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2.
Lancet Glob Health ; 8(6): e752-e753, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-32446341
3.
Lancet Glob Health ; 8(4): e511-e523, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-32199120

RESUMEN

BACKGROUND: The reduction by a third of premature non-communicable disease (NCD) mortality by 2030 is the ambitious target of Sustainable Development Goal (SDG) 3.4. However, the indicator is narrowly defined, including only four major NCDs (cardiovascular diseases, cancer, diabetes, and chronic respiratory diseases) and only for people aged 30-70 years. This study focuses on premature avertable mortality from NCDs-premature deaths caused by NCDs that could be prevented through effective public policies and health interventions or amenable to high-quality health care-to assess trends at global, regional, and national levels using estimates from the Global Burden of Disease, Injuries, and Risk Factors Study (GBD) 2017. METHODS: We reviewed existing lists of NCD causes of death that are either preventable through public health policies and interventions or amenable to health care to create a list of avertable NCD causes of death, which was mapped to the GBD cause list. We estimated age-standardised years of life lost (YLL) per 100 000 population due to premature avertable mortality from NCDs, avertable NCD cause clusters, and non-avertable NCD causes by sex, location, and year and reported their 95% uncertainty intervals (UIs). We examined trends in age-standardised YLL due to avertable and non-avertable NCDs, assessed the progress of premature avertable mortality from NCDs in achieving SDG 3.4, and explored specific avertable NCD cause clusters that could make a substantial contribution to overall trends in premature mortality. FINDINGS: Globally, premature avertable mortality from NCDs for both sexes combined declined -1·3% (95% UI -1·4 to -1·2) per year, from 12 855 years (11 809 to 14 051) in 1990 to 9008 years (8329 to 9756) in 2017. However, the absolute number of avertable NCD deaths increased 49·3% (95% UI 47·3 to 52·2) from 23·1 million (22·0-24·1) deaths in 1990 to 34·5 million (33·4 to 35·6) in 2017. Premature avertable mortality from NCDs reduced in every WHO region and in most countries and territories between 1990 and 2017. Despite these reductions, only the Western Pacific and European regions and 25 countries (most of which are high-income countries) are on track to achieve SDG target 3.4. Since 2017, there has been a global slowdown in the reduction of premature avertable mortality from NCDs. In 2017, high premature avertable mortality from NCDs was clustered in low-income and middle-income countries, mainly in the South-East Asia region, Eastern Mediterranean region, and African region. Most countries with large annual reductions in such mortality between 1990 and 2017 had achieved low levels of premature avertable mortality from NCDs by 2017. Some countries, the most populous examples being Afghanistan, the Central African Republic, Uzbekistan, Haiti, Mongolia, Turkmenistan, Pakistan, Ukraine, Laos, and Egypt, reported both an upward trend and high levels of premature avertable mortality from NCDs. Cardiovascular diseases, cancers, and chronic respiratory diseases have been the main drivers of the global and regional reduction in premature avertable mortality from NCDs, whereas premature mortality from substance use disorders, chronic kidney disease and acute glomerulonephritis, and diabetes have been increasing. INTERPRETATION: Worldwide, there has been a substantial reduction in premature avertable mortality from NCDs, but progress has been uneven across populations. Countries vary substantially in current levels and trends and, hence, the extent to which they are on track to achieve SDG 3.4. By accounting for premature avertable mortality while avoiding arbitrary age cutoffs, premature avertable mortality from NCDs is a robust, comprehensive, and actionable indicator for quantifying and monitoring global and national progress towards NCD prevention and control. FUNDING: None.


Asunto(s)
Salud Global/estadística & datos numéricos , Mortalidad Prematura/tendencias , Enfermedades no Transmisibles/mortalidad , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Femenino , Humanos , Masculino , Persona de Mediana Edad , Desarrollo Sostenible , Adulto Joven
4.
Artículo en Español | PAHO-IRIS | ID: phr-51862

