Exploring educational inequalities in hypertension control, salt knowledge and awareness, and patient advice: insights from the WHO STEPS surveys of adults from nine Eastern European and Central Asian countries.

OBJECTIVE: To inform strategies aimed at improving blood pressure (BP) control and reducing salt intake, we assessed educational inequalities in high blood pressure (HBP) awareness, treatment and control; physician's advice on salt reduction; and salt knowledge, perceptions and consumption behaviours in Eastern Europe and Central Asia. DESIGN: Data were collected in cross-sectional, population-based nationally representative surveys, using a multi-stage clustered sampling design. Five HBP awareness, treatment and control categories were created from measured BP and hypertension medication use. Education and other variables were self-reported. Weighted multinomial mixed-effects regression models, adjusted for confounders, were used to assess differences across education categories. SETTINGS: Nine Eastern European and Central Asian countries (Armenia, Azerbaijan, Belarus, Georgia, Kyrgyzstan, Republic of Moldova, Tajikistan, Turkey and Uzbekistan). PARTICIPANTS: Nationally representative samples of 30 455 adults aged 25-65 years. RESULTS: HBP awareness, treatment and control varied substantially by education. The coverage of physician's advice on salt was less frequent among participants with lower education, and those with untreated HBP or unaware of their HBP. The education gradient was evident in salt knowledge and perceptions of salt intake but not in salt consumption behaviours. Improved salt knowledge and perceptions were more prevalent among participants who received physician's advice on salt reduction. CONCLUSIONS: There is a strong education gradient in HBP awareness, treatment and control as well as salt knowledge and perceived intake. Enhancements in public and patient knowledge and awareness of HBP and its risk factors targeting socio-economically disadvantaged groups are urgently needed to alleviate the growing HBP burden in low- and middle-income countries.

[Information systems in health and health indicators: an integrating perspective]. / Sistemas de Información en Salud e indicadores de salud: una perspectiva integradora.

Health Information Systems (HIS) are the core support to decision-making in health organizations. Within HIS, health indicators (HI) reflect, numerically, events measured in the health-illness continuum. The integrated health information system is intended to standardize, integrate and organize all the information available in health information systems through an accessible and secure repository, and to conveniently distribute information for decision-making. To standardize information it is necessary to define standards and semantic information to enable us to identify concepts and relate them uniquely to each other. The definition of a catalog of entities (DEA) with concepts, attributes and domains will enable the configuration of the information system, so there will be a catalog of entities (concepts of information and domains). Based on operational systems, analytical systems enabling management and strategy in the management of organizations will be built. The maximum level of analysis is the Balanced Score Card (BSC), which is established as the strategic tool for managers. It is necessary for the organization an integrated information system to plan, manage, evaluate and therefore provide managers with a decision tool for strategic and tactical decision-making in short and medium term.

Control focal del paludismo: tratamiento focal usando quimioprofilaxis y rociado intradomiciliar con insecticida para el control del paludismo en el sur de México / Focal treatment with chemoprophylaxis and home spray with insecticides for the control of paludism in the Soyth of Mexico

La efectividad y eficiencia de una estrategia de aplicación focal para el control del paludismo, comparado con la estrategia tradicional de control, fueron evaluadas en dos grupos de localidades del Soconusco en el sur de Chiapas, México. El control focal consistió en la administración profiláctica de medicamentos antimaláricos a las personas que habían presentado episodios de paludismo en los dos años previos al estudio y la aplicación de rociado intradomiciliar con DDT en las casas de estas personas. El control tradicional consistió en el tratamiento de los casos de paludismo y el rociado de DDT a todas las casas de cada localidad. La estrategia de control focal mostró tener la misma efectividad (medida por el Índice Parasitario Anual) que la estrategia tradicional, pero su eficiencia fue superior con costos cuatro veces menor que los infringidos con medidas de control de cobertura total. El control focal tuvo además la ventaja de incorporar la participación comunitaria en la aplicación de las medidas de control.