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Two-thirds of Global South hypertension sufferers missing treatment – study

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Healthcare in low- and middle-income countries is poorly prepared for the increasing number of people with high blood pressure, with more than two-thirds of people affected going without treatment – a new study reveals.

Researchers studied health data for one million people in the Global South, discovering that less than half of those affected are diagnosed with high blood pressure or hypertension. Of these patients, only 30% are treated and only 10% have the disease under control.

The research team analysed the healthcare of hypertension in 44 countries. Using a cascade of care approach, which looked at the numbers of people with hypertension who had been screened, diagnosed, treated, and controlled, they determined how well the health systems of the various countries are treating people with hypertension.

University of Birmingham researchers worked with colleagues at the Harvard T.H. Chan School of Public Health, the University of Göttingen and the Medical Faculty of Heidelberg, publishing their findings in The Lancet.

Justine Davies, Professor of Global Health at the University of Birmingham’s Institute of Applied Health Research, comments: “Hypertension, or high blood pressure, is known from other studies to be prevalent in lower and middle income countries.

“Our research adds by showing that care in these countries is not able to match the number of people who need treatment. This is a particular problem as without treatment there is a considerable risk of complications – including stroke and death.

“It is not all bad news though. We found that some countries – like Costa Rica, Bangladesh, Brazil, Ecuador, Kyrgyzstan and Peru – are doing much better than expected, and it is important to look in more depth at those countries and learn from their success.”

The group carried out its research using surveys including the World Health Organisation’s STEPS survey – which uses a uniform approach to obtain data on established risk factors.

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“Our study shows not only that care for hypertension in these countries is severely inadequate, but also where exactly patients are being lost in the treatment system,” says Pascal Geldsetzer, postdoctoral research fellow at Harvard T.H. Chan School of Public Health and first author of the study.

Dr. Mary Mayige, Principle Research Scientist at the National Institute for Medical Research in Tanzania and co-author of the study, commented: “There is an urgent need to strengthen the healthcare system for chronic disease care in low income countries. This includes improving information systems and increased financing to ensure universal access across the continuum from preventive interventions to tertiary health care services.”

Researchers firstly determined how many people suffered from high blood pressure. Based on this, they determined how many of these patients were examined, diagnosed and treated each time. Finally, they analysed how many patients successfully controlled the disease with medication.

“High blood pressure can be treated relatively well and cheaply, but undiagnosed or untreated hypertension represents a considerable risk for the people affected,” says Sebastian Vollmer, Professor of Development Economics at the University of Göttingen.

“High blood pressure is one of the major widespread diseases in the Global South and increasingly common as populations in these countries age. This study provides important insights for policy-makers about where in the treatment chain for hypertension the greatest problems currently lie,” adds Till Bärnighausen, Professor of Global Health at Heidelberg University Hospital and the Medical Faculty of Heidelberg.

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Makinde lauds IUFMP initiative , promises to end flooding in Oyo

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Governor Seyi Makinde of Oyo state has expressed the readiness of his government to take proactive measures that would help put an end to flooding in the State.

Governor Makinde, who was represented by the Secretary to the State Government, Mrs. Olubamiwo Adeosun, made the pledge at the closing ceremony of the workshop on Ibadan flood forecast, early warning and implementation support programme held in the state capital, on Wednesday.

The Governor assured that his government would readily support the implementation of the Ibadan Urban Flood Management and other ongoing intervention projects in the state.

Contained in a statement signed by the Chief Press Secretary to the Governor, Mr. Taiwo Adisa, the Governor, commended the IUFMP on the flood forecast initiative, which he said: “will furnish our people with prior alerts about impending flood disasters”.

He stressed  that it was that a scientific initiative that would alert the people of the possibility of a looming flood disaster was being launched.

Governor Makinde, also described the Ibadan Urban Flood Management Project (lUFMP) as a people-oriented project set up to change the narrative of incessant and ravaging flood disasters, adding that the project was in consonance with his campaign promises.

The statement added that the Governor had at earlier meetings with the IUFMP team given assurances that Government would take necessary steps to protect the people while charging that the stakeholders on the project to ensure that all hands were on deck to achieve the effective implementation of the initiative.

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“Beyond building bridges, culverts, drain lines, and access roads which are on their own crucial towards ensuring the good life, we as a government also have a duty to give full support to the implementation of the IUFMP initiative that will furnish our people with prior alerts about impending flood disasters.

“This will enable our people to take proactive steps for the preservation of lives and properties. This is a step in the right direction and it will continue to enjoy maximum support of the State Government.

“It is pertinent that we are able to x-ray the factors that can ultimately protect our people from vulnerability to flooding, through adequate knowledge building and information flow on impending flooding and looming dangers. Such information, readily disseminated well ahead of time will save lives.
“I have been told that this workshop, which started yesterday is a two-day programme aimed at sensitising State officials, key stakeholder-agencies and representatives of communities situated along with flood-prone areas, while also informing high-level office-holders about the project,” the Governor said.
Governor Makinde further stated that the State would be expecting value for its investment in the project, which he noted should be in terms of “immediate gains in the area of safety of lives and properties, as well as measurable capacity building for our homegrown technocrats and public servants who would be required to sustain the initiative, post-IUFMP.”

