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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
A cost effectiveness analysis of salt reduction policies to reduce coronary heart disease in four Eastern Mediterranean countries
PLoS ONE, Volume 9, No. 1, Article e84445, Year 2014
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Description
Background: Coronary Heart Disease (CHD) is rising in middle income countries. Population based strategies to reduce specific CHD risk factors have an important role to play in reducing overall CHD mortality. Reducing dietary salt consumption is a potentially cost-effective way to reduce CHD events. This paper presents an economic evaluation of population based salt reduction policies in Tunisia, Syria, Palestine and Turkey. Methods and Findings: Three policies to reduce dietary salt intake were evaluated: a health promotion campaign, labelling of food packaging and mandatory reformulation of salt content in processed food. These were evaluated separately and in combination. Estimates of the effectiveness of salt reduction on blood pressure were based on a literature review. The reduction in mortality was estimated using the IMPACT CHD model specific to that country. Cumulative population health effects were quantified as life years gained (LYG) over a 10 year time frame. The costs of each policy were estimated using evidence from comparable policies and expert opinion including public sector costs and costs to the food industry. Health care costs associated with CHDs were estimated using standardized unit costs. The total cost of implementing each policy was compared against the current baseline (no policy). All costs were calculated using 2010 PPP exchange rates. In all four countries most policies were cost saving compared with the baseline. The combination of all three policies (reducing salt consumption by 30%) resulted in estimated cost savings of $235,000,000 and 6455 LYG in Tunisia; $39,000,000 and 31674 LYG in Syria; $6,000,000 and 2682 LYG in Palestine and $1,3000,000,000 and 378439 LYG in Turkey. Conclusion: Decreasing dietary salt intake will reduce coronary heart disease deaths in the four countries. A comprehensive strategy of health education and food industry actions to label and reduce salt content would save both money and lives. © 2014 Mason et al.
Available Materials
https://efashare.b-cdn.net/share/pmc/articles/PMC3883693/bin/pone.0084445.s001.doc
https://efashare.b-cdn.net/share/pmc/articles/PMC3883693/bin/pone.0084445.s002.docx
https://efashare.b-cdn.net/share/pmc/articles/PMC3883693/bin/pone.0084445.s003.docx
Authors & Co-Authors
Mason, Helen
United Kingdom, Glasgow
Glasgow Caledonian University
Shoaibi, Azza
Palestine, Birzeit
Birzeit University
Ghandour, Rula
Palestine, Birzeit
Birzeit University
O'Flaherty, M. Enrique
United Kingdom, Liverpool
University of Liverpool
Capewell, Simon J.
United Kingdom, Liverpool
University of Liverpool
Khatib, Rana A.
Palestine, Birzeit
Birzeit University
Jabr, Samer
Palestine, Gaza
Ministry of Health Palestine
Ünal, Belgin
Turkey, Inciralti
Dokuz Eylü L University Faculty of Medicine
Turkey, Izmir
Dokuz Eylül Üniversitesi
Sözmen, Kaan M.
Turkey, Izmir
Izmir Provincial Health Directorate
Turkey
Kaan Sözmen Narlidere Community Health Center
Arfa, Chokri
Tunisia, Tunis
Institut National du Travail et Des Etudes Sociales
Tunisia, Tunis
Faculté de Médecine de Tunis
Aissi, Waffa
Tunisia, Tunis
Faculté de Médecine de Tunis
Ben Romdhane, Habiba
Tunisia, Tunis
Faculté de Médecine de Tunis
Fouad, Fouad Mohammad
Syrian Arab Republic, Aleppo
Syrian Center for Tobacco Studies
Al Ali, Radwan
Syrian Arab Republic, Aleppo
Syrian Center for Tobacco Studies
Husseini, Abdullatif S.
Palestine, Birzeit
Birzeit University
Qatar, Doha
Qatar University
Critchley, Julia A.
United Kingdom, Newcastle
Newcastle University
Ahmad, Balsam S.
United Kingdom, Newcastle
Newcastle University
Phillimore, Peter R.
