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  1. Article ; Online: Assessing child development scores among minority and Indigenous language versus dominant language speakers

    Ann C Miller, PhD / David Flood, MD / Scott Tschida, MPhil / Katherine Douglas, MD / Peter Rohloff, MD

    The Lancet Global Health, Vol 12, Iss 1, Pp e90-e

    a cross-sectional analysis of national Multiple Indicator Cluster Surveys

    2024  Volume 99

    Abstract: Summary: Background: Multiple studies have highlighted the inequities minority and Indigenous children face when accessing health care. Health and wellbeing are positively impacted when Indigenous children are educated and receive care in their maternal ... ...

    Abstract Summary: Background: Multiple studies have highlighted the inequities minority and Indigenous children face when accessing health care. Health and wellbeing are positively impacted when Indigenous children are educated and receive care in their maternal language. However, less is known about the association between minority or Indigenous language use and child development risks and outcomes. In this study, we provide global estimates of development risks and assess the associations between minority or Indigenous language status and early child development using the ten-item Early Child Development Index (ECDI), a tool widely used for global population assessments in children aged 3–4 years. Methods: We did a secondary analysis of cross-sectional data from 65 UNICEF Multiple Indicator Cluster Surveys (MICS) containing the ECDI from 2009–19 (waves 4–6). We included individual-level data for children aged 2–4 years (23–60 months) from datasets with ECDI modules, for surveys that captured the language of the respondent, interview, or head of household. The Expanded Graded Intergenerational Disruption Scale was used to classify household languages as dominant versus minority or Indigenous at the country level. Our primary outcome was on-track overall development, defined per UNICEF's guidelines as development being on track for at least three of the four ECDI domains (literacy–numeracy, learning, physical, and socioemotional). We performed logistic regression of pooled, weighted ECDI scores, aggregated by language status and adjusting for the covariables of child sex, child nutritional status (stunting), household wealth, maternal education, developmental support by an adult caregiver, and country-level early child education proportion. Regression analyses were done for all children aged 3–4 years with ECDI results, and separately for children with functional disabilities and ECDI results. Findings: 65 MICS datasets were included. 186 393 children aged 3–4 years had ECDI and language data, corresponding to an ...
    Keywords Public aspects of medicine ; RA1-1270
    Subject code 410
    Language English
    Publishing date 2024-01-01T00:00:00Z
    Publisher Elsevier
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: Estimated effect of increased diagnosis, treatment, and control of diabetes and its associated cardiovascular risk factors among low-income and middle-income countries

    Sanjay Basu, MD / David Flood, MD / Pascal Geldsetzer, MD / Michaela Theilmann, MA / Maja E Marcus, MA / Cara Ebert, PhD / Mary Mayige, MBChB / Roy Wong-McClure, MD / Farshad Farzadfar, MD / Sahar Saeedi Moghaddam, MS / Kokou Agoudavi, MD / Bolormaa Norov, MSc / Corine Houehanou, PhD / Glennis Andall-Brereton, PhD / Mongal Gurung, PhD / Garry Brian, MD / Pascal Bovet, MD / Joao Martins, PhD / Rifat Atun, ProfFRCP /
    Till Bärnighausen, ProfMD / Sebastian Vollmer, ProfPhD / Jen Manne-Goehler, MD / Justine Davies, ProfMD

    The Lancet Global Health, Vol 9, Iss 11, Pp e1539-e

    a microsimulation model

    2021  Volume 1552

    Abstract: Summary: Background: Given the increasing prevalence of diabetes in low-income and middle-income countries (LMICs), we aimed to estimate the health and cost implications of achieving different targets for diagnosis, treatment, and control of diabetes and ...

