Shanthi Mendis's research while affiliated with Formation Universitaire a distance Suisse and other places

Publications (96)

Article
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Background: To help adapt cardiovascular disease risk prediction approaches to low-income and middle-income countries, WHO has convened an effort to develop, evaluate, and illustrate revised risk models. Here, we report the derivation, validation, and illustration of the revised WHO cardiovascular disease risk prediction charts that have been adap...
Article
Although there is measurable global progress in prevention of cardiovascular disease (CVD), it has been highly uneven and inadequate, particularly in low- and middle-income countries. Voluntary global targets have helped to galvanize attention, resources and accountability on tobacco use, harmful use of alcohol, unhealthy diet and physical inactivi...
Book
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Non-communicable diseases (NCDs) kill more people than anything else in the world. They include cardiovascular diseases, such as heart attacks and strokes; cancers; chronic respiratory diseases, such as chronic obstructed pulmonary disease and asthma; and diabetes. In 2013, the World Health Organization published a global action plan for the preven...
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The author reports no relationships that could be construed as a conflict of interest. Dr. Mendis served WHO for nearly 2 decades and retired recently.
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In 2011, the United Nations set key targets to reach by 2025 to reduce the risk of premature noncommunicable disease death by 25% by 2025. With cardiovascular disease being the largest contributor to global mortality, accounting for nearly half of the 36 million annual noncommunicable disease deaths, achieving the 2025 goal requires that cardiovasc...
Article
In 2011, the United Nations set key targets to reach by 2025 to reduce the risk of premature noncommunicable disease death by 25% by 2025. With cardiovascular disease being the largest contributor to global mortality, accounting for nearly half of the 36 million annual noncommunicable disease deaths, achieving the 2025 goal requires that cardiovasc...
Article
Introduction: A double blind placebo controlled randomized trial was conducted to investigate the effect of angiotensin-converting-enzyme (ACE) inhibitor enalapril on the progression of Chronic Kidney Disease (CKD) caused by chronic exposure to nephrotoxins. Methods: 263 people aged 18-70 years diagnosed with CKD stages I, II or III who were not ta...
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Household air pollution (HAP) resulting from the use of solid fuels presents a major public health hazard. Improved stoves have been offered as a potential tool to reduce exposure to HAP and improve health outcomes. Systematic information on stove interventions is limited. We conducted a systematic review of the current evidence of improved stove i...
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Despite numerous groundbreaking advances in the field, cardiovascular disease remains the leading cause of mortality in the United States, accounting for more than 787,000 deaths per year. Already leading the world in per capita healthcare expenditure, U.S. medical costs related to cardiovascular disease are projected to triple by 2030, to over $80...
Article
Despite numerous groundbreaking advances in the field, cardiovascular disease remains the leading cause of mortality in the United States, accounting for more than 787,000 deaths per year. Already leading the world in per capita healthcare expenditure, U.S. medical costs related to cardiovascular disease are projected to triple by 2030, to over $80...
Article
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The socioeconomic and health effect of stroke and other noncommunicable disorders (NCDs) that share many of the same risk factors with stroke, such as heart attack, dementia, and diabetes mellitus, is huge and increasing.1–4 Collectively, NCDs account for 34.5 million deaths (66% of deaths from all causes)3 and 1344 million disability-adjusted life...
Article
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Non-communicable diseases (NCDs) have large economic impact at multiple levels. To systematically review the literature investigating the economic impact of NCDs [including coronary heart disease (CHD), stroke, type 2 diabetes mellitus (DM), cancer (lung, colon, cervical and breast), chronic obstructive pulmonary disease (COPD) and chronic kidney d...
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The impact of non-communicable diseases (NCDs) in populations extends beyond ill-health and mortality with large financial consequences. To systematically review and meta-analyze studies evaluating the impact of NCDs (including coronary heart disease, stroke, type 2 diabetes mellitus, cancer (lung, colon, cervical and breast), chronic obstructive p...
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The global economic impact of non-communicable diseases (NCDs) on household expenditures and poverty indicators remains less well understood. To conduct a systematic review and meta-analysis of the literature evaluating the global economic impact of six NCDs [including coronary heart disease, stroke, type 2 diabetes mellitus (DM), cancer (lung, col...
