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PubMedDate not supplied

Poverty is a predictor of non-communicable disease among adults in Peruvian cities.

BACKGROUND: Rapid health and nutrition transitional changes are resulting in greater prominence of non-communicable disease (NCD) in Latin America, particularly among the poor. OBJECTIVE: The study aims to examine the extent to which NCD pxfsrevails in Peru and the socioeconomic status (SES) as a risk factor. DESIGN: Between 1998 and 2000, health surveys and clinical assessments were completed on 2337 adults in six cities, 18 to 60 years of age. Stratified by social class, multi-staged random sampling was used. Anthropometric data, blood pressure and serum samples were collected. RESULTS: Adjusting for age, hypertension, low HDL cholesterol, high total cholesterol and diabetes was found in 47%, 40%, 21% and 17% of women and in 44%, 38%, 27% and 19% of men, respectively. Over one quarter of the population exhibited multiple risk factors, not including overweight and obesity. Across all study sites, lowest SES revealed highest burden of NCD and appeared as an independent risk factor for associated NCD indicators. CONCLUSION: The high prevalence of NCD in urban areas of Peru is not only associated with excess body weight, but also with poverty itself. The greater burden of NCD in the poorest areas of society requires a better understanding of causal determinants and may have implications in terms of public health policies and interventions.

Adolescent↗
PubMed1997

Four years of practice-based and exercise-supported behavioural medicine in one community of the German CINDI area. Countrywide Integrated Non-Communicable Diseases Intervention.

The main goal of the preventive intervention study in one community of the German CINDI (Countrywide Integrated Non-Communicable Diseases Intervention programme of the WHO) area was to improve cardiovascular health by reducing the risk factors smoking, hypertension, obesity, hypercholesterolaemia, and by changing sedentary lifestyle. The intervention was performed by using the special "Three-Level-Strategy", which is characterised by activities of primary care physicians in the usual consulting hour (1st level), with patient groups in their practices (2nd level), and at community level (3rd level) where a special work group and a co-ordinating general practice are co-operating. To evaluate the occurrence of the risk factors in practice and the local population, four cross-sectional random samples (N(total) = 4881) were carried out in seven practices from 1992 to 1995. On the community level, 23 special exercise-based health groups (N(total) = 600) were established and were investigated by means of a questionnaire, related to behaviour and health beliefs. A "Local Health Information System" facilitated the evaluation, the management of the data, and the organisation of the health programme. The results of the practice samples showed a significant reduction of smoking (-17.8%) and hypertension (-31.5%) (p < 0.01). The exercise-based groups were combined with nutritional counselling or relaxation and were accepted very well by the participants (83.8%). The participants considerably improved their health behaviour: 82% discussed health in their family, 37.3% stated an increase of healthy nutrition, 52% of relaxation; 86.2% intended to regularly increase physical activity in leisure time and 82 % could not imagine regular health training without exercise meetings. We conclude that the practice-based "Three-Level-Strategy" provides a strong support for successful long-term prevention of cardiovascular risk, particularly, when exercise-based health training sessions are performed in order to change sedentary lifestyle. When organised on community level, they might have a positive impact on the health behaviour of the whole community. Physical activity can be used as a "prodrug" for health promotion in a holistic way.

Adult↗
PubMed1987

Communicable disease epidemiology following migration: studies from the African famine.

Few epidemiological studies have been undertaken of morbidity and mortality due to communicable disease in mass migration. This article reviews data from refugee displacement areas in north-east Africa. Risk factors to increase morbidity and mortality include 1) breakdown of health services, 2) movement to new ecological zones, 3) malnutrition, and 4) crowding and poor sanitation in relief camps. Highest mortalities are recorded in children under 5 years old, principal causes being measles, gastro-enteritis, chest infections, and malaria. The greatest morbidity and mortality occurs after arrival in relief camps, and could be reduced by epidemiologically based, selective health programs. This article stresses the importance of regional level coordination between relief agencies and the need for an effective disease surveillance system.

Africa↗
PubMed2002

Prevention and control of non-communicable diseases in Singapore: a review of national health promotion programmes.

The epidemiological transition in Singapore from infectious to chronic, non-communicable diseases created different challenges for our public health system. The population-based strategy is adopted in primary prevention, through the promotion of a healthy lifestyle--smoking cessation, physical activity, eating right and managing stress. Complementing this are measures to detect chronic conditions early through screening and optimal treatment of the disease. While improvements were seen in the common risk factors of smoking and physical inactivity, prevalence of measurable risk factors like hypertension increased between 1992 and 1998. In 2000, the Ministry of Health initiated a series of national disease management plans for major disease conditions affecting Singaporeans. This approach uses a comprehensive and systematic approach to integrate the various components, with identification of responsible parties to ensure successful implementation of initiatives. Chronic diseases will remain prevalent as our society rapidly ages. Close monitoring of our initiatives in disease management will provide information on the long-term efficacy of such strategies.

