Background The burden of ischemic heart disease (IHD) is high. There is limited information on the burden of IHD in identified high risk areas like Central Asia (CA) which is comprised of Armenia, Azerbaijan, Georgia, Kazakhstan, Kyrgyzstan, Turkmenistan, Mongolia, Uzbekistan and Tajikistan. This study addresses the burden of IHD in CA at the regional and country levels. Methods Using data from the latest iteration of the Global Burden of Disease Study (GBD), this study provides age-adjusted mortality, prevalence, and Disability Adjusted Life Years (DALYs) of IHD by sex in the CA region, and national levels for countries in this region from 1990 to 2017. Results The CA region has a higher IHD burden than the rest of the world over the studied period. Amongst the countries within this region, age-standardized mortality and DALY rates in Uzbekistan are the highest not only in CA but worldwide, while Armenia consistently has the lowest IHD burden in CA. Unhealthy diet, high systolic blood pressure and LDL-cholesterol are the risk factors with the highest attributable IHD DALYs. Conclusion Increasing burden of IHD over time in CA can be partially explained by the economic crisis in the 1990 s. There is considerable variation in IHD DALY rates among countries in the CA region. The reasons for such differences are likely multifactorial such as differences in risk factors distribution, health care effectiveness, political, social and economic factors.

The effective implementation of locally adapted cancer care solutions in low- and middle-income countries continues to be a challenge in the face of fragmented and inadequately resourced health systems. Consequently, the translation of global cancer care targets to local action for patients has been severely constrained. City Cancer Challenge (C/Can) is leveraging the unique value of cities as enablers in a health systems response to cancer that prioritizes the needs of end users (patients, their caregivers and families, and health care providers). C/Can’s City Engagement Process is an implementation framework whereby local stakeholders lead a staged city-wide process over a 2- to 3-year period to assess, plan, and execute locally adapted cancer care solutions. Herein, the development and implementation of the City Engagement Process Framework (CEPF) is presented, specifying the activities, outputs, processes, and indicators across the process life cycle. Lessons learned on the application of the framework in the first so-called Key Learning cities are shared, focusing on the early outputs from Cali, Colombia, the first city to join C/Can in 2017. Creating lasting change requires the creation of a high-trust environment to engage the right stakeholders as well as adapting to local context, leveraging local expertise, and fostering a sustainability mindset from the outset. In the short term, these early learnings inform the refinement of the approach in new cities. Over time, the implementation of this framework is expected to validate the proof-of-concept and contribute to a global evidence base for effective complex interventions to improve cancer care in low- and middle-income countries.

In this large cohort with gastrointestinal symptoms, only age >30 years and living in the capital were significant factors associated with infection. Lower SES, less education, and crowding did not confer an increased risk, in contrast to the findings of previous studies. Population-based studies are needed to identify potential routes and risk factors of H. pylori infection in ROG.

Elevated blood pressure (BP) is a growing burden worldwide, leading to over 10 million deaths each year. May Measurement Month (MMM) is a global initiative aimed at raising awareness of high BP and to act as a temporary solution to the lack of screening programmes worldwide. According to STEPS-Georgia, between 2010 and 2016, arterial hypertension prevalence (BP ≥140/90 mmHg or being treated) increased from 33.4% to 37.7%. According to the Health for All (HFA) (WHO data set) Database in Georgia in 2015 cardiovascular disease (CVD) mortality contributed to 42.6% of overall deaths; among them 23.3% is due to coronary heart disease (CHD), and 30% due to cerebrovascular diseases. An opportunistic screening of volunteers aged ≥18 was carried out in May 2017 (MMM17). BP measurement, the definition of hypertension and statistical analysis followed the standard MMM protocol. Screening was carried out in 50 sites at a national scale (clinics, public places). Five hundred volunteers, mostly medical personnel took part in the project. A total of 6144 individuals were screened during MMM17. After multiple imputations, 3744 (60.9%) had hypertension. Of those not on anti-hypertensive medication, 958 (28.5%) respondents were found to have hypertension, while 1862 (66.8%) individuals receiving anti-hypertensive medication, had uncontrolled BP. MMM17 was the largest BP screening campaign undertaken in Georgia. Approximately 60% of those screened had hypertension and among those who receive medication, up to 70% are treated inadequately. These results suggest that opportunistic screening can identify a significant number of people with raised BP.