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Ibro SA, Kasim AZ, Seid SS, Abdusemed KA, Senbiro IA, Waga SS, Abamecha F, Azalework HG, Soboka M, Gebresilassie A, Tesfaye S, Abafogi AA, Merga H, Husen A, Beyene DT. Mapping the evidence on integrated service delivery for non-communicable and infectious disease comorbidity in sub-Saharan Africa: protocol for a scoping review. BMJ Open 2024; 14:e084740. [PMID: 38904125 PMCID: PMC11191815 DOI: 10.1136/bmjopen-2024-084740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 05/30/2024] [Indexed: 06/22/2024] Open
Abstract
INTRODUCTION The concurrent occurrence of infectious diseases (IDs) and non-communicable diseases (NCDs) presents complex healthcare challenges in sub-Saharan Africa (SSA), where healthcare systems often grapple with limited resources. While an integrated care approach has been advocated to address these complex challenges, there is a recognised gap in comprehensive evidence regarding the various models of integrated care, their components and the feasibility of their implementation. This scoping review aims to bridge this gap by examining the breadth and nature of evidence on integrated care models for NCDs and IDs within SSA, thereby updating the current evidence base in the domain. METHODS AND ANALYSIS Based on the Joanna Briggs Institute (JBI) framework for scoping reviews, this study will include peer-reviewed and grey literature reporting on integrated care models for NCD-ID comorbidities in SSA. A comprehensive search of published sources in electronic databases (PubMed, Scopus, Embase, the Cochrane Library, Health System Evidence and Research4Life) and grey literature (Google Scholar, EBSCO Open Dissertations and relevant organisational websites) will be conducted to identify sources of information reported in English from 2018 onwards. The review will consider sources of evidence reporting on integrated care model for NCDs such as diabetes; chronic cardiovascular, respiratory and kidney diseases; cancers; epilepsy; and mental illness, and comorbid IDs such as HIV, tuberculosis and malaria. All sources of evidence will be considered irrespective of the study designs or methods used. The review will exclude sources that solely focus on the differentiated or patient-centred care delivery approach, and that focus on other conditions, populations or settings. The reviewers will independently screen the sources for eligibility and extract data using a JBI-adapted data tool on the Parsifal review platform. Data will be analysed using descriptive and thematic analyses and results will be presented in tables, figures, diagrams and a narrative summary. ETHICS AND DISSEMINATION Ethical approval is not required for this review as it will synthesise published data and does not involve human participants. The final report will be submitted for publication in a peer-reviewed journal. The findings will be used to inform future research. STUDY REGISTRATION OSF: https://doi.org/10.17605/OSF.IO/KFVEY.
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Affiliation(s)
| | | | | | | | | | | | - Fira Abamecha
- Health, Behavior and Society, Jimma University, Jimma, Ethiopia
| | | | | | | | | | | | - Hailu Merga
- Epidemiology, Jimma University, Jimma, Ethiopia
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Ayisi-Boateng NK, Opoku DA, Nkrumah I, Frempong B, Owusu M, Oduro E, Ampah BA, Konadu E, Norman B. Clinical profile and predictors of viral suppression in HIV-infected older adults at a University Hospital in Kumasi, Ghana. AIDS Care 2023; 35:1821-1829. [PMID: 36120907 DOI: 10.1080/09540121.2022.2119468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 08/25/2022] [Indexed: 10/14/2022]
Abstract
Availability of effective antiretroviral therapy (ART) has improved patient survival and older adults (≥50 years old) constitute 10% of the world's HIV population. However, data on this population are lacking, especially in sub-Saharan Africa. To identify the profile of older adults with HIV infection receiving ART and factors associated with viral suppression. A retrospective cross-sectional study involving HIV patients ≥50 years, registered at a University Hospital in Kumasi, Ghana from January 2010 to July 2020. All study participants had been on ARTs for ≥12 months. Data were analysed using STATA® and multivariate logistic regression was done to determine the association between variables. We recruited 132 study participants with a mean age of 58.1 years (±6.8). Non-communicable diseases (NCD) comprised the commonest comorbidity (67.4%; n = 89) and hypertension was the most prevalent (47.2%). The mean duration of ART was 63.2 months (±32.0) and approximately 84.1% (n = 111) achieved viral suppression (≤50 copies/ml). After adjustment, factors independently associated with viral suppression were widow(ed) (aOR = 0.23; 95% CI = 0.07-0.72) and good ART adherence (aOR = 3.51; 95% CI = 1.03-11.99). Hypertension is prevalent among this cohort of HIV patients. Approximately 84% of elderly patients on ARTs achieve viral suppression, influenced by widowhood and good drug adherence.
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Affiliation(s)
- Nana Kwame Ayisi-Boateng
- Department of Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- University Hospital, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Douglas Aninng Opoku
- School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Isaac Nkrumah
- University Hospital, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Bernard Frempong
- University Hospital, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Michael Owusu
- Department of Medical Diagnostics, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Eric Oduro
- University Hospital, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Brenda Abena Ampah
- University Hospital, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Emmanuel Konadu
- University Hospital, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Betty Norman
- Department of Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Chevé D, Macia E, Diallo M, Lalys L, Diallo AH, Sow S, Bergouignan A, Duboz P. Nothing in Excess: Physical Activity, Health, and Life World in Senegalese Fulani Male Pastoralists, a Mixed Method Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6999. [PMID: 37947557 PMCID: PMC10650956 DOI: 10.3390/ijerph20216999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 09/08/2023] [Accepted: 09/13/2023] [Indexed: 11/12/2023]
Abstract
OBJECTIVES The goal of this study was to evaluate the application of the short form of the International Physical Activity Questionnaire Survey (IPAQ-SF) in the rural Senegalese Fulani pastoralist population by combining quantitative and qualitative methods. DESIGN AND PARTICIPANTS For the quantitative method, 101 men completed the IPAQ-SF questionnaire measuring moderate, vigorous, and walking physical activity. Self-rated health, BMI, and sociodemographic variables were also collected. With regard to the qualitative methods, a total of 22 participants were recruited and interviewed. Four themes were addressed, including (i) physical activity (PA) and its definition, description, related experiences, and representations of social actors; (ii) PA and health; (iii) PA and sport; and (iv) the body and Fulani world of life (i.e., Pulaagu/Ndimaagu). RESULTS Sahelian herders have a high level of self-reported PA and a low amount of daily sitting time. The measure of PA as proposed by the IPAQ-SF is not adapted to the Senegalese Ferlo pastoralists, mainly because this scale gives too much importance to leisure-time PA, perceived as unproductive energy expenditure, which is factually and symbolically antinomic to the Fulani lifeworld. Thus, neither intense nor moderate PA is related to self-rated health. However, sedentary lifestyles are linked to self-rated health and, therefore, to mortality and morbidity in Fulani pastoralists. Finally, walking, which is the dominant PA during transhumance and herd surveillance, is related to BMI. It therefore represents a protective factor against the occurrence of overweight and associated chronic non-communicable diseases. CONCLUSION The mixed method approach developed in this study has shown that the IPAQ-SF is not a valid measure of PA in the population of Fulani male herders from the Ferlo region, given that unproductive energy expenditure is incompatible with the Fulani way of life, which condemns excess and immoderation.
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Affiliation(s)
- Dominique Chevé
- IRL 3189 ESS, Faculty of Medicine, Cheikh Anta Diop University, Dakar BP 5005, Senegal (E.M.)
| | - Enguerran Macia
- IRL 3189 ESS, Faculty of Medicine, Cheikh Anta Diop University, Dakar BP 5005, Senegal (E.M.)
| | - Moussa Diallo
- Department of Modern Literature, UFR LASHU, Assane Seck University, Ziguinchor BP 253, Senegal;
| | - Loic Lalys
- UMR 8045 BABEL, Institut Médico Légal, 2 Voie Mazas, 75012 Paris, France
| | - Amadou Hamath Diallo
- IRL 3189 ESS, Faculty of Medicine, Cheikh Anta Diop University, Dakar BP 5005, Senegal (E.M.)
| | - Sidaty Sow
- IRL 3189 ESS, Faculty of Medicine, Cheikh Anta Diop University, Dakar BP 5005, Senegal (E.M.)
| | | | - Priscilla Duboz
- IRL 3189 ESS, Faculty of Medicine, Cheikh Anta Diop University, Dakar BP 5005, Senegal (E.M.)
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Verster JC, Kraneveld AD, Garssen J. The Assessment of Immune Fitness. J Clin Med 2022; 12:jcm12010022. [PMID: 36614822 PMCID: PMC9821524 DOI: 10.3390/jcm12010022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 12/15/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022] Open
Abstract
Immune fitness (i.e., adequate functioning of the immune system) is essential to maintain health, prevent and resolve disease, and improve quality of life. This article provides an overview of how to assess immune fitness. It discusses how a single-item rating scale can be used to assess immune fitness. The scale can be used in conjunction with a single "yes" or "no" question asking whether the individual is experiencing reduced immune fitness. Retrospective assessments can be complemented with the Immune Status Questionnaire (ISQ) to provide more insight into the type and frequency of experiencing specific immune-related complaints. Momentary assessments of immune fitness can be complemented with biomarker measurements in body fluids. As individuals may be unaware of systemic inflammation (e.g., biomarker concentrations outside the normal range), it remains critical to combine immune fitness assessments with biomarker measurements of immune functioning.