Chronic Disease↗
PubMed1998

[Surveillance of communicable diseases in the European Union].

Important developments are taking place in the Public Health framework in the European Union (EU). A number of international surveillance networks have been developed between the countries of the EU. The European Commission has initiated horizontal and disease specific programmes in the field of infectious disease surveillance. These have stimulated European co-operation for prevention and control of infectious diseases. Much topical information can be found on several Internet pages. The challenge is to set up networks for all public health relevant infectious diseases.

Communicable Disease Control↗
PubMed2004

A model for non-communicable disease surveillance in Canada: the prairie pilot diabetes surveillance system.

The Prairie Pilot Diabetes Surveillance Project was organized to design and test a prototype population-based surveillance system, using administrative data, for a chronic disease exemplar - diabetes mellitus. The Canadian model of a public health surveillance system for chronic conditions described here specifies a process by which administrative and claims data arising from provincial health insurance programs are merged into an annual person-level summary file (APLSF), yielding one summary record for each person insured within each province. The APLSF is the basis for a variety of estimates, including incidence, prevalence, mortality, complication rates and health services utilization. The model was used to produce comparable interprovincial estimates of several parameters with respect to diabetes for the entire population in the provinces of Alberta, Manitoba and Saskatchewan. All processing of identifiable health data occurred within the provinces where the data were generated. Combining results across provinces was based on further aggregation of the summary data from each province and not by pooling of identifiable person-level data. On the basis of preliminary outputs for diabetes mellitus, the model appears to provide coherent estimates of key diabetes parameters and reflects anticipated differences in health services and outcomes, by disease state. Three characteristics of the model recommend it as a resource for non-communicable disease surveillance in Canada: a) it maximizes the utility of existing data; b) it includes both those with and those without the disease in question; and c) it respects provincial legislation regarding personal health data, yet permits reporting of multi-provincial, population-based data.

Adolescent↗
PubMed2006

Economic evaluations of non-communicable disease interventions in developing countries: a critical review of the evidence base.

BACKGROUND: Demographic projections suggest a major increase in non-communicable disease (NCD) mortality over the next two decades in developing countries. In a climate of scarce resources, policy-makers need to know which interventions represent value for money. The prohibitive cost of performing multiple economic evaluations has generated interest in transferring the results of studies from one setting to another. This paper aims to bridge the gap in the current literature by critically evaluating the available published data on economic evaluations of NCD interventions in developing countries. METHODS: We identified and reviewed the methodological quality of 32 economic evaluations of NCD interventions in developing countries. Developing countries were defined according to the World Bank classification for low- and lower middle-income countries. We defined NCDs as the 12 categories listed in the 1993 World Bank report Investing in Health. English language literature was searched for the period January 1984 and January 2003 inclusive in Medline, Science Citation Index, HealthStar, NHS Economic Evaluation Database and Embase using medical subheading terms and free text searches. We then assessed the quality of studies according to a set of pre-defined technical criteria. RESULTS: We found that the quality of studies was poor and resource allocation decisions made by local and global policy-makers on the basis of this evidence could be misleading. Furthermore we have identified some clear gaps in the literature, particularly around injuries and strategies for tackling the consequences of the emerging tobacco epidemic. CONCLUSION: In the face of poor evidence the role of so-called generalised cost-effectiveness analyses has an important role to play in aiding public health decision-making at the global level. Further research is needed to investigates the causes of variation among cost, effects and cost-effectiveness data within and between settings. Such analyses still need to take a broad view, present data in a transparent manner and take account of local constraints.

Journal Article↗
PubMed2004

[Multiple causes of death due to non-communicable diseases: a multidimensional analysis].

This study approaches multiple causes of death to analyze the associations between causes of death from non-communicable diseases, age, and gender in 3,106 death certificates issued in 1998, comprising individuals who were 20 years old or over and resided in Belo Horizonte, Minas Gerais State, Brazil. The multiple cause of death approach, by considering all the diagnoses mentioned in the death certificate, highlights conditions that are underestimated by the underlying-cause approach that has traditionally been used in mortality statistics. Association of causes of death was analyzed using the multidimensional data analysis method with the multiple correspondence factor analysis technique. The results reinforce the usefulness of the multiple causes approach to improve information on mortality and demonstrate important associations, such as hypertension and cerebrovascular diseases, obesity and diabetes or ischemic heart diseases, allowing to plan, prioritize, and reevaluate health actions.

Adult↗