faculty

Publications

Management of NCD in low- and middle-income countries

Groups and Associations William Checkley 1, Hassen Ghannem 2, Vilma Irazola 3, Sylvester Kimaiyo 4, Naomi S Levitt 5, J Jaime Miranda 6, Louis Niessen 7, Dorairaj Prabhakaran 8, Cristina Rabadán-Diehl 9, Manuel Ramirez-Zea 10, Adolfo Rubinstein 3, Alben Sigamani 11, Richard Smith 12, Nikhil Tandon 13, Yangfeng Wu 14, Denis Xavier 11, Lijing L Yan 15; GRAND South Network, UnitedHealth Group/National Heart, Lung, and Blood Institute Centers of Excellence
Global heart. 2014

Noncommunicable disease (NCD), comprising cardiovascular disease, stroke, diabetes, and chronic obstructive pulmonary disease, are increasing in incidence rapidly in low- and middle-income countries (LMICs). Some patients have access to the same treatments available in high-income countries, but most do not, and different strategies are needed. Most research on noncommunicable diseases has been conducted in high-income countries, but the need for research in LMICs has been recognized. LMICs can learn from high-income countries, but they need to devise their own systems that emphasize primary care, the use of community health workers, and sometimes the use of mobile technology. The World Health Organization has identified "best buys" it advocates as interventions in LMICs. Non-laboratory-based risk scores can be used to identify those at high risk. Targeting interventions to those at high risk for developing diabetes has been shown to work in LMICs. Indoor cooking with biomass fuels is an important cause of chronic obstructive pulmonary disease in LMICs, and improved cookstoves with chimneys may be effective in the prevention of chronic diseases.