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Kamvura TT, Dambi JM, Chiriseri E, Turner J, Verhey R, Chibanda D. Barriers to the provision of non-communicable disease care in Zimbabwe: a qualitative study of primary health care nurses. BMC Nurs 2022; 21:64. [PMID: 35303865 PMCID: PMC8932172 DOI: 10.1186/s12912-022-00841-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Accepted: 03/09/2022] [Indexed: 11/10/2022] Open
Abstract
Background Non-communicable diseases (NCDs) contribute significantly to the global disease burden, with low-and middle-income (LMICs) countries disproportionately affected. A significant knowledge gap in NCDs exacerbates the high burden, worsened by perennial health system challenges, including human and financial resources constraints. Primary health care workers play a crucial role in offering health care to most people in LMICs, and their views on the barriers to the provision of quality care for NCDs are critical. This study explored perceived barriers to providing NCDs care in primary health care facilities in Zimbabwe. Methods In-depth, individual semi-structured interviews were conducted with general nurses in primary care facilities until data saturation was reached. We focused on diabetes, hypertension, and depression, the three most common conditions in primary care in Zimbabwe. We used thematic content analysis based on an interview guide developed following a situational analysis of NCDs care in Zimbabwe and views from patients with lived experiences. Results Saturation was reached after interviewing 10 participants from five busy urban clinics. For all three NCDs, we identified four cross-cutting barriers, a) poor access to medication and functional equipment such as blood pressure machines, urinalysis strips; b) high cost of private care; c)poor working conditions; and d) poor awareness from both patients and the community which often resulted in the use of alternative potentially harmful remedies. Participants indicated that empowering communities could be an effective and low-cost approach to positive lifestyle changes and health-seeking behaviours. Participants indicated that the Friendship bench, a task-shifting programme working with trained community grandmothers, could provide a platform to introduce NCDs care at the community level. Also, creating community awareness and initiating screening at a community level through community health workers (CHWs) could reduce the workload on the clinic nursing staff. Conclusion Our findings reflect those from other LMICs, with poor work conditions and resources shortages being salient barriers to optimal NCDs care at the facility level. Zimbabwe's primary health care system faces several challenges that call for exploring ways to alleviate worker fatigue through strengthened community-led care for NCDs. Empowering communities could improve awareness and positive lifestyle changes, thus optimising NCD care. Further, there is a need to optimise NCD care in urban Zimbabwe through a holistic and multisectoral approach to improve working conditions, basic clinical supplies and essential drugs, which are the significant challenges facing the country's health care sector. The Friendship Bench could be an ideal entry point for providing an integrated NCD care package for diabetes, hypertension and depression. Supplementary Information The online version contains supplementary material available at 10.1186/s12912-022-00841-1.
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Affiliation(s)
- Tiny Tinashe Kamvura
- The Friendship Bench, Research Support Centre, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
| | - Jermaine M Dambi
- The Friendship Bench, Rehabilitation Sciences Unit, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Ephraim Chiriseri
- The Friendship Bench, Research Support Centre, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Jean Turner
- The Friendship Bench, Research Support Centre, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Ruth Verhey
- The Friendship Bench, Research Support Centre, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Dixon Chibanda
- The Friendship Bench, Research Support Centre, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
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Alwan NAS, Lami F, Khaleel HA, Alhilfi RA. Impact of COVID-19 on Affected Individuals in Iraq Focusing on Deceased Cancer Patients. JCO Glob Oncol 2022; 8:e2200001. [PMID: 35298294 PMCID: PMC8955141 DOI: 10.1200/go.22.00001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Mortality because of COVID-19 infections is continuously increasing among the high-risk groups, namely, elderly patients and those with underlying comorbidities including cardiovascular diseases, diabetes, respiratory problems, and cancer. The study aimed to assess the impact of COVID-19 on affected individuals in Iraq, focusing on the characteristics of COVID-19 deceased cases, with special emphasis on cancer as the associated comorbidity. About 70% of patients who died from COVID-19 infection in Iraq had associated comorbidities. Those with history of cancer were younger and spent significantly longer duration in the hospital.![]()
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Affiliation(s)
- Nada A S Alwan
- National Cancer Research Center, University of Baghdad, Baghdad, Iraq
| | - Faris Lami
- College of Medicine, University of Baghdad, Baghdad, Iraq
| | - Hanan A Khaleel
- Public Health Directorate, Ministry of Health, Baghdad, Iraq
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Ekoh PC, Chukwemeka E, Ezulike CD, George EO, Egbo IE, Agbawodikeizu PU, Anthony IO, Nnebe I. Ageing and Health in Africa: Assessing how low- and Middle-class Older Adults with Chronic Illnesses Navigate the Problem of Counterfeit Drugs in Nigeria. JOURNAL OF POPULATION AGEING 2022. [DOI: 10.1007/s12062-022-09363-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Motuma A, Demissie Regassa L, Gobena T, Teji Roba K, Berhane Y, Worku A. Almost all working adults have at least one risk factor for non-communicable diseases: Survey of working adults in Eastern Ethiopia. PLoS One 2022; 17:e0264698. [PMID: 35226698 PMCID: PMC8884490 DOI: 10.1371/journal.pone.0264698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 02/15/2022] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION The disease burden and mortality related to Non-communicable Diseases (NCD) increased in the last couple of decades in Ethiopia. As a result, an estimated 300,000 deaths per annum were due to NCD. According to a World Health Organization report, 39% of the total deaths in Ethiopia were attributable to NCD. Rapid urbanization characterized by unhealthy lifestyles such as tobacco and/or alcohol use, physical inactivity, low fruits and vegetable consumption, and overweight drive the rising burden of NCD. However, studies on risk factors for NCD and associated variables are limited among working adults in Eastern Ethiopia. Therefore, this study aimed to examine the magnitude of the risk factors of NCD and associated factors among working adults in Eastern Ethiopia. METHODS A cross-sectional study was carried out among 1,200 working adults in Eastern Ethiopia that were selected using a simple random sampling technique from December 2018 to February 2019. Data were collected following the World Health Organization Stepwise Approach to NCD Risk Factor Surveillance (WHO STEP) instruments translated into the local language. A total of five risk factors were included in the study. The Negative Binomial Regression Model was used to determine the association between NCD risk factor scores and other independent variables. Adjusted incidence rate ratio (AIRR) with a 95% Confidence Interval (CI) was used to report the findings while the association was declared significant at a p-value of less than 0.05. STATA version 16.1 was used for data clearing, validating and statistical analysis. RESULTS Totally, 1,164 (97% response rate) participants were employed for analysis. Overall, 95.8% (95% CI: 94.4-96.7%) of the participants had at least one of the five risk factors of NCD. Furthermore, the proportion of participants that had all NCD risk factors was 0.3%. Among the participants, 47.5% were alcohol drinkers, 5.1% were current smokers, 35.5% were overweight, 49.1% exercise low physical activity, and 95% had less than five portions of fruits and vegetables intake per day. Higher risk factor scores were associated with those of advanced age (AIRR = 1.24; 95% CI: 1.01-1.53 in 35-44 age group and AIRR = 1.28; 95% CI: 1.01-1.62 in 45-54 age group), and the ones who are higher educational level (AIRR = 1.23; 95% CI: 1.07-1.43 for those who have completed secondary school and AIRR = 1.29; 95% CI: 1.11-1.50 for those who have completed college education). CONCLUSION The overwhelming majority (95.8%) of the participants had at least one risk factor for non-communicable diseases. The risk score of non-communicable diseases was higher among those with advanced age and who completed secondary and above levels of education. In a nutshell, the finding shows the need for lifestyle modification and comprehensive non-communicable diseases prevention programs for working adults in Eastern Ethiopia.
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Affiliation(s)
- Aboma Motuma
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Lemma Demissie Regassa
- Epidemiology and Biostatistics Department, School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tesfaye Gobena
- Department of Environmental Health Science, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Kedir Teji Roba
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Yemane Berhane
- Department of Epidemiology and Biostatics, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | - Alemayehu Worku
- Department of Epidemiology and Biostatistics, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
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Koelmel JP, Lin EZ, DeLay K, Williams AJ, Zhou Y, Bornman R, Obida M, Chevrier J, Godri Pollitt KJ. Assessing the External Exposome Using Wearable Passive Samplers and High-Resolution Mass Spectrometry among South African Children Participating in the VHEMBE Study. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2022; 56:2191-2203. [PMID: 35089017 DOI: 10.1021/acs.est.1c06481] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Children in low- and middle-income countries are often exposed to higher levels of chemicals and are more vulnerable to the health effects of air pollution. Little is known about the diversity, toxicity, and dynamics of airborne chemical exposures at the molecular level. We developed a workflow employing state-of-the-art wearable passive sampling technology coupled with high-resolution mass spectrometry to comprehensively measure 147 children's personal exposures to airborne chemicals in Limpopo, South Africa, as part of the Venda Health Examination of Mothers, Babies, and Their Environment (VHEMBE). 637 environmental exposures were detected, many of which have never been measured in this population; of these 50 airborne chemical exposures of concern were detected, including pesticides, plasticizers, organophosphates, dyes, combustion products, and perfumes. Biocides detected in wristbands included p,p'-dichlorodiphenyltrichloroethane (p,p'-DDT), p,p'-dichlorodiphenyldichloroethane (p,p'-DDD), p,p'-dichlorodiphenyldichloroethylene (p,p'-DDE), propoxur, piperonyl butoxide, and triclosan. Exposures differed across the assessment period with 27% of detected chemicals observed to be either higher or lower in the wet or dry seasons.
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Affiliation(s)
- Jeremy P Koelmel
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, Connecticut 06520, United States
| | - Elizabeth Z Lin
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, Connecticut 06520, United States
| | - Kayley DeLay
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, Connecticut 06520, United States
| | - Antony J Williams
- Center for Computational Toxicology and Exposure, Office of Research and Development, United States Environmental Protection Agency, Research Triangle Park, North Carolina 27711, United States
| | - Yakun Zhou
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, Connecticut 06520, United States
| | - Riana Bornman
- University of Pretoria Institute for Sustainable Malaria Control and School of Health Systems and Public Health, University of Pretoria, Pretoria 0028, South Africa
| | - Muvhulawa Obida
- University of Pretoria Institute for Sustainable Malaria Control and School of Health Systems and Public Health, University of Pretoria, Pretoria 0028, South Africa
| | - Jonathan Chevrier
- Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montréal, Québec H3A 1A2, Canada
| | - Krystal J Godri Pollitt
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, Connecticut 06520, United States
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Yaya S, Anjorin S, Okolie EA. Obesity burden by socioeconomic measures between 2000 and 2018 among women in sub‐Saharan Africa: A cross‐sectional analysis of demographic and health surveys. Obes Sci Pract 2022; 8:617-626. [PMID: 36238218 PMCID: PMC9535666 DOI: 10.1002/osp4.595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 12/21/2021] [Accepted: 01/30/2022] [Indexed: 11/05/2022] Open
Affiliation(s)
- Sanni Yaya
- Faculty of Medicine University of Parakou Parakou Benin
| | - Seun Anjorin
- Warwick Centre for Global Health Division of Health Sciences Warwick Medical School University of Warwick Coventry West Midlands UK
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108
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Effects of the nutritional interventions in improving employee’s cardiometabolic risk factors in the workplace: A systematic review. CLINICAL NUTRITION OPEN SCIENCE 2022. [DOI: 10.1016/j.nutos.2022.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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109
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Xiang L, Deng K, Mei Q, Gao Z, Yang T, Wang A, Fernandez J, Gu Y. Population and Age-Based Cardiorespiratory Fitness Level Investigation and Automatic Prediction. Front Cardiovasc Med 2022; 8:758589. [PMID: 35071342 PMCID: PMC8767158 DOI: 10.3389/fcvm.2021.758589] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Accepted: 12/07/2021] [Indexed: 01/22/2023] Open
Abstract
Maximal oxygen consumption (VO2max) reflects aerobic capacity and is crucial for assessing cardiorespiratory fitness and physical activity level. The purpose of this study was to classify and predict the population-based cardiorespiratory fitness based on anthropometric parameters, workload, and steady-state heart rate (HR) of the submaximal exercise test. Five hundred and seventeen participants were recruited into this study. This study initially classified aerobic capacity followed by VO2max predicted using an ordinary least squares regression model with measured VO2max from a submaximal cycle test as ground truth. Furthermore, we predicted VO2max in the age ranges 21–40 and above 40. For the support vector classification model, the test accuracy was 75%. The ordinary least squares regression model showed the coefficient of determination (R2) between measured and predicted VO2max was 0.83, mean absolute error (MAE) and root mean square error (RMSE) were 3.12 and 4.24 ml/kg/min, respectively. R2 in the age 21–40 and above 40 groups were 0.85 and 0.75, respectively. In conclusion, this study provides a practical protocol for estimating cardiorespiratory fitness of an individual in large populations. An applicable submaximal test for population-based cohorts could evaluate physical activity levels and provide exercise recommendations.
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Affiliation(s)
- Liangliang Xiang
- Faculty of Sports Science, Ningbo University, Ningbo, China.,Research Academy of Grand Health, Ningbo University, Ningbo, China.,Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
| | - Kaili Deng
- Medical School, Ningbo University, Ningbo, China
| | - Qichang Mei
- Faculty of Sports Science, Ningbo University, Ningbo, China.,Research Academy of Grand Health, Ningbo University, Ningbo, China.,Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
| | - Zixiang Gao
- Faculty of Sports Science, Ningbo University, Ningbo, China.,Research Academy of Grand Health, Ningbo University, Ningbo, China
| | - Tao Yang
- Faculty of Sports Science, Ningbo University, Ningbo, China.,Research Academy of Grand Health, Ningbo University, Ningbo, China
| | - Alan Wang
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand.,Faculty of Medicine and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Justin Fernandez
- Research Academy of Grand Health, Ningbo University, Ningbo, China.,Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand.,Department of Engineering Science, The University of Auckland, Auckland, New Zealand
| | - Yaodong Gu
- Faculty of Sports Science, Ningbo University, Ningbo, China.,Research Academy of Grand Health, Ningbo University, Ningbo, China.,Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
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Zamorano P, Muñoz P, Espinoza M, Tellez A, Varela T, Suarez F, Fernandez MJ. Impact of a high-risk multimorbidity integrated care implemented at the public health system in Chile. PLoS One 2022; 17:e0261953. [PMID: 35030178 PMCID: PMC8759679 DOI: 10.1371/journal.pone.0261953] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 12/14/2021] [Indexed: 01/16/2023] Open
Abstract
During recent years, multimorbidity has taken relevance because of the impact of causes in the system, people, and their families, which has been a priority in the health care plan. Interventions strategies and their implementation are still an emerging topic. In this context, Centro de Innovación en Salud ANCORA UC, together with Servicio de Salud Metropolitano Sur Oriente, implemented as a pilot study High-Risk Multimorbidity Integrated Care strategy. This study aimed to evaluate the impact of this strategy in terms of health services utilization and mortality. A cohort study was conducted with high-risk patients with multimorbidity, stratified by ACG®, intervened between April 2017 and December 2019. The studied population was 3,933 patients who belonged to similar size and location primary care centers. The impact analysis was performed used generalized linear models. Results showed that intervened patients had a significantly lower incidence in mortality (OR 0.56; 95% CI 0.40–0.77), hospital admissions, length of stay, and the number of hospital emergency consultancies. With the proper barriers and facilitators of a real context intervention, the implementation process allowed the systematization and consolidation of the intervention provided in this study. The training for new roles and the constant implementation support from the Centro de Innovación en Salud ANCORA UC team were essential in the progress and success of the intervention. A complete description of the high-risk intervention strategy is provided to contribute to this emerging topic and facilitate its scale-up. We can conclude that this complex intervention was feasible to be implemented in a real context. The Ministry of Health has taken the systematization and consolidation of the conditions for the national scale-up.
