Can the Success of HIV Scale-Up Advance the Global Chronic NCD
                        Agenda?

Palma, Anton M.; Rabkin, Miriam; Nuwagaba‐Biribonwoha, Harriet; Bongomin, Pido; Lukhele, Nomthandazo; Dlamini, Xolisile; Kidane, Altaye; El‐Sadr, Wafaa

doi:10.1016/j.gheart.2016.10.012

Cited by 26 publications

(17 citation statements)

References 27 publications

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“…A better understanding of the intersection between HIV and cardiometabolic conditions such as diabetes and hypertension offers a potential avenue for health systems strengthening, as care programmes that have been established for PLWH may provide a ready platform for the response to non‐communicable diseases. Leveraging the overlap between HIV and cardiometabolic care programmes, and aligning both with efforts to expand universal health coverage, has the promise of improving population health for all .…”

Section: Introductionmentioning

confidence: 99%

Hypertension and diabetes control along the HIV care cascade in rural South Africa

et al. 2019

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Introduction Participation in antiretroviral therapy (ART) programmes has been associated with greater utilization of care for hypertension and diabetes in rural South Africa. The objective of this study was to assess whether people living with HIV on ART with comorbid hypertension or diabetes also have improved chronic disease management indicators. Methods The Health and Aging in Africa: a longitudinal study of an INDEPTH Community in South Africa (HAALSI) is a cohort of 5059 adults >40 years old. Enrollment took place between November 2014 and November 2015. The study collected population‐based data on demographics, healthcare utilization, height, weight, blood pressure (BP) and blood glucose as well as HIV infection, HIV‐1 RNA viral load (VL) and ART exposure. We used regression models to determine whether HIV care cascade stage (HIV‐negative, HIV+ /No ART, ART/Detected HIV VL, and ART/Undetectable VL) was associated with diagnosis or treatment of hypertension or diabetes, and systolic blood pressure and glucose among those with diagnosed hypertension or diabetes. ART use was measured from drug level testing on dried blood spots. Results and discussion Compared to people without HIV, ART/Undetectable VL was associated with greater awareness of hypertension diagnosis (adjusted risk ratio (aRR) 1.18, 95% CI: 1.09 to 1.28) and treatment of hypertension (aRR 1.24, 95% CI: 1.10 to 1.41) among those who met hypertension diagnostic criteria. HIV care cascade stage was not significantly associated with awareness of diagnosis or treatment of diabetes. Among those with diagnosed hypertension or diabetes, ART/Undetectable VL was associated with lower mean systolic blood pressure (5.98 mm Hg, 95% CI: 9.65 to 2.32) and lower mean glucose (3.77 mmol/L, 95% CI: 6.85 to 0.69), compared to being HIV‐negative. Conclusions Participants on ART with an undetectable VL had lower systolic blood pressure and blood glucose than the HIV‐negative participants. HIV treatment programmes may provide a platform for health systems strengthening for cardiometabolic disease.

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Section: Introductionmentioning

confidence: 99%

Hypertension and diabetes control along the HIV care cascade in rural South Africa

et al. 2019

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“…This raises the question as to why RHD has failed to gain traction, compared to issues such as malaria and HIV, for which there are widespread action and support. [ 31 ]…”

Section: Identifying Core Challenges In the Prevention And Control Ofmentioning

confidence: 99%

Prevention and control of rheumatic heart disease: Overcoming core challenges in resource-poor environments

et al. 2018

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Rheumatic heart disease (RHD) has long receded as a significant threat to public health in high-income countries. In low-resource settings, however, the specter of RHD remains unabated, as exemplified by recent data from the Global Burden of Diseases Study. There are many complex reasons for this ongoing global disparity, including inadequate data on disease burden, challenges in effective advocacy, ongoing poverty and inequality, and weak health systems, most of which predominantly affect developing nations. In this review, we discuss how each of these acts as a core challenge in RHD prevention and control. We then examine key lessons learnt from successful control programs in the past and highlight resources that have been developed to help create strong national RHD control programs.

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“…The Link4Health and Engage4Health studies represent the beginning of making HIV care streamlined and more client-centered. Changes in HIV treatment, which are likely to include longer-acting ART formulations [ 11 , 12 ] and integration of other chronic disease diagnosis and management into HIV care platforms [ 13 , 14 ], present opportunities for continued re-engineering of health systems. Building on the two studies presented in this issue and anticipating future changes, key priorities for future work include: first, reaching people who know their status but are not engaged in HIV care as they are missing from the HIV care continuum; and second, consistently and reliably reporting the impact on health, particularly viral suppression, and over longer durations than 12 months of follow-up.…”

Section: The Next Steps For Cis Interventionsmentioning

confidence: 99%