RESUMEN

[RESUMEN]. La Comisión Lancet de Hipertensión determinó que una medida clave para responder a la carga mundial que representa la hipertensión arterial era mejorar la calidad de las mediciones de la presión arterial, mediante la utilización de dispositivos cuya exactitud haya sido validada. En la actualidad existen 3000 dispositivos comercializados, pero muchos no tienen datos publicados sobre pruebas de exactitud conformes a las normas científicas establecidas. La falta de regulación o su ineficiencia, que permiten la autorización de dispositivos para uso comercial sin una validación oficial, posibilitan este problema. Además, han surgido tecnologías nuevas de medición de la presión arterial (por ejemplo, los sensores sin brazalete) sobre las cuales no existe unanimidad en la comunidad científica con respecto a las normas de exactitud de la medición. En conjunto, estos aspectos contribuyen a la disponibilidad generalizada de tensiómetros de consultorio o domiciliarios que ofrecen una exactitud limitada o incierta, que llevan a diagnósticos, manejo y farmacoterapia inapropiados de la hipertensión a escala mundial. Los problemas más importantes relacionados con la exactitud de los dispositivos de medición de la presión arterial se pueden resolver mediante el requisito regulatorio de una validación independiente obligatoria de los dispositivos, en consonancia con la norma ISO universalmente aceptada. Esta es una recomendación básica y constituye una necesidad internacional acuciante. Otras recomendaciones clave son la elaboración de normas de validación específicas para las tecnologías nuevas de medición de la presión arterial y la publicación en línea de listas de los dispositivos nuevos exactos que están a la disposición de los usuarios y los profesionales de salud. Las recomendaciones están en consonancia con las políticas de la Organización Mundial de la Salud sobre los dispositivos médicos y la atención universal de la salud. El cumplimiento de las recomendaciones aumentará la disponibilidad mundial de dispositivos de medición de la presión arterial que sean exactos y tendrá como efecto un mejor diagnóstico y tratamiento, reduciendo así la carga mundial de la hipertensión.


[ABSTRACT]. The Lancet Commission on Hypertension identified that a key action to address the worldwide burden of high blood pressure (BP) was to improve the quality of BP measurements by using BP devices that have been validated for accuracy. Currently, there are over 3 000 commercially available BP devices, but many do not have published data on accuracy testing according to established scientific standards. This problem is enabled through weak or absent regulations that allow clearance of devices for commercial use without formal validation. In addition, new BP technologies have emerged (e.g. cuffless sensors) for which there is no scientific consensus regarding BP measurement accuracy standards. Altogether, these issues contribute to the widespread availability of clinic and home BP devices with limited or uncertain accuracy, leading to inappropriate hypertension diagnosis, management and drug treatment on a global scale. The most significant problems relating to the accuracy of BP devices can be resolved by the regulatory requirement for mandatory independent validation of BP devices according to the universally-accepted International Organization for Standardization Standard. This is a primary recommendation for which there is an urgent international need. Other key recommendations are development of validation standards specifically for new BP technologies and online lists of accurate devices that are accessible to consumers and health professionals. Recommendations are aligned with WHO policies on medical devices and universal healthcare. Adherence to recommendations would increase the global availability of accurate BP devices and result in better diagnosis and treatment of hypertension, thus decreasing the worldwide burden from high BP.


[RESUMO]. A Comissão Lancet sobre Hipertensão Arterial identificou que uma iniciativa central para enfrentar a carga mundial da hipertensão arterial seria a melhoria na qualidade da mensuração da pressão arterial pelo uso aparelhos de pressão arterial validados quanto à acurácia. Atualmente, existem mais de 3 000 aparelhos de pressão arterial disponíveis comercialmente; entretanto, muitos não têm dados publicados sobre testes de acurácia realizados de acordo com padrões científicos estabelecidos. Este problema resulta de regulamentação fraca ou inexistente, o que permite a aprovação para uso comercial de dispositivos sem validação formal. Além disso, surgiram novas tecnologias de mensuração da pressão arterial (por exemplo, sensores sem algemas) sem consenso científico quanto aos padrões de acurácia. No conjunto, essas questões contribuem para a oferta generalizada de dispositivos de pressão arterial clínica e domiciliar com acurácia limitada ou incerta, levando a diagnóstico, gerenciamento e tratamento inadequados da hipertensão em escala global. Os problemas mais significativos relacionados com a acurácia dos dispositivos de pressão arterial podem ser resolvidos por regulamentação que imponha a obrigatoriedade de validação independente dos aparelhos de pressão arterial, de acordo com a norma universalmente aceita pela Organização Internacional de Normalização. Esta é uma recomendação fundamental para a qual existe uma necessidade internacional urgente. Outras recomendações essenciais incluem o desenvolvimento de padrões de validação especificamente para novas tecnologias de mensuração da pressão arterial e listas on-line de aparelhos com acurácia adequada que sejam acessíveis aos consumidores e profissionais de saúde. As recomendações estão alinhadas com as políticas da Organização Mundial da Saúde (OMS) sobre dispositivos médicos e atenção universal à saúde. A adesão às recomendações aumentaria a oferta global de dispositivos de pressão arterial com acurácia adequada e resultaria em melhor diagnóstico e tratamento da hipertensão arterial, diminuindo assim a carga mundial dessa doença.