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Governor Makinde, however called on the operators of the project to ensure that the advantages of the project were transferred to other communities in the state through a form of knowledge transfer.

“As I have assured officials of the IUFMP before now, our government will continue to provide enabling environment for the success of other intervention works being carried out at different locations/communities within Ibadan. We expect that all such projects are delivered on schedule to enable our people reap the benefits,” the Governor submitted.

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Health

Quit Flood-prone Areas, Kaduna Govt. Warns Residents

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Kaduna State Government through its   Ministry of Environment and Emergency Management Agency (KASEMA) has warned residents living around flood prone areas across the state  to urgently evacuate their homes.

“As the rains intensify, there’s a likelihood of flooding to occur”, the Agency hinted.

In  2018 , over 500 houses were submerged in flood and many residents were displaced  in areas like Going Gora,  Kamazo,  Karatudu,  kigo Road,  Ungwar Rimi,   Rafin Guza,  Romi and Zaria  among others, as a result of their refusal to heed to early warnings by emergency agencies.

The State Commissioner for Environment, Ibrahim Husseini, emphasized that  the warnings are important in order to avoid a recurrence of such unfortunate incidents.

This comes days after several persons were killed in Niger State, after some communities were ravaged by flood.

Also, hundreds were displaced in Jigawa State after some communities were hit by flood.

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Nigeria moves to end communicable diseases among people who use drugs

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“I have been injecting drugs for a long time and we share syringes,” says Ali who lives in the suburb of the Federal Capital Territory (FCT) and recently diagnosed to be co-infected with Tuberculosis (TB) and HIV. Consequent to difficulties of life in the streets, Ali was exposed to drug use as early as age 10 and started using injectable drugs when he was 14. “I wish I can stop now though, but It is very difficult” he laments. 

In response to the plight of people like Ali, the Nigerian Government is making moves to end communicable diseases among people who use drugs.

According to the World Health Organization (WHO), as of 2017 estimated that 271 million people globally were said to use drugs of which 11.3 million are injectable (Source: UN World Drug report 2019). In addition to associated mortality, injecting drug use has been linked with transmission of communicable diseases including HIV, Hepatitis C, Tuberculosis and a host of other blood-borne infections. People who inject drugs (PWID) account for 10% of HIV infections and about 23% of new Hepatitis C infections, while Tuberculosis is a leading AIDS-defining illness and cause of mortality among people living with HIV who inject drugs (Source: WHO – HIV Topics / WHO Hepatitis C factsheet).

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“Nigeria, with her huge population continues to experience an untold effect of drug use especially among youth,” say Mr Mashood Lawal Director Food and Drugs, Federal Ministry of Health (FMoH).

In addition, Government is making concerted efforts to address communicable diseases associated with drug use. This is being achieved through programming for key population groups within various national programmes focusing mainly on behavioral change and preventive interventions, including attempts at biomedical support and dilatory effects.

An independent report commissioned by the Global Fund in 2016 indicates a burgeoning need for a full package of interventions for these population group as defined by WHO. Also the findings of the national drug use survey conducted in 2018, revealed that 14.4% of the general population use drugs, a rate higher than the global average of 5.6%. The report further reveals that there are more people who inject drugs than previously estimated and of concern are injecting practices with increased risk of HIV and Viral Hepatitis transmission (UNODC-National Drug Use Survey Report,2018 ). This evidence calls for a holistic health sector driven approach for curbing the menace of drug use.

With this compelling evidence, WHO advocated to FMoH for the need to define a health response for the drug control. Hence, the National Programme on Drug Demand and Harm Reduction (NDDHR) which is closely linked to the Presidential Advisory Committee on the Elimination of Drug Abuse (PACEDA) was established in May,2019 with the mandate of coordinating the health sector response to drug use. Similarly, a National technical working group (TWG) was inaugurated to support the take-off of the programme.

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“Since inception of the programme, WHO has been at the forefront, leading other partners including the UN Organization for Drug Control, Global Fund and national stakeholders to support the government to develop a policy statement and strategy which will be incorporated into the National Drug Control Master Plan,” states Dr Rex Mpazanje, Communicable/Non communicable diseases cluster lead for WHO Nigeria.

“Similarly, a road map and National guideline for the implementation of a needle and syringe program (NSP) geared towards the elimination of communicable among PWID was developed. The NSP which is being funded through the Global Fund with technical support from WHO is expected to be piloted in 3 states across the country in the coming months,” he added.

Beyond communicable diseases, WHO is concerned with other health and social burdens associated with drug use. Therefore, efforts will continue to be made to enhance public health actions by providing the required leadership, strengthening partnerships and collaboration between government and health institutions towards the achievement of Sustainable Development Goals 2030 (SDG 2030).

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