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Background: Five million people die every year from non-communicable diseases (NCDs) globally. In Tanzania, more than two-thirds of deaths are NCD-related. The country is investing in preventive and advocacy activities as well as interventions to reduce the burden. Of particular interest, the Ministry of Health (MoH) commemorates NCDs' week using a multisectoral and multi-stakeholders' approach. This paper highlights activities conducted during NCDs week with the aim of sharing lessons for other countries with similar context and burdens., Methods: A thorough review of official reports and the national strategic plans for NCDs was done including the 2020 and 2021 National NCDs' week reports, the National Strategic Plan for NCDs 2015-2020, and the National NCDs agenda., Findings: NCDs week is commemorated annually throughout the country involving the five key activities. First, community awareness and participation are encouraged through media engagement and community-based preventive and advocacy activities. Second, physical activities and sports festivals are implemented with a focus on developing and renovating infrastructures for sports and recreation. Third, health education is provided in schools to promote healthy behaviors for secondary school adolescents in transition to adulthood. Fourth, health service provision and exhibitions are conducted involving screening for hypertension, diabetes, obesity, alcohol use, and physical activities. The targeted screening of NCDs identified 10% of individuals with at least one NCD in 2020. In 2021, a third of all screened individuals were newly diagnosed with hypertension, and 3% were found to have raised blood glucose levels. Fifth, the national NCDs scientific conferences conducted within the NCDs week provide an avenue for stakeholders to discuss scientific evidence related to NCDs and recommend strategies to mitigate NCDs burden., Conclusion: The initiation of NCDs week has been a cornerstone in advocating for NCDs control and prevention in the country. It has created awareness on NCDs, encourage healthy lifestyles and regular screening for NCDs. The multi-stakeholder and multi-sectoral approaches have made the implementation of the mentioned activities feasible and impactful. This has set an example for the united efforts toward NCD control and prevention at national, regional, and global platforms while considering contextual factors during adoption and implementation., Competing Interests: The authors have no competing interests to declare., (Copyright: © 2023 The Author(s).)

Background: Hypertension is the leading risk factor for mortality worldwide and is more common in sub-Saharan Africa than any other region. Work to date confirms that a lack of human and material resources for healthcare access contributes to this gap. The ways in which patients' knowledge and attitudes toward hypertension determine their engagement with and adherence to available care, however, remains unclear., Methods: We conducted an exploratory, qualitative descriptive study to assess awareness, knowledge, and attitudes towards hypertension and its management at a large private hospital in Kampala. We interviewed 64 participants (29 with hypertension and 34 without, 1 excluded) in English. General thematic analysis using the Integrated Conceptual Health Literacy Model was used to iteratively generate themes and categories., Results: We identified three main themes: Timing of Hypertension Diagnosis, Aiming for Health Literacy, and the Influence of Knowledge on Behavior. Most participants with hypertension learned of their condition incidentally, speaking to the lack of awareness of hypertension as an asymptomatic condition. Drove nearly all participants to desire more information. However, many struggled to translate knowledge into self-management behaviors due to incomplete information and conflicting desires of participants regarding lifestyle and treatment., Conclusions: Internal patient factors had a substantial impact on adherence, calling attention to the need for educational interventions. Systemic barriers such as cost still existed even for those with insurance and need to be recognized by treating providers.

Background: There is a growing concern for an increasing burden of non-communicable diseases (NCDs) in people living with HIV. This concern is evident especially in developing countries where dietary and lifestyle risk factors associated with NCDs are becoming more prominent. This study explored the prevalence of diabetes mellitus, hypertension, and hyperlipidemia and related risk factors in men and women living with HIV in Cambodia., Methods: This cross-sectional study was conducted among 510 adult people living with HIV randomly selected from one city and four provinces in Cambodia. A structured questionnaire was used to collect data on socio-demographic characteristics, health behaviors, medical history, and antiretroviral therapy (ART). Anthropometric and biological measurements were performed. Descriptive statistics were used to calculate proportions and means of the measured variables. An independent Student's t-test was used for continuous variables. Chi square test or Fisher's exact test was used for categorical variables to explore gender differences., Results: Prevalence of diabetes mellitus, hypertension, and hyperlipidemia was 9.4, 15.1, and 33.7%, respectively. The prevalence of hyperlipidemia was significantly higher among men compared to women. Mean systolic and diastolic blood pressures were also significantly higher among men. Regarding risk factors, 17.3% of participants were overweight, and 4.1% were obese. Tobacco and alcohol use was common, particularly among men. Fruit and vegetable consumption was considerably low among both men and women. Physical activity levels were also low. About 40% of participants reported having a job that involved mostly sitting or standing; 46.3% reported engaging in moderate activities; and 11.8% reported engaging in vigorous activities during leisure time. A significantly higher proportion of men compared to women engaged in vigorous activities both at work and during leisure time., Conclusions: The prevalence of diabetes mellitus, hypertension, and hyperlipidemia among men and women living with HIV in Cambodia is considerably high. Related risk factors were also common. Given the comorbidity of NCDs and HIV, policy and programmatic interventions are required, including integration of NCD screening into HIV programs. Distinctions in the levels of diseases and in health behaviors between men and women suggest that interventions need to be tailor-made and gender-specific, targeting their respective diseases and behaviors.

