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Sliwa K, Viljoen CA, Hasan B, Ntusi NAB. Nutritional Heart Disease and Cardiomyopathies: JACC Focus Seminar 4/4. J Am Coll Cardiol 2022; 81:S0735-1097(22)07308-9. [PMID: 36599756 DOI: 10.1016/j.jacc.2022.08.812] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 08/24/2022] [Indexed: 01/03/2023]
Abstract
This JACC Focus Seminar provides an overview of and highlights recently published research on cardiomyopathies and nutritional heart disease that have a higher prevalence in tropical regions. The development of tropical cardiomyopathies and nutritional cardiovascular disease (CVD) is complicated by high rates of poverty, fragmented health care systems, and suboptimal access to health care because of socioeconomic inequalities, leading to the fact that children, adolescents, and young adults are disproportionally affected. Such tropical cardiomyopathies and nutritional CVD that have not been prevalent in high-income countries in the past decades are now reemerging. When treating migrants or refugees, it is important for attending physicians to consider the burden of endemic diseases in the countries of origin and the likelihood that such patients might be affected. In this review, the authors propose an approach for adequate diagnostic work-up leading to appropriate care for those with suspected or confirmed tropical cardiomyopathies and nutritional CVD.
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Affiliation(s)
- Karen Sliwa
- Cape Heart Institute, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa; Division of Cardiology, Department of Medicine, Groote Schuur Hospital, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
| | - Charle Andre Viljoen
- Cape Heart Institute, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa; Division of Cardiology, Department of Medicine, Groote Schuur Hospital, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Babar Hasan
- Division of Cardio-Thoracic Sciences, Sindh Institute of Urology and Transplant, Karachi, Pakistan
| | - Ntobeko A B Ntusi
- Cape Heart Institute, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa; Division of Cardiology, Department of Medicine, Groote Schuur Hospital, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa; South African Medical Research Council Extramural Unit on Intersection of Noncommunicable Diseases and Infectious Diseases, Cape Town, South Africa
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2
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Dirksen J, Pinilla-Roncancio M, Wehrmeister FC, Ferreira LZ, Vidaletti LP, Kirkby K, Koller TS, Schlotheuber A, Tapia H, Vidal Fuertes C, Alkire S, Barros AJD, Hosseinpoor AR. Exploring the potential for a new measure of socioeconomic deprivation status to monitor health inequality. Int J Equity Health 2022; 21:56. [PMID: 35461294 PMCID: PMC9034442 DOI: 10.1186/s12939-022-01661-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 04/03/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Monitoring health inequalities is an important task for health research and policy, to uncover who is being left behind - and where - and to inform effective and equitable policies and programmes to tackle existing inequities. The choice of which measure to use to monitor and analyse health inequalities is thereby not trivial. This article explores a new measure of socioeconomic deprivation status (SDS) to monitor health inequalities. METHODS The SDS measure was constructed using the Alkire-Foster method. It includes eight indicators across two equally weighted dimensions (education and living standards) and specifies a four-level gradient of socioeconomic deprivation at the household-level. We conducted four exercises to examine the value-added of the proposed SDS measure, using Demographic and Health Surveys data. First, we examined the discriminatory power of the new measure when applied to outcomes in four select reproductive, maternal, neonatal, and child health (RMNCH) indicators across six countries: skilled birth attendance, stunting, U5MR, and DTP3 immunisation. Then, we analysed the behaviour and association of the new SDS measure vis-à-vis the DHS Wealth Index, including chi-squared test and Pearson correlation coefficient. Third, we analysed the robustness of the SDS measure results to changes in its structure, using pairwise comparisons and Kendal Tau-b rank correlation. Finally, we illustrated some of the advantageous properties of the new measure, disaggregation and decomposition, on Haitian data. RESULTS 1) Higher levels of socioeconomic deprivation are generally consistently associated with lower levels of achievements in the RMNCH indicators across countries. 2) 87% of all pairwise rank comparisons across a range of SDS measure structures were robust. 3) SDS and DHS Wealth Index are associated, but with considerable cross-country variation, highlighting their complementarity. 4) Haitian households in rural areas experienced, on average, more severe socioeconomic deprivation as well as lower levels of RMNCH achievement than urban households. CONCLUSIONS The proposed SDS measure adds analytical possibilities to the health inequality monitoring literature, in line with ethically and conceptually well-founded notions of absolute, multidimensional disadvantage. In addition, it allows for breakdown by its dimensions and components, which may facilitate nuanced analyses of health inequality, its correlates, and determinants.
