J. Jaime Miranda

• MD, MSc, PhD, FFPH
• Professor at The University of Sydney

To assess differences in cardiovascular risk profiles among rural-to-urban migrants and non-migrant groups. Cross-sectional study in Ayacucho and Lima, Peru. Participants were: rural (n=201); rural-to-urban migrants (n=589); and urban (n=199). Cardiovascular risk factors were assessed according to migrant status (migrants vs non-migrants), age at f...

Background: Despite their high prevalence and significant burden, mental disorders such as depression remain largely underdiagnosed and undertreated. Objective: The aim of the Allillanchu Project was to design, develop, and test an intervention to promote early detection, opportune referral, and access to treatment of patients with mental disord...

Background Latin America ranks among the regions with the highest level of intake of sugary beverages in the world. Innovative strategies to reduce the consumption of sugary drinks are necessary. Purpose Evaluate the effect of a one-off priest-led intervention on the choice and preference of soda beverages. Methods We conducted a pragmatic cluste...

Replacement of regular salt with potassium-enriched substitutes reduces blood pressure in controlled situations, mainly among people with hypertension. We report on a population-wide implementation of this strategy in a stepped-wedge cluster randomized trial (NCT01960972). The regular salt in enrolled households was retrieved and replaced, free of...

BACKGROUND: Describing the prevalence and trends of cardiometabolic risk factors that are associated with non-communicable diseases (NCDs) is crucial for monitoring progress, planning prevention, and providing evidence to support policy efforts. We aimed to analyse the transition in body-mass index (BMI), obesity, blood pressure, raised blood press...

Chronic care manages long-term, progressive conditions, while acute care addresses short-term conditions. Chronic conditions increasingly strain health systems, which are often unprepared for these demands. This study examines the burden of conditions requiring acute versus chronic care, including sequelae. Conditions and sequelae from the Global B...

Aims Identify and define relevant outcomes for people living with T1DM and their caregivers, and explore the differences across contexts and life stages. This exercise will inform the development of a Core Outcome Set (COS), an essential list of outcomes that should be measured for T1DM. Methods A systematic review of qualitative studies published...

Background The skeletal muscle has mainly a structural function and plays a role in human’s metabolism. Besides, the association between sleep quality and muscle mass, in the form of sarcopenia, has been reported. This study aimed to assess whether changes of skeletal muscle mass (SMM) over time are associated with baseline sleep duration and distu...

Urbanization results in increased numbers of people living in cities and poses challenges and opportunities to public health policies. Studies of urban scaling have unveiled how cities’ socio-economic and infrastructural attributes vary systematically with city size. Previous studies have explored the scaling properties of health outcomes across me...

Introduction Improving the sustainability of public health interventions is a priority for policymakers and program implementers. However, existing theories, models, and frameworks focus on describing constructs, processes, and measures of sustainability. Models to guide the improvement of sustainability of public health interventions are currently...

Background Understanding between-city variations in cancer mortality is crucial to inform national and subnational cancer prevention strategies. However, studies at the city level in Latin America are scarce. As part of the Salud Urbana en América Latina (SALURBAL) project, we aimed to describe the variability in cancer mortality rates across 343 c...

Background The skeletal muscle has mainly a structural function and plays a role in human’s metabolism. Besides, the association between sleep quality and muscle mass, in the form of sarcopenia, has been reported. This study aimed to assess whether changes of skeletal muscle mass (SMM) over time are associated with baseline sleep duration and distu...

Background Dementia is a global health challenge, especially in low‐ and middle‐income countries like Peru, where diagnosis, access, and awareness are limited. Within the IMPACT Dementia project, a component focuses on developing, testing, and implementing an mHealth‐enabled system for dementia screening and diagnosis, and assessing its cost‐effect...

Multimorbidity data is typically analysed by tallying disease counts, which overlooks nuanced relationships among conditions. We identified clusters of multimorbidity and subpopulations with varying risks and examined their association with all-cause mortality using a data-driven approach. We analysed 8-year follow-up data of people ≥35 years who w...

In its efforts to reduce increasing rates of obesity and nutrition-related noncommunicable diseases, Peru implemented front-of-package (FOP) warning labels (also called warnings) on processed and ultra-processed foods in June 2019. The goal was to inform consumers about high levels of sugars, saturated fats, sodium, and trans fats in packaged produ...

Importance Despite evidence of the short-term benefits of multicomponent primary care–based interventions, their long-term effects are unproven. Objective To evaluate the long-term outcomes of a system-integrated technology-enabled model of care (SINEMA intervention) for stroke management for systolic blood pressure (BP) and other outcomes among p...