Article
The views on actions to combat stroke have taken new directions with the recognition that noncommunicable diseases (NCDs) pose a serious threat not only to public health but also to socioeconomic development. Stroke affects all countries and regions but in different ways; whereas the majority of strokes occur in low- and middle-income countries (wh...
Article
There are many challenges that need to be overcome to address the global cardiovascular disease epidemic. They include (1) lack of multisectoral action to support reduction of behavioral risk factors and their determinants, (2) weak public health and health care system capacity for forging an accelerated national response, and (3) inefficient use o...
Article
Background: A World Health Organization (WHO) package of essential noncommunicable (PEN) disease interventions was piloted in two districts of Bhutan by non-physician health workers. They conducted risk assessment among patients aged over 40 years who visited the outpatient department of health institutions. Blood glucose was also measured among t...
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Approximately 17.3 million people died from cardiovascular disease (CVD) in 2008, and approximately 80% came from low- and middle-income countries. However, previous studies document poor research productivity related to CVD prevention and treatment in these countries between 1991 and 1996. The World Health Organization (WHO) developed a prioritize...
Article
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According to the results of the Global Burden of Disease Study 2010, the burden of non-communicable diseases (cardiovascular disease, cancer, chronic lung diseases, and diabetes) in the Arab world has increased, with variations between countries of diff erent income levels. Behavioural risk factors, including tobacco use, unhealthy diets, and physi...
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According to the results of the Global Burden of Disease Study 2010, the burden of non-communicable diseases (cardiovascular disease, cancer, chronic lung diseases, and diabetes) in the Arab world has increased, with variations between countries of diff erent income levels. Behavioural risk factors, including tobacco use, unhealthy diets, and physi...
Article
Full-text available
According to the results of the Global Burden of Disease Study 2010, the burden of non-communicable diseases (cardiovascular disease, cancer, chronic lung diseases, and diabetes) in the Arab world has increased, with variations between countries of different income levels. Behavioral risk factors, including tobacco use, unhealthy diets, and physica...
Article
If a combination of cost-effective health-care interventions and population-wide prevention interventions is implemented in a sustainable manner, a significant impact can be made on the cardiovascular disease and diabetes burden. Given the limited resources, weak health systems and competing health issues in Africa, the focus should be on intervent...
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Introduction: Over the last decade, total cardiovascular risk assessment and management has been recommended by cardiovascular prevention guidelines in most high-income countries and by WHO. Cardiovascular risk prediction charts have been developed based on multivariate equations of values of some well-known risk factors such as age, sex, smoking,...
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Background This study describes chronic kidney disease of uncertain aetiology (CKDu), which cannot be attributed to diabetes, hypertension or other known aetiologies, that has emerged in the North Central region of Sri Lanka. Methods A cross-sectional study was conducted, to determine the prevalence of and risk factors for CKDu. Arsenic, cadmium,...
Article
The aim of this study was to determine the extent to which adherence to individual vascular medications, assessed by different methods, influences the absolute and relative risks (RRs) of cardiovascular disease (CVD) and all-cause mortality. We performed a systematic review and meta-analysis of prospective epidemiological studies (cohort, nested ca...
Article
Background Noncommunicable diseases (NCDs) caused an estimated 36 million deaths in 2008. Recognizing that NCDs are a global health and development priority, Heads of State and government adopted the Political Declaration on NCDs (resolution A/RES/66/2) at the United Nations General Assembly in September 2011.Sources of dataThe Political Declaratio...
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Reliable quantification of the burden of stroke in low- and middle-income (LMI) countries is difficult as population-based surveillance reports are scarce and may vary considerably in methodology. We aimed to evaluate all available primary stroke surveillance studies by applying components of a benchmark protocol (WHO STEPwise approach to stroke su...
Data
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Local review boards for study countries. Lists each study country and its corresponding local review board.
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Background Noncommunicable diseases are an increasing health concern worldwide, but particularly in low- and middle-income countries. This study quantified and compared education- and wealth-based inequalities in the prevalence of five noncommunicable diseases (angina, arthritis, asthma, depression and diabetes) and comorbidity in low- and middle-i...
Data
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Noncommunicable diseases non-response rates, by country and sex, World Health Survey 2002–04. Displays the non-response rates to World Health Survey individual questionnaires for each studied noncommunicable disease, grouped by sex and low- or middle-income country status. Data represent 41 low- and middle-income countries that participated in the...