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Affiliation(s)
- Jakob Dirksen
- Oxford Poverty and Human Development Initiative, University of Oxford, Oxford, UK
| | - Monica Pinilla-Roncancio
- Oxford Poverty and Human Development Initiative, University of Oxford, Oxford, UK.,Universidad de los Andes, Bogotá, Colombia
| | - Fernando C Wehrmeister
- International Center for Equity in Health, Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Leonardo Z Ferreira
- International Center for Equity in Health, Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Luis Paulo Vidaletti
- International Center for Equity in Health, Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | | | | | | | - Heriberto Tapia
- Human Development Report Office, United Nations Development Programme, New York, USA
| | | | - Sabina Alkire
- Oxford Poverty and Human Development Initiative, University of Oxford, Oxford, UK
| | - Aluisio J D Barros
- International Center for Equity in Health, Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
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3
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Owolabi MO, Thrift AG, Mahal A, Ishida M, Martins S, Johnson WD, Pandian J, Abd-Allah F, Yaria J, Phan HT, Roth G, Gall SL, Beare R, Phan TG, Mikulik R, Akinyemi RO, Norrving B, Brainin M, Feigin VL. Primary stroke prevention worldwide: translating evidence into action. Lancet Public Health 2022; 7:e74-e85. [PMID: 34756176 PMCID: PMC8727355 DOI: 10.1016/s2468-2667(21)00230-9] [Citation(s) in RCA: 171] [Impact Index Per Article: 85.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 09/20/2021] [Accepted: 09/20/2021] [Indexed: 02/05/2023]
Abstract
Stroke is the second leading cause of death and the third leading cause of disability worldwide and its burden is increasing rapidly in low-income and middle-income countries, many of which are unable to face the challenges it imposes. In this Health Policy paper on primary stroke prevention, we provide an overview of the current situation regarding primary prevention services, estimate the cost of stroke and stroke prevention, and identify deficiencies in existing guidelines and gaps in primary prevention. We also offer a set of pragmatic solutions for implementation of primary stroke prevention, with an emphasis on the role of governments and population-wide strategies, including task-shifting and sharing and health system re-engineering. Implementation of primary stroke prevention involves patients, health professionals, funders, policy makers, implementation partners, and the entire population along the life course.
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Affiliation(s)
- Mayowa O Owolabi
- Center for Genomic and Precision Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria.
| | - Amanda G Thrift
- Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, VIC, Australia
| | - Ajay Mahal
- Nossal Institute for Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Marie Ishida
- Nossal Institute for Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Sheila Martins
- Department of Neurology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; Department of Neurology, Universidade Federal do Rio Grande do Sul, Rio Grande do Sul, Brazil; Department of Neurology, Hospital Moinhos de Vento, Porto Alegre, Brazil; Brazilian Stroke Network, São Paulo, Brazil
| | - Walter D Johnson
- School of Public Health, Loma Linda University, Loma Linda, CA, USA
| | - Jeyaraj Pandian
- School of Public Health, Christian Medical College, Ludhiana, Punjab, India
| | - Foad Abd-Allah
- Department of Neurology, Kasr Alainy School of Medicine, Cairo University, Cairo, Egypt
| | - Joseph Yaria
- Department of Neurology, University College Hospital, Ibadan, Nigeria
| | - Hoang T Phan
- Department of Neurology, Monash University, Melbourne, VIC, Australia; Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Greg Roth
- Institute for Health Metrics Evaluation, University of Washington, Seattle, WA, USA
| | - Seana L Gall
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Richard Beare
- Monash Health, and Peninsula Clinical School, Monash University, Melbourne, VIC, Australia; Developmental Imaging Group, Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Thanh G Phan
- Department of Neurology, Monash University, Melbourne, VIC, Australia; Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Robert Mikulik
- International Clinical Research Center, Neurology Department, St Anne's University Hospital, Masaryk University, Brno, Czech Republic
| | - Rufus O Akinyemi
- Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Bo Norrving
- Department of Clinical Sciences, and Department of Neurology, Skåne University Hospital, Lund University, Lund, Sweden
| | - Michael Brainin
- Department of Neuroscience and Preventive Medicine, Danube University Krems, Krems an der Donau, Austria
| | - Valery L Feigin
- Institute for Health Metrics Evaluation, University of Washington, Seattle, WA, USA; National Institute for Stroke and Applied Neurosciences, School of Clinical Sciences, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand; Scientific and Educational Department, Research Centre of Neurology, Moscow, Russia.
