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Pallangyo P, Komba MS, Mkojera ZS, Mfanga L, Mmari JE, Kailembo NV, Bhalia S, Aloyce M, Matemu GG, Faraji HY, Keria JS, Waane T, Kisenge PR. Perspectives for the Prevention of Noncommunicable Diseases in Tanzania: Is Knowledge Translated into Practice? Risk Manag Healthc Policy 2024; 17:1177-1186. [PMID: 38742139 PMCID: PMC11090195 DOI: 10.2147/rmhp.s460703] [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: 02/26/2024] [Accepted: 05/05/2024] [Indexed: 05/16/2024] Open
Abstract
Background In Tanzania, where over a third of the society is impoverished, the burden of NCDs which account for about two-fifths of all disability-adjusted life years (DALYs) and one-third of premature deaths has doubled in the past two decades. However, notwithstanding a wider realization of the escalating burden of NCDs across Tanzania, the link between NCD awareness and lifestyle practices at the population level is not well characterized. We aimed to establish the gap between NCD knowledge and healthy behaviors. Methods This multi-regional community-based cross-sectional study was conducted in 5 regions of Tanzania between September 2022 and June 2023. A 22-item standardized tool evaluating various NCD risk behaviors was used in knowledge assessment and a cut-off of ≥70% was used to denote good knowledge. Bivariate analyses were performed to compare knowledge of NCD risk factors across various NCD risk subgroups. All tests were two tailed, and the significance was set at p<0.05. Results A total of 5121 individuals were consecutively enrolled. The mean age was 47.2 years and females comprised over three-fifths (60.8%) of the participants. With regard to behavioral NCD risks, physical inactivity, unhealthy diet, smoking and alcohol consumption were present in 79.0%, 70.2%, 2.1% and 17.6% of participants, respectively. Moreover, biological risk factors, ie, excess body weight, hypertension, and diabetes were present in 68.4%, 55.8% and 13.0% of participants, respectively. The mean knowledge score was 77.1% and 70.3% of participants demonstrated good knowledge of NCD risk factors. Except for smoking, individuals who showed awareness of various NCD risk factors were found to have significant rates of risky behaviors. Conclusion Despite sufficient NCD risk knowledge, incongruent lifestyle practices persist, highlighting a crucial concern. This suggests that awareness of NCDs and their risks may influence motivation for change but may not necessarily result in lifestyle modification.
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Affiliation(s)
- Pédrö Pallangyo
- Department Research and Training, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
- Department of Cardiology, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
| | - Makrina Sotel Komba
- Department Research and Training, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
| | - Zabella Seif Mkojera
- Department Research and Training, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
| | - Loveness Mfanga
- Department Research and Training, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
| | - Janeth Elidaima Mmari
- Department Research and Training, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
- Department of Cardiology, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
| | - Neema Victor Kailembo
- Department Research and Training, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
| | - Smita Bhalia
- Department of Cardiology, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
| | - Mohamed Aloyce
- Department of Cardiology, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
| | - Genofeva Gerald Matemu
- Department of Public Relations, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
| | - Husna Yasin Faraji
- Department of Cardiology, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
| | - Jasmine Said Keria
- Department of Clinical Support Services, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
| | - Tatizo Waane
- Department of Cardiology, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
| | - Peter R Kisenge
- Department of Cardiology, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
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Taiek N, El Fadili NEH, Belkacem A, Cheikh AA, Kabbadj K, Damoun N, Aziouaz F, El Hangouche AJ. The Knowledge Assessment of Cardiovascular Disease Risk Factors: A Cross-Sectional Study. Cureus 2024; 16:e59774. [PMID: 38846251 PMCID: PMC11153971 DOI: 10.7759/cureus.59774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2024] [Indexed: 06/09/2024] Open
Abstract
INTRODUCTION Cardiovascular diseases (CVDs) are the primary cause of mortality worldwide. Numerous factors can indicate the likelihood of developing CVDs. Gaining a comprehensive understanding of these risk factors is the initial step towards implementing successful preventive measures to defy the prevalence of CVDs across all demographics. The aim of this study is to evaluate the Moroccan population's level of knowledge regarding cardiovascular risk factors (CVRF). METHODS This questionnaire-based cross-sectional study was conducted among 744 participants. Their knowledge of CVD risk factors was assessed by the Heart Disease Facts Questionnaire (HDFQ). Socio-demographic characteristics were collected and statistical analyses were performed using Statistical Package for the Social Sciences (IBM SPSS Statistics for Windows, IBM Corp., Version 26.0, Armonk, NY). RESULTS Among 744 participants, 475 (63%) were male and 409 (55%) were young adults. The mean HDFQ score was 64.36%. Overall, 47.4% of the respondents were aware of CVD risk factors, 27% had moderate knowledge and 25.6% had poor knowledge. The most commonly identified factors were smoking (86.8%), obesity (85.6%), and aging (80.5%). Age was the only factor that showed a significant association with the awareness of CVD risk factors. CONCLUSION The level of knowledge of CVRF is moderate among the Moroccan population. Effective health education about CVRF and adequate prevention measures is certainly essential to minimize the burden of CVD.
