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Brennan AT, Kileel EM, Fox MP, George JA, Khoza S, Rosen S, Raal F, Hibberd P, Chetty K, Mlisana K, Bor J, Crowther NJ. Assessing compliance with national guidelines in diabetes care: A study leveraging data from south Africa's National Health Laboratory Service (NHLS). PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003014. [PMID: 39226276 PMCID: PMC11371240 DOI: 10.1371/journal.pgph.0003014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 06/26/2024] [Indexed: 09/05/2024]
Abstract
Diabetes is a major global health issue. We evaluated compliance to laboratory-based management guidelines for diabetes (type 1 and 2), essential for effective treatment and reducing diabetes-related morbidity and mortality. Our study utilized South Africa's National Health Laboratory Services (NHLS) data, focusing on patients from birth to age 80 years who underwent initial diabetes laboratory testing between January 1, 2012-January 1, 2016. Patients were categorized into type 1 (<30 years) or type 2 (≥30-80 years) diabetes based on age at first diabetes test. National diabetes guidelines recommend blood glucose to be checked every three-six months post laboratory-diagnosis. We employed a sharp regression discontinuity design to estimate the effect of a laboratory-diagnosis of diabetes on the likelihood of having a follow-up laboratory test 24 months post-diagnosis. Among patients with type 2 diabetes, the probability of a diabetes follow-up laboratory test within 24 months was 52.4% for patients presenting above the diabetes diagnosis threshold vs 31.1% for those presenting below. Although the likelihood of repeat testing rose with higher HbA1c and glucose levels, at the diagnostic threshold there was no clinically meaningful difference (risk difference: -2.2%, 95% CI: -3.3%, -1.2%). These results were consistent among patients with type 1 diabetes, those living with and without HIV, and healthcare setting. In a national laboratory cohort, diabetes laboratory-diagnosis did not lead to increased monitoring as recommended in national guidelines. Strategies to improve patient education, healthcare provider communication, and healthcare system support are essential to enhance guideline compliance and overall diabetes management.
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Affiliation(s)
- A. T. Brennan
- Faculty of Health Sciences University of the Witwatersrand, Health Economics and Epidemiology Research Office, Johannesburg, South Africa
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, United States of America
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, United States of America
| | - E. M. Kileel
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, United States of America
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, United States of America
| | - M. P. Fox
- Faculty of Health Sciences University of the Witwatersrand, Health Economics and Epidemiology Research Office, Johannesburg, South Africa
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, United States of America
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, United States of America
| | - J. A. George
- Wits Diagnostic Innovation Hub, University of the Witwatersrand, Johannesburg, South Africa
- National Health Laboratory Service, Johannesburg, Gauteng, South Africa
| | - S Khoza
- National Health Laboratory Service, Johannesburg, Gauteng, South Africa
- Faculty of Health Sciences, Department of Chemical Pathology, University of the Witwatersrand, Johannesburg, South Africa
| | - S. Rosen
- Faculty of Health Sciences University of the Witwatersrand, Health Economics and Epidemiology Research Office, Johannesburg, South Africa
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, United States of America
| | - F. Raal
- Faculty of Health Sciences, Department of Internal Medicine, Division of Endocrinology and Metabolism, University of the Witwatersrand, Johannesburg, South Africa
| | - P. Hibberd
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, United States of America
| | - K. Chetty
- National Health Laboratory Service, Johannesburg, Gauteng, South Africa
| | - K. Mlisana
- National Health Laboratory Service, Johannesburg, Gauteng, South Africa
- Academic Affairs, Research and Quality Assurance, National Health Laboratory Service, Johannesburg, South Africa
| | - J. Bor
- Faculty of Health Sciences University of the Witwatersrand, Health Economics and Epidemiology Research Office, Johannesburg, South Africa
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, United States of America
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, United States of America
| | - N. J. Crowther
- National Health Laboratory Service, Johannesburg, Gauteng, South Africa
- Faculty of Health Sciences, Department of Chemical Pathology, University of the Witwatersrand, Johannesburg, South Africa
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Dambuza A, Rungqu P, Oyedeji AO, Miya G, Oriola AO, Hosu YS, Oyedeji OO. Therapeutic Potential of Pectin and Its Derivatives in Chronic Diseases. Molecules 2024; 29:896. [PMID: 38398646 PMCID: PMC10892547 DOI: 10.3390/molecules29040896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 11/28/2023] [Accepted: 12/01/2023] [Indexed: 02/25/2024] Open
Abstract
Non-communicable diseases (NCDs) are described as a collection of chronic diseases that do not typically develop from an acute infection, have long-term health effects, and frequently require ongoing care and therapy. These diseases include heart disease, stroke, cancer, chronic lung disease, neurological diseases, osteoporosis, mental health disorders, etc. Known synthetic drugs for the treatment or prevention of NCDs become increasingly dangerous over time and pose high risks due to side effects such as hallucination, heart attack, liver failure, etc. As a result, scientists have had to look for other alternatives that are natural products and that are known to be less detrimental and contain useful bioactive compounds. The increasing understanding of the biological and pharmacological significance of carbohydrates has helped to raise awareness of their importance in living systems and medicine, given they play numerous biological roles. For example, pectin has been identified as a class of secondary metabolites found in medicinal plants that may play a significant role in the treatment and management of a variety of NCDs. Pectin is mainly made of homogalacturonan, which is a linear polymer composed primarily of D-galacturonic acid units (at least 65%) linked in a chain by α-(1,4)-glycosidic linkages. There are also modified pectins or derivatives that improve pectin's bioavailability. Pectin is found in the cell walls of higher plants (pteridophytes, angiosperms, and gymnosperms), particularly in the middle lamella of the plant material. Citrus pectin is used in various industries. This article compiles information that has been available for years about the therapeutic importance of pectin in chronic diseases, different modes of pectin extraction, the chemistry of pectin, and the potency of pectin and its derivatives.
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Affiliation(s)
- Anathi Dambuza
- Department of Chemistry, Faculty of Science and Agriculture, University of Fort Hare, P/Bag X1314, Alice 5700, South Africa;
| | - Pamela Rungqu
- Department of Chemistry, Faculty of Science and Agriculture, University of Fort Hare, P/Bag X1314, Alice 5700, South Africa;
| | - Adebola Omowunmi Oyedeji
- Department of Chemical and Physical Sciences, Faculty of Natural Sciences, Walter Sisulu University, P/Bag X1, Mthatha 5117, South Africa; (A.O.O.); (G.M.); (A.O.O.)
| | - Gugulethu Miya
- Department of Chemical and Physical Sciences, Faculty of Natural Sciences, Walter Sisulu University, P/Bag X1, Mthatha 5117, South Africa; (A.O.O.); (G.M.); (A.O.O.)
| | - Ayodeji Oluwabunmi Oriola
- Department of Chemical and Physical Sciences, Faculty of Natural Sciences, Walter Sisulu University, P/Bag X1, Mthatha 5117, South Africa; (A.O.O.); (G.M.); (A.O.O.)
| | - Yiseyon Sunday Hosu
- Department of Business Management and Economics, Faculty of Economics and Financial Sciences, Walter Sisulu University, P/Bag X1, Mthatha 5117, South Africa;
| | - Opeoluwa Oyehan Oyedeji
- Department of Chemistry, Faculty of Science and Agriculture, University of Fort Hare, P/Bag X1314, Alice 5700, South Africa;
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Ndlovu IS, Tshilwane SI, Ngcamphalala PI, Vosloo A, Chaisi M, Mukaratirwa S. Metabolomics (Non-Targeted) of Induced Type 2 Diabetic Sprague Dawley Rats Comorbid with a Tissue-Dwelling Nematode Parasite. Int J Mol Sci 2023; 24:17211. [PMID: 38139040 PMCID: PMC10743009 DOI: 10.3390/ijms242417211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 11/22/2023] [Accepted: 11/27/2023] [Indexed: 12/24/2023] Open
Abstract
Type 2 diabetes is a non-communicable metabolic syndrome that is characterized by the dysfunction of pancreatic β-cells and insulin resistance. Both animal and human studies have been conducted, demonstrating that helminth infections are associated with a decreased prevalence of type 2 diabetes mellitus (T2DM). However, there is a paucity of information on the impact that helminths have on the metabolome of the host and how the infection ameliorates T2DM or its progression. Therefore, this study aimed at using a non-targeted metabolomics approach to systematically identify differentiating metabolites from serum samples of T2DM-induced Sprague Dawley (SD) rats infected with a tissue-dwelling nematode, Trichinella zimbabwensis, and determine the metabolic pathways impacted during comorbidity. Forty-five male SD rats with a body weight between 160 g and 180 g were used, and these were randomly selected into control (non-diabetic and not infected with T. zimbabwensis) (n = 15) and T2DM rats infected with T. zimbabwensis (TzDM) (n = 30). The results showed metabolic separation between the two groups, where d-mannitol, d-fructose, and glucose were upregulated in the TzDM group, when compared to the control group. L-tyrosine, glycine, diglycerol, L-lysine, and L-hydroxyproline were downregulated in the TzDM group when compared to the control group. Metabolic pathways which were highly impacted in the TzDM group include biotin metabolism, carnitine synthesis, and lactose degradation. We conclude from our study that infecting T2DM rats with a tissue-dwelling nematode, T. zimbabwensis, causes a shift in the metabolome, causing changes in different metabolic pathways. Additionally, the infection showed the potential to regulate or improve diabetes complications by causing a decrease in the amino acid concentration that results in metabolic syndrome.
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Affiliation(s)
- Innocent Siyanda Ndlovu
- School of Life Sciences, University of KwaZulu-Natal, Westville Campus, Durban 4001, South Africa; (I.S.N.); (P.I.N.); (A.V.)
| | - Selaelo Ivy Tshilwane
- Department of Veterinary Tropical Diseases, Faculty of Veterinary Science, University of Pretoria, Pretoria 0110, South Africa; (S.I.T.); (M.C.)
| | - Philile Ignecious Ngcamphalala
- School of Life Sciences, University of KwaZulu-Natal, Westville Campus, Durban 4001, South Africa; (I.S.N.); (P.I.N.); (A.V.)
| | - Andre’ Vosloo
- School of Life Sciences, University of KwaZulu-Natal, Westville Campus, Durban 4001, South Africa; (I.S.N.); (P.I.N.); (A.V.)
| | - Mamohale Chaisi
- Department of Veterinary Tropical Diseases, Faculty of Veterinary Science, University of Pretoria, Pretoria 0110, South Africa; (S.I.T.); (M.C.)
- Foundational Biodiversity Science, South African National Biodiversity Institute, Pretoria 0001, South Africa
| | - Samson Mukaratirwa
- School of Life Sciences, University of KwaZulu-Natal, Westville Campus, Durban 4001, South Africa; (I.S.N.); (P.I.N.); (A.V.)
- One Health Center for Zoonoses and Tropical Veterinary Medicine, School of Veterinary Medicine, Ross University, Basseterre KN0101, Saint Kitts and Nevis
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Ekpor E, Akyirem S, Adade Duodu P. Prevalence and associated factors of overweight and obesity among persons with type 2 diabetes in Africa: a systematic review and meta-analysis. Ann Med 2023; 55:696-713. [PMID: 36821504 PMCID: PMC9970251 DOI: 10.1080/07853890.2023.2182909] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 02/15/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND Type 2 diabetes and obesity are serious public health concerns globally and a growing burden in Africa. Both conditions have serious repercussions on health when they co-occur, yet the extent of their co-occurrence in Africa remains unknown. Therefore, this review aimed to identify the prevalence and associated factors of overweight and obesity among persons with type 2 diabetes in Africa. METHOD A systematic search was conducted on PubMed, MEDLINE, Embase, African Index Medicus (AIM), and African Journals Online (AJOL) for observational studies that reported the prevalence of overweight and/or obesity among type 2 diabetes patients in Africa. The prevalence data from individual studies were aggregated through a random-effects meta-analysis. The I2 statistic was used to evaluate between-studies heterogeneity, while subgroup analysis and mixed-effects meta-regression were performed to identify sources of heterogeneity. We assessed publication bias using funnel plots and Egger's test. This review adhered to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. RESULTS Of 1753 records retrieved, 80 articles were eligible for this review, with 74 cross-sectional studies included in the meta-analysis. The pooled prevalence of overweight and obesity was 35.6% and 25.6% respectively, while the overall prevalence of both overweight and obesity was 61.4%. Also, the pooled prevalence of both overweight and obesity across the five geographical areas in Africa ranged from 56.9% in East Africa to 88.5% in Southern Africa. Nineteen factors were significantly associated with overweight and obesity among patients with type 2 diabetes. CONCLUSION The high prevalence of overweight and obesity among patients with type 2 diabetes is a significant public health concern that transcends geographical boundaries within Africa. The findings from this review highlight the need for innovative weight management interventions that are tailored to the cultural context of the African setting.KEY MESSAGESThere was a high prevalence of overweight and obesity among the type 2 diabetes patients.Nineteen factors were identified to be significantly associated with overweight and obesity among type 2 diabetes patients.Only 12 out of the 80 included studies primarily focused on the prevalence of overweight and/or obesity which reflects a dearth of interest in this topic.
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Affiliation(s)
- Emmanuel Ekpor
- School of Nursing, University of Ghana, Legon, Ghana
- St. Martins de Porres Hospital, Eikwe, Ghana
| | - Samuel Akyirem
- Yale School of Nursing, Yale University, New Haven, CT, USA
| | - Precious Adade Duodu
- Department of Nursing and Midwifery, School of Human and Health Sciences, University of Huddersfield, England, UK
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Lee HK, Lee I, Yun J, Lee YJ, Jang EC, Min YS, Kwon SC. Relationship between job stress and impaired fasting glucose in male steel industry workers: a cross-sectional study. Ann Occup Environ Med 2023; 35:e12. [PMID: 37455849 PMCID: PMC10339050 DOI: 10.35371/aoem.2023.35.e12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 04/10/2023] [Accepted: 05/08/2023] [Indexed: 07/18/2023] Open
Abstract
Background The purpose of this study is to investigate the relationship between job stress and impaired fasting glycemia (IFG) of male workers in a manufacturing industry. Methods Data were collected from 5,886 male workers in a manufacturing industry who participated in the medical examination from June 19 to August 14, 2020 through self-reported questionnaires. The general characteristics of the subjects, shift work, high blood pressure, dyslipidemia, and job stress were included. Job stress was measured using the Korean Occupational Stress Scale (KOSS) consisting of 8 items and 43 questions. Multivariable logistic regression analysis was used to investigate the IFG association with job stress. Results Among the various factors that can cause job stress, only high job demand was associated with a risk of IFG (odds ratio, 1.43; 95% confidence interval, 1.13-1.82) especially in non-shift worker. For all other factors, no statistically significant results were obtained. Conclusions In this study of male workers engaged in the Korean steel manufacturing industry, the 'job demand' item among job stress of non-shift worker was related to IFG.