Anecdotal evidence suggests that non-communicable diseases (NCDs) contribute substantially to mortality, morbidity and disability in Ghana. Nonetheless, no data are presently available on Ghanaians with disability from major NCDs, such as hypertension, diabetes and stroke. Using data from the 2007/2008 Ghana World Health Organization Study on Global Ageing and Adult Health (SAGE) and applying ordinary least squares techniques, the prevalence of and associations between activity limitations and participation restrictions in Ghanaians with NCDs are examined in the present study. The results show stroke is the major contributor to activity limitations and participation restrictions among the Ghanaian population with NCDs. The study results further revealed that respondents with higher education reported high levels of disability compared to those with no education. The results suggest that functioning can be restored by providing assistive technologies, such as wheelchairs, prosthetic limbs, walking aids, etc., that can enhance participation of persons with disability in society. [ABSTRACT FROM AUTHOR]

Target 3.4 of the third Sustainable Development Goal (SDG) of the United Nations (UN) General Assembly proposes to reduce premature mortality from non-communicable diseases (NCDs) by one-third. Epidemiological data presented by the World Health Organization (WHO) in 2016 show that out of a total of 57 million deaths worldwide, approximately 41 million deaths occurred due to NCDs, with 78% of such deaths occurring in low-and-middle-income countries (LMICs). The majority of investigations on NCDs agree that the leading risk factor for mortality worldwide is hypertension. Over 75% of the world's mobile phone subscriptions reside in LMICs, hence making the mobile phone particularly relevant to mHealth deployment in Africa. This study is aimed at determining the scope of the literature available on hypertension diagnosis and management in Africa, with particular emphasis on determining the feasibility, acceptability and effectiveness of interventions based on the use of mobile phones. The bulk of the evidence considered overwhelmingly shows that SMS technology is yet the most used medium for executing interventions in Africa. Consequently, the need to define novel and superior ways of providing effective and low-cost monitoring, diagnosis, and management of hypertension-related NCDs delivered through artificial intelligence and machine learning techniques is clear. [ABSTRACT FROM AUTHOR]

Abstract Introduction Non-communicable diseases (NCDs) have recently become a global public health burden and a leading cause of premature death, mainly in low- and middle-income countries (LMICs). The aim of the study was to explore physicians’ perceptions on the availability and quality of clinical care for the management of NCDs. Methods This was a qualitative exploratory study meant to obtain expert perceptions on clinical care delivery for NCDs in one Zimbabwean central hospital setting. Data was collected from participants who consented and was analyzed using Stata version 13. A four-point Likert scale was used to categorize different levels of perceived satisfaction. Findings Twenty-three doctors participated in the study: four female doctors and nineteen males. Nineteen of the doctors were general practitioners, whilst four were specialists. The findings indicated that both categories perceived some shortfalls in clinical care for NCDs. Moreover, the perceptions of general practitioners and specialists were not significantly different. Participants perceived cancer care to be lagging far behind the other three NCDs under study. Care of cardiovascular diseases (CVDs) and diabetes showed mixed perceptions amongst participants, with positive perceptions almost equaling negative perceptions. Furthermore, hypertension was perceived to be clinically cared for better than the other NCDs under consideration. Reasons for the gaps in NCD clinical care were attributed by 33% of the participants to financial challenges; a further 27% to patient behavioral challenges; and 21% to communication challenges. Conclusions The article concludes that care delivery for the selected NCDs under study at CCH need to be improved. Furthermore, it is crucial to diagnose NCDs before patients show clinical symptoms. This helps disease prognosis to yield better care results. The evaluation of doctors’ perceptions indicates the need to improve NCD care at the institution in order to control NCD co-morbidities that may increase mortality.

