Showing papers by "Novartis Foundation published in 2020"

Evolution of Novartis’ Small Molecule Screening Deck Design

Abstract: This article summarizes the evolution of the screening deck at the Novartis Institutes for BioMedical Research (NIBR). Historically, the screening deck was an assembly of all available compounds. In 2015, we designed a first deck to facilitate access to diverse subsets with optimized properties. We allocated the compounds as plated subsets on a 2D grid with property based ranking in one dimension and increasing structural redundancy in the other. The learnings from the 2015 screening deck were applied to the design of a next generation in 2019. We found that using traditional leadlikeness criteria (mainly MW, clogP) reduces the hit rates of attractive chemical starting points in subset screening. Consequently, the 2019 deck relies on solubility and permeability to select preferred compounds. The 2019 design also uses NIBR's experimental assay data and inferred biological activity profiles in addition to structural diversity to define redundancy across the compound sets.

A comprehensive research agenda for zero leprosy

Abstract: Leprosy control achieved dramatic success in the 1980s–1990s with the implementation of short course multidrug therapy, which reduced the global prevalence of leprosy to less than 1 in 10 000 population. However, a period of relative stagnation in leprosy control followed this achievement, and only limited further declines in the global number of new cases reported have been achieved over the past decade. In 2016, major stakeholders called for the development of an innovative and comprehensive leprosy strategy aimed at reducing the incidence of leprosy, lowering the burden of disability and discrimination, and interrupting transmission. This led to the establishment of the Global Partnership for Zero Leprosy (GPZL) in 2018, with partners aligned around a shared Action Framework committed to achieving the WHO targets by 2030 through national leprosy program capacity-building, resource mobilisation and an enabling research agenda. GPZL convened over 140 experts from more than 20 countries to develop a research agenda to achieve zero leprosy. The result is a detailed research agenda focusing on diagnostics, mapping, digital technology and innovation, disability, epidemiological modelling and investment case, implementation research, stigma, post exposure prophylaxis and transmission, and vaccines. This research agenda is aligned with the research priorities identified by other stakeholders. Developing and achieving consensus on the research agenda for zero leprosy is a significant step forward for the leprosy community. In a next step, research programmes must be developed, with individual components of the research agenda requiring distinct expertise, varying in resource needs, and operating over different timescales. Moving toward zero leprosy now requires partner alignment and new investments at all stages of the research process, from discovery to implementation.

Hypertension prevalence and control in Ulaanbaatar, Mongolia.

Abstract: This study examines the prevalence, awareness, treatment, and control of hypertension in Ulaanbaatar, Mongolia, using both the American Heart Association and conventional thresholds (130/80 and 140/90 mm Hg, respectively). In this randomized cross-sectional study, two-stage cluster sampling was used to obtain a sample of 4515 individuals aged ≥20 years. Hypertension was defined by the use of antihypertensives in the last 2 weeks or a blood pressure at or above the thresholds of 140/90 and 130/80 mm Hg. The mean age of the participants was 41.1 ± 14.0 years and 54.5% were women. Hypertension prevalence was 25.6% (using 140/90 mm Hg) and 46.5% (using 130/80 mm Hg). Prevalence increased with age and below 50 years men were consistently more likely to be hypertensive. Among hypertensive participants, the rates of awareness, treatment, and control were 69.7%, 46.8%, and 24.0% (using 140/90 mm Hg) and 49.1%, 25.8%, and 6.4% (using 130/80 mm Hg, respectively). Men had lower rates of awareness, treatment, and control compared with women, with the most pronounced differences at younger ages. This study shows that awareness, treatment, and control rates in Ulaanbaatar are better than in most low- and middle-income countries but are still suboptimal. The largest "care gap" was in young men where a regulatory requirement for annual workplace blood pressure screening has the potential to enhance care. A major hypertension control program has just been initiated in Ulaanbaatar.

Association between physical activity, cardiorespiratory fitness and clustered cardiovascular risk in South African children from disadvantaged communities: results from a cross-sectional study

Abstract: Background/Aim Physical inactivity (PIA) is a growing global health problem and evidence suggests that PIA is a key driver for cardiovascular and chronic diseases. Recent data from South Africa revealed that only about half of the children achieved recommended daily physical activity (PA) levels. Assessing the intensity of PA in children from low socioeconomic communities in low-income and middle-income countries is important to estimate the extent of cardiovascular risk and overall impact on health. Methods We conducted a cross-sectional survey in eight quintile 3 primary schools in disadvantaged communities in the Port Elizabeth region, South Africa. Children aged 10–15 years were subjected to PA, blood pressure, cholesterol, blood glucose and skinfold thickness assessments. Cardiovascular risk markers were converted into standardised z-scores and summed, to obtain a clustered cardiovascular risk score. Results Overall, 650 children had complete data records. 40.8% of the children did not meet recommended PA levels (ie, logged Conclusions CRF and objectively assessed PA are closely linked with children’s clustered cardiovascular risk. Given that 4 out of 10 South African schoolchildren from marginalised communities do not meet international PA recommendations, efforts should be made to ensure that promoting a physically active lifestyle is recognised as an important educational goal in primary schools. Trial registration numbers ISRCTN68411960 and H14-HEA-HMS-002.