Despite the relevance of cities and city policies for health, there has been limited examination of large numbers of cities aimed at characterizing urban health determinants and identifying effective policies. The relatively few comparative studies that exist include few cities in lower and middle income countries. The Salud Urbana en America Latin...

Policy engagement is an essential component of implementation research for scaling up interventions targeting non-communicable diseases (NCDs). It refers to the many ways that research team members, implementers and policymakers, who represent government decision-making, connect and interact to explore common interests. Well-conducted engagement ac...

Purpose This prospective study evaluated the association between living at different degrees of urbanization and altitude with five different incident dyslipidemia traits. Methods Using baseline (2010) and follow-up data (~2.4 years later) of Peruvian adults (aged ≥35 years) from the CRONICAS Cohort Study, the incidence of each trait was separately...

Background The skeletal muscle has mainly a structural function and plays a role in human’s metabolism. Besides, the association between sleep quality and muscle mass, in the form of sarcopenia, has been reported. This study aimed to assess whether changes of skeletal muscle mass (SMM) over time are associated with baseline sleep duration and distu...

Background The skeletal muscle has mainly a structural function and plays a role in human’s metabolism. Besides, the association between sleep quality and muscle mass, in the form of sarcopenia, has been reported. This study aimed to assess whether changes of skeletal muscle mass (SMM) over time are associated with baseline sleep duration and distu...

Background Diabetes can be detected at the primary health-care level, and effective treatments lower the risk of complications. There are insufficient data on the coverage of treatment for diabetes and how it has changed. We estimated trends from 1990 to 2022 in diabetes prevalence and treatment for 200 countries and territories. Methods We used da...

BACKGROUND Latino adults with type 2 diabetes (T2D) have higher rates of diabetes medication non-adherence than non-Hispanic White adults. REACH is a text message-based platform based on the Information-Motivation-Behavioral skills (IMB) model that addresses barriers to adherence and was shown to improve adherence and hemoglobin A1c (HbA1c), but it...

Background Latino adults with type 2 diabetes (T2D) have higher rates of diabetes medication nonadherence than non-Hispanic White adults. REACH (Rapid Encouragement/Education And Communications for Health) is a text message platform based on the information-motivation-behavioral skills model that addresses barriers to adherence and was shown to imp...

Background The skeletal muscle has mainly a structural function and plays a role in human’s metabolism. Besides, the association between sleep quality and muscle mass, in the form of sarcopenia, has been reported. This study aimed to assess whether changes of skeletal muscle mass (SMM) over time are associated with baseline sleep duration and distu...

Background Adiposity can be measured using BMI (which is based on weight and height) as well as indices of abdominal adiposity. We examined the association between BMI and waist-to-height ratio (WHtR) within and across populations of different world regions and quantified how well these two metrics discriminate between people with and without hyper...

Background Using harmonized aggregated data on health and socioeconomic environments in Latin American cities (from the Salud Urbana en América Latina (SALURBAL) study), we assessed the association of city‐level contextual factors with the prevalence of the double burden of malnutrition (DBM) in urban settings. Methods This ecological study used a...

Introduction The burden of multimorbidity is recognised increasingly in low- and middle-income countries (LMICs), creating a strong emphasis on the need for effective evidence-based interventions. Core outcome sets (COS) appropriate for the study of multimorbidity in LMICs do not presently exist. These are required to standardise reporting and cont...

Improving accessibility to radiotherapy services in Cali, Colombia: cross-sectional equity analyses using open data and big data travel times from 2020. DOI: 10.1186/s12939-024-02211-6 Multilingual Abstract EN, SP, PT, FR More at https://padlet.com/Proyecto_AMORE_Project/products In this study, we evaluated and forecasted the cumulative opportuniti...

In Latin America and the Caribbean (LAC), sociodemographic context, socioeconomic disparities and the high level of urbanization provide a unique entry point to reflect on the burden of cardiometabolic disease in the region. Cardiovascular diseases are the main cause of death in LAC, precipitated by population growth and ageing together with a rapi...

Background Engaging diverse stakeholders in developing core outcome sets (COSs) can produce more meaningful metrics as well as research responsive to patient needs. The most common COS prioritisation method, Delphi surveys, has limitations related to selection bias and participant understanding, while qualitative methods like group discussions are...

