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de Thoisy B, Duron O, Epelboin L, Musset L, Quénel P, Roche B, Binetruy F, Briolant S, Carvalho L, Chavy A, Couppié P, Demar M, Douine M, Dusfour I, Epelboin Y, Flamand C, Franc A, Ginouvès M, Gourbière S, Houël E, Kocher A, Lavergne A, Le Turnier P, Mathieu L, Murienne J, Nacher M, Pelleau S, Prévot G, Rousset D, Roux E, Schaub R, Talaga S, Thill P, Tirera S, Guégan JF. Ecology, evolution, and epidemiology of zoonotic and vector-borne infectious diseases in French Guiana: Transdisciplinarity does matter to tackle new emerging threats. Infect Genet Evol 2021; 93:104916. [PMID: 34004361 DOI: 10.1016/j.meegid.2021.104916] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 05/09/2021] [Accepted: 05/12/2021] [Indexed: 02/06/2023]
Abstract
French Guiana is a European ultraperipheric region located on the northern Atlantic coast of South America. It constitutes an important forested region for biological conservation in the Neotropics. Although very sparsely populated, with its inhabitants mainly concentrated on the Atlantic coastal strip and along the two main rivers, it is marked by the presence and development of old and new epidemic disease outbreaks, both research and health priorities. In this review paper, we synthetize 15 years of multidisciplinary and integrative research at the interface between wildlife, ecosystem modification, human activities and sociodemographic development, and human health. This study reveals a complex epidemiological landscape marked by important transitional changes, facilitated by increased interconnections between wildlife, land-use change and human occupation and activity, human and trade transportation, demography with substantial immigration, and identified vector and parasite pharmacological resistance. Among other French Guianese characteristics, we demonstrate herein the existence of more complex multi-host disease life cycles than previously described for several disease systems in Central and South America, which clearly indicates that today the greater promiscuity between wildlife and humans due to demographic and economic pressures may offer novel settings for microbes and their hosts to circulate and spread. French Guiana is a microcosm that crystallizes all the current global environmental, demographic and socioeconomic change conditions, which may favor the development of ancient and future infectious diseases.
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Affiliation(s)
- Benoît de Thoisy
- Laboratoire des Interactions Virus-Hôtes, Institut Pasteur de la Guyane, Cayenne Cedex, French Guiana.
| | - Olivier Duron
- UMR MIVEGEC, IRD, CNRS, Université de Montpellier, Centre IRD de Montpellier, Montpellier, France; Centre de Recherche en Écologie et Évolution de la Santé, Montpellier, France
| | - Loïc Epelboin
- Infectious Diseases Department, Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Lise Musset
- Laboratoire de Parasitologie, Centre Collaborateur OMS Pour La Surveillance Des Résistances Aux Antipaludiques, Centre National de Référence du Paludisme, Pôle zones Endémiques, Institut Pasteur de la Guyane, Cayenne, French Guiana
| | - Philippe Quénel
- Université de Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail), UMR-S 1085 Rennes, France
| | - Benjamin Roche
- UMR MIVEGEC, IRD, CNRS, Université de Montpellier, Centre IRD de Montpellier, Montpellier, France; Centre de Recherche en Écologie et Évolution de la Santé, Montpellier, France
| | - Florian Binetruy
- UMR MIVEGEC, IRD, CNRS, Université de Montpellier, Centre IRD de Montpellier, Montpellier, France
| | - Sébastien Briolant
- Unité Parasitologie et Entomologie, Département Microbiologie et Maladies Infectieuses, Institut de Recherche Biomédicale des Armées, Marseille, France; Aix Marseille Université, IRD, SSA, AP-HM, UMR Vecteurs - Infections Tropicales et Méditerranéennes (VITROME), France; IHU Méditerranée Infection, Marseille, France
| | | | - Agathe Chavy
- Laboratoire des Interactions Virus-Hôtes, Institut Pasteur de la Guyane, Cayenne Cedex, French Guiana
| | - Pierre Couppié
- Dermatology Department, Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Magalie Demar