Aceitabilidade da quimioprofilaxia em área endêmica para a hanseníase: projeto PEP-Hans Brasil

Abstract: Resumo: O objetivo deste artigo foi analisar a aceitabilidade da quimioprofilaxia com rifampicina em dose unica (PEP) entre os contatos, casos indices de hanseniase e profissionais da saude e fatores relacionados que possam influenciar na adesao. Realizou-se um estudo qualitativo de analise de conteudo apos aplicacao de entrevistas semiestruturadas segundo protocolo proposto no programa LPEP (2016), realizado em Alta Floresta, Mato Grosso, Brasil, em julho de 2016. Participaram do estudo individuos notificados com hanseniase, contatos e profissionais da saude. Utilizou-se o software QRS NVivo versao 10. Foram contatados 80 individuos, sendo 54 (67%) contatos, 11 (14%) casos indices e 15 (19%) profissionais de saude. Dentre os contatos, 94% (51/54) tomaram PEP. Foram identificadas 3 categorias quanto a PEP: compreensao, aceitacao e expectativa da intervencao. A compreensao se mostrou relacionada ao cuidado da equipe de saude. Aceitar ou nao a medicacao revelou-se relacionada ao medo, confianca e protecao, operacionalidade da estrategia, autoestima e inseguranca quanto a intervencao. A expectativa da intervencao relacionou-se ao bem-estar, prevencao da doenca e de sequelas, diminuicao de gastos publicos e ampliacao do acesso. Houve reconhecimento da relevância da estrategia PEP pela possibilidade de interrupcao da cadeia de transmissao, diminuicao de casos novos e melhora na qualidade de vida. A inseguranca em tomar a medicacao e de a doenca se manifestar influenciaram negativamente a aceitacao da PEP; por outro lado, as informacoes previas sobre a estrategia PEP contribuiram para o fortalecimento da confianca nos profissionais de saude e para a aceitabilidade da medicacao.

Strengthening local health systems for hypertension prevention and control: the Communities for Healthy Hearts program in Ho Chi Minh City, Vietnam

Abstract: Background: Hypertension leads to an estimate of 91,000 deaths yearly, accounting for 21% of total mortality in Vietnam. However, the national health system is under-resourced to meet the population's needs for hypertension prevention and care. The Communities for Healthy Hearts program (the Program) introduced an innovative health service delivery model to address hypertension in underserved communities in 4 districts of Ho Chi Minh City (HCMC). This study evaluated a 3-year implementation of this program (2016–2019) on the strengthening of local health system and its capacity to better prevent and manage hypertension. Methods: A mixed approach of quantitative and qualitative studies was applied. The WHO’s health systems building blocks framework was employed to assess impact of the Program on the local health system. Results: Findings revealed that the Program developed a hypertension-ready system supported by enabling factors that are aligned with the WHO's building blocks. These were: increased availability of preventive and treatment services for hypertension; improved capacity of healthcare staff through trainings; effective communication materials, available technical guidelines; provision of stipends for collaborators; establishment of a collaborators network and blood pressure checkpoints with a strong collaboration among stakeholders. However, there was room for improvement and the Program provides a few lessons learned regarding planning in personnel changes and recruitment, efficacy of capacity building via training sessions, sustainability of financing, and completeness of patient information management. Conclusion: Given national objectives in Vietnam to strengthen primary care and address the rising tide of NCDs, The Communities for Healthy Hearts program provided a promising approach to strengthen HCMC's health system and extend coverage of community-based approaches to improve prevention and control of hypertension. This model provides several approaches and lessons learned that can support health providers and policy makers in their efforts to strengthen national health programs in Vietnam to address NCDs.

Knowledge change related to hypertension in the Southern province of Vietnam: a community based, before and after intervention evaluation

