Management of NCD in Low- and Middle-Income Countries

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.

Tackling NCD in LMIC: Achievements and Lessons Learned From the NHLBI—UnitedHealth Global Health Centers of Excellence Program

“…29, 30 COEs have also catapulted development of innovative interventions and their implementation- much needed in both low- and middle-income countries. 15 Supplementary grants promoted cross-collaboration between COEs and resulted in fast-track development and testing of state-of-the-art interventions combining technology with implementation in real-world settings. An example is technology-driven CVD risk ascertainment by community health workers in India and China.…”

“…First, the 11 COEs have created the Global Research Against Non-communicable Disease (GRAND South) Network 15 to continue sharing experiences and conducting relevant NCD research, capacity building, and policy engagement. The GRAND South Network goal is to combat non-communicable diseases at local and global levels by conducting innovative research to identify, understand, and overcome barriers to the adoption, adaptation, integration, scale-up and sustainability of evidence-based interventions and policies.…”

“…15, 16 . Others took advantage of the well characterized cohorts to ask fundamental basic science questions such as a comparative analysis of the pulmonary microbiome within biomass fuel exposed and unexposed populations.…”

Hypertension Prevalence, Awareness, Treatment, and Control in Selected LMIC Communities: Results From the NHLBI/UHG Network of Centers of Excellence for Chronic Diseases

“…We sought to evaluate the original data from those studies with the aim of generating valuable information about the prevalence, awareness, treatment and control of hypertension in selected communities in Africa, Asia, and Latin America. (10-12)…”

Bridging non-communicable disease burden research to clinical care: A rising tide or a tidal wave?

“…[5] Early case identification maximises the benefits of lifestyle and pharmacological interventions. At the community level, integrated programmes may destigmatise HIV and promote a culture of preventive health.…”