- TBIP, Université de Guyane, Cayenne, French Guiana; Université de Lille, CNRS, Inserm, Institut Pasteur de Lille, U1019-UMR 9017-CIIL Centre d'Infection et d'Immunité de Lille, Lille, France
| | - Maylis Douine
- Centre d'Investigation Clinique Antilles-Guyane, Inserm 1424, Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Isabelle Dusfour
- Département de Santé Globale, Institut Pasteur, Paris, France; Institut Pasteur de la Guyane, Vectopôle Amazonien Emile Abonnenc, Cayenne, French Guiana
| | - Yanouk Epelboin
- Institut Pasteur de la Guyane, Vectopôle Amazonien Emile Abonnenc, Cayenne, French Guiana
| | - Claude Flamand
- Epidemiology Unit, Institut Pasteur de la Guyane, Cayenne, French Guiana; Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, UMR 2000, CNRS, Paris, France
| | - Alain Franc
- UMR BIOGECO, INRAE, Université de Bordeaux, Cestas, France; Pleiade, EPC INRIA-INRAE-CNRS, Université de Bordeaux Talence, France
| | - Marine Ginouvès
- TBIP, Université de Guyane, Cayenne, French Guiana; Université de Lille, CNRS, Inserm, Institut Pasteur de Lille, U1019-UMR 9017-CIIL Centre d'Infection et d'Immunité de Lille, Lille, France
| | - Sébastien Gourbière
- UMR 5096 Laboratoire Génome et Développement des Plantes, Université de Perpignan Via Domitia, Perpignan, France
| | - Emeline Houël
- CNRS, UMR EcoFoG, AgroParisTech, Cirad, INRAE, Université des Antilles, Université de Guyane, Cayenne, France
| | - Arthur Kocher
- Transmission, Infection, Diversification & Evolution Group, Max-Planck Institute for the Science of Human History, Kahlaische Str. 10, 07745 Jena, Germany; Laboratoire Evolution et Diversité Biologique (UMR 5174), Université de Toulouse, CNRS, IRD, UPS, Toulouse, France
| | - Anne Lavergne
- Laboratoire des Interactions Virus-Hôtes, Institut Pasteur de la Guyane, Cayenne Cedex, French Guiana
| | - Paul Le Turnier
- Service de Maladies Infectieuses et Tropicales, Hôtel Dieu - INSERM CIC 1413, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Luana Mathieu
- Université de Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail), UMR-S 1085 Rennes, France
| | - Jérôme Murienne
- Laboratoire Evolution et Diversité Biologique (UMR 5174), Université de Toulouse, CNRS, IRD, UPS, Toulouse, France
| | - Mathieu Nacher
- Centre d'Investigation Clinique Antilles-Guyane, Inserm 1424, Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Stéphane Pelleau
- Université de Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail), UMR-S 1085 Rennes, France; Malaria: Parasites and Hosts, Institut Pasteur, Paris, France
| | - Ghislaine Prévot
- TBIP, Université de Guyane, Cayenne, French Guiana; Université de Lille, CNRS, Inserm, Institut Pasteur de Lille, U1019-UMR 9017-CIIL Centre d'Infection et d'Immunité de Lille, Lille, France
| | - Dominique Rousset
- Laboratoire de Virologie, Institut Pasteur de la Guyane, Cayenne Cedex, French Guiana
| | - Emmanuel Roux
- ESPACE-DEV (Institut de Recherche pour le Développement, Université de la Réunion, Université des Antilles, Université de Guyane, Université de Montpellier, Montpellier, France; International Joint Laboratory "Sentinela" Fundação Oswaldo Cruz, Universidade de Brasília, Institut de Recherche pour le Développement, Rio de Janeiro RJ-21040-900, Brazil
| | - Roxane Schaub
- TBIP, Université de Guyane, Cayenne, French Guiana; Université de Lille, CNRS, Inserm, Institut Pasteur de Lille, U1019-UMR 9017-CIIL Centre d'Infection et d'Immunité de Lille, Lille, France; Centre d'Investigation Clinique Antilles-Guyane, Inserm 1424, Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Stanislas Talaga
- UMR MIVEGEC, IRD, CNRS, Université de Montpellier, Centre IRD de Montpellier, Montpellier, France; Institut Pasteur de la Guyane, Vectopôle Amazonien Emile Abonnenc, Cayenne, French Guiana
| | - Pauline Thill
- Service Universitaire des Maladies Infectieuses et du Voyageur, Centre Hospitalier Dron, Tourcoing, France
| | - Sourakhata Tirera
- Laboratoire des Interactions Virus-Hôtes, Institut Pasteur de la Guyane, Cayenne Cedex, French Guiana
| | - Jean-François Guégan
- UMR MIVEGEC, IRD, CNRS, Université de Montpellier, Centre IRD de Montpellier, Montpellier, France; UMR ASTRE, INRAE, CIRAD, Université de Montpellier, Montpellier, France.