Asunto(s)
Salud Global , Tecnología Biomédica , Estándares de Referencia , Equipo para Diagnóstico , Salud Global , Tecnología Biomédica , Estándares de Referencia , Equipo para Diagnóstico , Salud Global , Tecnología Biomédica , Estándares de Referencia , Equipo para Diagnóstico
5.
J Clin Hypertens (Greenwich) ; 22(2): 142-149, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31967722

RESUMEN

Increased blood pressure is a leading risk factor for death worldwide, and improving the control of hypertension is a major health goal to reduce non-communicable disease. Thus, in 2016, as part of a regional effort between the Pan American Health Organization and Cuban Ministry of Public Health to reduce cardiovascular risk and disease, a community demonstration project was implemented to enhance hypertension control. The intervention project was in a population of 25 868 people served by the Carlos Verdugo Martínez Polyclinic in Matanzas, Cuba. The project implemented interventions currently recommended in the World Health Organization HEARTS modules, including a standardized clinical training program with certification for blood pressure measurement, routine screening for hypertension in clinics and in the community, a simple directive pharmacologic treatment algorithm, and a registry with performance reporting and feedback. Qualitative and quantitative program monitoring and evaluation was established. In a 2010 national survey, the prevalence of hypertension and the rate of hypertension control were estimated to be 31% and 36%, respectively. Following less than one year of the full implementation of the program, the prevalence of hypertension, proportion of the hypertensive population registered as having hypertension, proportion of those drug-treated who were controlled, and estimated population rate of control were 30%, 90%, 68%, and 58%, respectively. Based on these positive results, the program has been expanded to include another demonstration program initiated in a second region. In addition, preliminary efforts to disseminate and scale-up aspects of the program to the full Cuban population have started.

6.
J Hypertens ; 38(1): 21-29, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31790375

RESUMEN

: The Lancet Commission on Hypertension identified that a key action to address the worldwide burden of high blood pressure (BP) was to improve the quality of BP measurements by using BP devices that have been validated for accuracy. Currently, there are over 3000 commercially available BP devices, but many do not have published data on accuracy testing according to established scientific standards. This problem is enabled through weak or absent regulations that allow clearance of devices for commercial use without formal validation. In addition, new BP technologies have emerged (e.g. cuffless sensors) for which there is no scientific consensus regarding BP measurement accuracy standards. Altogether, these issues contribute to the widespread availability of clinic and home BP devices with limited or uncertain accuracy, leading to inappropriate hypertension diagnosis, management and drug treatment on a global scale. The most significant problems relating to the accuracy of BP devices can be resolved by the regulatory requirement for mandatory independent validation of BP devices according to the universally-accepted International Organisation for Standardization Standard. This is a primary recommendation for which there is an urgent international need. Other key recommendations are development of validation standards specifically for new BP technologies and online lists of accurate devices that are accessible to consumers and health professionals. Recommendations are aligned with WHO policies on medical devices and universal healthcare. Adherence to recommendations would increase the global availability of accurate BP devices and result in better diagnosis and treatment of hypertension, thus decreasing the worldwide burden from high BP.

7.
Rev. panam. salud pública ; 44: e21, 2020. tab
Artículo en Español | LILACS-Express | ID: biblio-1101778

RESUMEN

resumen está disponible en el texto completo


ABSTRACT The Lancet Commission on Hypertension identified that a key action to address the worldwide burden of high blood pressure (BP) was to improve the quality of BP measurements by using BP devices that have been validated for accuracy. Currently, there are over 3 000 commercially available BP devices, but many do not have published data on accuracy testing according to established scientific standards. This problem is enabled through weak or absent regulations that allow clearance of devices for commercial use without formal validation. In addition, new BP technologies have emerged (e.g. cuffless sensors) for which there is no scientific consensus regarding BP measurement accuracy standards. Altogether, these issues contribute to the widespread availability of clinic and home BP devices with limited or uncertain accuracy, leading to inappropriate hypertension diagnosis, management and drug treatment on a global scale. The most significant problems relating to the accuracy of BP devices can be resolved by the regulatory requirement for mandatory independent validation of BP devices according to the universally-accepted International Organization for Standardization Standard. This is a primary recommendation for which there is an urgent international need. Other key recommendations are development of validation standards specifically for new BP technologies and online lists of accurate devices that are accessible to consumers and health professionals. Recommendations are aligned with WHO policies on medical devices and universal healthcare. Adherence to recommendations would increase the global availability of accurate BP devices and result in better diagnosis and treatment of hypertension, thus decreasing the worldwide burden from high BP.


