Hypertension, obesity and central obesity in diabetics and non diabetics in Southern Ethiopia

Diabetes mellitus coexists at a greater frequency with hypertension, obesity, central obesity, dyslipedemia and proteinuria and that markedly increases the risk of atherosclerotic disease. A study was done for a period of four months in Sidama Zone, Southern Ethiopia to compare the prevalence of atherosclerotic risk factors between diabetic and non diabetic general population. One hundred ninety nine diabetic cases were selected from two hospitals diabetic clinics and 195 non diabetics subjects were selected from urban and rural areas. The general prevalence of hypertension in the entire study population was 18.8%, with 26.1% in diabetics and 10.2% in non diabetics. Multivariate logistic regression showed that hypertension, central obesity, overweight and obesity, and ethnicity had strong association with possibility of diabetes mellitus. The reason for possible racial difference to cardiovascular risk factors and population awareness to these factors should be studied. [Ethiop. J. Health Dev. 2010;24(2):145-147

Using climate information in the health sector

Many infectious and chronic diseases are either directly or indirectly sensitive to the climate. Managing this climate sensitivity more effectively requires new working relationships between the health sector and the providers of climate data and information. In Africa, where communities are particularly vulnerable, Ministries of Health and National Meteorological Services need to collaborate to reduce the burden of climaterelated ill health

Interplant Communication of Tomato Plants through Underground Common Mycorrhizal Networks

Plants can defend themselves to pathogen and herbivore attack by responding to chemical signals that are emitted by attacked plants. It is well established that such signals can be transferred through the air. In theory, plants can also communicate with each other through underground common mycorrhizal networks (CMNs) that interconnect roots of multiple plants. However, until now research focused on plant-to-plant carbon nutrient movement and there is no evidence that defense signals can be exchanged through such mycorrhizal hyphal networks. Here, we show that CMNs mediate plant-plant communication between healthy plants and pathogen-infected tomato plants (Lycopersicon esculentum Mill.). After establishment of CMNs with the arbuscular mycorrhizal fungus Glomus mosseae between tomato plants, inoculation of ‘donor’ plants with the pathogen Alternaria solani led to increases in disease resistance and activities of the putative defensive enzymes, peroxidase, polyphenol oxidase, chitinase, β-1,3-glucanase, phenylalanine ammonia-lyase and lipoxygenase in healthy neighbouring ‘receiver’ plants. The uninfected ‘receiver’ plants also activated six defence-related genes when CMNs connected ‘donor’ plants challenged with A. solani. This finding indicates that CMNs may function as a plant-plant underground communication conduit whereby disease resistance and induced defence signals can be transferred between the healthy and pathogen-infected neighbouring plants, suggesting that plants can ‘eavesdrop’ on defence signals from the pathogen-challenged neighbours through CMNs to activate defences before being attacked themselves

Global, regional, and national disability-adjusted life-years (DALYs) for 333 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016

BACKGROUND: Measurement of changes in health across locations is useful to compare and contrast changing epidemiological patterns against health system performance and identify specific needs for resource allocation in research, policy development, and programme decision making. Using the Global Burden of Diseases, Injuries, and Risk Factors Study 2016, we drew from two widely used summary measures to monitor such changes in population health: disability-adjusted life-years (DALYs) and healthy life expectancy (HALE). We used these measures to track trends and benchmark progress compared with expected trends on the basis of the Socio-demographic Index (SDI). METHODS: We used results from the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 for all-cause mortality, cause-specific mortality, and non-fatal disease burden to derive HALE and DALYs by sex for 195 countries and territories from 1990 to 2016. We calculated DALYs by summing years of life lost and years of life lived with disability for each location, age group, sex, and year. We estimated HALE using age-specific death rates and years of life lived with disability per capita. We explored how DALYs and HALE differed from expected trends when compared with the SDI: the geometric mean of income per person, educational attainment in the population older than age 15 years, and total fertility rate. FINDINGS: The highest globally observed HALE at birth for both women and men was in Singapore, at 75·2 years (95% uncertainty interval 71·9-78·6) for females and 72·0 years (68·8-75·1) for males. The lowest for females was in the Central African Republic (45·6 years [42·0-49·5]) and for males was in Lesotho (41·5 years [39·0-44·0]). From 1990 to 2016, global HALE increased by an average of 6·24 years (5·97-6·48) for both sexes combined. Global HALE increased by 6·04 years (5·74-6·27) for males and 6·49 years (6·08-6·77) for females, whereas HALE at age 65 years increased by 1·78 years (1·61-1·93) for males and 1·96 years (1·69-2·13) for females. Total global DALYs remained largely unchanged from 1990 to 2016 (-2·3% [-5·9 to 0·9]), with decreases in communicable, maternal, neonatal, and nutritional (CMNN) disease DALYs offset by increased DALYs due to non-communicable diseases (NCDs). The exemplars, calculated as the five lowest ratios of observed to expected age-standardised DALY rates in 2016, were Nicaragua, Costa Rica, the Maldives, Peru, and Israel. The leading three causes of DALYs globally were ischaemic heart disease, cerebrovascular disease, and lower respiratory infections, comprising 16·1% of all DALYs. Total DALYs and age-standardised DALY rates due to most CMNN causes decreased from 1990 to 2016. Conversely, the total DALY burden rose for most NCDs; however, age-standardised DALY rates due to NCDs declined globally. INTERPRETATION: At a global level, DALYs and HALE continue to show improvements. At the same time, we observe that many populations are facing growing functional health loss. Rising SDI was associated with increases in cumulative years of life lived with disability and decreases in CMNN DALYs offset by increased NCD DALYs. Relative compression of morbidity highlights the importance of continued health interventions, which has changed in most locations in pace with the gross domestic product per person, education, and family planning. The analysis of DALYs and HALE and their relationship to SDI represents a robust framework with which to benchmark location-specific health performance. Country-specific drivers of disease burden, particularly for causes with higher-than-expected DALYs, should inform health policies, health system improvement initiatives, targeted prevention efforts, and development assistance for health, including financial and research investments for all countries, regardless of their level of sociodemographic development. The presence of countries that substantially outperform others suggests the need for increased scrutiny for proven examples of best practices, which can help to extend gains, whereas the presence of underperforming countries suggests the need for devotion of extra attention to health systems that need more robust support. FUNDING: Bill & Melinda Gates Foundation