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Affiliation(s)
- Paula Zamorano
- Centro de Innovación en Salud ANCORA UC, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Health Technology Assessment Unit, Center of Clinical Research, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Paulina Muñoz
- Centro de Innovación en Salud ANCORA UC, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Manuel Espinoza
- Health Technology Assessment Unit, Center of Clinical Research, Pontificia Universidad Católica de Chile, Santiago, Chile
- Department of Public health, Pontificia Universidad Católica de Chile, Santiago, Chile
- * E-mail:
| | - Alvaro Tellez
- Centro de Innovación en Salud ANCORA UC, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Teresita Varela
- Centro de Innovación en Salud ANCORA UC, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Francisco Suarez
- Analysis and Management of Health Information Unit, Servicio de Salud Metropolitano Sur Oriente, Metropolitana, Chile
| | - Maria Jose Fernandez
- Development and management of Patient-Centered care strategies Unit, Servicio de Salud Metropolitano Sur Oriente, Metropolitana, Chile
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Wachira LJ, Arena R, Sallis JF, Lambert EV, Ong'wen OM, Laddu DR, Onywera V, Oyeyemi AL. Why are COVID-19 effects less severe in Sub-Saharan Africa? Moving more and sitting less may be a primary reason. Prog Cardiovasc Dis 2022; 71:103-105. [PMID: 35487264 PMCID: PMC9042414 DOI: 10.1016/j.pcad.2022.04.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Lucy-Joy Wachira
- Dept. of Physical Education and Exercise Science, School of Public Health and Applied Human Sciences, Kenyatta University, Nairobi, Kenya.
| | - Ross Arena
- Department of Physical Therapy, College of Applied Science, University of Illinois, Chicago, IL, United States of America; Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, United States of America.
| | - James F Sallis
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, United States of America; Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
| | - Estelle V Lambert
- Research Centre for Health through Physical Activity, Lifestyle and Sport (HPALS), Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | | | - Deepika R Laddu
- Department of Physical Therapy, College of Applied Science, University of Illinois, Chicago, IL, United States of America; Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, United States of America
| | - Vincent Onywera
- Dept. of Physical Education and Exercise Science, School of Public Health and Applied Human Sciences, Kenyatta University, Nairobi, Kenya
| | - Adewale L Oyeyemi
- Department of Physiotherapy, University of Maiduguri, P.M.B 1069, Maiduguri, Borno State, Nigeria
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Graf A, Konou AA, Meier L, Brattig NW, Utzinger J. More than seven decades of Acta Tropica: Partnership to advance the 2030 Agenda for Sustainable Development. Acta Trop 2022; 225:106175. [PMID: 34627762 DOI: 10.1016/j.actatropica.2021.106175] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 09/14/2021] [Accepted: 10/02/2021] [Indexed: 12/17/2022]
Abstract
The inaugural issue of Acta Tropica has been published in 1944, at a time of utmost international isolation and uncertainty due to World War II. Now, more than seven decades later, Acta Tropica is a trusted outlet to communicate and disseminate scientific advances in the fields of parasitology and tropical medicine. As a scholarly, peer-reviewed journal, Acta Tropica contributes to the 2030 Agenda for Sustainable Development, particularly the Sustainable Development Goal (SDG) 3, that is "Ensure healthy lives and promote well-being for all of all ages". This article explores how Acta Tropica has evolved over time. Our analysis is based on a systematic review of keywords derived from all issues published in a specific year, arbitrarily selected at decadal snapshots (1950, 1960, 1970, 1980, 1990, 2000, 2010, and 2020). Results indicate a decrease in interdisciplinarity in favour of more specialised expertise in various fields of infectious diseases research and public health with a particular emphasis on low- and middle-income countries. Yet, by examining first and last authors' institutional affiliations and classifying countries by the Human Development Index (HDI), we find that most authors are affiliated with institutions in high- and very high-HDI countries. Over time, the mean number of authors on a paper has increased severalfold (from 1.35 in 1950 to 7.51 in 2020). Taken together, Acta Tropica has become increasingly globally anchored and contributes not only to SDG 3, but increasingly also to SDG 17, that is "Revitalize the global partnership for sustainable development".
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Maniki PT, Khan R, Orchard A, De Rapper S, Padayachee N. Promoting the use of point of care testing in non-communicable disease screening among university students. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2022. [DOI: 10.1016/j.ijans.2022.100446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Denekew TW, Gautam Y, Bhandari D, Gautam GP, Sherchand JB, Pokhrel AK, Jha AR. Prevalence and determinants of hypertension in underrepresented indigenous populations of Nepal. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000133. [PMID: 36962278 PMCID: PMC10021878 DOI: 10.1371/journal.pgph.0000133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 11/29/2021] [Indexed: 11/19/2022]
Abstract
Indigenous populations residing in low- and middle-income countries (LMICs) are highly underrepresented in medicine and public health research. Specifically, data on non-communicable diseases (NCDs) from indigenous populations remains scarce. Despite the increasing burden of NCDs in the Himalayan region, their prevalence in many indigenous populations remains understudied. The nationally representative public health surveys often do not include the indigenous communities, especially those that reside in rural areas or exist in small numbers. This observational cross-sectional survey study aimed to assess the prevalence of three NCD risk factors namely obesity, hypertension, and tachycardia and identify dietary and lifestyle variables associated with them across underrepresented indigenous populations of Nepal. A total of 311 individuals (53.3% women, 46.7% men) with mean age 43±15 years from 12 indigenous Nepali communities residing in rural (47.9%) or semi-urban (52.1%) areas volunteered to participate in this study. Univariate tests and multivariable logistic regressions were used to analyze the survey data. The mean systolic and diastolic blood pressures were 121.3±19.5 mmHg and 81.3±11.8 mmHg respectively. Overall, the prevalence of obesity and tachycardia was low (0.64% and 3.22%, respectively) but hypertension was prevalent at 23.8%. Hypertension was not significantly different across populations, but it was associated with age, BMI, and tobacco use, and collectively, these variables explained 13.9% variation in hypertension prevalence. Although we were unable to detect direct associations between individual determinants of hypertension identified in non-indigenous Nepalis, such as education levels, alcohol consumption, and smoking in this study, having one or more determinants increased the odds of hypertension in the indigenous participants. Furthermore, ~14% of the hypertensive individuals had none of the universally identified hypertension risk factors. The lack of association between previously identified risk factors for hypertension in these individuals indicates that the additional determinants of hypertension remain to be identified in indigenous Nepali populations.
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Affiliation(s)
- Tsedenia Workneh Denekew
- Genetic Heritage Group, Program in Biology, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Yoshina Gautam
- Genetic Heritage Group, Program in Biology, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
- Himalayan Diversity Project, Department of Biomedical Data Science, Stanford University, Stanford, Palo Alto, United States of America
| | - Dinesh Bhandari
- School of Public Health, University of Adelaide, Adelaide, Australia
- Public Health Research Lab, Tribhuvan University Institute of Medicine, Maharajgunj, Nepal
| | | | | | - Amod K Pokhrel
- Society for Legal and Environmental Analysis and Development Research, Kathmandu, Nepal
- On-Campus/On-Line MPH program, School of Public Health, University of California, Berkeley, CA, United States of America
| | - Aashish R Jha
- Genetic Heritage Group, Program in Biology, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
- Himalayan Diversity Project, Department of Biomedical Data Science, Stanford University, Stanford, Palo Alto, United States of America
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Asadi-Lari M, Ahmadi Teymourlouy A, Maleki M, Eslambolchi L, Afshari M. Challenges and opportunities for Iranian global health diplomacy: lessons learned from action for prevention and control of noncommunicable diseases. Health Res Policy Syst 2021; 19:152. [PMID: 34952614 PMCID: PMC8703215 DOI: 10.1186/s12961-021-00800-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 12/03/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The steady rise in noncommunicable diseases (NCDs) worldwide has been a key global health challenge. Governments have the primary responsibility for taking action to prevent and control NCDs. Given the growing importance of globalization of healthcare as well as the increasing use of soft power, governments need to identify challenges and opportunities to enhance global health diplomacy (GHD) for NCD prevention and control. The purpose of this qualitative research was to explain the challenges and opportunities of GHD for NCDs in Iran. METHODS This study was conducted in 2020 using a qualitative approach and through in-depth, semi-structured interviews with 21 experts and specialists in related fields such as health policy, healthcare management, epidemiology and other related specialties. The participants were selected from all levels of diplomacy, including global, regional and national levels, with at least 3 years of experience in managerial, executive and scientific activities. Data analysis was performed by content analysis with an inductive approach. Data were analysed using inductive content analysis. RESULTS The identified challenges were categorized into five main themes, including content challenges, structural challenges, process challenges, governance challenges and cultural challenges. Opportunities extracted from the interviews were also categorized into four main themes, including strong political will, utilizing the capacity of nongovernmental organizations (NGOs), multisectoral collaborations and a well-developed health system. CONCLUSIONS NCD prevention and control requires a multilateral collaboration-based solution. Recognition of the challenges and opportunities in GHD can help draw significant lessons for building the necessary capacities and implementing more effective policies to prevent and control NCDs.
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Affiliation(s)
- Mohsen Asadi-Lari
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Ahmad Ahmadi Teymourlouy
- Department of Health Service Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Maleki
- Department of Health Service Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Leila Eslambolchi
- Health Management and Economics Department, School of Public Health, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Mahnaz Afshari
- Department of Health Service Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran. .,Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran.
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Etando A, Amu AA, Haque M, Schellack N, Kurdi A, Alrasheedy AA, Timoney A, Mwita JC, Rwegerera GM, Patrick O, Niba LL, Boahen-Boaten BB, Tabi FB, Amu OY, Acolatse J, Incoom R, Sefah IA, Guantai AN, Opanga S, Chikowe I, Khuluza F, Kibuule D, Kalemeera F, Hango E, Lates J, Fadare J, Ogunleye OO, Saleem Z, Oosthuizen F, Cordier W, Matlala M, Meyer JC, Schellack G, Massele A, Malande OO, Kalungia AC, Sichone J, Banda SS, Zaranyika T, Campbell S, Godman B. Challenges and Innovations Brought about by the COVID-19 Pandemic Regarding Medical and Pharmacy Education Especially in Africa and Implications for the Future. Healthcare (Basel) 2021; 9:1722. [PMID: 34946448 PMCID: PMC8701006 DOI: 10.3390/healthcare9121722] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 11/19/2021] [Accepted: 12/02/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Multiple measures introduced early to restrict COVID-19 have dramatically impacted the teaching of medical and pharmacy students, exacerbated by the lack of infrastructure and experience with e-learning at the start of the pandemic. In addition, the costs and reliability of the Internet across Africa pose challenges alongside undertaking clinical teaching and practical programmes. Consequently, there is a need to understand the many challenges and how these were addressed, given increasingly complex patients, to provide future direction. METHOD An exploratory study was conducted among senior-level medical and pharmacy educators across Africa, addressing four key questions, including the challenges resulting from the pandemic and how these were dealt with. RESULTS Staff and student members faced multiple challenges initially, including adapting to online learning. In addition, concerns with the lack of equipment (especially among disadvantaged students), the costs of Internet bundles, and how to conduct practicals and clinical teaching. Multiple activities were undertaken to address these challenges. These included training sessions, developing innovative approaches to teaching, and seeking ways to reduce Internet costs. Robust approaches to practicals, clinical teaching, and assessments have been developed. CONCLUSIONS Appreciable difficulties to teaching arising from the pandemic are being addressed across Africa. Research is ongoing to improve education and assessments.
