Suchergebnisse

Abstract Background The prevalence of Non Communicable Diseases (NCDs) is still unknown in Nepal. The Ministry of Health and Population, Government of Nepal has not yet formulated policy regarding NCDs in the absence of evidence based finding. The study aims to find out the hospital based prevalence of NCDs in Nepal, thus directing the concerned authorities at policy level. Methods A cross sectional study was conducted to identify the hospital based prevalence of 4 NCDs (cancer, cardiovascular disease, diabetes mellitus and chronic obstructive pulmonary disease), wherein 400 indoor patients admitted during 2009 were randomly selected from each of the 31 selected health institutions which included all non-specialist tertiary level hospitals outside the Kathmandu valley (n = 25), all specialist tertiary level hospitals in the country (n = 3) and 3 non-specialist tertiary level hospitals inside the Kathmandu valley. In case of Kathmandu valley, 3 non-specialist health institutions- one central hospital, one medical college and one private hospital were randomly selected. The main analyses are based on the 28 non-specialist hospitals. Univariate (frequency and percentage) and bivariate (cross-tabulation) analysis were used. Results In non-specialist institutions, the hospital based NCD prevalence was 31%. Chronic obstructive pulmonary disease (43%) was the most common NCD followed by cardiovascular disease (40%), diabetes mellitus (12%) and cancer (5%). Ovarian (14%), stomach (14%) and lung cancer (10%) were the main cancers accounting for 38% of distribution. Majority of CVD cases were hypertension (47%) followed by cerebrovascular accident (16%), congestive cardiac failure (11%), ischemic heart disease (7%), rheumatic heart disease (5%) and myocardial infarction (2%). CVD was common in younger age groups while COPD in older age groups. Majority among males (42%) and females (45%) were suffering from COPD. Conclusions The study was able to reveal that Nepal is also facing the surging burden of NCDs similar to other developing nations in South East Asia. Furthermore, the study has provided a background data on NCDs in Nepal which should prove useful for the concerned organizations to focus and contribute towards the prevention, control and reduction of NCD burden and its risk factors.

Abstract.  Communicable diseases pose a formidable challenge for public policy. Using numerical simulations, we show under which scenarios a monopolist's price and prevalence paths converge to a non‐zero steady state. In contrast, a planner typically eradicates the disease. If eradication is impossible, the planner subsidizes treatments as long as the prevalence can be controlled. Drug resistance exacerbates the welfare difference between monopoly and first best outcomes. Nevertheless, because the negative externalities from resistance compete with the positive externalities of treatment, a mixed competition/monopoly regime may perform better than competition alone. This result has important implications for the design of many drug patents.

This last decade, regional organizations progressively became
unavoidable actors of regional health governance and have been supported by some global health actors to strengthen such a role. Among these actors, the European Union (EU) is the only regional organization that implements health initiatives in cooperation with its regional counterparts. This article focuses on such "health interregionalism" toward Southeast Asia and Africa and in the field of communicable diseases, with the main objective of assessing its nature and identifying its main functions. It concludes that although appreciated and needed, the EU's health interregionalism should better reflect the EU's experience in regional health governance in order to represent a unique instrument of development aid and an added value for regional organizations

BACKGROUND: Non-communicable diseases contribute to 62% of total deaths in India; of concern are the preventable premature deaths, which account for a staggering 48% of mortality. The objective of this study was to establish a consensus research agenda for non-communicable disease prevention and control that has the potential to impact polices, programmes and healthcare delivery in India. METHODS: To develop a non-communicable disease research agenda, we engaged our community collaborative board and scientific advisory group in a three-step process using two web-based surveys and one in-person meeting. First, the Delphi methodology was used to generate topics. Second, these ideas were deliberated upon during the in-person meeting, leading to the prioritisation of 23 research questions, which were subjected to Strength, Weakness, Opportunities and Threat analysis by the stakeholders using the Snow Card methodology with the scientific advisory group and community collaborative board. This step resulted in the identification of 15 low effort, high impact priority research questions for various health outcomes across research disciplines based on discussion with the larger group to reach consensus. Finally, the second web-based survey resulted in the identification of 15 key priority research questions by all stakeholders as being the most important using a linear mixed effect regression model. RESULTS: The final set of 15 priority research questions focused on interventions at the individual, community, systems and policy levels. Research questions focused on identifying interventions that strengthen healthcare systems and healthcare delivery, including models of care and improved access to non-communicable disease screening, diagnosis and treatment, determining the impact of government policies, assessing the effectiveness of prevention programmes (e.g. tobacco, environmental improvements), and testing research tools and resources to monitor non-communicable diseases at the population level. CONCLUSION: To produce ...