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Affiliation(s)
- Joris C. Verster
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, 3584CG Utrecht, The Netherlands
- Centre for Human Psychopharmacology, Swinburne University, Melbourne, VIC 3122, Australia
- Correspondence: ; Tel.: +31-302-536-909
| | - Aletta D. Kraneveld
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, 3584CG Utrecht, The Netherlands
| | - Johan Garssen
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, 3584CG Utrecht, The Netherlands
- Global Centre of Excellence Immunology, Nutricia Danone Research, 3584CT Utrecht, The Netherlands
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Condon K, Zimmerman PA, Mason M, Sparke V. Audit of essential infection prevention and control content provided within undergraduate/postgraduate public health programs across Australian and New Zealand universities. Infect Dis Health 2022; 28:75-80. [PMID: 36182544 DOI: 10.1016/j.idh.2022.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 08/22/2022] [Accepted: 09/06/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND To describe and analyse the infection prevention and control (IPC) curricula within Public Health degrees across Australian and New Zealand Universities and identify foundational IPC knowledge deficits. METHODS A cross-sectional study of public health and related programs across tertiary education institutions within Australia and New Zealand was conducted to comprehensively illustrate the current inclusion of IPC core and elective courses and identify areas of IPC content deficit. RESULTS Australian (n = 32) and New Zealand (n = 9) universities were audited, consisting of 217 public health/public health related degrees within Australia and 45 within New Zealand. Within Australia 41% of public health degrees and 49% in New Zealand did not offer any IPC content as core or elective subjects. CONCLUSIONS Public health tertiary education in Australia and New Zealand is lacking in equipping and imbedding IPC skills and knowledge in public health graduates. This highlights the need for a framework guiding mandatory IPC content within Australian and New Zealand public health programs.
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Affiliation(s)
- Kathleena Condon
- School of Public Health, Griffith University, Queensland, Australia.
| | - Peta-Anne Zimmerman
- School of Nursing and Midwifery, Griffith University, Queensland, Australia; Collaborative for the Advancement of Infection Prevention and Control, Australia. https://twitter.com/@IPCPau
| | - Matt Mason
- School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, Australia; Collaborative for the Advancement of Infection Prevention and Control, Australia. https://twitter.com/@MattM_RN
| | - Vanessa Sparke
- College of Healthcare Sciences, James Cook University, Australia; Collaborative for the Advancement of Infection Prevention and Control, Australia
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Kumar A, Sakhare K, Bhattacharya D, Chattopadhyay R, Parikh P, Narayan KP, Mukherjee A. Communication in non-communicable diseases (NCDs) and role of immunomodulatory nutraceuticals in their management. Front Nutr 2022; 9:966152. [PMID: 36211513 PMCID: PMC9532975 DOI: 10.3389/fnut.2022.966152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 08/11/2022] [Indexed: 12/24/2022] Open
Abstract
Conveyance of pathogens between organisms causes communicable diseases. On the other hand, a non-communicable disease (NCD) was always thought to have no causative transmissible infective agents. Today, this clear distinction is increasingly getting blurred and NCDs are found to be associated with some transmissible components. The human microbiota carries a congregation of microbes, the majority and the most widely studied being bacteria in the gut. The adult human gut harbors ginormous inhabitant microbes, and the microbiome accommodates 150-fold more genes than the host genome. Microbial communities share a mutually beneficial relationship with the host, especially with respect to host physiology including digestion, immune responses, and metabolism. This review delineates the connection between environmental factors such as infections leading to gut dysbiosis and NCDs and explores the evidence regarding possible causal link between them. We also discuss the evidence regarding the value of appropriate therapeutic immunomodulatory nutritional interventions to reduce the development of such diseases. We behold such immunomodulatory effects have the potential to influence in various NCDs and restore homeostasis. We believe that the beginning of the era of microbiota-oriented personalized treatment modalities is not far away.
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Affiliation(s)
- Abhiram Kumar
- Esperer Onco Nutrition Pvt. Ltd., Mumbai, India
- Department of Biological Sciences, Birla Institute of Technology and Science – Pilani, Hyderabad, India
| | - Kalyani Sakhare
- Department of Biological Sciences, Birla Institute of Technology and Science – Pilani, Hyderabad, India
| | - Dwaipayan Bhattacharya
- Department of Biological Sciences, Birla Institute of Technology and Science – Pilani, Hyderabad, India
| | | | - Purvish Parikh
- Department of Clinical Haematology, Mahatma Gandhi Medical College and Hospital, Jaipur, India
| | - Kumar P. Narayan
- Department of Biological Sciences, Birla Institute of Technology and Science – Pilani, Hyderabad, India
- *Correspondence: Kumar P. Narayan,
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van Oostrom EC, Mulder KEW, Verheul MCE, Hendriksen PA, Thijssen S, Kraneveld AD, Vlieg-Boerstra B, Garssen J, Verster JC. A healthier daily diet is associated with greater immune fitness. PHARMANUTRITION 2022. [DOI: 10.1016/j.phanu.2022.100306] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Wu Y, Duffey M, Alex SE, Suarez-Reyes C, Clark EH, Weatherhead JE. The role of helminths in the development of non-communicable diseases. Front Immunol 2022; 13:941977. [PMID: 36119098 PMCID: PMC9473640 DOI: 10.3389/fimmu.2022.941977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 08/01/2022] [Indexed: 12/15/2022] Open
Abstract
Non-communicable diseases (NCDs) like cardiovascular disease, chronic respiratory diseases, cancers, diabetes, and neuropsychiatric diseases cause significant global morbidity and mortality which disproportionately affect those living in low resource regions including low- and middle-income countries (LMICs). In order to reduce NCD morbidity and mortality in LMIC it is imperative to understand risk factors associated with the development of NCDs. Certain infections are known risk factors for many NCDs. Several parasitic helminth infections, which occur most commonly in LMICs, have been identified as potential drivers of NCDs in parasite-endemic regions. Though understudied, the impact of helminth infections on the development of NCDs is likely related to helminth-specific factors, including species, developmental stage and disease burden. Mechanical and chemical damage induced by the helminth in combination with pathologic host immune responses contribute to the long-term inflammation that increases risk for NCD development. Robust studies from animal models and human clinical trials are needed to understand the immunologic mechanisms of helminth-induced NCDs. Understanding the complex connection between helminths and NCDs will aid in targeted public health programs to reduce helminth-induced NCDs and reduce the high rates of morbidity that affects millions of people living in parasite-endemic, LMICs globally.
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Affiliation(s)
- Yifan Wu
- Department of Pediatrics, Division of Tropical Medicine, Baylor College of Medicine, Houston, TX, United States
| | - Megan Duffey
- Department of Pediatrics, Division of Tropical Medicine, Baylor College of Medicine, Houston, TX, United States,Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX, United States
| | - Saira Elizabeth Alex
- National School of Tropical Medicine, Baylor College of Medicine, Houston, TX, United States
| | - Charlie Suarez-Reyes
- Department of Pediatrics, Division of Tropical Medicine, Baylor College of Medicine, Houston, TX, United States
| | - Eva H. Clark
- Department of Pediatrics, Division of Tropical Medicine, Baylor College of Medicine, Houston, TX, United States,Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX, United States,National School of Tropical Medicine, Baylor College of Medicine, Houston, TX, United States
| | - Jill E. Weatherhead
- Department of Pediatrics, Division of Tropical Medicine, Baylor College of Medicine, Houston, TX, United States,Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX, United States,National School of Tropical Medicine, Baylor College of Medicine, Houston, TX, United States,*Correspondence: Jill E. Weatherhead,
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9
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Khajebishak Y, Alivand M, Faghfouri AH, Moludi J, Payahoo L. The effects of vitamins and dietary pattern on epigenetic modification of non-communicable diseases. INT J VITAM NUTR RES 2021. [PMID: 34643416 DOI: 10.1024/0300-9831/a000735] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Background: Non-communicable diseases (NCDs) have received more attention because of high prevalence and mortality rate. Besides genetic and environmental factors, the epigenetic abnormality is also involved in the pathogenesis of NCDs. Methylation of DNA, chromatin remodeling, modification of histone, and long non-coding RNAs are the main components of epigenetic phenomena. Methodology: In this review paper, the mechanistic role of vitamins and dietary patterns on epigenetic modification was discussed. All papers indexed in scientific databases, including PubMed, Scopus, Embase, Google Scholar, and Elsevier were searched during 2000 - 2021 using, vitamins, diet, epigenetic repression, histones, methylation, acetylation, and NCDs as keywords. Results: The components of healthy dietary patterns like Mediterranean and dietary approaches to stop hypertension diets have a beneficial effect on epigenetic hemostasis. Both quality and quantity of dietary components influence epigenetic phenomena. A diet with calorie deficiency in protein content and methyl-donor agents in a long time, with a high level of fat, disrupts epigenetic hemostasis and finally, causes genome instability. Also, soluble and insoluble vitamins have an obvious role in epigenetic modifications. Most vitamins interact directly with methylation, acetylation, and phosphorylation pathways of histone and DNA. However, numerous indirect functions related to the cell cycle stability and genome integrity have been recognized. Conclusion: Considering the crucial role of a healthy diet in epigenetic homeostasis, adherence to a healthy dietary pattern containing enough levels of vitamin and avoiding the western diet seems to be necessary. Having a healthy diet and consuming the recommended dietary level of vitamins can also contribute to epigenetic stability.
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Affiliation(s)
- Yaser Khajebishak
- Department of Nutrition and Food Sciences, Maragheh University of Medical Sciences, Maragheh, Iran
| | - Mohammadreza Alivand
- Department of Medical Genetics, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Jalal Moludi
- School of Nutrition Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Laleh Payahoo
- Department of Nutrition and Food Sciences, Maragheh University of Medical Sciences, Maragheh, Iran
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Doraiswamy S, Cheema S, Mamtani R. The COVID-19 and lifestyle nexus: settling the debate. Glob Health Promot 2021; 29:96-100. [PMID: 34165015 DOI: 10.1177/17579759211018417] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
A recent debate that has gained our attention is that of coronavirus disease 2019 (COVID-19) being referred to as a lifestyle disease by the Royal College of General Practitioners (in the title of an online event) for which they later apologized and withdrew the reference. In this commentary, we demystify diseases related to 'lifestyle' and put this in the context of the age-old public health way of classifying diseases as communicable and non-communicable (NCDs). Evidence indicates that unhealthy lifestyles, in addition to causing NCDs, can also result in reduced immunity and/or cause injury to organs predisposing individuals to diseases, and their severity, traditionally defined as 'communicable' such as COVID-19. COVID-19 has demonstrated the nexus between communicable and NCDs as never before in no uncertain terms. Two important messages that have emerged from the pandemic are: (1) there is close proximity of communicable diseases to NCDs; and (2) individual personal hygiene-related lifestyles can influence the occurrence, severity and prevention of communicable diseases such as COVID-19.
