scholarly journals A simple six-step guide to National-Scale Hypertension Control Program implementation

2021 ◽  
Author(s):  
Danielle Cazabon ◽  
Margaret Farrell ◽  
Reena Gupta ◽  
Lindsay Joseph ◽  
Anupam Khungar Pathni ◽  
...  
Keyword(s):  
Public Health ◽  
Blood Pressure ◽  
Large Scale ◽  
Scale Up ◽  
Treatment Protocol ◽  
Control Program ◽  
Global Public Health ◽  
Hypertension Control ◽  
National Scale ◽  
Preventable Risk Factor

AbstractHypertension is the leading single preventable risk factor for death worldwide, and most of the disease burden attributed to hypertension weighs on low-and middle-income countries. Effective large-scale public health hypertension control programs are needed to control hypertension globally. National programs can follow six important steps to launch a successful national-scale hypertension control program: establish an administrative structure and survey current resources, select a standard hypertension treatment protocol, ensure supply of medication and blood pressure devices, train health care workers to measure blood pressure and control hypertension, implement an information system for monitoring patients and the program overall, and enroll and monitor patients with phased program expansion. Resolve to Save Lives, an initiative of global public health organization Vital Strategies, and its partners organized these six key steps and materials into a structured, stepwise guide to establish best practices in hypertension program design, launch, maintenance, and scale-up.

scholarly journals “Blood pressure monitoring should be a habit”: adaptation of the Check. Change. Control. program for Asian American older adults, from group-based in-person to one-on-one telephone delivery

2021 ◽  
Author(s):  
Sou Hyun Jang ◽  
Emily V R Brown ◽  
Eun Jeong Lee ◽  
Linda K Ko
Keyword(s):  
Blood Pressure ◽  
Older Adults ◽  
Asian American ◽  
Limited English Proficiency ◽  
Blood Pressure Monitoring ◽  
Control Program ◽  
Hypertension Control ◽  
Group Setting ◽  
Face To Face ◽  
The Usa

Abstract Asian Americans have the lowest rate of awareness about hypertension, including controlled hypertension, among all racial/ethnic groups in the USA. A high proportion of Asian American older adults have limited English proficiency (LEP) and hypertension. This study adapted the Check. Change. Control. (CCC) program, a community-based intervention for hypertension control delivered in a face-to-face group setting, to phone-based delivery and evaluated the acceptability of the program among Asian American older adults with LEP. Thirteen participants received phone-based educational sessions on hypertension control over 4 months. After 4 months of interventions, we interviewed the 13 Asian American older adults and 4 counselors to examine the acceptability of the adapted CCC program. Both Asian American older adults and counselors found the phone-based delivery of the CCC program to be acceptable, and some participants recommended holding an in-person meeting before telephone delivery to review the program content and clarify information. Future study needs to explore the effectiveness of the phone-based delivery of the program on blood pressure management among larger groups of Asian American older adults.

scholarly journals Capacity and site readiness for hypertension control program implementation in the Federal Capital Territory of Nigeria: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ikechukwu A. Orji ◽  
Abigail S. Baldridge ◽  
Kasarachi Omitiran ◽  
Mainzhao Guo ◽  
Whenayon Simeon Ajisegiri ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Essential Medicine ◽  
Control Program ◽  
Disease Diagnosis ◽  
Essential Medicines ◽  
System Level ◽  
World Health ◽  
Full Time ◽  
Hypertension Control ◽  
And Control

Abstract Background Nigeria faces an increase in the burden of non-communicable diseases (NCDs), including cardiovascular diseases (CVDs), leading to an estimated 29% of all deaths in the country. Nigeria has an estimated hypertension prevalence ranging from 25 to 40% of her adult population. Despite this high burden, awareness (14–30%), treatment (< 20%), and control (9%) rates of hypertension are low in Nigeria. Against this backdrop, we sought to perform capacity and readiness assessments of public Primary Healthcare Centers (PHCs) to inform Nigeria’s system-level hypertension control program’s implementation and adaptation strategies. Methods The study employed a multi-stage sampling to select 60 from the 243 PHCs in the Federal Capital Territory (FCT) of Nigeria. The World Health Organization (WHO) Service Availability and Readiness Assessment was adapted to focus on hypertension diagnosis and treatment and was administered to PHC staff from May 2019 – October 2019. Indicator scores for general and cardiovascular service readiness were calculated based on the proportion of sites with available amenities, equipment, diagnostic tests, and medications. Results Median (interquartile range [IQR]) number of full-time staff was 5 (3–8), and were predominantly community health extension workers (median = 3 [IQR 2–5]). Few sites (n = 8; 15%) received cardiovascular disease diagnosis and management training within the previous 2 years, though most had sufficient capacity for screening (n = 58; 97%), diagnosis (n = 56; 93%), and confirmation (n = 50; 83%) of hypertension. Few PHCs had guidelines (n = 7; 13%), treatment algorithms (n = 3; 5%), or information materials (n = 1; 2%) for hypertension. Most sites (n = 55; 92%) had one or more functional blood pressure apparatus. All sites relied on paper records, and few had a functional computer (n = 10; 17%) or access to internet (n = 5; 8%). Despite inclusion on Nigeria’s essential medicines list, 35 (59%) PHCs had zero 30-day treatment regimens of any blood pressure-lowering medications in stock. Conclusions This first systematic assessment of capacity and readiness for a system-level hypertension control program within the FCT of Nigeria demonstrated implementation feasibility based on the workforce, equipment, and paper-based information systems, but a critical need for essential medicine supply strengthening, health-worker training, and protocols for hypertension treatment and control in Nigeria.