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Miovsky M, Gavurova B, Ivankova V, Rigelsky M, Sejvl J. Fatal injuries and economic development in the population sample of Central and Eastern European Countries: the perspective of adolescents. Int J Public Health 2020; 65:1403-12. [PMID: 32766995 DOI: 10.1007/s00038-020-01449-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 07/19/2020] [Accepted: 07/21/2020] [Indexed: 12/27/2022] Open
Abstract
Objectives Researches consider the young generation (adolescents) to be the population group whose mortality from injury has the lowest effect on economic growth. The objective was to evaluate the relations between economic indicators and preventable injury mortality in Central and Eastern European Countries (CEECs), with a primary focus on adolescents. Methods The analyses included health indicators of preventable injury mortality and economic indicators that represent human development and economic growth in the CEECs from 1990 to 2016. The analytical process involved a population group divided by age (0–14 years: children, 15–24 years: adolescents, 25–74 years: adults) and gender. Descriptive analysis, cluster analysis and primarily panel regression analysis were used. Results Significant effects of economic indicators on drowning were found in all analysed relations. In the group of adolescents, significant effects of fatal falls were found. Overall, it can be concluded that the effects of fatal injuries are not homogenous between age and gender groups. Conclusions The effects of years and individual countries should be taken into account in the cross-sectional analyses. In terms of economic growth, public policies should focus on drowning in children, on falls in adolescents and on transport accidents, fire injuries and poisoning in adults.
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Abstract
This paper traces the history of the concept of metabolic disorder in global health and its application to the collection of health metrics relating to the 'epidemic' of non-communicable diseases in Southern Africa, with a focus on Malawi. Although the contemporary science of metabolism points to complexity and contingency, the application of a simplified version of 'metabolic disorder' or 'metabolic syndrome' as the supposed central driver of non-communicable disease in low- and middle-income countries runs the risk of obscuring the ways in which local circumstances and histories interact with global forces to produce epidemiological change. The paper discusses health data collection and its interpretation in Malawi to demonstrate how the use of this concept has led to a narrowing of the category of non-communicable disease and a neglect of the role of infectious disease in producing chronic conditions. Finally, the paper points to alternative approaches which might yield a better understanding of pressing health problems.
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Affiliation(s)
- Megan Vaughan
- Institute of Advanced Studies, University College London, Gower St, London WC1E 6BT, UK
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Mathew A, George PS, K M JK, Vasudevan D, James FV. Transition of cancer in populations in India. Cancer Epidemiol 2018; 58:111-120. [PMID: 30537646 DOI: 10.1016/j.canep.2018.12.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 11/29/2018] [Accepted: 12/03/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND & OBJECTIVES An assessment of transition of cancer in India during the past 30 years, according to changes in demographic and epidemiologic risk factors was undertaken. MATERIALS & METHODS Cancer registry data (http://www.ncdirindia.org), (population coverage <10%), was compared with transition in life-expectancy and prevalence on smoking, alcohol and obesity. We fitted linear regression to the natural logarithm of the estimated incidence rates of various cancer registries in India. RESULTS Burden of cancer in India increased from 0.6 million in 1991 to 1.4 million in 2015. Among males, common cancers are lung (12.0%), mouth (11.4%), prostate (7.0%), and tongue (7.0%) and among females, they are breast (21.0%), cervix-uteri (12.1%), ovary (6.9%), and lung (4.9%) in 2012. Increased life-expectancy and population growth as well as increased use of alcohol and increased prevalence of overweight/obesity reflected an increase in all cancers in both genders except a reduction in infection-related cancers such as cervix-uteri and tobacco-related cancers such as pharynx (excludes nasopharynx) and oesophagus. INTERPRETATION & CONCLUSION Transition in demographics and epidemiologic risk factors, reflected an increase in all cancers in both genders except a reduction in a few cancers. The increasing incidence of cancer and its associated factors demands a planned approach to reduce its burden. The burden assessment needs to be strengthened by increasing the population coverage of cancer registries. Continued effort for tobacco prevention and public health efforts for reducing obesity and alcohol consumption are needed to reduce the cancer burden.
