Pub Date : 2010-01-01DOI: 10.1016/j.cvdpc.2010.03.005
Bambang Budi Siswanto , Basuni Radi , Harmani Kalim , Anwar Santoso , Rurus Suryawan , Erwinanto , Eko Antono , T. Santoso , On behalf of all ADHERE study Indonesia team 2006
Indonesia is an archipelago consisting of 17,000 islands (6000 inhabited) to spanning by the equator in South East Asia. The total area is 741,096 sq mil (1,919,440 km sq). The population in 2005 was 241,973,879, with a population growth rate of 1.5%, a birth rate of 20.7/1000 population and a life expectancy of 69.6 years. There are 1246 hospitals in Indonesia, of which 49.8% are in private hospitals and 50.5% are located in Java. There is a total of 132,231 beds or one hospital bed per 1628 population.
In 2005 we did a pilot cohort study of 100 consecutive new cases of Acute Decompensated Heart Failure (ADHF) at NCVC Jakarta to search for predictors of mortality and re-hospitalization. We found the independent predictors for mortality and re-hospitalization are high NT proBNP at entry, NT proBNP at discharge, not decreased >35% during hospitalization, NYHA functional class 4, edema with a BMI >30 kg/m2, ejection fraction <20%, acute pulmonary edema, not on a beta-blocker, hemoglobin <12 g/dl and Hyponatremia <130 mmol/L. More than 78% using ACEI/ARB, diuretic and aldosterone antagonist, but only 32% using beta-blocker.
In 2006, we conducted an Acute Decompensated Heart Failure Registry (ADHERE) with the participation of five hospitals including National Cardiovascular Center (NCVC) Jakarta, the top cardiovascular referral hospital. In total, there were 1687 patients admitted with ADHF. The mean age was 60 years and male patients were 64.5%. Compared to other countries, our heart failure patients were younger, had more severe symptoms and there were more new patients (de novo acute ADHF). Hypertension (54.8%), coronary artery disease (49.9%), diabetes (31.2%), myocardial infarction (23.3%) and atrial fibrillation (14.6%) are the leading etiologies of our ADHF patients. There were 62.7% patients with ejection fraction (EF) <40% and the mean EF was 33%. The median hospital length of stay was 7.1 days and the hospital mortality was 6.7% [15].
In NCVC Jakarta, compliance with medical evaluation and drugs and diets are the predictors of hospitalizations. There were 47%, non compliant patients and the survival probability at 5 years was only 54%. The 5 year predictors of mortality are poor EF, Diabetes and male gender. The 5 year survival of males with poor EF and Diabetes was only 36%. Among socio-economic factors, only 33.5% had health insurance and 54.5% lived >20 km from hospital [16].
There are increasing numbers of hospitalized heart failure patients in NCVC Jakarta. In 2007 there were 1409 patients and an increase in 2008 to 1476 hospital admissions. Also there has been an increase in in-hospital morality to around 12 %.
Conclusion
Hea
印度尼西亚是一个群岛，由17000个岛屿(6000个有人居住)组成，横跨东南亚的赤道。总面积为741,096平方英里(1,919,440平方公里)。2005年人口为241,973,879人，人口增长率为1.5%，出生率为20.7/1000，预期寿命为69.6岁。印度尼西亚有1246家医院，其中49.8%是私立医院，50.5%位于爪哇。共有132 231张病床，即每1628人有一张病床。2005年，我们在雅加达NCVC医院对连续100例急性失代偿性心力衰竭(ADHF)的新病例进行了一项试点队列研究，以寻找死亡率和再住院的预测因素。我们发现死亡率和再住院的独立预测因子为入院时NT proBNP高，出院时NT proBNP未降低35%，NYHA功能等级4，水肿BMI为30 kg/m2，射血分数为20%，急性肺水肿未使用β受体阻滞剂，血红蛋白为12 g/dl，低钠血症为130 mmol/L。超过78%的患者使用ACEI/ARB、利尿剂和醛固酮拮抗剂，但只有32%的患者使用-受体阻滞剂。2006年，我们进行了急性失代偿性心力衰竭登记(坚持)，有五家医院参与，包括雅加达国家心血管中心(NCVC)，顶级心血管转诊医院。共入院ADHF患者1687例。平均年龄60岁，男性占64.5%。与其他国家相比，我们的心力衰竭患者更年轻，症状更严重，新发患者(de novo acute ADHF)更多。高血压(54.8%)、冠状动脉疾病(49.9%)、糖尿病(31.2%)、心肌梗死(23.3%)和房颤(14.6%)是ADHF患者的主要病因。62.7%的患者射血分数(EF)为40%，平均EF为33%。中位住院时间为7.1天，住院死亡率为6.7%。在雅加达全国儿童健康中心，遵守医疗评估以及药物和饮食是住院的预测因素。有47%的患者不依从，5年生存率只有54%。5年死亡率预测因子为EF差、糖尿病和男性。EF差和糖尿病的男性5年生存率仅为36%。在社会经济因素中，只有33.5%的人有医疗保险，54.5%的人住在离医院20公里的地方。在雅加达全国心脏健康中心，住院的心力衰竭患者越来越多。2007年有1409名病人，2008年住院人数增加到1476人。此外，医院内的道德水平也提高了12%左右。结论心力衰竭是非冠状病毒感染患者住院和再入院的主要原因。与其他国家相比，印尼心力衰竭患者更年轻，病情更重，EF和糖尿病较差。住院死亡率在6%至12%之间，再住院率为29%。依从性差、EF差和糖尿病是再入院的预测因素。健康保险提高了生存几率。我们需要更好的心力衰竭服务。
