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Cardiovascular diseases in Africa in the twenty-first century: Gaps and priorities going forward

Minja, N.W.; Nakagaayi, D.; Aliku, T. et al. Frontiers in Cardiovascular Medicine (2022) CC

In 2015, the United Nations set important targets to reduce premature cardiovascular disease (CVD) deaths by 33% by 2030. Africa disproportionately bears the brunt of CVD burden and has one of the highest risks of dying from non-communicable diseases (NCDs) worldwide. There is currently an epide...miological transition on the continent, where NCDs is projected to outpace communicable diseases within the current decade. Unchecked increases in CVD risk factors have contributed to the growing burden of three major CVDs—hypertension, cardiomyopathies, and atherosclerotic diseasesleading to devastating rates of stroke and heart failure. The highest age standardized disability-adjusted life years (DALYs) due to hypertensive heart disease (HHD) were recorded in Africa. The contributory causes of heart failure are changing—whilst HHD and cardiomyopathies still dominate, ischemic heart disease is rapidly becoming a significant contributor, whilst rheumatic heart disease (RHD) has shown a gradual decline. In a continent where health systems are traditionally geared toward addressing communicable diseases, several gaps exist to adequately meet the growing demand imposed by CVDs. Among these, high-quality research to inform interventions, underfunded health systems with high out-of-pocket costs, limited accessibility and affordability of essential medicines, CVD preventive services, and skill shortages. Overall, the African continent progress toward a third reduction in premature mortality come 2030 is lagging behind. More can be done in the arena of effective policy implementation for risk factor reduction and CVD prevention, increasing health financing and focusing on strengthening primary health care services for prevention and treatment of CVDs, whilst ensuring availability and affordability of quality medicines. Further, investing in systematic country data collection and research outputs will improve the accuracy of the burden of disease data and inform policy adoption on interventions. This review summarizes the current CVD burden, important gaps in cardiovascular medicine in Africa, and further highlights priority areas where efforts could be intensified in the next decade with potential to improve the current rate of progress toward achieving a 33% reduction in CVD mortality. more

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Associations of the built environment with type 2 diabetes in Asia: a systematic review

Aarthi, G.R.; Begum, T. S. M.; Al Moosawi, S.; et al. BMJ Open (2023) CC2

Objectives Our study aimed to systematically review the literature and synthesise findings on potential associations of built environment characteristics with type 2 diabetes (T2D) in Asia.

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Primary and Secondary Prevention of Ischemic Stroke

Paciaroni, M.; Bogousslavsky, J. European Neurology (2010) CC

Prevention of stroke and transient ischemic attack includes both conventional approaches to vascular risk factor management (blood pressure lowering, cholesterol reduction with statins, smoking cessation and antiplatelet therapy) and more specific interventions, such as carotid revascularization or... 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

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Improving the global diagnosis and management of asthma in children

Lenney, W.; Bush, A.; Fitzgerald, D.A. et al. BMJ Journals (2018) CC

Asthma is the most common chronic condition in children worldwide. It affects daytime activities, sleep and school attendance and causes anxiety to parents, families and other carers. The quality of asthma diagnosis and management globally still needs substantial improvement. From infancy to the tee... 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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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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Asia-Pacific Consensus Statement on the Management of Peripheral Artery Disease

Abola, M. T. B.; Golledge, J.; Miyata, T. et al. Journal of Atherosclerosis and Thrombosis (2020) CC

Peripheral artery disease (PAD) is the most underdiagnosed, underestimated and undertreated of the atherosclerotic vascular diseases despite its poor prognosis. There may be racial or contextual differences in the Asia-Pacific region as to epidemiology, availability of diagnostic and therapeutic mod... more

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Advocation for Cholesterol control: A world heard federation toolkit

World Heart Federation (2022) CC

The World Heart Federation (WHF) is a leading global advocate for stronger legislation and policies regarding cardiovascular disease (CVD) and its risk factors, including raised cholesterol. The present Cholesterol Advocacy Toolkit 2022 provides WHF member organizations with information as well as p... more

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City-level monitoring guidance for the prevention and control of noncommunicable diseases and injuries

