The Global Epidemiologic Transition

Atiim, George; Elliott, Susan J.

doi:10.1177/1090198115606918

Cited by 28 publications

(11 citation statements)

References 75 publications

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“…Patterns of diseases are changing globally, following Omran’s [39] theory of epidemiology of population change. While many LMICs are experiencing an epidemiological transition leading to growing rates of non-communicable diseases (NCDs), they also continue to experience a burden of communicable diseases whose management has historically shaped the major structures processes and practices of health systems and health education [40, 41]. Citizens of LMICs such as Ghana, therefore, are most familiar with the principles and policies used in managing communicable diseases (such as having a curative therapy that lasts for a short period).…”

Section: Discussionmentioning

confidence: 99%

Decision-making experiences of patients with end-stage kidney disease (ESKD) regarding treatment in Ghana: a qualitative study

2018

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BackgroundThis is the first qualitative study to explore patient decision-making regarding end-stage kidney disease (ESKD) treatment in sub-Saharan Africa. The study addresses an important gap in the literature concerning choice and decision-making in an international context.MethodsThe study employed a qualitative research design, using grounded theory methodology. In-depth interviews were conducted with twenty-two adult patients with ESKD in 3 clinical settings in Ghana. Data analysis involved coding and a constant comparative approach to generate key themes. Ethical approval was gained from relevant ethics committees both in Ghana and the United Kingdom.ResultsFour main factors (personal, financial, healthcare system, and support network) were identified to influence patient decision-making regarding ESKD treatment in Ghana. Treatment was initiated for various reasons, including, initially, the urgent need to avoid premature death. Many approached their condition hoping for a cure and did not always understand the chronic nature of their condition. Financial and geographical inaccessibility of renal replacement therapy (RRT), as well as a relative lack of biomedical treatment choices, made decision making daunting for the individual with ESKD in Ghana. The subject of death or conservative management was not openly discussed. Rather patients did everything possible to seek alternative forms of treatment, including the simultaneous use of other non-RRT and traditional or faith-based healing approaches.ConclusionsWhilst similarities exist, this study illuminates stark cultural and contextual differences which make decision-making on ESKD treatment a daunting experience for the individual with ESKD in Ghana - as compared to those in high-income countries. The challenges associated with ESKD management in Ghana calls for meticulous efforts at primary prevention of the disease, including interventions directed at effective management of diabetes mellitus, hypertension and other chronic kidney disease (CKD) precursor conditions. Enhancing information provision would promote informed decision making, particularly within the initial stages of patient decision-making.Electronic supplementary materialThe online version of this article (10.1186/s12882-018-1175-z) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Decision-making experiences of patients with end-stage kidney disease (ESKD) regarding treatment in Ghana: a qualitative study

2018

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“…Specifically, use of protease inhibitors (PI) as part of an ART regimen have been associated with hyperlipidaemia [ 6 , 7 ]. Many countries in SSA are experiencing an epidemiological transition, in which NCDs rather than infectious diseases are contributing more to the overall burden of disease [ 8 ]. CVDs are of particular concern because of the large number of people with HIV.…”

Section: Introductionmentioning

confidence: 99%

Prevalence and factors associated with hypertension among people living with HIV/AIDS on antiretroviral therapy in Uganda

