Assessing research activity on priority interventions for non-communicable disease prevention in low- and middle-income countries: a bibliometric analysis

Abstract

Introduction: Action is urgently needed to curb the rising rates of non-communicable diseases (NCDs) in low- and middle-income countries (LMICs) and reduce the resulting social and economic burdens. There is global evidence about the most cost-effective interventions for addressing the main NCD risk factors such as tobacco use, unhealthy diets, physical inactivity, and alcohol misuse. However, it is unknown how much research is focused on informing the local adoption and implementation of these interventions.

Objective: To assess the degree of research activity on NCD priority interventions in LMICs by using bibliometric analysis to quantify the number of relevant peer-reviewed scientific publications.

Methods: A multidisciplinary, multi-lingual journal database was searched for articles on NCD priority interventions. The interventions examined emphasise population-wide, policy, regulation, and legislation approaches. The publication timeframe searched was the year 2000-2011. Of the 11,211 articles yielded, 525 met the inclusion criteria.

Results: Over the 12-year period, the number of articles published increased overall but differed substantially between regions: Latin America & Caribbean had the highest (127) and Middle East & North Africa had the lowest (11). Of the risk factor groups, 'tobacco control' led in publications, with 'healthy diets and physical activity' and 'reducing harmful alcohol use' in second and third place. Though half the publications had a first author from a high-income country institutional affiliation, developing country authorship had increased in recent years.

Conclusions: While rising global attention to NCDs has likely produced an increase in peer-reviewed publications on NCDs in LMICs, publication rates directly related to cost-effective interventions are still very low, suggesting either limited local research activity or limited opportunities for LMIC researchers to publish on these issues. More research is needed on high-priority interventions and research funders should re-examine if intervention research is enough of a funding priority.

Fig. 1

Number of included research articles published between 2000 and 2011. Each research article addressed one or more non-communicable disease priority intervention and focused on one or more low- or middle-income country. Results include articles published as of February 13, 2012.

Fig. 2

Percent of articles set in a low- or middle-income country within a particular geographical region. Of the total number of included research articles, the percentage of them (and number) focusing on one or more low- or middle-income country within a particular geographical region. Articles focusing on more than one region are classified as ‘Multiple Regions.’

Fig. 3

Percent of articles on each intervention by risk factor for geographical regions. Of the total number of included research articles, the percentage of them (and number) addressing a non-communicable disease priority intervention. Interventions are grouped in three categories: tobacco control, healthy diets and physical activity, and reducing harmful alcohol use. Articles are organised by geographical region of focus. An article may be classified in more than one intervention type. Articles focusing on countries from more than one region are classified as ‘Multiple Regions.’

Fig. 4

Comparison of country income classification for first authors’ countries of institutional affiliation. For each geographical region of focus, a comparison of the percent of first authors who have an institutional affiliation in a low- or middle-income country versus the percent of first authors with a high-income country institutional affiliation. The number of articles associated with each region is listed.

Annexe 1

The number of included articles by first author's country of institutional affiliation. Articles are grouped by which country the first author's institutional affiliation lists. Countries are organised by income classification (high-income country affiliation or low- or middle-income country affiliation) and then alphabetically.