There is concern among public health professionals that the current economic downturn, initiated by the financial crisis that started in 2007, could precipitate the transmission of infectious diseases while also limiting capacity for control. Although studies have reviewed the potential effects of economic downturns on overall health, to our knowledge such an analysis has yet to be done focusing on infectious diseases. We performed a systematic literature review of studies examining changes in infectious disease burden subsequent to periods of crisis. The review identified 230 studies of which 37 met our inclusion criteria. Of these, 30 found evidence of worse infectious disease outcomes during recession, often resulting from higher rates of infectious contact under poorer living circumstances, worsened access to therapy, or poorer retention in treatment. The remaining studies found either reductions in infectious disease or no significant effect. Using the paradigm of the "SIR" (susceptible-infected-recovered) model of infectious disease transmission, we examined the implications of these findings for infectious disease transmission and control. Key susceptible groups include infants and the elderly. We identified certain high-risk groups, including migrants, homeless persons, and prison populations, as particularly vulnerable conduits of epidemics during situations of economic duress. We also observed that the long-term impacts of crises on infectious disease are not inevitable: considerable evidence suggests that the magnitude of effect depends critically on budgetary responses by governments. Like other emergencies and natural disasters, preparedness for financial crises should include consideration of consequences for communicable disease control.

The UN High-Level Meeting on Non-Communicable Diseases (NCDs) in September, 2011, is an unprecedented opportunity to create a sustained global movement against premature death and preventable morbidity and disability from NCDs, mainly heart disease, stroke, cancer, diabetes, and chronic respiratory disease. The increasing global crisis in NCDs is a barrier to development goals including poverty reduction, health equity, economic stability, and human security. The Lancet NCD Action Group and the NCD Alliance propose five overarching priority actions for the response to the crisis--leadership, prevention, treatment, international cooperation, and monitoring and accountability--and the delivery of five priority interventions--tobacco control, salt reduction, improved diets and physical activity, reduction in hazardous alcohol intake, and essential drugs and technologies. The priority interventions were chosen for their health effects, cost-effectiveness, low costs of implementation, and political and financial feasibility. The most urgent and immediate priority is tobacco control. We propose as a goal for 2040, a world essentially free from tobacco where less than 5% of people use tobacco. Implementation of the priority interventions, at an estimated global commitment of about US$9 billion per year, will bring enormous benefits to social and economic development and to the health sector. If widely adopted, these interventions will achieve the global goal of reducing NCD death rates by 2% per year, averting tens of millions of premature deaths in this decade. ; open

Collaboration occurs in many fields and is used as a 'buzz word' that can contextually mean different things. Research collaboration occurs primarily in the form of 'researchers working together on a common research problem or activity' (Rand, 1998: 11). Collaborative research continues to be an increasing phenomenon and there are higher levels of collaboration in the area of health and basic research. Research into communicable diseases is important because they are the second leading cause of death worldwide and have global impact. HIV/AIDS, Tuberculosis (TB) and malaria are the 'killer three' communicable diseases, together resulting in about 6 million deaths each year. Without further research these figures are likely to continue to increase. Identifying 'best practice' for research in this area is also important if Millennium Development Goal 6 'to combat HIV/AIDS, malaria and other diseases' is to be met. Research in communicable disease can be conducted either collaboratively, such as with joint resources or shared data, or non-collaboratively. As such, evaluating the nature and outcomes of research collaboration, and the form in which research is conducted in communicable disease, is important. This study identifies seven benefits and five costs of formal research collaboration . Benefits include to (1) increase access to data, knowledge and resources; (2) increase understanding of research problems; (3) enable access to facilities, equipment and laboratories; (4) enable flow of knowledge between researchers; (5) prevent duplication ; (6) strengthen research capacity, especially relevant with vertical collaboration such as between developed and developing countries; and (7) increase access to funding. Costs identified include (1) additional expenses; (2) additional time costs; (3) additional administration costs; (4) potentially unbalanced roles; and (5) priority diversion. Evaluation of whether research should be collaborative should be based on objectives of the research project. These objectives for research in HIV/AIDS , TB and malaria are broadly broken down into six areas including: to develop effective drugs, to develop vaccines, to increase understanding of the disease, to improve diagnostics, to establish surveillance, and to create new and innovative technologies. The scale and scope of these research problems and objectives is so vast that it can motivate research collaboration. An analysis of five case studies of research collaboration in HIV/AIDS, TB and malaria research, primarily funded through the Sixth Framework Programme (FP6) demonstrates the benefits of research collaboration. Each illustrates that collaboration can result in increased access to knowledge and data. The BioMalPar project for example held conferences on an annual basis to facilitate access to knowledge and data to meet its objectives successfully. The CASCADE collaborative project, a consortium between 11 European countries, Canada and Australia, was able to conduct research that would be impossible without such levels of involvement. This demonstrates that collaboration can effectively address issues that cannot be reliably addressed by individual studies or non-collaborative projects alone. However an unforeseen cost of collaboration emerges: that collaboration does not necessarily result in a quicker completion of projects. The European Union's Sixth Framework Programme for Research and Technology Development (FP6) has allocated substantial funding for collaborative research projects in areas such as communicable disease. The Australian National Health and Medical Research Council (NHMRC) and United States National institutes of Health (NIH) have also more than doubled funding for research in HIV/AIDS, TB and malaria within the past ten years. Although not directly funding research, the Global Fund to Fight AIDS, TB and Malaria (GFATM) also provides incentive for research in these diseases through its purchasing power. Despite this, the '90-10 gap', whereby 90 percent of the world's funding for health research is spent on 10 percent of the world's health problems, continues to prevail. To address this gap, funding needs to be allocated to 'best practice' methods of research. Vast amounts of funds are dedicated to research in the form of collaborative activities, without necessarily defining what level and types of activities these entail. Funding structures and levels also differ substantially between countries, institutions and Public-Private Partnerships and are commonly unspecified and complex. In this regard, collaborative research often receives vast amounts of funding without necessarily having structures in place to evaluate the projects, the effects, results or benefits of the collaboration. This is evident for example with Special Programme for Research and Training in Tropical Diseases (TDR) collaborative grants. The immense number of institutions, organisations and trusts involved in promoting research in this area makes it difficult to systematise information regarding research collaboration. In general, there are scientific, economic, and political benefits to be gained through international research collaboration, including additional access to resources, knowledge, establishing greater research capacity, and enabling nations to pool funds in order to address issues of global concern. Communicable disease such as HIV/AIDS, TB and malaria are certainly diseases of global concern, which is why a more structured or systematic approach to identify levels and types of collaboration in these diseases would be beneficial. Direct and indirect benefits of research collaboration also exist which indicate that there are several important advantages of research collaboration. Ultimately however, in order to assess whether projects should be collaborative, the costs and benefits of collaboration should be evaluated. importantly, the research objectives of a particular project should be taken into account. On the basis of this study it is concluded that research into communicable disease such as HIV/AIDS, TB and malaria should be assessed on a case-by-case basis and not be exclusively collaborative. Recommendations: • The costs and benefits of collaboration and the research objectives of a project should be taken into account when determining if research should be conducted collaboratively. • Funding organisations and bodies should have a structured approach to policies regarding international collaboration and clarify what kinds of collaborations are funded, and the reasons as to why projects are collaborative. • There needs to be more research conducted in this area that includes both qualitative and quantitative analysis which assesses if collaboration produces improved results.