RESUMO A Comissão Lancet sobre Hipertensão Arterial identificou que uma iniciativa central para enfrentar a carga mundial da hipertensão arterial seria a melhoria na qualidade da mensuração da pressão arterial pelo uso aparelhos de pressão arterial validados quanto à acurácia. Atualmente, existem mais de 3 000 aparelhos de pressão arterial disponíveis comercialmente; entretanto, muitos não têm dados publicados sobre testes de acurácia realizados de acordo com padrões científicos estabelecidos. Este problema resulta de regulamentação fraca ou inexistente, o que permite a aprovação para uso comercial de dispositivos sem validação formal. Além disso, surgiram novas tecnologias de mensuração da pressão arterial (por exemplo, sensores sem algemas) sem consenso científico quanto aos padrões de acurácia. No conjunto, essas questões contribuem para a oferta generalizada de dispositivos de pressão arterial clínica e domiciliar com acurácia limitada ou incerta, levando a diagnóstico, gerenciamento e tratamento inadequados da hipertensão em escala global. Os problemas mais significativos relacionados com a acurácia dos dispositivos de pressão arterial podem ser resolvidos por regulamentação que imponha a obrigatoriedade de validação independente dos aparelhos de pressão arterial, de acordo com a norma universalmente aceita pela Organização Internacional de Normalização. Esta é uma recomendação fundamental para a qual existe uma necessidade internacional urgente. Outras recomendações essenciais incluem o desenvolvimento de padrões de validação especificamente para novas tecnologias de mensuração da pressão arterial e listas on-line de aparelhos com acurácia adequada que sejam acessíveis aos consumidores e profissionais de saúde. As recomendações estão alinhadas com as políticas da Organização Mundial da Saúde (OMS) sobre dispositivos médicos e atenção universal à saúde. A adesão às recomendações aumentaria a oferta global de dispositivos de pressão arterial com acurácia adequada e resultaria em melhor diagnóstico e tratamento da hipertensão arterial, diminuindo assim a carga mundial dessa doença.

9.
Lancet Glob Health ; 7(10): e1388-e1397, 2019 10.
Artículo en Inglés | MEDLINE | ID: mdl-31537369

RESUMEN

BACKGROUND: The World Health Assembly 2018 approved a resolution on rheumatic heart disease to strengthen programmes in countries where this condition remains a substantial public health problem. We aimed to describe the regional burden, trends, and inequalities of rheumatic heart disease in the Americas. METHODS: In this secondary analysis of the Global Burden of Disease, Injuries, and Risk Factors Study (GBD) 2017, we extracted data for deaths, prevalence of cases, disability-adjusted life-years (DALYs), years lived with disability, and years of life lost (YLL) as measures of rheumatic heart disease burden using the GBD Results Tool. We analysed 1990-2017 trends in rheumatic heart disease mortality and prevalence, quantified cross-country inequalities in rheumatic heart disease mortality, and classified countries according to rheumatic heart disease mortality in 2017 and 1990-2017. FINDINGS: GBD 2017 estimated that 3 604 800 cases of rheumatic heart disease occurred overall in the Americas in 2017, with 22 437 deaths. We showed that in 2017 rheumatic heart disease mortality in the Americas was 51% (95% UI 44-59) lower (1·8 deaths per 100 000 population [95% uncertainty interval 1·7-1·9] vs 3·7 deaths per 100 000 population [3·4-3·9]) and prevalence was 30% (29-33) lower (346·4 cases per 100 000 [334·1-359·2] vs 500·6 cases per 100 000 [482·9-519·7]) than the corresponding global estimates. DALYs were half of those globally (55·7 per 100 000 [49·8-63·5] vs 118·7 per 100 000 [108·5 to 130·7]), with a 70% contribution from YLL (39·1 out of 55·7 per 100 000). A significant reduction in rheumatic heart disease mortality occurred, from a regional average of 88·4 YLL per 100 000 (95% uncertainty interval 88·2-88·6) in 1990 to 38·2 (38·1-38·4) in 2017, and a significant reduction in income-related inequality, from an excess of 191·7 YLL per 100 000 (68·6-314·8) between the poorest and richest countries in 1990 to 66·8 YLL per 100 000 (6·4-127·2) in 2017. Of the 37 countries studied, eight (22%) had both the highest level of premature rheumatic heart disease mortality in 2017 and the smallest reduction in this mortality between 1990 and 2017. INTERPRETATION: The Americas have greatly reduced premature mortality due to rheumatic heart disease since 1990. These health gains were paired with a substantial reduction in the magnitude of income-related inequalities across countries, which is consistent with overall socioeconomic and health improvements observed in the Region. Countries with less favourable rheumatic heart disease situations should be targeted for strengthening of their national programmes. FUNDING: None.

