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At least 19 recordsLinked to original sources
PubMed2005

Current concepts in screening for noncommunicable disease: World Health Organization Consultation Group Report on methodology of noncommunicable disease screening.

Screening people for serious diseases is receiving increasing attention as studies demonstrates the potential benefits of early detection and early intervention in preventing morbidity and mortality. Screening tests are available for some of the most important noncommunicable diseases, including cardiovascular disease, type 2 diabetes and several site-specific cancers. However, screening guidelines for cardiovascular disease, cancers and diabetes vary within and between countries because many national and international organizations are developing their own guidelines. There is a need to address the issue of screening for disease, with an emphasis on providing accurate and practical information relevant to all countries. This report arose from a Consultation Group meeting held at WHO headquarters in Geneva. It presents an examination of the principles of screening with an emphasis on noncommunicable disease prevention and control policy.

Humans↗
PubMed1988

Glucose intolerance as contributor to noncommunicable disease morbidity and mortality. WHO integrated program for community health in noncommunicable diseases.

The World Health Organization (WHO) has considerable evidence that several interrelated factors (e.g., smoking, hypertension, cholesterol, and obesity) contribute to total mortality. Data are presented documenting that glucose intolerance is also a risk factor for total mortality, as well as for cancer and cardiovascular morality. The Kaunas-Rotterdam Intervention Study, which documented glucose tolerance and mortality in a cohort of men, shows a linear increase in total mortality with increasing blood glucose levels. By use of multiple logistic regressions, glucose was shown to be a significant risk factor (c = .2534, t = 4.0) for total mortality. A paradigm is presented in which diabetes is placed as a disease and glucose intolerance as a risk factor within the total scheme for the development of noncommunicable diseases. The WHO action plan for integrated programs in noncommunicable diseases is discussed. The program expands on the experience gained by WHO investigators in community programs and proposes a cooperative effort globally in community-based programming.

Blood Glucose↗
PubMed1991

Demonstration projects for the integrated prevention and control of noncommunicable diseases (INTERHEALTH programme): epidemiological background and rationale. INTERHEALTH Sterring Committee.

Noncommunicable diseases--cardiovascular and cerebrovascular disease, pulmonary diseases, liver disease, cancer, diabetes, osteoporosis and trauma--constitute the major cause of death in developed countries and are predictably emerging as significant threats to health in countries at intermediate stages of the epidemiological transition. Based on the philosophy that diseases with common risk factors (inadequate prevention/control services, smoking, fat/salt diet, alcohol use, etc.) require common preventive strategies, the INTERHEALTH demonstration projects are designed to build regional capacities and to exchange social and medical technologies for broad-gauged noncommunicable disease prevention and control. Projects are at various stages of planning and implementation in all WHO regions: Africa (Mauritius, United Republic of Tanzania); the Americas (Chile, Cuba, United States); Eastern Mediterranean (Cyprus); Europe (Finland, Malta, USSR); South-East Asia (Sri Lanka, Thailand); the Western Pacific (Australia, China, Fiji, Japan). This article presents selected data which illustrate the long-term mortality trends and present noncommunicable disease risk-factor levels in participating countries at different stages of the epidemiological transition. The shift towards noncommunicable diseases as a cause of death is readily apparent and combinations of risk factors are present in each of the populations studied in the baseline phase of this research and demonstration programme. The use of data to estimate the noncommunicable disease-related mortality burden from different lifestyles and risk factors is illustrated and findings from the most advanced demonstration studies are briefly outlined.

Global Health↗
PubMed2006

Prevalence of noncommunicable diseases in Zimbabwe: results from analysis of data from the National Central Registry and Urban Survey.

