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Increases in the prevalence of noncommunicable diseases (NCDs), particularly cardiometabolic diseases such as cardiovascular disease, stroke and diabetes, and their major risk factors have not been uniform across settings: for example, cardiovascular disease mortality has declined over recent decades in high-income countries but increased in low- and middle-income countries (LMICs). The factors contributing to this rise are varied and are influenced by environmental, social, political and commercial determinants of health, among other factors. This Review focuses on understanding the rise of cardiometabolic diseases in LMICs, with particular emphasis on obesity and its drivers, together with broader environmental and macro determinants of health, as well as LMIC-based responses to counteract cardiometabolic diseases. The rise of cardiometabolic diseases in low- and middle-income countries is tied to a multitude of environmental, social and commercial determinants, which are discussed in this Review along with a strategy to counteract those factors., Author(s): J. Jaime Miranda [sup.1] [sup.2] , Tonatiuh Barrientos-Gutiérrez [sup.3] , Camila Corvalan [sup.4] , Adnan A. Hyder [sup.5] , Maria Lazo-Porras [sup.1] [sup.6] , Tolu Oni [sup.7] [sup.8] , [...]

BackgroundInjuries are quickly becoming a leading cause of death globally, disproportionately affecting sub-Saharan Africa, where reports on the epidemiology of injuries are extremely limited. Reports on the patterns and frequency of injuries are available from Cameroon are also scarce. This study explores the patterns of trauma seen at the emergency ward of the busiest trauma center in Cameroon's capital city.Materials and methodsAdministrative records from January 1, 2007, through December 31, 2007, were retrospectively reviewed; information on age, gender, mechanism of injury, and outcome was abstracted for all trauma patients presenting to the emergency ward. Univariate analysis was performed to assess patterns of injuries in terms of mechanism, date, age, and gender. Bivariate analysis was used to explore potential relationships between demographic variables and mechanism of injury.ResultsA total of 6,234 injured people were seen at the Central Hospital of Yaoundé's emergency ward during the year 2007. Males comprised 71% of those injured, and the mean age of injured patients was 29 years (SD = 14.9). Nearly 60% of the injuries were due to road traffic accidents, 46% of which involved a pedestrian. Intentional injuries were the second most common mechanism of injury (22.5%), 55% of which involved unarmed assault. Patients injured in falls were more likely to be admitted to the hospital (p

BackgroundInjuries are quickly becoming a leading cause of death globally, disproportionately affecting sub-Saharan Africa, where reports on the epidemiology of injuries are extremely limited. Reports on the patterns and frequency of injuries are available from Cameroon are also scarce. This study explores the patterns of trauma seen at the emergency ward of the busiest trauma center in Cameroon's capital city.Materials and methodsAdministrative records from January 1, 2007, through December 31, 2007, were retrospectively reviewed; information on age, gender, mechanism of injury, and outcome was abstracted for all trauma patients presenting to the emergency ward. Univariate analysis was performed to assess patterns of injuries in terms of mechanism, date, age, and gender. Bivariate analysis was used to explore potential relationships between demographic variables and mechanism of injury.ResultsA total of 6,234 injured people were seen at the Central Hospital of Yaoundé's emergency ward during the year 2007. Males comprised 71% of those injured, and the mean age of injured patients was 29 years (SD = 14.9). Nearly 60% of the injuries were due to road traffic accidents, 46% of which involved a pedestrian. Intentional injuries were the second most common mechanism of injury (22.5%), 55% of which involved unarmed assault. Patients injured in falls were more likely to be admitted to the hospital (p

BackgroundThere is need for more timely data to inform interventions that address the growing noncommunicable disease (NCD) epidemic. With a global increase in mobile phone ownership, mobile phone surveys can bridge this gap. ObjectiveThis study aimed to explore the acceptability and use of interactive voice response (IVR) surveys for surveillance of NCD behavioral risk factors in rural Uganda. MethodsThis qualitative study employed user group testing (UGT) with community members. The study was conducted at the Iganga-Mayuge Health and Demographic Surveillance Site (IM-HDSS) in Eastern Uganda. We conducted four UGTs which consisted of different categories of HDSS members: females living in urban areas, males living in urban areas, females living in rural areas, and males living in rural areas. Participants were individually sent an IVR survey, then were brought in for a group discussion using a semistructured guide. Data were analyzed thematically using directed content analysis. ResultsParticipants perceived that IVR surveys may be useful in promoting confidentiality, saving costs, and raising awareness on NCD behavioral risk factors. Due to the clarity and delivery of questions in the local language, the IVR survey was perceived as easy to use. Community members suggested scheduling surveys on specific days and sending reminders as ways to improve their use for surveillance. Social issues such as domestic violence and perceptions toward unknown calls, technological factors including poor network connections and inability to use phones, and personal issues such as lack of access to phones and use of multiple networks were identified as barriers to the acceptability and use of mobile phone surveys. However, incentives were reported to motivate people to complete the survey. ConclusionsCommunity members reflected on contextual and sociological implications of using mobile phones for surveillance of NCD behavioral risk factors. The opportunities and challenges that affect acceptability and use of IVR surveys should be considered in designing and implementing surveillance programs for NCD risk factors.