10.
Kidney Int ; 96(5): 1071-1076, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31563333

RESUMEN

In June 2018, the National Institute of Diabetes and Digestive and Kidney Diseases and the National Institute of Environmental Health Sciences sponsored a workshop to identify research gaps in an increasingly common form of chronic kidney disease in agricultural communities, often termed "CKDu." The organizers invited a broad range of experts who provided diverse expertise and perspectives, many of whom had never addressed this particular epidemic. Discussion was focused around selected topics, including identifying and mitigating barriers to research in CKDu, creating a case definition, and defining common data elements. All hypotheses regarding etiology were entertained, and meeting participants discussed potential research strategies, choices in study design, and novel tools that may prove useful in this disease. Achievements of the workshop included robust cross-disciplinary discussion and preliminary planning of research goals and design. Specific challenges in implementing basic and clinical research and interventions in low- and middle-income countries were recognized. A balanced approach to leveraging local resources and capacity building without overreaching was emphasized.

11.
Rev. cuba. salud pública ; 45(3): e1716, jul.-sep. 2019. tab, graf
Artículo en Español | LILACS-Express | ID: biblio-1058429

RESUMEN

RESUMEN Introducción: El control de la presión arterial es un desafío global y uno de los principales problemas de salud pública en la actualidad. Objetivos: Describir los factores relacionados con la evolución, detección y control de la hipertensión arterial en Cienfuegos en el periodo de 2001 a 2011, en un contexto de acceso universal a los servicios de salud. Métodos: Estudio poblacional desarrollado en el año 2011, con una muestra representativa probabilística de 1276 adultos entre 25-74 años, residentes en la ciudad de Cienfuegos, Cuba. Resultados: De los hipertensos, el 32,8 % desconocía su condición, el 90 % de los que conocían su condición llevaban tratamiento y el 29,8 % estaban controlados. El riesgo de no control fue significativamente superior en las personas con más de 65 años, en las de raza negra o mestiza y en las que tenían más de un año sin ir a su médico o controlarse la presión arterial. Con relación al 2001, el porcentaje de hipertensos que desconocían su condición se incrementó en 11,3 %; se redujo el número de tratados en un 3,4 % y el nivel de control en un 10 %. Conclusiones: Existe un grupo de factores como la edad, la raza, y la falta de seguimiento de las personas en los servicios de salud para la detección y control de la HTA que afectan su comportamiento. Los resultados, aunque superan los reportados por otros países de la región, sugieren brechas en la detección, el seguimiento de los casos y la gestión del sistema en el 2011, si se compara con la década precedente.


ABSTRACT Introduction: The control of blood pressure is a global challenge and one of the main public health problems nowadays. Objectives: To describe the factors related to the evolution, detection and control of hypertension in Cienfuegos from 2001 to 2011 in a scenario of universal access to health services. Methods: Population study developed during 2011, with a representative, probabilistic sample of 1276 adults in the ages from 25 to 74 years old whom lived in the city of Cienfuegos, Cuba. Results: From the hypertensive patients, 32,8 % were unaware of their condition, 90% of those who knew their condition had treatment, and 29,8 % were controlled. Uncontrolled hypertension's risk was significantly higher in people with age ≥ 65 years, the ones of black race or mixed race, in the ones not attending to the doctor's consultation or not controlling the blood pressure for more than one year. In relation to 2001, the percentage of hypertensive patients who did not know their condition increased by 11,3 %; the number of treated patients was reduced by 3,4 % and the level of control by 10%. Conclusions: There are a group of factors as age, race, and the lack of follow up to these patients in the health care services in order to detect and control hypertension that affect its behavior. The results, although better than those observed in other countries in the region, show a gap in terms of detection and control of hypertension, the follow up of the patients and management of the system in the year 2011 in comparison with the previous decade.