The disease burden from noncommunicable diseases (NCDs) in Africa is rapidly increasing based on projections from a limited number of reports. In the absence of national health surveys in Zimbabwe, all data nationally generated between 1990 and 1997 were analyzed. From 1990 to 1997, prevalence rates (expressed per 100,000 people) of hypertension increased from 1000 to 4000, rates of diabetes increased from 150 to 550, and rates of cerebrovascular accidents (CVA) increased from 5 to 15. The case fatality rate (CFR) for CVA decreased substantially during the period of study, implying improved case management of the disease, while the CFR for most other diseases did not change significantly throughout the study period. The observation of increased prevalence of some NCDs during the study period was corroborated by findings from a blood pressure survey subsequently conducted in an urban environment of Zimbabwe, which revealed a hypertension (blood pressure > or =140/90 mm Hg) prevalence of 35% in women and 24% in men. In spite of the limitations of the centrally generated hospital-based data, its analysis is still valuable. Countries are therefore encouraged to utilize this easily accessible resource for policy formulation and resource mobilization.

Cardiovascular Diseases↗
PubMed2001

Noncommunicable diseases in sub-Saharan Africa: where do they feature in the health research agenda?

There is no doubt that communicable diseases will remain the predominant health problem for the populations in sub-Saharan Africa, including adults, for the next 10-20 years. Concern has been expressed that the available resources to deal with this problem would be reduced by increasing the emphasis on noncommunicable diseases. The latter, however, already present a substantial burden because their overall age-specific rates are currently higher in adults in sub-Saharan Africa than in populations in Established Market Economies. There is also evidence that the prevalence of certain noncommunicable diseases, such as diabetes and hypertension, is increasing rapidly, particularly in the urban areas, and that significant demands are being made on the health services by patients with these diseases. To ignore the noncommunicable diseases would inevitably lead to an increase in their burden; the provision of health services for them would be largely undirected by issues of clinical and cost effectiveness, and their treatment and prevention would be left to the mercy of local and global commercial interests. Improved surveillance of all diseases within sub-Saharan Africa is needed in order to place noncommunicable diseases properly within the context of the overall burden of disease. Research is needed to guide improvements in the clinical and cost effectiveness of resources currently committed to the care of patients with noncommunicable diseases, and to direct and evaluate preventive measures.

Adult↗
PubMed2001

Trends in diet, nutritional status, and diet-related noncommunicable diseases in China and India: the economic costs of the nutrition transition.

Undernutrition is being rapidly reduced in India and China. In both countries the diet is shifting toward higher fat and lower carbohydrate content. Distinct features are high intakes of foods from animal sources and edible oils in China, and high intakes of dairy and added sugar in India. The proportion of overweight is increasing very rapidly in China among all adults; in India the shift is most pronounced among urban residents and high-income rural residents. Hypertension and stroke are relatively higher in China and adult-onset diabetes is relatively higher in India. Established economic techniques were used to measure and project the costs of undernutrition and diet-related noncommunicable diseases in 1995 and 2025. Current WHO mortality projections of diet-related noncommunicable diseases, dietary and body composition survey data, and national data sets of hospital costs for healthcare, are used for the economic analyses. In 1995, China's costs of undernutrition and costs of diet-related noncommunicable diseases were of similar magnitude, but there will be a rapid increase in the costs and prevalence of diet-related noncommunicable diseases by 2025. By contrast with China, India's costs of undernutrition will continue to decline, but undernutrition costs did surpass overnutrition diet-related noncommunicable disease costs in 1995. India's rapid increase in diet-related noncommunicable diseases and their costs projects similar economic costs of undernutrition and overnutrition by 2025.

China↗
PubMed2026

Power as equal ability, knowledge and resistance: Systematic review of experiences of adults with noncommunicable diseases.

PURPOSE: To analyse subjective experiences of power of adults with noncommunicable diseases in relationships with healthcare practitioners as well as underlying facilitators and barriers of these experiences. METHODS: Systematic review (4 databases) of experiences using reflexive thematic analysis underpinned by critical realist approach. The analysis was conducted with an abductive reasoning using previous theories on social power as well as retroduction. RESULTS: Based on 24 studies, we formed three themes, which depict experiences of power as 1) the position, equal ability and freedom to make one's own choices and (re)negotiate within shared dialogue, 2) the ability to use knowledge to claim one's rights, 3) resistance. Facilitators were connected to acknowledgement as an equally valuable individual, positive healthcare practitioner attitudes and actions towards patient activity and views, safety in the relationship as well as to sufficient, clear and varied information. Main barriers were experiences of dehumanisation, negative healthcare practitioner attitudes and actions, perceived or assumed practitioner domination in interactions, lack of or incomprehensible knowledge and testimonial smothering. CONCLUSION: Results suggest that adults with noncommunicable diseases may experience power primarily as a positive power: being acknowledged as having legitimate position to make decisions and being in possession of varied knowledge through which they can gain agency to protect and claim their rights, by resisting, if necessary. Healthcare practitioners are in key position to support these experiences through positive transforming actions, while knowledge asymmetries, persistent inequality and paternalistic structures continue to hinder it.