{"title":"Heart Failure in NCVC Jakarta and 5 hospitals in Indonesia","authors":"Bambang Budi Siswanto , Basuni Radi , Harmani Kalim , Anwar Santoso , Rurus Suryawan , Erwinanto , Eko Antono , T. Santoso , On behalf of all ADHERE study Indonesia team 2006","doi":"10.1016/j.cvdpc.2010.03.005","DOIUrl":"https://doi.org/10.1016/j.cvdpc.2010.03.005","url":null,"abstract":"<div><p>Indonesia is an archipelago consisting of 17,000 islands (6000 inhabited) to spanning by the equator in South East Asia. The total area is 741,096<!--> <!-->sq<!--> <!-->mil (1,919,440<!--> <!-->km<!--> <!-->sq). The population in 2005 was 241,973,879, with a population growth rate of 1.5%, a birth rate of 20.7/1000 population and a life expectancy of 69.6<!--> <!-->years. There are 1246 hospitals in Indonesia, of which 49.8% are in private hospitals and 50.5% are located in Java. There is a total of 132,231 beds or one hospital bed per 1628 population.</p><p>In 2005 we did a pilot cohort study of 100 consecutive new cases of Acute Decompensated Heart Failure (ADHF) at NCVC Jakarta to search for predictors of mortality and re-hospitalization. We found the independent predictors for mortality and re-hospitalization are high NT proBNP at entry, NT proBNP at discharge, not decreased<!--> <!-->>35% during hospitalization, NYHA functional class 4, edema with a BMI<!--> <!-->>30<!--> <!-->kg/m<sup>2</sup>, ejection fraction<!--> <!--><20%, acute pulmonary edema, not on a beta-blocker, hemoglobin<!--> <!--><12<!--> <!-->g/dl and Hyponatremia<!--> <!--><130<!--> <!-->mmol/L. More than 78% using ACEI/ARB, diuretic and aldosterone antagonist, but only 32% using beta-blocker.</p><p>In 2006, we conducted an Acute Decompensated Heart Failure Registry (ADHERE) with the participation of five hospitals including National Cardiovascular Center (NCVC) Jakarta, the top cardiovascular referral hospital. In total, there were 1687 patients admitted with ADHF. The mean age was 60<!--> <!-->years and male patients were 64.5%. Compared to other countries, our heart failure patients were younger, had more severe symptoms and there were more new patients (de novo acute ADHF). Hypertension (54.8%), coronary artery disease (49.9%), diabetes (31.2%), myocardial infarction (23.3%) and atrial fibrillation (14.6%) are the leading etiologies of our ADHF patients. There were 62.7% patients with ejection fraction (EF)<!--> <!--><40% and the mean EF was 33%. The median hospital length of stay was 7.1<!--> <!-->days and the hospital mortality was 6.7% <span>[15]</span>.</p><p>In NCVC Jakarta, compliance with medical evaluation and drugs and diets are the predictors of hospitalizations. There were 47%, non compliant patients and the survival probability at 5<!--> <!-->years was only 54%. The 5<!--> <!-->year predictors of mortality are poor EF, Diabetes and male gender. The 5<!--> <!-->year survival of males with poor EF and Diabetes was only 36%. Among socio-economic factors, only 33.5% had health insurance and 54.5% lived >20<!--> <!-->km from hospital <span>[16]</span>.</p><p>There are increasing numbers of hospitalized heart failure patients in NCVC Jakarta. In 2007 there were 1409 patients and an increase in 2008 to 1476 hospital admissions. Also there has been an increase in in-hospital morality to around 12 %.</p></div><div><h3>Conclusion</h3><p>Hea","PeriodicalId":11021,"journal":{"name":"Cvd Prevention and Control","volume":"5 1","pages":"Pages 35-38"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.cvdpc.2010.03.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91777272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2010-01-01DOI: 10.1016/J.CVDPC.2010.03.002
