Care for persons with noncommunicable diseases (NCDs), such as cardiovascular disease, diabetes, cancer, and chronic obstructive pulmonary disease, is a major health priority for most countries worldwide, particularly for low-middle income countries where the problem seems to be worsening. Globally,... research demonstrates that the vast majority of people with NCDs receive suboptimal care. Many people living with chronic conditions remain undiagnosed and unaware of their condition, while many others remain untreated or with inadequate control. Meanwhile the premature mortality caused by NCDs remains high in many countries. In response to the global epidemic of NCDs, the World Health Organization (WHO) launched the Global Strategy for the Prevention and Control of Noncommunicable Diseases in 2012, which establishes 9 voluntary global targets and indicators to be considered by Member States when formu- lating national plans to combat NCDs.
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The coronavirus outbreak that began in 2019 (COVID-19) threatens to reverse years of hard-won gains in preventing and treating HIV. Fragile health systems are further stressed as health workers navigate an increased client load and demands at work while also being concerned for their own health and ...that of their families. Health facilities have been redesigned to care for patients with COVID-19, posing challenges to other services. Governments and civil society organizations have redirected scarce resources and shifted programming priorities to respond to the pandemic. Several countries have reported intermittent declines in HIV testing and diagnosis, antenatal care visits, collection of antiretroviral medicines (ARVs) by people living with HIV, and attendance at clinic appointments. Community-based education and support programmes have had to rapidly adapt to restrictions on movement and public gatherings. Children, adolescents, and women have experienced multiple deprivations due to the adverse impact of the pandemic.
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PEPFAR Malawi’s Country Operational Plan 2022 (COP22) embodies joint priorities from national and subnational dialogues building on the 2020-2025 National Strategic Plan for HIV/AIDS. The interagency team has developed a person-centered, district-tailored and Malawi Population-Based HIV Impact Ass...essment (MPHIA)-informed strategy through extensive engagement with Government of Malawi (GoM) and Civil Society Organizations (CSOs) to sustain HIV epidemic control. At the end of COP21, PEPFAR Malawi was commended for contributing to reaching epidemic control in strong collaboration with GoM and stakeholders including the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund). This includes enrollment of 88% of recipients of care on three or more months of antiretroviral treatment (ART), better outcomes for Malawian children through remarkable efforts in Orphans and Vulnerable Children (OVC) programming and progress made towards reaching men with more intentional and focused programming.
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In a prospective cohort study in Bangwe primary care clinic, Blantyre, Malawi, all adults (18 years or older) presenting with an acute illness were screened for TB symptoms (cough, fever, night sweats, weight loss). Demographic characteristics were linked to exit interview by fingerprint bioidentifi...cation. Multivariable logistic regression models were constructed to estimate the proportion completing same-visit HIV testing, comparing between those with and without TB symptoms.
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To identify and to assess factors enhancing or hindering the delivery of breast and cervical cancer screening services in Malawi with regard to accessibility, uptake, acceptability and effectiveness.
Systematic review of published scientific evidence. A search of six bibliographic databases and gre...y literature was executed to identify relevant studies conducted in Malawi in the English language, with no time or study design restrictions. Data extraction was conducted in Excel and evidence synthesis followed a thematic analysis approach to identify and compare emerging themes.
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The Government of Malawi’s Health Sector Strategic Plan II highlights the importance of service integration; however, in practice, this has not been fully realized. We conducted a mixed methods evaluation of efforts to systematically implement integrated family planning and immunization services i...n all health facilities and associated community sites in Ntchisi and Dowa districts during June 2016–September 2017. Methods included secondary analysis of service statistics (pre- and postintervention), focus group discussions with mothers and fathers of children under age one, and in-depth interviews with service providers, supervisors, and managers. Results indicate statistically significant increases in family planning users and shifts in use of family planning services from health facilities to community sites. The intervention had no effect on immunization doses administered or dropout rates. According to mothers and fathers, benefits of service integration included time savings, convenience, and improved understanding of services. Provision and use of integrated services were affected by availability of human resources and commodities, community linkages, data collection procedures and availability, sociocultural barriers, organization of services, and supervision and commitment of health surveillance assistants. The integration approach was perceived to be feasible and beneficial by clients and providers.