    Abstract Summary: Background: Given the increasing prevalence of diabetes in low-income and middle-income countries (LMICs), we aimed to estimate the health and cost implications of achieving different targets for diagnosis, treatment, and control of diabetes and its associated cardiovascular risk factors among LMICs. Methods: We constructed a microsimulation model to estimate disability-adjusted life-years (DALYs) lost and health-care costs of diagnosis, treatment, and control of blood pressure, dyslipidaemia, and glycaemia among people with diabetes in LMICs. We used individual participant data—specifically from the subset of people who were defined as having any type of diabetes by WHO standards—from nationally representative, cross-sectional surveys (2006–18) spanning 15 world regions to estimate the baseline 10-year risk of atherosclerotic cardiovascular disease (defined as fatal and non-fatal myocardial infarction and stroke), heart failure (ejection fraction of <40%, with New York Heart Association class III or IV functional limitations), end-stage renal disease (defined as an estimated glomerular filtration rate <15 mL/min per 1·73 m2 or needing dialysis or transplant), retinopathy with severe vision loss (<20/200 visual acuity as measured by the Snellen chart), and neuropathy with pressure sensation loss (assessed by the Semmes-Weinstein 5·07/10 g monofilament exam). We then used data from meta-analyses of randomised controlled trials to estimate the reduction in risk and the WHO OneHealth tool to estimate costs in reaching either 60% or 80% of diagnosis, treatment initiation, and control targets for blood pressure, dyslipidaemia, and glycaemia recommended by WHO guidelines. Costs were updated to 2020 International Dollars, and both costs and DALYs were computed over a 10-year policy planning time horizon at a 3% annual discount rate. Findings: We obtained data from 23 678 people with diabetes from 67 countries. The median estimated 10-year risk was 10·0% (IQR 4·0–18·0) for cardiovascular events, 7·8% ...
    Keywords Public aspects of medicine ; RA1-1270
    Subject code 610
    Language English
    Publishing date 2021-11-01T00:00:00Z
    Publisher Elsevier
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Online: The state of diabetes treatment coverage in 55 low-income and middle-income countries

    David Flood, MD / Jacqueline A Seiglie, MD / Matthew Dunn, MPH / Scott Tschida, MPhil / Michaela Theilmann, MA / Maja E Marcus, MA / Garry Brian, MBChB / Bolormaa Norov, MD / Mary T Mayige, PhD / Mongal Singh Gurung, PhD / Krishna K Aryal, PhD / Demetre Labadarios, ProfMBChB / Maria Dorobantu, ProfFESC / Bahendeka K Silver, MBChB / Pascal Bovet, MD / Jutta M Adelin Jorgensen, MD / David Guwatudde, ProfPhD / Corine Houehanou, MD / Glennis Andall-Brereton, PhD /
    Sarah Quesnel-Crooks, MSc / Lela Sturua, PhD / Farshad Farzadfar, ProfMD / Sahar Saeedi Moghaddam, MSc / Rifat Atun, ProfFRCP / Sebastian Vollmer, ProfPhD / Till W Bärnighausen, ProfMD / Justine I Davies, ProfMD / Deborah J Wexler, MD / Pascal Geldsetzer, ScD / Peter Rohloff, MD / Manuel Ramírez-Zea, MD / Michele Heisler, ProfMD / Jennifer Manne-Goehler, MD

    The Lancet. Healthy Longevity, Vol 2, Iss 6, Pp e340-e

    a cross-sectional study of nationally representative, individual-level data in 680 102 adults

    2021  Volume 351

    Abstract: Summary: Background: Approximately 80% of the 463 million adults worldwide with diabetes live in low-income and middle-income countries (LMICs). A major obstacle to designing evidence-based policies to improve diabetes outcomes in LMICs is the scarce ... ...

    Abstract Summary: Background: Approximately 80% of the 463 million adults worldwide with diabetes live in low-income and middle-income countries (LMICs). A major obstacle to designing evidence-based policies to improve diabetes outcomes in LMICs is the scarce availability of nationally representative data on the current patterns of treatment coverage. The objectives of this study were to estimate the proportion of adults with diabetes in LMICs who receive coverage of recommended pharmacological and non-pharmacological diabetes treatment; and to describe country-level and individual-level characteristics that are associated with treatment. Methods: We did a cross-sectional analysis of pooled, individual data from 55 nationally representative surveys in LMICs. Our primary outcome of self-reported diabetes treatment coverage was based on population-level monitoring indicators recommended in the 2020 WHO Package of Essential Noncommunicable Disease Interventions. Surveys were included if they were done in 2008 or after in an LMIC, as classified by the World Bank in the year the survey was done; were nationally representative; had individual-level data; contained a diabetes biomarker (fasting glucose, random glucose, or glycated haemoglobin); and had data on one or more diabetes treatments. Our sample included non-pregnant individuals with an available diabetes biomarker who were at least 25 years of age. We assessed coverage of three pharmacological and three non-pharmacological treatments among people with diabetes. At the country level, we estimated the proportion of individuals reporting coverage by per-capita gross national income and geographical region. At the individual level, we used logistic regression models to assess coverage along several key individual characteristics including sex, age, body-mass index, wealth quintile, and educational attainment. In the primary analysis, we scaled sample weights such that countries were weighted equally. Findings: The final pooled sample from the 55 LMICs included 680 102 ...
    Keywords Geriatrics ; RC952-954.6 ; Medicine ; R
    Subject code 360
    Language English
    Publishing date 2021-06-01T00:00:00Z
    Publisher Elsevier
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

    Full text online

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