Fighting communicable diseases such HIV/AIDS, tuberculosis (TB, and malaria has become a global endeavor, with international health authorities urging the development of effective vaccines for the eradication of these global pandemics. Yet, despite the acknowledged urgency, and given the feasibility of effective vaccine development, public and private research efforts have failed to address a response adequate to the magnitude of the crisis. Members of the academic community suggest bridging this gap by devising research pull mechanisms capable of stimulating private investments, confident that competition‐based market devices are more effective than public intervention in shaping scientific breakthroughs. With reference to the economics of innovation, the paper argues that, whilst such an approach would lead to a socially suboptimal production of knowledge, direct public intervention in vaccine R&D activities would represent a far more socially desirable policy option. In recognition of the current financial and political fatigue affecting the international community towards communicable disease control, the paper resorts to the theories of global public goods (GPGs) to provide governments, both in the North and in the South, with a powerful rationale for committing to a cooperative approach for vaccine R&D. The paper encourages the creation of a Global Health Research Fund to manage such exercise and proposes enshrining countries' commitments into an International Health Treaty. The paper ends by providing a number of policy recommendations.

The actual or potential burden of infectious diseases is sometimes so great that governments treat them as threats to national security. However, such treatment potentially increases the risk that emergency disease-control measures will be ineffective, counterproductive and/or unjust. Research on ethical issues associated with infectious disease is a relatively new and rapidly growing area of academic inquiry, as is research on infectious diseases within the field of security studies. This volume incorporates ethical and security perspectives, thus furthering research in both fields. Its uniqu.

Chronic non-communicable diseases (NCDs) such as hypertension, stroke, diabetes and cancers, are major causes of disability and death in Ghana. NCDs are not only public health problems. They are also developmental problems, because the rising prevalence of long-term chronic conditions has major social and financial implications for affected individuals, families, healthcare providers and the government. This University of Ghana Readers volume from the Regional Institute for Population Studies presents social and medical science research on Ghanaís NCD burden. The body of multidisciplinary rese

Chronic diseases-cardiovascular disease, cancer, chronic respiratory disease and diabetes-are not only the principal cause of world-wide mortality but also are now responsible for a striking increase in the percentage of sickness in developing countries still grappling with the acute problems of infectious diseases. This "double disease burden" poses demanding questions concerning the organisation of health care, allocation of scarce resources and strategies for disease prevention, control and treatment; and it threatens not only improvement in health status but economic development in the man

Infektionskrankheiten sind ein Prüfungsschwerpunkt der Amtsarztprüfung, gilt es doch zu überprüfen, welche Krankheiten der Heilpraktiker nicht behandeln darf. Bisher gibt es kaum Literatur, die das ungeliebte und ausführliche abgefragte Prüfungsthema sorgfältig aufbereitet und ihm das entsprechende Gewicht gibt. -Grundlagen der Infektiologie und Epidemiologie. -Allgemeine Infektionslehre, Pathogenität und Virulenz, Prinzipien der immunologischen Infektabwehr. -Infektionskrankheiten geordnet nach Organsystemen. -komprimierte Darstellung der Krankheitsbilder. -Das Infektionsschutzgesetz - Inhalte und Ziele der gesetzlichen Bestimmungen