World Health Organisation (WHO) (2024) C_WHO

The guidance document provides a set of indicators for assessing the status of development, implementation and monitoring of key policy interventions for prevention and control of NCDs and injuries. It promotes city-level evidence based decision-making processes to identify gaps and take appropriate... more

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Global surveillance, prevention and control of chronic respiratory diseases - a comprehensive approach

Bousquet, J.; Khaltaev, N. (2007) C_WHO

Chronic respiratory diseases, such as asthma and chronic obstructive pulmonary disease, kill more than four million people every year and affect hundreds of millions more. These diseases erode the health and well-being of the patients and have a negative impact on families and societies. Women ... more

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how to use your pump correctly - Outcome of illustrated information leaflet on correct usage of asthma - metered dose inhaler

Wrench, W.; van Dyk, L.; Sirinivas, S.; Dowse, R. (2019) CC2

Research globally has shown that metered dose inhaler (MDI) technique is poor, with patient education and regular demonstration critical in maintaining correct use of inhalers. Patient information containing pictorial aids improves understanding of medicine usage; however, manufacturer leaflets i... more

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The Global Asthma Report 2022

Global Asthma Network (2022) CC2

The Global Asthma Report (GAR) 2022, prepared by the Global Asthma Network (GAN), is the fourth such report (others 2011, 2014, 2018). GAN builds upon the work of the International Study of Asthma and Allergies in Childhood (ISAAC) and The International Union Against Tuberculosis and Lung Disease (T... more

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Asthma management in low and middle income countries: case for change

Mortimer, K.; Reddel, H. K.; Pitrez, P. M.; et al. (2022) CC2

Asthma is the most common noncommunicable disease in children, and among the most common in adults. According to the most recent estimates from the Global Asthma Network Phase I study, around one in 10 children and adults have symptoms of asthma and one in 20 school-aged children have severe asthma ... more

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2020 Brazilian Thoracic Association recommendations for the management of asthma

Menezes Pizzichini, M. M.; de Carvalho-Pinto, R. M.; Delfini Cançado, J. E.; et al. (2020) CC2

The pharmacological management of asthma has changed considerably in recent decades, as it has come to be understood that it is a complex, heterogeneous disease with different phenotypes and endotypes. It is now clear that the goal of asthma treatment should be to achieve and maintain control of the... more

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WHO clinical consortium on healthy ageing 2023

World Health Organisation (WHO) (2024) C_WHO

The 2023 meeting of the WHO Clinical Consortium on Healthy Ageing (CCHA) was the group’s ninth gathering and took place in Geneva 5–7 December 2023. The meeting was structured around seven panels, with a series of technical presentations, plenary discussions and group work, and a final session o... more

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The missing link: Rethinking and reprioritizing HIV and gender-based violence in fragile settings

UNAIDS (2024) CC

This report explores the extent to which evidence, policy, normative guidance and commitments on HIV and gender-based violence, and their interlinkages, is being translated into action on the ground in fragile settings. These issues are explored through the lens of training of peace support operatio... more

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2024 global AIDS report — The Urgency of Now: AIDS at a Crossroads

UNAIDS (2024) CC

This UNAIDS 2024 report brings together new data and case studies which demonstrate that the decisions and policy choices taken by world leaders this year will decide the fate of millions of lives and whether the world’s deadliest pandemic is overcome.

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Task-shifting to improve asthma education for Malawian children: a qualitative analysis

Nkhalamba, L.; Rylance, S.; Muula, S. A. et al. Human Resources for Health (2021) CC

Background Asthma education, a key component of long-term asthma management, is challenging in resource-limited settings with shortages of clinical staff. Task-shifting educational roles to lay (non-clinical) staff is a potential solution. We conducted a randomised controlled trial of an enhanced a... more

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Risk factors for asthma among schoolchildren who participated in a casecontrol study in urban Uganda

Mpairwe, H.; Namutebi, M.; Nkurunungi, G. et al. eLife (2019) CC

Data on asthma aetiology in Africa are scarce. We investigated the risk factors for asthma among schoolchildren (5–17 years) in urban Uganda. We conducted a case-control study, among 555 cases and 1115 controls. Asthma was diagnosed by study clinicians. The main risk factors for asthma were tertia... more