scholarly journals Characterizing the molecular and metabolic mechanisms of insecticide resistance in Anopheles gambiae s.l. in Faranah, Guinea

2019 ◽  
Author(s):  
Caleb Stica ◽  
Claire L. Jeffries ◽  
Seth R. Irish ◽  
Yaya Barry ◽  
Denka Camara ◽  
...  
Keyword(s):  
Plasmodium Falciparum ◽  
Insecticide Resistance ◽  
Anopheles Gambiae ◽  
Scale Up ◽  
Indoor Residual Spraying ◽  
Control Program ◽  
Sub Saharan Africa ◽  
Health Concern ◽  
Global Public Health ◽  
Metabolic Resistance

AbstractBackgroundIn recent years, the scale-up of long-lasting insecticidal nets (LLINs) and indoor residual spraying (IRS) has greatly reduced malaria transmission. However, malaria remains a global public health concern with the majority of disease burden in sub-Saharan Africa. Insecticide resistance is a growing problem among Anopheles vector populations, with potential implications for the continued effectiveness of available control interventions. Improved understanding of current resistance levels and underlying mechanisms is essential to design appropriate management strategies and to mitigate future selection for resistance.MethodsAnopheles gambiae s.l. mosquitoes were collected from three villages in Faranah Prefecture, Guinea and their levels of susceptibility to seven insecticides were measured using CDC resistance intensity bioassays. Synergist assays with piperonyl butoxide (PBO) were also undertaken to assess the role of elevated mixed-function oxidases in resistance. RNA was extracted from 563 individuals and PCR was performed on cDNA to determine vector species, presence of target site mutations (L1014F kdr, N1575Y and G119S Ace-1), Plasmodium falciparum infection, and relative expression of three metabolic genes (CYP6M2, CYP6P3 and GSTD3).ResultsIn Faranah, resistance to permethrin and deltamethrin was observed, as well as possible resistance to bendiocarb. All assayed vector populations were fully susceptible to alpha-cypermethrin, pirimiphos-methyl, clothianidin and chlorfenapyr. Plasmodium falciparum infection was detected in 7.3% (37/508) mosquitoes tested. The L1014F kdr mutation was found in 100% of a sub-sample of 60 mosquitoes, supporting its fixation in the region. The N1575Y mutation was identified in 20% (113/561) of individuals, with ongoing selection evidenced by significant deviations from Hardy-Weinberg equilibrium. The G119S Ace-1 mutation was detected in 62.1% (18/29) of mosquitoes tested and was highly predictive of bendiocarb bioassay survival. The metabolic resistance genes, CYP6M2, CYP6P3 and GSTD3, were found to be overexpressed in wild resistant and susceptible An. gambiae s.s. populations, compared to a susceptible G3 colony. Furthermore, CYP6P3 was significantly overexpressed in bendiocarb survivors, implicating its potential role in carbamate resistance in Faranah.ConclusionsIdentification of intense resistance to permethrin and deltamethrin in Faranah, is of concern, as the Guinea National Malaria Control Program (NMCP) relies exclusively on the distribution of pyrethroid-treated LLINs for vector control. Study findings will be used to guide current and future control strategies in the region.

Mass Vaccination Programme: Public Health Success and Ethical Issues – Bangladesh Perspective

2020 ◽  
Vol 9 (3) ◽  
pp. 11-15
Author(s):  
Abu Sadat Mohammad Nurunnabi ◽  
Miliva Mozaffor ◽  
Mohammad Akram Hossain ◽  
Sadia Akther Sony
Keyword(s):  
Public Health ◽  
Vaccination Programme ◽  
Large Scale ◽  
Ethical Issues ◽  
Herd Immunity ◽  
Mass Vaccination ◽  
Global Public Health ◽  
National Programme ◽  
Serious Infections ◽  
Individual Protection

Vaccines are responsible for many global public health successes, such as the eradication of smallpox and significant reductions in other serious infections like diphtheria, pertussis, tetanus, polio and measles. However, mass vaccination has also been the subject of various ethical controversies for decades. Several factors need to be considered before any vaccine is deployed at national programme like the potential burden of disease in the country or region, the duration of the protection conferred, herd immunity in addition to individual protection, vaccine-related risks, financing and the logistical feasibility of the large-scale vaccination. Moreover, several ethical dilemmas revolve around authority and mandates for vaccination, informed consent, benefits vs. risks, and disparities in access to vaccination. This review paper aims to elaborate the ethical issues involved in mass vaccination programme and present some additional challenges in the context of a resource-poor settings of public health in Bangladesh.

scholarly journals An Ethical Framework for Communicating Public Health Crises: A Case Analysis of the COVID-19 Pandemic

2021 ◽  
Vol 4 ◽  
pp. 8-11
Author(s):  
Qingjiang Yao
Keyword(s):  
Public Health ◽  
Large Scale ◽  
Ethical Reasoning ◽  
Ethical Framework ◽  
Global Public Health ◽  
Epidemiological Investigation ◽  
Health Crisis ◽  
Teleological Reasoning ◽  
Public Health Crisis ◽  
Novel Virus

These Identifying the traditional principle of medical ethics of autonomy as a major factor that hinders epidemiological investigation and the understanding of a novel virus, this study adopts an ethical framework, consisting of the axes of ethical devotions (local, national, continental, and global) and ethical reasoning approaches (deontological and teleological), to analyze the approaches of communicating global public health crises like the COVID pandemic. The argument is made to endorse a global devotion with teleological reasoning in a large-scale public health crisis that needs global collaboration to cope with.

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