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Affiliation(s)
- Aleyamma Mathew
- Divisions of Cancer Epidemiology & Biostatistics, Regional Cancer Centre, Thiruvananthapuram, Kerala, India.
| | - Preethi Sara George
- Divisions of Cancer Epidemiology & Biostatistics, Regional Cancer Centre, Thiruvananthapuram, Kerala, India
| | - Jagathnath Krishna K M
- Divisions of Cancer Epidemiology & Biostatistics, Regional Cancer Centre, Thiruvananthapuram, Kerala, India
| | - Durga Vasudevan
- Divisions of Cancer Epidemiology & Biostatistics, Regional Cancer Centre, Thiruvananthapuram, Kerala, India
| | - Francis V James
- Radiation Oncology, Regional Cancer Centre, Thiruvananthapuram, Kerala, India
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Dugas LR, Lie L, Plange-Rhule J, Bedu-Addo K, Bovet P, Lambert EV, Forrester TE, Luke A, Gilbert JA, Layden BT. Gut microbiota, short chain fatty acids, and obesity across the epidemiologic transition: the METS-Microbiome study protocol. BMC Public Health 2018; 18:978. [PMID: 30081857 PMCID: PMC6090745 DOI: 10.1186/s12889-018-5879-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 07/24/2018] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND While some of the variance observed in adiposity and weight change within populations can be accounted for by traditional risk factors, a new factor, the gut microbiota, has recently been associated with obesity. However, the causal mechanisms through which the gut microbiota and its metabolites, short chain fatty acids (SCFAs) influence obesity are unknown, as are the individual obesogenic effects of the individual SCFAs (butyrate, acetate and propionate). This study, METS-Microbiome, proposes to examine the influence of novel risk factors, the gut microbiota and SCFAs, on obesity, adiposity and weight change in an international established cohort spanning the epidemiologic transition. METHODS The parent study; Modeling the Epidemiologic Transition Study (METS) is a well-established and ongoing prospective cohort study designed to assess the association between body composition, physical activity, and relative weight, weight gain and cardiometabolic disease risk in five diverse population-based samples in 2500 people of African descent. The cohort has been prospectively followed since 2009. Annual measures of obesity risk factors, including body composition, objectively measured physical activity and dietary intake, components which vary across the spectrum of social and economic development. In our new study; METS-Microbiome, in addition to continuing yearly measures of obesity risk, we will also measure gut microbiota and stool SCFAs in all contactable participants, and follow participants for a further 3 years, thus providing one of the largest gut microbiota population-based studies to date. DISCUSSION This new study capitalizes upon an existing, extensively well described cohort of adults of African-origin, with significant variability as a result of the widespread geographic distributions, and therefore variation in the environmental covariate exposures. The METS-Microbiome study will substantially advance the understanding of the role gut microbiota and SCFAs play in the development of obesity and provide novel obesity therapeutic targets targeting SCFAs producing features of the gut microbiota. TRIAL REGISTRATION Registered NCT03378765 Date first posted: December 20, 2017.