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Affiliation(s)
- Hyun-Kyo Lee
- Department of Occupational and Environmental Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
| | - Inho Lee
- Department of Occupational and Environmental Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
| | - Jisuk Yun
- Department of Occupational and Environmental Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
| | - Yong-Jin Lee
- Department of Occupational and Environmental Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
| | - Eun-Chul Jang
- Department of Occupational and Environmental Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
| | - Young-Sun Min
- Department of Occupational and Environmental Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
| | - Soon-Chan Kwon
- Department of Occupational and Environmental Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
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Onagbiye S, Ricci H, Bester P, Ricci C. Sedentariness and overweight in relation to mortality in sub-Saharan Africa. A mediation analysis based on the World Health Organization-Global Health Observatory data repository. J Public Health Afr 2023; 14:2155. [PMID: 37347064 PMCID: PMC10280244 DOI: 10.4081/jphia.2023.2155] [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: 02/21/2022] [Accepted: 05/28/2022] [Indexed: 06/23/2023] Open
Abstract
Background Globally, noncommunicable diseases (NCDs) have been continuously reported to be the number one leading cause of reduced life expectancy and poor life quality and have thus become a major public health concern. Objective This study aimed to investigate the complex mediation analysis between physical inactivity and overweight in relation to mortality. Methods The study is based on public data collected by the Global Health Observatory of the World Health Organization. Results We showed that the median early mortality attributable to NCDs during the period 2016-2019 in both men and women was 23.2% (5th to 95th range=17.2, 35.6) while that in men alone was 25.1% (16.5, 45.7) and that of women alone was 22.0% (17.0, 27.9). When considering regional early NCDs mortality for both men and women, a systematically high median was observed in Southern Africa [28.7% (22.2, 43.8)] and a low median in Eastern Africa [21.1% (17.15, 27.3)]. The analysis of the overall relation between physical inactivity, overweight and early mortality due to NCDs revealed a statistical significance of the direct association between physical inactivity and early mortality due to NCDs. Conclusion Our findings revealed three main epidemiological and public health concerns. First, early mortality attributable to NCDs in a range of about 20 to 30% across the sub-Saharan African regions for both sexes was observed. Second, there was a direct effect between physical inactivity and early NCDs mortality as well as the indirect effect mediated by overweight. Finally, a percentage point decrease in physical inactivity prevalence and overweight could effectively generate a reduction in mortality due to NCDs. Future studies are needed to confirm the scientific evidence observed in this study. Such studies should be based on observation of individual subjects, adopt a longitudinal design, and collect information that evaluates the complex relationship between physical inactivity and early NCDs mortality, along with the role of overweight as a possible mediator.
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Cuadros DF, Moreno CM, Tomita A, Singh U, Olivier S, Castle A, Moosa Y, Edwards JA, Kim HY, Siedner MJ, Wong EB, Tanser F. Geospatial assessment of the convergence of communicable and non-communicable diseases in South Africa. JOURNAL OF MULTIMORBIDITY AND COMORBIDITY 2023; 13:26335565231204119. [PMID: 37781137 PMCID: PMC10540575 DOI: 10.1177/26335565231204119] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Abstract
Introduction Several low-and middle-income countries are undergoing rapid epidemiological transition with a rising burden of non-communicable diseases (NCDs). South Africa (SA) is a country with one of the largest HIV epidemics worldwide and a growing burden of NCDs where the collision of these epidemics poses a major public health challenge. Methods Using data from a large nationally representative survey, the South Africa Demographic and Health Survey (SADHS 2016), we conducted a geospatial analysis of several diseases including HIV, tuberculosis (TB), cardiovascular, respiratory, and metabolic diseases to identify areas with a high burden of co-morbidity within the country. We explored the spatial structure of each disease and associations between diseases using different spatial and visual data methodologies. We also assessed the individual level co-occurrence of HIV and the other diseases included in the analysis. Results The spatial distribution for HIV prevalence showed that this epidemic is most intense in the eastern region of the country, mostly within the Gauteng, Mpumalanga, and Kwazulu-Natal provinces. In contrast, chronic diseases had their highest prevalence rates the southern region of the country, particularly in the Eastern and Western Cape provinces. Individual-level analyses were consistent with the spatial correlations and found no statistically significant associations between HIV infection and the presence of any NCDs. Conclusions We found no evidence of geospatial overlap between the HIV epidemic and NCDs in SA. These results evidence the complex epidemiological landscape of the country, characterized by geographically distinct areas exhibiting different health burdens. The detailed description of the heterogenous prevalence of HIV and NCDs in SA reported in this study could be a useful tool to inform and direct policies to enhance targeted health service delivery according to the local health needs of each community.
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Affiliation(s)
- Diego F Cuadros
- Digital Epidemiology Laboratory, Digital Futures, University of Cincinnati, Cincinnati, OH, USA
| | - Claudia M Moreno
- Howard Hughes Medical Institute, Department of Physiology and Biophysics, University of Washington School of Medicine, Seattle, WA, USA
| | - Andrew Tomita
- Centre for Rural Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
- KwaZulu-Natal Research Innovation and Sequencing Platform (KRISP), College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Urisha Singh
- Clinical Research Department, Africa Health Research Institute, KwaZulu-Natal, South Africa
- Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Stephen Olivier
- Clinical Research Department, Africa Health Research Institute, KwaZulu-Natal, South Africa
| | - Alison Castle
- Clinical Research Department, Africa Health Research Institute, KwaZulu-Natal, South Africa
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA, USA
- Global Health and Population, Harvard Medical School, Boston, MA, USA
| | - Yumna Moosa
- KwaZulu-Natal Research Innovation and Sequencing Platform (KRISP), College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
- Clinical Research Department, Africa Health Research Institute, KwaZulu-Natal, South Africa
| | - Johnathan A Edwards
- International Institute for Rural Health, University of Lincoln, Lincolnshire, UK
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA
- Department of Biomedical Informatics, School of Medicine, Emory University, Atlanta, GA, USA
| | - Hae-Young Kim
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Mark J Siedner
- Clinical Research Department, Africa Health Research Institute, KwaZulu-Natal, South Africa
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA, USA
- Global Health and Population, Harvard Medical School, Boston, MA, USA
- School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Emily B Wong
- Clinical Research Department, Africa Health Research Institute, KwaZulu-Natal, South Africa
- Division of Infectious Diseases, University of Alabama Birmingham, Birmingham, AL, USA
| | - Frank Tanser
- Centre for Epidemic Response and Innovation (CERI), School of Data Science and Computational Thinking, Stellenbosch University, Stellenbosch, South Africa
- School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), University of KwaZulu-Natal, Durban, South Africa
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Verma I, Gopaldasani V, Jain V, Chauhan S, Chawla R, Verma PK, Hosseinzadeh H. The impact of peer coach-led type 2 diabetes mellitus interventions on glycaemic control and self-management outcomes: A systematic review and meta-analysis. Prim Care Diabetes 2022; 16:719-735. [PMID: 36307372 DOI: 10.1016/j.pcd.2022.10.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 09/12/2022] [Accepted: 10/16/2022] [Indexed: 11/06/2022]
Abstract
Type 2 diabetes mellitus (T2DM) is a major health risk and dominant cause of global mortality and morbidity. Disease-specific support from peers with similar chronic condition has shown to improve chronic disease self-management outcomes. The purpose of this systematic review is to summarise the existing evidence on the impact of peer coach-led type 2 diabetes mellitus self-management interventions on glycaemic control and self-management outcomes. Databases including MEDLINE, PubMed, CINAHL Plus, Scopus, ProQuest Central, ScienceDirect, web of science, Wiley Online Library and UOW Library were searched for eligible papers. Thirteen randomised controlled trials (RCTs) published between 2008 and 2021 were included in this review. Random-effects meta-analyses found that there were statistically significant changes in Haemoglobin A1c HbA1c) after the interventions. However, the meta-analyses showed no significant changes in LDL (low-density lipoprotein), BMI (Body mass index), systolic BP (Blood Pressure), and HRQoL (Health-related quality of life) among intervention and control groups after the intervention. The identified studies mainly recruited patients with suboptimal glucose levels; majority of them belonging to low-income population. Our findings showed that peer coaching was helpful in improving HbA1c levels, quality of life, self-efficacy, diabetes distress and patient activation. Moreover, peer coaching associations with medication adherence, hypoglycaemic symptoms, diabetes specific social support and depression were inconclusive. This review concludes that peer-led community-based interventions with longer follow up, using a mixed method of delivery among patients with suboptimal levels of HbA1c were more efficient compared to usual care for improving T2DM self-management.
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Affiliation(s)
- Iksheta Verma
- School of Health and Society, University of Wollongong, Building 29, Room 315, NSW 2522, Australia.
| | - Vinod Gopaldasani
- School of Health and Society, University of Wollongong, Building 29, Room 315, NSW 2522, Australia
| | - Vishesh Jain
- Data & Analytics, RMIT Building 106, Level 7, 222 Lonsdale Street, Melbourne, VIC 3000, Australia
| | - Saroj Chauhan
- Employees State Insurance, Faridabad, Haryana 121002, India
| | - Rajeev Chawla
- North Delhi Diabetes Centre, 180, Jai Apartment, Rohini Sector 9, New Delhi 110085, India
| | | | - Hassan Hosseinzadeh
- School of Health and Society, University of Wollongong, Building 29, Room 315, NSW 2522, Australia
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Alathari BE, Nyakotey DA, Bawah AM, Lovegrove JA, Annan RA, Ellahi B, Vimaleswaran KS. Interactions between Vitamin D Genetic Risk and Dietary Factors on Metabolic Disease-Related Outcomes in Ghanaian Adults. Nutrients 2022; 14:2763. [PMID: 35807945 PMCID: PMC9269445 DOI: 10.3390/nu14132763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 06/22/2022] [Accepted: 06/27/2022] [Indexed: 11/16/2022] Open
Abstract
The Ghanaian population is experiencing an upsurge in obesity and type 2 diabetes (T2D) due to rapid urbanization. Besides dietary factors, vitamin D-related genetic determinants have also been shown to contribute to the development of obesity and T2D. Hence, we aimed to examine the interactions between dietary factors and vitamin D-related genetic variants on obesity and T2D related outcomes in a Ghanaian population. Three hundred and two healthy Ghanaian adults (25-60 years old) from Oforikrom, Municipality in Kumasi, Ghana were randomly recruited and had genetic tests, dietary consumption analysis, and anthropometric and biochemical measurements of glucose, HbA1c, insulin, cholesterol, and triglycerides taken. A significant interaction was identified between vitamin D-GRS and fiber intake (g/day) on BMI (pinteraction = 0.020) where those who were consuming low fiber (≤16.19 g/d) and carrying more than two risk alleles for vitamin D deficiency (p = 0.01) had a significantly higher BMI. In addition, an interaction between vitamin D-GRS and fat intake (g/day) on HbA1c (total fat, pinteraction = 0.029) was found, where participants who had a lower total fat intake (≤36.5 g/d), despite carrying more than two risk alleles, had significantly lower HbA1c (p = 0.049). In summary, our study has identified novel gene-diet interactions of vitamin D-GRS with dietary fiber and fat intakes on metabolic traits in Ghanaian adults.
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Affiliation(s)
- Buthaina E. Alathari
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences, Harry Nursten Building, Pepper Lane, University of Reading, Reading RG6 6DZ, UK; (B.E.A.); (J.A.L.)
- Department of Food Science and Nutrition, Faculty of Health Sciences, The Public Authority for Applied Education and Training, P.O. Box 14281, AlFaiha 72853, Kuwait
| | - David A. Nyakotey
- Department of Biochemistry and Biotechnology, College of Science, Kwame Nkrumah University of Science and Technology, Accra Road, Kumasi GH233, Ghana; (D.A.N.); (A.-M.B.); (R.A.A.)
- Liggins Institute, University of Auckland, 85 Park Road, Grafton, Auckland 1023, New Zealand
| | - Abdul-Malik Bawah
- Department of Biochemistry and Biotechnology, College of Science, Kwame Nkrumah University of Science and Technology, Accra Road, Kumasi GH233, Ghana; (D.A.N.); (A.-M.B.); (R.A.A.)
| | - Julie A. Lovegrove
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences, Harry Nursten Building, Pepper Lane, University of Reading, Reading RG6 6DZ, UK; (B.E.A.); (J.A.L.)
- Institute of Cardiovascular and Metabolic Research, Harry Nursten Building, Pepper Lane, University of Reading, Reading RG6 6DZ, UK
| | - Reginald A. Annan
- Department of Biochemistry and Biotechnology, College of Science, Kwame Nkrumah University of Science and Technology, Accra Road, Kumasi GH233, Ghana; (D.A.N.); (A.-M.B.); (R.A.A.)
| | - Basma Ellahi
- Faculty of Health and Social Care, University of Chester, Riverside Campus, Chester CH1 4BJ, UK;
| | - Karani S. Vimaleswaran
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences, Harry Nursten Building, Pepper Lane, University of Reading, Reading RG6 6DZ, UK; (B.E.A.); (J.A.L.)
- Institute of Cardiovascular and Metabolic Research, Harry Nursten Building, Pepper Lane, University of Reading, Reading RG6 6DZ, UK
- Institute for Food, Nutrition and Health, University of Reading, Reading RG6 6AH, UK
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10
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Ndambo MK, Nyondo-Mipando AL, Thakwalakwa C. Eating behaviors, attitudes, and beliefs that contribute to overweight and obesity among women in Lilongwe City, Malawi: a qualitative study. BMC Womens Health 2022; 22:216. [PMID: 35681137 PMCID: PMC9185864 DOI: 10.1186/s12905-022-01811-0] [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: 02/18/2022] [Accepted: 06/03/2022] [Indexed: 11/17/2022] Open
Abstract
Background Obesity is increasingly a public health concern in low- and middle-income countries, including Malawi where 36% of women have body mass index in overweight/obese categories in urban areas. Eating behaviors, attitudes, and beliefs are associated with body size, but have not been studied in-depth in sub-Saharan African countries. This study therefore, explored eating behaviors, attitudes, and beliefs of women in Lilongwe, Malawi.
Methods This was a descriptive ancillary qualitative study utilising in-depth interviews with 27 women (13 in normal weight range and 14 in overweight/obesity ranges) puporsively selected in Lilongwe City, Malawi from October to November 2017. The concept of data saturation guided data collection, and it was reached with the 27 interviewed participants when there was no new information coming from the participants. All interviews were conducted in the local language, transcribed verbatim, and translated into English. The transcripts were analysed manually using thematic content analysis. Results Majority of participants perceived overweight as an indication of good health such that with food affordability, women deliberately gain weight to demonstrate their good health. Most normal weight respondents said they ate less food than they wanted to because of financial constraints. Most women in overweight/obese ranges in our sample reported that they eat large portions and eat frequently due to the desire to portray a good image of their marital life since there is a societal expectation that when a woman is married, her weight should increase to show that the marriage is successful. The perceived contributors to weight gain include eating behaviors, feelings about weight gain, and gender roles and social expectations to gain weight. Conclusion Beliefs and attitudes related to eating behaviors may have contributed to women being in overweight range and should be considered in designing obesity prevention interventions targeting women in Malawi. Supplementary Information The online version contains supplementary material available at 10.1186/s12905-022-01811-0.