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Affiliation(s)
| | - Sohaila Cheema
- Institute for Population Health, Weill Cornell Medicine - Qatar, Qatar
| | - Ravinder Mamtani
- Institute for Population Health, Weill Cornell Medicine - Qatar, Qatar
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Kostova D, Richter P, Van Vliet G, Mahar M, Moolenaar RL. The Role of Noncommunicable Diseases in the Pursuit of Global Health Security. Health Secur 2021; 19:288-301. [PMID: 33961498 PMCID: PMC8217593 DOI: 10.1089/hs.2020.0121] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Noncommunicable diseases and their risk factors are important for all aspects of outbreak preparedness and response, affecting a range of factors including host susceptibility, pathogen virulence, and health system capacity. This conceptual analysis has 2 objectives. First, we use the Haddon matrix paradigm to formulate a framework for assessing the relevance of noncommunicable diseases to health security efforts throughout all phases of the disaster life cycle: before, during, and after an event. Second, we build upon this framework to identify 6 technical action areas in global health security programs that are opportune integration points for global health security and noncommunicable disease objectives: surveillance, workforce development, laboratory systems, immunization, risk communication, and sustainable financing. We discuss approaches to integration with the goal of maximizing the reach of global health security where infectious disease threats and chronic disease burdens overlap.
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Affiliation(s)
- Deliana Kostova
- Deliana Kostova, PhD, is a Senior Economist; Patricia Richter, PhD, is Branch Chief, Global Noncommunicable Diseases Branch; Michael Mahar, PhD, is a Public Health Advisor; and Ronald L. Moolenaar, MD, is Associate Director for Science; all in the Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA. Gretchen Van Vliet, MPH, is Senior Public Health Project Director, Global Public Health Impact Center, RTI International, Research Triangle Park, NC
| | - Patricia Richter
- Deliana Kostova, PhD, is a Senior Economist; Patricia Richter, PhD, is Branch Chief, Global Noncommunicable Diseases Branch; Michael Mahar, PhD, is a Public Health Advisor; and Ronald L. Moolenaar, MD, is Associate Director for Science; all in the Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA. Gretchen Van Vliet, MPH, is Senior Public Health Project Director, Global Public Health Impact Center, RTI International, Research Triangle Park, NC
| | - Gretchen Van Vliet
- Deliana Kostova, PhD, is a Senior Economist; Patricia Richter, PhD, is Branch Chief, Global Noncommunicable Diseases Branch; Michael Mahar, PhD, is a Public Health Advisor; and Ronald L. Moolenaar, MD, is Associate Director for Science; all in the Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA. Gretchen Van Vliet, MPH, is Senior Public Health Project Director, Global Public Health Impact Center, RTI International, Research Triangle Park, NC
| | - Michael Mahar
- Deliana Kostova, PhD, is a Senior Economist; Patricia Richter, PhD, is Branch Chief, Global Noncommunicable Diseases Branch; Michael Mahar, PhD, is a Public Health Advisor; and Ronald L. Moolenaar, MD, is Associate Director for Science; all in the Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA. Gretchen Van Vliet, MPH, is Senior Public Health Project Director, Global Public Health Impact Center, RTI International, Research Triangle Park, NC
| | - Ronald L Moolenaar
- Deliana Kostova, PhD, is a Senior Economist; Patricia Richter, PhD, is Branch Chief, Global Noncommunicable Diseases Branch; Michael Mahar, PhD, is a Public Health Advisor; and Ronald L. Moolenaar, MD, is Associate Director for Science; all in the Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA. Gretchen Van Vliet, MPH, is Senior Public Health Project Director, Global Public Health Impact Center, RTI International, Research Triangle Park, NC
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12
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Bösch S, Westerman L, Renshaw N, Pravst I. Trans Fat Free by 2023-A Building Block of the COVID-19 Response. Front Nutr 2021; 8:645750. [PMID: 33859993 PMCID: PMC8043112 DOI: 10.3389/fnut.2021.645750] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 02/03/2021] [Indexed: 12/13/2022] Open
Abstract
COVID-19 has brought to center stage the most important health issue of our era, largely ignored by policymakers and the public to date: non-communicable diseases (NCDs), the cause of 71% of deaths per year worldwide. People living with NCDs, and particularly those living with cardiovascular disease (CVD), are at higher risk of severe symptoms and death from COVID-19. As a result, the urgent need for policy measures to protect cardiovascular health is more apparent than ever. One example of "low-hanging fruit" in the prevention of CVD is the elimination of industrially-produced trans fatty acids (iTFA). Their removal from the global food supply could prevent up to 17 million deaths by 2040 and would be the first time an NCD risk factor has been eliminated.
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Affiliation(s)
| | | | | | - Igor Pravst
- Nutrition and Public Health Research Group, Nutrition Institute, Ljubljana, Slovenia
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Coates MM, Kintu A, Gupta N, Wroe EB, Adler AJ, Kwan GF, Park PH, Rajbhandari R, Byrne AL, Casey DC, Bukhman G. Burden of non-communicable diseases from infectious causes in 2017: a modelling study. LANCET GLOBAL HEALTH 2020; 8:e1489-e1498. [PMID: 33098769 PMCID: PMC8040338 DOI: 10.1016/s2214-109x(20)30358-2] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 07/28/2020] [Accepted: 07/29/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Non-communicable diseases (NCDs) cause a large burden of disease globally. Some infectious diseases cause an increased risk of developing specific NCDs. Although the NCD burden from some infectious causes has been quantified, in this study, we aimed to more comprehensively quantify the global burden of NCDs from infectious causes. METHODS In this modelling study, we identified NCDs with established infectious risk factors and infectious diseases with long-term non-communicable sequelae, and did narrative reviews between April 11, 2018, and June 10, 2020, to obtain relative risks (RRs) or population attributable fractions (PAFs) from studies quantifying the contribution of infectious causes to NCDs. To determine infection-attributable burden for the year 2017, we applied estimates of PAFs to estimates of disease burden from the Global Burden of Disease Study (GBD) 2017 for pairs of infectious causes and NCDs, or used estimates of attributable burden directly from GBD 2017. Morbidity and mortality burden from these conditions was summarised with age-standardised rates of disability-adjusted life-years (DALYs), for geographical regions as defined by the GBD. Estimates of NCD burden attributable to infectious causes were compared with attributable burden for the groups of risk factors with the highest PAFs from GBD 2017. FINDINGS Globally, we quantified 130 million DALYs from NCDs attributable to infection, comprising 8·4% of all NCD DALYs. The infection-NCD pairs with the largest burden were gastric cancer due to H pylori (14·6 million DALYs), cirrhosis and other chronic liver diseases due to hepatitis B virus (12·2 million) and hepatitis C virus (10·4 million), liver cancer due to hepatitis B virus (9·4 million), rheumatic heart disease due to streptococcal infection (9·4 million), and cervical cancer due to HPV (8·0 million). Age-standardised rates of infection-attributable NCD burden were highest in Oceania (3564 DALYs per 100 000 of the population) and central sub-Saharan Africa (2988 DALYs per 100 000) followed by the other sub-Saharan African regions, and lowest in Australia and New Zealand (803 DALYs per 100 000) followed by other high-income regions. In sub-Saharan Africa, the proportion of crude NCD burden attributable to infectious causes was 11·7%, which was higher than the proportion of burden attributable to each of several common risk factors of NCDs (tobacco, alcohol use, high systolic blood pressure, dietary risks, high fasting plasma glucose, air pollution, and high LDL cholesterol). In other broad regions, infectious causes ranked between fifth and eighth in terms of crude attributable proportions among the nine risks compared. The age-standardised attributable proportion for infectious risks remained highest in sub-Saharan Africa of the broad regions, but age-standardisation caused infectious risks to fall below dietary risks, high systolic blood pressure, and fasting plasma glucose in ranked attributable proportions within the region. INTERPRETATION Infectious conditions cause substantial NCD burden with clear regional variation, and estimates of this burden are likely to increase as evidence that can be used for quantification expands. To comprehensively avert NCD burden, particularly in low-income and middle-income countries, the availability, coverage, and quality of cost-effective interventions for key infectious conditions need to be strengthened. Efforts to promote universal health coverage must address infectious risks leading to NCDs, particularly in populations with high rates of these infectious conditions, to reduce existing regional disparities in rates of NCD burden. FUNDING Leona M and Harry B Helmsley Charitable Trust.