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Affiliation(s)
- Lara R. Dugas
- Public Health Sciences, Stritch School of Medicine, Loyola University Chicago, 2160 S. 1st Avenue, Maywood, IL 60153 USA
| | - Louise Lie
- Public Health Sciences, Stritch School of Medicine, Loyola University Chicago, 2160 S. 1st Avenue, Maywood, IL 60153 USA
| | - Jacob Plange-Rhule
- Department of Physiology, SMS, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Kweku Bedu-Addo
- Department of Physiology, SMS, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Pascal Bovet
- Institute of Social & Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland
- Ministry of Health, Republic of Seychelles, Lausanne, Switzerland
| | - Estelle V. Lambert
- Research Unit for Exercise Science and Sports Medicine, University of Cape Town, Cape Town, South Africa
| | - Terrence E. Forrester
- Solutions for Developing Countries, University of the West Indies, Mona, Kingston Jamaica
| | - Amy Luke
- Public Health Sciences, Stritch School of Medicine, Loyola University Chicago, 2160 S. 1st Avenue, Maywood, IL 60153 USA
| | - Jack A. Gilbert
- Microbiome Center, Department of Surgery, University of Chicago, Chicago, IL USA
| | - Brian T. Layden
- Division of Endocrinology, Diabetes, and Metabolism, University of Illinois at Chicago, Chicago, IL USA
- Jesse Brown Veterans Affairs Medical Center, Chicago, IL USA
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Atiim GA, Elliott SJ, Clarke AE. "If we are waiting for the numbers alone, we will miss the point": a qualitative study of the perceived rise of food allergy and associated risk factors in the Greater Accra Region, Ghana. Glob Health Res Policy 2017; 2:20. [PMID: 29202088 PMCID: PMC5683356 DOI: 10.1186/s41256-017-0040-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Accepted: 05/23/2017] [Indexed: 01/22/2023] Open
Abstract
Background Globally, food allergy [FA] is considered a growing health epidemic. While much of what is known comes from developed countries, there is growing interest in the epidemiology of FA in developing regions such as sub-Saharan Africa. Indeed, researchers are beginning to document the incidence and prevalence of FA and sensitization. The results outlined in this paper stem from an exploratory qualitative study examining the emergence of the health risk of FA in Ghana, a country undergoing epidemiologic changes. Methods Between June and August, 2015, we conducted thirty-seven (37) semi-structured in-depth interviews. This comprised seventeen (17) healthcare workers across 12 public and private hospitals and twenty (20) individuals with FA and families with allergic children. All interviews were recorded and transcribed verbatim. Transcripts were analyzed to develop thematic areas that characterize perceptions and experiences around FA. Results Three key broad themes arise from this study. First, FA is an emerging health risk, whose incidence is perceived to be increasing. Second, participants expressed mixed perceptions about the public health burden of FA. Third, participants identified individual and societal factors that may be influencing FA risks and susceptibility. Conclusion Our research suggests FA is a growing but unrecognized public health concern. There is the need for health policies and researchers to consider the full extent of ongoing epidemiologic changes for the health of populations in developing regions.
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Affiliation(s)
- George A Atiim
- Department of Geography and Environmental Management, Faculty of Environment, University of Waterloo, Waterloo, Ontario Canada
| | - Susan J Elliott
- Department of Geography and Environmental Management, Faculty of Environment, University of Waterloo, Waterloo, Ontario Canada
| | - Ann E Clarke
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta Canada
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Sharrow DJ, Anderson JJ. Quantifying Intrinsic and Extrinsic Contributions to Human Longevity: Application of a Two-Process Vitality Model to the Human Mortality Database. Demography 2016; 53:2105-2119. [PMID: 27837429 DOI: 10.1007/s13524-016-0524-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The rise in human life expectancy has involved declines in intrinsic and extrinsic mortality processes associated, respectively, with senescence and environmental challenges. To better understand the factors driving this rise, we apply a two-process vitality model to data from the Human Mortality Database. Model parameters yield intrinsic and extrinsic cumulative survival curves from which we derive intrinsic and extrinsic expected life spans (ELS). Intrinsic ELS, a measure of longevity acted on by intrinsic, physiological factors, changed slowly over two centuries and then entered a second phase of increasing longevity ostensibly brought on by improvements in old-age death reduction technologies and cumulative health behaviors throughout life. The model partitions the majority of the increase in life expectancy before 1950 to increasing extrinsic ELS driven by reductions in environmental, event-based health challenges in both childhood and adulthood. In the post-1950 era, the extrinsic ELS of females appears to be converging to the intrinsic ELS, whereas the extrinsic ELS of males is approximately 20 years lower than the intrinsic ELS.
