Within the framework of the seminar “Current challenges in chronic diseases: how to strengthen and implement strategies for better control?”, held at the IECS headquarters, members of the Department of Global Health of the University of Utrecht, in the Netherlands, shared lines of research and approaches to confront this group of pathologies.
After the introduction of the speakers by the Dr. Pablo Gulayin, coordinator of the Department of Chronic Disease Research at IECS, Dr. Kerstin Klipstein-Grobusch, epidemiologist and nutritionist, deputy director of the Julius Centre for Health Sciences and Primary Care at Utrecht University and visiting professor at the School of Public Health at the University of Witwatersrand, South Africa, presented the research lines of her Center and then addressed details of two projects she led in Africa.
In the first, she explored the perception and consumption of packaged or locally produced ultra-processed foods by adolescents in informal settlements in Kenya, including the identification of factors in the physical and social environment that influence their choice of such edible products (e.g., their low price or convenience, or the perception that they are “trendy”).
In the second paper presented, conducted in South Africa, Dr. Klipstein-Grobusch documented that living with the human immunodeficiency virus (HIV) is a risk factor for undiagnosed hypertension, and that more than half of HIV-positive or HIV-negative individuals on medication are unable to control their blood pressure. Therefore, a multicomponent intervention is being tested to improve HIV detection and management in primary care. Nationally, nearly 1 in 5 people aged 15 to 49 are living with HIV in that country.
Another speaker, Dr. Ilonca Vaartjes, professor and researcher at the Department of Epidemiology & Health Economics at the Julius Centre for Health Sciences and Primary Care at Utrecht University, addressed the topic of the “exposome”: the measurement of all the external and internal biological factors to which an individual is exposed from conception to death and how they influence health and disease.
Specifically, the epidemiologist described an "obesogenicity index" that takes into account all environmental characteristics that influence a population's risk of obesity, from the concentration of fast-food restaurants or fast-food outlets to the availability of sports facilities or the ease of walking or cycling. Applying this index to Utrecht and comparing it with various registries, Dr. Vaartjes and colleagues found that living in more obesogenic neighborhoods increases the risk of excess weight, hypertension, and lipid disorders. The specialist considered that the same type of analysis could be performed in cities like Buenos Aires.
Niklas Hlubek, a psychologist with a master's degree in social policy and public health, presented research on socioeconomic disparities, exposure to environmental pollution, and health effects. “Environmental pollution is one of the most significant health risks. It has been estimated to cause 2,2 million deaths annually and 147 million disability-adjusted years [a measure that combines years of life lost due to premature death and years lived with disability] worldwide,” Hlubek noted. Socioeconomic and geographic factors determine the different effects within the same cities or in urban and rural settings.
The last speaker from the Julius Center for Health Sciences and Primary Care at Utrecht University was Dr. Martin Heine, professor of implementation sciences and global health, who shared a project in Ghana aimed at increasing the training of health workers in strategies to bridge the gap between recommendations for addressing chronic noncommunicable diseases and their effective implementation to achieve social impact. He also shared another project planned in Mozambique to optimize the care pathway for patients with hypertension, diabetes, and mental illness. There is a clear "implementation gap," he stated.
The seminar was closed by the Dr. Vilma Irazola, director of the Department of Chronic Disease Research at IECS, who shared the institution's lines of work and pointed out possible instances of coordination and cooperation with her European colleagues.