The global NAFLD policy review and preparedness index: Are countries ready to address this silent public health challenge?
Background & Aims: Non-alcoholic fatty liver disease (NAFLD) is a highly prevalent, yet largely underappreciated liver condition which is closely associated with obesity and metabolic disease. Despite affecting an estimated 1 in 4 adults globally, NAFLD is largely absent on national and global h...
| Autores: | , , , , , , , |
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| Formato: | artículo |
| Estado: | Versión publicada |
| Fecha de publicación: | 2022 |
| País: | España |
| Recursos: | Universidad de Sevilla (US) |
| Repositorio: | idUS. Depósito de Investigación de la Universidad de Sevilla |
| OAI Identifier: | oai:idus.us.es:11441/137442 |
| Acesso em linha: | https://hdl.handle.net/11441/137442 https://doi.org/10.1016/j.jhep.2021.10.025 |
| Access Level: | acceso abierto |
| Palavra-chave: | Non-alcoholic fatty liver disease (NAFLD) Liver health Non-alcoholic steatohepatitis (NASH) Global public health Policy preparedness Health policy Multiple correspondence analysis |
| Resumo: | Background & Aims: Non-alcoholic fatty liver disease (NAFLD) is a highly prevalent, yet largely underappreciated liver condition which is closely associated with obesity and metabolic disease. Despite affecting an estimated 1 in 4 adults globally, NAFLD is largely absent on national and global health agendas. Methods: We collected data from 102 countries, accounting for 86% of the world population, on NAFLD policies, guidelines, civil society engagement, clinical management, and epidemiologic data. A preparedness index was developed by coding questions into 6 domains (policies, guidelines, civil awareness, epidemi ology and data, NAFLD detection, and NAFLD care management) and categorising the responses as high, medium, and low; a multiple correspondence analysis was then applied. Results: The highest scoring countries were India (42.7) and the United Kingdom (40.0), with 32 countries (31%) scoring zero out of 100. For 5 of the domains a minority of countries were cat egorised as high-level while the majority were categorised as low-level. No country had a national or sub-national strategy for NAFLD and <2% of the different strategies for related conditions included any mention of NAFLD. National NAFLD clinical guide lines were present in only 32 countries. Conclusions: Although NAFLD is a pressing public health prob lem, no country was found to be well prepared to address it. There is a pressing need for strategies to address NAFLD at na tional and global levels. Lay summary: Around a third of the countries scored a zero on the NAFLD policy preparedness index, with no country scoring over 50/100. Although NAFLD is a pressing public health prob lem, a comprehensive public health response is lacking in all 102 countries. Policies and strategies to address NAFLD at the na tional and global levels are urgently needed. |
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