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Affiliation(s)
- David J Sharrow
- University of Washington, Box 358218, Seattle, WA, 98195-8218, USA.
| | - James J Anderson
- University of Washington, Box 358218, Seattle, WA, 98195-8218, USA
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Barquera S, Pedroza-Tobías A, Medina C, Hernández-Barrera L, Bibbins-Domingo K, Lozano R, Moran AE. Global Overview of the Epidemiology of Atherosclerotic Cardiovascular Disease. Arch Med Res 2015; 46:328-38. [PMID: 26135634 DOI: 10.1016/j.arcmed.2015.06.006] [Citation(s) in RCA: 387] [Impact Index Per Article: 43.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Accepted: 06/18/2015] [Indexed: 01/03/2023]
Abstract
Atherosclerotic cardiovascular disease (ACD) is the leading cause of mortality worldwide. The objective of this paper is to provide an overview of the global burden of ACD and its risk factors and to discuss the main challenges and opportunities for prevention. Publicly available data from the Global Burden of Disease Study were analyzed for ischemic heart disease (IHD), ischemic stroke and ACD risk factors. Data from the WHO Global Health Observatory were used to describe prevalence of diverse cardiometabolic risk factors. World Bank Gross Domestic Product per capita (GDPc) information was used to categorize countries according to income level. Cardiovascular mortality decreased globally from 1990-2010 with important differences by GDPc; during 1990 there was a positive association between IHD mortality and GDPc. Higher-income countries had higher rates compared to those of lower-income countries. High levels of body mass index (BMI), blood pressure, glucose and cholesterol have a differential contribution to mortality by income group over time; high-income countries have been able to reduce the contribution from these risk factors in the last 20 years, whereas lower/middle income countries show an increasing trend in mortality attributable to high BMI and glucose. Although age-adjusted ACD mortality rate trends decreased globally, the absolute number of ACD deaths is increasing in part due to the growth of the population and aging, as well as to important lifestyle and food-system changes that likely attenuate gains in prevention. Population and individual level preventable causes of ACD must be aggressively and efficiently targeted in countries of lower economic development in order to reduce the growing burden of disease due to ACD.
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Affiliation(s)
- Simon Barquera
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico.
| | - Andrea Pedroza-Tobías
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico
| | - Catalina Medina
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico
| | - Lucía Hernández-Barrera
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico
| | - Kirsten Bibbins-Domingo
- Division of General Medicine, University of California at San Francisco, San Francisco, California, USA
| | - Rafael Lozano
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico
| | - Andrew E Moran
- Division of General Medicine, Columbia University, Presbyterian Hospital, New York, New York, USA
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Engelaer FM, Koopman JJE, van Bodegom D, Eriksson UK, Westendorp RGJ. Determinants of epidemiologic transition in rural Africa: the role of socioeconomic status and drinking water source. Trans R Soc Trop Med Hyg 2014; 108:372-9. [PMID: 24812066 DOI: 10.1093/trstmh/tru053] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Many African countries experience a protracted epidemiologic transition, different from the classical transition in western societies. The factors driving this protracted transition are largely unknown. In northeast Ghana, we studied an ongoing epidemiologic transition and investigated the effects of socioeconomic status and drinking water source on the transition. METHODS During a 9-year period, we followed a cohort of almost 30 000 individuals and collected information on mortality and fertility rates. In addition, using the standards set out by the WHO, we obtained the causes of death by verbal autopsy. Individuals were stratified according to their socioeconomic status and the households' use of an improved or unimproved drinking water source. RESULTS Mortality rates decreased by -5.0% annually (p<0.001) and the main cause of death shifted from infectious to non-infectious diseases (p=0.014). General fertility rates and child-women ratios decreased annually by -12.7% (p<0.001) and -11.9% (p<0.001), respectively. There was no difference in the decline of mortality and fertility depending on socioeconomic status or drinking water source. CONCLUSIONS Factors other than socioeconomic status and drinking water source are responsible for the observed declines in mortality and fertility observed during the protracted epidemiologic transition. Identifying the specific determinants of the ongoing transition is of importance, as they could be targeted in order to further improve public health in rural African countries.