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Since February 24th, 2022, the beginning of Russia’s aggression against Ukraine, more than 80,000 women were expected to give birth. Therefore, understanding the impact of war on the perinatal health of women is an important requisite to improve perinatal care. This narrative synthesis has two mai...n purposes: on one hand, it aims to summarize the current evidence available based on perinatal health outcomes and care among perinatal women; on the other, it attempts to identify the gaps still present in research in relation to perinatal care.
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Asthma is one of the neglected diseases in Africa with a high prevalence. Allergic fungal diseases have been reported to complicate asthma progression and treatment outcomes. However, data about fungal asthma and its associated complications are limited in Africa. We aimed to estimate the burden of ...fungal asthma among adults and children in Africa using a systematic review.
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The article "Barriers and determinants of asthma control in children and adolescents in Africa: a systematic review" analyzes factors contributing to poor asthma control in African youth. Based on studies conducted between 2014 and 2019 in Nigeria, Uganda, and South Africa, the review identifies key... challenges such as limited access to asthma diagnosis, inadequate use of inhaled corticosteroids, and environmental and socio-economic factors. It finds that urban living, older age, and concurrent allergic conditions significantly affect asthma management. The study emphasizes the need for improved diagnostic tools, better access to treatment, and tailored public health interventions to enhance asthma outcomes in African children.
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The article "Under- and over-diagnosis of COPD: a global perspective" reviews the worldwide variation in the prevalence of chronic obstructive pulmonary disease (COPD) and issues related to its misdiagnosis. It highlights that COPD is under-diagnosed due to factors such as limited access to spiromet...ry and variable diagnostic criteria, especially in low- and middle-income countries. Conversely, over-diagnosis often results from reliance on non-standard criteria or inadequate spirometry use. The article discusses key risk factors, including age, gender, exposure to pollutants, and comorbidities, and emphasizes the need for standardized diagnostic practices to better address and manage COPD globally.
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PEPFAR Malawi’s Country Operational Plan (COP) 2021 reflects a culmination of strong interagency collaboration between the PEPFAR Malawi team, Government of Malawi (GoM), and civil society organizations (CSOs) to mitigate the devastating impacts of COVID-19 and sustain progress achieved over the l...ast two decades towards HIV epidemic control.
At the conclusion of the March 2020 Johannesburg Regional Planning Meeting, the PEPFAR Malawi team presented a COP20 surge strategy to improve client-centered care, mitigate treatment disruption, scale prevention programs to key and vulnerable populations, and strengthen national health systems.
Following this meeting, the first three COVID-19 cases were reported in Malawi and immediately thereafter, adaptations to the COP20 strategy became imperative to deliver safe, client-centered care.
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Diabetes mellitus is a major cause of morbidity and mortality in Scotland and worldwide, with an increasing prevalence. In 2009 there were around 228,000 people registered as having diabetes in Scotland, an increase of 3.6% from the preceding year. This increase relates, in part, to the increasing a...ge of the population, an increase in obesity and also perhaps to increasing survival of those with diabetes.
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Diabetes is a major public health problem. The rising incidence of Diabetes Type 2 is related to the effects of urbanization and unhealthy lifestyles. Research studies show that healthy eating and regular physical activity can prevent or delay the onset of Diabetes Type 2, even in high-risk individu...als.
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In recent decades, India has witnessed a rapidly exploding epidemic of diabetes.
Indeed, India today has the second largest number of people with diabetes in the
world. The International Diabetes Federation (IDF) estimates that there are 72.9 million people with diabetes in India in 2017, which is... projected to rise to 134.3 million by the year 2045. The prevalence of diabetes in urban India, especially in large metropolitan cities has increased from 2% in the 1970s to over 20% at present and the rural areas are also fast catching up.