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Affiliation(s)
- Myness Kasanda Ndambo
- School of Global and Public Health, Kamuzu University of Health Sciences, Chichiri, Private Bag 360, Blantyre 3, Malawi.
| | - Alinane Linda Nyondo-Mipando
- School of Global and Public Health, Kamuzu University of Health Sciences, Chichiri, Private Bag 360, Blantyre 3, Malawi
| | - Chrissie Thakwalakwa
- Centre for Social Research, Chancellor College, University of Malawi, Zomba, Malawi
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Noor F, Tahir ul Qamar M, Ashfaq UA, Albutti A, Alwashmi ASS, Aljasir MA. Network Pharmacology Approach for Medicinal Plants: Review and Assessment. Pharmaceuticals (Basel) 2022; 15:572. [PMID: 35631398 PMCID: PMC9143318 DOI: 10.3390/ph15050572] [Citation(s) in RCA: 110] [Impact Index Per Article: 55.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 04/27/2022] [Accepted: 04/27/2022] [Indexed: 12/13/2022] Open
Abstract
Natural products have played a critical role in medicine due to their ability to bind and modulate cellular targets involved in disease. Medicinal plants hold a variety of bioactive scaffolds for the treatment of multiple disorders. The less adverse effects, affordability, and easy accessibility highlight their potential in traditional remedies. Identifying pharmacological targets from active ingredients of medicinal plants has become a hot topic for biomedical research to generate innovative therapies. By developing an unprecedented opportunity for the systematic investigation of traditional medicines, network pharmacology is evolving as a systematic paradigm and becoming a frontier research field of drug discovery and development. The advancement of network pharmacology has opened up new avenues for understanding the complex bioactive components found in various medicinal plants. This study is attributed to a comprehensive summary of network pharmacology based on current research, highlighting various active ingredients, related techniques/tools/databases, and drug discovery and development applications. Moreover, this study would serve as a protocol for discovering novel compounds to explore the full range of biological potential of traditionally used plants. We have attempted to cover this vast topic in the review form. We hope it will serve as a significant pioneer for researchers working with medicinal plants by employing network pharmacology approaches.
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Affiliation(s)
- Fatima Noor
- Department of Bioinformatics and Biotechnology, Government College University Faisalabad, Faisalabad 38000, Pakistan; (F.N.); (M.T.u.Q.)
| | - Muhammad Tahir ul Qamar
- Department of Bioinformatics and Biotechnology, Government College University Faisalabad, Faisalabad 38000, Pakistan; (F.N.); (M.T.u.Q.)
| | - Usman Ali Ashfaq
- Department of Bioinformatics and Biotechnology, Government College University Faisalabad, Faisalabad 38000, Pakistan; (F.N.); (M.T.u.Q.)
| | - Aqel Albutti
- Department of Medical Biotechnology, College of Applied Medical Sciences, Qassim University, Buraydah 51452, Saudi Arabia
| | - Ameen S. S. Alwashmi
- Department of Medical Laboratories, College of Applied Medical Sciences, Qassim University, Buraydah 51452, Saudi Arabia; (A.S.S.A.); (M.A.A.)
| | - Mohammad Abdullah Aljasir
- Department of Medical Laboratories, College of Applied Medical Sciences, Qassim University, Buraydah 51452, Saudi Arabia; (A.S.S.A.); (M.A.A.)
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12
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Noor F, Rehman A, Ashfaq UA, Saleem MH, Okla MK, Al-Hashimi A, AbdElgawad H, Aslam S. Integrating Network Pharmacology and Molecular Docking Approaches to Decipher the Multi-Target Pharmacological Mechanism of Abrus precatorius L. Acting on Diabetes. Pharmaceuticals (Basel) 2022; 15:414. [PMID: 35455411 PMCID: PMC9029140 DOI: 10.3390/ph15040414] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 03/07/2022] [Accepted: 03/14/2022] [Indexed: 12/26/2022] Open
Abstract
Type 2 diabetes mellitus (T2DM) is a notable health care load that imposes a serious impact on the quality of life of patients. The small amount of reported data and multiple spectra of pathophysiological mechanisms of T2DM make it a challenging task and serious economic burden in health care management. Abrus precatorius L. is a slender, perennial, deciduous, and woody twining plant used in various regions of Asia to treat a variety of ailments, including diabetes mellitus. Various in vitro studies revealed the therapeutic significance of A. precatorius against diabetes. However, the exact molecular mechanism remains unclarified. In the present study, a network pharmacology technique was employed to uncover the active ingredients, their potential targets, and signaling pathways in A. precatorius for the treatment of T2DM. In the framework of this study, we explored the active ingredient-target-pathway network and figured out that abrectorin, abrusin, abrisapogenol J, sophoradiol, cholanoic acid, precatorine, and cycloartenol decisively contributed to the development of T2DM by affecting AKT1, MAPK3, TNFalpha, and MAPK1 genes. Later, molecular docking was employed to validate the successful activity of the active compounds against potential targets. Lastly, we conclude that four highly active constituents, namely, abrusin, abrisapogenol J, precatorine, and cycloartenol, help in improving the body's sensitivity to insulin and regulate the expression of AKT1, MAPK3, TNFalpha, and MAPK1, which may act as potential therapeutic targets of T2DM. Integrated network pharmacology and docking analysis revealed that A. precatorius exerted a promising preventive effect on T2DM by acting on diabetes-associated signaling pathways. This provides a basis to understand the mechanism of the anti-diabetes activity of A. precatorius.
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Affiliation(s)
- Fatima Noor
- Department of Bioinformatics and Biotechnology, Government College University Faisalabad, Faisalabad 38000, Pakistan; (F.N.); (A.R.); (U.A.A.)
| | - Abdur Rehman
- Department of Bioinformatics and Biotechnology, Government College University Faisalabad, Faisalabad 38000, Pakistan; (F.N.); (A.R.); (U.A.A.)
| | - Usman Ali Ashfaq
- Department of Bioinformatics and Biotechnology, Government College University Faisalabad, Faisalabad 38000, Pakistan; (F.N.); (A.R.); (U.A.A.)
| | - Muhammad Hamzah Saleem
- College of Plant Science and Technology, Huazhong Agricultural University, Wuhan 430070, China;
| | - Mohammad K. Okla
- Department of Botany and Microbiology, College of Science, King Saud University, Riyadh 11451, Saudi Arabia; (M.K.O.); (A.A.-H.)
| | - Abdulrahman Al-Hashimi
- Department of Botany and Microbiology, College of Science, King Saud University, Riyadh 11451, Saudi Arabia; (M.K.O.); (A.A.-H.)
| | - Hamada AbdElgawad
- Integrated Molecular Plant Physiology Research, Department of Biology, University of Antwerp, 2000 Antwerpen, Belgium;
| | - Sidra Aslam
- Department of Bioinformatics and Biotechnology, Government College University Faisalabad, Faisalabad 38000, Pakistan; (F.N.); (A.R.); (U.A.A.)
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Kedar Mukthinuthalapati VVP, Sewram V, Ndlovu N, Kimani S, Abdelaziz AO, Chiao EY, Abou-Alfa GK. Hepatocellular Carcinoma in Sub-Saharan Africa. JCO Glob Oncol 2021; 7:756-766. [PMID: 34043413 PMCID: PMC8457845 DOI: 10.1200/go.20.00425] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
More than 80% of global hepatocellular carcinoma (HCC) patients are estimated to occur in sub-Saharan Africa (SSA) and Eastern Asia. The most common risk factor of HCC in SSA is chronic hepatitis B virus (HBV) infection, with the incidence highest in West Africa. HBV is highly endemic in SSA and is perpetuated by incomplete adherence to birth dose immunization, lack of longitudinal follow-up care, and impaired access to antiviral therapy. HBV may directly cause HCC through somatic genetic alterations or indirectly through altered liver function and liver cirrhosis. Other risk factors of HCC in SSA include aflatoxins and, to a lesser extent, African iron overload. HIV plus HBV co-infection increases the risk of developing HCC and is increasingly becoming more common because of improving the survival of patients with HIV infection. Compared with the rest of the world, patients with HCC in SSA have the lowest survival. This is partly due to the late presentation of HCC with advanced symptomatic disease as a result of underdeveloped surveillance practices. Moreover, access to care and resource limitations further limit outcomes for the patients who receive a diagnosis in SSA. There is a need for multipronged strategies to decrease the incidence of HCC and improve its outcomes in SSA.
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Affiliation(s)
| | - Vikash Sewram
- Department of Global Health, Faculty of Medicine and Health Sciences, African Cancer Institute, Stellenbosch University, Cape Town, South Africa
| | - Ntokozo Ndlovu
- University of Zimbabwe College of Health Sciences, Harare, Zimbabwe
| | - Stephen Kimani
- The University of North Carolina at Chapel Hill, Chapel Hill, NC
| | | | | | - Ghassan K Abou-Alfa
- Memorial Sloan Kettering Cancer Center, New York, NY.,Weill Medical College at Cornell University, New York, NY
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14
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Ephraim RKD, Owusu VB, Asiamah J, Mills A, Abaka-Yawson A, Kpene GE, Kwadzokpui PK, Adusei S. Predicting type 2 diabetes mellitus among fishermen in Cape Coast: a comparison between the FINDRISC score and the metabolic syndrome. J Diabetes Metab Disord 2021; 19:1317-1324. [PMID: 33520838 DOI: 10.1007/s40200-020-00650-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 09/28/2020] [Indexed: 01/24/2023]
Abstract
Background Studies over the past decades have observed a sharp rise in the prevalence and incidence of type 2 diabetes mellitus (T2DM). A highly sensitive and specific predictive tool for risky populations is essential. This study assessed two significant diabetes mellitus predictive tools for effectiveness and accuracy among people living in fishing communities in Cape Coast, Ghana. Method In April 2019, we recruited one hundred and thirty-five (135) fishermen from three fishing communities in Cape Coast in the Central Region of Ghana. Each participant underwent a standard metabolic procedure including clinical examination as well as taking of anthropometric variables such as weight, height, waist and hip circumference were also measured. The FINDRISC questionnaire was used to gather data from the respective participants. Serum glucose and lipids were estimated with enzymatic techniques, and metabolic syndrome (MetS) screened with the international diabetes federation (IDF) criteria. Results Of the 135 participants, 71 (52.6%) were women. The average age of study participants was 52 ± 16 years with females averagely older (56.6 ± 15.0) than the males (47.3 ± 15.0). This study recorded 31.1% and 8.9% prediabetic and diabetic fishermen respectively. Frequency of both prediabetes and diabetes was significantly predominant among females (71.4% vs 83.3%) than males (26.2% vs 25.0%) (p < 0.001) respectively. Prevalence of MetS according to the IDF criteria was 18.5%, significantly higher among females (92.0%) than recorded among the males (18.5%). The discriminatory accuracy of FINDRISC [aROC = 0.76 (95% CI 0.68 to 0.83); sensitivity = 58.3% and specificity = 86.9%; p = 0.003; optimal cut-off point = 13.50] and the MetS [aROC = 0.74 (95% CI 0.66 to 0.81); sensitivity = 75.0% and specificity = 71.5%; p = 0.002] despite demonstrating a significantly good capacity to detect T2DM were statistically comparable [aROC = 0.018 (95% CI -0.152 to 0.189); p = 0.834] in our study. Conclusion Our findings indicate that both FINDRISC (with a suitable cut-off value of 13.5) and MetS screening tools possess a good predictive capacity for the detection of T2DM. Additionally, FINDRISC can be employed to detect MetS in a high-risk population.
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Affiliation(s)
- Richard K D Ephraim
- Department of Medical Laboratory Science, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Victor Boachie Owusu
- Department of Medical Laboratory Science, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Jephthah Asiamah
- Department of Medical Laboratory Science, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Arnold Mills
- Department of Medical Laboratory Science, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Albert Abaka-Yawson
- Department of Medical Laboratory Science, School of Allied Health Sciences, University of Health and Allied Sciences, PMB 31, Ho, Ghana
| | - Godsway Edem Kpene
- Department of Medical Laboratory Science, School of Allied Health Sciences, University of Health and Allied Sciences, PMB 31, Ho, Ghana
| | - Precious Kwablah Kwadzokpui
- Department of Medical Laboratory Science, School of Allied Health Sciences, University of Health and Allied Sciences, PMB 31, Ho, Ghana
| | - Samuel Adusei
- Department of Obstetrics and Gynaecology, University of Cape Town, Cape Town, South Africa
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Burrows R, Correa-Burrows P, Bunout D, Barrera G, Rogan J, Kim E, Blanco E, Gahagan S. Obesity and impairment of pancreatic β-cell function in early adulthood, independent of obesity age of onset: The Santiago Longitudinal Study. Diabetes Metab Res Rev 2021; 37:e3371. [PMID: 32562305 DOI: 10.1002/dmrr.3371] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 05/23/2020] [Accepted: 06/03/2020] [Indexed: 12/25/2022]
Abstract
AIM We investigated the relation of time of onset and length of obesity with biomarkers of β-cell function in early adulthood in an infancy cohort. MATERIAL AND METHODS In 1039 23-year-olds, body-mass index (BMI) was measured at multiple time-points from enrollment. BMI trajectories were interpolated with cubic polynomials. Fasting glucose, insulin and adiponectin were measured at 23 years. Homeostatic model assessment-insulin resistance (HOMA-IR), HOMA-S, HOMA-β, HOMA-adiponectin (AD) and disposition index (DI) were estimated. IR and non-alcoholic fatty liver (NAFL) were diagnosed. According to the BMI trajectory, five groups were defined: participants who were never obese (NOB); participants with obesity starting in adolescence and remained obese into adulthood (recent-onset obesity, ROB); participants who were obese in early childhood but transitioned to non-obesity as preadolescents (former obesity, FOB); participants who were obese in early childhood and remained obese into adulthood (persistent obesity, POB); participants with obesity starting in preadolescence and transitioned to non-obesity as adolescents (transient obesity; TOB). RESULTS Obesity was present in 47% of participants during at least one time-point. ROBs and POBs had higher insulin, HOMA-IR and HOMA-β, lower HOMA-S and DI, and higher prevalence of IR and NAFL at 23 years than NOBs, TOBs and FOBs. No differences were found in the β-cell functionality of NOBs, TOBs and FOBs. CONCLUSIONS Persistent and recent obesity are both related to IR, NAFL and a decline of β-cell function in emerging adulthood. Defeating obesity in childhood or adolescence allows reaching emerging adulthood with β-cell functioning similar to that of subjects who were NOB.
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Affiliation(s)
- Raquel Burrows
- Instituto de Nutrición y Tecnología de los Alimentos, Universidad de Chile, Santiago, Chile
| | - Paulina Correa-Burrows
- Instituto de Nutrición y Tecnología de los Alimentos, Universidad de Chile, Santiago, Chile
| | - Daniel Bunout
- Instituto de Nutrición y Tecnología de los Alimentos, Universidad de Chile, Santiago, Chile
| | - Gladys Barrera
- Instituto de Nutrición y Tecnología de los Alimentos, Universidad de Chile, Santiago, Chile
| | - José Rogan
- Departamento de Física, Facultad de Ciencias, Universidad de Chile, Santiago, Chile
- Línea de Simulaciones, Centro para la Nanociencia y la Nanotecnología (CEDENNA), Santiago, Chile
| | - Elissa Kim
- Division of Child Development and Community Health, University of California San Diego, La Jolla, California, USA
| | - Estela Blanco
- Division of Child Development and Community Health, University of California San Diego, La Jolla, California, USA
| | - Sheila Gahagan
- Division of Child Development and Community Health, University of California San Diego, La Jolla, California, USA
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Maiga Y, Diallo S, Konipo FDN, Sangho O, Sangaré M, Diallo SH, Mahamadou S, Péréon Y, Giumelli B, Coulibaly A, Daou M, Traoré Z, Sow Sylla D, Albakaye M, Guinto CO, Ouologem M, Sissoko AS, Traoré HA, Coulibaly SP, Damier P, Attal N, Nizard J. Diabetic polyneuropathy with/out neuropathic pain in Mali: A cross-sectional study in two reference diabetes treatment centers in Bamako (Mali), Western Africa. PLoS One 2020; 15:e0241387. [PMID: 33166296 PMCID: PMC7652324 DOI: 10.1371/journal.pone.0241387] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Accepted: 10/13/2020] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Diabetic polyneuropathy (DPN) with or without neuropathic pain is a frequent complication of diabetes. This work aimed to determine the prevalence of diabetic polyneuropathy, to describe its epidemiological aspects, and to analyze the therapeutic itinerary of patients with DPN. METHODS This was a cross-sectional, descriptive study performed synchronously over six months at two major follow-up sites for patients with diabetes in Mali. DPN was diagnosed based on the Michigan Neuropathy Screening Instrument (MNSI). The neuropathic nature of the pain and the quality of life of patients were evaluated by the DN4 and the ED-5D scale, respectively. We used three (3) different questionnaires to collect data from patients (one at inclusion and another during the follow-up consultation) and from the caregivers of patients with DPN. RESULTS We included 252 patients with diabetes, and DPN was found to have a healthcare facility-based prevalence of 69.8% (176/252). The sex ratio was approximately three females for every male patient. The patients were mostly 31 to 60 years of age, 83% had type 2 diabetes, and 86.9% had neuropathic pain Approximately half of the patients (48.3%) had autonomic neuropathy and they reported moderate to intense pain, which was mainly described as a burning sensation. The patients exhibited impaired exteroceptive and proprioceptive sensations in 51.7% of cases. The patients smoked tobacco in 3.4% of cases, while 36.6% of the patients were obese and had dyslipidemia. The caregivers clearly indicated that appropriate medications were not readily accessible or available for their patients with DPN. CONCLUSION The healthcare facility-based prevalence of DPN with or without neuropathic pain was high in our cohort. These inexpensive and easy-to-use tools (MNSI, DN4) can be used to adequately diagnose DPN in the African context. In Mali, screening and early treatment of patients at risk of DPN should allow for a reduction of the burden of the disease, while caregivers need to be adequately trained to manage DPN.
