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Empowering Frontline Primary Healthcare Workers in a Global Health Partnership Training of Trainers Intervention to Strengthen the Prevention and Control of Cardiovascular Disease in Mozambique

Harris. P.; Juga, E.; Bay, N. et al. Global Heart (2022) CC

Unpreparedness of health professionals to address non-communicable diseases (NCD) at peripheral health facilities is a critical health system challenge in Mozambique. To address this weakness and decentralize NCD care, training of the primary care workforce is needed. We describe our experience in t... more

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Resource Effective Strategies to Prevent and Treat Cardiovascular Disease

Schwalm, J.; McKee, M.; Huffman, M. et al. Circulation (2016) CC

Cardiovascular disease (CVD) is the leading cause of global deaths, with the majority occurring in low- and middle-income countries (LMIC). The primary and secondary prevention of CVD is suboptimal throughout the world, but the evidence-practice gaps are much more pronounced in LMIC. Barriers at the... more

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Challenges in management and prevention of ischemic heart disease in low socioeconomic status people in LLMICs

Gupta, R.; Yusuf, S. BMC Medicine (2019) CC

Cardiovascular diseases, principally ischemic heart disease (IHD), are the most important cause of death and disability in the majority of low- and lower-middle-income countries (LLMICs). In these countries, IHD mortality rates are significantly greater in individuals of a low socioeconomic status (... more

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Screening for cardiovascular disease risk and subsequent management in low and middle income countries: challenges and opportunities

Bovet, P.; Chiolero, A.; Paccaud, F. et al. Public Health Reviews (2015) CC

Background: Cardiovascular disease (CVD), mainly heart attack and stroke, is the leading cause of premature mortality in low and middle income countries (LMICs). Identifying and managing individuals at high risk of CVD is an important strategy to prevent and control CVD, in addition to multisector... more

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Environmental Determinants of Cardiovascular Disease

Bhatnagar, A. Circulation Research (2018) CC

Many features of the environment have been found to exert an important influence on cardiovascular disease (CVD) risk, progression, and severity. Changes in the environment due to migration to different geographic locations, modifications in lifestyle choices, and shifts in social policies and cultu... more

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Preventing the next Pandemic: the Case for Investing in Circulatory Health

Global Coalition for Circulatory Health (2024) CC

The Coronavirus Disease 2019 (COVID-19) has had a continuous and robust impact on world health. The resulting COVID-19 pandemic has had a devastating physical, mental and fiscal impact on the millions of people living with noncommunicable diseases (NCDs), as they have a higher risk of severe illness... more

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World Heart Federation Cholesterol Roadmap 2022

Ray, K.K.; Ference, B.A.; Séverin, T. et al. World Heart Federation (2022) CC

Background: Atherosclerotic cardiovascular diseases (ASCVD) including myocardial infarction, stroke and peripheral arterial disease continue to be major causes of premature death, disability and healthcare expenditure globally. Preventing the accumulation of cholesterol-containing atherogenic lipopr... more

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WHF Roadmap for Digital Health in Cardiology

Tromp, J.; Jindal, D.; Redfern, J. et al. Global Heart (2022) CC

ABSTRACT More than 500 million people worldwide live with cardiovascular disease (CVD). Health systems today face fundamental challenges in delivering optimal care due to ageing populations, healthcare workforce constraints, financing, availability and affordability of CVD medicine, and service del... more

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World Heart Federation Roadmap on Atrial Fibrillation – A 2020 Update

Freedman, B.; Hindricks, G.; Banerjee, A. Global Heart (2021) CC

The World Heart Federation (WHF) commenced a Roadmap initiative in 2015 to reduce the global burden of cardiovascular disease and resultant burgeoning of healthcare costs. Roadmaps provide a blueprint for implementation of priority solutions for the principal cardiovascular diseases leading to death... more

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Cardiac arrhythmias in low- and middle-income countries

Mkoko, P.; Bahiru, E.; Ajijola, O.A. et al. Cardiovascular Diagnosis and Therapy (2019) CC

Many low- and middle-income countries (LMICs) are undergoing an epidemiological transition. With an improvement in socioeconomic conditions and an aging population, cardiovascular diseases (CVDs), like cardiac arrhythmias, are expected to increase in these countries. However, there are limited studi... more

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Cardiovascular disease risk profile and management practices in 45 low-income and middle-income countries: A cross-sectional study of nationally representative individual-level survey data

Peiris, D.; Ghosh, A.; Manne-Goehler, J. et al. PLoS Medicine (2021) CC

Global cardiovascular disease (CVD) burden is high and rising, especially in low-income and middle-income countries (LMICs). Focussing on 45 LMICs, we aimed to determine (1) the adult population’s median 10-year predicted CVD risk, including its variation within countries by socio-demographic char... more

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Cardiovascular Diseases in Sub-Saharan Africa Compared to High-Income Countries: An Epidemiological Perspective

Yuyun, M.F.; Sliwa, K.; Kengne, A.P. et al. Global Heart (2020) CC

Non-communicable diseases (NCDs) are the second common cause of death in sub-Saharan Africa (SSA) accounting for about 35% of all deaths, after a composite of communicable, maternal, neonatal, and nutritional diseases. Despite prior perception of low NCDs mortality rates, current evidence suggests t... more