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Affiliation(s)
- Nora Taiek
- Department of Physiology, Faculty of Medicine and Pharmacy of Tangier, Abdelmalek Essaadi University, Tangier, MAR
| | - Nour El Houda El Fadili
- Department of Physiology, Faculty of Medicine and Pharmacy of Tangier, Abdelmalek Essaadi University, Tangier, MAR
| | - Abderrahmane Belkacem
- Department of Physiology, Faculty of Medicine and Pharmacy of Tangier, Abdelmalek Essaadi University, Tangier, MAR
| | - Attoumane Abdou Cheikh
- Department of Physiology, Faculty of Medicine and Pharmacy of Tangier, Abdelmalek Essaadi University, Tangier, MAR
| | - Kaoutar Kabbadj
- Department of Physiology, Faculty of Medicine and Pharmacy of Tangier, Abdelmalek Essaadi University, Tangier, MAR
| | - Narjisse Damoun
- Department of Physiology, Faculty of Medicine and Pharmacy of Tangier, Abdelmalek Essaadi University, Tangier, MAR
| | - Faiza Aziouaz
- Department of Physiology, Faculty of Medicine and Pharmacy of Tangier, Abdelmalek Essaadi University, Tangier, MAR
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Vigneshwaran E, AlShahrani SM, Alanzi AR, Mohammad AAS, Sadiq MMJ, Khan NA, Alavudeen SS. Comparing knowledge, attitudes, and practices in cardiovascular disease prevention and health promotion between community and hospital pharmacists in Saudi Arabia: A cross-sectional study. Saudi Pharm J 2024; 32:101890. [PMID: 38192383 PMCID: PMC10772382 DOI: 10.1016/j.jsps.2023.101890] [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: 10/30/2023] [Accepted: 11/30/2023] [Indexed: 01/10/2024] Open
Abstract
Purpose Saudi Arabia is one of the leading nations in the world in terms of the high frequency of chronic diseases and their associated risk factors. Knowledge and awareness are crucial for pharmacists to play an active role in the prevention of cardiovascular diseases (CVD). The current study assessed the pharmacists' knowledge, attitude, and practice to determine the potential differences with respect to their respective practice settings toward CVD prevention and related health promotions. Methods It is a cross-sectional study targeted the registered pharmacists in the Kingdom of Saudi Arabia. An online questionnaire was prepared, and the link was circulated through various social media platforms. Descriptive statistics, multivariate linear regression analysis and chi square test were used to analyze the data accordingly. Results A total of 324 pharmacists were included in the study. Among these, 157 (48.4 %) were community pharmacists, and the remaining were hospital pharmacists (51.6 %). No significant differences in knowledge scores were observed between community and hospital pharmacists. The mean attitude score among community and hospital pharmacists was found to be 26.40 ± 5.125 and 25.09 ± 5.393 respectively, which was statistically significant (p = 0.026). Similarly, the total practice scores across the settings were statistically significant (p = 0.02). Gender plays a significant role in terms of knowledge scores among both community and hospital pharmacists (p = 0.016 & 0.029). Gender, professional practice experience, and number of prescriptions handled and prescriptions with CVD medications showed significant differences in the distribution of positive attitudes and good practice frequency between community and hospital pharmacists. Conclusion It is evident that there is a deficiency in knowledge among hospital pharmacists compared to community pharmacists. Which indicates that there is a need for a rigorous continuous pharmacy education covering the fundamental aspects of CVD primary prevention and health promotion among pharmacists, given more focus on hospital pharmacists.
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Affiliation(s)
- Easwaran Vigneshwaran
- Department of Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha, Saudi Arabia
| | - Sultan M. AlShahrani
- Department of Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha, Saudi Arabia
| | - Abdullah R. Alanzi
- Department of Pharmacognosy, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia
| | | | | | - Noohu Abdulla Khan
- Department of Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha, Saudi Arabia
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Odukoya OO, Isikekpei BC, Nwaneri SC, Akodu B, Odeniyi I, Oluwole EO, Osuntoki A. Co-occurrence of Modifiable Risk Factors for Cardiovascular Disease amongst Diabetic Patients in Lagos State, Nigeria. Niger Postgrad Med J 2024; 31:45-52. [PMID: 38321796 DOI: 10.4103/npmj.npmj_239_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 01/16/2024] [Indexed: 02/08/2024]
Abstract
BACKGROUND Diabetes significantly increases the likelihood of developing cardiovascular disease (CVD). This risk can be reduced by addressing modifiable risk factors. The objectives of this study were to assess the modifiable risks for CVD amongst persons with diabetes and identify the factors associated with multiple risk factors. METHODS This cross-sectional study was conducted amongst 357 diabetic patients attending a large tertiary hospital in Southwest Nigeria. Eligible patients were recruited consecutively on clinic days till the minimum sample size was reached. An interviewer-administered survey tool adapted from the World Health Organization STEPS was used to obtain information from study participants. The following risk factors were assessed: tobacco use, obesity, high blood pressure, physical activity, sedentary time and hours of sleep. Data were analysed using the STATA version 15.0 (Stata Corp.) statistical programme. RESULTS The mean age of the participants was 61.7 ± 12.6 years, and they were mostly females (63.9%). Of the risk factors assessed, the most prevalent modifiable risk factors amongst the respondents were inadequate sleep - <8 h on average (91.6%), abdominal obesity (82.6%) and high blood pressure (72%). Others were inadequate physical activity (56%) and lifetime tobacco use (21%). Up to 40.3% of the diabetic persons had three or more co-existing CVD risk factors. Age, gender, work and marital status (P ≤ 0.01) were statistically associated with multiple CVD risk factors. Being male, unmarried and increasing age were predictors of multiple CVD risk factors amongst the diabetic patients. CONCLUSION A significant proportion of the diabetic patients have multiple co-existing modifiable CVD risks. Abdominal obesity and poor sleep were the most prevalent. Older men who are unmarried were more likely to have multiple risks. Primary and secondary preventive measures to address CVD risks amongst diabetic patients are warranted and should target older unmarried men.