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4
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Owolabi MO, Thrift AG, Martins S, Johnson W, Pandian J, Abd-Allah F, Varghese C, Mahal A, Yaria J, Phan HT, Roth G, Gall SL, Beare R, Phan TG, Mikulik R, Norrving B, Feigin VL. The state of stroke services across the globe: Report of World Stroke Organization-World Health Organization surveys. Int J Stroke 2021; 16:889-901. [PMID: 33988062 PMCID: PMC8800855 DOI: 10.1177/17474930211019568] [Citation(s) in RCA: 62] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Improving stroke services is critical for reducing the global stroke burden. The World Stroke Organization-World Health Organization-Lancet Neurology Commission on Stroke conducted a survey of the status of stroke services in low and middle-income countries (LMICs) compared to high-income countries. METHODS Using a validated World Stroke Organization comprehensive questionnaire, we collected and compared data on stroke services along four pillars of the stroke quadrangle (surveillance, prevention, acute stroke, and rehabilitation) in 84 countries across World Health Organization regions and economic strata. The World Health Organization also conducted a survey of non-communicable diseases in 194 countries in 2019. RESULTS Fewer surveillance activities (including presence of registries, presence of recent risk factors surveys, and participation in research) were reported in low-income countries than high-income countries. The overall global score for prevention was 40.2%. Stroke units were present in 91% of high-income countries in contrast to 18% of low-income countries (p < 0.001). Acute stroke treatments were offered in ∼ 60% of high-income countries compared to 26% of low-income countries (p = 0.009). Compared to high-income countries, LMICs provided less rehabilitation services including in-patient rehabilitation, home assessment, community rehabilitation, education, early hospital discharge program, and presence of rehabilitation protocol. CONCLUSIONS There is an urgent need to improve access to stroke units and services globally especially in LMICs. Countries with less stroke services can adapt strategies from those with better services. This could include establishment of a framework for regular monitoring of stroke burden and services, implementation of integrated prevention activities and essential acute stroke care services, and provision of interdisciplinary care for stroke rehabilitation.
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Affiliation(s)
- Mayowa O Owolabi
- Center for Genomic and Precision Medicine, College of Medicine, University of Ibadan, Nigeria
| | - Amanda G Thrift
- Epidemiology and Prevention Division, Stroke and Ageing Research (STAR), School of Clinical Sciences, Monash University, Melbourne, Australia
| | - Sheila Martins
- Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Hospital Moinhos de Vento & Brazilian Stroke Network
| | | | | | - Foad Abd-Allah
- Department of Neurology, Kasr Alainy School of Medicine, Cairo University, Cairo, Egypt
| | - Cherian Varghese
- Non-communicable Disease Department, World Health Organization, Geneva, Switzerland
| | - Ajay Mahal
- Nossal Institute of Global Health, University of Melbourne, Australia
| | - Joseph Yaria
- Department of Neurology, University College Hospital, Ibadan, Nigeria
| | - Hoang T Phan
- Menzies Institute for Medical Research, University of Tasmania, Australia
| | - Gregory Roth
- NUI Galway Health Research Board, Clinical Research Coordination, Galway, Ireland
| | - Seana L Gall
- Menzies Institute for Medical Research, University of Tasmania, Australia
| | - Richard Beare
- Peninsula Clinical School, Monash University, and Developmental Imaging Group, Murdoch Children's Research Institute, Melbourne, Australia
| | - Thanh G Phan
- Department of Neurology, Monash Health and School of Clinical Sciences, Monash University, Melbourne, Australia