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Affiliation(s)
- Ayukafangha Etando
- Department of Medical Laboratory Sciences, Faculty of Health Sciences, Eswatini Medical Christian University, P.O. Box A624, Swazi Plaza, Mbabane H100, Eswatini
| | - Adefolarin A Amu
- Department of Pharmacy, Faculty of Health Sciences, Eswatini Medical Christian University, P.O. Box A624, Swazi Plaza, Mbabane H100, Eswatini
| | - Mainul Haque
- Unit of Pharmacology, Faculty of Medicine and Defence Health, Universiti Pertahanan Nasional Malaysia (National Defence University of Malaysia), Kem Perdana Sungai, Besi, Kuala Lumpur 57000, Malaysia
| | - Natalie Schellack
- Department of Pharmacology, Faculty of Health Sciences, Basic Medical Sciences Building, Prinshof Campus, University of Pretoria, Arcadia 0083, South Africa
| | - Amanj Kurdi
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow G4 0RE, UK
- Division of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Garankuwa, Pretoria 0208, South Africa
- Department of Pharmacology, College of Pharmacy, Hawler Medical University, P.O. Box 178, Erbil 44001, Iraq
| | - Alian A Alrasheedy
- Department of Pharmacy Practice, College of Pharmacy, Qassim University, Buraidah, Qassim 51452, Saudi Arabia
| | - Angela Timoney
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow G4 0RE, UK
- Chair SIGN Council, Healthcare Improvement Scotland, Edinburgh EH12 9EB, UK
| | - Julius C Mwita
- Department of Internal Medicine, Faculty of Medicine, University of Botswana, Gaborone, Botswana
| | | | - Okwen Patrick
- Effective Basic Services (eBASE) Africa, Ndamukong Street, Bamenda, Cameroon
- Adelaide University, Adelaide 5005, Australia
| | - Loveline Lum Niba
- Effective Basic Services (eBASE) Africa, Ndamukong Street, Bamenda, Cameroon
- Department of Public Health, University of Bamenda, P.O. Box 39, Bambili, Cameroon
| | - Baffour Boaten Boahen-Boaten
- Department of Psychology, Faculty of Applied Social Sciences, Eswatini Medical Christian University, P.O. Box A624, Swazi Plaza, Mbabane H100, Eswatini
| | - Felicity Besong Tabi
- Department of Social Work, Faculty of Applied Social Sciences, Eswatini Medical Christian University, P.O. Box A624, Swazi Plaza, Mbabane H100, Eswatini
| | - Olufunke Y Amu
- Department of Social Work, Faculty of Applied Social Sciences, Eswatini Medical Christian University, P.O. Box A624, Swazi Plaza, Mbabane H100, Eswatini
| | - Joseph Acolatse
- Pharmacy Directorate, Cape Coast Teaching Hospital (CCTH), Cape Coast, Ghana
| | - Robert Incoom
- Pharmacy Directorate, Cape Coast Teaching Hospital (CCTH), Cape Coast, Ghana
| | - Israel Abebrese Sefah
- Pharmacy Practice Department of Pharmacy Practice, School of Pharmacy, University of Health and Allied Sciences, Volta Region, Ghana
| | - Anastasia Nkatha Guantai
- Department of Pharmacology & Pharmacognosy, School of Pharmacy, University of Nairobi, P.O. Box 19676-00202 KNH, Nairobi 00200, Kenya
| | - Sylvia Opanga
- Department of Pharmaceutics and Pharmacy Practice, School of Pharmacy, University of Nairobi, P.O. Box 19676-00202 KNH, Nairobi 00200, Kenya
| | - Ibrahim Chikowe
- Pharmacy Department, Kamuzu University of Health Sciences (KUHeS), Blantyre, Malawi
| | - Felix Khuluza
- Pharmacy Department, Kamuzu University of Health Sciences (KUHeS), Blantyre, Malawi
| | - Dan Kibuule
- Department of Pharmacy Practice and Policy, Faculty of Health Sciences and Veterinary Medicine, University of Namibia, Windhoek 10000, Namibia
| | - Francis Kalemeera
- Department of Pharmacy Practice and Policy, Faculty of Health Sciences and Veterinary Medicine, University of Namibia, Windhoek 10000, Namibia
| | - Ester Hango
- Department of Pharmacy Practice and Policy, Faculty of Health Sciences and Veterinary Medicine, University of Namibia, Windhoek 10000, Namibia
| | - Jennie Lates
- Department of Pharmacy Practice and Policy, Faculty of Health Sciences and Veterinary Medicine, University of Namibia, Windhoek 10000, Namibia
| | - Joseph Fadare
- Department of Pharmacology and Therapeutics, Ekiti State University, Ado-Ekiti 362001, Nigeria
- Department of Medicine, Ekiti State University Teaching Hospital, Ado-Ekiti 362001, Nigeria
| | - Olayinka O Ogunleye
- Department of Pharmacology, Therapeutics and Toxicology, College of Medicine, Lagos State University, Ikeja, Lagos 21266, Nigeria
- Department of Medicine, Lagos State University Teaching Hospital, Ikeja, Lagos 101233, Nigeria
| | - Zikria Saleem
- Faculty of Pharmacy, The University of Lahore, Lahore 54000, Pakistan
| | - Frasia Oosthuizen
- Discipline of Pharmaceutical Sciences, School of Health Sciences, University of KwaZulu-Natal, Durban 4041, South Africa
| | - Werner Cordier
- Department of Pharmacology, Faculty of Health Sciences, Basic Medical Sciences Building, Prinshof Campus, University of Pretoria, Arcadia 0083, South Africa
| | - Moliehi Matlala
- Division of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Garankuwa, Pretoria 0208, South Africa
| | - Johanna C Meyer
- Division of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Garankuwa, Pretoria 0208, South Africa
| | | | - Amos Massele
- Hurbert Kairuki Memorial University, 70 Chwaku Road Mikocheni, Dar Es Salaam, Tanzania
| | - Oliver Ombeva Malande
- Department of Child Health and Paediatrics, Egerton University, Nakuru, Kenya
- East Africa Centre for Vaccines and Immunization (ECAVI), Namela House, Kampala, Uganda
| | | | - James Sichone
- Department of Biomedical Sciences, University of Zambia, Lusaka, Zambia
| | - Sekelani S Banda
- Department of Medical Education Development, University of Zambia, Lusaka, Zambia
| | - Trust Zaranyika
- Department of Medicine, University of Zimbabwe College of Health Sciences, Harare, Zimbabwe
| | - Stephen Campbell
- Centre for Primary Care and Health Services Research, School of Health Sciences, University of Manchester, Manchester M13 9PL, UK
- NIHR Greater Manchester Patient Safety Translational Research Centre, School of Health Sciences, University of Manchester, Manchester M13 9PL, UK
| | - Brian Godman
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow G4 0RE, UK
- Division of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Garankuwa, Pretoria 0208, South Africa
- Centre of Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman 20550, United Arab Emirates
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117
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Hoffman RM, Chibwana F, Kahn D, Banda BA, Phiri L, Chimombo M, Kussen C, Sigauke H, Moses A, van Oosterhout JJ, Phiri S, Currier JW, Currier JS, Moucheraud C. High Rates of Uncontrolled Blood Pressure in Malawian Adults Living with HIV and Hypertension. Glob Heart 2021; 16:81. [PMID: 34909372 PMCID: PMC8663744 DOI: 10.5334/gh.1081] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 10/29/2021] [Indexed: 01/15/2023] Open
Abstract
Background Hypertension is among the most commonly diagnosed non-communicable diseases in Africa, and studies have demonstrated a high prevalence of hypertension among individuals with HIV. Despite high prevalence, there has been limited attention on the clinical outcomes of hypertension treatment in this population. Objective We sought to characterize rates of and factors associated with blood pressure control over one year among individuals on antiretroviral therapy (ART) and antihypertensive medications. Methods We performed a prospective observational cohort study at an HIV clinic in Malawi. We defined uncontrolled hypertension as a systolic blood pressure ≥140 mm Hg and/or diastolic blood pressure ≥90 mm Hg at two or more follow-up visits during the year, while controlled hypertension was defined as <140 mm Hg systolic and <90 mm Hg diastolic at all visits, or at all but one visit. We calculated an antihypertensive non-adherence score based on self-report of missed doses at each visit (higher score = worse adherence) and used rank sum and chi-square tests to compare sociodemographic and clinical factors (including adherence) associated with blood pressure control over the year. Results At study entry, 158 participants (23.5%) were on antihypertensive medication; participants had a median age of 51.0 years, were 66.5% female, and had a median of 6.9 years on ART. 19.0% (n = 30) achieved blood pressure control over the year of follow-up. Self-reported non-adherence to hypertension medications was the only factor significantly associated with uncontrolled blood pressure. The average non-adherence score for those with controlled blood pressure was 0.22, and for those with uncontrolled blood pressure was 0.61 (p = 0.009). Conclusions Adults living with HIV and hypertension in our cohort had low rates of blood pressure control over one year associated with self-reported non-adherence to antihypertensive medications. Given the high prevalence and incidence of hypertension, interventions to improve blood pressure control are needed to prevent associated long-term cardio- and cerebrovascular morbidity and mortality.
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Affiliation(s)
- Risa M. Hoffman
- Department of Medicine and Division of Infectious Diseases, David Geffen School of Medicine at the University of California, Los Angeles, California, US
| | | | - Daniel Kahn
- Department of Medicine, David Geffen School of Medicine at the University of California, Los Angeles, California, US
| | | | | | | | | | | | | | | | | | - Jesse W. Currier
- Department of Medicine, Division of Cardiology, David Geffen School of Medicine at the University of California, Los Angeles, California, US
| | - Judith S. Currier
- Department of Medicine and Division of Infectious Diseases, David Geffen School of Medicine at the University of California, Los Angeles, California, US
| | - Corrina Moucheraud
- Department of Health Policy and Management, Fielding School of Public Health at the University of California, Los Angeles, California, US
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118
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Xulu-Kasaba ZN, Kalinda C. Prevalence of blindness and its major causes in sub-Saharan Africa in 2020: A systematic review and meta-analysis. BRITISH JOURNAL OF VISUAL IMPAIRMENT 2021. [DOI: 10.1177/02646196211055924] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Background: Global studies show that the prevalence of visual impairment and blindness continued to rise despite the implementation of strategies outlined in the Global Action Plan, aimed at reducing these by the year 2020. Vision impairment impacts negatively on one’s independence, opportunities, and quality of life. Therefore, knowledge of the prevalence, and the major causes of blindness impairment in any population, is vital in designing strategies to address this public health challenge. Methods: Literature mapping evidence of vision impairment was searched for on PubMed, Google Scholar, and EBSCOhost databases MEDLINE, Health Source: Nursing/Academic Edition, Health Source – Consumer Edition, CINAHL, and Academic Search Complete. Studies that were searched for included peer-reviewed and grey literature published in English from various countries in sub-Saharan Africa (SSA). Results: Only 77 studies with 191,173 participants, contributing data from 26 countries within SSA, met the inclusion criteria for the final review. The overall pooled prevalence estimate (PPE) of blindness from the selected studies was 10% (95% confidence interval [CI]: 8.0% – 11.0%). West Africa and East Africa had the highest prevalence. The identified leading causes of blindness were cataracts (46%; 95% CI: 40% – 52%), followed by glaucoma (14%; 95% CI: 11% – 18%). There was a high level of heterogeneity in most pooled estimates (I2 ˃ 80%, p < .001). Conclusion: The prevalence of blindness in SSA has increased in all four regions with most cases being avoidable. Policymakers should prioritise blindness prevention programmes, ensure enabling health systems, and provide the necessary resources towards reducing blindness in SSA.
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Affiliation(s)
| | - Chester Kalinda
- University of Global Health Equity (UGHE), Bill and Joyce Cummings Institute of Global Health, Kigali, Rwanda
- University of KwaZulu-Natal, South Africa
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119
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Aslam MZ, Trail M, Cassell AK, Khan AB, Payne S. Establishing a sustainable healthcare environment in low- and middle-income countries. BJU Int 2021; 129:134-142. [PMID: 34837300 DOI: 10.1111/bju.15659] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The dynamics of disease prevalence and healthcare systems continue to change dramatically in low- and middle-income countries (LMICs). This is a result of multiple factors including the demands of an ageing population in the context of increasing life expectancy and the rise of non-communicable diseases putting an additional burden on an already weak healthcare system. Further healthcare deficiency is attributable to additional factors such as low financial budgets, political conflicts and civil war, as well as continuing burden of communicable diseases, which are known to be the major risk to health in LMICs. Surgical needs largely remain unmet despite a Lancet report published in 2015. Various deficient aspects of healthcare systems need to be addressed immediately to provide any hope of creating a sustainable healthcare environment in the coming decades. These include developing strong primary and secondary care structures as well as strengthening tertiary care hospitals with an adequately trained healthcare workforce. The facilities required to improve patients' access to healthcare cannot be developed and sustained solely within the local budget allocation and require major input from international organizations such as the World Bank and the World Health Organization as well as a chain of donor networks. To create and retain a local healthcare workforce, improved training and living conditions and greater financial security need to be provided. Finally, healthcare economics need to be addressed with financial models that can provide insurance and security to the underprivileged population to achieve universal health coverage, which remains the goal of several global organizations promoting equity in high-standard healthcare provision.
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Affiliation(s)
- Muhammad Z Aslam
- UROLINK, British Association of Urological Surgeons, UK.,London School of Hygiene and Tropical Medicine, London, UK
| | - Matthew Trail
- UROLINK, British Association of Urological Surgeons, UK.,East of Scotland Training Programme in Urology, UK
| | | | - Abdul B Khan
- Indus Hospital and Health Network, Karachi, Pakistan
| | - Steven Payne
- UROLINK, British Association of Urological Surgeons, UK
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120
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Dalal J, Triulzi I, James A, Nguimbis B, Dri GG, Venkatasubramanian A, Noubi Tchoupopnou Royd L, Botero Mesa S, Somerville C, Turchetti G, Stoll B, Abbate JL, Mboussou F, Impouma B, Keiser O, Coelho FC. COVID-19 mortality in women and men in sub-Saharan Africa: a cross-sectional study. BMJ Glob Health 2021; 6:bmjgh-2021-007225. [PMID: 34815243 PMCID: PMC8611236 DOI: 10.1136/bmjgh-2021-007225] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 10/24/2021] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Since sex-based biological and gender factors influence COVID-19 mortality, we wanted to investigate the difference in mortality rates between women and men in sub-Saharan Africa (SSA). METHOD We included 69 580 cases of COVID-19, stratified by sex (men: n=43 071; women: n=26 509) and age (0-39 years: n=41 682; 40-59 years: n=20 757; 60+ years: n=7141), from 20 member nations of the WHO African region until 1 September 2020. We computed the SSA-specific and country-specific case fatality rates (CFRs) and sex-specific CFR differences across various age groups, using a Bayesian approach. RESULTS A total of 1656 deaths (2.4% of total cases reported) were reported, with men accounting for 70.5% of total deaths. In SSA, women had a lower CFR than men (mean [Formula: see text] = -0.9%; 95% credible intervals (CIs) -1.1% to -0.6%). The mean CFR estimates increased with age, with the sex-specific CFR differences being significant among those aged 40 years or more (40-59 age group: mean [Formula: see text] = -0.7%; 95% CI -1.1% to -0.2%; 60+ years age group: mean [Formula: see text] = -3.9%; 95% CI -5.3% to -2.4%). At the country level, 7 of the 20 SSA countries reported significantly lower CFRs among women than men overall. Moreover, corresponding to the age-specific datasets, significantly lower CFRs in women than men were observed in the 60+ years age group in seven countries and 40-59 years age group in one country. CONCLUSIONS Sex and age are important predictors of COVID-19 mortality globally. Countries should prioritise the collection and use of sex-disaggregated data so as to design public health interventions and ensure that policies promote a gender-sensitive public health response.
