Biomedical subjects

Ivor Katz

Publications and source records attributed to Ivor Katz.

3 recordsLinked to original sources

PubMed2005

Kidney and kidney related chronic diseases in South Africa and chronic disease intervention program experiences.

The burden of chronic kidney disease (CKD) is rising in the world and the greatest burden is likely in developing countries such as South Africa (SA). This burden is related to the increase of 130% in noncommunicable diseases (NCD) such as diabetes and hypertension. SA has an additional burden of human immunodeficiency virus (HIV), which has infected 19.9% of adults and contributes to 30% of deaths. NCDs remain the major causes of death (37%). Hypertension is considered as a cause of end-stage renal disease (ESRD) in 34.6% of Blacks, 4.3% Whites, 20.9% of mixed race people, and 13.9% of Indians. Diabetes is believed to occur in 10% to 16% of South Africans. These risk factors, together with a high HIV/CKD burden (8%), result in a large burden of CKD. Other nontraditional risk factors, such as low birth weight, must also be considered. Despite rates of ESRD suspected to be about 400 per million population (pmp), only 99 pmp receive renal replacement therapy (RRT). Novel methods have to be established in the developing world to tackle the NCD and communicable disease burden. This article investigates the option of an integrated approach to chronic diseases as an answer to some of this burden. Both an urban-based and a rural-based NCD prevention and treatment program are reviewed.

Humans↗

PubMed2005

International aid and medical practice in the less-developed world: doing it right, what can renal organizations learn?

The delivery of health care in poorer countries is reliant on international aid organizations. This article will focus on international aid and medical practice in the developing world. It will review the general issues, practices, and problems with international aid in the medical arena and will then focus on international aid, kidney detection, and prevention programs. The article will analyze some of the existing and successful organizations and their initiatives. The first part of this article will analyze such aspects as: the access of existing resources and available aid projects; the establishment of contact with international aid projects; the access of funds for the development of the project and, once it is established, the management of those funds; the planning of projects; and the role of research in international aid and medical practice both as a means of accessing resources and of managing the project. The second part of the article will look more specifically at issues in nephrology and international aid. The focus will be on current programs in nephrology and the critical appraisal of some existing programs. The last part will focus specifically on practical tasks which are needed when accessing international aid for medical projects. It will draw on the experiences of various programs and then outline suggested phases one should consider when establishing aid projects in order to best implement them. Kidney groups with intentions to deliver prevention and management strategies to developing countries need to learn from the experiences of existing international aid organizations and chronic kidney disease programs.

Australia↗

PubMed2005

A chronic disease outreach program for Aboriginal communities.

BACKGROUND: Our objective is to describe a program to improve awareness and management of hypertension, renal disease, and diabetes in 3 remote Australian Aboriginal communities. METHODS: The program espouses that regular integrated checks for chronic disease and their risk factors are essential elements of regular adult health care. Programs should be run by local health workers, following algorithms for testing and treatment, with backup, usually from a distance, from nurse coordinators. Constant evaluation is essential to develop community health profiles and adapt program structure. RESULTS: Participation ranged from 65% to 100% of adults. Forty-one percent of women and 72% of men were current smokers. Body weight varied markedly by community. Although excessive in all, rates of chronic diseases also differed markedly among communities. Rates increased with age, but the greatest numbers of people with morbidities were middle age and young adults. Multiple morbidities were common by middle age. Hypertension and renal disease were early features, whereas diabetes was a variable and later manifestation of this integrated chronic disease syndrome. Adherence to testing and treatment protocols improved markedly over time. Substantial numbers of new diagnoses were made. Blood pressure improved in people in whom antihypertensive agents were started or increased. Components of a systematic activity plan became more clearly defined with time. Treatment of people in the community with the greatest disease burden posed a large additional workload. Lack of health workers and absenteeism were major impediments to productivity. CONCLUSION: We cannot generalize about body habitus, and chronic disease rates among Aboriginal adults. Pilot data are needed to plan resources based on the chronic disease burden in each community. Systematic screening is useful in identifying high-risk individuals, most at an early treatable stage. Community-based health profiles provide critical information for the development of rational health policy and needs-based health services.

Adult↗