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Affiliation(s)
- Youssoufa Maiga
- Faculty of Medicine, University of Technical Sciences and Technologies, Bamako, Mali
- Department of Neurology, Gabriel Touré Teaching Hospital, Bamako, Mali
- Laboratory of Therapeutics (EA3826), Faculty of Medicine of Nantes, University of Nantes, Nantes, France
| | - Salimata Diallo
- Department of Neurology, Gabriel Touré Teaching Hospital, Bamako, Mali
| | | | - Oumar Sangho
- Faculty of Medicine, University of Technical Sciences and Technologies, Bamako, Mali
| | - Modibo Sangaré
- Faculty of Medicine, University of Technical Sciences and Technologies, Bamako, Mali
| | - Seybou H. Diallo
- Faculty of Medicine, University of Technical Sciences and Technologies, Bamako, Mali
- Department of Neurology, Gabriel Touré Teaching Hospital, Bamako, Mali
| | | | - Yann Péréon
- Reference Center of Neuromuscular Diseases Atlantique-Occitanie-Caraïbes, Hôtel-Dieu, UHC of Nantes, Nantes, France
| | | | - Awa Coulibaly
- Department of Neurology, Gabriel Touré Teaching Hospital, Bamako, Mali
| | - Mariam Daou
- Department of Neurology, Gabriel Touré Teaching Hospital, Bamako, Mali
| | | | - Djeneba Sow Sylla
- Faculty of Medicine, University of Technical Sciences and Technologies, Bamako, Mali
- Center for Combating Diabetes in Mali (CCD), Bamako, Mali
| | - Mohamed Albakaye
- Department of Neurology, Gabriel Touré Teaching Hospital, Bamako, Mali
| | - Cheick Oumar Guinto
- Faculty of Medicine, University of Technical Sciences and Technologies, Bamako, Mali
| | - Madani Ouologem
- Faculty of Dental Surgery, University of Nantes, Nantes, France
| | - Adama S. Sissoko
- Faculty of Medicine, University of Technical Sciences and Technologies, Bamako, Mali
| | - Hamar A. Traoré
- Faculty of Medicine, University of Technical Sciences and Technologies, Bamako, Mali
| | | | | | - Nadine Attal
- INSERM U 98, CET, CHU Ambroise Paré, 92100 Boulogne-Billancourt, France
| | - Julien Nizard
- Laboratory of Therapeutics (EA3826), Faculty of Medicine of Nantes, University of Nantes, Nantes, France
- Faculty of Medicine, University of Nantes, Nantes, France
- Federal Pain Palliative Care and Support, Laboratory of Therapeutics, Nantes UHC, Nantes, France
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Otovwe A, Akpojubaro EH. Diabetes mellitus in primary and secondary schools in Africa: an exploratory review. ALEXANDRIA JOURNAL OF MEDICINE 2020. [DOI: 10.1080/20905068.2020.1833278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- Agofure Otovwe
- Department of Public and Community Health, College of Health Sciences, Novena University Ogume, Ogume, Nigeria
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18
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Kiptisia RT, Maiyoh GK, Macharia BN, Tuei VC. Safety evaluation and antihyperglycaemic effect of root extract of Maerua decumbens (Brongn.) DeWolf in Wistar rats. SCIENTIFIC AFRICAN 2020. [DOI: 10.1016/j.sciaf.2020.e00379] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
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Wang J, Cai Y, Yu F, Ping Z, Liu L. Body mass index increases the lymph node metastasis risk of breast cancer: a dose-response meta-analysis with 52904 subjects from 20 cohort studies. BMC Cancer 2020; 20:601. [PMID: 32600328 PMCID: PMC7325029 DOI: 10.1186/s12885-020-07064-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 06/11/2020] [Indexed: 12/31/2022] Open
Abstract
Background Since body mass index (BMI) is a convincing risk factor for breast cancer, it is speculated to be associated with lymph node metastasis. However, epidemiological studies are inconclusive. Therefore, this study was conducted to investigate the effect of BMI on the lymph node metastasis risk of breast cancer. Methods Cohort studies that evaluating BMI and lymph node metastasis in breast cancer were selected through various databases including PubMed, PubMed Central (PMC), Web of science, the China National Knowledge Infrastructure (CNKI), Chinese Scientific Journals (VIP) and Wanfang Data Knowledge Service Platform (WanFang) until November 30, 2019. The two-stage, random effect meta-analysis was performed to assess the dose-response relationship between BMI and lymph node metastasis risk. Between-study heterogeneity was assessed using I2. Subgroup analysis was done to find possible sources of heterogeneity. Results We included a total of 20 studies enrolling 52,904 participants. The summary relative risk (RR) (1.10, 95%CI: 1.06–1.15) suggested a significant effect of BMI on the lymph node metastasis risk of breast cancer. The dose-response meta-analysis (RR = 1.01, 95%CI: 1.00–1.01) indicated a positive linear association between BMI and lymph node metastasis risk. For every 1 kg/m2 increment of BMI, the risk of lymph node metastasis increased by 0.89%. In subgroup analyses, positive linear dose-response relationships between BMI and lymph node metastasis risk were observed among Asian, European, American, premenopausal, postmenopausal, study period less than 5 years, and more than 5 years groups. For every 1 kg/m2 increment of BMI, the risk of lymph node metastasis increased by 0.99, 0.85, 0.61, 1.44, 1.45, 2.22, and 0.61%, respectively. Conclusion BMI significantly increases the lymph node metastasis risk of breast cancer as linear dose-response reaction. Further studies are needed to identify this association.
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Affiliation(s)
- Junyi Wang
- College of Public Health, Zhengzhou University, No.100 Science Avenue, Zhengzhou City, 450001, Henan Province, China
| | - Yaning Cai
- College of Public Health, Zhengzhou University, No.100 Science Avenue, Zhengzhou City, 450001, Henan Province, China
| | - Fangfang Yu
- College of Public Health, Zhengzhou University, No.100 Science Avenue, Zhengzhou City, 450001, Henan Province, China
| | - Zhiguang Ping
- College of Public Health, Zhengzhou University, No.100 Science Avenue, Zhengzhou City, 450001, Henan Province, China.
| | - Li Liu
- School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, Henan, China.
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Tesfaye B, Tewabe M, Ferede A, Dawson A. Induced Second Trimester Abortion and Associated Factors at Debre Markos Referral Hospital: Cross-Sectional Study. WOMEN'S HEALTH (LONDON, ENGLAND) 2020; 16:1745506520929546. [PMID: 32578513 PMCID: PMC7315676 DOI: 10.1177/1745506520929546] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 04/21/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND Although most induced abortions in Ethiopia are performed in the first trimester, many women will still require second trimester abortions. While access to abortion in Ethiopia is limited, few data are being available concerning the demand for and associated outcomes of second trimester abortions. This knowledge is important for planning the health service response to abortion. OBJECTIVE The main objective of this study was to determine the proportion and associated factors of second trimester abortion among women presenting for abortion care services at Debre Markos Referral Hospital, Debre Markos, Northwest Ethiopia. METHODS An institution-based cross-sectional study was conducted at Debre Markos Referral Hospital on a sample of 262 calculated using the single population proportion formula. Women who sought abortion services were interviewed consecutively from 12 February 2017 to 14 March 2017. Data were collected in a face-to-face exit interview and document review and analyzed using SPSS version 24.0 software. Bivariate and multivariable analyses were undertaken to identify factors. RESULT Of the women who presented for abortion care services in Debre Markos Referral Hospital, 73 (29.6%) had induced second trimester abortion. Unmarried women (adjusted odds ratio = 4.93, 95% confidence interval = 1.41-17.16) and women employed at private business (adjusted odds ratio = 6.17, 95% confidence interval = 1.16-32.76) were associated with induced second trimester abortion. CONCLUSION This study revealed that almost one-third of women who presented for abortion care services at Debre Markos Referral Hospital had induced second trimester abortions. Raising awareness of the health consequence of second trimester abortion at community levels and counseling to avoid further occurrences are helpful to minimize the problem. Furthermore, early management of induced second trimester abortion is very crucial to prevent further complications.
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Affiliation(s)
- Bekele Tesfaye
- Department of Nursing, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Mesenbet Tewabe
- Department of Medicine, School of Medicine, Debre Markos University, Debre Markos, Ethiopia
| | - Aster Ferede
- Department of Public Health, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Angela Dawson
- The Australian Centre for Public and Population Health Research (ACPPHR), Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
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Boachie RT, Okoro FL, Imai K, Sun L, Elom SO, Nwankwo JO, Ejike CECC, Udenigwe CC. Enzymatic release of dipeptidyl peptidase-4 inhibitors (gliptins) from pigeon pea (Cajanus cajan) nutrient reservoir proteins: In silico and in vitro assessments. J Food Biochem 2019; 43:e13071. [PMID: 31576595 DOI: 10.1111/jfbc.13071] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 09/17/2019] [Accepted: 09/17/2019] [Indexed: 12/13/2022]
Abstract
In silico and in vitro parameters were used to assess the potential of pigeon pea (Cajanus cajan) nutrient reservoir proteins as sources of dipeptidyl peptidase (DPP)-4 inhibitors. In silico, 40 pigeon pea proteins evaluated had 46% of amino acids associated with DPP-4 inhibition. After virtual hydrolysis, pepsin had the highest frequency of release and bioactivity of released DPP-4 inhibiting peptides, compared to papain and thermolysin. In vitro, thermolysin released the most active DPP-4 inhibitors. The protein hydrolysates contained similar amino acids but different particle sizes. Thus, the bioactivity patterns are attributable to the different nature and behavior of proteins/peptides under actual and virtual conditions. Using eight physicochemical variables, a random forest model with moderate prediction accuracy was developed for predicting DPP-4 inhibitory activity of papain hydrolysates. The findings demonstrate that proteins from pigeon pea are precursors of DPP-4 inhibitors, with potential use in formulating functional food for managing type 2 diabetes. PRACTICAL APPLICATIONS: The emerging use of in silico simulations to predict bioactivity of peptides can provide a framework to direct further wet lab assessments. This pattern can enhance focusing on factors relevant to the bioactive properties of interest. However, there is still limited evidence to confirm the reliability and accuracy of this tool. This study therefore provides insight into the practical use of in silico simulations to predict bioactivity of food peptides by assessing the factors relevant to the enzymatic release of dipeptidyl peptidase-4 inhibitors from pigeon pea seed storage proteins and validating the findings with wet lab assessment. This work also provides important information that can enhance the utilization of pigeon pea, which is an orphan crop, in developing functional food products for managing type 2 diabetes mellitus in developing countries.
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Affiliation(s)
- Ruth T Boachie
- School of Nutrition Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Faith L Okoro
- Department of Medical Biochemistry, Faculty of Basic Medical Sciences, College of Medical Sciences, Alex Ekwueme Federal University, Ndufu-Alike, Abakaliki, Nigeria
| | - Kento Imai
- School of Nutrition Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
- Department of Biomolecular Engineering, Graduate School of Engineering, Nagoya University, Nagoya, Japan
| | - Lu Sun
- School of Nutrition Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Sunday O Elom
- Department of Medical Biochemistry, Faculty of Basic Medical Sciences, College of Medical Sciences, Alex Ekwueme Federal University, Ndufu-Alike, Abakaliki, Nigeria
| | - Joseph O Nwankwo
- Department of Medical Biochemistry, Faculty of Basic Medical Sciences, College of Medical Sciences, Alex Ekwueme Federal University, Ndufu-Alike, Abakaliki, Nigeria
| | - Chukwunonso E C C Ejike
- Department of Medical Biochemistry, Faculty of Basic Medical Sciences, College of Medical Sciences, Alex Ekwueme Federal University, Ndufu-Alike, Abakaliki, Nigeria
| | - Chibuike C Udenigwe
- School of Nutrition Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
- Department of Medical Biochemistry, Faculty of Basic Medical Sciences, College of Medical Sciences, Alex Ekwueme Federal University, Ndufu-Alike, Abakaliki, Nigeria
- Department of Chemistry and Biomolecular Sciences, Faculty of Science, University of Ottawa, Ottawa, Ontario, Canada
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Kiros KG, Abyu GY, Belay DS, Goyteom MH, Welegebriel TK. Magnitude of overweight and associated factors among type 2 diabetes mellitus patients at Mekelle public hospitals, Tigray, Ethiopia: a cross-sectional study. BMC Res Notes 2019; 12:762. [PMID: 31752985 PMCID: PMC6873548 DOI: 10.1186/s13104-019-4791-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 11/11/2019] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE To assess magnitude of overweight and associated factors among type 2 diabetes mellitus patients at Mekelle public hospitals, Tigray, Ethiopia. RESULTS A total of 365 participants were enrolled in this study. One hundred ninety-eight (54.2%) of the participants were males and 288 (78.9%) of the study participants were from an urban residence. In this study 161 (44.1%) and 12 (3.3%) of the study subjects were alcohol consumers and smokers respectively. Besides, 166 (45%) of the study participants had poor dietary intake and around 302 (82.7%) had low level of vigorous physical activity. The proportion of individuals who were overweight using body mass index as a measure was 149 (40.8%) and the proportion of individuals who had central obesity using waist circumference as a measure was 194 (53.2%). The magnitude of overweight among study participants from urban residence and alcohol consumers was 138 (92.6%) and 93 (62.4%) respectively. Residence area, alcohol consumption, physical activities, central obesity and dietary intake were the determinant factors for overweight among type 2 diabetes mellitus patients.