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Affiliation(s)
- Matthew M Coates
- Program in Global Noncommunicable Diseases and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA; Division of Global Health Equity, Brigham and Women's Hospital, Boston, MA, USA
| | - Alexander Kintu
- Program in Global Noncommunicable Diseases and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA; Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Neil Gupta
- Program in Global Noncommunicable Diseases and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA; Division of Global Health Equity, Brigham and Women's Hospital, Boston, MA, USA; Partners In Health, Boston, MA, USA
| | - Emily B Wroe
- Program in Global Noncommunicable Diseases and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA; Division of Global Health Equity, Brigham and Women's Hospital, Boston, MA, USA; Partners In Health, Boston, MA, USA
| | - Alma J Adler
- Program in Global Noncommunicable Diseases and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Gene F Kwan
- Program in Global Noncommunicable Diseases and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA; Partners In Health, Boston, MA, USA; Section of Cardiovascular Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Paul H Park
- Program in Global Noncommunicable Diseases and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA; Division of Global Health Equity, Brigham and Women's Hospital, Boston, MA, USA; Partners In Health, Boston, MA, USA
| | - Ruma Rajbhandari
- Division of Global Health Equity, Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA; Mount Auburn Hospital, Cambridge, MA, USA
| | - Anthony L Byrne
- Socios En Salud Sucursal Perú, Lima, Peru; Centre for Research Excellence in Tuberculosis, Sydney, NSW, Australia; Heart Lung Clinic, St Vincent's Hospital Clinical School, University of New South Wales Sydney, Sydney, NSW, Australia
| | | | - Gene Bukhman
- Program in Global Noncommunicable Diseases and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA; Division of Global Health Equity, Brigham and Women's Hospital, Boston, MA, USA; Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA, USA; Partners In Health, Boston, MA, USA.
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14
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Gupta N, Coates MM, Bekele A, Dupuy R, Fénelon DL, Gage AD, Getachew T, Karmacharya BM, Kwan GF, Lulebo AM, Masiye JK, Mayige MT, Ndour Mbaye M, Mridha MK, Park PH, Dagnaw WW, Wroe EB, Bukhman G. Availability of equipment and medications for non-communicable diseases and injuries at public first-referral level hospitals: a cross-sectional analysis of service provision assessments in eight low-income countries. BMJ Open 2020; 10:e038842. [PMID: 33040014 PMCID: PMC7549470 DOI: 10.1136/bmjopen-2020-038842] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
CONTEXT AND OBJECTIVES Non-communicable diseases and injuries (NCDIs) comprise a large share of mortality and morbidity in low-income countries (LICs), many of which occur earlier in life and with greater severity than in higher income settings. Our objective was to assess availability of essential equipment and medications required for a broad range of acute and chronic NCDI conditions. DESIGN Secondary analysis of existing cross-sectional survey data. SETTING We used data from Service Provision Assessment surveys in Bangladesh, the Democratic Republic of the Congo, Ethiopia, Haiti, Malawi, Nepal, Senegal and Tanzania, focusing on public first-referral level hospitals in each country. OUTCOME MEASURES We defined sets of equipment and medications required for diagnosis and management of four acute and nine chronic NCDI conditions and determined availability of these items at the health facilities. RESULTS Overall, 797 hospitals were included. Medication and equipment availability was highest for acute epilepsy (country estimates ranging from 40% to 95%) and stage 1-2 hypertension (28%-83%). Availability was low for type 1 diabetes (1%-70%), type 2 diabetes (3%-57%), asthma (0%-7%) and acute presentations of diabetes (0%-26%) and asthma (0%-4%). Few hospitals had equipment or medications for heart failure (0%-32%), rheumatic heart disease (0%-23%), hypertensive emergencies (0%-64%) or acute minor surgical conditions (0%-5%). Data for chronic pain were limited to only two countries. Availability of essential medications and equipment was lower than previous facility-reported service availability. CONCLUSIONS Our findings demonstrate low availability of essential equipment and medications for diverse NCDIs at first-referral level hospitals in eight LICs. There is a need for decentralisation and integration of NCDI services in existing care platforms and improved assessment and monitoring to fully achieve universal health coverage.
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Affiliation(s)
- Neil Gupta
- Program in Global Noncommunicable Disease and Social Change, Harvard Medical School Department of Global Health and Social Medicine, Boston, Massachusetts, USA
- Division of Global Health Equity, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Partners In Health, Boston, Massachusetts, USA
| | - Matthew M Coates
- Program in Global Noncommunicable Disease and Social Change, Harvard Medical School Department of Global Health and Social Medicine, Boston, Massachusetts, USA
- Division of Global Health Equity, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Abebe Bekele
- Health System and Reproductive Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Roodney Dupuy
- Le Ministère de la Santé Publique et de la Population, Port-au-Prince, Haiti
| | | | - Anna D Gage
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Theodros Getachew
- Health System and Reproductive Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
- College of Medicine and Health Science, Institute of Public Health, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia
| | - Biraj Man Karmacharya
- Department of Community Medicine, Kathmandu University School of Medical Sciences, Kathmandu, Nepal
| | - Gene F Kwan
- Program in Global Noncommunicable Disease and Social Change, Harvard Medical School Department of Global Health and Social Medicine, Boston, Massachusetts, USA
- Partners In Health, Boston, Massachusetts, USA
- Section of Cardiovascular Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Aimée M Lulebo
- Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | | | | | - Maïmouna Ndour Mbaye
- Department of Internal Medicine, University Hospital Center of Dakar, Cheikh Anta Diop University, Dakar, Senegal
| | - Malay Kanti Mridha
- Center for Non-communicable Diseases and Nutrition, BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - Paul H Park
- Program in Global Noncommunicable Disease and Social Change, Harvard Medical School Department of Global Health and Social Medicine, Boston, Massachusetts, USA
- Division of Global Health Equity, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Partners In Health, Boston, Massachusetts, USA
| | - Wubaye Walelgne Dagnaw
- Partners In Health, Boston, Massachusetts, USA
- Ethiopia Ministry of Health, Addis Ababa, Ethiopia
| | - Emily B Wroe
- Program in Global Noncommunicable Disease and Social Change, Harvard Medical School Department of Global Health and Social Medicine, Boston, Massachusetts, USA
- Division of Global Health Equity, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Partners In Health, Boston, Massachusetts, USA
| | - Gene Bukhman
- Program in Global Noncommunicable Disease and Social Change, Harvard Medical School Department of Global Health and Social Medicine, Boston, Massachusetts, USA
- Division of Global Health Equity, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Partners In Health, Boston, Massachusetts, USA
- Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
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15
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Bukhman G, Mocumbi AO, Atun R, Becker AE, Bhutta Z, Binagwaho A, Clinton C, Coates MM, Dain K, Ezzati M, Gottlieb G, Gupta I, Gupta N, Hyder AA, Jain Y, Kruk ME, Makani J, Marx A, Miranda JJ, Norheim OF, Nugent R, Roy N, Stefan C, Wallis L, Mayosi B. The Lancet NCDI Poverty Commission: bridging a gap in universal health coverage for the poorest billion. Lancet 2020; 396:991-1044. [PMID: 32941823 PMCID: PMC7489932 DOI: 10.1016/s0140-6736(20)31907-3] [Citation(s) in RCA: 146] [Impact Index Per Article: 36.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 05/29/2020] [Accepted: 08/25/2020] [Indexed: 12/14/2022]
Affiliation(s)
- Gene Bukhman
- Department of Global Health and Social Medicine, Harvard University, Boston, MA, USA; Program in Global NCDs and Social Change, Harvard University, Boston, MA, USA; Partners In Health, Boston, MA, USA; Division of Global Health Equity, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA; Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.
| | - Ana O Mocumbi
- Universidade Eduardo Mondlane, Maputo, Mozambique; Instituto Nacional de Saúde, Maputo, Mozambique
| | - Rifat Atun
- Department of Global Health and Population, Harvard T H Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Anne E Becker
- Department of Global Health and Social Medicine, Harvard University, Boston, MA, USA
| | - Zulfiqar Bhutta
- Center for Global Child Health, Hospital for Sick Kids, Toronto, ON, Canada; Centre of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan; Institute for Global Health & Development, Aga Khan University, South-Central Asia, East Africa, and UK
| | | | - Chelsea Clinton
- Clinton Foundation, New York, NY, USA; Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Matthew M Coates
- Department of Global Health and Social Medicine, Harvard University, Boston, MA, USA; Program in Global NCDs and Social Change, Harvard University, Boston, MA, USA; Division of Global Health Equity, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | | | - Majid Ezzati
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - Gary Gottlieb
- Department of Psychiatry, Harvard Medical School, Harvard University, Boston, MA, USA
| | - Indrani Gupta
- Health Policy Research Unit, Institute of Economic Growth, Delhi, India
| | - Neil Gupta
- Department of Global Health and Social Medicine, Harvard University, Boston, MA, USA; Program in Global NCDs and Social Change, Harvard University, Boston, MA, USA; Partners In Health, Boston, MA, USA; Division of Global Health Equity, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Adnan A Hyder
- Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Yogesh Jain
- Jan Swasthya Sahyog, Bilaspur, Chhattisgarh, India
| | - Margaret E Kruk
- Department of Global Health and Population, Harvard T H Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Julie Makani
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Andrew Marx
- Department of Global Health and Social Medicine, Harvard University, Boston, MA, USA; Program in Global NCDs and Social Change, Harvard University, Boston, MA, USA
| | - J Jaime Miranda
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Ole F Norheim
- Department of Global Health and Population, Harvard T H Chan School of Public Health, Harvard University, Boston, MA, USA; Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Rachel Nugent
- Research Triangle Institute International, Seattle, WA, USA
| | - Nobhojit Roy
- WHO Collaborating Centre for Research on Surgical Care Delivery in LMICs, Department of Surgery, BARC Hospital, HBNI University, Government of India, Mumbai, India; Field Health Systems Laboratory, Bihar Technical Support Programme, CARE India, Madhubani, Bihar, India
| | - Cristina Stefan
- SingHealth Duke-NUS Global Health Institute (SDGHI), Duke-NUS Medical School, Singapore; African Medical Research and Innovation Institute, Cape Town, South Africa
| | - Lee Wallis
- Division of Emergency Medicine, University of Cape Town, Cape Town, South Africa
| | - Bongani Mayosi
- Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
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16
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Cuschieri S, Grech V. Withdrawn: COVID-19 is ageist, sexist, ruthless, dispassionate and opportunistic - Protecting our vulnerable. Early Hum Dev 2020:105214. [PMID: 33041153 PMCID: PMC7528947 DOI: 10.1016/j.earlhumdev.2020.105214] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
This article has been withdrawn at the request of the author(s) and/or editor. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal.