Humans↗
PubMed1988

Integrated programme for noncommunicable diseases prevention and control (NCD).

In spite of the difference between developed and developing countries, health conditions change in a predictable pattern: the mortality and morbidity rates caused by infectious diseases decline while the rates related to non-infectious pathology increase. Taking into account the increasing importance of noncommunicable diseases, the majority of countries are developing a set of disease-oriented (cancer, cardiovascular diseases, diabetes, etc.) prevention and control programmes as well as factor-oriented programmes such as anti-smoking, alcohol abuse and nutrition. The Integrated Programme for Community Health in Noncommunicable Diseases, which is being developed both in WHO headquarters and in the Regional Offices, aims to amalgamate into one programme activities directed at influencing a group of risk factors common to several of the most important noncommunicable diseases. The four main directions being developed for the realization of this programme are: experimental testing, mathematical modelling, training activity and research development: At present WHO headquarters: has established 18 demonstration projects in 15 countries for experimental testing of different intervention programmes; is collecting mathematical models for prediction of efficacy and effectiveness of different alternatives and scenarios; is developing different types of training courses; is investigating the competing risk among noncommunicable diseases and time lag for different intervention programmes, etc. In order to develop all these directions many collaborating centres are participating, and close cooperation with some nongovernmental organizations has been established.(ABSTRACT TRUNCATED AT 250 WORDS)

Cause of Death↗
PubMed2026

Clustering patterns of behavioral and metabolic risk factors for noncommunicable diseases in Iran: findings from a national STEPS survey.

BACKGROUND: Noncommunicable diseases (NCDs) are the leading cause of mortality in Iran, driven by behavioral and metabolic risk factors that frequently co-occur. OBJECTIVE: To identify patterns of co-occurring behavioral and metabolic NCD risk factors among Iranian adults and characterize their demographic and socioeconomic correlates. METHODS: This cross-sectional study analyzed data from 16,618 adults aged ≥25 years who participated in Iran's 2021 nationally representative STEPS survey. Thirteen behavioral and metabolic variables, including physical activity, nutrition score, smoking frequency, alcohol intake, salt intake, body mass index, blood pressure, fasting plasma glucose, and lipid markers, were entered into a K-means clustering analysis. Clusters were characterized by their risk profiles and demographic/socioeconomic attributes. Multinomial logistic regression examined associations between cluster membership and sociodemographic factors. RESULTS: Five distinct behavioral-metabolic clusters emerged. The smokers-drinkers (SD) cluster (3.1%) comprised mostly older, less-educated men with high smoking and alcohol use. The healthy-low-risk (HLR) cluster (40.3%) showed favorable profiles and included younger, more educated individuals. The physically active (PA) cluster (6.6%) was characterized mainly by younger men with markedly high physical activity levels. The dyslipidemic (DLP) cluster (26.0%) exhibited high dyslipidemia and overweight prevalence, while the hypertensive-diabetic (HTD) cluster (24.0%) had the highest obesity, hypertension, and diabetes rates, common among older urban adults. CONCLUSION: Behavioral and metabolic NCD risk factors in Iran formed five distinct co-occurrence patterns. Nearly half of adults belonged to metabolically high-risk clusters, highlighting the need for targeted prevention strategies that combine lifestyle interventions with screening and management of obesity, hypertension, diabetes, and dyslipidemia.

Humans↗
PubMed2006

Preventable risk factors for noncommunicable diseases in rural Indonesia: prevalence study using WHO STEPS approach.