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There is increasing interest in understanding the role of air pollution as one of the greatest threats to human health worldwide. Nine of 10 individuals breathe air with polluted compounds that have a great impact on lung tissue. The nature of the relationship is complex, and new or updated data are... constantly being reported in the literature. The goal of our review was to summarize the most important air pollutants and their impact on the main respiratory diseases (chronic obstructive pulmonary disease, asthma, lung cancer, idiopathic pulmonary fibrosis, respiratory infections, bronchiectasis, tuberculosis) to reduce both short- and the long-term exposure consequences. We considered the most important air pollutants, including sulfur dioxide, nitrogen dioxide, carbon monoxide, volatile organic compounds, ozone, particulate matter and biomass smoke, and observed their impact on pulmonary pathologies. We focused on respiratory pathologies, because air pollution potentiates the increase in respiratory diseases, and the evidence that air pollutants have a detrimental effect is growing. It is imperative to constantly improve policy initiatives on air quality in both high- and low-income countries.
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Global Development: Where Are We Now?
Today, we are facing a vital opportunity to change the profile of cardiovascular disease around the world.
The Millennium Development Goals (MDGs) are due to expire at the end of 2015, placing the cardiovascular health community in a unique position to shape t...he priorities for the next development agenda, and save millions of lives.
Despite its devastating impact on people of all ages, genders and ethnicities, cardiovascular disease was excluded from the Millennium Development Goals (MDGs), which were announced by the United Nations in 2000. That oversight was far-reaching;
for well over a decade, non-communicable diseases were omitted from the global funding agenda and deprioritized by other mechanisms. During that period of muted government action, the prevalence and burden of non-communicable diseases increased in every region of the world.
Fifteen years later, as the successors to the MDGs are being negotiated, we are in a position to call for the prioritization of cardiovascular disease on the forthcoming global development agenda. Once we have ensured that CVD is recognised at the global policy level, our efforts will turn to encouraging governments to honour their commitments on
the prevention and control of CVD.
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Obesity and diabetes are affecting the peoples of the Americas at high and increasing rates. National surveys demonstrate that obesity is increasing in prevalence among all age groups; 7% to 12% of children under 5 years old and
one-fi fth of adolescents are obese, while rates of overweight and obe...sity among adults approach 60%. Obesity is the major modifi able risk factor for diabetes.
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Issue Brief No. 40 provides healthcare professionals with the most relevant treatment guidelines, prevention measures and training material on MVD
Diabetes is a significant public health issue that affects approximately one in 10 adults globally, with type 2 diabetes accounting for 90–95% of cases. This chronic condition causes considerable morbidity and mortality and is growing in impact, with cases projected to rise from 537 million in 202...1 to 784 million by 2045.1 As cases rise, it is imperative to ensure the healthcare workforce is prepared to care for affected individuals. However, there is a growing global shortage of healthcare workers, which was estimated, pre pandemic, to reach 15 million by 2030.2 Therefore, all of the healthcare workforce will need to be utilised to their fullest potential in order to address the growing global burden of diabetes. Pharmacists will continue to be essential in this endeavour.
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While epidemiological data for type 1 diabetes (T1D) in low/middle-income countries, and particularly low-income countries (LICs) including Liberia is lacking, prevalence in LICs is thought to be increasing. T1D care in LICs is often impacted by challenges in diagnosis and management. These challeng...es, including misdiagnosis and access to insulin, can affect T1D outcomes and frequency of severe complications. Despite the severe nature of T1D and growing burden in subSaharan Africa, little is currently known about the impact of T1D on patients and caregivers in the region. Methods We conducted a qualitative study consisting of interviews with patients with T1D, caregivers, providers, civil society members and a policy-maker in Liberia to better understand the psychosocial and economic impact of living with T1D, knowledge of T1D and selfmanagement, and barriers and facilitators for accessing T1D care.
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