Introduction: Non-communicable diseases (NCDs) have recently become a global public health burden and a leading cause of premature death, mainly in low- and middle-income countries (LMICs). The aim of the study was to explore physicians' perceptions on the availability and quality of clinical care for the management of NCDs.Methods: This was a qualitative exploratory study meant to obtain expert perceptions on clinical care delivery for NCDs in one Zimbabwean central hospital setting. Data was collected from participants who consented and was analyzed using Stata version 13. A four-point Likert scale was used to categorize different levels of perceived satisfaction.Findings: Twenty-three doctors participated in the study: four female doctors and nineteen males. Nineteen of the doctors were general practitioners, whilst four were specialists. The findings indicated that both categories perceived some shortfalls in clinical care for NCDs. Moreover, the perceptions of general practitioners and specialists were not significantly different. Participants perceived cancer care to be lagging far behind the other three NCDs under study. Care of cardiovascular diseases (CVDs) and diabetes showed mixed perceptions amongst participants, with positive perceptions almost equaling negative perceptions. Furthermore, hypertension was perceived to be clinically cared for better than the other NCDs under consideration. Reasons for the gaps in NCD clinical care were attributed by 33% of the participants to financial challenges; a further 27% to patient behavioral challenges; and 21% to communication challenges.Conclusions: The article concludes that care delivery for the selected NCDs under study at CCH need to be improved. Furthermore, it is crucial to diagnose NCDs before patients show clinical symptoms. This helps disease prognosis to yield better care results. The evaluation of doctors' perceptions indicates the need to improve NCD care at the institution in order to control NCD co-morbidities that may increase mortality. [ABSTRACT FROM AUTHOR]

Abstract Background Hypertension is the leading risk factor for mortality worldwide and is more common in sub-Saharan Africa than any other region. Work to date confirms that a lack of human and material resources for healthcare access contributes to this gap. The ways in which patients’ knowledge and attitudes toward hypertension determine their engagement with and adherence to available care, however, remains unclear. Methods We conducted an exploratory, qualitative descriptive study to assess awareness, knowledge, and attitudes towards hypertension and its management at a large private hospital in Kampala. We interviewed 64 participants (29 with hypertension and 34 without, 1 excluded) in English. General thematic analysis using the Integrated Conceptual Health Literacy Model was used to iteratively generate themes and categories. Results We identified three main themes: Timing of Hypertension Diagnosis, Aiming for Health Literacy, and the Influence of Knowledge on Behavior. Most participants with hypertension learned of their condition incidentally, speaking to the lack of awareness of hypertension as an asymptomatic condition. Drove nearly all participants to desire more information. However, many struggled to translate knowledge into self-management behaviors due to incomplete information and conflicting desires of participants regarding lifestyle and treatment. Conclusions Internal patient factors had a substantial impact on adherence, calling attention to the need for educational interventions. Systemic barriers such as cost still existed even for those with insurance and need to be recognized by treating providers.

Background: The global escalating prevalence of lifestyle-related non-communicable diseases places a significant burden on health systems. Chronic diseases of lifestyle (CDL) are a group of diseases that share similar modifiable risk factors that can result in long-term disease processes. Considering the socio-behavioral-metabolic risk profiles of communities and risk factors predictive of the presence of CDL can assist in the development of focused and effective community-based prevention, intervention, and treatment programs for CDL.Aim: To determine the socio-behavioral-metabolic risk profiles and identify associated factors for the following CDL: obesity, cardiovascular disease, hypertension, and type 2 diabetes mellitus in rural and urban communities in central South Africa.Methodology: This cross-sectional study included adults aged 25–65 years in the rural Southern Free State and urban Mangaung. Social determinants, behavioral and metabolic risk factors, and inflammatory biomarkers for CDL were determined.Results: In total, 575 rural (mean age: 42 years; 71% female) and 429 urban (mean age: 44 years; 76% female) participants were included in the study. More than 20% of participants in both communities reported being previously diagnosed with cardiovascular diseases; with reported hypertension and diabetes mellitus more prevalent among rural participants. Insufficient intake of fruit and vegetables, alcohol use, and high blood pressure were among the top five risk factors in both communities. Physical inactivity ranked among the top two risk factors in the urban community; while alcohol and tobacco use was significantly higher in the rural community. Fibrinogen was the most prevalent inflammatory marker in both communities (32.9 rural vs. 48.3% urban). High sensitivity C-reactive protein (Hs-CRP), only available for rural participants, was high with increased levels in more than 80% of participants. In both communities, being female, having high blood pressure and increased fibrinogen levels were associated with obesity.Conclusion: This study illustrated the high prevalence of socio-behavioral-metabolic risk factors for CDL, and identified similarities and distinct differences in the risk profiles of rural and urban communities. Considering the CDL risk profiles of communities can assist in prioritizing health needs and contribute to the development of tailor-made community-based primary health care prevention, intervention, and health promotion programs.