Abstract: Background: This study describes the changes in knowledge of hypertension among adults aged 40 and above in four districts of Ho Chi Minh City as a result of the Communities for Healthy Hearts program, which started in 2016 and ended in 2019. Methods: We conducted a baseline and endline cross-sectional study of the Communities for Healthy Hearts program, the former in May 2016, and the latter in July 2019. A combination of multistage cluster random sampling techniques was used to recruit a total of 1296 adults within four districts of Ho Chi Minh City: including District 8, District 12, Go Vap, and Thu Duc. Information on the knowledge of hypertension, sociodemographic characteristics, and health behaviors were collected. Multivariable logistic regression analyses were employed to estimate the influence of socio-demographic factors on the knowledge of hypertension. Results: In the endline survey, a majority of participants showed adequate knowledge on the identification of normal blood pressure range (64.4%), hypertension risk factors (91.7% for correctly identifying at least three modifiable risk factors) and its symptoms (85.5% for correctly identifying at least three symptoms), which demonstrated a significant increase from the baseline survey. Higher educational levels and those previously diagnosed with hypertension had a significant positive correlation with the knowledge of hypertension in both survey evaluations. Whereas, knowledge was poorer in those who were retired/ unemployed compared to officers (adjusted odds ratio, 0.33; 95% confidence interval, 0.18– 0.61). Besides television, health care professionals, and the project's channels (SMS message and collaborator) become the primary source of information for hypertension knowledge. Conclusion: The Communities for Healthy Hearts Program improved the levels of hypertension knowledge among people in the program areas. However, a lack of knowledge was observed among the uneducated, suggesting a streamlining of educational campaigns in this specific subsection of the population.

Effect of community-based intervention on self-management of blood pressure among hypertensive adults: findings from the Communities for Healthy Hearts Quasi-experimental Study in Vietnam

Abstract: Background: Hypertension is one of the leading causes of cardiovascular diseases and deaths globally. Controlling blood pressure is the key factor to reduce clinical events. The current study aims to evaluate the effects of Communities for Healthy Hearts intervention in improving the self-management of blood pressure among hypertensive patients. Methods: From October 2017 to September 2019 a quasi-experimental study was implemented in the intervention and control districts of Ho Chi Minh City, Vietnam. 2,701 hypertensive adults (1,315 in the intervention group and 1386 in the control group) were interviewed at the onset and for four rounds of follow-up after the intervention. Selfmanagement of blood pressure was assessed via the utilization of self-management tools, including blood pressure monitors, diaries and practical guidelines. Random slope mixedeffects models with propensity matching method were employed to evaluate the effectiveness of the project and identified factors related to self-management. Results: The percentage of hypertensive adults who self-managed blood pressure increased in both intervention and control groups, although the increase in the intervention group was 8.5% higher. Compared to the difference in self-management of blood pressure between the intervention and control group at baseline, significant increase in intervention effects was observed at round three and four of follow-up, with odds ratio (OR), 1.77 (95% confidence interval [CI], 1.24–2.52) and 1.48 (95% CI, 1.00–2.18), respectively. As compared to housewives and non-smokers, freelance workers and current smokers had a lower likelihood of self-management of blood pressure whereas, higher age, higher education, and being obese were protective factors. Conclusion: The Communities for Healthy Hearts intervention improved the selfmanagement of blood pressure among hypertensive adults via the utilization of blood J Glob Health Sci. 2020 Jun;2(1):e10 https://doi.org/10.35500/jghs.2020.2.e10 pISSN 2671-6925·eISSN 2671-6933

Facilitating factors and barriers to the implementation of hypertension prevention programs in Vietnam: lessons learned from the Communities for Healthy Hearts program

Abstract: Background: Non-communicable disease (NCD) is the greatest contributor to premature deaths worldwide, with hypertension at the forefront. There was a need for a new model to help battle the burden of hypertension. In 2016, an innovative service delivery communitybased model was launched in Ho Chi Minh City, Vietnam: “Communities for Healthy Hearts (CH2) program.” This qualitative study's focus is on the facilitators and barriers of the 5 aims of the Program. Methods: We purposively selected 39 key participants, 20 for focus group discussions, and 19 for semi-structured interviews. We employed thematic content analysis and used NVIVO12 for data analysis. Results: Overall, the diverse communication activities, training courses, and general support by key stakeholders were highlighted as the facilitators of the CH2 program. Barriers reported by interviewees were heavy workloads and the lack of financial incentives among the network, poor and inadequate referral services for patients, and the pending application of the digital registry for patient management. Overall, many informants were satisfied with the communication strategies, the increased accessibility of the hard-to-reach groups, the increased knowledge of residents, and early detection of hypertension; however, they expressed their concern about the long-term sustainability of this innovative model and the potential for scale-up. Conclusion: The CH2 program enhanced knowledge about hypertension and its early detection, but challenges remain, such as sustaining the collaborator network of volunteers in the community, and the need for further capacity building in order for it to be integrated and scaled nationally. More attention should be focus on the recruitment process, development of the fully-functional eHypertension.Tracker software to support the referral process prior to scaling-up to ensure the program sustainability. We therefore suggested that the CH2 program should continuously engage stakeholders at all levels to scale-up this model in other provinces in Vietnam. J Glob Health Sci. 2020 Jun;2(1):e11 https://doi.org/10.35500/jghs.2020.2.e11 pISSN 2671-6925·eISSN 2671-6933