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Tesfaye B, Alebel A, Gebrie A, Zegeye A, Tesema Leshargie C, Ferede A, Abera H, Alam K. Diabetes Mellitus and Its Association with Hypertension in Ethiopia: A Systematic Review and Meta-Analysis. Diabetes Res Clin Pract 2019; 156:107838. [PMID: 31520712 DOI: 10.1016/j.diabres.2019.107838] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 08/20/2019] [Accepted: 08/30/2019] [Indexed: 01/12/2023]
Abstract
BACKGROUND Diabetes mellitus (DM) is a growing public health concern globally, including Ethiopia. Although numerous studies have been published from different parts of Ethiopia, no attempt is made so far to estimate the burden of DM at the national level. This study aims to estimate the pooled prevalence of DM and its association with hypertension in Ethiopia. METHODS A systematic search was conducted in major databases. Two authors extracted the necessary data and analysis was conducted using STATA version 14. Heterogeneity across the studies was evaluated by Cochran's Q test and I2 statistics. RESULTS Eighteen studies with a total of 45,284 participants were included in this review. The pooled prevalence of DM was 4.99% (95% CI: 3.86%, 6.11%). Hypertension was significantly associated with DM (OR: 8.32; 95% CI: 3.05, 22.71). CONCLUSION The burden of DM in Ethiopia is considerable, and the association between diabetes and hypertension is significant. Based on the evidence, this review recommends establishing the coordinated national programs that counteract the increasing burden of DM in the country is very essential. In addition, Early hypertension screening should be done in diabetic patients to control co-morbidity and further complications.
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Affiliation(s)
- Bekele Tesfaye
- Department of Nursing, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia.
| | - Animut Alebel
- Department of Nursing, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Alemu Gebrie
- Department of Biomedical Science, School of Medicine, Debre Markos University, Debre Markos, Ethiopia
| | - Abriham Zegeye
- Department of Biomedical Science, School of Medicine, Debre Markos University, Debre Markos, Ethiopia
| | - Cheru Tesema Leshargie
- Department of Public Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Aster Ferede
- Department of Public Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Habtamu Abera
- Department of Nursing, Allied Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Khorshed Alam
- School of Commerce and Centre for Health, Informatics and Economic Research, University of Southern Queensland, Toowoomba, QLD 4350, Australia
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Kindarara DM, Silva GE. Prevalence and Associated Risk Factors of Diabetes in the African Immigrant Population of Sacramento County, California. THE DIABETES EDUCATOR 2019; 45:225-239. [PMID: 30819051 DOI: 10.1177/0145721719834245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Purpose The purpose of this study was to determine the prevalence and associated risk factors of diabetes in the African immigrant population in Sacramento County, California. Methods A cross-sectional study was conducted in Sacramento County, California, from June to August 2018. The convenience sample included 126 African immigrants aged 21 years and older. Sociodemographic and clinical characteristics were collected. Hemoglobin A1C (A1C) level, blood pressure, height, and weight were measured per standard methods. Data were analyzed using descriptive statistics and χ2 test at value of P < .05. Results Of 126 adult individuals included in this study, 32 (25.4%) had diabetes, of whom 25 (19.8%) were previously diagnosed and 7 (5.6%) represented new cases of diabetes. Also, 36 (28.6%) had prediabetes, of whom 24 (19.1%) had previously been told they had prediabetes and 12 (9.5%) represented new cases of prediabetes. Diabetes and prediabetes were significantly higher among participants in the age group of 36 to 60 years, married, employed full-time, and those with hypertension, high blood cholesterol, and participating in 0 to 2 days per week of moderate physical activities. Only one-fifth of all participants with previously known diabetes or previously on treatment had a good glycemic control status. Conclusions The present study found a high prevalence of prediabetes, diabetes, and multiple risk factors of diabetes in the African immigrant population, as well as a poor glycemic control among those with diabetes, calling for urgent attention. Strategies aimed to improving a healthy lifestyle in the African immigrant population are necessary to reduce the burden of diabetes.
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Affiliation(s)
- Désiré M Kindarara
- School of Nursing, College of Health and Human Services, California State University, Sacramento (CSUS), Sacramento, California
- School of Medicine, Department of Public Health Sciences, University of California Davis (UCD), Davis, California
- VA Medical Center, Sacramento, California
| | - Graciela E Silva
- University of Arizona, College of Nursing and College of Public Health, Tucson, Arizona
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Abstract
This paper traces the history of the concept of metabolic disorder in global health and its application to the collection of health metrics relating to the 'epidemic' of non-communicable diseases in Southern Africa, with a focus on Malawi. Although the contemporary science of metabolism points to complexity and contingency, the application of a simplified version of 'metabolic disorder' or 'metabolic syndrome' as the supposed central driver of non-communicable disease in low- and middle-income countries runs the risk of obscuring the ways in which local circumstances and histories interact with global forces to produce epidemiological change. The paper discusses health data collection and its interpretation in Malawi to demonstrate how the use of this concept has led to a narrowing of the category of non-communicable disease and a neglect of the role of infectious disease in producing chronic conditions. Finally, the paper points to alternative approaches which might yield a better understanding of pressing health problems.
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Affiliation(s)
- Megan Vaughan
- Institute of Advanced Studies, University College London, Gower St, London WC1E 6BT, UK
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Koncz V, Geldsetzer P, Manne‐Goehler J, Wendt AS, Teufel F, Subramanian S, Bärnighausen T, De Neve J. Shorter Height is Associated with Diabetes in Women but not in Men: Nationally Representative Evidence from Namibia. Obesity (Silver Spring) 2019; 27:505-512. [PMID: 30801987 PMCID: PMC6646871 DOI: 10.1002/oby.22394] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 11/18/2018] [Indexed: 01/12/2023]
Abstract
OBJECTIVE This study aimed to test the hypothesis that attained adult height, as an indicator of childhood nutrition, is associated with diabetes in adulthood in Namibia, a country where stunting is highly prevalent. METHODS Data from 1,898 women and 1,343 men aged 35 to 64 years included in the Namibia Demographic and Health Survey in 2013 were analyzed. Multiple logistic regression models were used to calculate odds ratios (ORs) and 95% CIs of having diabetes in relation to height. The following three models were considered: Model 1 included only height, Model 2 included height as well as demographic and socioeconomic variables, and Model 3 included body mass index in addition to the covariates from Model 2. RESULTS Overall crude diabetes prevalence was 6.1% (95% CI: 5.0-7.2). Being taller was inversely related with diabetes in women but not in men. In Model 3, a 1-cm increase in women's height was associated with 4% lower odds of having diabetes (OR, 0.96; 95% CI: 0.94-0.99; P = 0.023). CONCLUSIONS Height is associated with a large reduction in diabetes in women but not in men in Namibia. Interventions that allow women to reach their full growth potential may help prevent the growing diabetes burden in the region.
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Affiliation(s)
- Viola Koncz
- Institute of Global Health, Medical Faculty and University HospitalHeidelberg UniversityHeidelbergGermany
- IBE Institute for Medical Information Processing, Biometry and EpidemiologyLudwig Maximilian University of MunichMunichGermany
| | - Pascal Geldsetzer
- Department of Global Health and PopulationHarvard T.H. Chan School of Public HealthBostonMassachusettsUSA
| | - Jennifer Manne‐Goehler
- Department of MedicineBeth Israel Deaconess Medical Center, Harvard Medical SchoolBostonMassachusettsUSA
| | - Amanda S. Wendt
- Institute of Global Health, Medical Faculty and University HospitalHeidelberg UniversityHeidelbergGermany
| | - Felix Teufel
- Institute of Global Health, Medical Faculty and University HospitalHeidelberg UniversityHeidelbergGermany
| | - S.V. Subramanian
- Department of Social and Behavioral SciencesHarvard T.H. Chan School of Public HealthBostonMassachusettsUSA
- Center for Population and Development StudiesHarvard T.H. Chan School of Public HealthBostonMassachusettsUSA
| | - Till Bärnighausen
- Institute of Global Health, Medical Faculty and University HospitalHeidelberg UniversityHeidelbergGermany
- Department of Global Health and PopulationHarvard T.H. Chan School of Public HealthBostonMassachusettsUSA
- Africa Health Research InstituteKwaZulu‐NatalSouth Africa
| | - Jan‐Walter De Neve
- Institute of Global Health, Medical Faculty and University HospitalHeidelberg UniversityHeidelbergGermany
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Njume C, Donkor O, McAinch AJ. Predisposing factors of type 2 diabetes mellitus and the potential protective role of native plants with functional properties. J Funct Foods 2019. [DOI: 10.1016/j.jff.2018.12.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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Mwila KF, Bwembya PA, Jacobs C. Experiences and challenges of adults living with type 2 diabetes mellitus presenting at the University Teaching Hospital in Lusaka, Zambia. BMJ Open Diabetes Res Care 2019; 7:e000497. [PMID: 31798889 PMCID: PMC6861007 DOI: 10.1136/bmjdrc-2017-000497] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 09/23/2019] [Accepted: 10/25/2019] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVE The study explored the experiences and challenges of adults living with type 2 diabetes mellitus (T2DM) presenting at the University Teaching Hospital (UTH) in Lusaka. RESEARCH DESIGN A qualitative descriptive study was conducted. The research relied on purposive sampling to select 28 participants for in-depth interviews. Participants were interviewed during clinical visits at UTH. RESULTS Views from participants showed that some adults living with T2DM experienced physical and mental illnesses. Participants' views reflected that their livelihood with T2DM was influenced by family support, poor or non-adherence to treatment guidelines and access to information, education and communication materials. The most important challenges reported were psychosocial and financial. CONCLUSION The study concluded that some adults living with T2DM experience a lot of physical sicknesses and their challenges, especially of the psychosocial nature may require professional attention. However, particular attention should be paid to the patient's self-care and psychosocial therapy. Self-care protocols should be tailored to complement the different types of patients with diabetes and improve their quality of life. Cite Now.
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Affiliation(s)
- Kunda Faith Mwila
- Department of Population studies and Nutrition, University of Zambia School of Medicine (Public Health), Lusaka, Zambia
- Department of Pediatrics and Child Health, The University Teaching Hospital, Lusaka, Zambia
| | - Phoebe Albina Bwembya
- Department of Population studies and Nutrition, University of Zambia School of Medicine (Public Health), Lusaka, Zambia
| | - Choolwe Jacobs
- Department of Epidemiology and Bio-Statics, University of Zambia School of Medicine, Lusaka, Lusaka, Zambia
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Gurmu Y, Gela D, Aga F. Factors associated with self-care practice among adult diabetes patients in West Shoa Zone, Oromia Regional State, Ethiopia. BMC Health Serv Res 2018; 18:732. [PMID: 30249246 PMCID: PMC6154910 DOI: 10.1186/s12913-018-3448-4] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 08/06/2018] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Diabetes, a rising global health problem, requires continuous self-care practice to prevent acute and chronic complications. However, studies show that few diabetes patients practice the recommended self-care in Ethiopia. The aim of this study was to assess factors associated with self-care practice among adult diabetes patients in public hospitals of West Shoa Zone, Oromia Regional State, Ethiopia. METHODS In this cross-sectional study, 257 diabetes patients (mean age 42.9 ± 14.6 years, 54.1% male) completed the survey in Afan Oromo and Amharic languages. A questionnaire consisting standardized tools was used to collect the data. Descriptive and logistic regression analyses were conducted using SPSS version 21. RESULTS The mean score for diabetes self-care was 39.8 ± 9.5 and 45.5% of the participants scored below the mean. Multiple logistic regression analysis revealed that having higher diabetes knowledge (AOR = 2.42, 95% CI = 1.22, 4.80), self-efficacy (AOR = 3.30, 95% CI = 1.64, 6.62), social support (AOR = 2.86, 95% CI = 1.37, 5.96), secondary school education (AOR = 6.0, 95% CI = 1.90, 18.85), and longer duration of diabetes (AOR = 5.55, 95% CI = 2.29, 13.44) were important predictors of good diabetes self-care practice. CONCLUSION The diabetes education programs should use strategies that enhance patients' diabetes knowledge, self-efficacy, and social support. Patients with recent diabetes diagnosis need special attention as they may relatively lack knowledge and skills in self-care. Further studies are needed to elucidate pathways through which diabetes knowledge, self-efficacy, social support, and health literacy affect diabetes self-care.
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Affiliation(s)
- Yonas Gurmu
- Department of Nursing, College of Medicine & Health Sciences, Ambo University, P. O. Box: 19, Ambo, Ethiopia
| | - Debela Gela
- Department of Nursing & Midwifery, School of Allied Health Sciences, College of Health Science, Addis Ababa University, P.O. Box: 4412, Addis Ababa, Ethiopia
| | - Fekadu Aga
- Department of Nursing & Midwifery, School of Allied Health Sciences, College of Health Science, Addis Ababa University, P.O. Box: 9083, Addis Ababa, Ethiopia
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Issaka A, Paradies Y, Stevenson C. Modifiable and emerging risk factors for type 2 diabetes in Africa: a systematic review and meta-analysis protocol. Syst Rev 2018; 7:139. [PMID: 30208942 PMCID: PMC6136189 DOI: 10.1186/s13643-018-0801-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Accepted: 08/27/2018] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) remains a public health problem in low-income countries, including African countries. Risk factors of this disease in Africa are still unclear. This study will examine the modifiable and emerging risk factors associated with T2DM in Africa. METHODOLOGY The study will include a systematic review and meta-analysis of published and unpublished empirical studies, reporting quantitative data only. We will conduct a search on scientific databases (e.g. Global Health), general online search engines (e.g. Google Scholar) and key websites for grey literature using a combination of key countries/geographic terms, risk factors (e.g. overweight/obesity) and T2DM (including a manual search of the included reference lists). We will use the Comprehensive Meta-Analysis Software (CMA) version 2.0 for data management and analysis. This protocol follows the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). DISCUSSION The systematic review and meta-analysis will provide a robust and reliable evidence base for policy makers and future research. This may help with identifying and implementing more cost-effective diabetes prevention strategies and improved resource allocation. SYSTEMATIC REVIEW REGISTRATION This protocol has been registered with the PROSPERO international prospective register of systematic reviews. The reference number is CRD42016043027 .
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Affiliation(s)
- Ayuba Issaka
- School of Health and Social Development, Faculty of Health, Deakin University, 221 Burwood Highway, Burwood, Victoria 3125 Australia
| | - Yin Paradies
- Alfred Deakin Institute, Faculty of Arts and Education, Deakin University, 221 Burwood Highway, Burwood, Victoria 3125 Australia
| | - Christopher Stevenson
- School of Health and Social Development, Faculty of Health, Deakin University, 221 Burwood Highway, Burwood, Victoria 3125 Australia
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Prevalence of diabetic retinopathy and visual impairment in patients with diabetes mellitus in Zambia through the implementation of a mobile diabetic retinopathy screening project in the Copperbelt province: a cross-sectional study. Eye (Lond) 2018; 32:1201-1208. [PMID: 29503450 DOI: 10.1038/s41433-018-0055-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2017] [Revised: 01/13/2018] [Accepted: 01/30/2018] [Indexed: 11/08/2022] Open
Abstract
AIMS A paucity of literature exists on prevalence of diabetic retinopathy (DR) in sub-Saharan Africa. We aim to estimate the prevalence of DR and visual impairment in Zambia's Copperbelt province through a cross-sectional study. METHODS All patients with a diagnosis of diabetes mellitus attending a DR screening programme were eligible to participate. Fundus photographs were graded in accordance with the DR grading system used in the UK National Health service (NHS). Visual impairment data were collected from visual acuity measurements recorded using Snellen chart. RESULTS A total of 2689 patients were screened and of these, 2153 patients had a least one eye of gradable quality for analysis. Fifty-five per cent (1190/2153) of patients were male. Mean age was 56 (SD 11). Fifty-two per cent (1113/2153) showed evidence of diabetic retinopathy (DR). Thirty-six per cent of patients graded (779/2153) had sight threatening DR. Proliferative DR was found in 7% (14/208) of type 1 diabetics compared to 5% (42/921) type 2 diabetics (p = <0.001). Duration of diabetes, random blood glucose, systolic and diastolic BP, and use of insulin and oral hypoglycaemics were strongly associated with DR in univariate analysis. The associations of increased systolic BP, random blood glucose, duration of diabetes and insulin use with DR were maintained in multivariate analysis. CONCLUSION We observed a high prevalence of sight threatening DR which is close to the upper range of estimates that currently exist on DR. This study represents further evidence of global health inequality and the scale of the epidemic which sub-Saharan African countries now face.