Data
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Crude prevalence (%) of noncommunicable diseases among adults aged 18 or higher living in 41 low- and middle-income countries, by education, World Health Survey 2002–04. Displays the crude prevalence rates (percentage) of each studied noncommunicable disease and comorbidity among adults (aged 18 or higher), according to education level. Data are gr...
Data
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Wealth-related relative inequality in noncommunicable disease prevalence among adults aged 18 or higher living in 41 low- and middle-income countries, World Health Survey 2002–04. Displays the relative index of inequality and corresponding 95% confidence interval for each studied noncommunicable disease and comorbidity among adults (aged 18 or high...
Data
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Education-related relative inequality in noncommunicable disease prevalence among adults aged 18 or higher living in 41 low- and middle-income countries, World Health Survey 2002–04. Displays the relative index of inequality and corresponding 95% confidence interval for each studied noncommunicable disease and comorbidity among adults (aged 18 or h...
Data
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Title. Crude prevalence of risk factors for noncommunicable diseases among adults aged 18 or higher living in 48 low- and middle-income countries, World Health Survey 2002–04. Description: Displays the crude prevalence rates (percentage) and 95% confidence intervals for each studied noncommunicable disease risk factor among adults (aged 18 or highe...
Data
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Crude prevalence (%) of non-communicable diseases among adults aged 18 or higher living in 41 low- and middle-income countries, by wealth, World Health Survey 2002–04. Displays the crude prevalence rates (percentage) of each studied noncommunicable disease and comorbidity among adults (aged 18 or higher), according to wealth quintile. Data are grou...
Data
Study sample size by country and sex, World Health Survey 2002–04. Displays the study sample size of men and women (aged 18 or higher) from 41 low- and middle-income countries that participated in the 2002–04 World Health Survey.
Article
Kidney International aims to inform the renal researcher and practicing nephrologists on all aspects of renal research. Clinical and basic renal research, commentaries, The Renal Consult, Nephrology sans Frontieres, minireviews, reviews, Nephrology Images, Journal Club. Published weekly online and twice a month in print.
Data
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Appendices 1–5: Details of (1) countries in the epidemiological sub-regions, (2) effectiveness of tobacco control interventions, (3) effectiveness of cardiovascular disease interventions, (4) impact and costs of diabetes interventions, (5) resource use at patient level for cardiovascular disease interventions
Data
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General appendix (referred to by all the papers in this cluster)
Article
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To determine the relative costs and health effects of interventions to combat cardiovascular disease, diabetes, and tobacco related disease in order to guide the allocation of resources in developing countries. Cost effectiveness analysis of 123 single or combined prevention and treatment strategies for cardiovascular disease, diabetes, and smoking...
Data
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Appendices 6 and 7: (6) Full results of costs, effects, and cost effectiveness of interventions, (7) cost per treated case for cardiovascular disease interventions
Article
Noncommunicable diseases (NCDs) are the most common causes of premature death and morbidity and have a major impact on health-care costs, productivity, and growth. Cardiovascular disease, cancer, diabetes, and chronic respiratory disease have been prioritized in the Global NCD Action Plan endorsed by the World Health Assembly, because they share be...
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Noncommunicable diseases (NCDs) have become a major public health problem in India accounting for 62% of the total burden of foregone DALYs and 53% of total deaths. In this paper, we review the social and economic impact of NCDs in India. We outline this impact at household, health system and the macroeconomic level. Cardiovascular diseases (CVDs)...
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To assess the prevalence of cardiovascular (CV) risk factors in Seychelles, a middle-income African country, and compare the cost-effectiveness of single-risk-factor management (treating individuals with arterial blood pressure ≥ 140/90 mmHg and/or total serum cholesterol ≥ 6.2 mmol/l) with that of management based on total CV risk (treating indivi...
Article
OBJECTIVE: To assess the prevalence of cardiovascular (CV) risk factors in Seychelles, a middle-income African country, and compare the cost-effectiveness of single-risk-factor management (treating individuals with arterial blood pressure > 140/90 mmHg and/or total serum cholesterol > 6.2 mmol/l) with that of management based on total CV risk (trea...
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The Global Kidney Disease Prevention Network is an international public health organization devoted to encouraging and enhancing efforts to increase awareness and recognition of kidney disease, detect it early, and provide treatment to prevent disease progression, improve patient outcomes, and decrease costs. Twenty-six participants from 12 low-, m...
