March 2009 - Non-Communicable Diseases


HLT/058 - March 2009




Social Science & Medicine 68(6); March 2009

Smits, J.; Monden, C. Length of life inequality around the globe Pp. 1114-1123

Inequality in the distribution of adult length of life – defined as age at death in the population aged 15 and over – is studied for virtually all countries of the world using a new database with over 9000 life tables covering a period of up to two centuries. The data reveal huge variation among countries and time periods in the degree to which the available years of life are distributed equally among the population. Most length of life inequality (about 90%) is within-country inequality. Our findings make clear that measures of length of life inequality should be adjusted for life expectancy to get a more relevant indicator of length of life differentials across populations. At similar levels of life expectancy, substantial differences in inequality are observed, even among highly developed countries. Expressed as premature mortality, inequality may be 35–70% higher in the most unequal countries compared to the most equal ones. Countries that reached a certain level of life expectancy earlier in time than other countries, and countries that improved their life expectancy more quickly than others, experienced higher levels of inequality…



BMC Endocrine Disorders  9(9); March 2009

Ogbera, A.O. et al. Clinical features, predictive factors and outcome of hyperglycaemic emergencies in a developing country

Hyperglycaemic emergencies are common acute complications of diabetes mellitus (DM) but unfortunately, there is a dearth of published data on this entity from Nigeria. This study attempts to describe the clinical and laboratory scenario associated with this complication of DM. This study was carried out in DM patients who presented to an urban hospital in Nigeria with hyperglycaemic emergencies (HEs). The information extracted included biodata, laboratory data and hospitalization outcome. Outcome measures included mortality rates, case fatality rates and predictive factors for HEs mortality. Statistical tests used are chi 2 , Student's t test and logistic regression. The mortality rate for HEs in this report is 20% and the case fatality rates for DKA and HHS are 18% and 35% respectively. The predictive factors for HEs mortality include, sepsis, foot ulceration , previously undetected DM, hypokalaemia and being elderly. HHS carry a higher case fatality rate than DKA and the predictive factors for hyperglycaemic emergencies' mortality in the Nigerian with DM include foot ulcers, hypokalaemia and being elderly…


European Journal of Cancer 45(4); March 2009

Gianni, L. et al. Second non-breast primary cancer following adjuvant therapy for early breast cancer: A report from the International Breast Cancer Study Group Pp.561-571

The incidence of second non-breast primary cancer following adjuvant treatment was evaluated using data from patients enrolled from 1978 to 1999 in four International Breast Cancer Study Group (IBCSG) trials. The occurrence of these tumours as sites of the first failure was assessed separately for two treatment comparisons: toremifene versus tamoxifen for 5 years in 1035 patients in IBCSG Trials 12-93 and 14-93 with a median follow-up of 8 years and endocrine therapy (toremifene or tamoxifen) versus chemo-endocrine therapy (CMF or AC plus toremifene or tamoxifen) in 1731 patients from IBCSG Trials III, VII and 12-93, with a combined median follow-up of 14 years. No significant differences in second non-breast primary tumours were observed in either comparison. In particular, the incidences of second primary uterine tumours with toremifene and tamoxifen were similar and no significant increase of secondary leukaemias was observed with chemo-endocrine therapy compared with endocrine therapy…


International Journal of Gynecology & Obstetrics 104(Supp.1); March 2009

Hannan, C. Women, gender equality, and diabetes Pp. S4-S7

Discussion of women, gender equality, and diabetes should be placed in the context of United Nations mandates on women's health which highlight the need for equal access to information, prevention activities, services, and care across the life cycle. Gender differences and inequalities have been identified in relation to causes and consequences of diabetes and access to services and support between women and men, and among different groups of women. Appropriate gender-sensitive policy responses, including research and data collection, need to be developed. The recent United Nations resolution on diabetes provides an opportunity to strengthen the focus on women and diabetes…


International Journal of Gynecology & Obstetrics 104(Supp.1); March 2009

Wolfson, E. M. ; DeKalb, A.; Rojhani, A. Women's health in the 21st century Pp. S2-S3