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Affiliation(s)
- Frouke M Engelaer
- Leyden Academy on Vitality and Ageing, Rijnsburgerweg 10, 2333 AA, Leiden, The Netherlands Department of Gerontology and Geriatrics, Leiden University Medical Center, Post Box 9600, 2300 RC, Leiden, The Netherlands
| | - Jacob J E Koopman
- Leyden Academy on Vitality and Ageing, Rijnsburgerweg 10, 2333 AA, Leiden, The Netherlands Department of Gerontology and Geriatrics, Leiden University Medical Center, Post Box 9600, 2300 RC, Leiden, The Netherlands
| | - David van Bodegom
- Leyden Academy on Vitality and Ageing, Rijnsburgerweg 10, 2333 AA, Leiden, The Netherlands Department of Gerontology and Geriatrics, Leiden University Medical Center, Post Box 9600, 2300 RC, Leiden, The Netherlands
| | - Ulrika K Eriksson
- Department of Gerontology and Geriatrics, Leiden University Medical Center, Post Box 9600, 2300 RC, Leiden, The Netherlands
| | - Rudi G J Westendorp
- Leyden Academy on Vitality and Ageing, Rijnsburgerweg 10, 2333 AA, Leiden, The Netherlands Department of Gerontology and Geriatrics, Leiden University Medical Center, Post Box 9600, 2300 RC, Leiden, The Netherlands
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Engelaer FM, van Bodegom D, Mangione JNA, Eriksson UK, Westendorp RGJ. Seasonal variation in child and old-age mortality in rural Ghana. Trans R Soc Trop Med Hyg 2014; 108:147-53. [PMID: 24473476 DOI: 10.1093/trstmh/tru007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Mortality in tropical countries varies considerably from season to season. As many of these countries have seen mortality moving from child to old-age mortality, we have studied seasonal variation in child and old-age mortality in a rural area in Ghana that currently undergoes an epidemiologic transition. METHODS In an annual survey from 2002 through to 2011, we followed 29 642 individuals and obtained the cause and month of death from 1406 deceased individuals by making use of verbal autopsies. RESULTS When comparing the seasons, we observed a trend for higher mortality during the wet season. When comparing separate months, we observed 34% more deaths than expected in September (95% CI 1.04-1.69; p = 0.024) at the end of the wet season and 43% more deaths in April (95% CI 1.13-1.80; p = 0.004) at the end of the dry season, while there were 42% less deaths than expected in December (95% CI 0.52-0.70; p = 0.003), shortly after the wet season. Cause-specific analysis indicated that the peak at the end of the wet season was due to excess mortality from infectious diseases in children and older people alike, whereas the peak in old-age mortality at the end of the dry season was due to non-infectious causes in older people only. CONCLUSIONS Taken together, our data suggest that during the epidemiologic transition, mortality not only shifts from child to old-age and from infectious to non-infectious, but also from the wet to the dry season.
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Affiliation(s)
- Frouke M Engelaer
- Leyden Academy on Vitality and Ageing, Rijnsburgerweg 10, 2333 AA Leiden, the Netherlands
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Buso DL, Longo-Mbenza B, Bovet P, van den Borne B, Okwe AN, Mzingelwa M. Deaths rates in public hospitals of eastern cape province of South Africa. Iran J Public Health 2012; 41:19-25. [PMID: 23641386 PMCID: PMC3640777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2012] [Accepted: 11/18/2012] [Indexed: 11/10/2022]
Abstract
BACKGROUND South Africa (SA) is experiencing a rapid epidemiologic transition as a consequence of political, economic and social changes. In this study we described, based on hospital data, the mortality patterns of Non communicable Diseases (NCD), Communicable Diseases (CD), the NCD/CD ratios, and the trends of deaths. METHODS We conducted a cross-sectional survey of all deaths occurring in several public hospitals in the Eastern Cape Province of SA between 2002 and 2006. Causes of deaths were coded according to the ICD 10 Edition. RESULTS A total of 107380 admissions responded to the inclusion criteria between 2002 and 2006. The crude death rate was 4.3% (n=4566) with a mean age of 46±21 years and a sex ratio of 3.1 men (n=3453): 1 woman (n=1113). Out of all deaths, there were 62.9% NCD (n=2872) vs. 37.1% CD (n=1694) with NCD/CD ratio of 1.7. The ratio NCD/CD deaths in men was 1.3 (n=1951/1502) vs. NCD/CD deaths in women of 1.9 (n=735/378). The peak of deaths was observed in winter season. The majority of NCD deaths were at age of 30-64 years, whereas the highest rate of CD deaths was at age< 30 years. The trend of deaths including the majority of NCD, increased from 2002 to 2006. There was a tendency of increase in tuberculosis deaths, but a tendency of decrease in HIV/AIDS deaths was from 2002 to 2006. CONCLUSION Non-communicable diseases are the leading causes of deaths in rural Eastern Cape province of SA facing Post-epidemiologic transition stages. We recommend overarching priority actions for the response to the Non-communicable Diseases: policy change, prevention, treatment, international cooperation, research, monitoring, accountability, and re-orientation of health systems.