12.
Lancet Glob Health ; 7(5): e604-e612, 2019 05.
Artículo en Inglés | MEDLINE | ID: mdl-31000130

RESUMEN

BACKGROUND: In accordance with the age parameters specified in Sustainable Development Goal target 3.4, current policy and monitoring of non-communicable disease (NCD) mortality trends focus on people aged 30-69 years. This approach excludes the majority of NCD deaths, which occur at older ages. We aimed to compare cardiovascular mortality for different age groups in the WHO Region of the Americas. METHODS: We extracted mortality data from the Pan American Health Organization regional mortality database for 36 countries for the period 2000 to 2015. We calculated age-standardised mortality rates (ASMRs) from cardiovascular diseases for different age groups for these countries. Joinpoint regression models were used to estimate mortality trends, providing estimates of the average annual percentage change for the period 2000-15. FINDINGS: Individuals aged 70 years or older accounted for the majority of cardiovascular disease deaths in all countries (range 52-82%). Considerable variation in cardiovascular deaths was observed between countries for all age categories. Between 2000 and 2015, in most countries, the largest reductions in ASMR were observed in the older age groups (aged ≥70 years). The total number of regional cardiovascular disease deaths that hypothetically could have been averted in 2015 for people aged 30-79 years was 440 777, of which 211 365 (48%) occurred among people aged 70-79 years. INTERPRETATION: Data for the WHO Region of the Americas are sufficiently robust to permit comparative analysis of cardiovascular disease mortality trends for people aged 70 years and older over time and across countries. Although the reduction of cardiovascular disease mortality in individuals aged 30-69 years is a valid policy goal for the Americas region, this objective should be expanded to include people at older ages. FUNDING: None.

13.
Artículo en Español | PAHO-IRIS | ID: phr-50523

RESUMEN

[RESUMEN]. El análisis de las causas que impactan la mortalidad prematura es una función esencial de la vigilancia de salud pública. Para evaluar con precisión e informar la magnitud y las tendencias de la mortalidad prematura se han utilizado diversos métodos; algunos de estos métodos, sin embargo, tienen importantes limitaciones, en particular para cuantificar las muertes prematuras. Nosotros respaldamos que los años de vida perdidos (YLL, por sus siglas en inglés), tal como se conceptualiza en el contexto de los años de vida ajustados por discapacidad (DALY, por sus siglas en inglés), son una medida robusta y abarcadora de la mortalidad prematura. El estudio de carga global de enfermedad proporciona sistemáticamente estimados de YLL; sin embargo, esta medida y sus métodos no se han adoptado ampliamente a nivel de los países, entre otras razones porque sus bases conceptuales y metodológicas parecieran no ser suficientemente conocidas y entendidas. En este artículo se presentan los conceptos y la metodología para estimar los YLL, inclusive la selección de la función de pérdida que define el tiempo perdido debido a la muerte prematura y los métodos detallados para calcular las métricas de YLL. También se ilustra cómo utilizar los YLL para cuantificar los niveles y las tendencias de la mortalidad prematura por enfermedades no transmisibles en la Región de las Américas. El estilo tutorial del ejemplo ilustrativo tiene como propósito educar a la comunidad de profesionales de la salud pública y estimular la utilización del YLL en los programas de prevención y control en los diferentes niveles del sistema de salud.


[ABSTRACT]. The analysis of causes impacting on premature mortality is an essential function of public health surveillance. Diverse methods have been used for accurately assessing and reporting the level and trends of premature mortality; however, many have important limitations, particularly in capturing actual early deaths. We argue that the framework of years of life lost (YLL), as conceptualized in disability-adjusted life-years (DALYs), is a robust and comprehensive measure of premature mortality. Global Burden of Disease study is systematically providing estimates of YLL; however, it is not widely adopted at country level, among other reasons because its conceptual and methodological bases seem to be not sufficiently known and understood. In this paper, we provide the concepts and the methodology of the YLL framework, including the selection of the loss of function that defines the time lost due to premature deaths, and detailed methods for calculating YLL metrics. We also illustrate how to use YLL to quantify the level and trends of premature non-communicable disease (NCD) mortality in the Americas. The tutorial style of the illustrative example is intended to educate the public health community and stimulate the use of YLL in disease prevention and control programmes at different levels.


Asunto(s)
Mortalidad Prematura , Métodos Epidemiológicos , Enfermedades Transmisibles , Mortalidad Prematura , Métodos Epidemiológicos , Enfermedades no Transmisibles , Vigilancia en Salud Pública , Vigilancia en Salud Pública
14.
Int J Epidemiol ; 48(4): 1367-1376, 2019 08 01.
Artículo en Inglés | MEDLINE | ID: mdl-30629192

RESUMEN

The analysis of causes impacting on premature mortality is an essential function of public health surveillance. Diverse methods have been used for accurately assessing and reporting the level and trends of premature mortality; however, many have important limitations, particularly in capturing actual early deaths. We argue that the framework of years of life lost (YLL), as conceptualized in disability-adjusted life-years (DALYs), is a robust and comprehensive measure of premature mortality. Global Burden of Disease study is systematically providing estimates of YLL; however, it is not widely adopted at country level, among other reasons because its conceptual and methodological bases seem to be not sufficiently known and understood. In this paper, we provide the concepts and the methodology of the YLL framework, including the selection of the loss of function that defines the time lost due to premature deaths, and detailed methods for calculating YLL metrics. We also illustrate how to use YLL to quantify the level and trends of premature non-communicable disease (NCD) mortality in the Americas. The tutorial style of the illustrative example is intended to educate the public health community and stimulate the use of YLL in disease prevention and control programmes at different levels.