| | - Robert Mikulik
- International Clinical Research Center and Neurology Department of St. Anne's, University Hospital and Masaryk University, Brno, Czech Republic
| | - Bo Norrving
- Department of Clinical Sciences, Lund University, Sweden
| | - Valery L Feigin
- National Institute for Stroke and Applied Neurosciences (NISAN), School of Clinical Sciences, Auckland University of Technology, New Zealand
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Gupta N, Mocumbi A, Arwal SH, Jain Y, Haileamlak AM, Memirie ST, Larco NC, Kwan GF, Amuyunzu-Nyamongo M, Gathecha G, Amegashie F, Rakotoarison V, Masiye J, Wroe E, Koirala B, Karmacharya B, Condo J, Nyemazi JP, Sesay S, Maogenzi S, Mayige M, Mutungi G, Ssinabulya I, Akiteng AR, Mudavanhu J, Kapambwe S, Watkins D, Norheim O, Makani J, Bukhman G. Prioritizing Health-Sector Interventions for Noncommunicable Diseases and Injuries in Low- and Lower-Middle Income Countries: National NCDI Poverty Commissions. GLOBAL HEALTH: SCIENCE AND PRACTICE 2021; 9:626-639. [PMID: 34593586 PMCID: PMC8514044 DOI: 10.9745/ghsp-d-21-00035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 06/01/2021] [Indexed: 11/20/2022]
Abstract
Noncommunicable Disease and Injury (NCDI) Poverty Commissions in 16 low- and middle-income countries provided evidence-based recommendations on a local, expanded set of priority NCDIs and health-sector interventions needed in national initiatives to attain universal health coverage. These commissions provide a collective platform for policy, research, and advocacy efforts to improve coverage of cost-effective and equitable health-sector interventions for populations living in extreme poverty. Health sector priorities and interventions to prevent and manage noncommunicable diseases and injuries (NCDIs) in low- and lower-middle-income countries (LLMICs) have primarily adopted elements of the World Health Organization Global Action Plan for NCDs 2013–2020. However, there have been limited efforts in LLMICs to prioritize among conditions and health-sector interventions for NCDIs based on local epidemiology and contextually relevant risk factors or that incorporate the equitable distribution of health outcomes. The Lancet Commission on Reframing Noncommunicable Diseases and Injuries for the Poorest Billion supported national NCDI Poverty Commissions to define local NCDI epidemiology, determine an expanded set of priority NCDI conditions, and recommend cost-effective, equitable health-sector interventions. Fifteen national commissions and 1 state-level commission were established from 2016–2019. Six commissions completed the prioritization exercise and selected an average of 25 NCDI conditions; 15 conditions were selected by all commissions, including asthma, breast cancer, cervical cancer, diabetes mellitus type 1 and 2, epilepsy, hypertensive heart disease, intracerebral hemorrhage, ischemic heart disease, ischemic stroke, major depressive disorder, motor vehicle road injuries, rheumatic heart disease, sickle cell disorders, and subarachnoid hemorrhage. The commissions prioritized an average of 35 health-sector interventions based on cost-effectiveness, financial risk protection, and equity-enhancing rankings. The prioritized interventions were estimated to cost an additional US$4.70–US$13.70 per capita or approximately 9.7%–35.6% of current total health expenditure (0.6%–4.0% of current gross domestic product). Semistructured surveys and qualitative interviews of commission representatives demonstrated positive outcomes in several thematic areas, including understanding NCDIs of poverty, informing national planning and implementation of NCDI health-sector interventions, and improving governance and coordination for NCDIs. Overall, national NCDI Poverty Commissions provided a platform for evidence-based, locally driven determination of priorities within NCDIs.
