19 research outputs found
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Use of Climate Information in Malaria Stratification/Early Warning Systems/Impact Assessment for Malaria Interventions
A report on the training workshop and stakeholder meeting hosted by the Tanzania Meteorological Agency in Dar es Salaam, Tanzania October 16th-18th 2013
Climate and health in Africa
This paper describes the work of the International Research Institute for Climate and Society (IRI) and its partners towards the development of climate services for the health sector in Africa; integrating research, operational applications and capacity building alongside policy development and advocacy. It follows the evolution of IRI’s health work from an initial focus on the use of seasonal climate forecasts to a wider agenda serving climate and environmental information needs to a broad range of health-related users. Recognizing that climate information must be relevant to the priority policy and programming needs of national and international health stakeholders, this review highlights an approach that has centered not only on the assessment and creation of evidence, but also on knowledge transfer through engagement with decision-makers. Current opportunities and priorities identified for the routine use of climate and environmental information in health in Africa include: i) understanding mechanisms by which climate impacts on transmission and occurrence of disease; ii) mapping populations at risk both in space and by season; iii) developing early warning systems; iv) understanding the contributions of climate to trends in disease incidence v) improving the evaluation of the impacts of climate-sensitive interventions. While traditional metrics (e.g. peer review publications) have been important in establishing evidence for policy, the IRI’s role as a knowledge broker (in research and professional capacity building, facilitation of communities of practice, and engagement in policy dialogue at local and global scale) has been critical to delivery of its mission
Familial hypercholesterolaemia in children and adolescents from 48 countries: a cross-sectional study
Background: Approximately 450 000 children are born with familial hypercholesterolaemia worldwide every year, yet only 2·1% of adults with familial hypercholesterolaemia were diagnosed before age 18 years via current diagnostic approaches, which are derived from observations in adults. We aimed to characterise children and adolescents with heterozygous familial hypercholesterolaemia (HeFH) and understand current approaches to the identification and management of familial hypercholesterolaemia to inform future public health strategies. Methods: For this cross-sectional study, we assessed children and adolescents younger than 18 years with a clinical or genetic diagnosis of HeFH at the time of entry into the Familial Hypercholesterolaemia Studies Collaboration (FHSC) registry between Oct 1, 2015, and Jan 31, 2021. Data in the registry were collected from 55 regional or national registries in 48 countries. Diagnoses relying on self-reported history of familial hypercholesterolaemia and suspected secondary hypercholesterolaemia were excluded from the registry; people with untreated LDL cholesterol (LDL-C) of at least 13·0 mmol/L were excluded from this study. Data were assessed overall and by WHO region, World Bank country income status, age, diagnostic criteria, and index-case status. The main outcome of this study was to assess current identification and management of children and adolescents with familial hypercholesterolaemia. Findings: Of 63 093 individuals in the FHSC registry, 11 848 (18·8%) were children or adolescents younger than 18 years with HeFH and were included in this study; 5756 (50·2%) of 11 476 included individuals were female and 5720 (49·8%) were male. Sex data were missing for 372 (3·1%) of 11 848 individuals. Median age at registry entry was 9·6 years (IQR 5·8-13·2). 10 099 (89·9%) of 11 235 included individuals had a final genetically confirmed diagnosis of familial hypercholesterolaemia and 1136 (10·1%) had a clinical diagnosis. Genetically confirmed diagnosis data or clinical diagnosis data were missing for 613 (5·2%) of 11 848 individuals. Genetic diagnosis was more common in children and adolescents from high-income countries (9427 [92·4%] of 10 202) than in children and adolescents from non-high-income countries (199 [48·0%] of 415). 3414 (31·6%) of 10 804 children or adolescents were index cases. Familial-hypercholesterolaemia-related physical signs, cardiovascular risk factors, and cardiovascular disease were uncommon, but were more common in non-high-income countries. 7557 (72·4%) of 10 428 included children or adolescents were not taking lipid-lowering medication (LLM) and had a median LDL-C of 5·00 mmol/L (IQR 4·05-6·08). Compared with genetic diagnosis, the use of unadapted clinical criteria intended for use in adults and reliant on more extreme phenotypes could result in 50-75% of children and adolescents with familial hypercholesterolaemia not being identified. Interpretation: Clinical characteristics observed in adults with familial hypercholesterolaemia are uncommon in children and adolescents with familial hypercholesterolaemia, hence detection in this age group relies on measurement of LDL-C and genetic confirmation. Where genetic testing is unavailable, increased availability and use of LDL-C measurements in the first few years of life could help reduce the current gap between prevalence and detection, enabling increased use of combination LLM to reach recommended LDL-C targets early in life
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Climate and Health in Africa: 10 Years On Workshop Report, UNECA Conference Center, Addis Ababa, April 4-7, 2011
One of the defining challenges of the 21st century is increasingly recognised to be the world’s changing climate. The health consequences of climate variability and change are linked inextricably to poverty, equity and development choices. Protecting health from climate impacts is now a priority for the public health community. The need for this is greatest in developing countries, where vulnerable people do not have the basic economic choices and infrastructure to cope with the varying climate. These communities bear a disproportionately large burden of infectious diseases and climate related disasters while having the poorest access to effective public health services. Climate change will exacerbate this inequity.