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Makwero MT, Mollentze WF, Joubert G, Steinberg WJ. Anthropometric profile and complications in patients with diabetes mellitus seen at Maluti Adventist Hospital, Lesotho. S Afr Fam Pract (2004) 2018. [DOI: 10.1080/20786190.2018.1426901] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- MT Makwero
- Department of Family Medicine, University of the Free State , Bloemfontein, South Africa
| | - WF Mollentze
- Department of Internal Medicine, University of the Free State , Bloemfontein, South Africa
| | - G Joubert
- Department of Biostatistics, University of the Free State , Bloemfontein, South Africa
| | - WJ Steinberg
- Department of Family Medicine, University of the Free State , Bloemfontein, South Africa
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Structured peer-led diabetes self-management and support in a low-income country: The ST2EP randomised controlled trial in Mali. PLoS One 2018; 13:e0191262. [PMID: 29357380 PMCID: PMC5777645 DOI: 10.1371/journal.pone.0191262] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 12/28/2017] [Indexed: 01/11/2023] Open
Abstract
Objectives Our objective was to evaluate the effectiveness of peer-led self-management education in improving glycaemic control in patients with type 2 diabetes in a low-income country (Mali). Methods We conducted an open-label randomised controlled trial. A total of 151 adults (76% women, mean age 52.5) with type 2 diabetes (HbA1c≥8%), treated in the diabetes consultation units of two secondary health centres in Bamako, were allocated to peer-led structured patient education (n = 76) or conventional care alone (n = 75). The intervention group received 1 year of culturally tailored structured patient education (3 courses of 4 sessions) delivered in the community by five trained peer educators. Both groups underwent conventional diabetes monitoring and follow-up. Primary outcome was the mean absolute change in HbA1c from baseline to 12 months. Results 177 education sessions were delivered to the intervention group. Patient attrition was 8%. From baseline to 12 months, the decrease in HbA1c levels was 1.05% (SD = 2.0; CI95%: 1.54;-0.56) in the intervention group compared with 0.15% (SD = 1.7; CI95%: -0.56; 0.26) in the control group, p = 0.006. Mean BMI change was -1.65 kg/m2 (SD = 2.5; CI95%: -2.25; -1.06) in the intervention group and +0.05 kg/m2 (SD = 3.2; CI95%: -0.71; 0.81) in the control group, p = 0.0005. Mean waist circumference decreased by 3.34 cm (SD = 9.3; CI95%: -5.56;-1.13) in the intervention group and increased by 2.65 cm (SD = 10.3; CI95%: 0.20; 5.09) in the control group, p = 0.0003. Conclusions Peer-led structured patient education delivered over 1 year to patients with poorly controlled type 2 diabetes in Mali yielded substantial improvements in glycaemic control and anthropometric parameters. This is of importance for the scaling up of efficient interventions in low-resource settings in the future. Trial registration ClinicalTrials.gov NCT01485913
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Ndayisaba A, Harerimana E, Borg R, Miller AC, Kirk CM, Hann K, Hirschhorn LR, Manzi A, Ngoga G, Dusabeyezu S, Mutumbira C, Mpunga T, Ngamije P, Nkikabahizi F, Mubiligi J, Niyonsenga SP, Bavuma C, Park PH. A Clinical Mentorship and Quality Improvement Program to Support Health Center Nurses Manage Type 2 Diabetes in Rural Rwanda. J Diabetes Res 2017; 2017:2657820. [PMID: 29362719 PMCID: PMC5738565 DOI: 10.1155/2017/2657820] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Accepted: 11/08/2017] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION The prevalence of diabetes mellitus is rapidly rising in SSA. Interventions are needed to support the decentralization of services to improve and expand access to care. We describe a clinical mentorship and quality improvement program that connected nurse mentors with nurse mentees to support the decentralization of type 2 diabetes care in rural Rwanda. METHODS This is a descriptive study. Routinely collected data from patients with type 2 diabetes cared for at rural health center NCD clinics between January 1, 2013 and December 31, 2015, were extracted from EMR system. Data collected as part of the clinical mentorship program were extracted from an electronic database. Summary statistics are reported. RESULTS The patient population reflects the rural settings, with low rates of traditional NCD risk factors: 5.6% of patients were current smokers, 11.0% were current consumers of alcohol, and 11.9% were obese. Of 263 observed nurse mentee-patient encounters, mentor and mentee agreed on diagnosis 94.4% of the time. Similarly, agreement levels were high for medication, laboratory exam, and follow-up plans, at 86.3%, 87.1%, and 92.4%, respectively. CONCLUSION Nurses that receive mentorship can adhere to a type 2 diabetes treatment protocol in rural Rwanda primary health care settings.
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Affiliation(s)
| | | | - Ryan Borg
- Partners in Health/Inshuti Mu Buzima, Kigali, Rwanda
| | | | | | | | | | | | - Gedeon Ngoga
- Partners in Health/Inshuti Mu Buzima, Kigali, Rwanda
| | | | | | | | | | | | - Joel Mubiligi
- Partners in Health/Inshuti Mu Buzima, Kigali, Rwanda
| | | | - Charlotte Bavuma
- Ministry of Health, Kigali, Rwanda
- University of Rwanda College of Medicine and Health Sciences, Kigali, Rwanda
| | - Paul H. Park
- Partners in Health/Inshuti Mu Buzima, Kigali, Rwanda
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Bornman MS, Aneck-Hahn NH, de Jager C, Wagenaar GM, Bouwman H, Barnhoorn IEJ, Patrick SM, Vandenberg LN, Kortenkamp A, Blumberg B, Kimmins S, Jegou B, Auger J, DiGangi J, Heindel JJ. Endocrine Disruptors and Health Effects in Africa: A Call for Action. ENVIRONMENTAL HEALTH PERSPECTIVES 2017; 125:085005. [PMID: 28935616 PMCID: PMC5783641 DOI: 10.1289/ehp1774] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 05/22/2017] [Accepted: 05/24/2017] [Indexed: 06/01/2023]
Abstract
BACKGROUND Africa faces a number of unique environmental challenges. Unfortunately, it lacks the infrastructure needed to support the comprehensive environmental studies that could provide the scientific basis to inform environmental policies. There are a number of known sources of endocrine-disrupting chemicals (EDCs) and other hazardous chemicals in Africa. However, a coordinated approach to identify and monitor these contaminants and to develop strategies for public health interventions has not yet been made. OBJECTIVES This commentary summarizes the scientific evidence presented by experts at the First African Endocrine Disruptors meeting. We describe a "call to action" to utilize the available scientific knowledge to address the impact of EDCs on human and wildlife health in Africa. DISCUSSION We identify existing knowledge gaps about exposures to EDCs in Africa and describe how well-designed research strategies are needed to address these gaps. A lack of resources for research and a lag in policy implementation slows down intervention strategies and poses a challenge to advancing future health in Africa. CONCLUSION To address the many challenges posed by EDCs, we argue that Africans should take the lead in prioritization and evaluation of environmental hazards, including EDCs. We recommend the institution of education and training programs for chemical users, adoption of the precautionary principle, establishment of biomonitoring programs, and funding of community-based epidemiology and wildlife research programs led and funded by African institutes and private companies. https://doi.org/10.1289/EHP1774.
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Affiliation(s)
- Maria S Bornman
- Environmental and Occupational Health, School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa
- Environmental Chemical Pollution and Health Research Unit, University of Pretoria, Pretoria, South Africa
| | - Natalie H Aneck-Hahn
- Environmental and Occupational Health, School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa
- Environmental Chemical Pollution and Health Research Unit, University of Pretoria, Pretoria, South Africa
- Department of Urology, University of Pretoria , Pretoria, South Africa
| | - Christiaan de Jager
- Environmental and Occupational Health, School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa
- Environmental Chemical Pollution and Health Research Unit, University of Pretoria, Pretoria, South Africa
| | - Gesina M Wagenaar
- Department of Zoology, University of Johannesburg , Johannesburg, South Africa
| | - Hindrik Bouwman
- Unit for Environmental Sciences and Management, North-West University , Potchefstroom, South Africa
| | | | - Sean M Patrick
- Environmental and Occupational Health, School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa
- Environmental Chemical Pollution and Health Research Unit, University of Pretoria, Pretoria, South Africa
| | - Laura N Vandenberg
- Department of Environmental Health Sciences, University of Massachusetts Amherst School of Public Health and Health Sciences , Amherst, Massachusetts, USA
| | - Andreas Kortenkamp
- Institute of Environment, Health and Societies, Brunel University London , Uxbridge, UK
| | - Bruce Blumberg
- Department of Developmental and Cell Biology, University of California, Irvine , Irvine, California, USA
| | - Sarah Kimmins
- Department of Pharmacology and Therapeutics, Faculty of Medicine, McGill University , Montreal, Canada
- Department of Animal Science, Faculty of Agricultural and Environmental Sciences, McGill University , Montreal, Canada
| | - Bernard Jegou
- Institut de Recherche en Santé, Environnement et Travail (IRSET-INSERM UMR 1085 ), Institut national de la santé et de la recherche médicale (INSERM) , Rennes, France
- Ecole des Hautes Études en Santé Publique (EHESP) , Rennes, France
| | - Jacques Auger
- INSERM U1016, Equipe Génomique, Epigénétique et Physiologie de la Reproduction, Institut Cochin, Université Paris Descartes , Paris, France
| | - Joseph DiGangi
- International POPs Elimination Network (IPEN) , Gothenburg, Sweden
| | - Jerrold J Heindel
- Division of Extramural Research and Training, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services , Research Triangle Park, North Carolina, USA
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Duboz P, Boëtsch G, Gueye L, Macia E. Type 2 diabetes in a Senegalese rural area. World J Diabetes 2017; 8:351-357. [PMID: 28751958 PMCID: PMC5507832 DOI: 10.4239/wjd.v8.i7.351] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 12/16/2016] [Accepted: 01/18/2017] [Indexed: 02/05/2023] Open
Abstract
AIM To estimate the prevalence of diabetes in the rural population of Tessekere (Senegal) and investigate associated risk factors.
METHODS Data from a 2015 survey of 500 individuals age 20 and over representative of the population of the municipality of Tessekere were used. Sociodemographic characteristics, health related variables, capillary whole blood glucose, and weight and height measurements of individuals were collected during face-to-face interviews. Statistical analyses used were bivariate tests and binary logistic regressions.
RESULTS The percentage of individuals having impaired fasting glucose (IFG) is 6.6%. Those with fasting blood glucose (FBG) levels ≥ 126 mg/dL and/or currently being treated for diabetes is 4.2%. Only mean body mass index (BMI) is significantly higher among diabetic individuals and among those having FBG levels ≥ 110 mg/dL. After adjustment for sex, age, educational level, BMI and hypertension, only BMI is associated with diabetes.
CONCLUSION Prevalence of diabetes and IFG in our study correspond to the high range of rural sub-Saharan Africa prevalence. Diabetes is thus becoming a pressing public health concern, even in rural areas. But the risk factors identified in Tessekere suggest that the diabetes epidemic is still in the early stages, such that concerted action would make it possible to contain the devastating impact of this chronic condition.
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Amendezo E, Walker Timothy D, Karamuka V, Robinson B, Kavabushi P, Ntirenganya C, Uwiragiye J, Mukantagwabira D, Bisimwa J, Uwintwali Marie H, Umulisa H, Niyomwungeri S, Ndayambaje B, Dusabejambo V, Bavuma C. Effects of a lifestyle education program on glycemic control among patients with diabetes at Kigali University Hospital, Rwanda: A randomized controlled trial. Diabetes Res Clin Pract 2017; 126:129-137. [PMID: 28237859 DOI: 10.1016/j.diabres.2017.02.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2016] [Revised: 01/15/2017] [Accepted: 02/02/2017] [Indexed: 12/20/2022]
Abstract
AIM Evidence to show whether lifestyle intervention programs are beneficial for patients with diabetes in resource-limited countries is lacking. The present study assessed the additional efficacy of a structured lifestyle education program, as compared to the current standard of diabetic care in Rwanda. METHODS 251 consecutive adult patients attending a tertiary diabetic care practice were randomly assigned to either an intervention group (standard of care plus monthly lifestyle group education sessions of 45min duration) or to a control group. The primary outcome was between-groups difference in glycated hemoglobin (HbA1c) observed after 12-months follow up. Outcome measures in the intervention and control groups were compared using the ANCOVA test with a two-sided significance of 5%. RESULTS Of the 251 subjects recruited, 223 were included in the analysis; of whom 115 were assigned to the intervention group, and 108 to the control group. After 12-months, the median HbA1c levels reduced by 1.70 (95% CI: -2.09 to -1.31; p<0.001) in the intervention group; and by 0.52 (95% CI: -0.95 to -0.10; p=0.01) in the control group. The difference in HbA1c reduction between the intervention and control groups was statistically significant (p<0.001) after adjustment for subjects' age, sex, education level, BMI, diabetes duration and diabetic medications. CONCLUSIONS This study demonstrated that a structured lifestyle group education program for people with diabetes is an attractive option in a resource-limited setting, as it showed significant benefits in improved glycemic control over a 12-month period. TRIAL REGISTRATION ClinicalTrials.gov: NCT02032108.
