In a groundbreaking article published in the prestigious Nature Medicine journal, a team of international experts collaborated to address evidence gaps for non-communicable diseases (NCDs) in children and adolescents.
This study was conceived and designed by Dr Bhutta, who also played a pivotal role in securing funding for the project. Dr Rehana Salam from the University of Sydney led the team, which comprised Dr Zulfiqar Bhutta, Dr Jai Das, and Syed Saqlain Ali Meerza from the Institute for Global Health and Development at Aga Khan University (IGHD-AKU), Laura Lewis-Watts from the Hospital for Sick Children (SickKids), and Maryam Hameed Khan from Johns Hopkins University.
The research, titled "An evidence gap map of interventions for noncommunicable diseases and risk factors among children and adolescents," sheds light on the significant burden these diseases place on young lives and carry on in adulthood. These diseases include obesity, mental health conditions, type 1 diabetes, cancers, cardiovascular and chronic respiratory diseases, and substance misuse. Collectively, these diseases contribute to 41% of disability-adjusted life years related to NCDs among children and adolescents worldwide.
Dr Rehana Salam adds, "Our research underscores the imperative of addressing the evidence gaps for non-communicable diseases in children and adolescents. By focusing on LMICs and collaborating across borders, we aim to pave the way for impactful interventions that can shape the health outcomes of the next generation."
Dr Jai Das, Assistant Director at IGHD, emphasizes, "Childhood and adolescence provide a window of opportunity for targeting and improving behaviours and risk factors which can then lead to better health and hence productivity in adulthood." Shockingly, the study reveals a scarcity of evidence on risk factors and interventions for this age group, particularly in low- and middle-income countries (LMICs), where approximately 70% of premature deaths stem from health-related behaviours originating in childhood and adolescence.
The study identifies well-evidenced treatment interventions for biomarkers and adverse events related to NCDs. However, interventions for mental health conditions, obesity and substance misuse are found to be moderately to very low in evidence. The findings underscore the need to prioritize actions that integrate NCD strategies with child health and survival initiatives, spanning from early childhood to adolescence. Additionally, the study recommends focusing on evaluating the effectiveness of digital and community-based delivery platforms, especially for preventing these conditions among marginalized and at-risk populations.
“This is the first of a series of Gap Maps conceptualized and initiated by our multi-country research group, focusing on what needs to be done to bridge the evidence divide that many LMICs face in addressing priority non-communicable diseases in children and adolescents, as only 3.8% studies were conducted in LMICs. We trust that these findings will stimulate action and implementation research in many countries confronting myriad challenges in the post-pandemic world," says Dr Zulfiqar Bhutta, a Distinguished University Professor at IGHD-AKU.
The study's implications align with global health goals, including the Sustainable Development Goals (SDGs), which call for a one-third reduction in premature mortality from NCDs through prevention and management by 2030.