A large proportion of the publications focused on cancer studies This was followed by CVD studies Over half Interventional studies did not exceed 2. Study designs varied significantly by type of NCD examined. Laboratory-based studies and case reports and case series were the most dominant study types for cancer studies Case-control study methodologies were equally employed for CVD, DM, and chronic respiratory disease range Review articles tackled cancer and CVDs close to The extent to which each of the four risk factors tobacco, physical activity, dietary-related factors, and obesity were addressed across the four NCDs is illustrated in Figure 2.
Smoking was mostly examined in publications focusing on CVDs This was followed, in descending order, by papers focusing on chronic respiratory diseases Dietary factors were examined in Obesity was examined in Finally, physical inactivity was mostly examined in association with DM Distribution of risk factors addressed in NCD research, stratified by study focus, a Kuwait, — Compared to disease burden of NCD, results showed a clear relative surplus of research produced on cancer.
The need for a stronger scientific evidence base for curbing the NCD epidemic has long been identified by public health actors and various stakeholders. Concurrently, it is crucial to ensure that data and research output match national disease burden and public health priorities, such that countries worst affected by NCDs are producing a considerable amount of literature for monitoring and evaluation.
The present study showed that Kuwait has been overall increasingly productive in NCD research, with more than a two-fold increase in output from until The slight drop around has been observed in other reviews in the region and is likely to be the result of the political upheavals that struck the region in and were at their peak in [ 13 ].
The rise in publication rate over time is higher than the trend in other countries in the region but remains lower than, for example, Lebanon, a middle-income country, where the increase has been close to six-fold [ 8 ]. It is worth noting that Kuwait has so far conducted two STEPwise surveys, in [ 14 ] and [ 4 ], yet the output from this effort was limited to two country reports and merely one paper in a refereed journal [ 15 ]. While this fell behind its cause-specific burden assessed in terms of PMRs, the deficit in CVD research output was diluted and became negligible when the burden was assessed in terms of DALYs.
This is because DALYs take into consideration both mortality and morbidity characteristics of the disease, and compared to cancer, for example, CVD has lower case fatality rates. The majority of the CVD studies were population-based, with cross-sectional and follow-up studies constituting half of the research produced in this subject area. Hence, risk factor epidemiology topped the focus of CVD research, with smoking, dietary factors, and obesity being addressed in a substantial proportion of the studies.
Yet, the proportion of studies that examined associations with physical activity was negligible 2. Except for diabetes, this deficiency was observed across NCD groups. Given the high prevalence of physical inactivity in Kuwait, it is worrisome to note the low interest among researchers in studying physical inactivity in the country. Today, lack of physical inactivity is the fourth leading risk factor for global mortality and is one of the leading public health indicators [ 16 ].
Physical activity in many countries of the Gulf region is hampered by lack of public parks, reduced opportunities for exercise, and the hot climate and car-dominated transport. Also, women are less likely to be members of the workforce, further restricting their potentiality for a physically active lifestyle. These structural determinants with context-specific research questions need to be addressed in future studies.
Furthermore, the majority of studies were accounted for by laboratory-based studies and lower-evidence research e.
This explains our finding of the relatively low percentages of cancer studies that focus on risk factors range 0. Cancer accounts for 10 of the top 25 causes of death in Kuwait [ 3 ], and cancer-related behavioral risk factors are highly prevalent in the Kuwaiti adult population. For instance, the Kuwait STEPs survey revealed that, among adults aged 18—69, the prevalence of smoking among men is With such a high prevalence of cancer-related risk factors in the country, it is worrisome to note in our study the low interest of risk-factor epidemiology in cancer research.
Etiology and epidemiological studies are of relevance not only to the scientific community but also to policy makers and program developers, for a better understanding of the attributable risk to well-known risk factors and for monitoring progress in the country.
Journal of Communicable Diseases (P-ISSN: 0019-5138 & E-ISSN: 2581-351X)
Kuwait is known to host one of the highest prevalence rates of DM worldwide. With a prevalence of Although the national Dasman Diabetes Institute, established in , has been playing a leading role in combatting the diabetes epidemic in Kuwait through focused diabetes research, integrated prevention, training, and education, our findings are compelling for the need to promote more investment in community genetic research targeting NCDs with the highest morbidity, heritability, and health burden [ 11 ].
This review identified other issues that are worth noting. A small proportion of the studies targeted adults greater than 50 years of age. The lack of representation of the older population has been observed in an earlier review of cancer publications in the region [ 18 ] and is a deficiency that needs to be addressed in future studies.