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Affiliation(s)
- Oluwakemi Ololade Odukoya
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos State, Nigeria
- Department of Community Health and Primary Care, Lagos University Teaching Hospital, Lagos State, Nigeria
| | - Brenda C Isikekpei
- Department of Community Health and Primary Care, Lagos University Teaching Hospital, Lagos State, Nigeria
| | - Solomon Chiekezi Nwaneri
- Department of Biomedical Engineering, College of Medicine, University of Lagos, Lagos State, Nigeria
- Department of Biomedical Engineering, Faculty of Engineering, University of Lagos, Lagos State, Nigeria
| | - Babatunde Akodu
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos State, Nigeria
| | - Ifedayo Odeniyi
- Department of Internal Medicine, Endocrinology Unit, College of Medicine, University of Lagos, Lagos State, Nigeria
| | - Esther O Oluwole
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos State, Nigeria
| | - Akinniyi Osuntoki
- Department of Biochemistry, College of Medicine, University of Lagos, Lagos State, Nigeria
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Bashatah A, Syed W, Al-Rawi MBA. Knowledge of Cardiovascular Disease Risk Factors and Its Primary Prevention Practices Among the Saudi Public - A Questionnaire-Based Cross-Sectional Study. Int J Gen Med 2023; 16:4745-4756. [PMID: 37881476 PMCID: PMC10596219 DOI: 10.2147/ijgm.s433472] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 10/04/2023] [Indexed: 10/27/2023] Open
Abstract
Background and Objectives In response to the aging population and rapid rise of chronic diseases, it is important to understand the knowledge about primary prevention. We aim to explore Saudi adults' knowledge of cardiovascular disease (CVD) risk factors and its primary prevention practices among the Saudi public. Methods This is a cross-sectional community-based study, conducted among people living in Saudi Arabia to assess the knowledge of CVD risk factors using a total of 24-item questionnaires divided into two sections using the Likert scale, true /False/I do not know. The data were analyzed using the statistical software SPSS v. 26.0 (SPSS Inc., Chicago, IL, USA). Results In this study, the 81.8% of participants (n=296) agreed that high blood pressure was a risk factor for CVD, while more than two-thirds (68.8%; n=249) believed that diabetes was a risk factor for CVD. Furthermore, about the same proportion of respondents ((79.8%; n=289) and (78.7%; n=285)) agreed that physical inactivity and smoking were risk factors for CVD. In addition, the vast majority of them (n=324; 89.5%) believed that regular exercise aids in the prevention of CVD. In contrast, 74.9% (n=271) of individuals agreed that quitting smoking helps prevent CVD. This study indicated that 55.8% (n=202) of respondents had strong knowledge of CVD, while 44.2% (n=160) had inadequate awareness of CVD risk factors and prevention methods. In terms of the association between socio-demographic factors and overall participants' knowledge of CVD risk factors and preventative measures, we discovered that age (p=0.000), gender (p=0.011), educational status (p=0.000), and the presence of chronic disease (p=0.000) were all significantly associated with CVD knowledge score levels. Conclusion Saudi adults have adequate knowledge of CVD risk factors and prevention interventions, but more effort is needed to raise continuous awareness to reduce the prevalence of CVD.
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Affiliation(s)
- Adel Bashatah
- Department of Nursing Administration & Education, College of Nursing, King Saud University, Riyadh, 11451, Saudi Arabia
| | - Wajid Syed
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, 11451, Saudi Arabia
| | - Mohmood Basil A Al-Rawi
- Department of Optometry, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
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Motlohi NF, Wiafe E, Mensah KB, Padayachee N, Petrus R, Bangalee V. A systematic review of the role of community pharmacists in the prevention and control of cardiovascular diseases: the perceptions of patients. Syst Rev 2023; 12:160. [PMID: 37705090 PMCID: PMC10500864 DOI: 10.1186/s13643-023-02338-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 08/28/2023] [Indexed: 09/15/2023] Open
Abstract
BACKGROUND Cardiovascular diseases are a leading cause of mortality globally. The modifiable risk factors can be measured and identified early at primary healthcare facilities. Community pharmacists present an opportunity for improved management of cardiovascular diseases and health outcomes. The systematic review aims to identify the roles of community pharmacists in preventing and controlling cardiovascular diseases and patients' perceptions towards such functions. METHODS A systematic review of the literature was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The team searched MEDLINE, CINAHL via EBSCOhost, and Web of Science from January 2001 to December 2021 with a focus on studies reporting the role of community pharmacists in preventing and controlling cardiovascular diseases, and patients' perceptions of such roles. Search terms included were ''interventions,'' ''community pharmacists,'' ''patients,'' ''cardiovascular diseases,'' ''risk factors,'' and "perceptions". The quality of studies was appraised using the Joanne Briggs Institute checklist. RESULTS A total of 45 studies met the inclusion criteria: 35 (78%) and 10 (22%) reported community pharmacists' preventive and control roles, respectively. Generally, drug therapy monitoring, medicine and lifestyle counselling, and health education were most common roles, with pharmacist-initiated prescribing and social support least common. A total of 11 (24%) studies reported patients' perceptions of community pharmacists' contribution in preventing (73%, n = 8) and controlling (27%, n = 3) cardiovascular diseases. Patients were satisfied with community pharmacists' services in 10 of 11 studies. CONCLUSIONS The findings highlight community pharmacists' capability of providing primary healthcare services in preventing and controlling cardiovascular diseases and provide evidence for their inclusion in primary healthcare frameworks. Future research should assess the effectiveness of these roles and provide a comprehensive evaluation of clinical, humanistic, and economic outcomes. SYSTEMATIC REVIEW REGISTRATION Open Science Framework (OSF) registration https://doi.org/10.17605/OSF.IO/WGFXT .