Salim Ma, Fazila-tun-nesa Malik, Nazir Ahmed, M. Badiuzzaman, R. J. Khan, K.M.H.S. Sirajul Haque, Abdul Malik
{"title":"In-hospital outcome of primary percutaneous coronary intervention for the management of acute ST-segment elevation myocardial infarction in a Bangladeshi population","authors":"Salim Ma, Fazila-tun-nesa Malik, Nazir Ahmed, M. Badiuzzaman, R. J. Khan, K.M.H.S. Sirajul Haque, Abdul Malik","doi":"10.1016/J.CVDPC.2010.03.002","DOIUrl":"https://doi.org/10.1016/J.CVDPC.2010.03.002","url":null,"abstract":"","PeriodicalId":11021,"journal":{"name":"Cvd Prevention and Control","volume":"4 1","pages":"23-26"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90645123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2010-01-01DOI: 10.1016/j.cvdpc.2010.04.003
{"title":"Message from the President of the APSC","authors":"","doi":"10.1016/j.cvdpc.2010.04.003","DOIUrl":"https://doi.org/10.1016/j.cvdpc.2010.04.003","url":null,"abstract":"","PeriodicalId":11021,"journal":{"name":"Cvd Prevention and Control","volume":"5 1","pages":"Page 5"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.cvdpc.2010.04.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90130471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2010-01-01DOI: 10.1016/J.CVDPC.2010.03.005
B. Siswanto, B. Radi, H. Kalim, A. Santoso, R. Suryawan, Erwinanto, Eko Antono, T. Santoso
{"title":"Heart Failure in NCVC Jakarta and 5 hospitals in Indonesia","authors":"B. Siswanto, B. Radi, H. Kalim, A. Santoso, R. Suryawan, Erwinanto, Eko Antono, T. Santoso","doi":"10.1016/J.CVDPC.2010.03.005","DOIUrl":"https://doi.org/10.1016/J.CVDPC.2010.03.005","url":null,"abstract":"","PeriodicalId":11021,"journal":{"name":"Cvd Prevention and Control","volume":"121 1","pages":"35-38"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78429689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2010-01-01DOI: 10.1016/j.cvdpc.2010.03.004
Mariana Bárbara Specogna
Objective
To identify barriers and facilitating factors for the inclusion of tobacco cessation treatment coverage in the Argentine health system and to outline priority health policies for the development of smoking cessation programs.
Methods
A qualitative methodology was used based on in-depth interviews conducted with key informants from the State, NGOs and the health insurance sector.
Results
Nine barriers were identified: tobacco consumption is not appreciated as an addiction or illness; lack of a culture of prevention in the health system; lack of agreement on the relevance of coverage in all clinical cases; mistrust about policy-making decisions made under pressure from various lobbies; lack of agreement about the importance of the different components of cessation; fear of overloading the health system with additional expenses; prioritization of other tobacco control interventions as being more effective; health professionals not completely trained to deliver cessation treatment. Four main facilitating factors were recognized: consensus about the necessity of cessation treatment coverage; magnitude of the problem of tobacco use; pressure from a more informed society for the inclusion of coverage; the emergence of new paradigms for the inclusion of health public policies.
