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MEDiterranean studies of Cardiovascular disease and Hyperglycaemia: Analytical Modelling of Population Socio-economic transitions

Periodic Report Summary 1 - MEDCHAMPS (Mediterranean studies of cardiovascular disease and hyperglycaemia: analytical modelling of population socio-economic transitions)

Project Context and Objectives

Non-communicable diseases (NCDs), particularly cardiovascular diseases (CVD) and diabetes are increasing dramatically in many low and middle income countries. The main reasons for this are an increase in major risk factors, particularly increasing obesity [as a consequence of changes in nutrition and decreases in physical activity], and increasing tobacco use. In the Mediterranean partners involved (Palestine, Syria, Tunisia, Turkey), obesity levels are particularly high among women, and tobacco use common in men. Globalization, urbanization and an ageing population are contributing to this trend. A common misperception is that NCDs are diseases of affluence, but in fact they are common amongst poorer sectors of populations. Health services in these countries, developed to tackle acute infectious diseases, are often not ideally organised to promote effective care and prevention for NCDs. The goal of this project is to reduce the burdens of CVD and diabetes. The overall objective is to be able to make recommendations about the policy initiatives likely to be the most effective and cost-effective in reducing these disease burdens in each country.

Description of the work

Activity has focussed on:

i) establishing composition and protocols for the Project Management Committee (PMC), Project Management Advisory Committee (ProMAC) and Technical Advisory Group (TAG).
ii) refining and agreeing the project methods and proformas (WP1)
iii) collecting (from routinely available data sources, expert consultation and some ad hoc surveys) and assessing the quality of quantitative data on population structures and trends, CVD and T2DM burdens and major CVD and T2DM risk factors for epidemiological modelling (WP2)
iv) a detailed local and national situation analysis using a variety of qualitative research methods (WP5)
v) adapting and developing a suite of epidemiological models to predict future burdens of CHD, IS and T2DM with and without a range of policy options (WP4).
vi) providing training in qualitative data collection and analysis, CVD and T2DM epidemiology and modelling, and methods of economic evaluation to ensure that the project tools are implemented in standardised ways across the project
vii) widespread dissemination and consultation with regional and national stakeholders to raise awareness of the MedCHAMPS project in each of the four Mediterranean countries, and ensure that policy makers' perspectives are taken into account.

Main results achieved so far:

The epidemiological data collection exercise highlighted the lack of good quality data in key areas; particularly disease burdens outside of hospital (in communities) and information on adherence to medications. Data on causes of death were also of variable quality and completeness across the partner countries. A number of abstracts have already been submitted for publication, and a joint publication is also being prepared.

We have also adapted and improved the pre-existing CHD IMPACT model, and developed two "new" epidemiological models; specifically for IS and for T2DM. These models have now been tested and validated with both Western and regional data. Results for the T2DM model have already been presented at a conference, and several publications are also in preparation.

Expected final results and their potential impact and use:

The national partnerships formulated as a result of this project are providing a novel foundation for the active engagement of academia and policy makers to improve CVD and DM health in each of the four Mediterranean countries. These new avenues for communications can be vital to advancing population health in the future, especially given the scarcity of such partnerships in the Eastern Mediterranean region at the moment.

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