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Affiliation(s)
| | - Ebenezer Wiafe
- Discipline of Pharmaceutical Sciences, University of KwaZulu-Natal, Durban, South Africa
- Ho Teaching Hospital, Ho, Ghana
| | - Kofi Boamah Mensah
- Discipline of Pharmaceutical Sciences, University of KwaZulu-Natal, Durban, South Africa
- Faculty of Pharmacy and Pharmaceutical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Neelaveni Padayachee
- Department of Pharmacy and Pharmacology, University of Witwatersrand, Johannesburg, South Africa
| | - Ruwayda Petrus
- Discipline of Psychology, University of KwaZulu-Natal, Durban, South Africa
| | - Varsha Bangalee
- Discipline of Pharmaceutical Sciences, University of KwaZulu-Natal, Durban, South Africa
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Alavudeen SS, Easwaran V, Khan NA, Venkatesan K, Paulsamy P, Mohammed Hussein AT, Imam MT, Almalki ZS, Akhtar MS. Cardiovascular Disease-Related Health Promotion and Prevention Services by Pharmacists in Saudi Arabia: How Well Are They Prepared? Healthcare (Basel) 2023; 11:healthcare11111614. [PMID: 37297754 DOI: 10.3390/healthcare11111614] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 05/27/2023] [Accepted: 05/29/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND Cardiovascular diseases (CVDs) have been identified as the leading reason for morbidity and mortality in Saudi Arabia. Pharmacists play a major role in CVD prevention and health promotion. We aimed to assess the knowledge, attitudes, and involvement of pharmacists in CVD prevention and evaluate the influence of continuing medical education in CVD-prevention services in Saudi Arabia. METHOD A cross-sectional study was conducted to evaluate the involvement of pharmacists in CVD-related prevention services along with their knowledge and attitudes. A 34-item questionnaire was developed and distributed among the participants. RESULTS A total of 324 responses were included in the study. More than 60% of pharmacists had provided counseling regarding the importance of healthy lifestyles and self-monitoring CVD risk factors. About half of the participants (49.1%) had never received any CVD-related continuing medical education. Overall, more than 60% of the participants reported positively towards their role in CVD prevention. Lack of time (66%) and lack of educational materials and tools (41%) were the top perceived barriers for providing CVD-prevention and health-promotion activities, followed by lack of skills in using tools (36%) and lack of privacy/space (33%). CONCLUSIONS The involvement of pharmacists in the prevention of CVD is limited in this study. Further education and capacity building are required to strengthen pharmacists' involvement in CVD-prevention and health-promotion activities.
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Affiliation(s)
| | - Vigneshwaran Easwaran
- Department of Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha 62223, Saudi Arabia
| | - Noohu Abdulla Khan
- Department of Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha 62223, Saudi Arabia
| | - Krishnaraju Venkatesan
- Department of Pharmacology, College of Pharmacy, King Khalid University, Abha 62223, Saudi Arabia
| | - Premalatha Paulsamy
- College of Nursing, Mahalah Branch for Girls, King Khalid University, Abha 61421, Saudi Arabia
| | | | - Mohammad Tarique Imam
- Department of Clinical Pharmacy, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Al-Kharj 16273, Saudi Arabia
| | - Ziyad Saeed Almalki
- Department of Clinical Pharmacy, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Al-Kharj 16273, Saudi Arabia
| | - Md Sayeed Akhtar
- Department of Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha 62223, Saudi Arabia
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' Some of my patients only come to renew their prescriptions. They are not interested in any additional advice or support'. Physicians' perceptions on their roles in cardiovascular diseases risk reduction and management in Fiji. Prim Health Care Res Dev 2023; 24:e11. [PMID: 36752134 PMCID: PMC9971845 DOI: 10.1017/s1463423622000779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023] Open
Abstract
BACKGROUND Primary health care (PHC) physicians' perceptions are vital to understand as they are the first-line health care providers in cardiovascular diseases (CVD) risk assessment and management. This study aims to explore PHC physicians' perceptions on their roles and their perceptions on management and risk reduction approaches on CVD risk reduction and management in Fiji. METHODS This is a qualitative study conducted in the Suva Medical area among 7 health centers from 1 August to 31 September, 2021. Purposive sampling was used to recruit physicians who worked in the Suva medical area as PHC physicians with at least 6 months' experience in the Special Outpatients Department clinics. In-depth interview were conducted using a semi-structured questionnaire over the telephone and recorded on a tablet device application. The interview content was then transcribed, and thematic analysis was done. RESULTS This study included 25 PHC physicians. From the thematic analysis, 2 major themes emerged with 6 subthemes. Theme 1 was CVD management skills with 3 subthemes including education, experience and trainings, beliefs and attitudes of physicians, self-confidence and effectiveness in CVD risk reduction and management. Theme 2 was roles and expectations with 3 subthemes including perceptions of effective treatment, perceptions of physicians' roles and perceptions of patients' expectations. Physicians generally see their role as central and imperative. They perceive to be important and leading toward combating CVDs. CONCLUSIONS Physicians' perceptions on their commitment to prevention and management of CVDs through their skills and knowledge, beliefs and motivation should be acknowledged. It is recommended that the physicians are updated on the current evidence-based medicine. Limitations include results that may not be the reflection of the entire physician and multidisciplinary community and the difficulties in face-to-face interviews due to the coronavirus diseases of 2019 pandemic.
