ORCID Profile
0000-0002-7791-5167
Current Organisation
The University of Edinburgh
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Publisher: Public Library of Science (PLoS)
Date: 04-03-2021
DOI: 10.1371/JOURNAL.PMED.1003485
Abstract: Global cardiovascular disease (CVD) burden is high and rising, especially in low-income and middle-income countries (LMICs). Focussing on 45 LMICs, we aimed to determine (1) the adult population’s median 10-year predicted CVD risk, including its variation within countries by socio-demographic characteristics, and (2) the prevalence of self-reported blood pressure (BP) medication use among those with and without an indication for such medication as per World Health Organization (WHO) guidelines. We conducted a cross-sectional analysis of nationally representative household surveys from 45 LMICs carried out between 2005 and 2017, with 32 surveys being WHO Stepwise Approach to Surveillance (STEPS) surveys. Country-specific median 10-year CVD risk was calculated using the 2019 WHO CVD Risk Chart Working Group non-laboratory-based equations. BP medication indications were based on the WHO Package of Essential Noncommunicable Disease Interventions guidelines. Regression models examined associations between CVD risk, BP medication use, and socio-demographic characteristics. Our complete case analysis included 600,484 adults from 45 countries. Median 10-year CVD risk (interquartile range [IQR]) for males and females was 2.7% (2.3%–4.2%) and 1.6% (1.3%–2.1%), respectively, with estimates indicating the lowest risk in sub-Saharan Africa and highest in Europe and the Eastern Mediterranean. Higher educational attainment and current employment were associated with lower CVD risk in most countries. Of those indicated for BP medication, the median (IQR) percentage taking medication was 24.2% (15.4%–37.2%) for males and 41.6% (23.9%–53.8%) for females. Conversely, a median (IQR) 47.1% (36.1%–58.6%) of all people taking a BP medication were not indicated for such based on CVD risk status. There was no association between BP medication use and socio-demographic characteristics in most of the 45 study countries. Study limitations include variation in country survey methods, most notably the s le age range and year of data collection, insufficient data to use the laboratory-based CVD risk equations, and an inability to determine past history of a CVD diagnosis. This study found underuse of guideline-indicated BP medication in people with elevated CVD risk and overuse by people with lower CVD risk. Country-specific targeted policies are needed to help improve the identification and management of those at highest CVD risk.
Publisher: Public Library of Science (PLoS)
Date: 18-08-2022
DOI: 10.1371/JOURNAL.PSTR.0000026
Abstract: The COVID-19 pandemic has disrupted agriculture in India in many ways, yet no nationally representative survey has been conducted to quantify these impacts. The three objectives of this study were to evaluate how the pandemic has influenced: (1) cropping patterns and input use, (2) farmers’ willingness to adopt sustainable agricultural practices, and (3) farmers’ COVID-19 symptoms. Phone surveys were conducted between December 2020 and January 2021 with farmers who had previously participated in a nationally representative survey. Values are reported as weighted percent (95% confidence interval). A total of 3,637 farmers completed the survey 59% (56–61%) were small/marginal farmers 72% (69–74%) were male and 52% (49–55%) had a below poverty line ration card. A majority of farmers (84% [82–86%]) reported cultivating the same crops in 2019 and 2020. Farmers who reported a change in their cropping patterns were more likely to be cultivating vegetables (p = 0.001) and soybean (p .001) and less likely to be cultivating rice (p .001). Concerning inputs, 66% (63–68%) of farmers reported no change in fertilizers 66% (64–69%) reported no change in pesticides and 59% (56–62%) reported no change in labor. More than half of farmers (62% [59–65%]) were interested in trying sustainable farming, primarily because of government schemes or because their peers were practicing it. About one-fifth (18% [15–21%]) of farmers reported COVID-19 symptoms in the past month (cough, fever, or shortness of breath) and among those with symptoms, 37% (28–47%) reported it affected their ability to work. In conclusion, COVID-19 infections had started to impact farmers’ productivity even during the first wave in India. Most farmers continued to grow the same crops with no change in input use. However, many expressed an interest in learning more about practicing sustainable farming. Findings will inform future directions for resilient agri-food systems.
Publisher: Elsevier BV
Date: 07-2019
DOI: 10.1093/JN/NXZ040
Abstract: The WHO recommends 400 g/d of fruits and vegetables (the equivalent of ∼5 servings/d) for the prevention of noncommunicable diseases (NCDs). However, there is limited evidence regarding in idual-level correlates of meeting these recommendations in low- and middle-income countries (LMICs). In order to target policies and interventions aimed at improving intake, global monitoring of fruit and vegetable consumption by socio-demographic subpopulations is required. The aims of this study were to 1) assess the proportion of in iduals meeting the WHO recommendation and 2) evaluate socio-demographic predictors (age, sex, and educational attainment) of meeting the WHO recommendation. Data were collected from 193,606 in iduals aged ≥15 y in 28 LMICs between 2005 and 2016. The prevalence of meeting the WHO recommendation took into account the complex survey designs, and countries were weighted according to their World Bank population estimates in 2015. Poisson regression was used to estimate associations with socio-demographic characteristics. The proportion (95% CI) of in iduals aged ≥15 y who met the WHO recommendation was 18.0% (16.6-19.4%). Mean intake of fruits was 1.15 (1.10-1.20) servings per day and for vegetables, 2.46 (2.40-2.51) servings/d. The proportion of in iduals meeting the recommendation increased with increasing country gross domestic product (GDP) class (P < 0.0001) and with decreasing country FAO food price index (FPI indicating greater stability of food prices P < 0.0001). At the in idual level, those with secondary education or greater were more likely to achieve the recommendation compared with in iduals with no formal education: risk ratio (95% CI), 1.61 (1.24-2.09). Over 80% of in iduals aged ≥15 y living in these 28 LMICs consumed lower amounts of fruits and vegetables than recommended by the WHO. Policies to promote fruit and vegetable consumption in LMICs are urgently needed to address the observed inequities in intake and prevent NCDs.
Publisher: Elsevier BV
Date: 05-2021
DOI: 10.1093/AJCN/NQAA370
Publisher: Elsevier BV
Date: 02-2019
Location: United States of America
Location: United Kingdom of Great Britain and Northern Ireland
Location: United States of America
Location: No location found
No related grants have been discovered for Lindsay Jaacks.