Abstract Background There is a growing concern for an increasing burden of non-communicable diseases (NCDs) in people living with HIV. This concern is evident especially in developing countries where dietary and lifestyle risk factors associated with NCDs are becoming more prominent. This study explored the prevalence of diabetes mellitus, hypertension, and hyperlipidemia and related risk factors in men and women living with HIV in Cambodia. Methods This cross-sectional study was conducted among 510 adult people living with HIV randomly selected from one city and four provinces in Cambodia. A structured questionnaire was used to collect data on socio-demographic characteristics, health behaviors, medical history, and antiretroviral therapy (ART). Anthropometric and biological measurements were performed. Descriptive statistics were used to calculate proportions and means of the measured variables. An independent Student’s t-test was used for continuous variables. Chi square test or Fisher’s exact test was used for categorical variables to explore gender differences. Results Prevalence of diabetes mellitus, hypertension, and hyperlipidemia was 9.4, 15.1, and 33.7%, respectively. The prevalence of hyperlipidemia was significantly higher among men compared to women. Mean systolic and diastolic blood pressures were also significantly higher among men. Regarding risk factors, 17.3% of participants were overweight, and 4.1% were obese. Tobacco and alcohol use was common, particularly among men. Fruit and vegetable consumption was considerably low among both men and women. Physical activity levels were also low. About 40% of participants reported having a job that involved mostly sitting or standing; 46.3% reported engaging in moderate activities; and 11.8% reported engaging in vigorous activities during leisure time. A significantly higher proportion of men compared to women engaged in vigorous activities both at work and during leisure time. Conclusions The prevalence of diabetes mellitus, hypertension, and hyperlipidemia among men and women living with HIV in Cambodia is considerably high. Related risk factors were also common. Given the comorbidity of NCDs and HIV, policy and programmatic interventions are required, including integration of NCD screening into HIV programs. Distinctions in the levels of diseases and in health behaviors between men and women suggest that interventions need to be tailor-made and gender-specific, targeting their respective diseases and behaviors.

Non-communicable diseases (NCDs) lead to substantial mortality and morbidity worldwide. The most common NCDs are cardiovascular diseases (CVD), diabetes, cancer and chronic respiratory diseases. With the rapid increase in NCD-related deaths in Asia Pacific countries, NCDs are now the major cause of deaths and disease burden in the region. NCDs hamper achievement of the Millennium Development Goals (MDG). People in the low socio-economic group are most affected by NCDs as they have poor access to policies, legislations, regulations and healthcare services meant to combat NCDs. This results in loss of productivity by a decreasing labor force with implications at the macroeconomic level. The 3 major NCDs in the Asia Pacific region are CVDs, cancer and diabetes due to the increasing loss of disability adjusted life years (DALYs). The 4 major behavioral risk factors for NCDs are: tobacco use, alcohol consumption, inadequate physical activity and unhealthy diet. The underlying risk factors are urbanization, globalization, sedentary lifestyle, obesity and hypertension. Strategies to combat NCDs in the Asia Pacific region are as follows: population-based dietary salt reduction, health education, psychological interventions, i.e., cognitive behavioral therapy and motivational-interviewing, taxation and bans on tobacco-related advertisements, implementing smoke-free zones and surveillance by the World Health Organization. Control measures must focus on prevention and strengthening inter-sectorial collaboration.

The integrated chronic disease management (ICDM) model was introduced as a response to the dual burden of HIV/AIDS and non-communicable diseases (NCDs) in South Africa, one of the first of such efforts by an African Ministry of Health. The aim of the ICDM model is to leverage HIV programme innovations to improve the quality of chronic disease care. There is a dearth of literature on the perspectives of healthcare providers and users on the quality of care in the novel ICDM model. This paper describes the viewpoints of operational managers and patients regarding quality of care in the ICDM model. In 2013, we conducted a case study of the seven PHC facilities in the rural Agincourt sub-district in northeast South Africa. Focus group discussions (n = 8) were used to obtain data from 56 purposively selected patients ≥18 years. In-depth interviews were conducted with operational managers of each facility and the sub-district health manager. Donabedian’s structure, process and outcome theory for service quality evaluation underpinned the conceptual framework in this study. Qualitative data were analysed, with MAXQDA 2 software, to identify 17 a priori dimensions of care and unanticipated themes that emerged during the analysis. The manager and patient narratives showed the inadequacies in structure (malfunctioning blood pressure machines and staff shortage); process (irregular prepacking of drugs); and outcome (long waiting times). There was discordance between managers and patients regarding reasons for long patient waiting time which managers attributed to staff shortage and missed appointments, while patients ascribed it to late arrival of managers to the clinics. Patients reported anti-hypertension drug stock-outs (structure); sub-optimal defaulter-tracing (process); rigid clinic appointment system (process). Emerging themes showed that patients reported HIV stigmatisation in the community due to defaulter-tracing activities of home-based carers, while managers reported treatment of chronic diseases by traditional healers and reduced facility-related HIV stigma because HIV and NCD patients attended the same clinic. Leveraging elements of HIV programmes for NCDs, specifically hypertension management, is yet to be achieved in the study setting in part because of malfunctioning blood pressure machines and anti-hypertension drug stock-outs. This has implications for the nationwide scale up of the ICDM model in South Africa and planning of an integrated chronic disease care in other low- and middle-income countries. [ABSTRACT FROM AUTHOR]