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Public Health Interventions Delivered by Pharmacy Professionals in Low- and Middle-Income Countries in Africa: A Systematic Scoping Review. PHARMACY 2023; 11:pharmacy11010024. [PMID: 36827662 PMCID: PMC9960443 DOI: 10.3390/pharmacy11010024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 01/25/2023] [Accepted: 01/27/2023] [Indexed: 02/03/2023] Open
Abstract
Pharmacists and their teams play an important role in providing public health services, however little is known about their level of contribution and the strength of evidence in Africa's Low- and Middle-Income Countries (LMICs). The purpose of this scoping review was to explore and map the available evidence on pharmacy professional-delivered public health interventions in Africa's LMICs. Six electronic databases (Medline, Embase, International Pharmaceutical Abstract, PsycInfo, Maternity and Infant Care, and Cochrane database), relevant grey literature sources, key journals focused on African health issues, and libraries of relevant organizations were searched between January 2010 and December 2020. Studies were included if they reported public health interventions delivered by pharmacy professionals (pharmacists or pharmacy technicians) or their teams. The quality of the individual studies was assessed using an adapted grading system. Thirty-nine studies were included in this review. Pharmacy professionals delivered a wide range of public health interventions, with the most common themes being noncommunicable diseases, infectious diseases, sexual and reproductive health, antimicrobial resistance, and other health conditions, e.g., dental health, unused drugs or waste, minor ailments. The majority of the studies were classified as low-quality evidence. They were predominantly feasibility and acceptability studies conducted in a narrow study area, in a small number of LMICs in Africa, resulting in little evidence of service effectiveness, issues of broad generalizability of the findings, and sustainability. The major constraints to service provision were identified as a lack of training, public recognition, and supporting policies. Pharmacy professionals and their teams across LMICs in Africa have attempted to expand their practice in public health. However, the pace of the expansion has been slow and lacks strong evidence for its generalizability and sustainability. Future research is needed to improve the quality of evidence, which will subsequently serve as a foundation for policy reform, allowing pharmacy professionals to make significant contributions to the public health initiatives in the region.
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Awareness of Cardiovascular Disease Risk Factors by Community Pharmacists in Saudi Arabia. Healthcare (Basel) 2023; 11:healthcare11020151. [PMID: 36673520 PMCID: PMC9859281 DOI: 10.3390/healthcare11020151] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 12/29/2022] [Accepted: 12/31/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Pharmacists in community settings are recognized as highly accessible healthcare practitioners and demonstrate a crucial role in the primary prevention of cardiovascular disease. Evidence indicates that community pharmacists can make a significant impact on controlling cardiovascular disease risk factors, particularly on hypertension. OBJECTIVES We aimed to assess the knowledge of community pharmacists in Saudi Arabia regarding cardiovascular disease risk factors. METHODS A cross-sectional study involving community pharmacists was conducted. The knowledge of cardiovascular disease risk factors was assessed with the Heart Disease Fact Questionnaire (HDFQ). A web link for an anonymous questionnaire was shared with the licensed community pharmacists in Saudi Arabia using the "Seha" platform of the Ministry of Health. Data analysis was performed with R version 4.0.5. RESULTS Three hundred seventy-four community pharmacists responded to the questionnaire. Many community pharmacists (94.4%) had satisfactory awareness of cardiovascular disease risk factors. The odds of having satisfactory HDFQ knowledge for community pharmacists seeing more than 20 individuals with diabetes per month were 20 times (AOR = 19.9, 95% CI: 1.73-260, and p = 0.019) more compared to those seeing fewer than 10 individuals with diabetes per month. The age of the community pharmacists and the average number of individuals with diabetes seen per month were found to be factors associated with satisfactory HDFQ knowledge. CONCLUSION The practicing pharmacists had a substantial understanding of cardiovascular disease risk factors. In line with counseling and education, the implementation of community pharmacy models for improving the knowledge of pharmacists, particularly the young pharmacists, is needed to effectively assist patients with cardiovascular disease.
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Akinmoladun OF, Femi FA, Nesamvuni CN. Implication of knowledge, lifestyle and self-efficacy in the prevention of cardiovascular diseases' risk factors among the urban elderly. Nutr Health 2022:2601060221138894. [PMID: 36377358 DOI: 10.1177/02601060221138894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Background: Cardiovascular disease (CVD) is preventable by effectively managing its risk factors. Such risk factors (smoking, unhealthy eating habits, sedentary lifestyles, etc.) are judged to reflect an individual's self-efficacy, lifestyle modification, and CVD knowledge. Objectives: To evaluate the relationship between lifestyle practices, self-efficacy, and knowledge of CVDs risk factors among the elderly. Methods: A descriptive cross-sectional study was conducted on 424 randomly individuals whose age is ≥60 years. A questionnaire-based survey was administered on the self-efficacy rate, lifestyle practices, and respondents' knowledge of CVDs risk factors. Respondents with a score of ≤50%, 51%-74.99%, and ≥75% were classified as having low, medium, or high self-efficacy. Similarly, the same score was used to classify poor, fair, or good lifestyle; and low, average, or high knowledge. Data were analysed using Statistical Package for Social Sciences, while association among variables was determined using chi-square. Results: Few respondents were involved in physical exercise (1.7%), cigarette smoking (4.5%), regular soft drinks (18.2%), and alcohol consumption (13.2%). Many respondents used excess salt during cooking (92.7%) or ate outside their homes (64.6%). 58.5%, 30.0%, and 11.6% of the respondents had fair, good, and poor lifestyle practices. 11.3%, 58.7%, and 30.0% had low, medium, and high self-efficacy scores. A total of 45.3%, 35.4%, and 19.3% had low, average, and high knowledge. Knowledge and self-efficacy scores were significantly different (P = 0.001). Conclusion: High self-efficacy and its significant relationship with knowledge could mean that CVD risk factors can be checked if the elderly have a proper lifestyle, positive attitudes, and nutrition education.