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Affiliation(s)
- DL Buso
- Walter Sisulu University, Faculty of Health Sciences, Mthatha, Eastern Cap, South Africa
| | - B Longo-Mbenza
- Walter Sisulu University, Faculty of Health Sciences, Mthatha, Eastern Cap, South Africa,Corresponding Author: Tel: +27732822843
| | - P Bovet
- Institute of Social and Preventive Medicine, University of Lausanne, Switzerland
| | - B van den Borne
- Dept. of Health Promotion, Faculty of Medicine, Maastricht University, The Nederland
| | - A Nge Okwe
- Biostatistics Unit, LOMO MEDICAL Center and Heart of Africa Center of Cardiology DRC, South Africa
| | - M Mzingelwa
- Walter Sisulu University, Faculty of Health Sciences, Mthatha, Eastern Cap, South Africa
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Chen Y, McClintock TR, Segers S, Parvez F, Islam T, Ahmed A, Rakibuz-Zaman M, Hasan R, Sarwar G, Ahsan H. Prospective investigation of major dietary patterns and risk of cardiovascular mortality in Bangladesh. Int J Cardiol 2012; 167:1495-501. [PMID: 22560940 DOI: 10.1016/j.ijcard.2012.04.041] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2012] [Accepted: 04/09/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND Dietary pattern analysis is emerging as a practical, effective tool for relating comprehensive dietary intake to risk of cardiovascular disease mortality. However, no studies have applied this technique to a population outside of the developed world. METHODS We conducted prospective cohort analyses in 11,116 participants enrolled in the Health Effects of Arsenic Study in Araihazar, Bangladesh, measuring deaths attributable to disease of circulatory system, heart disease, and cerebrovascular disease. Participants were enrolled in 2000 and followed up for an average of 6.6 years. Dietary information was obtained through a previously validated food-frequency questionnaire at baseline. RESULTS Principal component analysis based on our comprehensive, 39 item FFQ yielded 3 dietary patterns: (i) a "balanced" pattern, comprised of steamed rice, red meat, fish, fruit and vegetables; (ii) an "animal protein" diet, which was more heavily weighted towards eggs, milk, red meat, poultry, bread, and vegetables; and (iii) a "gourd and root vegetable" diet that heavily relied on a variety of gourds, radishes, pumpkin, sweet potato, and spinach. We observed a positive association between increasing adherence to the animal protein diet and risk of death from both disease of the circulatory system and heart disease; the hazard ratios were 1.13 (95% CI, 1.00-1.28, p=0.05) and 1.17 (95% CI, 0.99-1.38, p=0.07), respectively, in relation to one standard deviation increase in the factor scores for the animal protein diet pattern, after controlling for age, sex, body mass index, smoking status, and energy intake. The positive association was more significant among ever smokers; the hazard ratios (95% CI) for deaths from disease of the circulatory system and heart disease were 1.17 (1.02-1.34) and 1.20 (1.00-1.45), respectively, in relation to one standard deviation increase in the factor scores for the animal protein diet pattern. CONCLUSIONS An animal protein-rich diet in rural Bangladesh may increase risk of heart disease mortality, especially among smokers. This emphasizes the need to further explore and address the impact of dietary patterns on cardiovascular disease in populations undergoing epidemiologic transition.
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Affiliation(s)
- Yu Chen
- Department of Environmental Medicine, New York University School of Medicine, New York, NY, USA.
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