Drowning is a public health problem globally, with over 90% of deaths occurring in low- and middle-income countries . Unintentional drowning was estimated to cause about 295,210 deaths in 2017worldwide. The true burden of drowning is expected to be much higher owing to challenges in classification, reporting and data collection. The World Health Organization has identified several interventions to prevent deaths due to unintentional drowning, including the use of life jacket in high-risk recreational and occupational settings.
Despite substantial evidence on the effectiveness of life jackets and the subsequent adoption of laws in several countries, the use of life jackets has largely remained low, including in high-income countries.However, there has been no qualitative synthesis of evidence to understand the context and internal perceptions and experiences that may influence life-jacket use. The study, published in Journal of Safety Research this week filled this important knowledge gap and found :
Life jacket use was shaped through complex interactions between lived experience and cultural norms which influenced the risk-perception of life jacket utility in preventing deaths.
The high cost of life jackets was almost always a barrier for its usage
Adoption of laws and its subsequent enforcement was perceived to be an important facilitator for life jacket use.
Design issues around comfort, fashion-sense, and shelf life influenced usage of life-jackets
The International Snakebite Awareness Day has taken place annually on Sept 19 since 2018. Snakebites kill an estimated 137 880 people each year and three times as many survivors live with life-changing disabilities. ,,Since 2018, there has been some increased funding for research and development of antivenoms and other therapies. But there is a pressing need to additionally focus on the chronic aspects of snakebite care. The WHO strategy for snakebite envenoming aims to decrease not only mortality but also morbidity by 50% by 2030.
In a comment piece in The Lancet , Soumyadeep Bhaumik & colleagues propose a system-oriented approach with multi-component interventions to address chronic aspects of snakebite care, together with social support and investments in multidisciplinary research to end the neglect of snakebite. It highlights that the NTD community’s goal to “end the neglect” can be truly achieved in the snakebite domain only if snakebite survivors are at the centre of the response here (free but needs registration by e-mail) .
Snakebite remains a major public health challenge in many parts of rural Africa, Asia and South America. Available estimates suggest that there are about 94 000 deaths across the world annually due to snakebites; a conservative estimate as many deaths in low and middle-income countries are not reported.The burden on health systems due to snakebite is much higher than what is indicated by the mortality, because even non-venomous snakebite victims visit healthcare facilities for assessment and the morbidity due to snakebite has been scarcely documented. The social and economic consequences of snakebite are known to be high in communities with high prevalence.
Despite its consequences, snakebite has largely been neglected in global health. The WHO readded snakebite to the list of neglected tropical diseases in 2017—potentially implying more attention and funding for disease control programmes and treatment access initiatives. Such initiatives and programme planning are informed by recommendations in practice guidelines. WHO guidelines are highly influential in South Asia, South-East Asia and sub-Saharan Africa (countries with high burden of snakebite) where the lack of in-country capacity for guideline development means WHO guidelines are used as it is or are being adapted .
Read the full article by Dr. Soumyadeep B and colleagues which presents the evaluation of WHO guidelines on snakebite at BMJ Global Health. (open access)
“More than 50% of all medicines are prescribed, dispensed or sold inappropriately, and half of all patients fail to take medicines correctly.” WHO Fact Sheet 2012
So why do half of all patients fail to take medicines correctly?
Issues of adherence are different depending on whether the condition in acute chronic. For example, it is extremely common for patients to fail to take the complete course of antibiotics for an acute infection, thereby predisposing to antibiotic resistance. For background on adherence in relation to chronic conditions, you can freely download the WHO publication ‘Adherence to Long-term Therapies’ (1.5Mb): (Open Access)
Here are the “Take-home messages” (reproduced from the report):
1. Poor adherence to treatment of chronic diseases is a worldwide problem of striking magnitude
Adherence to long-term therapy for chronic illnesses in developed countries averages 50%. In developing countries, the rates are even lower. It is undeniable that many patients experience difficulty in following treatment recommendations.
2. The impact of poor adherence grows as the burden of chronic disease grows worldwide
Noncommunicable diseases and mental disorders, human immunodeficiency virus/acquired immunodeficiency syndrome and tuberculosis, together represented 54% of the burden of all diseases worldwide
in 2001 and will exceed 65% worldwide in 2020.The poor are disproportionately affected. The consequences of poor adherence to long-term therapies are poor health outcomes and increased health care costs
3. Poor adherence to long-term therapies severely compromises the effectiveness of treatment making this a critical issue in population health both from the perspective of quality of life and of health economics. Interventions aimed at improving adherence would provide a significant positive return on investment through primary prevention (of risk factors) and secondary prevention of adverse health outcomes.
With a shift in disease epidemiology trends, non-communicable diseases (NCDs) are fast becoming leaders in the global burden of disease. NCDs are estimated to cause 36 million deaths annually and have become the focal point of concern for global public health. To meet the increasing challenge, WHO plans to rope in innovative technologies to aid its fight against NCDs.
Tobacco is the leading global cause of preventable death and kills nearly 6 million people and causes hundreds of billions of dollars of economic damage globally1.The WHO predicts that if current trends continue, by 2030 tobacco will kill more than 8 million people worldwide each year, with 80% of these premature deaths occurring among people living in low- and middle-income countries. Tobacco kills one in two of its long-term users1.Continue reading “Is plain packaging the way forward?”
Even before the days of Hippocrates Adverse Drug Reactions (ADR) has been studied. However they came into the forefront only after the Thalidomide Disaster. In the modern day practice where secondary/supernumerary infections and combination therapy consisting of multi-drug regimes seem to be the norm ADR monitoring assumes special significance. Rising costs of patient care, increasing awareness of patients towards the untoward effects of drugs and the rise in the frequency of cases of litigation against doctors and hospitals has entailed the need of a comprehensive ADR monitoring. The paper briefly reviews the various aspects of ADR -its importance, incidence and prevalence under various settings, problems with pharmaco-vigilance and ADR monitoring techniques.Continue reading “Clout over Adverse Drug Reactions”