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Affiliation(s)
- Sarah Cuschieri
- Anatomy Department, Faculty of Medicine and Surgery, University of Malta, Malta.
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17
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Zeeb M, Kerrinnes T, Cicin-Sain L, Guzman CA, Puppe W, Schulz TF, Peters A, Berger K, Castell S, Karch A. Seropositivity for pathogens associated with chronic infections is a risk factor for all-cause mortality in the elderly: findings from the Memory and Morbidity in Augsburg Elderly (MEMO) Study. GeroScience 2020; 42:1365-1376. [PMID: 32648237 PMCID: PMC7525922 DOI: 10.1007/s11357-020-00216-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 06/11/2020] [Indexed: 12/17/2022] Open
Abstract
Immunostimulation by chronic infection has been linked to an increased risk for different non-communicable diseases, which in turn are leading causes of death in high- and middle-income countries. Thus, we investigated if a positive serostatus for pathogens responsible for common chronic infections is individually or synergistically related to reduced overall survival in community dwelling elderly. We used data of 365 individuals from the German MEMO (Memory and Morbidity in Augsburg Elderly) cohort study with a median age of 73 years at baseline and a median follow-up of 14 years. We examined the effect of a positive serostatus at baseline for selected pathogens associated with chronic infections (Helicobacter pylori, Borrelia burgdorferi sensu lato, Toxoplasma gondii, cytomegalovirus, Epstein-Barr virus, herpes simplex virus 1/2, and human herpesvirus 6) on all-cause mortality with multivariable parametric survival models. We found a reduced survival time in individuals with a positive serostatus for Helicobacter pylori (accelerated failure time (AFT) - 15.92, 95% CI - 29.96; - 1.88), cytomegalovirus (AFT - 22.81, 95% CI - 36.41; - 9.22) and Borrelia burgdorferi sensu lato (AFT - 25.25, 95% CI - 43.40; - 7.10), after adjusting for potential confounders. The number of infectious agents an individual was seropositive for had a linear effect on all-cause mortality (AFT per additional infection - 12.42 95% CI - 18.55; - 6.30). Our results suggest an effect of seropositivity for Helicobacter pylori, cytomegalovirus, and Borrelia burgdorferi sensu lato on all-cause mortality in older community dwelling individuals. Further research with larger cohorts and additional biomarkers is required, to assess mediators and molecular pathways of this effect.
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Affiliation(s)
- Marius Zeeb
- Institute for Medical Information Science, Biometry and Epidemiology, Ludwig Maximilians University, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
- Department for Epidemiology, Helmholtz Centre for Infection Research, Brunswick, Germany
| | - Tobias Kerrinnes
- Department for Epidemiology, Helmholtz Centre for Infection Research, Brunswick, Germany
| | - Luka Cicin-Sain
- Department of Vaccinology and Applied Microbiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
- Cluster of Excellence RESIST (EXC 2155), Hannover Medical School (MHH), Hannover, Germany
- Centre for Individualised Infection Medicine (CIIM), a joint venture of HZI and MHH, Hannover, Germany
- German Centre for Infection Research (DZIF), Hannover-Braunschweig site, Braunschweig, Germany
| | - Carlos A Guzman
- Department of Vaccinology and Applied Microbiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Wolfram Puppe
- Cluster of Excellence RESIST (EXC 2155), Hannover Medical School (MHH), Hannover, Germany
- German Centre for Infection Research (DZIF), Hannover-Braunschweig site, Braunschweig, Germany
- Institute for Virology, Hannover Medical School (MHH), Hannover, Germany
| | - Thomas F Schulz
- Cluster of Excellence RESIST (EXC 2155), Hannover Medical School (MHH), Hannover, Germany
- German Centre for Infection Research (DZIF), Hannover-Braunschweig site, Braunschweig, Germany
- Institute for Virology, Hannover Medical School (MHH), Hannover, Germany
| | - Annette Peters
- Institute for Medical Information Science, Biometry and Epidemiology, Ludwig Maximilians University, Munich, Germany
- German Research Center for Environmental Health, Munich, Germany
| | - Klaus Berger
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - Stefanie Castell
- Department for Epidemiology, Helmholtz Centre for Infection Research, Brunswick, Germany
| | - André Karch
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany.
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18
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Singh V. Can Vitamins, as Epigenetic Modifiers, Enhance Immunity in COVID-19 Patients with Non-communicable Disease? Curr Nutr Rep 2020; 9:202-209. [PMID: 32661859 PMCID: PMC7356139 DOI: 10.1007/s13668-020-00330-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
PURPOSE OF REVIEW The highly infectious transmissible disease, the novel SARS-CoV-2, causing the coronavirus disease (COVID-19), has a median incubation time of 5 to 15 days. The symptoms vary from person to person and many are "hidden carriers." Few people experience immediate reaction and even death within 48 h of infection. However, many show mild to chronic symptoms and recover. Nevertheless, the death rate due to COVID-19 transmission is high especially among patients with non-communicable diseases. The purpose of this review is to provide evidence to consider vitamins as epigenetic modifiers to enhance immunity and reduce inflammatory response in COVID-19 patients with non-communicable diseases. RECENT FINDINGS Clinical evidence has suggested the risk of getting infected is high among individuals with non-communicable diseases such as cardiovascular disease, type-2 diabetes, cancer, acute respiratory distress syndrome, and renal disease, as well as the elderly with high mortality rate among the cohort. The impact is due to an already compromised immune system of patients. Every patient has a different response to COVID-19, which shows that the ability to combat the deadly virus varies individually. Thus, treatment can be personalized and adjusted to help protect and combat COVID-19 infections, especially in individuals with non-communicable diseases. Based on current published scientific and medical evidence, the suggestions made in this article for combination of vitamin therapy as epigenetic modifiers to control the unregulated inflammatory and cytokine marker expressions, further needs to be clinically proven. Future research and clinical trials can apply the suggestions given in this article to support metabolic activities in patients and enhance the immune response.
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Affiliation(s)
- Varsha Singh
- Centre for Life Sciences, Chitkara School of Health Sciences, Chitkara University, Punjab, 140401, India.
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19
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Azarpazhooh MR, Morovatdar N, Avan A, Phan TG, Divani AA, Yassi N, Stranges S, Silver B, Biller J, Tokazebani Belasi M, Kazemi Neya S, Khorram B, Frydman A, Nilanont Y, Onorati E, Di Napoli M. COVID-19 Pandemic and Burden of Non-Communicable Diseases: An Ecological Study on Data of 185 Countries. J Stroke Cerebrovasc Dis 2020; 29:105089. [PMID: 32807484 PMCID: PMC7315949 DOI: 10.1016/j.jstrokecerebrovasdis.2020.105089] [Citation(s) in RCA: 71] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 06/11/2020] [Accepted: 06/16/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The interaction between coronavirus disease 2019 (COVID-19) and non-communicable diseases may increase the global burden of disease. We assessed the association of COVID-19 with ageing and non-communicable diseases. METHODS We extracted data regarding non-communicable disease, particularly cardiovascular disease, deaths, disability-adjusted life years (DALYs), and healthy life expectancy (HALE) from the Global Burden of Disease Study (GBD) 2017. We obtained data of confirmed COVID-19 cases, deaths, and tests from the Our World in Data database as of May 28, 2020. Potential confounders of pandemic outcomes analyzed include institutional lockdown delay, hemispheric geographical location, and number of tourists. We compared all countries according to GBD classification and World Bank income level. We assessed the correlation between independent variables associated with COVID-19 caseload and mortality using Spearman's rank correlation and adjusted mixed model analysis. FINDINGS High-income had the highest, and the Southeast Asia, East Asia, and Oceania region had the least cases per million population (3050.60 vs. 63.86). Sub-saharan region has reported the lowest number of COVID-19 mortality (1.9). Median delay to lockdown initiation varied from one day following the first case in Latin America and Caribbean region, to 34 days in Southeast Asia, East Asia, and Oceania. Globally, non-communicable disease DALYs were correlated with COVID-19 cases (r = 0.32, p<0.001) and deaths (r = 0.37, p<0.001). HALE correlated with COVID-19 cases (r = 0.63, p<0.001) and deaths (r = 0.61, p<0.001). HALE was independently associated with COVID-19 case rate and the number of tourists was associated with COVID-19 mortality in the adjusted model. INTERPRETATION Preventive measures against COVID-19 should protect the public from the dual burden of communicable and non-communicable diseases, particularly in the elderly. In addition to active COVID-19 surveillance, policymakers should utilize this evidence as a guide for prevention and coordination of health services. This model is timely, as many countries have begun to reduce social isolation.
