Action to address the household economic burden of non-communicable diseases

Jan, Stephen; Laba, Tracey‐Lea; Essue, Beverley M; Gheorghe, Adrian; Muhunthan, Janani; Engelgau, Michael M.; Mahal, Ajay; Griffiths, Ulla K.; McIntyre, Di; Meng, Qingyue; Nugent, Rachel; Atun, Rifat

doi:10.1016/s0140-6736(18)30323-4

Cited by 193 publications

(169 citation statements)

References 99 publications

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“…However, there is a dearth of similar research from lowand-middle income countries, and on potential differences in the association between dietary behaviours and disease outcomes by sex. Given the Sustainable Development Goals (SDG) of achieving good health and wellbeing (SDG 3) and gender equality (SDG 5) [26], it is important to investigate sex differences in dietary behaviours and any relationship with health outcomes in a global setting to inform nutrition interventions and thereby reduce the burden of CVD and its adverse financial consequences [27].…”

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confidence: 99%

Evaluation of sex differences in dietary behaviours and their relationship with cardiovascular risk factors: a cross-sectional study of nationally representative surveys in seven low- and middle-income countries

McKenzie

Santos

Geldsetzer

et al. 2020

Nutr J

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Background: Cardiovascular diseases (CVD) are the leading causes of death for men and women in low-andmiddle income countries (LMIC). The nutrition transition to diets high in salt, fat and sugar and low in fruit and vegetables, in parallel with increasing prevalence of diet-related CVD risk factors in LMICs, identifies the need for urgent action to reverse this trend. To aid identification of the most effective interventions it is crucial to understand whether there are sex differences in dietary behaviours related to CVD risk.Methods: From a dataset of 46 nationally representative surveys, we included data from seven countries that had recorded the same dietary behaviour measurements in adults; Bhutan, Eswatini, Georgia, Guyana, Kenya, Nepal and St Vincent and the Grenadines (2013)(2014)(2015)(2016)(2017). Three dietary behaviours were investigated: positive salt use behaviour (SUB), meeting fruit and vegetable (F&V) recommendations and use of vegetable oil rather than animal fats in cooking. Generalized linear models were used to investigate the association between dietary behaviours and waist circumference (WC) and undiagnosed and diagnosed hypertension and diabetes. Interaction terms between sex and dietary behaviour were added to test for sex differences. Results: Twenty-four thousand three hundred thirty-two participants were included. More females than males reported positive SUB (31.3 vs. 27.2% p-value < 0.001), yet less met F&V recommendations (13.2 vs. 14.8%, p-value< 0.05). The prevalence of reporting all three dietary behaviours in a positive manner was 2.7%, varying by country, but not sex. Poor SUB was associated with a higher prevalence of undiagnosed hypertension for females (13.1% vs. 9.9%, p-value = 0.04), and a higher prevalence of undiagnosed diabetes for males (2.4% vs. 1.5%, p-value = 0.02). Meeting F&V recommendations was associated with a higher prevalence of high WC (24.4% vs 22.6%, p-value = 0.01), but was not associated with undiagnosed or diagnosed hypertension or diabetes.

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confidence: 99%

Evaluation of sex differences in dietary behaviours and their relationship with cardiovascular risk factors: a cross-sectional study of nationally representative surveys in seven low- and middle-income countries

McKenzie

Santos

Geldsetzer

et al. 2020

Nutr J

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“…It has been reported that lncRNA could participate in the initiating and the progress of diseases by interfering with transcription, translation, epigenetic inheritance and some basic process of cell life activities [3]. Previous researches have demonstrated that lncRNAs play a significant role in various types of tumour [4][5][6][7], especially in lung adenocarcinoma [8][9][10]. For example, White and his colleagues characterized the lncRNA landscape in lung cancer and discovered 111 differentially expressed lncRNAs, which were termed as lung cancer-associated lncRNAs (LCALs).…”

Section: Introductionmentioning

confidence: 99%

The long noncoding RNA linc00858 promotes progress of lung cancer through miR-3182/MMP2 axis