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Affiliation(s)
- Jyoti Dalal
- Association Actions en Santé, The GRAPH Network, Geneve, Switzerland
| | - Isotta Triulzi
- Association Actions en Santé, The GRAPH Network, Geneve, Switzerland.,Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Ananthu James
- Association Actions en Santé, The GRAPH Network, Geneve, Switzerland.,Department of Chemical Engineering, Indian Institute of Science, Bangalore, India
| | - Benedict Nguimbis
- Association Actions en Santé, The GRAPH Network, Geneve, Switzerland
| | - Gabriela Guizzo Dri
- Association Actions en Santé, The GRAPH Network, Geneve, Switzerland.,Institute of Global Health, University of Geneva, Geneva, Switzerland
| | - Akarsh Venkatasubramanian
- Association Actions en Santé, The GRAPH Network, Geneve, Switzerland.,Gender, Equality, Diversity and Inclusion Deparment, International Labour Organization, Geneve, Switzerland
| | - Lucie Noubi Tchoupopnou Royd
- Association Actions en Santé, The GRAPH Network, Geneve, Switzerland.,Health Systems Strengthening and Development Group Center, Yaounde, Cameroon
| | - Sara Botero Mesa
- Association Actions en Santé, The GRAPH Network, Geneve, Switzerland.,Institute of Global Health, University of Geneva, Geneva, Switzerland
| | - Claire Somerville
- The Gender Center, Institute of International and Development Studies, Geneva, Switzerland
| | | | - Beat Stoll
- Association Actions en Santé, The GRAPH Network, Geneve, Switzerland.,Institute of Global Health, University of Geneva, Geneva, Switzerland
| | - Jessica Lee Abbate
- Association Actions en Santé, The GRAPH Network, Geneve, Switzerland.,UMI TransVIHMI, Montpellier, Languedoc-Roussillon, France.,Geomatys, Montpellier, France
| | - Franck Mboussou
- World Health Organization Regional Office for Africa, Brazzaville, Brazzaville, Congo
| | - Benido Impouma
- Association Actions en Santé, The GRAPH Network, Geneve, Switzerland.,World Health Organization Regional Office for Africa, Brazzaville, Brazzaville, Congo
| | - Olivia Keiser
- Association Actions en Santé, The GRAPH Network, Geneve, Switzerland .,Institute of Global Health, University of Geneva, Geneva, Switzerland
| | - Flávio Codeço Coelho
- Association Actions en Santé, The GRAPH Network, Geneve, Switzerland.,School of Applied Mathematics, Getulio Vargas Foundation, Rio de Janeiro, Brazil
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121
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McCombe G, Murtagh S, Lazarus JV, Van Hout MC, Bachmann M, Jaffar S, Garrib A, Ramaiya K, Sewankambo NK, Mfinanga S, Cullen W. Integrating diabetes, hypertension and HIV care in sub-Saharan Africa: a Delphi consensus study on international best practice. BMC Health Serv Res 2021; 21:1235. [PMID: 34781929 PMCID: PMC8591882 DOI: 10.1186/s12913-021-07073-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 09/16/2021] [Indexed: 11/25/2022] Open
Abstract
Background Although HIV continues to have a high prevalence among adults in sub-Saharan Africa (SSA), the burden of noncommunicable diseases (NCD) such as diabetes and hypertension is increasing rapidly. There is an urgent need to expand the capacity of healthcare systems in SSA to provide NCD services and scale up existing chronic care management pathways. The aim of this study was to identify key components, outcomes, and best practice in integrated service provision for the prevention, identification and treatment of HIV, hypertension and diabetes. Methods An international, multi stakeholder e-Delphi consensus study was conducted over two successive rounds. In Round 1, 24 participants were asked to score 27 statements, under the headings ‘Service Provision’ and ‘Benefits of Integration’, by importance. In Round 2, the 16 participants who completed Round 1 were shown the distribution of scores from other participants along with the score that they attributed to an outcome and were asked to reflect on the score they gave, based on the scores of the other participants and then to rescore if they wished to. Nine participants completed Round 2. Results Based on the Round 1 ranking, 19 of the 27 outcomes met the 70% threshold for consensus. Four additional outcomes suggested by participants in Round 1 were added to Round 2, and upon review by participants, 22 of the 31 outcomes met the consensus threshold. The five items participants scored from 7 to 9 in both rounds as essential for effective integrated healthcare delivery of health services for chronic conditions were improved data collection and surveillance of NCDs among people living with HIV to inform integrated NCD/HIV programme management, strengthened drug procurement systems, availability of equipment and access to relevant blood tests, health education for all chronic conditions, and enhanced continuity of care for patients with multimorbidity. Conclusions This study highlights the outcomes which may form key components of future complex interventions to define a model of integrated healthcare delivery for diabetes, hypertension and HIV in sub-Saharan Africa.
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Affiliation(s)
| | | | - Jeffrey V Lazarus
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain
| | | | | | | | - Anupam Garrib
- Liverpool School of Tropical Medicine, Liverpool, UK
| | | | | | - Sayoki Mfinanga
- National Institute for Medical Research, Dar es Salaam, Tanzania
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122
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Asadi-Lari M, Ahmadi Teymourlouy A, Maleki M, Afshari M. Opportunities and challenges of global health diplomacy for prevention and control of noncommunicable diseases: a systematic review. BMC Health Serv Res 2021; 21:1193. [PMID: 34736461 PMCID: PMC8567539 DOI: 10.1186/s12913-021-07240-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 10/29/2021] [Indexed: 11/11/2022] Open
Abstract
Background and aim The growing globalization has changed the goals and methods of diplomacy. Due to the challenges and complexities of dealing with noncommunicable diseases (NCDs) at the national and international levels, policy makers require global health diplomacy (GHD) to achieve the goals of prevention and control of NCDs. The purpose of this systematic review was to identify the challenges and opportunities in GHD for NCDs. Methods A systematic review of articles was conducted by searching MEDLINE via PubMed, Web of Science, Scopus, and Embase and by using Google and Google Scholar search engines. Additional articles were identified by reviewing reference lists and a number of special journals. The inclusion criteria include literature published in English from 2007 to 2020, and the exclusion criteria are literature published in any language other than English, absence of full text, dissertations, and duplicates. Overall, 32 articles met the requirements for inclusion in this review and were analyzed using content analysis in MAXQDA 10. Findings There are 32 published articles on GHD for NCDs. Identified challenges were classified into three levels: global (global health governance), national (Governance at the state level, health sector, and civil society), and industry. The progress on global health issues has created opportunities for the development of GHD for the prevention and control of NCDs. These opportunities were divided into three levels: international, national, and individual level. Conclusion Various challenges at the global level, national level, and industry led to less engagement of policymakers in GHD for prevention and control of NCDs and, as a consequence, a less coordinated approach to address prevention and control of NCDs worldwide. So, there is a need for more efforts of collective action and negotiation for tackling NCDs. Policymakers and managers of the health system should increase the advocacy, building a coalition with civil society, use negotiation and diplomacy to engage with other sectors and organizations, manage industry conflicts, and leverage foreign policy to promote health and welfare. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-07240-3.
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Affiliation(s)
- Mohsen Asadi-Lari
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Ahmad Ahmadi Teymourlouy
- Department of Health Service Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Maleki
- Department of Health Service Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Mahnaz Afshari
- Department of Health Service Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.
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Douglas M, Kgatla N, Sodi T, Musinguzi G, Mothiba T, Skaal L, Makgahlela M, Bastiaens H. Facilitators and barriers in prevention of cardiovascular disease in Limpopo, South Africa: a qualitative study conducted with primary health care managers. BMC Cardiovasc Disord 2021; 21:492. [PMID: 34641818 PMCID: PMC8507214 DOI: 10.1186/s12872-021-02290-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 09/27/2021] [Indexed: 11/18/2022] Open
Abstract
Background In the Southern African countries, cardiovascular disease burden is increasing and the second most prevalent cause of death after infectious diseases. The sustainable primary prevention of cardiovascular disease is associated with the engagement of facilitators that support it and hindered by barriers that undermine the support of a healthy lifestyle at the community level. The purpose of the study was to investigate facilitators and barriers at the level of primary health care facilities, on prevention of cardiovascular disease in Limpopo Province of South Africa. Methods This study is an exploratory and descriptive qualitative design, where open-ended key informant interviews were conducted among 20 primary health care managers conveniently sampled in their respective health care facilities. Coding and analysis were done using the thematic analysis method with the assistance of Atlas ti qualitative software. Results Various facilitators for the prevention of CVD were identified in this study. One of such facilitators is the availability and adherence to CVD treatment guidelines in the district. Other facilitators included top-down health education programme; collaboration with schools, traditional and religious leaders; the use of modern technology; and a structured healthcare system. Barriers were also identified as poor infrastructural development; shortage of medical supplies and equipment; lack of health promotion activities; shortage of nurses and other health care personnel; and poor accessibility to primary health care services. Conclusion This study has identified barriers and facilitators that may be harnessed to improve cardiovascular disease prevention, care, and management in a rural setting in South Africa. The facilitators should be strengthened, and barriers identified redressed. Trial registration number: REC-0310111-031. Supplementary Information The online version contains supplementary material available at 10.1186/s12872-021-02290-1.
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Affiliation(s)
- Mbuyiselo Douglas
- Faculty of Humanities and Health Sciences, University of Limpopo, Sovenga, South Africa.
| | - Nancy Kgatla
- Faculty of Humanities and Health Sciences, University of Limpopo, Sovenga, South Africa
| | - Tholene Sodi
- Faculty of Humanities and Health Sciences, University of Limpopo, Sovenga, South Africa
| | - Geofrey Musinguzi
- Primary and Interdisciplinary Care, University of Antwerp, Antwerp, Belgium
| | - Tebogo Mothiba
- Faculty of Humanities and Health Sciences, University of Limpopo, Sovenga, South Africa
| | - Linda Skaal
- Faculty of Humanities and Health Sciences, University of Limpopo, Sovenga, South Africa
| | - Mpsanyana Makgahlela
- Faculty of Humanities and Health Sciences, University of Limpopo, Sovenga, South Africa
| | - Hilde Bastiaens
- Primary and Interdisciplinary Care, University of Antwerp, Antwerp, Belgium
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Fisher S, Bellinger DC, Cropper ML, Kumar P, Binagwaho A, Koudenoukpo JB, Park Y, Taghian G, Landrigan PJ. Air pollution and development in Africa: impacts on health, the economy, and human capital. Lancet Planet Health 2021; 5:e681-e688. [PMID: 34627472 DOI: 10.1016/s2542-5196(21)00201-1] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 06/30/2021] [Accepted: 07/22/2021] [Indexed: 05/22/2023]
Abstract
BACKGROUND Africa is undergoing both an environmental and an epidemiological transition. Household air pollution is the predominant form of air pollution, but it is declining, whereas ambient air pollution is increasing. We aimed to quantify how air pollution is affecting health, human capital, and the economy across Africa, with a particular focus on Ethiopia, Ghana, and Rwanda. METHODS Data on household and ambient air pollution were from WHO Global Health Observatory, and data on morbidity and mortality were from the 2019 Global Burden of Disease Study. We estimated economic output lost due to air pollution-related disease by country, with use of labour income per worker, adjusted by the probability that a person (of a given age) was working. Losses were expressed in 2019 international dollars and as a proportion of gross domestic product (GDP). We also quantified the contribution of particulate matter (PM)2·5 pollution to intelligence quotient (IQ) loss in children younger than 10 years, with use of an exposure-response coefficient based on previously published data. FINDINGS Air pollution was responsible for 1·1 million deaths across Africa in 2019. Household air pollution accounted for 697 000 deaths and ambient air pollution for 394 000. Ambient air pollution-related deaths increased from 361 000 in 2015, to 383 000 in 2019, with the greatest increases in the most highly developed countries. The majority of deaths due to ambient air pollution are caused by non-communicable diseases. The loss in economic output in 2019 due to air pollution-related morbidity and mortality was $3·02 billion in Ethiopia (1·16% of GDP), $1·63 billion in Ghana (0·95% of GDP), and $349 million in Rwanda (1·19% of GDP). PM2·5 pollution was estimated to be responsible for 1·96 billion lost IQ points in African children in 2019. INTERPRETATION Ambient air pollution is increasing across Africa. In the absence of deliberate intervention, it will increase morbidity and mortality, diminish economic productivity, impair human capital formation, and undercut development. Because most African countries are still early in development, they have opportunities to transition rapidly to wind and solar energy, avoiding a reliance on fossil fuel-based economies and minimising pollution. FUNDING UN Environment Programme.
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Affiliation(s)
- Samantha Fisher
- Global Public Health and the Common Good, Boston College, Chestnut Hill, MA, USA.
| | | | | | - Pushpam Kumar
- UN Environment Programme-Africa Office, Nairobi, Kenya
| | | | | | - Yongjoon Park
- University of Massachusetts Amherst, Amherst, MA, USA
| | - Gabriella Taghian
- Global Public Health and the Common Good, Boston College, Chestnut Hill, MA, USA
| | - Philip J Landrigan
- Global Public Health and the Common Good, Boston College, Chestnut Hill, MA, USA
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Al-Zubayer MA, Ahammed B, Sarder MA, Kundu S, Majumder UK, Islam SMS. Double and triple burden of non-communicable diseases and its determinants among adults in Bangladesh: Evidence from a recent demographic and health survey. Int J Clin Pract 2021; 75:e14613. [PMID: 34235819 DOI: 10.1111/ijcp.14613] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 07/05/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Globally, non-communicable diseases (NCDs) are a significant public health problem. NCDs are the leading cause of death in Bangladesh. This study aimed to estimate the prevalence of double burden of NCDs (DBNCDs) and triple burden of NCDs (TBNCDs) such as hypertension, diabetes and overweight or obesity and to explore the risk factors of DBNCDs and TBNCDs in Bangladesh. MATERAILS AND METHODS This study included 12 685 participants (5465 male and 7220 female) from 2017 - 2018 nationally representative Bangladesh Demographic and Health Survey. Descriptive statistics were calculated for the distribution and prevalence of DBNCDs and TBNCDs. Bivariate and multilevel logistic regression analyses were used to assess the individual- and community-level determinants of DBNCDs and TBNCDs. RESULTS The prevalence of DBNCDs and TBNCDs was 21.4% and 6.1%, respectively. At individual-level, higher age, female, currently and formerly/ever married, richest, higher education were more likely to suffer from the DBNCDs and TBNCDs. Furthermore, at the community level, the division had a significant association with DBNCDs and TBNCDs. In addition, family size had a significant effect on DBNCDs, and caffeinate drinks and poverty significantly affected TBNCDs. CONCLUSION Overall, there is a low prevalence of TBNCDs compared with DBNCDs in Bangladesh. Age, gender, marital status, wealth index, education level and division are significantly associated with DBNCDs and TBNCDs. The government and non-government health organisations should pay proper attention to handle the burden of NCDs in Bangladesh.