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Affiliation(s)
- M Reza Azarpazhooh
- Stroke Prevention and Atherosclerosis Research Centre, Robarts Research Institute, Western University, London, Ontario, Canada; Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada; Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Negar Morovatdar
- Clinical Research Development Unit, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Abolfazl Avan
- Department of Public Health, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Thanh G Phan
- Department of Neurology Monash Health, Clinical Trials, Imaging and Informatics division of Stroke and Ageing Research Group, Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, Australia
| | - Afshin A Divani
- Department of Neurology, School of Medicine, University of New Mexico, Albuquerque, NM, USA
| | - Nawaf Yassi
- Departments of Medicine and Neurology, Melbourne Brain Centre at The Royal Melbourne Hospital, University of Melbourne, Parkville, Australia; Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia
| | - Saverio Stranges
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada; Department of Family Medicine, Schulich School of Medicine and Dentistry Western University, London, ON, Canada; Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Brian Silver
- Department of Neurology, University of Massachusetts Medical School, Worcester, MA, USA
| | - José Biller
- Department of Neurology, Loyola University Chicago Stritch School of Medicine, Maywood, IL, USA
| | - Masoud Tokazebani Belasi
- Research centre for Prevention of cardiovascular disease, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran
| | - Sepideh Kazemi Neya
- Research centre for Prevention of cardiovascular disease, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran
| | - Bita Khorram
- Dalla Lana School of Public Health, University of Toronto; Toronto, ON, Canada
| | - Asher Frydman
- Stroke Prevention and Atherosclerosis Research Centre, Robarts Research Institute, Western University, London, Ontario, Canada
| | - Yongchai Nilanont
- Siriraj Stroke Center, Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Elisa Onorati
- Department of Neurology and Stroke Unit, San Camillo de' Lellis General District Hospital, Rieti, Italy
| | - Mario Di Napoli
- Department of Neurology and Stroke Unit, San Camillo de' Lellis General District Hospital, Rieti, Italy; Neurological Section, Neuro-epidemiology Unit, SMDN-Centre for Cardiovascular Medicine and Cerebrovascular Disease Prevention, Sulmona, L'Aquila, Italy.
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Developmental Origins of Health and Disease: Impact of environmental dust exposure in modulating microbiome and its association with non-communicable diseases. J Dev Orig Health Dis 2020; 11:545-556. [PMID: 32536356 DOI: 10.1017/s2040174420000549] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Non-communicable diseases (NCDs) including obesity, diabetes, and allergy are chronic, multi-factorial conditions that are affected by both genetic and environmental factors. Over the last decade, the microbiome has emerged as a possible contributor to the pathogenesis of NCDs. Microbiome profiles were altered in patients with NCDs, and shift in microbial communities was associated with improvement in these health conditions. Since the genetic component of these diseases cannot be altered, the ability to manipulate the microbiome holds great promise for design of novel therapies in the prevention and treatment of NCDs. Together, the Developmental Origins of Health and Disease concept and the microbial hypothesis propose that early life exposure to environmental stimuli will alter the development and composition of the human microbiome, resulting in health consequences. Recent studies indicated that the environment we are exposed to in early life is instrumental in shaping robust immune development, possibly through modulation of the human microbiome (skin, airway, and gut). Despite much research into human microbiome, the origin of their constituent microbiota remains unclear. Dust (also known as particulate matter) is a key determinant of poor air quality in the modern urban environment. It is ubiquitous and serves as a major source and reservoir of microbial communities that modulates the human microbiome, contributing to health and disease. There are evidence that reported significant associations between environmental dust and NCDs. In this review, we will focus on the impact of dust exposure in shaping the human microbiome and its possible contribution to the development of NCDs.
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Fagunwa OE, Olanbiwoninu AA. Accelerating the sustainable development goals through microbiology: some efforts and opportunities. Access Microbiol 2020; 2:acmi000112. [PMID: 32974577 PMCID: PMC7494191 DOI: 10.1099/acmi.0.000112] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 02/12/2020] [Indexed: 12/28/2022] Open
Abstract
Modernization has thrown humanity and other forms of life on our planet into a ditch of problems. Poverty, climate change, injustice and environmental degradation are a few of the shared global problems. The United Nations Sustainable Development Goals (SDGs) are the blueprint to achieve a better and more sustainable future for all. The SDGs are well structured to address the global challenges we face including poverty, inequalities, hunger, climate change, environmental degradation, peace and justice. Five years into the implementation, the SDGs have been driven mainly by international donors and 'professional' international development organizations. The world is left with 10 years to achieve these ambitious goals and targets. Various reviews show that little has been achieved overall, and the SDGs will not be a reality if a new strategy is not in place to bring inclusion. Microbiology, the scientific discipline of microbes, their effects and practical uses has insightful influence on our day-to-day living. We present how microbiology and microbiologists could increase the scorecard and accelerate these global goals. Microbiology has a direct link to achieving SDGs addressing food security, health and wellbeing, clean energy, environmental degradation and climate change. A non-classical growing relationship exists between microbiology and other SDGs such as peace, justice, gender equality, decent work and economic growth. The pledge of 'Leave No One Behind' will fast track progress and microbiology is in a better position to make this work.
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Affiliation(s)
- Omololu E Fagunwa
- Department of Food and Drugs, Federal Ministry of Health, Abuja, Nigeria.,School of Applied Sciences, Biological and Geographical Department, University of Huddersfield, Huddersfield, UK
| | - Afolake A Olanbiwoninu
- Department of Biological Sciences, Laboratory of Food and Industrial Microbiology, Ajayi Crowther University, Oyo, Nigeria
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Coates MM, Kamanda M, Kintu A, Arikpo I, Chauque A, Mengesha MM, Price AJ, Sifuna P, Wamukoya M, Sacoor CN, Ogwang S, Assefa N, Crampin AC, Macete EV, Kyobutungi C, Meremikwu MM, Otieno W, Adjaye-Gbewonyo K, Marx A, Byass P, Sankoh O, Bukhman G. A comparison of all-cause and cause-specific mortality by household socioeconomic status across seven INDEPTH network health and demographic surveillance systems in sub-Saharan Africa. Glob Health Action 2019; 12:1608013. [PMID: 31092155 PMCID: PMC6534200 DOI: 10.1080/16549716.2019.1608013] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Background: Understanding socioeconomic disparities in all-cause and cause-specific mortality can help inform prevention and treatment strategies. Objectives: To quantify cause-specific mortality rates by socioeconomic status across seven health and demographic surveillance systems (HDSS) in five countries (Ethiopia, Kenya, Malawi, Mozambique, and Nigeria) in the INDEPTH Network in sub-Saharan Africa. Methods: We linked demographic residence data with household survey data containing living standards and education information we used to create a poverty index. Person-years lived and deaths between 2003 and 2016 (periods varied by HDSS) were stratified in each HDSS by age, sex, year, and number of deprivations on the poverty index (0–8). Causes of death were assigned to each death using the InterVA-4 model based on responses to verbal autopsy questionnaires. We estimated rate ratios between socioeconomic groups (2–4 and 5–8 deprivations on our poverty index compared to 0–2 deprivations) for specific causes of death and calculated life expectancy for the deprivation groups. Results: Our pooled data contained almost 3.5 million person-years of observation and 25,038 deaths. All-cause mortality rates were higher among people in households with 5–8 deprivations on our poverty index compared to 0–2 deprivations, controlling for age, sex, and year (rate ratios ranged 1.42 to 2.06 across HDSS sites). The poorest group had consistently higher death rates in communicable, maternal, neonatal, and nutritional conditions (rate ratios ranged 1.34–4.05) and for non-communicable diseases in several sites (1.14–1.93). The disparities in mortality between 5–8 deprivation groups and 0–2 deprivation groups led to lower life expectancy in the higher-deprivation groups by six years in all sites and more than 10 years in five sites. Conclusions: We show large disparities in mortality on the basis of socioeconomic status across seven HDSS in sub-Saharan Africa due to disparities in communicable disease mortality and from non-communicable diseases in some sites. Life expectancy gaps between socioeconomic groups within sites were similar to the gaps between high-income and lower-middle-income countries. Prevention and treatment efforts can benefit from understanding subpopulations facing higher mortality from specific conditions.
