCD), such as hypertension and diabetes among people living with human immunodeficiency virus (PLWH), has increased the demand for integrated care due to multiple chronic care needs. However, there is a dearth of evidence on contextual factors implementing integrated hypertension and diabetes care with HIV care. This study aimed to identify facilitators and barriers that could affect the integration of hypertension and diabetes with HIV care at primary health care in Ethiopia. Five primary health facilities from five districts of the Wolaita zone of South Ethiopia were included in the qualitative study. Fifteen key informant interviews were conducted with healthcare providers and managers from the zonal, district, and facility levels from October to November 2022. Data collection and analysis were guided by a consolidated framework of implementation research (CFIR). Ten CFIR constructs were found to influence the integration. Perceived benefit of integration to patients, healthcare providers, and organization; perceived possibilities of integration implementation; availability of NCD guidelines and strategies; a supportive policy of decentralization and integration; perceived leaders and healthcare provider commitment were found to be facilitators. Perceived increased cost, insufficient attention to NCD care needs, inadequate number of trained professionals, inadequate equipment and apparatus such as blood pressure measurement, glucometers, strips, and NCD drugs, inadequate allocation of budget and weak health financing system and poor culture of data capturing and reporting were identified as barriers to integration. It is important to address contextual barriers through innovative implementation science solutions to address multiple chronic care needs of PLWH by implementing integrated hypertension and diabetes with HIV care in primary healthcare. Training and task shifting, pairing experienced professionals, and strengthening the health care financing system to implement evidence-based integration of hypertension and diabetes are recommended.

Unravelling the determinants of human health in French Polynesia: the MATAEA project.

French Polynesia is a French overseas collectivity in the Southeast Pacific, comprising 75 inhabited islands across five archipelagoes. The human settlement of the region corresponds to the last massive migration of humans to empty territories, but its timeline is still debated. Despite their recent population history and geographical isolation, inhabitants of French Polynesia experience health issues similar to those of continental countries. Modern lifestyles and increased longevity have led to a rise in non-communicable diseases (NCDs) such as obesity, diabetes, hypertension, and cardiovascular diseases. Likewise, international trade and people mobility have caused the emergence of communicable diseases (CDs) including mosquito-borne and respiratory diseases. Additionally, chronic pathologies including acute rheumatic fever, liver diseases, and ciguatera, are highly prevalent in French Polynesia. However, data on such diseases are scarce and not representative of the geographic fragmentation of the population. The present project aims to estimate the prevalence of several NCDs and CDs in the population of the five archipelagoes, and identify associated risk factors. Moreover, genetic analyses will contribute to determine the sequence and timings of the peopling history of French Polynesia, and identify causal links between past genetic adaptation to island environments, and present-day susceptibility to certain diseases. This cross-sectional survey is based on the random selection of 2,100 adults aged 18-69 years and residing on 18 islands from the five archipelagoes. Each participant answered a questionnaire on a wide range of topics (including demographic characteristics, lifestyle habits and medical history), underwent physical measurements (height, weight, waist circumference, arterial pressure, and skin pigmentation), and provided biological samples (blood, saliva, and stool) for biological, genetic and microbiological analyses. For the first time in French Polynesia, the present project allows to collect a wide range of data to explore the existence of indicators and/or risk factors for multiple pathologies of public health concern. The results will help health authorities to adapt actions and preventive measures aimed at reducing the incidence of NCDs and CDs. Moreover, the new genomic data generated in this study, combined with anthropological data, will increase our understanding of the peopling history of French Polynesia. https://clinicaltrials.gov/, identifier: NCT06133400.

Elderly Female with Pulmonary Oedema Manifestation of Dengue Hemorrhagic Fever : a Case Report

Dengue Hemorrhagic Fever (DHF) is an arthropod borne viral disease. The main vector of the disease are the Aedes mosquitoes. Indonesia as one of the tropical nations in South Asia falls into one of the countries in which DHF is an endemic. The notable clinical symptoms are fever usually 400c with a biphasic pattern in 6% of DHF cases, body ache, muscles, retroorbital and joints, nausea, and vomiting. Fluid accumulation, due to plasma leakage, may occur in the abdominal cavities, pleural space, and even the lungs. The rise of non-communicable diseases like diabetes mellitus has impacted the clinical progression of DHF by increasing the risk of developing into dengue shock syndrome and atypical clinical manifestation of dengue plasma leakage and bleeding disorder. This case report discusses one of these atypical clinical manifestations of DHF. The case is an elderly female presenting in the emergency room with a DHF, Diabetes mellitus type 2, cardiomegaly, and during inpatient care developed a pulmonary Oedema. The patient experienced prolonged fever and on the 7th day of care develops a pulmonary oedema, the patient is then moved to the intensive care unit, and with proper treatment and monitoring was able to recover from the disease