title: Management of NCD in low- and middle-income countries.
abstract: Noncommunicable disease (NCD), comprising cardiovascular disease, stroke, diabetes, and chronic obstructive pulmonary disease, are increasing in incidence rapidly in low- and middle-income countries (LMICs). Some patients have access to the same treatments available in high-income countries, but most do not, and different strategies are needed. Most research on noncommunicable diseases has been conducted in high-income countries, but the need for research in LMICs has been recognized. LMICs can learn from high-income countries, but they need to devise their own systems that emphasize primary care, the use of community health workers, and sometimes the use of mobile technology. The World Health Organization has identified "best buys" it advocates as interventions in LMICs. Non-laboratory-based risk scores can be used to identify those at high risk. Targeting interventions to those at high risk for developing diabetes has been shown to work in LMICs. Indoor cooking with biomass fuels is an important cause of chronic obstructive pulmonary disease in LMICs, and improved cookstoves with chimneys may be effective in the prevention of chronic diseases.
authors.affiliation: Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, MD, USA; Program in Global Disease Epidemiology and Control, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; CRONICAS Center of Excellence for Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru.
authors.forename: William
authors.initials: W
authors.lastname: Checkley
authors.affiliation: Department of Epidemiology, Chronic Disease Prevention Research Centre, University Hospital Farhat Hached, Sousse, Tunisia.
authors.forename: Hassen
authors.initials: H
authors.lastname: Ghannem
authors.affiliation: Centro de Excelencia en Salud Cardiovascular para el Cono Sur (CESCAS), Institute for Clinical Effectiveness and Health Policy (IECS), Buenos Aires, Argentina.
authors.forename: Vilma
authors.initials: V
authors.lastname: Irazola
authors.affiliation: AMPATH, Moi University School of Medicine, Eldoret, Kenya; Moi Teaching and Referral Hospital, Eldoret, Kenya.
authors.forename: Sylvester
authors.initials: S
authors.lastname: Kimaiyo
authors.affiliation: Chronic Disease Initiative for Africa (CDIA), Cape Town, South Africa; Division of Diabetic Medicine and Endocrinology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
authors.forename: Naomi S
authors.initials: NS
authors.lastname: Levitt
authors.affiliation: CRONICAS Center of Excellence for Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru; Department of Medicine, School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru. Electronic address: Jaime.Miranda@upch.pe.
authors.forename: J Jaime
authors.initials: JJ
authors.lastname: Miranda
authors.affiliation: Centre for Control of Chronic Diseases (CCCD), International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Centre for Applied Health Research and Delivery, Liverpool School of Tropical Medicine, Liverpool, United Kingdom.
authors.forename: Louis
authors.initials: L
authors.lastname: Niessen
authors.affiliation: Centre for Chronic Disease Control, New Delhi, India; Centre of Excellence in Cardio-Metabolic Risk Reduction in South Asia, Public Health Foundation of India, New Delhi, India.
authors.forename: Dorairaj
authors.initials: D
authors.lastname: Prabhakaran
authors.affiliation: Office of Global Health, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA; Office of Global Affairs, U.S. Department of Health and Human Services, Washington, DC, USA.
authors.forename: Cristina
authors.initials: C
authors.lastname: Rabadán-Diehl
authors.affiliation: INCAP Research Center for the Prevention of Chronic Diseases (CIIPEC), Institute of Nutrition of Central America and Panama (INCAP), Guatemala City, Guatemala.
authors.forename: Manuel
authors.initials: M
authors.lastname: Ramirez-Zea
authors.affiliation: Centro de Excelencia en Salud Cardiovascular para el Cono Sur (CESCAS), Institute for Clinical Effectiveness and Health Policy (IECS), Buenos Aires, Argentina.
authors.forename: Adolfo
authors.initials: A
authors.lastname: Rubinstein
authors.affiliation: St. John's Medical College and Research Institute, Bangalore, India.
authors.forename: Alben
authors.initials: A
authors.lastname: Sigamani
authors.affiliation: Chronic Disease Initiative, UnitedHealth Group, London, United Kingdom. Electronic address: richardswsmith@yahoo.co.uk.
authors.forename: Richard
authors.initials: R
authors.lastname: Smith
authors.affiliation: Department of Endocrinology, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Nikhil
authors.initials: N
authors.lastname: Tandon
authors.affiliation: The George Institute for Global Health at Peking University Health Science Center, Beijing, China; Peking University School of Public Health and Clinical Research Institute, Beijing, China.
authors.forename: Yangfeng
authors.initials: Y
authors.lastname: Wu
authors.affiliation: St. John's Medical College and Research Institute, Bangalore, India.
authors.forename: Denis
authors.initials: D
authors.lastname: Xavier
authors.affiliation: The George Institute for Global Health at Peking University Health Science Center, Beijing, China; Duke Global Health Institute and Global Heath Research Center, Duke Kunshan University, Kunshan, China.
authors.forename: Lijing L
authors.initials: LL
authors.lastname: Yan
mesh_terms: D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000517:prevention & control / Q000628:therapy*; D003906:Developing Countries; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000517:prevention & control / Q000628:therapy*; D006801:Humans; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000517:prevention & control / Q000628:therapy*; D020521:Stroke / Q000175:diagnosis / Q000517:prevention & control / Q000628:therapy*