Moreover, almost half of the studies were conducted in a hospital or clinical setting, with few being population-based with a public health perspective for prevention and control. On the other hand, while most of the studies were conducted by the Kuwait University, the only public academic institution in the country, the engagement of the Ministry of Health in the production of knowledge on NCD is noteworthy.
This can be seen as conducive to raising awareness among policy makers, healthcare providers, and other stakeholders of the vital need for evidence to guide the planning of interventions and programs.
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One of the limitations of this review is that it is based on a single search engine. Also, the analyses covered only scientific publications in peer-reviewed journals, thus missing further evidence from the grey literature or other reports that remain unpublished.
Yet, this remains the first detailed analyses of NCD research productivity in Kuwait providing a case study for mapping NCD research production in other countries in the region and elsewhere. Health coverage and access to care, including cost of chronic medications, is free for Kuwaiti citizens.
This is not the case for migrant workers, who have to pay for health insurance and for some services, such as laboratory and radiological investigations [ 19 ]. This may adversely affect compliance rates among expatriates and result in worsening of NCD burden. A working plan is underway to extend this service to the secondary and tertiary health services, which is expected to be in service soon. This will facilitate outcome research with a better assessment of the evidence-based and guideline-concordant performance of NCD care in Kuwait. In conclusion, findings from this study reveal three main areas of concern.
Firstly, there is a surplus of cancer studies—and these are mostly of the case-report or case-series type, which lack a methodological framework for examining associations with risk factors and assessing attributable risks. Secondly, despite the huge burden of DM in Kuwait, this remains an under-researched topic. Thirdly, there is an overall deficiency of studies that address physical activity.
This is a missed opportunity for greater awareness and recognition by health professionals and policy makers of the importance of physical activity for NCD prevention and control.
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NCD is a global health issue, with recent calls for research that would inform policy reforms. This study calls for a coordinated discussion and a think tank comprising research centers, universities, and researchers in Kuwait that would support a better understanding of the NCD research landscape and approaches towards shaping NCD research agenda priorities responsive to emerging needs in the country. We hope that findings from this study will incite further discussions on research priority setting and funding allocation in the region and beyond.
The original study and data collection for this paper were carried out with the aid of a grant from the International Development Research Centre, Ottawa, Canada Reference number No funding was available for the analyses and write-up of the current paper. HB carried out the analysis and wrote the first draft. All authors contributed to the interpretation of data and write-up of the paper, with significant input from AS.
All authors reviewed the results and agree to the final version of the manuscript. Murray C and Lopez A. Mortality by cause for eight regions of the world: Global Burden of Disease Study. The Lancet.
Disease Reporting | Wisconsin Department of Health Services
Non-communicable diseases in the Arab world. World Health Organization. Accessed February 3, Survey for risk factors for chronic non-communicable diseases. Accessed December 10, Who reports disease cases and to whom? Which diseases are reportable in North Carolina? What reporting systems and processes are used in North Carolina? How are the data used? Where can I find N. Public health disease surveillance is the ongoing, systematic collection, analysis and interpretation of the who, what, where, when and how of disease case occurrence in a population.
All 50 states and United States territories have laws, statutes or other regulations that mandate reporting of communicable or infectious diseases and have the authority to collect and monitor a central repository of disease case information where patterns, clusters, and outbreaks may be detected. Although the list of reportable diseases may vary slightly from state to state, everyone uses the same criteria to define what constitutes a case of a given disease.
These case definitions are standardized by the Council of State and Territorial Epidemiologists in consensus with the U. Timely and complete disease reporting allows public health practitioners to monitor and respond to the changing health status of their community. It also helps ensure that prevention activities reach the right people and that public health and community programs get the resources they need. Physicians, school administrators and child care operators, medical facilities and operators of restaurants and other food or drink establishments G.
Division of Public Health G. Laboratories may report to the local health department, except in the case of syphilis results, which the laboratories must report directly to the Communicable Disease Branch or the nearest regional office 10A NCAC 41A. The lists of reportable diseases vary slightly from state to state. North Carolina's list of reportable diseases and the timeframes in which they are required to be reported to DPH is specified in the N.
Required notification times are effective from the time that a reportable condition is reasonably suspected to exist and range from immediate to seven days, depending on the disease. Immediate reporting is required for potential bioterrorism-related diseases, such as anthrax and botulism; the severe or highly communicable diseases, such as cholera and cryptosporidiosis, must be reported within 24 hours of diagnosis; other diseases and conditions, such as mumps and chlamydia, have a seven-day reporting timeframe.
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