Problem The burden oftrauma and injuries in Uganda is substantial and growing.Two important gaps that need addressing are the shortage of trained people and a lack of national data on noncommunicable diseases and their risk factors in Uganda. Approach We developed and implemented a new track within an existing master of public health programme, aimed at developing graduate-level capacity and promoting research on key national priorities for trauma and injuries. We also offered training opportunities to a wider audience and set up a high-level national injury forum to foster national dialogue on addressing the burden of trauma, injuries and disability. Local setting The Chronic Consequences of Trauma, Injuries and Disability in Uganda programme was implemented In 2012 at Makerere University School of Public Health in Kampala, Uganda, in conjunction with Johns Hopkins Bloomberg School of Public Health in Baltimore, United States of America. Relevant changes Over the years 2012 to 2017 we supported four cohorts of master's students, with a total of 14 students (9 females and 5 males; mean age 30 years). Over 1300 individuals participated in workshops and seminars of the short-term training component of the programme. The forum hosted three research symposia and two national injury forums. Lessons learnt Institutional support and collaborative engagement is important for developing and implementing successful capacity development programmes. Integration of training components within existing academic structures is key to sustainability. Appropriate mentorship for highly motivated and talented students is valuable for guiding students through the programme. Probleme La charge de morbidite liee aux traumatismes et aux blessures en Ouganda est importante et en augmentation. La penurie de personnes formees et le manque de donnees nationales sur les maladies non transmissibles et leurs facteurs de risque en Ouganda constituent deux lacunes importantes qui doivent etre comblees. Approche Nous avons elabore et mis en oeuvre un nouveau parcours au sein d'un master de sante publique existant, destine a developper des capacites de niveau universitaire et a promouvoir la recherche sur les principales priorites nationales relatives aux traumatismes et aux blessures. Nous avons egalement propose des possibilites deformation a un plus large public et organise un forum national de haut niveau sur les blessures pour encourager un dialogue national sur la charge induite par les traumatismes, les blessures et le handicap. Environnement local Le programme Consequences chroniques des traumatismes, des blessures et du handicap en Ouganda a ete mis en oeuvre en 2012 a l'Ecole de sante publique de l'Universite Makerere a Kampala, en Ouganda, en collaboration avec l'Ecole de sante publique Bloomberg de l'Universite Johns Hopkins a Baltimore, aux Etats-Unis d'Amerique. Changements significatifs Entre 2012 et 2017, nous avons soutenu quatre cohortes d'etudiants en master, pour un total de 14 etudiants (9 femmes et 5 hommes; age moyen 30 ans). Plus de 1300 personnes ont participe aux ateliers et seminaires du volet formation courte du programme. Le forum a accueilli trois symposiums de recherche et deux forums nationaux sur les blessures. Lecons tirees Le soutien institutionnel et l'engagement collaboratif sont importants pour elaborer et mettre en oeuvre avec succes des programmes de renforcement des capacites. L'integration des volets deformation aux structures universitaires existantes est essentielle pour leur viabilite. Un tutorat adapte pour les etudiants motives et brillants est utile pour les accompagner pendant toute la duree du programme. Problema La carga de traumatismos y lesiones en Uganda es notable y sigue creciendo. Dos deficiencias importantes que deben abordarse son la escasez de personal formado y la falta de datos nacionales sobre las enfermedades no contagiosas y sus factores de riesgo en Uganda. Enfoque Se ha desarrollado e implementado un nuevo curso dentro de un programa de master en salud publica existente, destinado a desarrollar la capacidad de nivel de postgrado y promover la investigacion sobre prioridades nacionales clave para traumatismos y lesiones. Tambien se ofrecieron oportunidades de formacion a un publico mas amplio y se establecio un foro nacional de alto nivel sobre lesiones para fomentar el dialogo nacional sobre la carga de los traumatismos, las lesiones y la discapacidad. Marco regional El programa Consecuencias cronicas de los traumatismos, las lesiones y la discapacidad en Uganda se implemento en 2012 en la Escuela de Salud Publica de la Universidad de Makerere en Kampala, Uganda, junto con la Escuela de Salud Publica Johns Hopkins Bloomberg en Baltimore, EE.UU. Cambios importantes Entre los anos 2012 y 2017 se respaldaron cuatro cohortes de estudiantes de master, con un total de 14 estudiantes (9 mujeres y 5 hombres, con una edad media de 30 anos). Mas de 1300 personas participaron en talleres y seminarios del componente de formacion a corto plazo del programa. El foro fue sede de tres simposios de investigacion y dos foros nacionales sobre lesiones. Lecciones aprendidas El apoyo institucional y el compromiso colaborativo son importantes para desarrollar e implementar programas de desarrollo de capacidades de exito. La integracion de los componentes de formacion dentro de las estructuras academicas actuales es clave para la sostenibilidad. Una tutoria apropiada para estudiantes muy motivados y con talento es valiosa para guiar a los estudiantes por el programa., Introduction Injuries are a leading cause of death in the African Region, where they claim over 900 000 lives annually, (1) and within Africa, Uganda has one of the highest [...]