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Affiliation(s)
- Neil Gupta
- Partners In Health NCD Synergies, Boston, MA, USA. .,Division of Global Health Equity, Brigham & Women's Hospital, Boston MA, USA.,Program in Global NCDs and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Ana Mocumbi
- Universidade Eduardo Mondlane, Maputo, Mozambique; Instituto Nacional de Saúde, Maputo, Mozambique
| | - Said H Arwal
- Afghan Ministry of Public Health, Kabul, Afghanistan
| | | | | | | | - Nancy C Larco
- Fondation Haïtienne de Diabète et de Maladies Cardio-Vasculaires, Port-au-Prince, Haiti
| | - Gene F Kwan
- Partners In Health NCD Synergies, Boston, MA, USA.,Program in Global NCDs and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA.,Section of Cardiovascular Medicine, Boston University School of Medicine, Boston, MA, USA
| | | | | | | | | | | | - Emily Wroe
- Partners In Health NCD Synergies, Boston, MA, USA.,Division of Global Health Equity, Brigham & Women's Hospital, Boston MA, USA.,Program in Global NCDs and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Bhagawan Koirala
- Manmohan Cardiothoracic Vascular and Transplant Center Institute of Medicine, Kathmandu, Nepal
| | - Biraj Karmacharya
- Department of Public Health and Community Programs, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
| | - Jeanine Condo
- School of Public Health, University of Rwanda, Kigali, Rwanda
| | | | - Santigie Sesay
- Sierra Leone Ministry of Health and Sanitation, Freetown, Sierra Leone
| | - Sarah Maogenzi
- Tanzania Ministry of Health, Community Development, Gender, Elderly and Children, Dodoma, Tanzania
| | - Mary Mayige
- National Institute for Medical Research, Dar es Salaam, Tanzania
| | | | - Isaac Ssinabulya
- Uganda Initiative for Integrated Management of Non-Communicable Diseases, Kampala, Uganda.,Makerere University College of Health Sciences, Kampala, Uganda
| | - Ann R Akiteng
- Uganda Initiative for Integrated Management of Non-Communicable Diseases, Kampala, Uganda
| | | | | | - David Watkins
- Division of General Internal Medicine, Department of Medicine and Department of Global Health, University of Washington, Seattle, WA, USA
| | - Ole Norheim
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,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
| | - Gene Bukhman
- Partners In Health NCD Synergies, Boston, MA, USA.,Division of Global Health Equity, Brigham & Women's Hospital, Boston MA, USA.,Program in Global NCDs and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA.,Division of Cardiovascular Medicine, Department of Medicine, Brigham & Women's Hospital, Boston, MA, USA
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6
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Zhang P. Study on the Experience of Public Health System Construction in China's COVID-19 Prevention. Front Public Health 2021; 9:610824. [PMID: 33981659 PMCID: PMC8107211 DOI: 10.3389/fpubh.2021.610824] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 03/22/2021] [Indexed: 11/13/2022] Open
Abstract
Background: China's experience in the process of COVID-19 prevention provides a reference for other countries in the world. This article studied the experience of public health system construction in China's COVID-19 prevention. Methods: Based on literature review and theoretical analysis, this paper constructs a theoretical framework of national public health system construction in health crisis. Based on this theoretical framework, combined with the policies and measures formulated by the Chinese government in the process of COVID-19 prevention, this article evaluate the advantages and deficiencies of China's public health system construction in response to COVID-19. Results: The Chinese government ensured the adequate supply of health resources, improved people's ability to pay medical expenses, and adopted advanced public health propaganda methods based on the Internet to help people grasp the basic information and development trend of COVID-19 in the process of COVID-19 prevention. At the same time, the utilization efficiency of health resources was low in China, people's ability to pay for medical expenses was unequal, and the disclosure of virus information in the early stage of the outbreak of COVID-19 is not timely. Conclusions: Other countries can learn from the advantages of China's public health system construction and avoid China's deficiencies in the process of public health system construction, which will help them improve the efficiency of COVID-19 prevention.
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Affiliation(s)
- Pengfei Zhang
- School of Labor and Human Resources, Renmin University of China, Beijing, China
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7
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Abstract
Background: The emergence of novel coronavirus disease 2019 (COVID-19), caused by the Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2), has presented an unprecedented global challenge for the healthcare community. The ability of SARS-CoV-2 to get transmitted during the asymptomatic phase, and its high infectivity have led to the rapid transmission of COVID-19 beyond geographic regions facilitated by international travel, leading to a pandemic. To guide effective control and interventions, primary data is required urgently, globally, including from low- and middle-income countries where documentation of cardiovascular manifestations and risk factors in people hospitalized with COVID-19 is limited. Objectives: This study aims to describe the cardiovascular manifestations and cardiovascular risk factors in patients hospitalized with COVID-19. Methods: We propose to conduct an observational cohort study involving 5000 patients recruited from hospitals in low-, middle- and high-income countries. Eligible adult COVID-19 patients will be recruited from the participating hospitals and followed-up until 30 days post admission. The outcomes will be reported at discharge and includes the need of ICU admission, need of ventilator, death (with cause), major adverse cardiovascular events, neurological outcomes, acute renal failure, and pulmonary outcomes. Conclusion: Given the enormous burden posed by COVID-19 and the associated severe prognostic implication of CVD involvement, this study will provide useful insights on the risk factors for severe disease, clinical presentation, and outcomes of various cardiovascular manifestations in COVID-19 patients particularly from low and middle income countries from where the data remain scant.