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Affiliation(s)
| | - Benojir Ahammed
- Statistics Discipline, Khulna University, Khulna, Bangladesh
| | | | - Subarna Kundu
- Statistics Discipline, Khulna University, Khulna, Bangladesh
| | | | - Sheikh Mohammed Shariful Islam
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Melbourne, VIC, Australia
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Olowoyo P, Popoola F, Yaria J, Akinyemi R, Maffia P, Owolabi MO. Strategies for Reducing Non-Communicable Diseases in Africa. Pharmacol Res 2021; 170:105736. [PMID: 34147659 PMCID: PMC8800856 DOI: 10.1016/j.phrs.2021.105736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Paul Olowoyo
- Department of Medicine, College of Medicine and Health Sciences, Afe Babalola University, Ado-Ekiti and Federal Teaching Hospital, Ido-Ekiti, Nigeria
| | - Femi Popoola
- Center for Genomic and Precision Medicine, College of Medicine, University of Ibadan, Nigeria
| | - Joseph Yaria
- Department of Medicine, University College Hospital, Ibadan, Nigeria
| | - Rufus Akinyemi
- Center for Genomic and Precision Medicine, College of Medicine, University of Ibadan, Nigeria; Department of Medicine, University College Hospital, Ibadan, Nigeria
| | - Pasquale Maffia
- Centre for Immunobiology, Institute of Infection, Immunity and Inflammation, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom; Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom; Department of Pharmacy, University of Naples Federico II, Naples, Italy
| | - Mayowa Ojo Owolabi
- Center for Genomic and Precision Medicine, College of Medicine, University of Ibadan, Nigeria; Department of Medicine, University College Hospital, Ibadan, Nigeria.
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Neighborhood-Level Influences and Adolescent Health Risk Behaviors in Rural and Urban Sub-Saharan Africa: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147637. [PMID: 34300089 PMCID: PMC8305046 DOI: 10.3390/ijerph18147637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 07/14/2021] [Accepted: 07/16/2021] [Indexed: 11/24/2022]
Abstract
The impact of neighborhoods on adolescent engagement in health-risk behaviors (HRBs), such as substance use and sexual activity, has been well documented in high-income countries; however, evidence from low and middle-income country settings is limited, particularly in sub-Saharan African (SSA) countries. Neighborhoods and communities in SSA continue to experience urbanization, epidemiologic transition, and the simultaneous presence of large populations living in rurality and urbanicity. This is a dynamic context for exploring adolescent health challenges. This review seeks to identify and summarize existing literature that investigates adolescent engagement in HRBs when compared across rural and urban neighborhoods across SSA. We performed searches using three electronic databases, targeted grey literature searches and scanned reference lists of included studies. Following dual-screening, our search yielded 23 relevant studies that met all inclusion criteria. These were categorized into six broad themes including studies on: (1) sexual risk taking, (2) injury-related, (3) violence, (4) eating and/or exercise-related, (5) substance use, and (6) personal hygiene. We found that neighborhood factors relating to accessibility and availability of health information and care impacted adolescent engagement in HRBs in rural and urban areas. Urbanization of areas of SSA plays a role in differences in engagement in HRBs between rural and urban dwelling adolescents.
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Mphekgwana PM, Mabila LN, Maimela E. Indirect and direct effects of factors associated with diabetes amongst the rural black population in the Dikgale Health and Demographic Surveillance System, South Africa. Afr J Prim Health Care Fam Med 2021; 13:e1-e6. [PMID: 34342480 PMCID: PMC8335786 DOI: 10.4102/phcfm.v13i1.2819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 03/17/2021] [Accepted: 04/01/2021] [Indexed: 11/17/2022] Open
Abstract
Background Diabetes is an enormous, growing clinical and public health problem, which together with hypertension contributes significantly to the high risk of cardiovascular diseases (CVDs) globally. Aim To examine the indirect and direct effects of risk factors simultaneously as a network of multiple pathways leading to diabetes in the rurally based adult population (aged 15+) using a household survey. Methods This investigation was based on a predictive model using a cross-sectional community-based study to identify the direct and indirect effects of diabetes risk factors in the Dikgale Health and Demographic Surveillance System (HDSS) consisting of 15 villages, with 7200 households and a total population of approximately 36 000. Fasting blood glucose and total cholesterol were measured using ILAB 300 with the following cut-off values: high fasting blood glucose 7 mmol/L and triglycerides 1.70 mmol/L. Results A total of 1407 individuals were interviewed, of whom 1281 had their blood pressure (BP) measured. The conceptual model was validated by the goodness-of-fit indexes (comparative fit index [CFI] = 1.00, Tucker Lewis index [TLI] = 1.041, root mean square error of approximation [RMSEA] = 0.001). Hypertension had the strongest direct effect of 0.0918 on diabetes, followed by age (0.0039) and high waist circumference (−0.0023). Hypertension also mediates the effects that high waist circumference (0.0005) and triglycerides (0.0060) have on diabetes status. Conclusion The results in this study confirm the conceptual model considered in the risk factors for diabetes and suggest that hypertension, age and high waist circumference are the key variables directly affecting the diabetes status in the South African rural black population. The direct effect of triglycerides on diabetes suggests mediation by some measured factor(s).
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Affiliation(s)
- Peter M Mphekgwana
- Department of Research Administration and Development, University of Limpopo, Polokwane.
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Apidechkul T, Tamornpark R, Chomchoei C, Upala P, Yeemard F. Association Between Lifestyle Behaviors and Hypertension Among Hill Tribe Adults in Thailand: a Cross-Sectional Study. J Racial Ethn Health Disparities 2021; 9:1517-1527. [PMID: 34185305 DOI: 10.1007/s40615-021-01090-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 06/12/2021] [Accepted: 06/14/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Hypertension (HT) is a serious problem in the adult population, particularly among individuals who are living in poor economic conditions and have a low education level. This study aimed to determine the associations between lifestyle and HT among adult hill tribe populations in Thailand. METHODS A cross-sectional study was conducted to gather information on several risk behaviors related to HT among the hill tribe population aged 30 years and older by using a validated questionnaire and 5 mL blood specimens. The study was conducted in 30 selected hill tribe villages in Chiang Rai Province, Northern Thailand. Logistic regression was used to detect the associations. RESULTS A total of 2552 participants participated in the project; 65.9% were female, 72.4% were aged 40-69 years, and 54.2% were Buddhist. The overall prevalence of HT was 33.7%. After controlling for all potential confounding variables, two variables were found to be associated with HT: participants who used moderate (AOR=1.57; 95% CI=1.03-3.76) and high amounts (AOR=1.59; 95% CI=1.05-3.78) of oil for cooking had greater odds of having HT than those who used small amounts. Those who had low (AOR=1.45; 95% CI=1.13-1.88), moderate (AOR=2.68; 95% CI=1.80-8.78), and high (AOR=1.61; 95% CI=1.36-7.26) levels of depression had greater odds of having HT than those who were not depressed. CONCLUSIONS Effective public health programs that focus on reducing the use of daily oil for cooking and decreasing the prevalence of depression in hill tribe people are urgently needed.
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Affiliation(s)
- Tawatchai Apidechkul
- Center of Excellence for the Hill Tribe Health Research, Mae Fah Luang University, Chiang Rai, Thailand. .,School of Health Science, Mae Fah Luang University, Chiang Rai, Thailand.
| | | | - Chalitar Chomchoei
- Center of Excellence for the Hill Tribe Health Research, Mae Fah Luang University, Chiang Rai, Thailand
| | - Panupong Upala
- Center of Excellence for the Hill Tribe Health Research, Mae Fah Luang University, Chiang Rai, Thailand
| | - Fartima Yeemard
- Center of Excellence for the Hill Tribe Health Research, Mae Fah Luang University, Chiang Rai, Thailand
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130
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Associations Between Household Socioeconomic Status, Car Ownership, Physical Activity, and Cardiorespiratory Fitness in South African Primary Schoolchildren Living in Marginalized Communities. J Phys Act Health 2021; 18:883-894. [PMID: 34172589 DOI: 10.1123/jpah.2020-0839] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 04/06/2021] [Accepted: 04/08/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Little is known whether physical activity (PA)-promoting environments are equally accessible to children with divergent socioeconomic status (SES) in low-/middle-income countries. The authors, therefore, examined whether South African children from poorer versus wealthier families living in marginalized communities differed in moderate to vigorous PA and cardiorespiratory fitness. We also tested associations between family car ownership and PA/cardiorespiratory fitness. METHODS Parents/guardians of 908 children (49% girls, mean age = 8.3 [1.4] y) completed a survey on household SES. PA was assessed via 7-day accelerometry, parental and child self-reports, and cardiorespiratory fitness with the 20-m shuttle run test. RESULTS Based on accelerometry, most children met current moderate to vigorous PA recommendations (≥60 min/d). About 73% of the children did not engage in structured physical education lessons. Whereas children of the lowest SES quintile accumulated higher levels of device-based moderate to vigorous PA, peers from the highest SES quintile engaged in more sedentary behaviors, but self-reported higher engagement in sports, dance, and moving games after school. Families' car ownership was associated with higher parent/self-reported leisure-time PA. CONCLUSIONS A deeper understanding is needed about why wealthier children are more sedentary, but simultaneously engage in more leisure-time PA. The fact that access to structural physical education is denied to most children is critical and needs to be addressed.
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Wagner RG, Crowther NJ, Micklesfield LK, Boua PR, Nonterah EA, Mashinya F, Mohamed SF, Asiki G, Tollman S, Ramsay M, Davies JI. Estimating the burden of cardiovascular risk in community dwellers over 40 years old in South Africa, Kenya, Burkina Faso and Ghana. BMJ Glob Health 2021; 6:bmjgh-2020-003499. [PMID: 33479017 PMCID: PMC7825268 DOI: 10.1136/bmjgh-2020-003499] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 11/26/2020] [Accepted: 12/25/2020] [Indexed: 12/20/2022] Open
Abstract
Introduction Cardiovascular disease (CVD) risk factors are increasing in sub-Saharan Africa. The impact of these risk factors on future CVD outcomes and burden is poorly understood. We examined the magnitude of modifiable risk factors, estimated future CVD risk and compared results between three commonly used 10-year CVD risk factor algorithms and their variants in four African countries. Methods In the Africa-Wits-INDEPTH partnership for Genomic studies (the AWI-Gen Study), 10 349 randomly sampled individuals aged 40–60 years from six sites participated in a survey, with blood pressure, blood glucose and lipid levels measured. Using these data, 10-year CVD risk estimates using Framingham, Globorisk and WHO-CVD and their office-based variants were generated. Differences in future CVD risk and results by algorithm are described using kappa and coefficients to examine agreement and correlations, respectively. Results The 10-year CVD risk across all participants in all sites varied from 2.6% (95% CI: 1.6% to 4.1%) using the WHO-CVD lab algorithm to 6.5% (95% CI: 3.7% to 11.4%) using the Framingham office algorithm, with substantial differences in risk between sites. The highest risk was in South African settings (in urban Soweto: 8.9% (IQR: 5.3–15.3)). Agreement between algorithms was low to moderate (kappa from 0.03 to 0.55) and correlations ranged between 0.28 and 0.70. Depending on the algorithm used, those at high risk (defined as risk of 10-year CVD event >20%) who were under treatment for a modifiable risk factor ranged from 19.2% to 33.9%, with substantial variation by both sex and site. Conclusion The African sites in this study are at different stages of an ongoing epidemiological transition as evidenced by both risk factor levels and estimated 10-year CVD risk. There is low correlation and disparate levels of population risk, predicted by different risk algorithms, within sites. Validating existing risk algorithms or designing context-specific 10-year CVD risk algorithms is essential for accurately defining population risk and targeting national policies and individual CVD treatment on the African continent.
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Affiliation(s)
- Ryan G Wagner
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
| | - Nigel J Crowther
- Department of Chemical Pathology, National Health Laboratory Service, Johannesburg, Gauteng, South Africa.,Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
| | - Lisa K Micklesfield
- SAMRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
| | - Palwende Romauld Boua
- Clinical Research Unit of Nanoro, Institut de Recherche en Sciences de la Sante, Ouagadougou, Centre, Burkina Faso
| | - Engelbert A Nonterah
- Navrongo Health Research Centre, Ghana Health Service, Accra, Greater Accra, Ghana
| | - Felistas Mashinya
- Department of Pathology and Medical Sciences, Faculty of Health Sciences, University of Limpopo, Sovenga, Limpopo, South Africa
| | - Shukri F Mohamed
- Health and Systems for Health, African Population and Health Research Center, Nairobi, Kenya
| | - Gershim Asiki
- Health and Systems for Health, African Population and Health Research Center, Nairobi, Kenya
| | - Stephen Tollman
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa.,Umeå Centre for Global Health Research, Umeå University, Umeå, Sweden.,International Network for the Demographic Evaluation of People and Their Health, INDEPTH Network, Accra, Ghana
| | - Michèle Ramsay
- Sydney Brenner Institute for Molecular Bioscience and Division of Human Genetics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Justine I Davies
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa.,Institute of Applied Health Research, University of Birmingham, Birmingham, UK
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Global burden of hypertension among people living with HIV in the era of increased life expectancy: a systematic review and meta-analysis. J Hypertens 2021; 38:1659-1668. [PMID: 32371769 DOI: 10.1097/hjh.0000000000002446] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Although HIV infection and antiretroviral therapy (ART) increase the risk for hypertension in people living with HIV (PLHIV), the global and regional burden of hypertension in PLHIV is not well characterized. METHODS In this systematic review and meta-analysis, we searched multiple databases for studies reporting on hypertension in PLHIV and conducted between 2007 and 2018. Meta-analysis through random-effect models served to obtain the pooled prevalence estimates. Heterogeneity was assessed via the χ test on Cochran's Q statistic. RESULTS We included 194 studies (396 776 PLHIV from 61 countries). The global prevalence of hypertension was 23.6% [95% confidence interval (95% CI: 21.6-25.5)] with substantial heterogeneity. The regional distribution was Western and Central Europe and North America [28.1% (95% CI: 24.5-31.9)], West and Central Africa [23.5% (16.6-31.0)], Latin America and the Caribbean [22.0% (17.8-26.5)], Eastern and Southern Africa [19.9% (17.2-22.8)], and Asia and Pacific [16.5% (12.5-21.0)]; P = 0.0007. No study originated from the Middle East and North Africa, and Eastern Europe and Central Asia regions. The prevalence was higher in high-income countries than others (P = 0.0003) and higher in PLHIV taking ART than those ART-naive (P = 0.0003). The prevalence increased over time (mainly driven by Eastern and Southern Africa) and with age. There was no difference between men and women. We estimated that in 2018, there were 8.9 (95% CI: 8.3-9.6) million cases of hypertension in PLHIV globally, among whom 59.2% were living in Sub-Saharan Africa. CONCLUSION Cost-effective strategies to curb the dreadful burden of hypertension among PLHIV are needed.