OBJECTIVE: To gain a better understanding of the health transition in Indonesia, we sought to describe the prevalence and distribution of risk factors for noncommunicable diseases and to identify the risk-factor burden among a rural population and an urban population. METHODS: Using the protocol of the WHO STEPwise approach to Surveillance (STEPS), risk factors for noncommunicable diseases were determined for 1502 men and 1461 women aged 15-74 years at the Purworejo Demographic Surveillance Site in 2001. FINDINGS: Smoking prevalence was high among men (913/1539; weighted percentage=53.9.%) in both rural and urban populations; it was almost non-existent among women. A higher proportion of the urban population and the richest quintile of the rural population had high blood pressure and were classified as being overweight or obese when compared with the poorest quintile of the rural population. Those classified as being in the richest quintile who lived in the rural area were 1.5 times more likely to have raised blood pressure and 8 times more likely to be overweight than those classified as being in the poorest quintile and living in the rural area. Clustering of risk factors was higher among those classified as being in the richest quintile of those living in the rural area compared with those classified as being in the poorest quintile; and the risks of clustering were just 20-30% lower compared with the urban population. CONCLUSION: Both the rural and urban populations in Purworejo face an unequally distributed burden of risk factors for noncommunicable diseases. The burden among the most well-off group in the rural area has already reached a level similar to that found in the urban area. The implementation of the WHO STEPS approach was feasible, and it provides a comprehensive picture of the burden of risk factors, allowing appropriate health interventions to be implemented to address health inequities.

Adolescent↗
PubMedDate not supplied

Noncommunicable diseases among the Bahraini population: a review.

The review investigates changes in the morbidity and mortality due to noncommunicable diseases in the Bahraini population and looks at the conditions which may have contributed to them in the 1980s and 1990s. Data were extracted from the Ministry of Health annual health reports and the 1981 and 1991 censuses and other relevant published papers. Government strategies for the control of noncommunicable diseases and the promotion of healthy lifestyles are outlined.

Adolescent↗
PubMed2005

Integrated population-based surveillance of noncommunicable diseases: the Pakistan model.

The escalating burden of noncommunicable diseases (NCDs) worldwide warrants an urgent public health response. Resource constraints and other factors necessitate an integrated and concerted approach to the range of NCDs. A necessary prerequisite for effective planning, implementation, and evaluation of NCD prevention programs is access to reliable and timely information on mortality, morbidity, risk factors, and their socioeconomic determinants. However, there is limited experience in the setting up of integrated NCD surveillance models in low-resource settings. As part of the National Action Plan for the Prevention and Control of NCDs in Pakistan, an integrated, systematic, and sustainable population-based NCD surveillance system is being established, and will be maintained and expanded over time. This is a common population surveillance mechanism for all NCDs (with the exception of cancer). The model includes population surveillance of main risk factors that predict many NCDs and combines modules on population surveillance of injuries, mental health, and stroke. In addition, the model has been adapted for program evaluation; this will enable it to track implementation processes using appropriate indicators, facilitating an assessment of how interventions work and which components contribute most to success. This paper outlines the first activity in this sequential process, including its merits and limitations.

Adolescent↗
PubMed2004

Integrating injuries into noncommunicable disease prevention: a case study from Pakistan.

Injuries in Pakistan take a considerable toll on individuals, families and health systems. Recently, as part of the National Action Plan for Noncommunicable Diseases Prevention, Control and Health Promotion in Pakistan (NAP-NCD), injuries have been grouped alongside other noncommunicable diseases. The NAP-NCD is a public-private tripartite collaborative programme of an NGO Heartfile, the Ministry of Health, Government of Pakistan and the WHO Pakistan office. The NAP-NCD adopts an integrated approach and addresses the multidisciplinary range of issues within a prevention and control framework across the broad range of NCDs, albeit with an expanded definition. This paper discusses NAP-NCD's integrated approach to injury prevention and takes the form of a case study from Pakistan. The approach embodied in the Action Plan is grounded in the principle that decisions people make about healthy choices are shaped by the physical, social, economic and legal environment. It, therefore, has a comprehensive configuration with evidence-based policy and action-oriented dimensions calling for a change at the institutional, community and public policy levels.