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Affiliation(s)
- Etienne Amendezo
- Department of Internal Medicine, University of Rwanda, Rwanda; King Faisal Hospital, Kigali, Rwanda.
| | - David Walker Timothy
- Department of Internal Medicine, University of Rwanda, Rwanda; University Teaching Hospital of Butare, Rwanda
| | | | - Brian Robinson
- University Teaching Hospital of Kigali, Rwanda; Human Resources for Health, Rwanda; Brown University, USA
| | - Patrick Kavabushi
- Department of Internal Medicine, University of Rwanda, Rwanda; University Teaching Hospital of Kigali, Rwanda
| | - Cyprien Ntirenganya
- Department of Internal Medicine, University of Rwanda, Rwanda; University Teaching Hospital of Butare, Rwanda
| | | | | | | | | | | | | | | | - Vincent Dusabejambo
- Department of Internal Medicine, University of Rwanda, Rwanda; University Teaching Hospital of Kigali, Rwanda
| | - Charlotte Bavuma
- Department of Internal Medicine, University of Rwanda, Rwanda; University Teaching Hospital of Kigali, Rwanda
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Matovu N, Matovu FK, Sseguya W, Tushemerirwe F. Association of dietary intake and BMI among newly diagnosed type 2 diabetes patients attending diabetic clinics in Kampala. BMC Nutr 2017; 3:21. [PMID: 32153803 PMCID: PMC7050777 DOI: 10.1186/s40795-017-0141-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2016] [Accepted: 03/01/2017] [Indexed: 11/28/2022] Open
Abstract
Background Dietary intake is a known determinant of body mass index (BMI) among different populations and is therefore a useful component for BMI control. To our knowledge, no study has investigated the usual dietary intake and its association with BMI in type 2 diabetes patients among the Ugandan population. This study aimed to analyse the usual dietary intake of newly diagnosed type 2 diabetes patients and determine the association between the different dietary nutrients and BMI. Methods We conducted a cross sectional study among 200 newly diagnosed type 2 diabetes patients in two major diabetic clinics of Kampala district. Sociodemographic, lifestyle, clinical measurements and dietary intake data were collected using a pretested structured questionnaire and a 24-h dietary recall respectively. Patients were divided according to quintile of nutrient intake. The association between dietary intake and BMI was investigated using multiple linear regression. Results The average energy intake was 1960.2 ± 594.6 kilocalories/day. Carbohydrate, protein and fat contributed 73, 12.6 and 14.4% of the daily energy consumption respectively. We observed an inverse association between protein intake and BMI. Slopes (95% C.I) of average BMI for patients in the respective quintiles were: 0.0, -2.1 (-4.2, -0.06), -4.4 (-6.9, -1.9), -5.6 (-8.2, -3.0), and -7.3 (-10.6, -4.0); ptrend <0.001. In contrast, the findings showed a positive association between carbohydrate intake and BMI. Slopes (95% C.I) of average BMI for patients in the respective quintiles were: 0.0, 3.0 (0.6, 5.4), 3.5 (0.5, 6.4), 5.2 (1.9, 8.6) and 9.7 (5.3, 14.1); ptrend <0.001 after adjusting for sociodemographic, clinical and dietary intake variables. We found no significant association between the dietary intake of fibre, fat, saturated fat, polyunsaturated fat and monounsaturated fat with BMI in the final adjusted model. Conclusion Higher intake of carbohydrate was associated with higher BMI while higher intake of protein was associated with lower BMI.
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Affiliation(s)
- Nicholas Matovu
- 1Department of Community Health and Behavioural Sciences, School of Public Health, Makerere University, Kampala, Uganda
| | - Flavia K Matovu
- 2Department of Epidemiology and Biostatistics, School of Public Health, Makerere University and Makerere University - John Hopkins University Research Collaboration, Kampala, Uganda
| | | | - Florence Tushemerirwe
- 1Department of Community Health and Behavioural Sciences, School of Public Health, Makerere University, Kampala, Uganda
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Alouki K, Delisle H, Besançon S. Analyse des coûts médicaux directs des soins du diabète de type 2 au Mali. Rev Epidemiol Sante Publique 2017; 65:41-51. [DOI: 10.1016/j.respe.2016.06.334] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Revised: 03/24/2016] [Accepted: 06/21/2016] [Indexed: 01/28/2023] Open
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Gatimu SM, Milimo BW, Sebastian MS. Prevalence and determinants of diabetes among older adults in Ghana. BMC Public Health 2016; 16:1174. [PMID: 27871259 PMCID: PMC5117548 DOI: 10.1186/s12889-016-3845-8] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Accepted: 11/15/2016] [Indexed: 02/05/2023] Open
Abstract
Background Diabetes is one of the leading non-communicable diseases in Africa, contributing to the increasing disease burden among the old adults. Thus, the aim of this study was to determine the prevalence and determinants of diabetes among adults aged 50 years and above in Ghana. Methods A cross sectional study based on data collected from Study of Ageing and Adult Health (SAGE) Wave 1 from 2007 to 2008. Data was collected from 5565 respondents of whom 4135 were aged 50+ years identified using a multistage stratified clusters design. Bivariate and hierarchical multivariable logistic regression models were used to examine the association of the determinants and diabetes. Results The weighted prevalence of diabetes among the adults aged 50 years and above in Ghana was 3.95% (95% Confidence Interval: 3.35–4.55) with the prevalence being insignificantly higher in females than males (2.16%, 95% CI: 1.69–2.76 vs. 1.73%, 95% CI: 1.28–2.33). Low level of physical activity (Adjusted Odds Ratio [AOR] 2.11, 95% CI: 1.21–3.69) and obesity (AOR 4.81, 95% CI: 1.92–12.0) were associated with increased odds of diabetes among women while old age (AOR 2.58, 95% CI: 1.29–5.18) and university (AOR 12.8, 95% CI: 4.20–39.1), secondary (AOR 3.61, 95% CI: 1.38–9.47) and primary education (AOR 2.71, 95% CI: 1.02–7.19) were associated with increased the odds of diabetes among men. Conclusion The prevalence of diabetes among old adults shows a similar trend with that of the general population. However, the prevalence may have been underestimated due to self-reporting and a high rate of undiagnosed diabetes. In addition, the determinants of diabetes among older adults are a clear indication of the need for diabetes prevention programme targeting the young people and that are gender specific to reduce the burden of diabetes at old age. Physical activity and nutrition should be emphasised in any prevention strategy.
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Affiliation(s)
- Samwel Maina Gatimu
- Department of Midwifery and Gender, School of Nursing, Moi University, P.O. Box 4606, 30100, Eldoret, Kenya. .,School of Nursing, Moi University, PO. Box 4606, 30100, Eldoret, Kenya.
| | - Benson Williesham Milimo
- Department of Midwifery and Gender, School of Nursing, Moi University, P.O. Box 4606, 30100, Eldoret, Kenya.,School of Nursing, Moi University, PO. Box 4606, 30100, Eldoret, Kenya
| | - Miguel San Sebastian
- Department of Public Health and Clinical Medicine, Umeå International School of Public Health, Umeå University, SE-90 185, Umeå, Sweden.,Department of Nursing I, University of the Basque country, Bilbao, Spain
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Katchunga PB, Cikomola J, Tshongo C, Baleke A, Kaishusha D, Mirindi P, Tamburhe T, Kluyskens Y, Sadiki A, Bwanamudogo S, Kashongwe Z, Twagirumukiza M. Obesity and diabetes mellitus association in rural community of Katana, South Kivu, in Eastern Democratic Republic of Congo: Bukavu Observ Cohort Study Results. BMC Endocr Disord 2016; 16:60. [PMID: 27835951 PMCID: PMC5105280 DOI: 10.1186/s12902-016-0143-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2016] [Accepted: 11/01/2016] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Factual data exploring the relationship between obesity and diabetes mellitus prevalence from rural areas of sub-Saharan Africa remain scattered and are unreliable. To address this scarceness, this work reports population study data describing the relationship between the obesity and the diabetes mellitus in the general population of the rural area of Katana (South Kivu in the Democratic Republic of the Congo). METHODS A cohort of three thousand, nine hundred, and sixty-two (3962) adults (>15 years old) were followed between 2012 and 2015 (or 4105 person-years during the observation period), and data were collected using the locally adjusted World Health Organization's (WHO) STEPwise approach to Surveillance (STEPS) methodology. The hazard ratio for progression of obesity was calculated. The association between diabetes mellitus and obesity was analyzed with logistic regression. RESULTS The diabetes mellitus prevalence was 2.8 % versus 3.5 % for obese participants and 7.2 % for those with metabolic syndrome, respectively. Within the diabetes group, 26.9 % had above-normal waist circumference and only 9.8 % were obese. During the median follow-up period of 2 years, the incidence of obesity was 535/100,000 person-years. During the follow-up, the prevalence of abdominal obesity significantly increased by 23 % (p <0.0001), whereas the increased prevalence of general obesity (7.8 %) was not significant (p = 0.53). Finally, diabetes mellitus was independently associated with age, waist circumference, and blood pressure but not body mass index. CONCLUSION This study confirms an association between diabetes mellitus and abdominal obesity but not with general obesity. On the other hand, the rapid increase in abdominal obesity prevalence in this rural area population within the follow-up period calls for the urgent promoting of preventive lifestyle measures.
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Affiliation(s)
- Philippe Bianga Katchunga
- Observatory NCDs VLIR-UOS/UCB, Faculty of Medicine of the Catholic University of Bukavu, Bukavu, South-Kivu Province Democratic Republic of the Congo
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Reference Provincial General Hospital of Bukavu, Bukavu, South-Kivu Province Democratic Republic of the Congo
| | - Justin Cikomola
- Observatory NCDs VLIR-UOS/UCB, Faculty of Medicine of the Catholic University of Bukavu, Bukavu, South-Kivu Province Democratic Republic of the Congo
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Reference Provincial General Hospital of Bukavu, Bukavu, South-Kivu Province Democratic Republic of the Congo
| | - Christian Tshongo
- Observatory NCDs VLIR-UOS/UCB, Faculty of Medicine of the Catholic University of Bukavu, Bukavu, South-Kivu Province Democratic Republic of the Congo
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Reference Provincial General Hospital of Bukavu, Bukavu, South-Kivu Province Democratic Republic of the Congo
| | - Arsene Baleke
- Observatory NCDs VLIR-UOS/UCB, Faculty of Medicine of the Catholic University of Bukavu, Bukavu, South-Kivu Province Democratic Republic of the Congo
| | - David Kaishusha
- Observatory NCDs VLIR-UOS/UCB, Faculty of Medicine of the Catholic University of Bukavu, Bukavu, South-Kivu Province Democratic Republic of the Congo
| | - Patrick Mirindi
- Regional School of Public Health (ERSP), Faculty of Medicine of the Catholic University of Bukavu, Bukavu, South-Kivu Province Democratic Republic of the Congo
| | - Théodore Tamburhe
- Observatory NCDs VLIR-UOS/UCB, Faculty of Medicine of the Catholic University of Bukavu, Bukavu, South-Kivu Province Democratic Republic of the Congo
- Institut de technique médicale, hôpital général de référence de Katana, Katana, Sud-Kivu Democratic Republic of the Congo
| | - Yves Kluyskens
- Observatory NCDs VLIR-UOS/UCB, Faculty of Medicine of the Catholic University of Bukavu, Bukavu, South-Kivu Province Democratic Republic of the Congo
- Department of Pharmacology, Faculty of Medicine and Health sciences, Ghent University, Ghent, Belgium
| | - Antoine Sadiki
- Department of Clinical Biology, Reference Provincial General Hospital of Bukavu, Bukavu, South-Kivu Province Democratic Republic of the Congo
| | - Socrate Bwanamudogo
- Department of Clinical Biology, Reference Provincial General Hospital of Bukavu, Bukavu, South-Kivu Province Democratic Republic of the Congo
| | - Zacharie Kashongwe
- Observatory NCDs VLIR-UOS/UCB, Faculty of Medicine of the Catholic University of Bukavu, Bukavu, South-Kivu Province Democratic Republic of the Congo
| | - Marc Twagirumukiza
- Observatory NCDs VLIR-UOS/UCB, Faculty of Medicine of the Catholic University of Bukavu, Bukavu, South-Kivu Province Democratic Republic of the Congo
- Department of Pharmacology, Faculty of Medicine and Health sciences, Ghent University, Ghent, Belgium
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Shilubane H, Netshikweta L, Ralineba T. Beliefs and practices of diabetic patients in Vhembe district of Limpopo Province. Afr J Prim Health Care Fam Med 2016; 8:e1-6. [PMID: 27380846 PMCID: PMC4913381 DOI: 10.4102/phcfm.v8i2.949] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Revised: 03/01/2016] [Accepted: 03/03/2016] [Indexed: 11/28/2022] Open
Abstract
Background Diabetes mellitus (DM) is a chronic condition affecting over 18 million people worldwide. It can lead to debilitating complications and premature death if not effectively controlled. South Africa, like any sub-Saharan countries and the world at large, is no exception. The prevalence of diabetes among South African adults has increased by 50% from 2009 to date, and an increase of some 11 million new diabetes diagnoses is expected by the year 2020. Purpose The purpose of this study was to describe the beliefs and management practices of patients with DM in Vhembe district, Limpopo province. Setting The study was conducted at Vhembe district clinics. Methods A probability, purposive sampling was used to sample 100 diabetic patients. Data were collected using a pre-tested questionnaire. Data were analysed using the Statistical Package for Social Sciences version 19.0. Descriptive statistics, frequencies, and percentages were used to summarise the data from the study. Results The majority of the respondents had poor management practice of feet care and annual eye examinations. Twenty four (24.0%) of the respondents believed that DM can be cured and 22 (22.0%) did not believe that diet helps in the management of DM. Conclusion The belief that DM is curable can have a negative effect as patients can quit taking treatment once the disease is under control. This happens irrespective of the national guidelines for the management of DM. Therefore, some strategies should be sought that could enhance the implementation of the guidelines in order to combat the disease.
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Mogre V, Wanaba P, Apala P, Nsoh JA. Self-reported receipt of healthcare professional's weight management counselling is associated with self-reported weight management behaviours of type 2 diabetes mellitus patients. SPRINGERPLUS 2016; 5:379. [PMID: 27066386 PMCID: PMC4811845 DOI: 10.1186/s40064-016-2029-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Accepted: 03/18/2016] [Indexed: 01/22/2023]
Abstract
BACKGROUND Weight loss has been shown to influence the health outcomes of type 2 diabetes patients. Providing weight management counselling to diabetes patients may help them adopt appropriate weight management behaviours to lose weight. This study determined the association between self-reported receipt of healthcare professional's weight management counselling and the weight management behaviours of type 2 diabetes patients. METHODS This cross-sectional study was conducted among 378 type 2 diabetes mellitus patients seeking care from two hospitals. Using a questionnaire, participants' weight management behaviours were assessed as well as receipt of healthcare professional's weight management counselling. RESULTS Half (51.3 %) of the participants reported receipt of healthcare professional's weight management counselling in the last 12 months. Half of the participants ever tried to lose weight. Fewer than half of the participants reported modifying their dietary habits (45.5 %) or engaging in exercise (48.7 %) to lose weight. Those who reported receipt of weight management counselling were more likely to report ever trying to lose weight (AOR 43.0, 95 % CI 23.0-81.6; p < 0.001), modifying their dietary habits (AOR 22.5, 95 % CI 13.0-39.19; p < 0.001), and engaging in exercise (AOR 13.0, 95 % CI 7.8-21.7; p < 0.001) to lose weight. CONCLUSION Participants engaged in varied weight management behaviours. Receipt of health care professionals' weight management counselling was associated to participants' reported participation in weight management behaviours. Weight management counselling from health care professionals may support the adoption of weight management behaviours in type 2 diabetes mellitus patients.