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8
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Fronteira I, Sidat M, Magalhães JP, de Barros FPC, Delgado AP, Correia T, Daniel-Ribeiro CT, Ferrinho P. The SARS-CoV-2 pandemic: A syndemic perspective. One Health 2021; 12:100228. [PMID: 33614885 PMCID: PMC7887445 DOI: 10.1016/j.onehlt.2021.100228] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 02/10/2021] [Accepted: 02/11/2021] [Indexed: 01/07/2023] Open
Abstract
The SARS-CoV-2 pandemic has affected communities, populations, and countries throughout the world. As the SARS-CoV-2 pandemic developed, the extent to which the disease interacted with already existing endemic, non-communicable and infectious diseases became evident, hence deeply influencing health outcomes. Additionally, a synergistic effect has been demonstrated also with socio-economic, cultural, and contextual determinants of health which seem to contribute to poorer health and accumulating social disadvantages. In this essay, using as a starting point the syndemic theory that translates the cumulative and intertwined factors between different epidemics, we argue that the SARS-CoV-2 is a one health issue of a syndemic nature and that the failure to acknowledge this contributes to weakened policy-making processes and public health responses and ineffective health policies and programs.
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Affiliation(s)
- Inês Fronteira
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Portugal,Corresponding author.
| | - Mohsin Sidat
- Community Health Department, Faculty of Medicine, University Eduardo Mondlane, Mozambique
| | - João Paulo Magalhães
- Public Health Unit, Group of Primary Care Centers of Porto Oriental, North Health Regional Administration, Ministry of Health, Portugal
| | | | - António Pedro Delgado
- University of Cabo Verde, Cabo Verde, Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Portugal
| | - Tiago Correia
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Portugal
| | - Cláudio Tadeu Daniel-Ribeiro
- Laboratório de Pesquisa em Malária, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro and Centro de Pesquisa Diagnóstico e Treinamento em Malária, Fiocruz e Secretaria de Vigilância em Saúde, Brazil
| | - Paulo Ferrinho
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Portugal
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9
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Ntsekhe M, Fourie JM, Scholtz W, Scarlatescu O, Nel G, Sliwa K. PASCAR and WHF Cardiovascular Diseases Scorecard project. Cardiovasc J Afr 2021; 32:47-56. [PMID: 33646241 PMCID: PMC8756008 DOI: 10.5830/cvja-2021-002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Data collected by the Pan-African Society of Cardiology for the World Heart Federation's Cardiovascular Diseases Scorecard project in Africa are presented. We summarise the strengths, threats, weaknesses and priorities identified from the collected data for South Africa, which need to be considered in conjunction with the associated sections in the accompanying infographic. Data sets that were used include open-source data available online and government publications. In the section on priorities and the way forward, we highlight the multifactorial health challenges with which South Africa has had to deal and the progress that has been made.
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Affiliation(s)
- Mpiko Ntsekhe
- Division of Cardiology, Department of Medicine, University of Cape Town/Groote Schuur Hospital, Cape Town, South Africa; South African Heart Association, Cape Town, South Africa (vice-president and member of the Board); Pan-African Society of Cardiology, Cape Town, South Africa (secretary general south)
| | - Jean M Fourie
- Pan-African Society of Cardiology, Cape Town, South Africa
| | - Wihan Scholtz
- Pan-African Society of Cardiology, Cape Town, South Africa.
| | | | - George Nel
- Pan-African Society of Cardiology, Cape Town, South Africa
| | - Karen Sliwa
- Division of Cardiology, Department of Medicine, University of Cape Town/Groote Schuur Hospital, Cape Town, South Africa; Pan-African Society of Cardiology, Cape Town, South Africa (vice-president south) World Heart Federation, Geneva, Switzerland; Hatter Institute for Cardiovascular Research in Africa, Faculty of Health Sciences, University of Cape Town, South Africa
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