Asunto(s)
Carga Global de Enfermedades/estadística & datos numéricos , Transición de la Salud , Esperanza de Vida/tendencias , Mortalidad Prematura/tendencias , Enfermedades no Transmisibles/mortalidad , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Personas con Discapacidad , Femenino , Salud Global/estadística & datos numéricos , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Años de Vida Ajustados por Calidad de Vida , Factores Socioeconómicos , Adulto Joven
15.
Lancet Public Health ; 4(2): e79-e80, 2019 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-30683585
16.
Artículo en Español | PAHO-IRIS | ID: phr-50476

RESUMEN

[RESUMEN]. El análisis de las causas que impactan la mortalidad prematura es una función esencial de la vigilancia de salud pública. Para evaluar con precisión e informar la magnitud y las tendencias de la mortalidad prematura se han utilizado diversos métodos; algunos de estos métodos, sin embargo, tienen importantes limitaciones, en particular para cuantificar las muertes prematuras. Nosotros respaldamos que los años de vida perdidos (YLL, por sus siglas en inglés), tal como se conceptualiza en el contexto de los años de vida ajustados por discapacidad (DALY, por sus siglas en inglés), son una medida robusta y abarcadora de la mortalidad prematura. El estudio de carga global de enfermedad proporciona sistemáticamente estimados de YLL; sin embargo, esta medida y sus métodos no se han adoptado ampliamente a nivel de los países, entre otras razones porque sus bases conceptuales y metodológicas parecieran no ser suficientemente conocidas y entendidas. En este artículo se presentan los conceptos y la metodología para estimar los YLL, inclusive la selección de la función de pérdida que define el tiempo perdido debido a la muerte prematura y los métodos detallados para calcular las métricas de YLL. También se ilustra cómo utilizar los YLL para cuantificar los niveles y las tendencias de la mortalidad prematura por enfermedades no trasmisibles en la Región de las Américas. El estilo tutorial del ejemplo ilustrativo tiene como propósito educar a la comunidad de profesionales de la salud pública y estimular la utilización del YLL en los programas de prevención y control en los diferentes niveles del sistema de salud.


[ABSTRACT]. The analysis of causes impacting on premature mortality is an essential function of public health surveillance. Diverse methods have been used for accurately assessing and reporting the level and trends of premature mortality; however, many have important limitations, particularly in capturing actual early deaths. We argue that the framework of years of life lost (YLL), as conceptualized in disability-adjusted life-years (DALYs), is a robust and comprehensive measure of premature mortality. Global Burden of Disease study is systematically providing estimates of YLL; however, it is not widely adopted at country level, among other reasons because its conceptual and methodological bases seem to be not sufficiently known and understood. In this paper, we provide the concepts and the methodology of the YLL framework, including the selection of the loss of function that defines the time lost due to premature deaths, and detailed methods for calculating YLL metrics. We also illustrate how to use YLL to quantify the level and trends of premature non-communicable disease (NCD) mortality in the Americas. The tutorial style of the illustrative example is intended to educate the public health community and stimulate the use of YLL in disease prevention and control programmes at different levels.


Asunto(s)
Mortalidad Prematura , Métodos Epidemiológicos , Enfermedades no Transmisibles , Mortalidad Prematura , Métodos Epidemiológicos , Enfermedades no Transmisibles , Vigilancia en Salud Pública , Vigilancia en Salud Pública
19.
J Clin Hypertens (Greenwich) ; 20(6): 984-990, 2018 06.
Artículo en Inglés | MEDLINE | ID: mdl-29790259

RESUMEN

The Pan American Health Organization (PAHO)-World Hypertension League (WHL) Hypertension Monitoring and Evaluation Framework is summarized. Standardized indicators are provided for monitoring and evaluating national or subnational hypertension control programs. Five core indicators from the World Health Organization hearts initiative and a single PAHO-WHL core indicator are recommended to be used in all hypertension control programs. In addition, hypertension control programs are encouraged to select from 14 optional qualitative and 33 quantitative indicators to facilitate progress towards enhanced hypertension control. The intention is for hypertension programs to select quantitative indicators based on the current surveillance mechanisms that are available and what is feasible and to use the framework process indicators as a guide to program management. Programs may wish to increase or refine the number of indicators they use over time. With adaption the indicators can also be implemented at a community or clinic level. The standardized indicators are being pilot tested in Cuba, Colombia, Chile, and Barbados.