Lubega¹,

Mayanja²,

Lutaakome³

et al. 2021

Pan Afr Med J

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Introduction antiretroviral therapy (ART) has improved survival of People Living with HIV (PLWH); however, this has resulted in an increasingly high prevalence of non-communicable diseases (NCD) like hypertension. Hypertension is a major risk factor for cardiovascular and cerebral vascular disease, which are both associated with high morbidity and mortality rates. We studied the prevalence and factors associated with hypertension among PLWH on ART. Methods we conducted a retrospective data analysis of PLWH on ART enrolled between 2011 and 2014 into a randomized double-blinded placebo-controlled trial investigating the safety of discontinuing cotrimoxazole prophylaxis (COSTOP) among PLWH in Central Uganda. We used the mean blood pressure (BP) measurements of the first four monthly clinic visits to define hypertension. Patients were categorised as: having normal BP (≤120/80mmHg), elevated BP (systolic >120-129, and diastolic ≤80), Stage 1 hypertension (systolic 130-139, or diastolic >80-89) and Stage 2 hypertension (systolic ≥140 or diastolic ≥90). Multiple logistic regression was used to evaluate factors associated with hypertension. Results data from 2026 COSTOP trial study participants were analysed, 74.1% were women and 77.2% were aged 35 years and above. The overall prevalence of hypertension was 29%, of whom 19.5% had Stage 1 hypertension and 9.5% had Stage 2 hypertension. About 21.4% were overweight or obese. Factors independently associated with hypertension among PLWH on ART included increasing age (p≤0.001) and high body mass index (p≤0.001). Efavirenz (p≤0.001) and lopinavir/ritonavir (p=0.036) based regimen had lower odds of hypertension than Nevirapine based regimens. Conclusion PLWH on ART have a high prevalence of hypertension, which rises with increasing age and body mass index (BMI) and among those on nevirapine-based ART. Implementation of hypertension prevention measures among PLWH on ART and integration of NCD and HIV care to improve patients’ management outcomes are required.

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“…Asthma has become a serious public health concern [ 1 ] as the global prevalence and mortality continues to increase, particularly in African countries [ 2 – 4 ]. The Global Burden of Disease collaboration estimated that at least 400,000 people died prematurely from asthma, mainly in Africa and other low- and middle-income countries (LMICs) in 2016 [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…All age groups are affected, especially children who endure the greatest burden [ 2 , 6 ]. In 2018, 339 million individuals were estimated to have asthma worldwide [ 7 ] with the number expected to exceed 400 million by 2025 if the current rising trends continue [ 1 , 4 ]. The high asthma burden is characterised by poor quality of life and associated direct and indirect costs such as expensive medicine, frequent hospital admissions and absences from school or work [ 7 – 9 ].…”

Section: Introductionmentioning

confidence: 99%

Assessing the nature of asthma in African epidemiological studies: a scoping review protocol

2020

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Background Asthma is one of the most common chronic respiratory conditions in the world and is increasing in prevalence, particularly in Africa and other low-income countries. The disproportionately high numbers of premature deaths and severe or uncontrolled cases in many African countries are indicative of their inability to cope with a costly disease like asthma. Progress has, however, been made in understanding the complex and heterogeneous nature of the disease. The objective of this study will be to summarise the epidemiological literature on the nature of asthma in African countries. Methods We registered a study protocol for a scoping review. The review was designed following the Arksey and O’Malley framework. We will search PubMed/MEDLINE, African Journals Online (AJOL) and relevant grey literature (e.g. Google Scholar, EBSCOhost) from January 1990 onwards. Only primary epidemiological studies of asthma (e.g. frequency, disease mechanisms, associated risk factors and comorbidities) written in English and conducted in Africa will be included. Two reviewers will independently screen all citations, full-text articles and abstract data. Potential conflicts will be resolved through discussion. Findings will be reported using narrative synthesis and tabulation of the summaries. Discussion This scoping review will capture the state of the current epidemiological literature on asthma in African countries. Results will be published in a peer-reviewed journal. We anticipate this review will identify gaps and make recommendations for future areas of study. Scoping review registration Open Science Framework http://osf.io/n2p87/

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The Global Epidemiologic Transition

Cited by 28 publications

References 75 publications

Decision-making experiences of patients with end-stage kidney disease (ESKD) regarding treatment in Ghana: a qualitative study

Decision-making experiences of patients with end-stage kidney disease (ESKD) regarding treatment in Ghana: a qualitative study

Prevalence and factors associated with hypertension among people living with HIV/AIDS on antiretroviral therapy in Uganda

Assessing the nature of asthma in African epidemiological studies: a scoping review protocol

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