Using climate information in the health sector

Many infectious and chronic diseases are either directly or indirectly sensitive to the climate. Managing this climate sensitivity more effectively requires new working relationships between the health sector and the providers of climate data and information. In Africa, where communities are particularly vulnerable, Ministries of Health and National Meteorological Services need to collaborate to reduce the burden of climate related ill health. The Ministry of Health and the National Meteorological Agency of Ethiopia have made significant progress towards the development of a climate-informed early warning and response system for diseases such as malaria and other climate-sensitive diseases. An important enabling mechanism is a Climate and Health Working Group, which is a multi-sectoral partnership created to spearhead the use of climate information for health interventions. While this is a work in progress, the key ingredients necessary to sustain such a joint venture are described to encourage similar activities in other countries faced with a growing climate-sensitive disease burden, to facilitate networking and to increase the return from the investment.<br>De nombreuses infections et maladies chroniques sont sensibles, directement ou indirectement, au climat. Une gestion plus efficace de cette sensibilité au climat passe par l’instauration d’une coopération entre le secteur de la santé et les fournisseurs de données et d’informations sur le climat. En Afrique, où les communautés sont particulièrement vulnérables, le ministère de la Santé et les Services de météorologie nationale doivent collaborer pour réduire le fardeau des maladies liées au climat.Le ministère de la Santé et l’Agence de météorologie nationale d’Ethiopie ont fait des progrès considérables dans le développement d’un système d’alerte et de réponse précoces basé sur les informations climatiques pour des maladies comme le paludisme et d’autres maladies sensibles au climat. Le Groupe de travail Climat et Santé, partenariat multisectoriel créé pour utiliser les informations sur le climat pour des interventions en matière de santé, joue un rôle essentiel. Alors que le travail est en cours, les ingrédients clés nécessaires pour soutenir une telle joint-venture sont décrits pour encourager des actions similaires dans d’autres pays qui sont confrontés à un nombre croissant de maladies sensibles au climat, pour faciliter la mise en réseau des informations et pour augmenter le retour sur investissement.<br>Muchas enfermedades contagiosas y enfermedades crónicas son directa o indirectamente sensibles al clima. Controlar esta sensibilidad al clima de manera más efectiva requiere nuevas relaciones de trabajo entre el sector sanitario y las personas que proporcionan datos e información climática. En África, donde las comunidades son especialmente vulnerables, los Ministerios de Sanidad y los Servicios Meteorológicos Nacionales deben colaborar para reducir el peso de la mala salud relacionada con el clima.El Ministerio de Sanidad y la Agencia Meteorológica Nacional de Etiopía han hecho un gran progreso hacia el desarrollo de un sistema de respuesta y de alerta temprana relacionada con el clima para enfermedades como malaria y otras enfermedades sensibles al clima. Un importante mecanismo de apoyo es un Grupo de Trabajo sobre la Salud y el Clima, que es una asociación multisectorial creada para encabezar el uso de información sobre el clima para intervenciones sanitarias. Aunque esto es un trabajo en curso, los ingredientes clave necesarios para sostener tal empresa conjunta ya están descritos para favorecer así actividades similares en otros países que se enfrentan a una creciente carga de enfermedades sensibles al clima, para facilitar la red de contactos y para aumentar el regreso de la inversión