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Affiliation(s)
- Victor Mogre
- />Department of Human Biology, School of Medicine and Health Sciences, University for Development Studies, P.O. Box TL 1883, Tamale, Ghana
| | - Peter Wanaba
- />Department of Nursing, School of Allied Health Sciences, University for Development Studies, Tamale, Ghana
| | - Peter Apala
- />Department of Nursing, School of Allied Health Sciences, University for Development Studies, Tamale, Ghana
| | - Jonas A. Nsoh
- />Department of Nursing, School of Allied Health Sciences, University for Development Studies, Tamale, Ghana
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Mutowo MP, Owen AJ, Billah B, Lorgelly PK, Gumbie KE, Mangwiro JC, Renzaho AMN. Burden attributable to Cardiometabolic Diseases in Zimbabwe: a retrospective cross-sectional study of national mortality data. BMC Public Health 2015; 15:1213. [PMID: 26644134 PMCID: PMC4672515 DOI: 10.1186/s12889-015-2554-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 12/01/2015] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Cardiometabolic diseases (CMDs) are an important cause of mortality worldwide and the burden associated with them is increasing in Sub-Saharan Africa. The tracking of mortality helps support evidence based health policy and priority setting. Given the growing prevalence of non-communicable diseases in Zimbabwe, a study was designed to determine the mortality attributable to CMDs in Zimbabwe. METHODS The study design was a retrospective cross-sectional analysis of national mortality from 1996 to 2007, collated by the Ministry of Health and Child Welfare in Zimbabwe. We employed generalized additive models to flexibly estimate the trend of the CMD mortality and a logistic regression model was used to find significant factors (cause of death according to the death certificate) of the CMD mortality and predict CMD mortality to 2040. RESULTS CMDs accounted for 8.13% (95% CI: 8.08% - 8.18%) of all deaths during 1996 to 2007 (p = 0.005). During the study period CMD mortality rate increased by 29.4% (95% CI: 19.9% - 41.1%). The association between gender and CMD mortality indicated female mortality was higher for diabetes (p < 0.001), hypertensive disease (p < 0.001), CVD (p < 0.001) and pulmonary disease (p < 0.001), while male mortality was higher for ischaemic (p = 0.010) and urinary diseases (p < 0.001). There was no gender difference for endocrine disease (p = 0.893). Overall, females have 1.65% higher mortality than males (p < 0.001). CMD mortality is predicted to increase from 9.6 (95% CI: 8.0% - 11.1%) in 2015 to 13.7% (95% CI: 10.2% - 17.2%) in 2040 for males, and from 11.6% (95% CI: 10.2% - 12.9%) in 2015 to 16.2% (95% CI: 13.1% - 19.3%) in 2040 in females. CONCLUSION The findings of this study indicate a growing prevalence of CMDs and related mortality in Zimbabwe. Health policy decisions and cost-effective preventive strategies to reduce the burden of CMDs are urgently required.
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Affiliation(s)
- Mutsa P Mutowo
- School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004, Australia.
| | - Alice J Owen
- School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004, Australia.
| | - Baki Billah
- School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004, Australia.
| | - Paula K Lorgelly
- Centre for Health Economics, Monash University, Melbourne, 3004, Australia.
| | - Kudzai E Gumbie
- Fellow of the Institute of Actuaries (FIA) , Harare, Zimbabwe.
| | - John C Mangwiro
- Zimbabwe Diabetes Association, PO Box 1797, Harare, Zimbabwe.
| | - Andre M N Renzaho
- School of Social Science and Psychology, University of Western Sydney, Sydney, 2751, , New South Wales, Australia.
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White tea consumption restores sperm quality in prediabetic rats preventing testicular oxidative damage. Reprod Biomed Online 2015; 31:544-56. [DOI: 10.1016/j.rbmo.2015.06.021] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 06/16/2015] [Accepted: 06/23/2015] [Indexed: 12/19/2022]
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Demographic factors, weight management behaviours, receipt of healthcare professional's counselling and having knowledge in basic anthropometric measurements associated with underassessment of weight status in overweight and obese type 2 diabetes patients. Obes Res Clin Pract 2015; 10:381-9. [PMID: 26385600 DOI: 10.1016/j.orcp.2015.08.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2015] [Revised: 07/27/2015] [Accepted: 08/29/2015] [Indexed: 11/23/2022]
Abstract
OBJECTIVES To describe the prevalence of underassessment of weight status and weight management behaviours and to evaluate how underassessment of weight status is associated with demographic factors, receipt of healthcare professional's weight management counselling, weight management behaviours and having knowledge in basic anthropometric measurements. METHODS This cross-sectional study included 222 overweight and obese type 2 diabetes patients. Participants' weight and height were determined using appropriate tools. Demographic characteristics, knowledge in basic anthropometric measurements and self-assessment of weight status were determined using a questionnaire. RESULTS They were more overweight (65.8%) than obese (34.2%) participants. Sixty percent reported receipt of weight management counselling from health care professionals. The majority (50.5%) of the participants did not know which category of weight status they were, 30.6% assessed themselves as normal weight and 18.0% assessed themselves as overweight/obese. Prevalence of underassessment was 63.6%. Participants underassessing (2.9% vs. 20%; p=0.004) their weight status were less likely to be able to measure their weight and calculate BMI than their counterparts who accurately self-assessed their weight status. Overweight participants were 3 times more likely to underassess their weight status than obese participants. Underassessment of weight status was less likely in females and in participants who reported receipt of weight management counselling than in those who did not receive weight management counselling. CONCLUSION Underassessment of weight status was more common in overweight than in obese participants. Receipt of weight management counselling was associated with having accurate assessment of weight status. Lack of knowledge in anthropometric measurements was widespread.
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Kavishe B, Biraro S, Baisley K, Vanobberghen F, Kapiga S, Munderi P, Smeeth L, Peck R, Mghamba J, Mutungi G, Ikoona E, Levin J, Bou Monclús MA, Katende D, Kisanga E, Hayes R, Grosskurth H. High prevalence of hypertension and of risk factors for non-communicable diseases (NCDs): a population based cross-sectional survey of NCDS and HIV infection in Northwestern Tanzania and Southern Uganda. BMC Med 2015; 13:126. [PMID: 26021319 PMCID: PMC4476208 DOI: 10.1186/s12916-015-0357-9] [Citation(s) in RCA: 116] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Accepted: 04/30/2015] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The burden of non-communicable diseases (NCDs) is increasing in sub-Saharan Africa, but data available for intervention planning are inadequate. We determined the prevalence of selected NCDs and HIV infection, and NCD risk factors in northwestern Tanzania and southern Uganda. METHODS A population-based cross-sectional survey was conducted, enrolling households using multistage sampling with five strata per country (one municipality, two towns, two rural areas). Consenting adults (≥18 years) were interviewed using the WHO STEPS survey instrument, examined, and tested for HIV and diabetes mellitus (DM). Adjusting for survey design, we estimated population prevalences of hypertension, DM, obstructive pulmonary disease, cardiac failure, epilepsy and HIV, and investigated factors associated with hypertension using logistic regression. RESULTS Across strata, hypertension prevalence ranged from 16 % (95 % confidence interval (CI): 12 % to 22 %) to 17 % (CI: 14 % to 22 %) in Tanzania, and from 19 % (CI: 14 % to 26 %) to 26 % (CI: 23 % to 30 %) in Uganda. It was high in both urban and rural areas, affecting many young participants. The prevalence of DM (1 % to 4 %) and other NCDs was generally low. HIV prevalence ranged from 6 % to 10 % in Tanzania, and 6 % to 12 % in Uganda. Current smoking was reported by 12 % to 23 % of men in different strata, and 1 % to 3 % of women. Problem drinking (defined by Alcohol Use Disorder Identification Test criteria) affected 6 % to 15 % men and 1 % to 6 % women. Up to 46 % of participants were overweight, affecting women more than men and urban more than rural areas. Most patients with hypertension and other NCDs were unaware of their condition, and hypertension in treated patients was mostly uncontrolled. Hypertension was associated with older age, male sex, being divorced/widowed, lower education, higher BMI and, inversely, with smoking. CONCLUSIONS The high prevalence of NCD risk factors and unrecognized and untreated hypertension represent major problems. The low prevalence of DM and other preventable NCDs provides an opportunity for prevention. HIV prevalence was in line with national data. In Tanzania, Uganda and probably elsewhere in Africa, major efforts are needed to strengthen health services for the PREVENTION, early detection and treatment of chronic diseases.
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Affiliation(s)
- Bazil Kavishe
- Mwanza Intervention Trials Unit, National Institute for Medical Research, PO 11936, Mwanza, Tanzania.
| | - Samuel Biraro
- MRC/UVRI Uganda Research Unit on AIDS / Uganda Virus Research Institute, Entebbe, Uganda.
| | - Kathy Baisley
- MRC Tropical Epidemiology Group, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
| | - Fiona Vanobberghen
- Mwanza Intervention Trials Unit, National Institute for Medical Research, PO 11936, Mwanza, Tanzania.
- MRC Tropical Epidemiology Group, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
| | - Saidi Kapiga
- Mwanza Intervention Trials Unit, National Institute for Medical Research, PO 11936, Mwanza, Tanzania.
- MRC Tropical Epidemiology Group, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
| | - Paula Munderi
- MRC/UVRI Uganda Research Unit on AIDS / Uganda Virus Research Institute, Entebbe, Uganda.
| | - Liam Smeeth
- MRC Tropical Epidemiology Group, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
| | - Robert Peck
- Weill Bugando School of Medicine, Mwanza, Tanzania.
- Weill Cornell Medical College, New York, USA.
| | - Janneth Mghamba
- Ministry of Health and Social Welfare, Dar es Salaam, Tanzania.
| | | | | | - Jonathan Levin
- MRC/UVRI Uganda Research Unit on AIDS / Uganda Virus Research Institute, Entebbe, Uganda.
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
| | | | - David Katende
- MRC/UVRI Uganda Research Unit on AIDS / Uganda Virus Research Institute, Entebbe, Uganda.
| | - Edmund Kisanga
- Mwanza Intervention Trials Unit, National Institute for Medical Research, PO 11936, Mwanza, Tanzania.
| | - Richard Hayes
- MRC Tropical Epidemiology Group, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
| | - Heiner Grosskurth
- MRC Tropical Epidemiology Group, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
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Zatu MC, van Rooyen JM, Loots DT, Greeff M, Schutte AE. A comparison of the cardiometabolic profile of black South Africans with suspected non-alcoholic fatty liver disease (NAFLD) and excessive alcohol use. Alcohol 2015; 49:165-72. [PMID: 25543202 DOI: 10.1016/j.alcohol.2014.11.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Accepted: 11/11/2014] [Indexed: 01/01/2023]
Abstract
Excessive alcohol use and non-alcoholic fatty liver disease (NAFLD) are putative cardiovascular disease risk factors. In order to ease the identification of these conditions on primary health care level, we aimed to determine and compare the demographic and cardiometabolic characteristics of excessive alcohol users and those with suspected NAFLD in black South Africans. In the Prospective Urban Rural Epidemiology study (North West Province, South Africa, N = 2021, collected in 2005) we selected 338 participants, namely: 1) alcohol users (N = 143) reporting 'yes' to alcohol intake, with high gamma-glutamyl transferase (GGT) ≥80 U/L and a percentage carbohydrate deficient transferrin (%CDT) ≥2%; 2) non-alcohol users (N = 127) self-reporting 'no' to alcohol intake with GGT ≤30 U/L and %CDT ≤2%; and 3) NAFLD group (N = 68) who were non-drinkers with GGT levels ≥60 U/L and %CDT ≤ 2%. The demographics indicated that the alcohol users were mostly men (73%) with a body mass index (BMI) of 19.8 (15.2-27.3) kg/m(2), 90% of which were smokers. Systolic blood pressure (SBP) of alcohol users significantly correlated with high-density lipoprotein cholesterol (HDL-C) (β = 0.24; p = 0.003) and waist circumference (WC) (β = 0.22; p = 0.006). Non-alcohol users were mostly women (84%) with a BMI of 26.0 (18.0-39.2) kg/m(2) and blood pressure in this group related positively with triglycerides. The NAFLD group were also mostly women (72%) with a comparatively larger WC (p < 0.001) and an adverse metabolic profile (total cholesterol: 5.55 ± 1.69 mmol/L; glycosylated hemoglobin: 6.03 (4.70-9.40) %). Diastolic blood pressure in the NAFLD group associated positively with WC (β = 0.27; p = 0.018). We therefore found disparate gender and cardiometabolic profiles of black South Africans with suspected NAFLD and excessive alcohol use. The described profiles may aid health care practitioners in low resource settings when using these crude screening measures of gender, obesity indices (and self-reported alcohol use) to identify individuals at risk.
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Affiliation(s)
- Mandlenkosi Caswell Zatu
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, North West Province 2520, South Africa; Department of Physiology, University of Limpopo (Medunsa), Pretoria, Gauteng 0001, South Africa; Medical Research Council: Research Unit for Hypertension and Cardiovascular Disease, Faculty of Health Sciences, North West University, South Africa
| | - Johannes Marthinus van Rooyen
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, North West Province 2520, South Africa; Medical Research Council: Research Unit for Hypertension and Cardiovascular Disease, Faculty of Health Sciences, North West University, South Africa
| | - Du Toit Loots
- Centre for Human Metabonomics, North-West University, Potchefstroom, North West Province 2520, South Africa
| | - Minrie Greeff
- Africa Unit for Transdisciplinary Health Research (AUTHeR), North-West University, Potchefstroom, North West Province 2520, South Africa
| | - Aletta Elisabeth Schutte
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, North West Province 2520, South Africa; Medical Research Council: Research Unit for Hypertension and Cardiovascular Disease, Faculty of Health Sciences, North West University, South Africa.
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Daily consumption of white tea (Camellia sinensis (L.)) improves the cerebral cortex metabolic and oxidative profile in prediabetic Wistar rats. Br J Nutr 2015; 113:832-42. [PMID: 25716141 DOI: 10.1017/s0007114514004395] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Diabetes mellitus (DM) is a major public health problem and its incidence is rising dramatically. The brain, particularly the cerebral cortex, is very susceptible to glucose fluctuations and hyperglycaemia-induced oxidative stress. Tea (Camellia sinensis (L.)) is widely consumed; however, the antidiabetic properties of white tea remain largely unexplored. In the present study, we investigated the effects of daily consumption of white tea on the cerebral cortex of prediabetic rats. The cerebral cortex metabolic profile was evaluated, and the expression levels of GLUT, phosphofructokinase-1, lactate dehydrogenase (LDH) and monocarboxylate transporter 4 were assessed. LDH activity was also determined. The cerebral cortex oxidative profile was determined by evaluating its antioxidant power, lipid peroxidation and protein oxidation levels. Catalase, glutathione, glutamate, N-acetylaspartate, aspartate, choline, γ-aminobutyric acid, taurine and valine contents were determined. Daily consumption of white tea ameliorated glucose tolerance and insulin sensitivity. Moreover, white tea altered the cortex glycolytic profile, modulating GLUT expression and lactate and alanine contents. Finally, white tea consumption restored protein oxidation and lipid peroxidation levels and catalase expression, and improved antioxidant capacity. In conclusion, daily consumption of white tea improved the cerebral cortex metabolic and oxidative profile in prediabetic rats, suggesting it as a good, safe and inexpensive strategy to prevent DM-related effects in the cerebral cortex.
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Prevalence of diabetes in Zimbabwe: a systematic review with meta-analysis. Int J Public Health 2014; 60:1-11. [PMID: 25432797 DOI: 10.1007/s00038-014-0626-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Revised: 10/31/2014] [Accepted: 11/17/2014] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE Diabetes appears to be a growing problem in the African region. This study aims to estimate the prevalence of diabetes in Zimbabwe by collating and analyzing previously published data. METHODS Systematic review and meta-analysis of data reporting prevalence of diabetes in Zimbabwe was conducted based on the random effects model. We searched for studies published between January 1960 and December 2013 using MEDLINE, EMBASE and Scopus and University of Zimbabwe electronic publication libraries. In the meta-analysis, sub-groups were created for studies conducted before 1980 and after 1980, to understand the potential effect of independence on prevalence. RESULTS Seven studies were included in the meta-analysis with a total of 29,514 study participants. The overall pooled prevalence of diabetes before 1980 was 0.44% (95% CI 0.0-1.9%), after 1980 the pooled prevalence was 5.7% (95% CI 3.3-8.6%). CONCLUSIONS This study showed that the prevalence of diabetes in Zimbabwe has increased significantly over the past three decades. This poses serious challenges to the provision of care and prevention of disabling co-morbidities in an already disadvantaged healthcare setting.
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