Xue

Shi

et al. 2019

Artificial Cells, Nanomedicine, and Biotechnology

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In previous studies, numerous dysregulated lncRNAs were identified using RNA-sequencing. Lung cancer is the most common malignant tumour worldwide and the second leading cause in cancer. The aim of this study is to investigate the function and mechanism of lincRNA00858 in the lung cancer. RT-PCR was used to detect the expression of lincRNA00858. Proliferation, invasion, and epithelial-mesenchymal transition (EMT) were examined by CCK8, transwell assay and western blot to evaluate the function of linc00858. Dual-luciferase reporter assay was used to identified the potential target of linc00858. Overexpression of linc00858 significantly promoted cell proliferation, invasion. We also found that linc00858 facilitated the EMT process. Dual-luciferase reporter assay revealed that linc00858 can bind with miR-3182 directly. Linc00858 can negatively regulate the expression of miR-3182. Further experiments demonstrated that MMP2 was the direct target of miR-3182. Rescue experiments revealed that linc00858 functioned through miR-3182/MMP2 axis. Taken together, we verified the role of an unknown linc00858 in lung cancer and provided its mechanism. Mechanistically, linc00858 acted as a competitive endogenous RNA to sponged miR-3182 and regulate MMP2 in lung cancer. Our study provided new clues for understanding the mechanism of lung cancer.

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“…In a recent report, the Nepal Noncommunicable Diseases and Injuries Poverty Commission reported that NCDs and injuries account for 33% of out-of-pocket healthcare expenditure by Nepalese patients [27]. Catastrophic healthcare expenses for secondary CVD treatment and the resulting impoverishing effect have already been noted in many low-and middle-income countries including Nepal [28]. Given this relationship, the Lancet Taskforce on NCDs and Economics recommends removing financial barriers to the poor to improve healthcare systems financing [28].…”

Section: Discussionmentioning

confidence: 99%

Estimated cost for cardiovascular disease risk-based management at a primary healthcare center in Nepal

Aryal¹,

Citrin

Halliday

et al. 2020

glob health res policy

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Background: Low-and middle-income countries are facing an increasing burden of disability and death due to cardiovascular diseases. Policy makers and healthcare providers alike need resource estimation tools to improve healthcare delivery and to strengthen healthcare systems to address this burden. We estimated the direct medical costs of primary prevention, screening, and management for cardiovascular diseases in a primary healthcare center in Nepal based on the Global Hearts evidence based treatment protocols for risk-based management. Methods: We adapted the World Health Organization's non-communicable disease costing tool and built a model to predict the annual cost of primary CVD prevention, screening, and management at a primary healthcare center level. We used a one-year time horizon and estimated the cost from the Nepal government's perspective. We used Nepal health insurance board's price for medicines and laboratory tests, and used Nepal government's salary for human resource cost. With the model, we estimated annual incremental cost per case, cost for the entire population, and cost per capita. We also estimated the amount of medicines for one-year, annual number of laboratory tests, and the monthly incremental work load of physicians and nurses who deliver these services. Results: For a primary healthcare center with a catchment population of 10,000, the estimated cost to screen and treat 50% of eligible patients is USD21.53 per case and averages USD1.86 per capita across the catchment population. The cost of screening and risk profiling only was estimated to be USD2.49 per case. At same coverage level, we estimated that an average physician's workload will increase annually by 190 h and by 111 h for nurses, i.e., additional 28.5 workdays for physicians and 16.7 workdays for nurses. The total annual cost could amount up to USD18,621 for such a primary healthcare center. Conclusion: This is a novel study for a PHC-based, primary CVD risk-based management program in Nepal, which can provide insights for programmatic and policy planners at the Nepalese municipal, provincial and central levels in implementing the WHO Global Hearts Initiative. The costing model can serve as a tool for financial resource planning for primary prevention, screening, and management for cardiovascular diseases in other low-and middleincome country settings globally.

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Action to address the household economic burden of non-communicable diseases

Cited by 193 publications

References 99 publications

Evaluation of sex differences in dietary behaviours and their relationship with cardiovascular risk factors: a cross-sectional study of nationally representative surveys in seven low- and middle-income countries

Evaluation of sex differences in dietary behaviours and their relationship with cardiovascular risk factors: a cross-sectional study of nationally representative surveys in seven low- and middle-income countries

The long noncoding RNA linc00858 promotes progress of lung cancer through miR-3182/MMP2 axis

Estimated cost for cardiovascular disease risk-based management at a primary healthcare center in Nepal

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