ABSTRACT
OBJECTIVE: The objective of this systematic review is to synthesize studies on economic burden and economic impact of noncommunicable diseases (NCDs) in the World Health Organization South-East Asian Region (WHO SEAR) countries. INTRODUCTION: WHO SEAR countries represent 8.6% of the world's population and 75% of all deaths in this region are attributable to NCDs. In addition, there is a pattern of low government spending on health in SEAR countries, leading to a high proportion of health financing by patients', risking impoverishment for households. INCLUSION CRITERIA: We will consider observational (cross-sectional, cohort, and case-control) and interventional (either single arm or comparative) studies that report economic burden (direct and indirect costs, out-of-pocket expenditure) and economic impact (catastrophic health expenditure, hardship financing, impoverishment, and gross domestic product impact at individual, household, and/or country levels). This includes government surveys, surveillance, and secondary data analyses for one or more NCDs prevalent in the WHO SEAR. METHODS: We will conduct a comprehensive search for relevant studies in databases, including PubMed (MEDLINE), Embase (Ovid), Scopus, Web of Science, Google Scholar, and gray literature with no date limits. Two independent reviewers will screen titles and abstracts, followed by full-text screening. Included studies will be critically appraised for quality. Data will be extracted accordingly and, if possible, random effects meta-analyses will be conducted on the pooled data for resource utilization and costs (including burden and impact), presenting the degree of variation between studies. The characteristics and results of the included studies will be narratively summarized with accompanying tables. REVIEW REGISTRATION: PROSPERO CRD42023421302.
ABSTRACT
To estimate sex-specific prevalence and associated socio-economic, demographic, and lifestyle risk factors of hypertension in India. We used data from the National Family Health Survey (NFHS-4) of 2015-16. The analysis based on 6,99,686 women (15-49 years) and 1,12,122 men (15-54 years) whose blood pressure (BP) were measured during the survey. Bivariate distribution was used to show the prevalence of hypertension and, maps were used to present its spatial patterns. Logistic regression model was used to identify sex-specific association between risk factors and hypertension. Results show that the overall prevalence of hypertension was 16.32% among men and 11.56% among women. We also found that the prevalence of hypertension across selected socio-economic, demographic and lifestyle background characteristics and in a majority of the states was higher among men compared to women. Odds ratios from logistic regression analysis direct sex-related differences in risk factors. Hypertension increases with an increase in age and the risk is higher among older women (AOR, 5.58; 95% CI, 5.16-6.03 for women aged 40-49 and AOR, 4.24; 95% CI, 3.94-4.57 for men aged 50-54) compared to men. Education, types of jobs (specially technical, administrative and managerial), marital status and non-vegetarian diet were significantly associated with hypertension in men. While other than age; non-working, consumption of alcohol, and being a diabetic was found to be major risk factors for this disease among women. There are sex-related differences in prevalence as well as risk factors of hypertension in India. In order to prevent early developments of hypertension, awareness related to changing lifestyles such as a diet rich in fruits, vegetables as well as screening to control BP should be promoted among youths and adults in India. The study also recommends sex-specific approaches in health infrastructure and policies besides increasing public awareness.