Conclusions
The barriers create a vicious circle: members of the health care system do not fully appreciate the issues related to smoking, which leads to an inappropriate set of priorities resulting in a lack of preventive policies and insufficient health practices and interventions to curb the problem. However, this situation is changing since the facilitating factors are gaining strength, an observation supported by the changes witnessed in Argentina over the last few years.
{"title":"Cessation coverage in Argentina: A qualitative study about its barriers and facilitating factors","authors":"Mariana Bárbara Specogna","doi":"10.1016/j.cvdpc.2010.03.004","DOIUrl":"10.1016/j.cvdpc.2010.03.004","url":null,"abstract":"<div><h3>Objective</h3><p>To identify barriers and facilitating factors for the inclusion of tobacco cessation treatment coverage in the Argentine health system and to outline priority health policies for the development of smoking cessation programs.</p></div><div><h3>Methods</h3><p>A qualitative methodology was used based on in-depth interviews conducted with key informants from the State, NGOs and the health insurance sector.</p></div><div><h3>Results</h3><p>Nine barriers were identified: tobacco consumption is not appreciated as an addiction or illness; lack of a culture of prevention in the health system; lack of agreement on the relevance of coverage in all clinical cases; mistrust about policy-making decisions made under pressure from various lobbies; lack of agreement about the importance of the different components of cessation; fear of overloading the health system with additional expenses; prioritization of other tobacco control interventions as being more effective; health professionals not completely trained to deliver cessation treatment. Four main facilitating factors were recognized: consensus about the necessity of cessation treatment coverage; magnitude of the problem of tobacco use; pressure from a more informed society for the inclusion of coverage; the emergence of new paradigms for the inclusion of health public policies.</p></div><div><h3>Conclusions</h3><p>The barriers create a vicious circle: members of the health care system do not fully appreciate the issues related to smoking, which leads to an inappropriate set of priorities resulting in a lack of preventive policies and insufficient health practices and interventions to curb the problem. However, this situation is changing since the facilitating factors are gaining strength, an observation supported by the changes witnessed in Argentina over the last few years.</p></div>","PeriodicalId":11021,"journal":{"name":"Cvd Prevention and Control","volume":"5 1","pages":"Pages 7-11"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.cvdpc.2010.03.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86087367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2009-12-01DOI: 10.1016/j.cvdpc.2009.12.002
Ansam F. Sawalha
Objectives
The objective of this study was to compare acute stroke (AS) and acute myocardial infarction (AMI) in terms of clinical characteristics, medications at discharge, and in-hospital outcomes.
Methods
Data were obtained from personal interviews as well as the medical files of the patients admitted to Al-wattani hospital, Palestine in the period September 2006 until August 2007. All data were analyzed using SPSS v15. Chi-square and student’s t test were used to test for significance.
Results
A total of 281 patients were included, 186 had AS and 95 had AMI. AMI patients were significantly younger than those with AS (P = 0.000). Hypertension (HTN) (% 69.9) was the most prevalent risk factor for AS patients, while diabetes mellitus (DM) (46.3%) was the most prevalent risk factor for AMI patients. The prevalence of the following risk factors was significantly different between AS and AMI: HTN (P = 0.000), previous stroke (P = 0.000), and atrial fibrillation (P = 0.027). Antiplatelets (P = 0.000), statins (P = 0.000), and beta blockers (P = 0.005) were prescribed significantly more for patients with AMI than for patients with AS at discharge. However, ACE-I was the only class that was prescribed significantly (P = 0.000) more for AS patients compared to AMI. In-hospital mortality among both groups was 20.9% for AS and 16.8% for AMI. There was no significant difference in in-hospital mortality between AS and AMI patients regardless of age. Gender differences in in-hospital mortality between AS and AMI were observed. AS was significantly (P = 0.010) more fatal than AMI for males. However, AMI was significantly (P = 0.048) more fatal than AS in female patients. Furthermore, males who died after AMI were significantly younger than those who died after AS (P = 0.001).
Conclusion
AMI affects people at early life phases compared to AS. HTN and DM are among the common risk factors. Prescribing of medications for secondary prevention could be improved. Gender and age differences in outcome are seen in both AS and AMI patients.
