ABSTRACT
Raised blood pressure (BP) is the leading cause of preventable death in the world. Yet, its global prevalence is increasing, and it remains poorly detected, treated, and controlled in both high- and low-resource settings. From the perspective of members of the International Society of Hypertension based in all regions, we reflect on the past, present, and future of hypertension care, highlighting key challenges and opportunities, which are often region-specific. We report that most countries failed to show sufficient improvements in BP control rates over the past three decades, with greater improvements mainly seen in some high-income countries, also reflected in substantial reductions in the burden of cardiovascular disease and deaths. Globally, there are significant inequities and disparities based on resources, sociodemographic environment, and race with subsequent disproportionate hypertension-related outcomes. Additional unique challenges in specific regions include conflict, wars, migration, unemployment, rapid urbanization, extremely limited funding, pollution, COVID-19-related restrictions and inequalities, obesity, and excessive salt and alcohol intake. Immediate action is needed to address suboptimal hypertension care and related disparities on a global scale. We propose a Global Hypertension Care Taskforce including multiple stakeholders and societies to identify and implement actions in reducing inequities, addressing social, commercial, and environmental determinants, and strengthening health systems implement a well-designed customized quality-of-care improvement framework.
ABSTRACT
INTRODUCTION: Ischaemic heart disease (IHD) is one of the leading causes of death and disease burden in India affecting all age groups. To reduce the deaths and tackle the burden of existing IHD, the government approach has been mostly through the National Health Policy (2017) and National Programme for Prevention and Control of Diabetes, Cardiovascular diseases and Stroke. This paper offers a protocol for the systematic review of studies exploring the factors influencing service readiness of the public health system of India to tackle the burden of IHD. METHODS AND ANALYSIS: Electronic databases of Embase (Ovid), AMED (Ovid), HMIC (Ovid), BNI (ProQuest), CINAHL (EBSCO), EMCARE (Ovid), PsycINFO (ProQuest), MEDLINE/PubMed and Web of Science (Clarivate Analytics) will be searched till 2020 for primary studies. Grey literature will be accessed through OpenGrey, TRIP Medical, WHO database, MoHFW website, Open Government Data (OGD) Platform of India and Google Scholar (between 2010 and 2020). Primary studies meeting the eligibility criteria and grey literature published in English between 2010 and 2020 will be included. Data will be analysed through a conceptual framework, and the primary outcome will constitute both quantitative and qualitative data. The quality of included studies will be assessed based on study design. Data will be managed on the COVIDENCE platform. All authors will be involved in data extraction, quality appraisal, data synthesis and formulation of the final draft. ETHICS AND DISSEMINATION: This study, being a systematic review, does not involve any clinical trial, primary data collection or empirical study involving humans or animals. Therefore, no ethical permissions were sought by reviewers. PROSPERO REGISTRATION NUMBER: CRD42020219490.
Subject(s)
Coronary Artery Disease , Myocardial Ischemia , Health Policy , Humans , Myocardial Ischemia/prevention & control , Public Health , Research Design , Systematic Reviews as TopicABSTRACT
Abstract The COVID-19 pandemic has impacted social, economic, and environmental systems worldwide, slowing down and reversing the progress made in achieving the Sustainable Development Goals (SDGs). SDGs belong to the 2030 Agenda to transform our world by tackling humankind's challenges to ensure well-being, economic prosperity, and environmental protection. We explore the potential impacts of the pandemic on SDGs for Nepal. We followed a knowledge co-creation process with experts from various professional backgrounds, involving five steps: online survey, online workshop, assessment of expert's opinions, review and validation, and revision and synthesis. The pandemic has negatively impacted most SDGs in the short term. Particularly, the targets of SDG 1, 4, 5, 8, 9, 10, 11, and 13 have and will continue to have weakly to moderately restricting impacts. However, a few targets of SDG 2, 3, 6, and 11 could also have weakly promoting impacts. The negative impacts have resulted from impeding factors linked to the pandemic. Many of the negative impacts may subside in the medium and long terms. The key five impeding factors are lockdowns, underemployment and unemployment, closure of institutions and facilities, diluted focus and funds for non-COVID-19-related issues, and anticipated reduction in support from development partners. The pandemic has also opened a window of opportunity for sustainable transformation, which is short-lived and narrow. These opportunities are lessons learned for planning and action, socio-economic recovery plan, use of information and communication technologies and the digital economy, reverse migration and 'brain gain,' and local governments' exercising authorities.
ABSTRACT
The pandemic COVID-19 caused by novel coronavirus (SARS-CoV-2) is a highly infectious disease that has created an unprecedented global challenge affecting all the countries including Nepal. In Nepal, the first case of COVID-19 was reported on 24 January, 2020. The number of case increased to 1,798 by June 1, 2020. Most of these cases were recorded in the lowland Tarai districts of the country indicating that the major transmission slipped from the border between Nepal and India. Thousands of Nepali people go to India for work every year. This year, they returned en-masse to Nepal after India declared lockdown. However, the first case of COVID-19 was detected in a student who had returned from China and a few initial cases were from people who had returned from Europe via Middle East using international flights. As of June 1, 2020, the coronavirus has spread to 61 districts (out of 77) of Nepal as those home returning people, mostly the migrant workers made their destinations by roads using public vehicles. Reports are mounting that the infected cases are increasing in the rural mountains gradually. This study aims to prepare time series tracking map of the infection in Nepal. It is based on a total of 71,903 PCR tests that were conducted till June 1, 2020. There is a strong correlation between PCR tests and the identified case;however, the number of tests is much limited to develop a decision support scenario.
ABSTRACT
COVID-19 pandemic has threatened millions of human lives and devastated social and economic conditions globally. This pandemic also threatens wildlife, particularly fragile populations. Many news and rumors linking COVID-19 with wildlife have flooded in early phase of pandemic, which has impacted the conservation in long run. Understanding the unexpected threats posed by COVID-19 is crucial to preserving such animals. Negative perception towards wildlife, financial uncertainty for conservation activities, and increase pressure on poaching and illegal killing of animals would be new challenges due to this pandemic. Educating people on how disease could transfer from wildlife to human and tackling COVID-19 rumors against wild animals are necessary in this situation.