United Kingdom, Newcastle
Newcastle University
Zaman, Shahaduz
United Kingdom, Newcastle
Newcastle University
Dherani, Mukesh K.
United Kingdom, Liverpool
University of Liverpool
Vartjes, Illonca
United Kingdom, Liverpool
University of Liverpool
Netherlands, Utrecht
Universiteit Utrecht
Bennett, K. E.
Ireland, Dublin
Trinity College Dublin
Altun, Deniz
Turkey
Kaan Sözmen Narlidere Community Health Center
Arik, Hale
Turkey
Kaan Sözmen Narlidere Community Health Center
Aslan, Özgür
Turkey
Kaan Sözmen Narlidere Community Health Center
Demiral, Yücel
Turkey
Kaan Sözmen Narlidere Community Health Center
Doganay, Sinem
Turkey
Kaan Sözmen Narlidere Community Health Center
Ergor, Gul
Turkey
Kaan Sözmen Narlidere Community Health Center
Gerçeklioǧlu, Gül
Turkey
Kaan Sözmen Narlidere Community Health Center
Kılıç, Bülent
Turkey
Kaan Sözmen Narlidere Community Health Center
Saatli, Gül
Turkey
Kaan Sözmen Narlidere Community Health Center
Şimşek, Hatice
Turkey
Kaan Sözmen Narlidere Community Health Center
Satman, İlhan
Turkey, Istanbul
İstanbul Tıp Fakültesi
Göǧen, Sibel
Turkey, Samsun
Turkish Ministry of Health
Kalaça, Sibel
Turkey, Istanbul
Marmara Üniversitesi
Elias, Madonna
Syrian Arab Republic, Aleppo
Syrian Center for Tobacco Studies
Rastam, Samer
Syrian Arab Republic, Aleppo
Syrian Center for Tobacco Studies
Soulaiman, Nesrien
Syrian Arab Republic, Aleppo
Syrian Center for Tobacco Studies
Moukeh, Ghmaez
Syrian Arab Republic, Aleppo
Syrian Center for Tobacco Studies
Maziak, Wasim
Syrian Arab Republic, Aleppo
Syrian Center for Tobacco Studies
United States, Miami
Florida International University
Abou Mayaleh, Maher
Syrian Arab Republic
Aga Khan Foundation
Abu-Rmeileh, Niveen M.E.
Palestine, Birzeit
Birzeit University
Jaber, Samer
Palestine, Birzeit
Birzeit University
Khatib, Rasha
Palestine, Birzeit
Birzeit University
Mikki, Nahed
Palestine, Birzeit
Birzeit University
Abu-Kteish, Heidar
Palestine, Gaza
Palestinian Medical Relief Society
Allani, Riadh
Tunisia, Tunis
Faculté de Médecine de Tunis
Beltaïfa, L.
Tunisia, Tunis
Faculté de Médecine de Tunis
Ben Mansour, N.
Tunisia, Tunis
Faculté de Médecine de Tunis
Lassoued, Olfa
Tunisia, Tunis
Faculté de Médecine de Tunis
Saidi, Olfa
Tunisia, Tunis
Faculté de Médecine de Tunis
Tlili, Faten
Tunisia, Tunis
Faculté de Médecine de Tunis
Achour, Nourredinne
Tunisia, Tunis
Institut National de Santé Publique
Ben Salah, Nabil
Tunisia, Tunis
Ministry of Health
Collins, Marissa
United Kingdom, Glasgow
Glasgow Caledonian University
Roglić, Gojka
Switzerland, Geneva
Organisation Mondiale de la Santé
Fadhil, Ibtihal
Egypt, Cairo
Who/emro
Unwin, Nigel C.
Jamaica, Kingston
The University of the West Indies
Statistics
Citations: 80
Authors: 58
Affiliations: 26
Identifiers
Doi:
10.1371/journal.pone.0084445
e-ISSN:
19326203
Research Areas
Food Security
Health System And Policy
Noncommunicable Diseases
Study Design
Cross Sectional Study
Study Approach
Systematic review
Study Locations
Tunisia