Liberating non-communicable disease data

Bennett, Peter H.; Magliano, Dianna J.; Alberti, K. G. M. M.; Zimmet, Paul

doi:10.1016/s2213-8587(16)30220-0

Cited by 5 publications

(2 citation statements)

References 8 publications

(6 reference statements)

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“…Even though we have chosen to use estimates from NCD-RisC 16 for illustration, and recognise that this work has utility in making comparisons across regions and over time, the reliability of the prevalence data for individual countries in sub-Saharan Africa is questionable. [22][23][24] 21 countries in sub-Saharan Africa had missing data and, in those countries with data, samples were often small and data were old.…”

Section: Panel 2: Estimating the Prevalence Of Diabetes In Sub-saharamentioning

confidence: 99%

Diabetes in sub-Saharan Africa: from clinical care to health policy

Atun

Davies

Gale

et al. 2017

The Lancet Diabetes & Endocrinology

364

432

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Key message 2: diabetes and its consequences are costly to patients and economies We estimate that, in 2015, the overall cost of diabetes in sub-Saharan Africa was US$19•45 billion or 1•2% of cumulative gross domestic product (GDP). Around $10•81 billion (55•6%) of this cost arose from direct costs, which included expenditure on diabetes treatment (eg, medication, hospital stays, and treatment of complications), with out-of-pocket expenditure likely to exceed 50% of the overall health expenditure in many countries. We estimate that the total cost will increase to between $35•33 billion (1•1% of GDP) and $59•32 billion (1•8% of GDP) by 2030. Putting in place systems to prevent, detect, and manage hyperglycaemia and its consequences is therefore warranted from a health economics perspective. Key message 3: health systems in countries in sub-Saharan Africa are unable to cope with the current burden of diabetes and its complications By use of information from WHO Service Availability Readiness Assessment surveys and World Bank Service Delivery Indicator surveys and the local knowledge of Commissioners, we found inadequacies at all levels of the health system required to provide adequate management for diabetes and its associated risk factors and sequelae. We found inadequate availability of simple equipment for diagnosis and monitoring, a lack of sufficiently knowledgable health-care providers, insufficient availability of treatments, a dearth of locally appropriate guidelines, and few disease registries. These inadequacies result in a substantial dropoff of patients along the diabetes care cascade, with many patients going undiagnosed and with those who are diagnosed not receiving the advice and drugs they need. We also noted scarce facilities to manage the microvascular and macro vascular complications of diabetes. Additionally, despite calls for adding the care of diabetes and other cardiovascular risk factors onto existing infectious disease programmes (such as those for HIV), we found little evidence that such combined programmes are successful at improving outcomes.

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Section: Panel 2: Estimating the Prevalence Of Diabetes In Sub-saharamentioning

confidence: 99%

Diabetes in sub-Saharan Africa: from clinical care to health policy

Atun

Davies

Gale

et al. 2017

The Lancet Diabetes & Endocrinology

364

432

View full text Add to dashboard Cite

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“…Adoption of the modern Western high calorie diet (HCD; high fat and high sugar) has significantly contributed to the global major public health problems of metabolic syndrome and resultant obesity, type-2 diabetes and cardiovascular disease; ageing-associated comorbidities that impact on both healthspan and lifespan [1,2]. Interestingly, epidemiological data suggest that such HCD-associated diseases are rising fastest in in the developing world [2,3], regions where parasitic worms (helminths) and other infectious agents used to be endemic but where they are now being eradicated [4]. Helminths promote their survival by releasing excretorysecretory (ES) products that, by dampening inflammation and promoting tissue repair, act to prevent worm expulsion but also limit host pathology [4,5].…”

Section: Introductionmentioning

confidence: 99%

The parasitic worm product ES-62 promotes health- and life-span in a high calorie diet-accelerated mouse model of ageing

et al. 2020

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Improvements in hygiene and health management have driven significant increases in human lifespan over the last 50 years. Frustratingly however, this extension of lifespan has not been matched by equivalent improvements in late-life health, not least due to the global pandemic in type-2 diabetes, obesity and cardiovascular disease, all ageing-associated conditions exacerbated and accelerated by widespread adoption of the high calorie Western diet (HCD). Recently, evidence has begun to emerge that parasitic worm infection might protect against such ageing-associated co-morbidities, as a serendipitous side-effect of their evolution of pro-survival, anti-inflammatory mechanisms. As a novel therapeutic strategy, we have therefore investigated the potential of ES-62, an anti-inflammatory secreted product of the filarial nematode Acanthocheilonema viteae, to improve healthspan (the period of life before diseases of ageing appear) by targeting the chronic inflammation that drives metabolic dysregulation underpinning ageing-induced ill-health. We administered ES-62 subcutaneously (at a dose of 1 μg/week) to C57BL/6J mice undergoing HCD-accelerated ageing throughout their lifespan, while subjecting the animals to analysis of 120 immunometabolic responses at various time-points. ES-62 improved a number of inflammatory parameters, but markedly, a range of pathophysiological, metabolic and microbiome parameters of ageing were also successfully targeted. Notably, ES-62-mediated promotion of healthspan in male and female HCD-mice was associated with different mechanisms and reflecting this, machine learning modelling identified sex-specific signatures predictive of ES-62 action against HCD-accelerated ageing. Remarkably, ES-62 substantially increased the median survival of male HCD-mice. This was not the case with female animals and unexpectedly, this difference between the two sexes could not be explained in terms of suppression of the chronic inflammation driving ageing, as ES-62 tended to be more effective in reducing this in female mice. Rather, the difference appeared to be associated with ES-62's

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