Background Current clustering of multimorbidity based on the frequency of common disease combinations is inadequate. We estimated the causal relationships among prevalent diseases and mapped out the clusters of multimorbidity progression among them. Methods In this cohort study, we examined the progression of multimorbidity among 190 diseases amon...

In highly urbanized and unequal Latin America, urban health and health equity research are essential to effective policymaking. To ensure the application of relevant and context-specific evidence to efforts to reduce urban health inequities, urban health research in Latin America must incorporate strategic research translation efforts. Beginning in...

Background The co-occurrence of chronic diseases and acute infectious events exacerbates disability and diminishes quality of life, yet research in Low- and Middle-Income countries is scarce. We aimed to investigate the relationship between infectious events and multimorbidity in resource-constrained settings. Methods We conducted a sequential mix...

BACKGROUND Dementia is a global health priority with significant challenges due to its complex nature and increasing prevalence. Health systems worldwide struggle to address chronic conditions like dementia, often providing fragmented care. However, information about how health systems respond to the needs of people with dementia (PWD) and their ca...

Background Dementia is a global health priority with significant challenges due to its complex nature and increasing prevalence. Health systems worldwide struggle to address chronic conditions like dementia, often providing fragmented care. However, information about how health systems respond to the needs of people with dementia and their carers,...

The lifespan is influenced by adverse childhood experiences that create predispositions to poor health outcomes. Here we propose an allostatic framework of childhood experiences and their impact on health across the lifespan, focusing on Latin American and Caribbean countries. This region is marked by significant social and health inequalities nest...

Introduction Scaling up interventions targeting non-communicable diseases (NCDs) is a global health priority, and implementation research can contribute to that effort. In 2019, the Global Alliance for Chronic Diseases funded 27 implementation research studies to improve evidence for scaling up interventions targeting prevention and/or control of h...

In this study, we employed a methodology to evaluate and forecast the cumulative opportunities for residents to access radiotherapy services in Cali, Colombia, while accounting for traffic congestion from an equity perspective. Furthermore, we identified 1-2 optimal locations where new services would maximise accessibility. We utilised open data an...

Background Current strategies to prevent adverse cardiovascular outcomes focus on secondary prevention and primary prevention in high-risk groups. The proportion of events occurring in lower-risk groups globally is unknown. Methods We prospectively documented fatal or non-fatal myocardial infarction, stroke, heart failure, or any other fatal cardio...

Available at SSRN: https://ssrn.com/abstract=4722439 In this study, we employed a methodology to evaluate and forecast the cumulative opportunities for residents to access radiotherapy services in Cali, Colombia, while accounting for traffic congestion from an equity perspective. Furthermore, we identified 1-2 optimal locations where new services...

Summary Background Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. Methods We used data...

Objective: As a secondary trial plan analysis, we aim to examine whether participant characteristics, measured before randomization, modified the effect of a digital intervention designed to improve depressive symptoms (CONEMO - Emotional Control) on recovery from depression that has presented a substantive impact on previous research. Method: M...

Introduction The burden of multimorbidity is recognised increasingly in low- and middle-income countries (LMICs), creating a strong emphasis on the need for effective evidence-based interventions. A core outcome set (COS) appropriate for the study of multimorbidity in LMIC contexts does not presently exist. This is required to standardise reporting...

Background Health research on ambient nitrogen dioxide (NO2) is sparse in Latin America, despite the high prevalence of NO2-associated respiratory diseases in the region. This study describes within-city distributions of ambient NO2 concentrations at high spatial resolution and urban characteristics associated with neighbourhood ambient NO2 in 326...

Introduction The COVID-19 pandemic emerged in a context that lacked adequate prevention, preparedness, and response (PPR) activities, and global, regional, and national leadership. South American countries were among world’s hardest hit by the pandemic, accounting for 10.1% of total cases and 20.1% of global deaths. Methods This study explores how...

Background The long-term impact of elevated blood pressure on mortality outcomes has been recently revisited due to proposed changes in cut-offs for hypertension. This study aimed at assessing the association between high blood pressure levels and 10-year mortality using the Seventh Report of the Joint National Committee on Prevention, Detection, E...

The spread of COVID-19 in Peru resulted in the declaration of a national health emergency, in which Indigenous peoples were identified as being particularly vulnerable due to their pre-existing poor health indicators and disadvantaged social conditions. The aim of this paper is to examine how the Peruvian government responded to the health and food...

Introduction Governments must scale-up evidence-based interventions to reduce the burden of non-communicable diseases (NCDs). Implementation research can help develop contextually appropriate strategies and optimise interventions for scale-up. We aimed to determine the priorities of the Global Alliance for Chronic Diseases (GACD) 2019 funding round...

Fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) are both used to diagnose diabetes, but these measurements can identify different people as having diabetes. We used data from 117 population-based studies and quantified, in different world regions, the prevalence of diagnosed diabetes, and whether those who were previously undiagnosed and de...

Introduction Living with a chronic condition is a challenging experience, as it can disrupt your capacity to function and fulfill social roles such as being a father. Fatherhood constitutes an important component of masculinity that has not received significant attention in studies aimed at understanding the role of gender norms in health-related b...

Objectives Chronic obstructive pulmonary disease (COPD) disproportionately affects low- and middle-income countries. Health systems are ill prepared to manage the increase in COPD cases. Methods We performed a pilot effectiveness-implementation randomized field trial of a community health worker (CHW)-supported, 1-year self-management intervention...

Purpose of Review Taxes on sugary drinks and foods have emerged as a key strategy to counteract the alarming levels of diabetes worldwide. Added sugar consumption from industrialized foods and beverages has been strongly linked to type 2 diabetes. This review provides a synthesis of evidence on how taxes on sugary products can influence the onset o...

Global Health recognizes the interconnectedness of communities across the world in terms of health problems and solutions; yet, despite being foundationally different from international and tropical health, the term maintains a focus on low- and middle-income countries. The practice of global health is not a one-way street and, in order to follow a...

Aims Describe the outcomes reported in research on health systems interventions for type 1 diabetes management in comparison to the outcomes proposed by a core outcome set (COS) for this condition, an essential list of outcomes that studies should measure. Methods Systematic search of studies published between 2010 and 2021 reporting health system...

Background: Few birth cohorts in South America evaluate the joint effect of minerals and toxic metals on neonatal health. In Madre de Dios, Peru, mercury exposure is prevalent owing to artisanal gold mining, yet its effect on neonatal health is unknown. Objectives: We aimed to determine whether toxic metals are associated with lower birth weight...

Aims: Heart failure with reduced ejection fraction (HFrEF) is treatable but guideline-directed medical therapy (GDMT) may not be affordable or accessible to people living with the disease. Methods and results: In this cross-sectional survey, we investigated the price, affordability, and accessibility of four pivotal classes of HFrEF GDMT: angiot...

Background Five modifiable risk factors are associated with cardiovascular disease (CVD) and all-cause mortality. The regional and sex-specific prevalence of these modifiable risk factors and their impact on CVD and all-cause mortality have not been evaluated using individual-level data. Methods The Global Cardiovascular Risk Consortium harmonized...

Latin American populations may present patterns of sociodemographic, ethnic and cultural diversity that can defy current universal models of healthy aging. The potential combination of risk factors that influence aging across populations in Latin American and Caribbean (LAC) countries is unknown. Compared to other regions where classical factors su...

The COVID-19 pandemic and the climate change emergency are among the greatest socioenvironmental crises of our time. These crises have exacerbated health inequalities,1 revealing substantial weaknesses in health systems and community preparedness.2 Indigenous peoples globally face some of the greatest risks associated with pandemics and globa...

Rationale: Chronic obstructive pulmonary disease (COPD) is a prevalent and burdensome condition in low- and middle-income countries (LMICs). Challenges to better care include more effective diagnosis, and access to affordable interventions. There are no previous reports describing therapeutic needs in LMIC populations with COPD identified through...

Background : Undernutrition is projected to be a major consequence of climate change. Biodiversity could enhance climate change resilience by improving nutritional outcomes and providing healthy food resources during and/or after climate-related events. For Indigenous populations who currently base their diet on local biodiversity, rapid climate ch...

Background: Preterm birth has been associated with increased risk of hypertension and cardiovascular disease later in adulthood, attributed to cardiovascular and metabolic alterations in early life. However, there is paucity of evidence from low- and middle-income countries (LMICs). Methods: We investigated the differences between preterm (<37 w...

Background: Diabetes is one of the leading causes of death and disability worldwide, and affects people regardless of country, age group, or sex. Using the most recent evidentiary and analytical framework from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), we produced location-specific, age-specific, and sex-specific estimat...

Background Estimating and analyzing trends and patterns of health loss are essential to promote efficient resource allocation and improve Peru’s healthcare system performance. Methods Using estimates from the Global Burden of Disease (GBD), Injuries, and Risk Factors Study (2019), we assessed mortality and disability in Peru from 1990 to 2019. We...