{"title":"A comparison of clinical characteristics, medications, and outcome between acute stroke and acute myocardial infarction","authors":"Ansam F. Sawalha","doi":"10.1016/j.cvdpc.2009.12.002","DOIUrl":"10.1016/j.cvdpc.2009.12.002","url":null,"abstract":"<div><h3>Objectives</h3><p>The objective of this study was to compare acute stroke (AS) and acute myocardial infarction (AMI) in terms of clinical characteristics, medications at discharge, and in-hospital outcomes.</p></div><div><h3>Methods</h3><p>Data were obtained from personal interviews as well as the medical files of the patients admitted to Al-wattani hospital, Palestine in the period September 2006 until August 2007. All data were analyzed using SPSS v15. Chi-square and student’s <em>t</em> test were used to test for significance.</p></div><div><h3>Results</h3><p>A total of 281 patients were included, 186 had AS and 95 had AMI. AMI patients were significantly younger than those with AS (<em>P</em> <!-->=<!--> <!-->0.000). Hypertension (HTN) (% 69.9) was the most prevalent risk factor for AS patients, while diabetes mellitus (DM) (46.3%) was the most prevalent risk factor for AMI patients. The prevalence of the following risk factors was significantly different between AS and AMI: HTN (<em>P</em> <!-->=<!--> <!-->0.000), previous stroke (<em>P</em> <!-->=<!--> <!-->0.000), and atrial fibrillation (<em>P</em> <!-->=<!--> <span>0.027). Antiplatelets (</span><em>P</em> <!-->=<!--> <!-->0.000), statins (<em>P</em> <!-->=<!--> <!-->0.000), and beta blockers (<em>P</em> <!-->=<!--> <span>0.005) were prescribed significantly more for patients with AMI than for patients with AS at discharge. However, ACE-I was the only class that was prescribed significantly (</span><em>P</em> <!-->=<!--> <!-->0.000) more for AS patients compared to AMI. In-hospital mortality among both groups was 20.9% for AS and 16.8% for AMI. There was no significant difference in in-hospital mortality between AS and AMI patients regardless of age. Gender differences in in-hospital mortality between AS and AMI were observed. AS was significantly (<em>P</em> <!-->=<!--> <!-->0.010) more fatal than AMI for males. However, AMI was significantly (<em>P</em> <!-->=<!--> <!-->0.048) more fatal than AS in female patients. Furthermore, males who died after AMI were significantly younger than those who died after AS (<em>P</em> <!-->=<!--> <!-->0.001).</p></div><div><h3>Conclusion</h3><p>AMI affects people at early life phases compared to AS. HTN and DM are among the common risk factors. Prescribing of medications for secondary prevention could be improved. Gender and age differences in outcome are seen in both AS and AMI patients.</p></div>","PeriodicalId":11021,"journal":{"name":"Cvd Prevention and Control","volume":"4 4","pages":"Pages 201-206"},"PeriodicalIF":0.0,"publicationDate":"2009-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.cvdpc.2009.12.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78242926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2009-12-01DOI: 10.1016/j.cvdpc.2009.12.003
N. Campbell, B. Legowski, B. Legetic, R. Wilks, A.B. Pinto de Almeida Vasconcellos, On behalf of the PAHO/WHO Regional Expert Group on Cardiovascular Disease Prevention through Dietary Salt Reduction.
{"title":"PAHO/WHO Regional Expert Group Policy Statement – Preventing cardiovascular disease in the Americas by reducing dietary salt intake population-wide","authors":"N. Campbell, B. Legowski, B. Legetic, R. Wilks, A.B. Pinto de Almeida Vasconcellos, On behalf of the PAHO/WHO Regional Expert Group on Cardiovascular Disease Prevention through Dietary Salt Reduction.","doi":"10.1016/j.cvdpc.2009.12.003","DOIUrl":"10.1016/j.cvdpc.2009.12.003","url":null,"abstract":"","PeriodicalId":11021,"journal":{"name":"Cvd Prevention and Control","volume":"4 4","pages":"Pages 189-191"},"PeriodicalIF":0.0,"publicationDate":"2009-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.cvdpc.2009.12.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79347179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chandigarh healthy heart action project (CHHAP) was initiated in 2004 to increase awareness in the community for the major NCD risk factors by health promotion, training of health staff for CVD risk assessment and management, and surveillance of NCD risk factors.