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Affiliation(s)
- Oluwaseun F Akinmoladun
- Department of Nutrition, School of Health Sciences, 56868University of Venda, Thohoyandou, South Africa
- Nutrition and Dietetics Unit, Department of Food Science and Technology, College of Agriculture, Food Science and Technology, 398081Wesley University, Ondo, Ondo State, Nigeria
| | - Fortune A Femi
- Department of Food Science and Technology, School of Agriculture and Agricultural Technology, 119054Federal University of Technology, Minna, Niger State, Nigeria
| | - Cebisa N Nesamvuni
- Department of Nutrition, School of Health Sciences, 56868University of Venda, Thohoyandou, South Africa
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12
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Pallangyo P, Komba M, Mkojera ZS, Mayala HA, Bhalia SV, Millinga J, Wibonela S, Swai G, Minja DA, Janabi M. Non-Communicable Disease Risk Factors Among Caregivers of Patients Attending a Tertiary Cardiovascular Hospital in Tanzania. Int J Gen Med 2022; 15:4685-4696. [PMID: 35548586 PMCID: PMC9084384 DOI: 10.2147/ijgm.s364392] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 04/20/2022] [Indexed: 01/01/2023] Open
Abstract
Background Notwithstanding the ever-present burden of infectious diseases, the sub-Saharan Africa (SSA) region has experienced a 67% rise in the non-communicable disease (NCD) burden in less than three decades. Furthermore, regardless of the increased recognition of NCDs threat in the region, reliable local estimates and associated drivers are generally lacking. We therefore conducted this cross-sectional study to establish the pattern and correlates of the modifiable NCD risk factors among caregivers of patients attending a tertiary cardiovascular centre in Tanzania. Methods A cross-sectional survey was conducted at Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania. We used a structured questionnaire bearing a modified WHO STEPwise Approach to NCD Risk Factor Surveillance (STEPS) tool to explore the modifiable behavioral and modifiable biological NCD risk factors. Results A total of 1063 caregivers were enrolled in this study. The mean age was 40.5 years, and 55.7% were female. Nearly 80% of participants had a good knowledge regarding NCDs and 85.4% had a positive family history of NCDs. Overall, 1027 (96.6%) participants had at least one modifiable NCD risk factor while 510 (48.0%) had three or more (i.e., clustering). With respect to modifiable behavioral NCD risk factors, 34 (3.2%) were tobacco users, 56 (5.3%) had harmful alcohol consumption, 691 (65%) had unhealthy eating behavior, and 820 (77.1%) were physically inactive. Pertaining to modifiable biological NCD risk factors, 710 (66.8%) had excess body weight, 420 (39.5%) had hypertension and 62 (5.8%) were diabetic. Conclusion A vast majority of caregivers of NCD patients in this tertiary setting were found to have modifiable NCD risk factors with a strong tendency of clustering. These findings call for intensification of both population strategies and targeted group interventions for better control of the NCD threat and its correlates.
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Affiliation(s)
- Pedro Pallangyo
- Department of Research and Training, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
- Department of Cardiology, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
- Correspondence: Pedro Pallangyo, Email
| | - Makrina Komba
- Department of Research and Training, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
| | - Zabella S Mkojera
- Department of Research and Training, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
| | - Henry A Mayala
- Department of Clinical Support Services, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
| | - Smita V Bhalia
- Department of Cardiology, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
| | - Jalack Millinga
- Department of Nursing, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
| | - Salma Wibonela
- Department of Nursing, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
| | - Gudila Swai
- Department of Nursing, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
| | - Dickson A Minja
- Department of Clinical Support Services, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
| | - Mohamed Janabi
- Department of Cardiology, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
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Olubiyi OA, Rotimi BF, Afolayan MA, Alatishe-Muhammad BW, Olubiyi OM, Balami AD. The ten-year risk of developing cardiovascular disease among public health workers in North-Central Nigeria using Framingham and atherogenic index of plasma risk scores. BMC Public Health 2022; 22:847. [PMID: 35477421 PMCID: PMC9047388 DOI: 10.1186/s12889-022-13044-9] [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: 11/08/2021] [Accepted: 03/22/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Estimation of total cardiovascular disease (CVD) risk with the use of risk prediction charts such as the Framingham risk score and Atherogenic index of plasma score is a huge improvement on the practice of identifying and treating each of the risk factors such as high blood pressure and elevated blood cholesterol. The estimation of the total risk highlights that CVD risk factors occur together and thereby predicts who should be treated. There is scarcity of data on the risk scoring of adults in Nigeria including health workers. Therefore, this study was done to estimate the cardiovascular risks of health workers in public health services in north-central Nigeria. METHODS A cross-sectional survey was performed using validated Framingham risk score calculator and calculation of risk based on the lipid profile of 301 randomly selected health workers in North-central Nigeria. Descriptive analysis was done using frequency counts and percentages while inferential statistics were done using chi square and correlation analyses using statistical Package for Social Sciences (SPSS) version 21.0. The confidence level was 95% and the level of significance was set at 0.05. RESULTS The 10-year risk of developing CVD was generally low in the health workers. Using Framingham risk score, 98.3% of health workers have low risk, 1.0% have moderate risk and 0.7% have high risk. Among the cadres of health workers, 1.5% of the nurses have moderate risk while 2.5% of the doctors and 3.3% of the CHEWs have high risk of developing CVD in 10 years. Using Atherogenic index of plasma scoring, only 2% of the health workers have high risk, 4.7% have intermediate risk while 93.4% have low risk. Across the cadres, 6.3% of the nurses and 3.3% of the CHEWs have intermediate risk while 2.4% of the nurses and 3.3% of the CHEWs have high risk. These findings were however not statistically significant. CONCLUSIONS The 10-year risk of developing cardiovascular disease was low in the health workers in this study using both Framingham's risk score and atherogenic index of plasma scores.