Asunto(s)
Hipertensión/prevención & control , Vigilancia de la Población/métodos , Evaluación de Programas y Proyectos de Salud/métodos , Barbados , Chile , Colombia , Cuba , Indicadores de Salud , Humanos , Organización Panamericana de la Salud , Organización Mundial de la Salud
20.
Artículo en Español | PAHO-IRIS | ID: phr-34897

RESUMEN

[RESUMEN]. Las enfermedades no transmisibles (ENT) representan uno de los mayores desafíos para el desarrollo en el siglo XXI, debido al devastador impacto social, económico y de la salud pública que provocan. El propósito de este artículo es describir la evolución y los factores de riesgo de las ENT en Cuba, principalmente en el período 1990–2015, reseñar las acciones emprendidas por el Ministerio de Salud Pública y destacar los desafíos más importantes para su prevención y control. La información contenida proviene de los datos colectados y publicados por la Dirección de Registros Médicos y Estadísticas de Salud, investigaciones sobre los factores de riesgo, otros estudios fundamentados y la documentación de acciones integrales. La mortalidad en Cuba está determinada por cuatro grandes problemas de salud: enfermedades cardiovasculares, tumores malignos, enfermedades crónicas de las vías respiratorias inferiores y diabetes mellitus, que en conjunto causan el 68,0% de los fallecimientos. La tendencia del cáncer es al ascenso y la enfermedad renal crónica emerge como un grave problema de salud. Cuba cuenta con una línea de base conocida sobre los factores de riesgo, de ellos la hipertensión y el consumo de tabaco son los principales relacionados con la mortalidad por ENT. En consonancia con la importancia de estas enfermedades se aprecian hitos e intervenciones de impacto positivo, así como brechas y desafíos en el marco del Plan de Acción Mundial de la Organización Mundial de la Salud para el enfrentamiento a las ENT.


[ABSTRACT]. Non-communicable diseases (NCDs) represent one of the greatest challenges for development of the 21st century due to their devastating social, economic and public health impact. The objective of this article are to describe the evolution and risk factors for NCDs in Cuba, mainly in the period 1990–2015, to outline actions undertaken by the Ministry of Public Health of Cuba, and to highlight the most important challenges with a focus on their prevention and control. The information is based on data collected and published by the Directorate of Medical Records and Health Statistics, research on risk factors, other studies and documentation of comprehensive actions. Mortality in Cuba is determined by four major health problems: cardiovascular diseases, malignant tumors, chronic diseases of the lower respiratory tract and diabetes mellitus, which together cause 68.0% of deaths. Cancer presents a growing trend, and chronic kidney disease emerges as a serious health problem. Cuba has a known baseline on risk factors, and hypertension and tobacco consumption are the main factors related to NCDs mortality. In line with the importance of these diseases, there are milestones and interventions with a positive impact, as well as gaps and challenges within the framework of the World Health Organization’s Global Action Plan for the Prevention and Control of NCDs.


[RESUMO]. As doenças não transmissíveis (DNT) representam um dos maiores desafios do século 21 para o desenvolvimento devido ao desvastador impacto social, econômico e de saúde pública que elas causam. O objetivo deste artigo é descrever a evolução e os fatores de risco das doenças não transmissíveis em Cuba, principalmente no período de 1990–2015, para delinear as ações realizadas pelo Ministério da Saúde Pública de Cuba e destacar os desafios mais importantes para sua prevenção e controle. A informação vem dos dados coletados e publicados pela Diretoria de Registros Médicos e Estatísticas de Saúde, pesquisa sobre fatores de risco, outros estudos fundamentados e documentação de ações abrangentes. A mortalidade em Cuba é determinada por quatro principais problemas de saúde: doenças cardiovasculares, tumores malignos, doenças crônicas do trato respiratório inferior e diabetes mellitus, que em conjunto causam 68,0% das mortes. O câncer tem uma tendência crescente, e a doença renal crônica surge como um grave problema de saúde. Cuba tem uma linha de base conhecida sobre os fatores de risco, dos quais a hipertensão e o consumo de tabaco são os principais relacionados à mortalidade por DNT. Em consonância com a importância dessas doenças, há marcos e intervenções com impacto positivo, bem como lacunas e desafios no âmbito do Plano de Ação Mundial da Organização Mundial da Saúde para enfrentar as doenças não transmissíveis.


Asunto(s)
Enfermedad Crónica , Factores de Riesgo , Mortalidad Prematura , Cuba , Enfermedad Crónica , Factores de Riesgo , Mortalidad Prematura , Determinantes Sociales de la Salud , Determinantes Sociales de la Salud , Enfermedad Crónica , Factores de Riesgo , Mortalidad Prematura , Determinantes Sociales de la Salud
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