Differences in healthy longevity by HIV status and viral load among older South African adults: an observational cohort modelling study

Payne, Collin F.; Houle, Brian; Chinogurei, Chido; Herl, Carlos Riumallo; Kabudula, Chodziwadziwa Whiteson; Kobayashi, Lindsay C.; Salomon, Joshua A.; Manne‐Goehler, Jennifer

doi:10.1016/s2666-7568(22)00062-9

Cited by 3 publications

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“…Similarly, SDG 3 constitutes a specific target for NCDs (SDG 3.4) that anticipates reducing by 2030 one-third of premature mortality from NCDs, with target 3.4.1 focusing specifically on reducing the mortality rate attributed to diabetes mellitus, cardiovascular disease, respiratory diseases, and malignant neoplasms that account for 80% of all premature NCD deaths. In the last two decades, substantial global and domestic investments have been made to prevent and manage these diseases, including a range of options for antiretroviral treatment (ART) that helped people with HIV (PWH) live longer with the disease [1][2][3][4] . In contrast, the implications of longevity with IDs and their predisposition to chronic NCDs are underexplored and considerably neglected [5][6][7] .…”

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confidence: 99%

Mapping digital health ecosystems in Africa in the context of endemic infectious and non-communicable diseases

et al. 2023

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Investments in digital health technologies such as artificial intelligence, wearable devices, and telemedicine may support Africa achieve United Nations (UN) Sustainable Development Goal for Health by 2030. We aimed to characterize and map digital health ecosystems of all 54 countries in Africa in the context of endemic infectious and non-communicable diseases (ID and NCD). We performed a cross-national ecological analysis of digital health ecosystems using 20-year data from the World Bank, UN Economic Commission for Africa, World Health Organization, and Joint UN Programme on HIV/AIDS. Spearman’s rank correlation coefficients were used to characterize ecological correlations between exposure (technology characteristics) and outcome (IDs and NCDs incidence/mortality) variables. Weighted linear combination model was used as the decision rule, combining disease burden, technology access, and economy, to explain, rank, and map digital health ecosystems of a given country. The perspective of our analysis was to support government decision-making. The 20-year trend showed that technology characteristics have been steadily growing in Africa, including internet access, mobile cellular and fixed broadband subscriptions, high-technology manufacturing, GDP per capita, and adult literacy, while many countries have been overwhelmed by a double burden of IDs and NCDs. Inverse correlations exist between technology characteristics and ID burdens, such as fixed broadband subscription and incidence of tuberculosis and malaria, or GDP per capita and incidence of tuberculosis and malaria. Based on our models, countries that should prioritize digital health investments were South Africa, Nigeria, and Tanzania for HIV; Nigeria, South Africa, and Democratic Republic of the Congo (DROC) for tuberculosis; DROC, Nigeria, and Uganda for malaria; and Egypt, Nigeria, and Ethiopia for endemic NCDs including diabetes, cardiovascular disease, respiratory diseases, and malignancies. Countries such as Kenya, Ethiopia, Zambia, Zimbabwe, Angola, and Mozambique were also highly affected by endemic IDs. By mapping digital health ecosystems in Africa, this study provides strategic guidance about where governments should prioritize digital health technology investments that require preliminary analysis of country-specific contexts to bring about sustainable health and economic returns. Building digital infrastructure should be a key part of economic development programs in countries with high disease burdens to ensure more equitable health outcomes. Though infrastructure developments alongside digital health technologies are the responsibility of governments, global health initiatives can cultivate digital health interventions substantially by bridging knowledge and investment gaps, both through technology transfer for local production and negotiation of prices for large-scale deployment of the most impactful digital health technologies.

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Section: Introductionmentioning

confidence: 99%

Mapping digital health ecosystems in Africa in the context of endemic infectious and non-communicable diseases

et al. 2023

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Impact of diabetes on longevity and disability-free life expectancy among older South African adults: A prospective longitudinal analysis

Payne

Liwin

Wade

et al. 2023

Diabetes Research and Clinical Practice

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Impact of diabetes on longevity and disability-free life expectancy among older South African adults: a prospective longitudinal analysis

Payne

Liwin

Wade

et al. 2022

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ObjectiveWe seek to understand the coexisting effects of population aging and a rising burden of diabetes on healthy longevity in South Africa.Research Design and MethodsWe used longitudinal data from the 2015 and 2018 waves of the “Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa” (HAALSI) study to explore life expectancy (LE) and disability-free life expectancy (DFLE) of adults aged 45 and older with and without diabetes in rural South Africa. We estimated LE and DFLE by diabetes status using Markov-based microsimulation.ResultsWe find a clear gradient in remaining LE and DFLE based on diabetes status. At age 45, a man without diabetes could expect to live 7.4 [95% CI 3.4 – 11.7] more years than a man with diabetes, and a woman without diabetes could expect to live 3.9 [95% CI: 0.8 – 6.9] more years than a woman with diabetes. Individuals with diabetes lived proportionately more years subject to disability than individuals without diabetes. Additional analyses separating individuals with diabetes based on whether they knew their disease status found that individuals with diabetes diagnosed by a healthcare worker had shorter remaining LE than those who were unaware of their status or those without diabetes.ConclusionsOur findings highlight the large and important decrements in healthy, disability-free aging for people with diabetes in South Africa. This finding should motivate efforts to strengthen prevention and treatment efforts for diabetes and its complications for older adults in this setting.

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Differences in healthy longevity by HIV status and viral load among older South African adults: an observational cohort modelling study

Cited by 3 publications

References 0 publications

Mapping digital health ecosystems in Africa in the context of endemic infectious and non-communicable diseases

Mapping digital health ecosystems in Africa in the context of endemic infectious and non-communicable diseases

Impact of diabetes on longevity and disability-free life expectancy among older South African adults: A prospective longitudinal analysis

Impact of diabetes on longevity and disability-free life expectancy among older South African adults: a prospective longitudinal analysis

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