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Management of NCD in Low- and Middle-Income Countries

Authors:

William Checkley,

Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, MD; Program in Global Disease Epidemiology and Control, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, US; CRONICAS Center of Excellence for Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, PE
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Hassen Ghannem,

Department of Epidemiology, Chronic Disease Prevention Research Centre, University Hospital Farhat Hached, Sousse, TN
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Vilma Irazola,

Centro de Excelencia en Salud Cardiovascular para el Cono Sur (CESCAS), Institute for Clinical Effectiveness and Health Policy (IECS), Buenos Aires, AR
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Sylvester Kimaiyo,

AMPATH, Moi University School of Medicine, Eldoret; Moi Teaching and Referral Hospital, Eldoret, KE
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Naomi S. Levitt,

Chronic Disease Initiative for Africa (CDIA), Cape Town; Division of Diabetic Medicine and Endocrinology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, ZA
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J. Jaime Miranda,

CRONICAS Center of Excellence for Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima; Department of Medicine, School of Medicine, Universidad Peruana Cayetano Heredia, Lima, PE
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Louis Niessen,

Centre for Control of Chronic Diseases (CCCD), International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, BD; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, US; Centre for Applied Health Research and Delivery, Liverpool School of Tropical Medicine, Liverpool, GB
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Dorairaj Prabhakaran,

Centre for Chronic Disease Control, New Delhi; Centre of Excellence in Cardio-Metabolic Risk Reduction in South Asia, Public Health Foundation of India, New Delhi, IN
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Cristina Rabadán-Diehl,

Office of Global Health, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD; Office of Global Affairs, U.S. Department of Health and Human Services, Washington, DC, US
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Manuel Ramirez-Zea,

INCAP Research Center for the Prevention of Chronic Diseases (CIIPEC), Institute of Nutrition of Central America and Panama (INCAP), Guatemala City, GT
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Adolfo Rubinstein,

Centro de Excelencia en Salud Cardiovascular para el Cono Sur (CESCAS), Institute for Clinical Effectiveness and Health Policy (IECS), Buenos Aires, AR
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Alben Sigamani,

St. John’s Medical College and Research Institute, Bangalore, IN
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Richard Smith ,

Chronic Disease Initiative, UnitedHealth Group, London, GB
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Nikhil Tandon,

Department of Endocrinology, All India Institute of Medical Sciences, New Delhi, IN
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Yangfeng Wu,

The George Institute for Global Health at Peking University Health Science Center, Beijing; Peking University School of Public Health and Clinical Research Institute, Beijing, CN
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Denis Xavier,

St. John’s Medical College and Research Institute, Bangalore, IN
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Lijing L. Yan,

The George Institute for Global Health at Peking University Health Science Center, Beijing; Duke Global Health Institute and Global Heath Research Center, Duke Kunshan University, Kunshan, CN
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GRAND South Network, UnitedHealth Group/ National Heart, Lung, and Blood Institute Centers of Excellence

Abstract

Noncommunicable disease (NCD), comprising cardiovascular disease, stroke, diabetes, and chronic obstructive pulmonary disease, are increasing in incidence rapidly in low- and middle-income countries (LMICs). Some patients have access to the same treatments available in high-income countries, but most do not, and different strategies are needed. Most research on noncommunicable diseases has been conducted in high-income countries, but the need for research in LMICs has been recognized. LMICs can learn from high-income countries, but they need to devise their own systems that emphasize primary care, the use of community health workers, and sometimes the use of mobile technology. The World Health Organization has identified ‘best buys’ it advocates as interventions in LMICs. Non-laboratory-based risk scores can be used to identify those at high risk. Targeting interventions to those at high risk for developing diabetes has been shown to work in LMICs. Indoor cooking with biomass fuels is an important cause of chronic obstructive pulmonary disease in LMICs, and improved cookstoves with chimneys may be effective in the prevention of chronic diseases.

Highlights

  • Noncommunicable diseases are increasing in prevalence in LMICs.
  • The WHO has identified “best buys” it advocates as interventions in LMICs.
  • Non-laboratory-based risk scores can be a useful tool.
  • There is a need to identify and target those at high risk for developing diabetes in LMICs.
  • Cookstoves with chimneys can be effective in COPD prevention.
How to Cite: Checkley W, Ghannem H, Irazola V, Kimaiyo S, Levitt NS, Miranda JJ, et al.. Management of NCD in Low- and Middle-Income Countries. Global Heart. 2014;9(4):431–43. DOI: http://doi.org/10.1016/j.gheart.2014.11.003
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Published on 01 Dec 2014.
Peer Reviewed

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