Journal
INTERNATIONAL HEALTH
Volume 7, Issue 6, Pages 390-399Publisher
OXFORD UNIV PRESS
DOI: 10.1093/inthealth/ihv040
Keywords
Co-morbidity; Communicable disease; Health transition; Infectious disease; Low and middle-income countries; Non-communicable disease
Categories
Funding
- Carnegie Corporation Postdoctoral Fellowship
- Harry Crossley Senior Clinical Fellowship
- Wellcome Trust
- University of the West Indies
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In today's globalized world, rapid urbanization, mechanization of the rural economy, and the activities of transnational food, drink and tobacco corporations are associated with behavioral changes that increase the risk of chronic non-communicable diseases (NCDs). These changes include less healthy diet, lower physical activity, tobacco smoking and increased alcohol consumption. As a result, population health profiles are rapidly changing. For example, the global burden of type 2 diabetes mellitus is expected to double by 2030, with 80% of adult cases occurring in low and middle-income countries (LMIC). Many LMIC are undergoing rapid changes associated with developing high rates of NCD while concomitantly battling high levels of certain communicable diseases, including HIV, TB and malaria. This has population health, health systems and economic implications for these countries. This critical review synthesizes evidence on the overlap and interactions between established communicable and emerging NCD epidemics in LMIC. The review focuses on HIV, TB and malaria and explores the disease-specific interactions with prevalent NCDs in LMIC including diabetes, cardiovascular disease, chronic obstructive pulmonary disease, chronic renal disease, epilepsy and neurocognitive diseases. We highlight the complexity, bi-directionality and heterogeneity of these interactions and discuss the implications for health systems.
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