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Epidemiology, Pathophysiology, Diagnosis and Treatment of Heart Failure in Diabetes

Park, J.J. Diabetes & Metabolism Journal (2021) CC

The cardiovascular disease continuum begins with risk factors such as diabetes mellitus (DM), progresses to vasculopathy and myocardial dysfunction, and finally ends with cardiovascular death. Diabetes is associated with a 2- to 4-fold increased risk for heart failure (HF). Moreover, HF patients wit... more

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Infrastructure, policy and regulatory interventions to increase physical activity to prevent cardiovascular diseases and diabetes: a systematic review

Durão, S.; Burns, J.; Schmidt, B. et al. BMC Public Health (2023) CC

Background Noncommunicable diseases are major contributors to morbidity and mortality worldwide. Modifying the risk factors for these conditions, such as physical inactivity, is thus essential. Addressing the context or circumstances in which physical activity occurs may promote physical activity a...t a population level. We assessed the effects of infrastructure, policy or regulatory interventions for increasing physical activity. Methods We searched PubMed, Embase and clinicaltrials.gov to identify randomised controlled trials (RCTs), controlled before-after (CBAs) studies, and interrupted time series (ITS) studies assessing population-level infrastructure or policy and regulatory interventions to increase physical activity. We were interested in the effects of these interventions on physical activity, body weight and related measures, blood pressure, and CVD and type 2 diabetes morbidity and mortality, and on other secondary outcomes. Screening and data extraction was done in duplicate, with risk of bias was using an adapted Cochrane risk of bias tool. Due to high levels of heterogeneity, we synthesised the evidence based on effect direction. Results We included 33 studies, mostly conducted in high-income countries. Of these, 13 assessed infrastructure changes to green or other spaces to promote physical activity and 18 infrastructure changes to promote active transport. The effects of identified interventions on physical activity, body weight and blood pressure varied across studies (very low certainty evidence); thus, we remain very uncertain about the effects of these interventions. Two studies assessed the effects of policy and regulatory interventions; one provided free access to physical activity facilities and showed that it may have beneficial effects on physical activity (low certainty evidence). The other provided free bus travel for youth, with intervention effects varying across studies (very low certainty evidence). Conclusions Evidence from 33 studies assessing infrastructure, policy and regulatory interventions for increasing physical activity showed varying results. The certainty of the evidence was mostly very low, due to study designs included and inconsistent findings between studies. Despite this drawback, the evidence indicates that providing access to physical activity facilities may be beneficial; however this finding is based on only one study. Implementation of these interventions requires full consideration of contextual factors, especially in low resource settings. more

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Socioeconomic status and risk of cardiovascular disease in 20 low-income, middle-income, and high-income countries: the Prospective Urban Rural Epidemiologic (PURE) study

Rosengren, A.; Smyth, A.; Rangarajan, S. et al. The Lancet Global Health (2019) CC

Socioeconomic status is associated with differences in risk factors for cardiovascular disease incidence and outcomes, including mortality. However, it is unclear whether the associations between cardiovascular disease and common measures of socioeconomic status—wealth and education—differ among... more

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Quality of stroke guidelines in low- and middle-income countries: a systematic review

Yaria, J.; Gil, A.; Makanjuola, A. et al. Bulletin of the World Health Organization (2021) C_WHO

Objective: To identify gaps in national stroke guidelines that could be bridged to enhance the quality of stroke care services in low- and middle-income countries. Methods: We systematically searched medical databases and websites of medical societies and contacted international organizations. Co... more

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Prevention and management of CVD in LMICs: why do ethnicity, culture, and context matter?

Anand, S.; Bradshaw, C.; Prabhakaran, D. BMC Medicine (2020) CC

Background Low- and middle-income countries now experience the highest prevalence and mortality rates of cardiovascular disease. Main text While improving the availability and delivery of proven, effective therapies will no doubt mitigate this burden, we posit that studies evaluating cardiovasc... more

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Kenya Asthma Management Guideline

Ministry of Health (2021) CC

Bonchial asthma is the most common chronic respiratory disease in the world. In Kenya, it has been estimated that about 7.5% of the Kenyan population, nearly 4 million people, are currently living with asthma. Many cases tend to be underdiagnosed and undertreated which leads to high levels of morbid... more

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The burden of severe asthma in sub-Saharan Africa: Findings from the African Severe Asthma Project

Kirenga, B.J.; Chakaya, J.; Yimer, G. et al. Journal of Allergy and Clinical Immunology: Global (2024) CC

Severe asthma is associated with high morbidity, mortality, and health care utilization, but its burden in Africa is unknown. This article wants to determine the burden (prevalence, mortality, and activity and work impairment) of severe asthma in 3 countries in East Africa: Uganda, Kenya, and Ethio... more

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Integrated operational framework for mental health, brain health and substance use

World Health Organisation (WHO) (2024) C_WHO

This integrated operational framework provides an overview of the connections between mental health, neurological and substance use (MNS) conditions, and their links to health, well-being and the broader public health and sustainable development agenda. The need for integrated approaches is increasi... more