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Affiliation(s)
- Matthew M Coates
- a Department of Global Health and Social Medicine, Program in Global Noncommunicable Diseases and Social Change , Harvard Medical School , Boston , USA
| | | | - Alexander Kintu
- c Department of Global Health and Population , Harvard T.H. Chan School of Public Health , Boston , USA
| | - Iwara Arikpo
- b INDEPTH Network , Accra , Ghana.,d Cross River Health & Demographic Surveillance System (CRHDSS) , University of Calabar , Calabar , Nigeria
| | - Alberto Chauque
- b INDEPTH Network , Accra , Ghana.,e Centro de Investigação em Saúde da Manhiça (CISM) , Mozambique
| | - Melkamu Merid Mengesha
- b INDEPTH Network , Accra , Ghana.,f College of Health and Medical Sciences , Haramaya University , Harar , Ethiopia
| | - Alison J Price
- b INDEPTH Network , Accra , Ghana.,g Department of Population Health , London School of Hygiene & Tropical Medicine , London , UK.,h Malawi Epidemiology and Intervention Research Unit , Lilongwe , Malawi
| | - Peter Sifuna
- b INDEPTH Network , Accra , Ghana.,i US Army Medical Research Directorate-Kenya (USAMRD-K)/Kenya Medical Research Institute (KEMRI) , Kisumu , Kenya
| | - Marylene Wamukoya
- b INDEPTH Network , Accra , Ghana.,j African Population and Health Research Center , Nairobi , Kenya
| | - Charfudin N Sacoor
- b INDEPTH Network , Accra , Ghana.,e Centro de Investigação em Saúde da Manhiça (CISM) , Mozambique
| | - Sheila Ogwang
- b INDEPTH Network , Accra , Ghana.,i US Army Medical Research Directorate-Kenya (USAMRD-K)/Kenya Medical Research Institute (KEMRI) , Kisumu , Kenya
| | - Nega Assefa
- b INDEPTH Network , Accra , Ghana.,f College of Health and Medical Sciences , Haramaya University , Harar , Ethiopia
| | - Amelia C Crampin
- b INDEPTH Network , Accra , Ghana.,g Department of Population Health , London School of Hygiene & Tropical Medicine , London , UK.,h Malawi Epidemiology and Intervention Research Unit , Lilongwe , Malawi
| | - Eusebio V Macete
- b INDEPTH Network , Accra , Ghana.,e Centro de Investigação em Saúde da Manhiça (CISM) , Mozambique
| | - Catherine Kyobutungi
- b INDEPTH Network , Accra , Ghana.,j African Population and Health Research Center , Nairobi , Kenya
| | - Martin M Meremikwu
- b INDEPTH Network , Accra , Ghana.,d Cross River Health & Demographic Surveillance System (CRHDSS) , University of Calabar , Calabar , Nigeria
| | - Walter Otieno
- b INDEPTH Network , Accra , Ghana.,i US Army Medical Research Directorate-Kenya (USAMRD-K)/Kenya Medical Research Institute (KEMRI) , Kisumu , Kenya.,k Department of Paediatrics and Child Health , Maseno University School of Medicine , Kisumu , Kenya
| | | | - Andrew Marx
- a Department of Global Health and Social Medicine, Program in Global Noncommunicable Diseases and Social Change , Harvard Medical School , Boston , USA
| | - Peter Byass
- b INDEPTH Network , Accra , Ghana.,m Department of Epidemiology and Global Health , Umeå University , Umeå , Sweden.,n Medical Research Council/Wits University Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa.,o Institute of Applied Health Sciences , University of Aberdeen , Aberdeen , Scotland
| | - Osman Sankoh
- b INDEPTH Network , Accra , Ghana.,p Statistics Sierra Leone , Freetown , Sierra Leone.,q College of Medicine and Allied Health Sciences , University of Sierra Leone , New England , Sierra Leone.,r School of Public Health, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa
| | - Gene Bukhman
- a Department of Global Health and Social Medicine, Program in Global Noncommunicable Diseases and Social Change , Harvard Medical School , Boston , USA.,s Division of Global Health Equity , Brigham and Women's Hospital , Boston , MA , USA.,t Partners In Health , Boston , MA , USA
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Lumagbas LB, Coleman HLS, Bunders J, Pariente A, Belonje A, de Cock Buning T. Non-communicable diseases in Indian slums: re-framing the Social Determinants of Health. Glob Health Action 2018; 11:1438840. [PMID: 29589512 PMCID: PMC5912444 DOI: 10.1080/16549716.2018.1438840] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background: The epidemic of non-communicable diseases (NCDs) in slums has pushed its residents to heightened vulnerability. The Social Determinants of Health (SDH) framework has been used to understand the social dynamics and impact of NCDs, especially in poorly resourced communities. Whilst the SDH has helped to discredit the characterisation of NCDs as diseases of affluence, its impact on policy has been less definite. Given the multitude of factors that interact in the presentation of NCDs, operationalising the SDH for policies and programmes that account for the contextual complexity of slums has stalled. Objective: To organise the complex networks of relations between SDH in slums so as to identify options for Indian municipal policy that are feasible to implement in the short term. Methods: The study reviews the literature describing SDH in Indian slums, specifically those that establish causal relations between SDH and NCDs. Root cause analysis was then used to organise the identified relations of SDH and NCDs. Results: Although poverty remains the largest structural determinant of health in slums, the multi-dimensional relations between SDH and NCDs are structured around four themes that describe the dynamics of slums, namely scarce clean water, low education, physical (in)activity and transportation. From the reviewed literature, four logic trees visualising the relations between SDH in slums and NCDs were constructed. The logic trees separate symptomatic problems from their more distal causes, and recommendations were formulated based on features of these relationships that are amenable to policy intervention. Conclusion: Root cause analysis provides a means to focus the lens of examination of SDH, as evidenced here for Indian slums. It provides a guide for the development of policies that are grounded in the actual health concerns of people in slums, and takes account of the complex pathways through which diseases are socially constituted.
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Affiliation(s)
- Lily Beth Lumagbas
- a ILAW , Barangay Maybunga 1607, Pasig City, Philippines.,b Athena Institute, Faculty of Science , Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands.,c Le Centre de Recherche Inserm, University of Bordeaux Segalen , 33000 Bordeaux, France
| | | | - Joske Bunders
- b Athena Institute, Faculty of Science , Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
| | - Antoine Pariente
- c Le Centre de Recherche Inserm, University of Bordeaux Segalen , 33000 Bordeaux, France
| | - Anne Belonje
- d Dutch Heart Foundation , 2496 XD Den Haag , The Netherlands
| | - Tjard de Cock Buning
- b Athena Institute, Faculty of Science , Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
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Universal Health Coverage in Africa: Coinfections and Comorbidities. Trends Parasitol 2018; 34:813-817. [PMID: 30057348 DOI: 10.1016/j.pt.2018.07.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Revised: 07/06/2018] [Accepted: 07/09/2018] [Indexed: 11/23/2022]
Abstract
At the 67th session of the World Health Organization (WHO) Regional Committee meeting in August 2017, African health ministers adopted a range of transformational actions intended to strengthen health systems in countries, leading to Universal Health Coverage (UHC). A critical challenge for UHC is the existence of coinfections and noncommunicable diseases (NCDs), characterised by comorbidities.
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25
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Ezzati M, Pearson-Stuttard J, Bennett JE, Mathers CD. Acting on non-communicable diseases in low- and middle-income tropical countries. Nature 2018; 559:507-516. [DOI: 10.1038/s41586-018-0306-9] [Citation(s) in RCA: 115] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 05/24/2018] [Indexed: 02/06/2023]
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Perera N, Yang FL, Chern J, Chiu HW, Hsieh CY, Li LH, Zhang YL, Hua KF, Wu SH. Carboxylic and O-acetyl moieties are essential for the immunostimulatory activity of glucuronoxylomannan: a novel TLR4 specific immunostimulator from Auricularia auricula-judae. Chem Commun (Camb) 2018; 54:6995-6998. [DOI: 10.1039/c7cc09927d] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
O-acetyl and carboxylic functionalities of Auricularia auricula-judae glucuronoxylomannan play critical roles in TLR4/MD2 receptor binding for its immunostimulatory activity.
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Affiliation(s)
- Namal Perera
- Institute of Biological Chemistry
- Academia Sinica
- Taipei
- Taiwan
- Chemical Biology and Molecular Biophysics Program
| | - Feng-Ling Yang
- Institute of Biological Chemistry
- Academia Sinica
- Taipei
- Taiwan
| | - Jeffy Chern
- Institute of Biological Chemistry
- Academia Sinica
- Taipei
- Taiwan
- Chemical Biology and Molecular Biophysics Program
| | - Hsiao-Wen Chiu
- Graduate Institute of Life Sciences
- National Defense Medical Center
- Taipei
- Taiwan
- Department of Biotechnology and Animal Science
| | - Chih-Yu Hsieh
- Department of Biotechnology and Animal Science
- National Ilan University
- Ilan
- Taiwan
| | - Lan-Hui Li
- Department of Laboratory Medicine, Linsen
- Chinese Medicine and Kunming Branch
- Taipei City Hospital
- Taipei
- Taiwan
| | - Yan-Long Zhang
- Key Laboratory of Molecular Biology of Heilongjiang Province
- College of Life Sciences
- Heilongjiang University
- Harbin 150080
- China
| | - Kuo-Feng Hua
- Department of Biotechnology and Animal Science
- National Ilan University
- Ilan
- Taiwan
- Department of Pathology
| | - Shih-Hsiung Wu
- Institute of Biological Chemistry
- Academia Sinica
- Taipei
- Taiwan
- Chemical Biology and Molecular Biophysics Program
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Mhango EKG, Kalhapure RS, Jadhav M, Sonawane SJ, Mocktar C, Vepuri S, Soliman M, Govender T. Preparation and Optimization of Meropenem-Loaded Solid Lipid Nanoparticles: In Vitro Evaluation and Molecular Modeling. AAPS PharmSciTech 2017; 18:2011-2025. [PMID: 27933586 DOI: 10.1208/s12249-016-0675-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Accepted: 11/18/2016] [Indexed: 12/20/2022] Open
Abstract
Encapsulation of antibiotics into nanocarriers has the potential to overcome resistance and disadvantages associated with conventional dosage forms as well as increase half-life of an antibiotic. Encapsulation of meropenem (MRPN) into solid lipid nanoparticles (SLNs) remains unexplored among the limited work reported on nanoformulation incorporating MRPN. The study aimed to use an experimental design, to optimize MRPN-loaded SLNs, and to undertake in vitro and in silico evaluations. A Box-Behnken design (BBD) was used to optimize manufacturing conditions of glycerol monostearate (GMS) SLNs loaded with MRPN. The SLNs were prepared using hot homogenization and ultrasonication method. Optimized MRPN-SLNs showed particle size, zeta potential, and entrapment efficiency of 112.61 ± 0.66 nm, -20.43 ± 0.99 mV, and 89.94 ± 1.26%, respectively. The morphology of the SLNs revealed nearly spherical shaped particles. Differential scanning calorimetry and X-ray diffraction analysis showed that meropenem was present in amorphous form in the SLNs. Controlled in vitro MRPN release from SLNs was achieved and followed the Korsmeyer-Peppas model (R 2 = 0.9679). Prolonged in vitro antibacterial activity against Escherichia coli was also observed. The molecular modeling showed that both hydrophobic interactions and hydrogen bonding led to a stable MRPN-GMS complex formation, which was confirmed by its low heat of formation (-5536.13 kcal/mol). This stable complex could have contributed to the controlled release of MRPN from the SLNs and subsequent sustained antibacterial activity.