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Antiamylase, Antiglucosidase, and Antiglycation Properties of Millets and Sorghum from Sri Lanka. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:5834915. [PMID: 34239583 PMCID: PMC8233094 DOI: 10.1155/2021/5834915] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 03/25/2021] [Accepted: 05/26/2021] [Indexed: 02/06/2023]
Abstract
The present study evaluated a range of biological activities of selected millet types and sorghum varieties in Sri Lanka in relation to diabetes and its complications management. Five millet types, namely, proso millet, white finger millet, kodo millet, foxtail millet, and finger millet (Oshadha and Rawana), and two sorghum varieties, namely, sweet sorghum and sorghum ICSV 112, were used in this study. Methanolic extracts of whole grains were studied for antiamylase, antiglucosidase, and early- and middle-stage antiglycation and glycation reversing activities in vitro. Tested millets and sorghum showed significant (p < 0.05) and dose-dependent antiamylase (IC50: 33.34 ± 1.11-1446.70 ± 54.10 μg/ml), early-stage antiglycation (IC50: 15.42 ± 0.50-270.03 ± 16.29 μg/ml), middle-stage antiglycation (135.08 ± 12.95-614.54 ± 6.99 μg/ml), early-stage glycation reversing (EC50: 91.82 ± 6.56-783.20 ± 61.70 μg/ml), and middle-stage glycation reversing (393.24 ± 8.68-1374.60 ± 129.30 μg/ml) activities. However, none of the studied millet and sorghum showed antiglucosidase activity. Out of the samples studied, pigmented samples, namely, sweet sorghum, Oshadha, and Rawana, exhibited significantly high (p < 0.05) antiamylase and early- and middle-stage antiglycation and glycation reversing activities compared to other millet and sorghum samples. Interestingly, sweet sorghum exhibited nearly four times potent antiamylase activity compared to the standard drug acarbose (IC50 111.98 ± 2.68 μg/ml) and sweet sorghum, kodo millet, Oshadha, and Rawana showed comparable early-stage antiglycation activities in comparison to the reference standard Rutin (IC50 21.88 ± 0.16 μg/ml). Therefore, consumption of whole grains of pigmented millet and sorghum in Sri Lanka may play an important role in the prevention and management of diabetes and its complications. Interestingly, this is the 1st study to report all the tested biological activities for millet and sorghum in Sri Lanka and the 1st study to report both early- and middle-stage glycation reversing activities of millet and sorghum worldwide.
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Fothergill-Misbah N, Walker R, Kwasa J, Hooker J, Hampshire K. "Old people problems", uncertainty and legitimacy: Challenges with diagnosing Parkinson's disease in Kenya. Soc Sci Med 2021; 282:114148. [PMID: 34153822 DOI: 10.1016/j.socscimed.2021.114148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 06/09/2021] [Accepted: 06/14/2021] [Indexed: 02/08/2023]
Abstract
Very little is known about the experience of people living with Parkinson's disease (PD) in low- and middle-income countries, such as those in sub-Saharan Africa. The number of specialists in the region is low and awareness is limited among the population and healthcare professionals. Drawing on ten months of ethnographic fieldwork in urban and rural Kenya with 55 people living with PD (PwP), 23 family members and 22 healthcare professionals from public and private clinics, we set out to understand the experience of diagnosis among PwP in Kenya. The diagnostic journeys of our study participants were typically long, convoluted and confusing. Lack of relevant information, combined with comorbidities and expectations about 'normal' ageing, often conspired to delay interactions with health services for many. There often followed an extended period of diagnostic uncertainty, misdiagnosis and even 'undiagnosis', where a diagnostic decision was reversed. Following diagnosis, patients continued to lack information about their condition and prognosis, making it difficult for friends, family members and others to understand what was happening to them. We suggest that awareness of PD and its symptoms needs to improve among the general population and healthcare professionals. However, diagnosis is only the first step, and needs to be accompanied by better access to information, affordable treatment and support.
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Affiliation(s)
| | - Richard Walker
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom; Northumbria Healthcare NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Judith Kwasa
- Department of Medicine, University of Nairobi, Nairobi, Kenya
| | | | - Kate Hampshire
- Department of Anthropology, Durham University, Durham, United Kingdom
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Petry N, Rohner F, Phall MC, Jallow B, Ceesay AA, Sawo Y, Darboe MK, Barrow S, Sarr A, Ceesay PO, Fofana MN, Prentice AM, Wegmüller R, Wirth JP. Prevalence and co-existence of cardiometabolic risk factors and associations with nutrition-related and socioeconomic indicators in a national sample of Gambian women. Sci Rep 2021; 11:12057. [PMID: 34103653 PMCID: PMC8187481 DOI: 10.1038/s41598-021-91592-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 05/11/2021] [Indexed: 01/25/2023] Open
Abstract
Cardiovascular diseases (CVD) are on the rise in Sub-Saharan Africa, and a large proportion of the adult population is thought to suffer from at least one cardiometabolic risk factor. This study assessed cardiometabolic risk factors and the contribution of nutrition-related indicators in Gambian women. The prevalence and co-existence of diabetes (elevated glycated hemoglobin (HbA1c ≥ 6.5%) or prediabetes (HbA1c ≥ 5.7% to < 6.5%), hypertension (systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg), obesity (body mass index (BMI) ≥ 30.0) and inflammation (C-reactive protein (CRP) > 3 mg/L or alpha-1-acid glycoprotein (AGP) > 1 g/L) and the contribution of nutrition related and socioeconomic indicators were measured in non-pregnant women 15-49 years of age in the Gambia using data from a nationally representative cross-sectional stratified survey. Nationally, 54.5% (95% CI: 47.4, 61.4) of 1407 women had elevated HbA1c. Of these, 14.9% were diabetic and 85.1% were prediabetic. Moreover, 20.8% (95% CI 17.8, 20.0) of 1685 women had hypertension, 11.1% (95% CI 9.0, 13.7) of 1651 were obese and 17.2% (95% CI 5.1, 19.6) of 1401 had inflammation. At least one of the aforementioned cardiometabolic risk factor was present in 68.3% (95% CI 63.0, 73.1) of women. Obesity increased the risk of hypertension (aRR 1.84; 95% CI 1.40, 2.41), diabetes (aRR 1.91; 95% CI 1.29, 2.84), elevated HbA1c (aRR 1.31; 95% CI 1.14, 1.51) and inflammation (aRR 3.47; 95% CI 2.61, 4.61). Inflammation increased the risk of hypertension (aRR 1.42; 95% CI 1.14, 1.78). Aging increased the risk of hypertension, obesity and inflammation. Further, inadequate sanitation increased the risk for diabetes (aRR 1.65; 95% CI 1.17, 2.34) and iron deficiency increased the risk of elevated HbA1c (aRR 1.21; 95% CI 1.09, 1.33). The high prevalence of cardiometabolic risk factors and their co-existence in Gambian women is concerning. Although controlling obesity seems to be key, multifaceted strategies to tackle the risk factors separately are warranted to reduce the prevalence or minimize the risk of CVD.
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Affiliation(s)
| | | | | | | | | | | | - Momodou K Darboe
- Medical Research Council Unit the Gambia at London, School of Hygiene and Tropical Medicine, Atlantic Boulevard, Fajara, Banjul, The Gambia
| | | | | | | | | | - Andrew M Prentice
- Medical Research Council Unit the Gambia at London, School of Hygiene and Tropical Medicine, Atlantic Boulevard, Fajara, Banjul, The Gambia
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Cheza A, Tlou B, Zhou DT. Incidence of non-communicable diseases (NCDs) in HIV patients on ART in a developing country: Case of Zimbabwe's Chitungwiza Central Hospital-A retrospective cohort study (2010-2019). PLoS One 2021; 16:e0252180. [PMID: 34043718 PMCID: PMC8158936 DOI: 10.1371/journal.pone.0252180] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 05/12/2021] [Indexed: 11/19/2022] Open
Abstract
Introduction The incidence of non-communicable diseases (NCDs) has been reported to be rising over the years leading up to 2010. In Zimbabwe, there are few studies done to examine the incidence of NCDs in people living with HIV (PLHIV) on anti-retroviral treatment (ART). Objective To determine the incidence of NCDs in HIV patients on ART at the Chitungwiza Central Hospital over ten years and the associated risk factors. Methods This was a retrospective cohort study using data from 203 patients enrolled on ART at the Chitungwiza Central Hospital between 2010 and 2019. All 500 records were considered and the selection was based on participants’ consenting to the study and their strict adherence to ART without absconding. The incidence of NCDs was determined and generalized estimating equations (GEE) were used to estimate the association between NCDs and the selected risk factors. Findings Data collected at the study’s baseline (2010) showed that the most prevalent NCD was hypertension, found in (18/203) 8.9% of the study participants, followed by diabetes (6.9%), then followed by cardiovascular diseases (CVD) (3.9%), and the least common NCD was cancer (1.9%). Incidences of all of these NCDs showed an increasing trend as the time of follow-up progressed. The factors found to be significantly associated with the development of NCDs were gender (p = 0.002) and follow-up time (p<0.001). Geographical location was a significant risk factor as urban patients were more likely to develop hypertension as compared to the peri-urban patients (p = 0.001). Conclusions NCDs and HIV comorbidity is common with women more likely than males to develop NCDs as they advance in age. There is need to devise targeted intervention approach to the respective NCDs and risk factors since they affect differently in relation to the demographic details of the participants. Recommendations This paper recommends a multi-stakeholder approach to the management of NCDs, with researchers, clinicians and the government and its various arms taking a leading role.
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Affiliation(s)
- Alexander Cheza
- School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
- * E-mail:
| | - Boikhutso Tlou
- School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Danai Tavonga Zhou
- Department of Medical Laboratory Sciences, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
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Bigna JJ, Temfack E. PrEP for men who have sex with men in Africa. Lancet HIV 2021; 8:e388-e389. [PMID: 34048795 DOI: 10.1016/s2352-3018(21)00024-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Accepted: 01/26/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Jean Joel Bigna
- Department of Epidemiology and Public Health, Centre Pasteur of Cameroon, Yaounde, Cameroon; School of Public Health, Faculty of Medicine, University of Paris Saclay, Montigny-le-Bretonneux, France.
| | - Elvis Temfack
- Department of Internal Medicine, Douala General Hospital, Douala, Cameroon; National Public Health Laboratory, Yaounde, Cameroon
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Arinda IK, Sserwanja Q, Nansubuga S, Mukunya D, Akampereza P. Factors Associated with Over-Nutrition Among Men 15-54 years in Uganda: A National Survey. Nutr Metab Insights 2021; 14:11786388211016833. [PMID: 34035652 PMCID: PMC8132092 DOI: 10.1177/11786388211016833] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 04/15/2021] [Indexed: 01/13/2023] Open
Abstract
Background Globally and in Sub-Saharan Africa (SSA), the prevalence of overweight and obesity are on the rise. Data on overweight and obesity among men are scarce. Objective We aimed to determine the prevalence and factors associated with over-nutrition among men in Uganda. Methods We used Uganda Demographic and Health Survey (UDHS) 2016 data of 5,408 men aged 15 to 45 years. Multistage stratified sampling was used to select study participants and data were collected using validated questionnaires. Multivariable logistic regression was used to determine factors associated with over-nutrition among 15 to 54-year-old men in Uganda. Results The prevalence of over nutrition was 9.1%, where that of overweight was 7.9% (95% CI 7.2-8.7 and obesity was1.2% (95% CI 0.9-1.5). Men who were aged 25 to 34 (AOR = 3.28; 95% CI: 1.92-5.59), 35-44 (AOR = 4.51; 95% CI: 2.61-7.82) and 45 to 54 (AOR = 4.28; 95% CI: 2.37-7.74) were more likely to have over-nutrition compared to those aged 15 to 24 years. Married men (AOR=2.44; 95% CI: 1.49-3.99) were 2 times more likely to have over-nutrition than men who were not married. Men in the central region (AOR = 1.78; 95% CI: 1.22-2.60) were 1.78 times more likely to have over-nutrition than men in the northern region. Men who were in the richest wealth index quintiles were 10 times more likely to have over-nutrition compared to those in the poorest wealth index quintile (AOR = 9.38: 95 % CI 5.14-17.10). Conclusion The factors associated with over-nutrition among Ugandan men in our study were increasing age, marital status, increasing wealth and region of origin. This shows the need for measures to abate the regional development inequalities, need to promote physical activity among older men and need to improve on the knowledge of nutrition and dietetic practices for married couples and men of different social classes.