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Affiliation(s)
- Olubunmi Abiola Olubiyi
- Department of Disease Control and Elimination, Medical Research Council Unit The Gambia at the London, School of Hygiene and Tropical Medicine, Atlantic Boulevard, Fajara. P.O Box 273, Banjul, The Gambia.
| | - Bosede Folashade Rotimi
- Department of Community Health, Federal Medical Centre, Bida, P.M.B 14, Niger State, Nigeria
| | | | | | - Olufemi Mubo Olubiyi
- Department of Family Medicine, Bafrow Medical Centre, 156 Mosque Rd, Serrekunda, Banjul, The Gambia
| | - Ahmed Dahiru Balami
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
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Workina A, Habtamu A, Diribsa T, Abebe F. Knowledge of modifiable cardiovascular diseases risk factors and its primary prevention practices among diabetic patients at Jimma University Medical Centre: A cross-sectional study. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000575. [PMID: 36962379 PMCID: PMC10022065 DOI: 10.1371/journal.pgph.0000575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 06/16/2022] [Indexed: 11/19/2022]
Abstract
Cardiovascular diseases (CVDs) are the most common cause of mortality and morbidity globally. This is due to the increasing prevalence of modifiable CVDs risk factors. Hence, the study was aimed to identify knowledge and unhealthy behaviors that contribute to CVD among diabetes mellitus patients. An institutional-based cross-sectional study design was employed among diabetes mellitus patients. A close-ended questionnaire developed from up-to-date similar literature was pretested and face-to-face interview techniques were used to collect data. Checked data were entered into the Epidata 4.1 versions. Then, descriptive and bivariate logistic regression was done using SPSS 25 versions. Of the study participants included in the study, 318, more than half of them, 167(52.5%), were aged ≥45 years and 187(58.8%) of them were females. Among the study participants, more than half, 198(62.3%), had good Knowledge of modifiable CVDs risk factors. Most of the study participants identified consuming foods rich in fats instead of vegetables and fruits 198(62.3%), followed by physical inactivity 196(61.6%) as a risk factor for CVD. Regarding CVDs prevention practice, 175(55.0%) of the patients had a good practice. More than three-fourths, 267(84.0%), practice avoiding foods rich in fats and, sugar, and cigarette smoking 250(78.6%). Predictors like educational status, college and above (AOR 2.68; 95% CI 1.14-6.27), and urban residence area (AOR 1.94; 95% CI 1.09-3.15) were associated with knowledge of CVDs risk factors. While sex, marital status monthly income, and age of the participants had no association with knowledge and prevention practice of modifiable CVDs risk factors. The study participants' knowledge and prevention practice of modifiable cardiovascular disease risk factors was satisfactory, even though continuous awareness creation is required to lower CVD mortality and morbidity burdens. Educational status and residence are of the study participants affect the knowledge and prevention practice modifiable of cardiovascular disease risk factors.
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Affiliation(s)
- Abdata Workina
- School of Nursing, Jimma University, Jimma, Oromia, Ethiopia
| | | | - Tujuba Diribsa
- School of Midwifery, Jimma University, Jimma, Oromia, Ethiopia
| | - Fikadu Abebe
- School of Midwifery, Jimma University, Jimma, Oromia, Ethiopia
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Sanuade OA, Kushitor MK, Awuah RB, Asante PY, Agyemang C, de-Graft Aikins A. Lay knowledge of cardiovascular disease and risk factors in three communities in Accra, Ghana: a cross-sectional survey. BMJ Open 2021; 11:e049451. [PMID: 34907046 PMCID: PMC8671941 DOI: 10.1136/bmjopen-2021-049451] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 11/05/2021] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVES Cardiovascular disease is a major cause of morbidity and mortality in Ghana, and urban poor communities are disproportionately affected. Research has shown that knowledge of cardiovascular disease (CVD) is the first step to risk reduction. This study examines knowledge of CVD and risk factors and determinants of CVD knowledge in three urban poor communities in Accra, Ghana. METHODS Using the Cardiovascular Disease Risk Factors Knowledge Level Scale, which has been validated in Ghana, we conducted a cross-sectional survey with 775 respondents aged 15-59 years. CVD knowledge was computed as a continuous variable based on correct answers to 27 questions, and each correct response was assigned one point. Linear regression was used to determine the factors associated with CVD knowledge. RESULTS The mean age of the participants was 30.3±10.8 years and the mean knowledge score was 19.3±4.8. About one-fifth of participants were living with chronic diseases. Overall, 71.1% had good CVD knowledge, and 28.9% had moderate or poor CVD knowledge. CVD knowledge was low in the symptoms and risk factor domains. A larger proportion received CVD knowledge from radio and television. The determinants of CVD knowledge included ethnicity, alcohol consumption, self-reported health and sources of CVD knowledge. CVD knowledge was highest among a minority Akan ethnic group, those who were current alcohol consumers and those who rated their health as very good/excellent, compared with their respective counterparts. CVD knowledge was significantly lower among those who received information from health workers and multiple sources. CONCLUSION This study underscores the need for health education programmes to promote practical knowledge on CVD symptoms, risks and treatment. We outline health systems and community-level barriers to good CVD knowledge and discuss the implications for developing context-specific and culturally congruent CVD primary prevention interventions.