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Agho AO, John EB. Occupational therapy and physiotherapy education and workforce in Anglophone sub-Saharan Africa countries. HUMAN RESOURCES FOR HEALTH 2017; 15:37. [PMID: 28606103 PMCID: PMC5469184 DOI: 10.1186/s12960-017-0212-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Accepted: 06/02/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Sub-Saharan Africa (SSA) countries are faced with the challenge of educating a critical mass of occupational therapists (OTs) and physiotherapists (PTs) to meet the growing demand for health and rehabilitation services. The World Federation of Occupational Therapy (WFOT) and World Confederation of Physical Therapy (WCPT) have argued for the need of graduate-level training for OTs and PTs for decades. However, very few studies have been conducted to determine the availability of OT and PT training programs and practitioners in SSA countries. METHODS Initial data were collected and compiled from an extensive literature search conducted using MEDLINE and PubMed to examine the availability of OT and PT education and training programs in SSA countries. Additional data were collected, compiled, and collated from academic institutions, ministries of health, health professions associations, and licensing authorities in SSA countries. Secondary data were also collected from the websites of organizations such as the World Bank, World Health Organization (WHO), WFOT, and WCPT. RESULTS This investigation revealed that there are limited number of OT and PT training programs and that these training programs in Anglophone SSA countries are offered at or below the bachelor's level. More than half of the countries do not have OT or PT training programs. The number of qualified OTs and PTs appears to be insufficient to meet the demand for rehabilitation services. Nigeria and South Africa are the only countries offering post-entry-level masters and doctoral-level training programs in physiotherapy and occupational therapy. CONCLUSIONS Higher learning institutions in SSA countries need to collaborate and partner with other regional and foreign universities to elevate the educational training and increase the supply of PTs and OTs in the region.
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Affiliation(s)
- Augustine O. Agho
- Office of Academic Affairs, Old Dominion University, Norfolk, VA United States of America
| | - Emmanuel B. John
- Department of Physical Therapy, Chapman University, Irvine, CA United States of America
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Duboz P, Boëtsch G, Gueye L, Macia E. Hypertension in the Ferlo (Northern Senegal): prevalence, awareness, treatment and control. Pan Afr Med J 2017; 25:177. [PMID: 28292139 PMCID: PMC5326029 DOI: 10.11604/pamj.2016.25.177.10105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 07/25/2016] [Indexed: 11/27/2022] Open
Abstract
Introduction The aim of this article is to assess prevalence, awareness, treatment and control of hypertension in rural Senegal (Sahelian Ferlo region). Methods This study was carried out in 2015 on a population sample of 500 individuals living in the municipality of Tessekere, constructed using the quota method. Sociodemographic characteristics, hypertension, hypertension awareness, treatment and control, and body mass index of individuals were collected during face-to-face interviews. Statistical analyses used were Chi-square tests and binary logistic regressions. Results Prevalence of hypertension was 31.40%. Prevalence of awareness, treatment and control among hypertensives, were 43.31%, 24.84% and 11.46% respectively. Logistic regression showed that the prevalence and awareness of hypertension increased with age. Overweight and obese subjects were more often hypertensive, but did not differ from others in awareness and treatment. Conclusion Given the very high prevalence of hypertension in the region, a strategic approach to prevent and control hypertension is critically needed.
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Affiliation(s)
- Priscilla Duboz
- UMR 7268 ADèS, Téssékéré international Human-Environment Observatory, Aix-Marseille Université/EFS/CNRS, Faculté de Médecine Secteur Nord Boulevard Pierre Dramard, 13955 Marseille cedex 15, France
| | - Gilles Boëtsch
- UMI 3189 Environnement, Santé, Sociétés CNRS/Université Cheikh Anta Diop/Université de Bamako/CNRST, Laboratoire de Physiologie Exploratoire et Fonctionnelle, Faculté de Médecine de Dakar, Université Cheikh Anta Diop, Dakar, Sénégal
| | - Lamine Gueye
- UMI 3189 Environnement, Santé, Sociétés CNRS/Université Cheikh Anta Diop/Université de Bamako/CNRST, Laboratoire de Physiologie Exploratoire et Fonctionnelle, Faculté de Médecine de Dakar, Université Cheikh Anta Diop, Dakar, Sénégal
| | - Enguerran Macia
- UMI 3189 Environnement, Santé, Sociétés CNRS/Université Cheikh Anta Diop/Université de Bamako/CNRST, Laboratoire de Physiologie Exploratoire et Fonctionnelle, Faculté de Médecine de Dakar, Université Cheikh Anta Diop, Dakar, Sénégal
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Abstract
Noncommunicable disease (NCD), principally cardiovascular diseases, cancer, chronic lung disease, and diabetes, constitutes the major cause of death worldwide. Evidence of a continuing increase in the global burden of these diseases has generated recent urgent calls for global action to tackle and reduce related death and disability. Because the majority of NCD deaths occur in low- and middle-income countries, increased attention has been focused on this group of countries. However, in sub-Saharan Africa, where all countries are members of the low- and middle-income grouping, NCDs are not the leading causes of death or potential life years lost. Thus, strategies to tackle NCDs in sub-Saharan Africa are best conceived and executed in alignment with existing strategies for the prevention, treatment, and control of the actual leading causes of death in this region. This commentary addresses caveats to be considered as strategies are developed to tackle NCDs in sub-Saharan Africa as part of the global effort to prevent, treat, and control NCDs.
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Affiliation(s)
- George A Mensah
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
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Kalhapure RS, Suleman N, Mocktar C, Seedat N, Govender T. Nanoengineered drug delivery systems for enhancing antibiotic therapy. J Pharm Sci 2014; 104:872-905. [PMID: 25546108 DOI: 10.1002/jps.24298] [Citation(s) in RCA: 125] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Revised: 11/07/2014] [Accepted: 11/07/2014] [Indexed: 12/12/2022]
Abstract
Formulation scientists are recognizing nanoengineered drug delivery systems as an effective strategy to overcome limitations associated with antibiotic drug therapy. Antibiotics encapsulated into nanodelivery systems will contribute to improved management of patients with various infectious diseases and to overcoming the serious global burden of antibiotic resistance. An extensive review of several antibiotic-loaded nanocarriers that have been formulated to target drugs to infectious sites, achieve controlled drug release profiles, and address formulation challenges, such as low-drug entrapment efficiencies, poor solubility and stability is presented in this paper. The physicochemical properties and the in vitro/in vivo performances of various antibiotic-loaded delivery systems, such as polymeric nanoparticles, micelles, dendrimers, liposomes, solid lipid nanoparticles, lipid-polymer hybrid nanoparticles, nanohybirds, nanofibers/scaffolds, nanosheets, nanoplexes, and nanotubes/horn/rods and nanoemulsions, are highlighted and evaluated. Future studies that will be essential to optimize formulation and commercialization of these antibiotic-loaded nanosystems are also identified. The review presented emphasizes the significant formulation progress achieved and potential that novel nanoengineered antibiotic drug delivery systems have for enhancing the treatment of patients with a range of infections.
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Affiliation(s)
- Rahul S Kalhapure
- Discipline of Pharmaceutical Sciences, School of Health Sciences, University of KwaZulu-Natal, Durban, 4000, South Africa
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Abdulsalam S, Olugbenga-Bello A, Olarewaju O, Abdus-salam I. Sociodemographic correlates of modifiable risk factors for hypertension in a rural local government area of oyo state South west Nigeria. Int J Hypertens 2014; 2014:842028. [PMID: 25580284 PMCID: PMC4281460 DOI: 10.1155/2014/842028] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Revised: 10/16/2014] [Accepted: 11/11/2014] [Indexed: 12/25/2022] Open
Abstract
Modifiable risk factors of hypertension contribute significantly to all-cause morbidity and mortality worldwide. The study aimed to determine the prevalence of and the association of modifiable risk factors with hypertension in rural community. A cross-sectional study was conducted among 166 male and 201 female adults of 18 years and above using cluster sampling technique. Data were collected using modified WHO STEPS instrument and hypertensive subjects were defined as those with systolic greater than or equal to 140 and diastolic of 90 mmHg. Data were analyzed with SPSS version 17 with level of significance at P < 0.05. The mean age of the subjects was 36.36 (±16.88) years and mean systolic and diastolic pressures were 124 (±16.93) and 76.32 (±11.85) mmHg, respectively. The prevalence of hypertension was high (22.9%) in this rural communities but awareness was low, 10.71%. The prevalence of alcohol consumption, sedentary lifestyle, abnormal weight, inadequate sleep, smoking, significant stress, and female use of hormonal contraceptives was 149 (40.6%), 91 (24.8%), 88 (24.0%), 122 (33.2%), 14 (3.8%), 65 (17.7%), and 53 (26.5%), respectively. Overweight, sex, inadequate sleep, and stress were established as positive predictors of hypertension. The rising prevalence of hypertension and its modifiable risk factors in rural communities require prompt interventions directed at reversing these trends.
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Affiliation(s)
- Saliu Abdulsalam
- Department of Community Medicine, Ladoke Akintola University of Technology Teaching Hospital, Ogbomoso, Oyo State, Nigeria
| | - Adenike Olugbenga-Bello
- Department of Community Medicine, Faculty of Clinical Sciences, College of Health Sciences, Ladoke Akintola University of Technology, Osogbo, Nigeria
| | - Olakunle Olarewaju
- Department of Community Medicine, Ladoke Akintola University of Technology Teaching Hospital, Ogbomoso, Oyo State, Nigeria
| | - Ismail Abdus-salam
- Directorate of Disease Control, Lagos State Ministry of Health, Alausa, Ikeja 100282, Lagos State, Nigeria
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Angkurawaranon C, Jiraporncharoen W, Chenthanakij B, Doyle P, Nitsch D. Urbanization and non-communicable disease in Southeast Asia: a review of current evidence. Public Health 2014; 128:886-95. [DOI: 10.1016/j.puhe.2014.08.003] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Revised: 04/13/2014] [Accepted: 08/04/2014] [Indexed: 01/22/2023]
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Kapiga S. Commentary: Non-communicable diseases in sub-Saharan Africa: a new global health priority and opportunity. Int J Epidemiol 2011; 40:902-3. [PMID: 21685221 DOI: 10.1093/ije/dyr098] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Saidi Kapiga
- Department of Infectious Diseases Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK.
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