Methods
Key strategies included capacity building, health promotion in different settings, risk factor surveillance and advocacy. Educational materials for the project included modules for doctors, health workers and school teachers; brochures, WHO protocol charts for CVD risk assessment and management, handbills and posters. Multiple health promotion activities were undertaken. An intersectoral committee for policy issues and a coordination committee for technical issues were also constituted.
Results
Most of doctors in public (245) and private sectors (150), health workers (227), school teachers (190) and pharmacists/staff nurses (181) were trained for CVD assessment and management in batches during 2005–07. NCD risk factor surveillance encompassed 2763 individuals in the population of Chandigarh. The prevalence of smoking was 10.2% (20.1% among males and 0.8% among females). Alcohol was consumed by 14.2% (26.8% males and 1.2% females). A sedentary occupation was identified in 94.2% in Chandigarh. Due to strong advocacy, Chandigarh was declared a smoke free city from July 2007, which is a first in the developing world, and the project was up scaled to an integrated State NCD control program in the 11th 5-year plan (2007–12).
Conclusion
CHHAP is a large-scale implementation of the WHO CVD risk management package, implemented as a routine in the health care delivery system.
{"title":"Integrated non-communicable disease control program in a Northern part of India: Lessons from a demonstration project in low resource settings of a developing country","authors":"J.S. Thakur , Star Pala , Yashpaul Sharma , Sanjay Jain , Savita Kumari , Rajesh Kumar","doi":"10.1016/j.cvdpc.2009.11.001","DOIUrl":"10.1016/j.cvdpc.2009.11.001","url":null,"abstract":"<div><h3>Background</h3><p>Chandigarh healthy heart action project (CHHAP) was initiated in 2004 to increase awareness in the community for the major NCD risk factors by health promotion, training of health staff for CVD risk assessment and management, and surveillance of NCD risk factors.</p></div><div><h3>Methods</h3><p>Key strategies included capacity building, health promotion in different settings, risk factor surveillance and advocacy. Educational materials for the project included modules for doctors, health workers and school teachers; brochures, WHO protocol charts for CVD risk assessment and management, handbills and posters. Multiple health promotion activities were undertaken. An intersectoral committee for policy issues and a coordination committee for technical issues were also constituted.</p></div><div><h3>Results</h3><p>Most of doctors in public (245) and private sectors (150), health workers (227), school teachers (190) and pharmacists/staff nurses (181) were trained for CVD assessment and management in batches during 2005–07. NCD risk factor surveillance encompassed 2763 individuals in the population of Chandigarh. The prevalence of smoking was 10.2% (20.1% among males and 0.8% among females). Alcohol was consumed by 14.2% (26.8% males and 1.2% females). A sedentary occupation was identified in 94.2% in Chandigarh. Due to strong advocacy, Chandigarh was declared a smoke free city from July 2007, which is a first in the developing world, and the project was up scaled to an integrated State NCD control program in the 11th 5-year plan (2007–12).</p></div><div><h3>Conclusion</h3><p>CHHAP is a large-scale implementation of the WHO CVD risk management package, implemented as a routine in the health care delivery system.</p></div>","PeriodicalId":11021,"journal":{"name":"Cvd Prevention and Control","volume":"4 4","pages":"Pages 193-199"},"PeriodicalIF":0.0,"publicationDate":"2009-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.cvdpc.2009.11.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73133511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2009-12-01DOI: 10.1016/S1875-4570(10)00018-5
{"title":"Volume Contents for CVD Prevention and Control, Volume 3","authors":"","doi":"10.1016/S1875-4570(10)00018-5","DOIUrl":"https://doi.org/10.1016/S1875-4570(10)00018-5","url":null,"abstract":"","PeriodicalId":11021,"journal":{"name":"Cvd Prevention and Control","volume":"4 4","pages":"Pages III-V"},"PeriodicalIF":0.0,"publicationDate":"2009-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1875-4570(10)00018-5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136818449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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