Accident Prevention↗
PubMed1991

The relation of physical activity to cardiovascular disease risk factors in Mauritians. Mauritius Noncommunicable Disease Study Group.

The authors investigated the relation between physical activity and cardiovascular disease risk factors in a random sample of 4,658 Asian Indian, Creole, and Chinese adults aged 25-74 years from the island nation of Mauritius. Subjects known to have diabetes were excluded from analyses. Subjects were divided into "active" and "inactive" groups on the basis of a combined leisure and occupational physical activity score determined at interview (April 1987). Two-hour plasma glucose concentration and fasting and 2-hour serum insulin concentrations were significantly lower and high density lipoprotein (HDL) cholesterol was significantly higher in active subjects of both sexes. Plasma uric acid and fasting triglyceride levels were also lower among active subjects, but significantly so only in females. Systolic and diastolic blood pressure levels, body mass index (weight (kg)/height (m)2), and waist:hip ratio varied little between the two activity groups. In multiple linear regression analyses, physical activity made an independent negative contribution to the models for 2-hour glucose and insulin in both males and females, as well as for fasting insulin in males. When glucose and insulin were not included, physical activity also made an independent contribution to the models for plasma triglycerides (inversely) in females and HDL cholesterol and HDL cholesterol as a proportion of total cholesterol (positively) in males. The authors have demonstrated improved cardiovascular disease profiles associated with physical activity in Mauritians. The data suggest that much of the effect is modulated via an effect on insulin-glucose metabolism. Promotion of exercise should become an important strategy in the prevention of cardiovascular disease and glucose intolerance in this population.

Adult↗
PubMed1992

A model protocol for a diabetes and other noncommunicable disease field survey.

Field surveys of diabetes and other noncommunicable diseases and their risk factors are increasingly being performed in both developed and developing countries. Although individual priorities and circumstances will influence survey design, a model survey manual and protocol is described which might assist investigators in formulating plans and preparing manuals for their own surveys. The model presented has been successfully used in developing countries, for both rural and urban communities, over more than a decade. It describes examples of survey objectives, and gives specific details of survey procedures and measurement techniques which may be utilized. It contains sufficient flexibility to allow its adaptation to local circumstances.

Adult↗
PubMed2004

Risk factors of major noncommunicable diseases in Bahrain. The need for a surveillance system.

Noncommunicable diseases NCDs are the major cause of morbidity and mortality in Bahrain. The review examines the prevalence of risk factors of major NCDs from the available literature and determines the impact of the rapid socio economic changes on their burden. It further recommends ways of improving their reporting and monitoring. Smoking, obesity, diabetes, hypertension, hyperlipidemia, physical activity and nutrition are considered. The review points out that data on some of the factors is available but deficient for others. The call for the establishment of an integrated surveillance system using the World Health Organization STEPwise approach is stressed.

Adolescent↗
PubMed1992

Dietary intake, exercise, obesity and noncommunicable disease in rural and urban populations of three Pacific Island countries.

Dietary intake surveys of rural and urban communities in three Pacific Island countries were conducted using an adjusted 24-hour dietary recall method. Dietary survey samples were drawn from noncommunicable disease surveys of Melanesians and Indians in Fiji, Micronesians in Kiribati and Melanesians in Vanuatu. Comparisons of total energy and macronutrient intakes and of obesity, hypertension, diabetes mellitus, serum cholesterol and physical activity levels revealed similar rural/urban trends. Urban subjects were more obese than rural ones, had higher prevalence rates of diabetes and hypertension, and generally had higher cholesterol levels. Rural subjects were leaner, suffered less from diabetes and hypertension, and had greater total energy intakes than urban dwellers. Rural people ate a greater proportion of carbohydrates, while urban subjects ate proportionally more protein and fat, apart from the outer Kiribati atolls with high coconut intakes. Rural subjects in all three studies had higher levels of physical activity. These studies provide persuasive evidence that exercise as well as diet has a significant effect on rural/urban differentials in obesity and noncommunicable disease, and that energy intake reflects energy expenditure.

Diet↗