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      A profile and approach to chronic disease in Abu Dhabi

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      Publication date (Electronic):
      Journal: Globalization and Health
      Publisher: BioMed Central

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          Abstract

          As a country, the United Arab Emirates has developed very rapidly from a developing country with a largely nomadic population, to a modern and wealthy country with a Western lifestyle. This economic progress has brought undoubted social benefits and opportunities for UAE citizens, including a high and increasing life expectancy. However, rapid modernization and urbanization have contributed to a significant problem with chronic diseases, particularly obesity-related cardiovascular risk. In response the Health Authority of Abu Dhabi has significantly strengthened its data systems to better assess the baseline and measure the impact of targeted interventions. The unique population-level Weqaya Programme for UAE Nationals living in Abu Dhabi has recruited more than 94% of adults into a screening programme for the rapid identification of those at risk and the deployment of targeted interventions to control that risk. This article describes the burden of non-communicable disease in Abu Dhabi, and the efforts made by the Health Authority of Abu Dhabi to tackle this burden including the development of a whole population cardiovascular screening programme changes to health policy, particularly in terms of lifestyle and behaviour change, and empowerment of the community to enable individuals to make healthier choices. In addition, recommendations have been made for global responsibility for tackling chronic disease.

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          The effects of waterpipe tobacco smoking on health outcomes: a systematic review.

          Elie A. Akl, Swarna Gaddam, Sameer K Gunukula … (2010)
          There is a need for a comprehensive and critical review of the literature to inform scientific debates about the public health effects of waterpipe smoking. The objective of this study was therefore to systematically review the medical literature for the effects of waterpipe tobacco smoking on health outcomes. We conducted a systematic review using the Cochrane Collaboration methodology for conducting systematic reviews. We rated the quality of evidence for each outcome using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. Twenty-four studies were eligible for this review. Based on the available evidence, waterpipe tobacco smoking was significantly associated with lung cancer [odds ratio (OR) = 2.12; 95% confidence interval (CI) 1.32-3.42], respiratory illness (OR = 2.3; 95% CI 1.1-5.1), low birth-weight (OR = 2.12; 95% CI 1.08-4.18) and periodontal disease (OR = 3-5). It was not significantly associated with bladder cancer (OR = 0.8; 95% CI 0.2-4.0), nasopharyngeal cancer (OR = 0.49; 95% CI 0.20-1.23), oesophageal cancer (OR = 1.85; 95% CI 0.95-3.58), oral dysplasia (OR = 8.33; 95% CI 0.78-9.47) or infertility (OR = 2.5; 95% CI 1.0-6.3) but the CIs did not exclude important associations. Smoking waterpipe in groups was not significantly associated with hepatitis C infection (OR = 0.98; 95% CI 0.80-1.21). The quality of evidence for the different outcomes varied from very low to low. Waterpipe tobacco smoking is possibly associated with a number of deleterious health outcomes. There is a need for high-quality studies to identify and quantify with confidence all the health effects of this form of smoking.
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            Tobacco smoking using a waterpipe: a re-emerging strain in a global epidemic.

            T Eissenberg, Rabab Ward, W Maziak … (2004)
            The global tobacco epidemic may kill 10 million people annually in the next 20-30 years, with 70% of these deaths occurring in developing countries. Current research, treatment, and policy efforts focus on cigarettes, while many people in developing regions (Asia, Indian subcontinent, Eastern Mediterranean) smoke tobacco using waterpipes. Waterpipes are increasing in popularity, and more must be learned about them so that we can understand their effects on public health, curtail their spread, and help their users quit. To conduct a comprehensive review regarding global waterpipe use, in order to identify current knowledge, guide scientific research, and promote public policy. A Medline search using as keywords "waterpipe", "narghile", "arghile", "shisha", "hookah", "goza", "hubble bubble" and variant spellings (for example, "hooka"; "hukka") was conducted. Resources compiled recently by members of GLOBALink were used. Every identified published study related to waterpipe use was included. Research regarding waterpipe epidemiology and health effects is limited; no published studies address treatment efforts. Waterpipe use is increasing globally, particularly in the Eastern Mediterranean Region, where perceptions regarding health effects and traditional values may facilitate use among women and children. Waterpipe smoke contains harmful constituents and there is preliminary evidence linking waterpipe smoking to a variety of life threatening conditions, including pulmonary disease, coronary heart disease, and pregnancy related complications. More scientific documentation and careful analysis is required before the spread of waterpipe use and its health effects can be understood, and empirically guided treatment and public policy strategies can be implemented.
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              The Abu Dhabi Cardiovascular Program: the continuation of Framingham.

              Cother Hajat, Oliver Harrison (2010)
              Sixty years on from its first publication, the Framingham study has made an historic impact in risk identification and prediction of cardiovascular disease (CVD) burden globally. The challenge for the 21st century is in finding practical and scalable methods for effective implementation of population-level interventions that are adaptable to low-, middle-, and high-income settings. Within its first 2 years, the Abu Dhabi Cardiovascular Program, "Weqaya," has delivered a Framingham Risk Score for almost every adult Emirati. This is complemented by a clear and progressive program including the health sector and societal approach to the delivery of interventions for CVD. The health sector response includes the use of clear, evidence-based standards of clinical care, customer-focused service innovation such as the use of mobile and wellness clinics, and attention to the patient experience, and improving compliance using a mixture of encourage, enable, and enforce mechanics. Components of the Abu Dhabi societal approach include "top-down" measures to align the civil sector response including use of policies and regulation, for example, for trade and urban planning. The "bottom-up" measures aim to empower individuals, groups, and populations. Key to the success of this approach lies in central coordination and routine monitoring and evaluation, incorporating the use of simple, shared metrics. The Abu Dhabi approach has created a solid platform for scalable intervention, and for "learning by doing," with impact being monitored at the level of individuals, groups and the whole population. The unique data architecture in Abu Dhabi will enable the first cardiovascular risk score to be developed for the region and the incorporation of novel, modifiable risk factors into the model. The last 2 years have seen huge progress in Abu Dhabi for CVD, but the coming 5 to 10 years promise to unearth real, large-scale solutions, building on the original Framingham model. Furthermore, the Abu Dhabi model is scalable and adaptable to low- and middle-income country settings. Local and global data on CVD risk are stark and raise a clear challenge for public health; the time for clear actions has arrived. Copyright 2010 Elsevier Inc. All rights reserved.
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                Author and article information

                Contributors
                Cother Hajat
                Oliver Harrison
                Zainab Shather
                Journal
                Journal ID (nlm-ta): Global Health
                Journal ID (iso-abbrev): Global Health
                Title: Globalization and Health
                Publisher: BioMed Central
                ISSN (Electronic): 1744-8603
                Publication date Collection: 2012
                Publication date (Electronic): 27 June 2012
                Volume: 8
                Page: 18
                Affiliations
                [1 ]Department of Public Health & Research, Health Authority Abu Dhabi, Airport Rd, PO Box 5674, Abu Dhabi, United Arab Emirates
                Article
                Publisher ID: 1744-8603-8-18
                DOI: 10.1186/1744-8603-8-18
                PMC ID: 3512533
                PubMed ID: 22738714
                SO-VID: b3f09ca7-8b4b-47b8-828d-cbfc2436478a
                Copyright © Copyright ©2012 Hajat et al.; licensee BioMed Central Ltd.
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 13 October 2011
                Date accepted : 15 May 2012
                Categories
                Subject: Review

                ScienceOpen disciplines: Health & Social care
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                ScienceOpen disciplines: Health & Social care

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