Resurgence of non-communicable diseases in LMICs: a cause for concern?

This editorial is devoted solely to non-communicable diseases (NCDs) papers published in the 2019 June issue of African Health Sciences. This is a departure from AHS practice of having one editorial per issue. This time, we have decided to have three thematic editorials, which will help our readers focus attention on the themes of their choice. The other areas of interest in this June issue of African Health Sciences are sexual/reproductive and child health; as well as infectious diseases, which have had 2 separate editorials, written by Prof. Grace Ndeezi, and Dr. David Mukunya.

This editorial is devoted solely to non-communicable diseases (NCDs) papers published in the 2019 June issue of African Health Sciences. This is a departure from AHS practice of having one editorial per issue. This time, we have decided to have three thematic editorials, which will help our readers focus attention on the themes of their choice. The other areas of interest in this June issue of African Health Sciences are sexual/reproductive and child health; as well as infectious diseases, which have had 2 separate editorials, written by Prof. Grace Ndeezi, and Dr. David Mukunya.

Now to NCDs
We begin with three interesting papers on the cardiovascular system. Adje and others 1 , have written a research paper on cardiovascular risk assessment from a community in Nigeria. In a study of adults aged 40-80 years, they found that up to 30% were hypertensive and a similar proportion was overweight, and had abnormal cholesterol levels. Scientists from China 2 , on the other hand, carried out a meta-analysis, which showed that levels of triglyceride and glucose were the predisposing factors for ischemic stroke in the Asian population. Finally, Ifeluwa and others 3 demonstrated impaired right ventricular systolic function of patients with heart failure secondary to hypertension in Ibadan Nigeria. These remind us that cardiovascular diseases are no longer the preserve of people in high income countries.
The next set of papers is on cancer, which has become ubiquitous and dominates conversations in the social media, clubs, restaurants, taxis, bodabodas, buses and work places in Africa! Hence, Mohammedi and others 4 report on cyclin D1 over-expression in Algerian breast cancer women. They conclude that this could be considered for routine diagnosis of breast cancer. On the other hand, Indian scientists report on the association of inflammatory biomarkers with lung cancer in a North Indian population. They conclude that 'CRP, TNF-α, IL-6 and IL-8 are the promising biomarkers in the identification of lung cancer patients' 5 . Cancer chemotherapy has unpleasant cytotoxic effects. In the next paper, the authors found that polysaccharides from mycelia of Cordycepsmilitarisa melioratedcytotoxic effects from doxorubicin 6 . Another paper 7 is on diabetes mellitus, and reports on the lack of association between vitamin D receptor gene BsmI polymorphism, and type 2 diabetes mellitus in Pakistani populations. An important negative finding!

Now to mental health and other issues
A study from Uganda reports on mental health professionals' views on exercise for people with mental illness 8 , while work from South Africa reports on the disuse of hearing aids in the elderly with presbycusis 9 . Other authors from South Africa assert that hospital-acquired acute kidney injury (AKI) in adults is associated with adverse patient outcomes. They recommend automated electronic alerts to empower health workers, detect and manage the AKI 10 . Saudi authors on the other hand report that aerobic exercise modulates cytokine profile and sleep quality in the elderly 11 .
What follows is a diverse group of papers on several aspects of NCDs. From Turkey we have staff perceptions of patient safety culture and safety grades in general surgery departments 12 . Zimbabwean researchers found that A. stenophyllaaqueous extract increases glucose uptake partly through increasing the GLUT 4 mRNA and translocation potentially acting via the PI-3-K pathway 13 . The study confirms 'the ethno-pharmacological uses of A.stenophylla' especially its potential for treating diabetes mellitus.

The next set of papers is relevant to education in NCDs.
We have a paper on colour vision deficiency among students in Lagos State, Nigeria 14 , followed by a faculty's experiences of a formal mentoring programme 15 , and one on the effect of nutrient intakes on anthropometric profiles among university students in Malaysia 16 . Kose's paper on the effectiveness of basic life support training on nursing students' knowledge and basic life support practices is the jewel in the crown of this pedagogy section 17 . It is followed by a description of the challenges faced by student accoucheurs during clinical placement at the free state maternal health care institutions in South Africa 18 . Surprisingly, Ugandan researchers report that parental involvement was not associated with academic achievement among deaf children in Kampala 19 . They recommend a search for other factors associated with academic achievement in the deaf children. Nigerian authors report that using real time sonography as an anatomy teaching aid was the least popular method among undergraduate students 20 . The implications are not clear given the lack of cadavers in medical schools worldwide. We end with a few case reports: one on rectus sheath hematoma and retroperitoneal bleeding due to rivaroxaban 20 ; and the other on diagnostic challenges and surgical management of osteoblastoma and aneurysmal bone cyst of the lumbar spine in a child 22 .
This treatise reflected on a wide range of non-communicable diseases, which reminds us that these NCDS are diverse. That they are on the rise in LMIC is an understatement. Individuals, researchers and policy makers need to keep on the alert, with a view to preventing the NCDs. Ensuring universal health access is a key priority, in line with the sustainable development goals.