Extracts from Journals / For your Resource Centre - February 2010


Extracts from Journals

Why hypertensive patients are not taking their medication in DRC

A small focus group study at Vanga Hospital, Bandundu Province, Democratic Republic of Congo found that hypertensive patients did not adhere to their medication because of unpleasant side effects,. They take medication only when they experience perceived symptoms, and they lack overall knowledge about their disease. Lack of support from family and difficulty obtaining medication also played a role in non-compliance to anti-hypertension medication.

See "Reasons for non-compliance among patients with hypertension at Vanga Hospital, Bandundu Province, Democratic Republic of Congo: A qualitative study" African Journal of Primary Health Care & Family Medicine 2009; 1(1): 68 (open access) http://www.phcfm.org/index.php/phcfm/article/view/68

Extracted from procor Weekly Prevention Update 7 October 2009 www.procor.org


'Harmonising the Metabolic Syndrome' is a Joint Interim Statement of the International Diabetes Federation (IDF) Task Force on Epidemiology and Prevention and several other institutions.

A cluster of risk factors for cardiovascular disease and type 2 diabetes mellitus, which occur together more often than by chance alone, have become known as the metabolic syndrome. The risk factors include raised blood pressure, dyslipidemia (raised triglycerides and lowered high-density lipoprotein cholesterol), raised fasting glucose, and central obesity. Various diagnostic criteria have been proposed by different organizations over the past decade. The present statement is the outcome of a meeting between several major organizations in an attempt to unify criteria.

It was agreed that there should not be an obligatory component, but that waist measurement would continue to be a useful preliminary screening tool. Three abnormal findings out of five would qualify a person for the metabolic syndrome. A single set of cut-off points would be used for all components except waist circumference, for which further work is required. In the interim, national or regional cut points for waist circumference can be used.

Download the full statement at www.world-heart-federation.org/publications .
Data from "Global Dialogue" [email protected] 23 October 2009


Global health risks: Mortality and burden of disease attributable to selected major risks is a new downloadable report from WHO. Text, charts, and data show the nature of 24 health risks and discuss the joint effects of risk factors. Among the many findings are:

  • One quarter of the 60 million deaths estimated to occur annually are due to childhood underweight, unsafe sex, alcohol use, lack of safe water, sanitation and hygiene, and high blood pressure
  • More than a third of the global child deaths can be attributed to a few nutritional risk factors such as childhood underweight, inadequate breastfeeding, and zinc deficiency.
  • Unhealthy and unsafe environments cause one in four child deaths worldwide.
  • 10 leading preventable risks decrease life expectancy by nearly seven years globally and by more than 10 years for Africa.

Download full report PDF (3.77 MB) at www.who.int/healthinfo/global_burden_disease/GlobalHealthRisks_report_full.pdf or specific sections; a PowerPoint presentation of key figures and graphs; and statistics from the report at www.who.int/healthinfo/global_burden_disease/global_health_risks/en.

Extracted from procor website www.procor.org


For Your Resource Centre:


World Diabetes Day (14 November 2009) marked the start of a 5-year campaign on "Diabetes education and prevention". Some useful resources for educating the public and health professionals are:

  • International curriculum for diabetes health professional education: Training modules for diabetes educators on pathophysiology and classification of diabetes, psychological issues and behavioral change, nutrition, physical activity, and self-management. Available in Arabic and English. Print and CD-ROM copies may be ordered from: http://shop.idf.org/catalog. International Diabetes Federation, 2008.


  • Diabetic Medicine: Journal of diabetes clinical research and practice. Free online access available to institutions in developing countries through HINARI. Diabetes UK.www.wiley.com/bw/journal.asp?ref42-3071
  • Patient-focused pamphlets on diabetes prevention and care including basic food guides and meal sheets (from New Zealand but could be adapted) seewww.dptresources.org.nz/res1.html

Data from http://www.procor.org/resources For more resources visit http://www.procor.org/resources or use ProCor’s Search by Topic feature (http://www.procor.org/search) and select risk factors 
(See above on page 17 for the numbers of people with diabetes.)


The 'Book for Midwives' from the Hesperian Foundation is available in HTML format at
http://www.hesperian.org/publications_download_midwives.php. All Hesperian books including the 2009 edition of 'Where There is No Doctor' are available in HTML format athttp://www.hesperian.org/publications_download.php


'Child Health Now' is a new well-illustrated 49 page report from World Vision which calls for a renewed global effort to decrease child deaths in developing countries. It highlights the importance of community health education and the role of community health workers.  See www.childhealthnow.org/docs/pdf/Child_Health_Now-Report.pdf


The Child Healthcare Problem Identification Programme (Child PIP) at http://www.childpip.org.za is a mortality audit tool that uses the mortality review process to assess and improve the quality of care given to children in South Africa. The tool emerges out of a simple thought process:

  • As health workers who care, we reflect on what we do.
  • When we reflect on what we do, we end up asking a simple question: 'Is this the best I can do'?

The Child PIP package answers this question and consists of Mortality Review Training Resources, Paper Tools and a Software Data Management and Analysis Programme.

The audit of several thousand deaths provides information on cause of death, health context (especially HIV and nutritional status), and modifiable factors (instances of suboptimal care and missed opportunities throughout the health system).

If you are keen to make a difference to the care given to sick children, consider implementing the Child Healthcare Problem Identification Programme (Child PIP) in your hospital.

To find out more go to www.childpip.org.za  and see particularly the March 2008 publication "Every Death Counts: Saving the lives of mothers, babies and children in South Africa"


JAMA Patient Pages
Compilation of more than 500 one-page information sheets for patients on medical issues. CVD-related topics include cardiac stress testing, chest pain, diabetes, heart failure, hypertrophic cardiomyopathy, peripheral arterial disease, and more. All handouts are available as PDF files. Journal of the American Medical Association. http://jama.ama-assn.org/cgi/collection/patient_page

The Journal of Infection in Developing Countries Vol 3, No 9: October 2009 is downloadable at http://www.jidc.org/index.php/journal. Among the many articles are:

  • A step by step procedure towards the pandemic influenza preparedness
  • Antimicrobial susceptibility of select respirator tract pathogens in Dakar
  • The aetiology of acute community acquired bacterial meningitis in children and adults in Maputo.


Palliative care toolkit and training manual.

Help the Hospices has helped to create a Toolkit that is designed to equip, empower and encourage health workers in resource-limited settings to integrate palliative care into their work and their communities.

The illustrated and easy-to-read toolkit 'Palliative care toolkit: Improving care from the roots up in resource-limited settings' provides a holistic and 'can do' approach to delivering care to those with life-limiting diseases. The training manual aim to supports education and training in hospice and palliative care in developing countries.

You can download the toolkit and training manual (chapter by chapter if you want) at http://www.helpthehospices.org.uk/our-services/international/what-we-do-internationally/education-and-training/palliative-care-toolkit.

The toolkit is available in print and CD if you work in hospice and palliative care in a resource-poor setting or are planning to travel to a resource-poor setting to deliver training. Email [email protected]