Although women's health has been under-attended for most of the 20th century, it has gained international attention in recent decades. Medical and social research on heart disease, lung cancer, HIV/AIDS, and trachoma indicate that bio-socio variables affect women's health differently from men's. With regard to diabetes, data on pregnancy, diabetic ketoacidosis (DKA), depression, and heart disease corroborate the differentials between men and women. Data also indicate that social factors place diabetic women at a disadvantage regarding access to treatment and outcomes. Ascertaining the precise interactions that cause these differences and applying this information to policies and programs are imperative in the 21st century…


The Lancet 373(9667); 14 March 2009

Krum, H.; Abraham, W.T. Heart failure Pp. 941-955

Despite advances in management of heart failure, the condition remains a major public-health issue, with high prevalence, poor clinical outcomes, and large health-care costs. Risk factors are well known and, thus, preventive strategies should have a positive effect on disease burden. Treatment of established systolic chronic heart failure includes use of agents that block the renin-angiotensin-aldosterone and sympathetic nervous systems to prevent adverse remodelling, to reduce symptoms and prolong survival. Diuretics are used to achieve and maintain euvolaemia. Devices have a key role in management of advanced heart failure and include cardiac resynchronisation in patients with evidence of cardiac dyssynchrony and implantation of a cardioverter defibrillator in individuals with low ejection fraction. Approaches for treatment of acute heart failure and heart failure with preserved ejection fraction are supported by little clinical evidence. Emerging strategies for heart failure management include individualisation of treatment, novel approaches to diagnosis and tracking of therapeutic response, pharmacological agents aimed at new targets, and cell-based and gene-based methods for cardiac regeneration…



International Journal of Mental Health Systems 3(5);

Mbatia, J.; Shah, A.; Jenkins, R. Knowledge, attitudes and practice pertaining to depression among primary health care workers in Tanzania

Examination of consultation data in a variety of primary care settings in Tanzania shows that, while psychoses are routinely diagnosed and treated at primary care level, depression is rarely recorded as a reason for consultation. Since, epidemiological studies elswhere show that depression is a much more common disorder than psychosis, a series of studies were undertaken to elucidate this apparent paradox in Tanzania and inform mental health policy; firstly, a household prevalence study to ascertain the prevalence of common mental disorders at community level in Tanzania; secondly, a study to ascertain the prevalence of common mental disorders in primary care attenders; and thirdly, a study to ascertain the current status of the knowledge, attitude and practice pertaining to depression among primary health care workers. This paper reports the findings of the latter study.The majority of respondents felt that rates of depression had increased in recent years, believed that life events were important in the aetiology of depression, and generally held positive views about pharmacological and psychological treatments of depression, prognosis and their own involvement in the treatment of depressed patients. However, the majority of respondents felt that becoming depressed is a way that people with poor stamina deal with life difficulties.The findings suggest a need to strengthen the training of primary health care workers in Tanzania about the detection of depression, pharmacological and psychological treatments, and psychosocial interventions…



Nutrition & Metabolism  6(12) ; March 2009

Layman, D.K.  Dietary guidelines should reflect new understandings about adult protein needs

Dietary Guidelines for Americans provide nutrition advice aimed at promoting healthy dietary choices for life-long health and reducing risk of chronic diseases. With the advancing age of the population, the 2010 Dietary Guidelines confront increasing risks for age-related problems of obesity, osteoporosis, type 2 diabetes, Metabolic Syndrome, heart disease, and sarcopenia. New research demonstrates that the meal distribution and amount of protein are important in maintaining body composition, bone health and glucose homeostasis. This editorial reviews the benefits of dietary protein for adult health, addresses omissions in current nutrition guidelines, and offers concepts for improving the Dietary Guidelines…

Destaque Publicações

rds-report-2010-pt-tnActividades da OMS na Região Africana 2010
Relatório Anual do Director Regional [pdf 1.3Mb]


reaching-mdgs-tnTowards reaching the health-related millennium development goals: progress report and the way forward
Report of the Regional Director [pdf 6MB]


strat-15-ptPara Alcançar o Desenvolvimento Sustentável da Saude na Região Africana:
Orientações Estratégicas para a OMS, 2010-2015
[pdf 1.1Mb]

rd-report-2008-2009_afr_rc60_2_1_poActividades da OMS na Região Africana 2008-2009
Relatório Bienal do Director Regional
[pdf 3.3Mb]