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Review

Management of NCD in Low- and Middle-Income Countries

Authors
  • William Checkley
  • Hassen Ghannem
  • Vilma Irazola
  • Sylvester Kimaiyo
  • Naomi S. Levitt
  • J. Jaime Miranda
  • Louis Niessen
  • Dorairaj Prabhakaran
  • Cristina Rabadán-Diehl
  • Manuel Ramirez-Zea
  • Adolfo Rubinstein
  • Alben Sigamani
  • Richard Smith
  • Nikhil Tandon
  • Yangfeng Wu
  • Denis Xavier
  • Lijing L. Yan
  • GRAND South Network, UnitedHealth Group/ National Heart, Lung, and Blood Institute Centers of Excellence

Abstract

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.

Highlights

  • Noncommunicable diseases are increasing in prevalence in LMICs.
  • The WHO has identified “best buys” it advocates as interventions in LMICs.
  • Non-laboratory-based risk scores can be a useful tool.
  • There is a need to identify and target those at high risk for developing diabetes in LMICs.
  • Cookstoves with chimneys can be effective in COPD prevention.
Published on Dec 1, 2014
Peer Reviewed