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Affiliation(s)
- Ivan Kato Arinda
- Department of Nutrition Research, Nutri-worth International. Kampala, Uganda
| | - Quraish Sserwanja
- Department of Monitoring and Evaluation, Doctors with Africa, CUAMM, Juba, South Sudan
| | - Sylvia Nansubuga
- Directorate of Medical Services, Uganda Christian University, Mukono, Uganda
| | - David Mukunya
- Department of Public Health, Busitema University, Mbale, Uganda
| | - Phiona Akampereza
- Nutrition Department, Action Against Hunger-USA, Bibi Bibi Refugee Settlement, Yumbe, Uganda
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The Potential of Sweetpotato as a Functional Food in Sub-Saharan Africa and Its Implications for Health: A Review. Molecules 2021; 26:molecules26102971. [PMID: 34067782 PMCID: PMC8156662 DOI: 10.3390/molecules26102971] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 05/04/2021] [Accepted: 05/11/2021] [Indexed: 12/12/2022] Open
Abstract
Increasing urbanization in developing countries has resulted in busier lifestyles, accompanied by consumption of fast foods. The consequence is an increased prevalence in noncommunicable diseases (NCDs). Food-based approaches would be cheaper and more sustainable in reducing these NCDs compared to drugs, which may have side effects. Studies have suggested that consuming functional foods could potentially lower NCD risks. Sweetpotato is regarded as a functional food because it contains bioactive compounds. Recently, sweetpotato has gained attention in sub-Saharan Africa (SSA), but research has focused on its use in alleviating micronutrient deficiencies such as vitamin A deficiency, particularly the orange-fleshed variety of sweetpotato. Some studies conducted in other parts of the world have investigated sweetpotato as a functional food. There is a need to characterize the sweetpotato varieties in SSA and determine how processing affects their bioactive components. This review highlights some of the studies conducted in various parts of the world on the functionality of sweetpotato, its bioactive compounds, and how these are influenced by processing. In addition, the potential health benefits imparted by sweetpotato are expounded. The knowledge gaps that remain in these studies are also addressed, focusing on how they can direct sweetpotato research in SSA.
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Gbaguidi GN, Houehanou CY, Amidou SA, Vigan J, Houinato DS, Lacroix P. Prevalence of abnormal kidney function in a rural population of Benin and associated risk factors. BMC Nephrol 2021; 22:116. [PMID: 33789608 PMCID: PMC8011182 DOI: 10.1186/s12882-021-02316-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 03/22/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The global burden of kidney disease has increased in recent years worldwide. Risk factors for kidney disease are common in Africa, but data on their prevalence are lacking. This study aims to determine the prevalence of abnormal kidney function and associated factors among participants included in the TAnve HEalth Study (TAHES) cohort in Benin. METHODS This was a cross-sectional study nested within the TAHES cohort. It was carried out in 2019, among TAHES participants aged 25 years and above, living in Tanvè and Dékanmè, two villages located in southwestern Benin. Data on risk factors were collected using the World Health Organization's STEPS questionnaire. Anthropometric measurements and capillary creatinine measurements were performed. Abnormal kidney function was defined as a low glomerular filtration rate (< 60 mL/min/1.73 m2). RESULTS Creatinine was measured among 1360 out of the 1583 participants in the cohort in 2019. The median age was 39 [32-53]. The prevalence of abnormal kidney function was 16.10%; 95%CI = [14.15-18.05]. The results of the multivariate logistic regression showed that the probability of abnormal kidney function increased significantly with age (adjusted OR (aOR) = 2.75; 95%CI = [1.83-4.14]), female gender (aOR = 2; 95%CI = [1.37-2.91]), hypertension (aOR = 1.54; 95%CI = [1.12-2.13]), high body mass index (aOR = 1, 56; 95%CI = [1.12-2.17]) and hyperglycemia (aOR = 2.86; 95%CI = [1.68-4.88]). CONCLUSION The prevalence of abnormal kidney function was high. These data should guide national authorities and help to raise community awareness of the benefits of early detection of this condition.
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Affiliation(s)
- Gwladys N Gbaguidi
- Faculty of Health Sciences, Epidemiology Laboratory of Chronic and Neurologic Diseases, University of Abomey-Calavi, Cotonou, Benin. .,INSERM, Univ. Limoges, CHU Limoges, IRD, U1094 Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, 87000, Limoges, France.
| | - Corine Y Houehanou
- Faculty of Health Sciences, Epidemiology Laboratory of Chronic and Neurologic Diseases, University of Abomey-Calavi, Cotonou, Benin.,ENATSE, University of Parakou, Parakou, Benin
| | - Salimanou A Amidou
- Faculty of Health Sciences, Epidemiology Laboratory of Chronic and Neurologic Diseases, University of Abomey-Calavi, Cotonou, Benin
| | | | - Dismand S Houinato
- Faculty of Health Sciences, Epidemiology Laboratory of Chronic and Neurologic Diseases, University of Abomey-Calavi, Cotonou, Benin.,INSERM, Univ. Limoges, CHU Limoges, IRD, U1094 Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, 87000, Limoges, France.,Neurology Unit, CNHU Cotonou, Cotonou, Benin
| | - Philippe Lacroix
- INSERM, Univ. Limoges, CHU Limoges, IRD, U1094 Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, 87000, Limoges, France.,Department of Vascular Medicine, CHU Limoges, 87000, Limoges, France
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Paromita P, Chowdhury HA, Mayaboti CA, Rakhshanda S, Rahman AKMF, Karim MR, Mashreky SR. Assessing service availability and readiness to manage Chronic Respiratory Diseases (CRDs) in Bangladesh. PLoS One 2021; 16:e0247700. [PMID: 33661982 PMCID: PMC7932138 DOI: 10.1371/journal.pone.0247700] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 02/11/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Chronic Respiratory Diseases (CRDs) are some of the most prevailing non-communicable diseases (NCDs) worldwide and cause three times higher morbidity and mortality in low- and middle-income countries (LMIC) than in developed nations. In Bangladesh, there is a dearth of data about the quality of CRD management in health facilities. This study aims to describe CRD service availability and readiness at all tiers of health facilities using the World Health Organization's (WHO) Service Availability and Readiness Assessment (SARA) tool. METHODS A cross-sectional study was conducted from December 2017 to June 2018 in a total of 262 health facilities in Bangladesh using the WHO SARA Standard Tool. Surveys were conducted with facility management personnel by trained data collectors using REDCap software. Descriptive statistics for the availability of CRD services were calculated. Composite scores for facility readiness (Readiness Index 'RI') were created which included four domains: staff and guideline, basic equipment, diagnostic capacity, and essential medicines. RI was calculated for each domain as the mean score of items expressed as a percentage. Indices were compared to a cutoff of70% which means that a facility index above 70% is considered 'ready' to manage CRDs at that level. Data analysis was conducted using SPSS Vr 21.0. RESULTS It was found, tertiary hospitals were the only hospitals that surpassed the readiness index cutoff of 70%, indicating that they had adequate capacity and were ready to manage CRDs (RI 78.3%). The mean readiness scores for the other hospital tiers in descending order were District Hospitals (DH): 40.6%, Upazila Health Complexes (UHC): 33.3% and Private NGOs: 39.5%). CONCLUSION Only tertiary care hospitals, constituting 3.1% of sampled health facilities, were found ready to manage CRD. Inadequate and unequal supplies of medicine as well as a lack of trained staff, guidelines on the diagnosis and treatment of CRDs, equipment, and diagnostic facilities contributed to low readiness index scores in all other tiers of health facilities.
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Affiliation(s)
- Progga Paromita
- Kirtipasha Union Health and Family Welfare Centre, Jhalokathi Sadar Upazila, Barishal, Bangladesh
| | | | | | - Shagoofa Rakhshanda
- Centre for Injury Prevention and Research, Bangladesh (CIPRB), Dhaka, Bangladesh
| | | | - Md. Rizwanul Karim
- Department of Non Communicable Disease Control, Directorate General of Health and Services, Dhaka, Bangladesh
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Nkambule SJ, Moodley I, Kuupiel D, Mashamba-Thompson TP. Association between food insecurity and key metabolic risk factors for diet-sensitive non-communicable diseases in sub-Saharan Africa: a systematic review and meta-analysis. Sci Rep 2021; 11:5178. [PMID: 33664339 PMCID: PMC7933340 DOI: 10.1038/s41598-021-84344-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 02/15/2021] [Indexed: 01/31/2023] Open
Abstract
In previous studies, food insecurity has been hypothesised to promote the prevalence of metabolic risk factors on the causal pathway to diet-sensitive non-communicable diseases (NCDs). This systematic review and meta-analysis aimed to determine the associations between food insecurity and key metabolic risk factors on the causal pathway to diet-sensitive NCDs and estimate the prevalence of key metabolic risk factors among the food-insecure patients in sub-Saharan Africa. This study was guided by the Centre for Reviews and Dissemination (CRD) guidelines for undertaking systematic reviews in healthcare. The following databases were searched for relevant literature: PubMed, EBSCOhost (CINAHL with full text, Health Source - Nursing, MedLine). Epidemiological studies published between January 2015 and June 2019, assessing the associations between food insecurity and metabolic risk outcomes in sub-Saharan African populations, were selected for inclusion. Meta-analysis was performed with DerSimonian-Laird's random-effect model at 95% confidence intervals (CIs). The I2 statistics reported the degree of heterogeneity between studies. Publication bias was assessed by visual inspection of the funnel plots for asymmetry, and sensitivity analyses were performed to assess the meta-analysis results' stability. The Mixed Methods Appraisal Tool (MMAT) - Version 2018 was used to appraise included studies critically. The initial searches yielded 11,803 articles, 22 cross-sectional studies were eligible for inclusion, presenting data from 26,609 (46.8% males) food-insecure participants, with 11,545 (42.1% males) reported prevalence of metabolic risk factors. Of the 22 included studies, we identified strong evidence of an adverse association between food insecurity and key metabolic risk factors for diet-sensitive NCDs, based on 20 studies. The meta-analysis showed a significantly high pooled prevalence estimate of key metabolic risk factors among food-insecure participants at 41.8% (95% CI: 33.2% to 50.8%, I2 = 99.5% p-value < 0.00) derived from 14 studies. The most prevalent type of metabolic risk factors was dyslipidaemia 27.6% (95% CI: 6.5% to 54.9%), hypertension 24.7% (95% CI: 15.6% to 35.1%), and overweight 15.8% (95% CI: 10.6% to 21.7%). Notably, the prevalence estimates of these metabolic risk factors were considerably more frequent in females than males. In this systematic review and meta-analysis, exposure to food insecurity was adversely associated with a wide spectrum of key metabolic risk factors, such as obesity, dyslipidaemia, hypertension, underweight, and overweight. These findings highlight the need to address food insecurity as an integral part of diet-sensitive NCDs prevention programmes. Further, these findings should guide recommendations on the initiation of food insecurity status screening and treatment in clinical settings as a basic, cost-effective tool in the practice of preventive medicine in sub-Saharan Africa.PROSPERO registration number: PROSPERO 2019 CRD42019136638.
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Affiliation(s)
- Sphamandla Josias Nkambule
- grid.16463.360000 0001 0723 4123Department of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Indres Moodley
- grid.16463.360000 0001 0723 4123Department of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Desmond Kuupiel
- grid.16463.360000 0001 0723 4123Department of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Tivani P. Mashamba-Thompson
- grid.16463.360000 0001 0723 4123Department of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa ,grid.49697.350000 0001 2107 2298Faculty of Health Sciences, University of Pretoria, Pretoria, Gauteng Province South Africa
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Chikowore T, Kamiza AB, Oduaran OH, Machipisa T, Fatumo S. Non-communicable diseases pandemic and precision medicine: Is Africa ready? EBioMedicine 2021; 65:103260. [PMID: 33639396 PMCID: PMC7921515 DOI: 10.1016/j.ebiom.2021.103260] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 01/12/2021] [Accepted: 02/10/2021] [Indexed: 12/14/2022] Open
Abstract
Non-communicable diseases (NCDs) kill more than 41 million people every year, accounting for 71% of all deaths globally. The prevalence of NCDs is estimated to be higher than that of infectious diseases in Africa by 2030. Precision medicine may help with early identification of cases, resulting in timely prevention and improvement in the efficacy of treatments. However, Africa has been lagging behind in genetic research, a key component of the precision medicine initiative. A number of genomic research initiatives which could lead to translational genomics are emerging on the African continent which includes the Non-communicable Diseases Genetic Heritage Study (NCDGHS) and the Men of African Descent and Carcinoma of the Prostate (MADCaP) Network. These offer a promise that precision medicine can be applied in African countries. This review evaluates the advances of genetic studies for cancer, hypertension, type 2 diabetes and body mass index (BMI) in Africa.
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Affiliation(s)
- Tinashe Chikowore
- MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
| | - Abram Bunya Kamiza
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Ovokeraye H Oduaran
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Tafadzwa Machipisa
- Hatter Institute for Cardiovascular Diseases Research in Africa (HICRA), Department of Medicine, University of Cape Town, Cape Town, South Africa; Population Health Research Institute, David Braley Cardiac, Vascular and Stroke Research Institute, 237 Barton Street East, Hamilton, ON L8L 2 × 2, Canada
| | - Segun Fatumo
- The African Computational Genomics (TACG) Research group, MRC/UVRI and LSHTM, Uganda; London School of Hygiene and Tropical Medicine London UK; H3Africa Bioinformatics Network (H3ABioNet) Node, Centre for Genomics Research and Innovation, NABDA/FMST, Abuja, Nigeria.
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Development and Sensory Evaluation of Omega-3-Rich Nile Perch Fish Oil-Fortified Yogurt. INTERNATIONAL JOURNAL OF FOOD SCIENCE 2021; 2021:8838043. [PMID: 33628772 PMCID: PMC7899769 DOI: 10.1155/2021/8838043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 01/20/2021] [Accepted: 02/05/2021] [Indexed: 11/21/2022]
Abstract
Nile perch (Lates niloticus) is a major fish species in East Africa and its processing produces sufficient amounts of by-products containing significant amounts of long-chain polyunsaturated fatty acids (PUFAs). Due to the health benefits associated with PUFAs, they can be incorporated into commonly consumed foods such as yoghurt. This study is aimed at developing an omega-3-rich functional yoghurt and evaluating its quality and acceptability. Omega-3-rich fish oils were obtained from Nile perch fat pads in the presence and absence of a commercial food grade enzyme Alcalase. Recovery of omega-3-rich fish oil was done by centrifugation at 1000 × g at room temperature. The peroxide value (PV), anisidine value (AV), total oxidation (TOTOX), and free fatty acids (FFA) were some of the quality parameters investigated. Natural yoghurt (150 ml) was prepared and spiked with 3.5 g of omega-3-rich Nile perch oil. To mask the fishy flavor and taste, four different flavors were used and sensory evaluation of the yoghurt samples was performed. The liberation of Nile perch fish oil in the absence of Alcalase gave better yield (60.7% wet weight), while the use of Alcalase gave lower yields (48.3% wet weight). Assessment of the quality of the extracted fish oils showed that all parameters were within the required limits. Sensory characterization by a panel of students showed that passion and strawberry flavors were the most liked with mean values of 4.65 and 4.625, respectively. This study revealed that substantial amounts of omega-3-rich fish oil can be extracted from Nile perch fish pads in the absence of exogenous enzymes. Fortification of yoghurt with omega-3-rich Nile perch fish oils is an approach towards increasing omega-3 intake within the Kenyan population and globally.