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The feasibility of conducting a large-scale Polypill clinical trial in developing countries remains unclear. More information is needed regarding the efficacy in reducing the risk factors of cardiovascular disease (CVD), side effects, improvement in adherence and physician/patient "acceptability" of the Polypill. We conducted an open-label, paralle...
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Robust national policies and strategies developed and owned by national authorities are fundamental for prevention and control of non-communicable diseases (NCDs). The objective of this paper is to address broad policy areas in respect of NCD prevention and control from a public health perspective, with a special focus on low- and middle-income cou...
Article
The management of high blood pressure (BP) is particularly inadequate in low-income countries, where the unavailability of a reliable, durable, and affordable BP-measurement device is a major obstacle to accurate diagnosis. Recognizing this, a World Health Organization committee was established to correct this deficiency by influencing manufacturer...
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WHO has played a leading role in the formulation and promulgation of standard criteria for the diagnosis of coronary heart disease and myocardial infarction since early 1970s. The revised definition takes into consideration the following: well-resourced settings can use the ESC/ACC/AHA/WHF definition, which has new biomarkers as a compulsory featur...
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The Framingham Heart Study has been a trailblazer in the field of cardiovascular epidemiology. The wealth of novel scientific data that it has generated over 5 decades has made a significant contribution to cardiovascular disease (CVD) prevention in the United States and indirectly influenced global CVD prevention strategies. The Framingham Study h...
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To evaluate a simple cardiovascular risk management package for assessing and managing cardiovascular risk using hypertension as an entry point in primary care facilities in low-resource settings. Two geographically distant regions in two countries (China and Nigeria) were selected and 10 pairs of primary care facilities in each region were randoml...
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OBJECTIVE: To evaluate a simple cardiovascular risk management package for assessing and managing cardiovascular risk using hypertension as an entry point in primary care facilities in low-resource settings. METHODS: Two geographically distant regions in two countries (China and Nigeria) were selected and 10 pairs of primary care facilities in each...
Article
Good public policies are vital for protecting the health of populations. For the prevention and control of noncommunicable diseases (NCD), a single national policy is essential. Such a policy ensures clarity of vision and purpose, sets the platform for joint action to address risk factors and determinants that are shared by major NCDs, and provides...
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Scaling up research is essential to prevent and contain the rapidly growing epidemic of cardiovascular diseases (CVD) in low-and middle-income (LMIC) countries. Research funds are generally limited and need to be invested pri-marily to generate new knowledge on how to translate existing evidence into action and not for the discovery of novel causes...
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Recent improvements in the monitoring and modelling of stroke have led to more reliable estimates of stroke mortality and burden worldwide. However, little is known about the global distribution of stroke and its relations to the prevalence of cardiovascular disease risk factors and sociodemographic and economic characteristics. National estimates...
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This work has been made available to the staff and students of the University of Sydney for the purposes of research and study only. It constitutes material that is held by the University for the purposes of reporting for HERDC and the ERA. This work may not be downloaded, copied and distributed to any third party .
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Cardiovascular disease (CVD) is the leading cause of the growing global disease burden due to non-communicable diseases. For successful prevention and control of CVD, strategies that focus on individuals need to complement population-wide strategies. Strategies that focus on individuals are cost effective only when targeted at high-risk groups. Ris...
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To ascertain the reliability of applying the WHO Cardiovascular Risk Management Package by non-physician health-care workers (NPHWs) in typical primary health-care settings. Based on an a priori 80% agreement level between the NPHWs and the "expert" physicians (gold standard), 649 paired (matched) applications of the protocol were obtained for anal...
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OBJECTIVE: To ascertain the reliability of applying the WHO Cardiovascular Risk Management Package by non-physician health-care workers (NPHWs) in typical primary health-care settings. METHODS: Based on an a priori 80% agreement level between the NPHWs and the "expert" physicians (gold standard), 649 paired (matched) applications of the protocol we...
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Objective To assess the availability and affordability of medicines used to treat cardiovascular disease, diabetes, chronic respiratory disease and glaucoma and to provide palliative cancer care in six low- and middle-income countries. Methods A survey of the availability and price of 32 medicines was conducted in a representative sample of public...