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Babashahi S, Hansen P, Sullivan T. Creating a priority list of non-communicable diseases to support health research funding decision-making. Health Policy 2020; 125:221-228. [PMID: 33357963 DOI: 10.1016/j.healthpol.2020.12.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 11/22/2020] [Accepted: 12/02/2020] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To develop and pilot a framework based on multi-criteria decision analysis (MCDA) to prioritize non-communicable diseases (NCDs) to support health research funding decision-making. METHODS The framework involves identifying NCDs to be prioritized, specifying prioritization criteria and determining their weights from a survey of stakeholders. The mean weights from the survey are applied to the NCDs' ratings on the criteria to generate a 'total score' for each NCD, by which the NCDs are prioritized. RESULTS Nineteen NCDs and five criteria were included. The criteria, in decreasing order of importance (mean weights in parentheses), are: deaths across the population (27.7 %), loss of quality-of-life across the population (23.0 %), cost to patients and families (18.6 %), cost to the health system (17.2 %), and whether vulnerable groups are disproportionately affected (13.4 %). The priority list of NCDs, stratified into four tiers of importance, is: 'Very critical' priority: coronary heart disease, back and neck pain, diabetes mellitus; 'Critical' priority: dementia and Alzheimer's disease, stroke; 'High' priority: colon and rectum cancer, depressive disorders, chronic obstructive pulmonary disease, chronic kidney disease, breast cancer, prostate cancer, arthritis, lung cancer; and 'Medium' priority: asthma, hearing loss, melanoma skin cancer, addictive disorders, non-melanoma skin cancer, headaches. CONCLUSION The results indicate the framework for prioritizing NCDs for research funding is feasible and effective. The framework could also be used for other health conditions.
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Affiliation(s)
| | - Paul Hansen
- Department of Economics, University of Otago, Dunedin, New Zealand; 1000minds Ltd, Wellington, New Zealand
| | - Trudy Sullivan
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
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Andarge E, Fikadu T, Temesgen R, Shegaze M, Feleke T, Haile F, Endashaw G, Boti N, Bekele A, Glagn M. Intention and Practice on Personal Preventive Measures Against the COVID-19 Pandemic Among Adults with Chronic Conditions in Southern Ethiopia: A Survey Using the Theory of Planned Behavior. J Multidiscip Healthc 2020; 13:1863-1877. [PMID: 33299323 PMCID: PMC7721310 DOI: 10.2147/jmdh.s284707] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 11/11/2020] [Indexed: 01/30/2023] Open
Abstract
PURPOSE With prevention being the only and best available intervention, COVID-19 has recently become a global threat, having had and continuing to have enormous health, economic, and societal impacts. Evidence so far has documented a heightened risk of mortality to people with chronic conditions. There is a dearth of evidence regarding chronic disease patients' intention and practice on the preventive measures. This study tried to fill this gap by assessing the intention to practice and practice on personal preventive measures (PPMs) among adults with chronic conditions. MATERIALS AND METHODS A facility-based cross-sectional study was conducted in Southern Ethiopia among 806 adults with chronic conditions by employing a multistage sampling technique. Data were collected using a pre-tested and structured questionnaire. Statistical analysis was done using IBM SPSS software version 25. Binary logistic regression analysis was done to identify factors associated with intention and practice. Level of statistical significance was declared at a P-value of less than 0.05. RESULTS The study showed that 52% (95% CI=47.61-54.80) and 76.3% (95% CI=73.36-79.24) of adults with chronic conditions were intending to practice and had ever practiced the personal preventive measures. Participants' subjective norm (SN) (AOR=4.94; 95% CI=3.49-6.96) and perceived behavioral control (PBC) (AOR=4.13; 95% CI=2.69-6.34) were the factors associated with their intention. Good knowledge and a positive attitude were found to be significant factors associated with the participants' actual practice of the PPMs among other independent factors. CONCLUSION Around half of the participants were intending to practice PPMs, and three-quarters had good practice on the PPMs against COVID-19. Interventions targeted to improve intention and practice on the PPMs need to take into account improving knowledge and attitude, and build positive subjective norms and heighten the confidence to control the preventive behaviors.
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Affiliation(s)
- Eshetu Andarge
- School of Public Health, Arba Minch University, Arba Minch, Southern Nations Nationalities and Peoples Regional State, Ethiopia
| | - Teshale Fikadu
- School of Public Health, Arba Minch University, Arba Minch, Southern Nations Nationalities and Peoples Regional State, Ethiopia
| | - Rodas Temesgen
- Department of Internal Medicine, School of Medicine, Arba Minch University, Arba Minch, Southern Nations Nationalities and Peoples Regional State, Ethiopia
| | - Mulugeta Shegaze
- School of Public Health, Arba Minch University, Arba Minch, Southern Nations Nationalities and Peoples Regional State, Ethiopia
| | - Tesfaye Feleke
- School of Public Health, Arba Minch University, Arba Minch, Southern Nations Nationalities and Peoples Regional State, Ethiopia
| | - Firehiwot Haile
- School of Public Health, Arba Minch University, Arba Minch, Southern Nations Nationalities and Peoples Regional State, Ethiopia
| | - Gisila Endashaw
- School of Nursing, Arba Minch University, Arba Minch, Southern Nations Nationalities and Peoples Regional State, Ethiopia
| | - Negussie Boti
- School of Public Health, Arba Minch University, Arba Minch, Southern Nations Nationalities and Peoples Regional State, Ethiopia
| | - Alemayehu Bekele
- Center for Neglected Tropical Diseases, Arba Minch University, Arba Minch, Southern Nations Nationalities and Peoples Regional State, Ethiopia
| | - Mustefa Glagn
- School of Public Health, Arba Minch University, Arba Minch, Southern Nations Nationalities and Peoples Regional State, Ethiopia
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147
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Bandyopadhyay S. Letter to the Editor Regarding "Emerging Trends in the Neurosurgical Workforce of Low- and Middle-Income Countries: A Cross-Sectional Study". World Neurosurg 2020; 143:605. [PMID: 33167134 DOI: 10.1016/j.wneu.2020.07.229] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 07/30/2020] [Indexed: 10/23/2022]
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148
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Tesema AG, Ajisegiri WS, Abimbola S, Balane C, Kengne AP, Shiferaw F, Dangou JM, Narasimhan P, Joshi R, Peiris D. How well are non-communicable disease services being integrated into primary health care in Africa: A review of progress against World Health Organization's African regional targets. PLoS One 2020; 15:e0240984. [PMID: 33091037 PMCID: PMC7580905 DOI: 10.1371/journal.pone.0240984] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 10/06/2020] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE In Africa, mortality due to non-communicable diseases (NCDs) is projected to overtake the combined mortality from communicable, maternal, neonatal, and nutritional diseases by 2030. To address this growing NCD burden, primary health care (PHC) systems will require substantial re-orientation. In this study, we reviewed the progress of African countries towards integrating essential NCD services into PHC. METHODS A review of World Health Organization (WHO) reports was conducted for all 47 countries in the WHO African Region. To report each country's progress, we used an a priori framework developed by the WHO regional office for Africa (AFRO). Twelve indicators were used to measure countries' progress. The proportion of countries meeting each indicator was tabulated using a heat map. Correlation between country income status and attainment of each indicator was also assessed. FINDINGS No country met all the recommended indicators to integrate NCD services into PHC and seven countries met none of the indicators. Few countries (30%) had nationally approved guidelines for NCD management and very few reported availabilities of all essential NCD medicines (13%) and technologies (11%) in PHC facilities. There was no overall correlation between a country's GDP per capita and the aggregate of targets being met (rho = 0.23; P = .12). There was, however, a modestly negative correlation between out-of-pocket expenditure and overall country progress (rho = -0.58; P < .001). CONCLUSION Progress by AFRO Member States in integrating NCD care into PHC is variable across the region. Enhanced government commitment and judicious resource allocation to prioritize NCDs are needed. Particular areas of focus include increasing the uptake of simplified guidelines for NCDs; increasing workforce capacity to manage NCDs; and removing access barriers to essential medicines and basic diagnostic technologies.
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Affiliation(s)
| | | | - Seye Abimbola
- The George Institute for Global Health, University of New South Wales (UNSW), Sydney, Australia
- School of Public Health, University of Sydney, Sydney, Australia
| | - Christine Balane
- The George Institute for Global Health, University of New South Wales (UNSW), Sydney, Australia
| | - Andre Pascal Kengne
- Non-communicable Diseases Research Unit, South African Medical Research Council & University of Cape Town, Cape Town, South Africa
| | - Fassil Shiferaw
- World Health Organization, Ethiopia Office, Addis Ababa, Ethiopia
| | - Jean-Marie Dangou
- World Health Organization, Regional Office for Africa, Brazzaville, Republic of Congo
| | - Padmanesan Narasimhan
- School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia
| | - Rohina Joshi
- The George Institute for Global Health, University of New South Wales (UNSW), Sydney, Australia
- School of Public Health, University of Sydney, Sydney, Australia
- The George Institute for Global Health, New Delhi, India
| | - David Peiris
- The George Institute for Global Health, University of New South Wales (UNSW), Sydney, Australia
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149
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Yosef T. Prevalence and associated factors of chronic non-communicable diseases among cross-country truck drivers in Ethiopia. BMC Public Health 2020; 20:1564. [PMID: 33069207 PMCID: PMC7568414 DOI: 10.1186/s12889-020-09646-w] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 10/05/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Non-communicable diseases (NCDs) are diseases that are not transmitted from one person to another. Currently, NCDs are the primary causes of morbidity and mortality globally. Truck driving is an occupation that prone drivers to risk factors for NCDs than other occupations. Eventhough risk of developing NCDs among these population is high, studies that showed the prevalence and associated factors of chronic NCDs among truck drivers in Ethiopia are not available. Therefore, this study aimed to assess the prevalence and associated factors of chronic NCDs among truck drivers in Ethiopia. METHODS A cross-sectional study was conducted among 422 cross-country truck drivers at the Modjo dry port in Ethiopia. The interviwer-administered questionnaire technique was used to collect the data. The body mass index of the study participants was measured using DHM-15A standardized scale (BMI Height and Weight body fat scale). RESULTS Of the 400 truck drivers interviewed, the prevalence of chronic non-communicable diseases was 28.5, 95% CI (24.1-32.9%). Eighty (20%) had hypertension followed by 32(8%), and 22 (5.5%) had diabetes mellitus and asthma, respectively. The study also found that being married (AOR = 3.14, 95%CI [1.78-5.86]) and Separated/Divorced/Widower (AOR = 2.31, 95% CI [1.12-3.55]), having 3 or more family sizes (AOR = 1.46, 95% CI [1.33-4.42]), BMI ≥ 25 (AOR = 4.66, 95% CI [2.85-7.62]), smoking cigarettes [AOR = 1.71, 95% CI [1.03-2.81]), driving 10 or more years (AOR = 3.48, 95% CI [1.89-5.24]) and driving 9 or more hours daily (AOR = 3.76, 95% CI [1.96-6.54]) were statistically associated with chronic non-communicable diseases. CONCLUSION The prevalence of chronic NCDs among truck drivers was significant (28.5%), and we can conclude that chronic NCDs are of public health importance among truck drivers in Ethiopia. This may create a substantial load on the healthcare system as an end result of increased demand and contact with healthcare services. Therefore, a rigorous effort is needed to develop strategies for the prevention and management of NCDs.
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Affiliation(s)
- Tewodros Yosef
- Department of Public Health, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan Teferi, Ethiopia.
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150
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Mphekgwana PM, Malema N, Monyeki KD, Mothiba TM, Makgahlela M, Kgatla N, Makgato I, Sodi T. Hypertension Prevalence and Determinants among Black South African Adults in Semi-Urban and Rural Areas. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E7463. [PMID: 33066410 PMCID: PMC7602258 DOI: 10.3390/ijerph17207463] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 08/22/2020] [Accepted: 08/26/2020] [Indexed: 11/03/2022]
Abstract
The burden of hypertension is reported to be on the rise in developing countries, such as South Africa, despite increased efforts to address it. Using a cross-sectional study design, we assessed and compared the prevalence of and risk factors associated with hypertension amongst adults aged ≥18 years in semi-urban and rural communities (1187 semi-urban and 1106 rural). Trained community health workers administered the INTERHEART Risk Score tool and performed blood pressure assessments using the MEDIC Pharmacists Choice Blood Pressure Monitor. Hypertension was defined to be a systolic blood pressure (BP) ≥ 140 mmHg and diastolic BP ≥ 90 mmHg. A multivariate logistic regression model was used to identify factors and determine their relationship with hypertension. The prevalence of hypertension amongst semi-urban and rural communities was 21% with no gender difference. In the semi-urban area, physical activity, family history, fruit intake, salty food, and eating meat were significantly associated with the odds of hypertension among women, whereas only the waist-to-hip ratio (WHR), diabetic status, and salty food were the predictors for rural women. Factors such as fried food and low fruit intake were significantly associated with the odds of hypertension among men in the semi-urban area, whereas only the WHR was significant among men in the rural area. Hypertension was found to be prevalent among semi-urban and rural adults in Limpopo Province, South Africa.
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Affiliation(s)
- Peter M. Mphekgwana
- Research Administration and Development, University of Limpopo, Polokwane 0700, South Africa
| | - Nancy Malema
- Department of Psychology, University of Limpopo, Polokwane 0700, South Africa; (N.M.); (M.M.); (I.M.); (T.S.)
| | - Kotsedi D. Monyeki
- Department of Physiology and Environmental Health, University of Limpopo, Polokwane 0700, South Africa;
| | - Tebogo M. Mothiba
- Faculty of Health Science, University of Limpopo, Polokwane 0700, South Africa;
| | - Mpsanyana Makgahlela
- Department of Psychology, University of Limpopo, Polokwane 0700, South Africa; (N.M.); (M.M.); (I.M.); (T.S.)
| | - Nancy Kgatla
- Department of Nursing Science, University of Limpopo, Polokwane 0700, South Africa;
| | - Irene Makgato
- Department of Psychology, University of Limpopo, Polokwane 0700, South Africa; (N.M.); (M.M.); (I.M.); (T.S.)
| | - Tholene Sodi
- Department of Psychology, University of Limpopo, Polokwane 0700, South Africa; (N.M.); (M.M.); (I.M.); (T.S.)
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