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Affiliation(s)
- Olutobi Adekunle Sanuade
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | | | | | | | - Charles Agyemang
- Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
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16
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Dele-Ojo BF, Raimi TH, Fadare JO, Dada SA, Ajayi EA, Ajayi DD, Ogunmodede JA, Ajayi AO. Association between metabolic syndrome and healthcare work status in Ekiti State, Nigeria. Pan Afr Med J 2021; 39:257. [PMID: 34707758 PMCID: PMC8520423 DOI: 10.11604/pamj.2021.39.257.26201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 06/18/2021] [Indexed: 11/11/2022] Open
Abstract
Introduction metabolic syndrome portends an increased risk of cardiovascular events and death. Evidence showed that healthcare workers are at higher risk of cardiovascular events because of their engagement in night-shift work. Therefore, this study determined the association between metabolic syndrome and healthcare work status in Ekiti State, Nigeria. Methods this was a cross-sectional study involving 105 healthcare workers and 143 non-healthcare workers. The diagnosis of metabolic syndrome was made based on the International Diabetic Federation criteria: abdominal obesity plus, any two of: elevated blood pressure ≥ 130/85 mmHg or previous diagnosis of hypertension on the use of antihypertensive medications; impaired fasting glucose; elevated triglycerides; and low HDL-cholesterol. Factors associated with metabolic syndrome were analysed using univariable and multivariable analysis. Results men comprised 37.9% of the study population and the mean age was 42.1 ± 9.7 years. The prevalence of metabolic syndrome was similar in both groups (HCWs-29.5% vs non-HCWs- 28.0%, p-value=0.789); overall prevalence was 28.6%. Abdominal obesity, elevated total cholesterol and elevated LDL-cholesterol occurred more frequently in HCWs than in non-HCWs: (68.6% vs 55.2%, p-value=0.034; 65.7% vs 39.2%, p-value= < 0.001 and 50.5 vs 28.7%; p-value < 0.001) respectively. Female sex (aOR: 3.67, 95% CI: 1.74-7.45; p < 0.001) and obesity (aOR: 4.39, 95% CI: 2.31-8.37; p < 0.001) were associated with metabolic syndrome. Conclusion a similar prevalence of metabolic syndrome was observed in the healthcare workers and the non- healthcare workers. However, abdominal obesity, elevated total cholesterol and elevated LDL-cholesterol occurred more frequently in healthcare workers than in non- healthcare workers.
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Affiliation(s)
- Bolade Folasade Dele-Ojo
- Department of Medicine, Ekiti State University, Ekiti State University Teaching Hospital, Ado-Ekiti, Ekiti State, Nigeria
| | - Taiwo Hussean Raimi
- Department of Medicine, Ekiti State University, Ekiti State University Teaching Hospital, Ado-Ekiti, Ekiti State, Nigeria
| | - Joseph Olusesan Fadare
- Department of Pharmacology and Therapeutics, Ekiti State University, Ekiti State University Teaching Hospital, Ado-Ekiti, Ekiti State, Nigeria
| | - Samuel Ayokunle Dada
- Department of Medicine, Ekiti State University, Ekiti State University Teaching Hospital, Ado-Ekiti, Ekiti State, Nigeria
| | - Ebenezer Adekunle Ajayi
- Department of Medicine, Ekiti State University, Ekiti State University Teaching Hospital, Ado-Ekiti, Ekiti State, Nigeria
| | - David Daisi Ajayi
- Department of Chemical Pathology, Ekiti State University Teaching Hospital, Ado-Ekiti, Ekiti State, Nigeria
| | | | - Akande Oladimeji Ajayi
- Department of Medicine, Ekiti State University, Ekiti State University Teaching Hospital, Ado-Ekiti, Ekiti State, Nigeria
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Opportunistic screening of cardiovascular disease risk factors in community pharmacies in Nigeria: a cross-sectional study. Int J Clin Pharm 2020; 42:1469-1479. [PMID: 32960427 DOI: 10.1007/s11096-020-01112-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Accepted: 07/25/2020] [Indexed: 10/23/2022]
Abstract
Background Early identification and treatment of cardiovascular disease (CVD) risk factors through screening are crucial in the primary prevention of CVD and reduction in healthcare-related costs. Use of Non-Physician Healthcare-workers including Community Pharmacists has been advocated as an effective and cost-efficient model of healthcare delivery. In Nigeria the use of community pharmacists for mass screening of CVD risk factors has not been explored. Objective We sought to investigate the possibility of mass CVD risk factor screening in community pharmacies by pharmacists. Setting Lagos, Nigeria. Methods Between October and December 2018 eight hundred and eighty-nine apparently healthy participants were screened for obesity, hypertension, diabetes and hypercholesterolaemia in ten community pharmacies. Diabetes and hypercholesterolaemia were screened for using point-of-care testing modalities. A structured questionnaire was used to obtain the socio-demographic data of the participants. Main outcome measures Prevalence of overweight/obesity, hypertension, diabetes, hypercholesterolaemia, smoking and alcohol intake. Results Mean age of the subjects was 56.8 ± 21.1 years. Majority (57.4%) were females. Prevalence of smoking and alcohol intake were 4.3% and 26.7% respectively. 59.7% and 71.5% of males and females were either overweight (BMI ≥ 25 kg/m2) or obese (BMI ≥ 30 kg/m2) respectively. Prevalence of hypertension was 28.2% in all subjects, 30.9% in males and 26.3% in females, p < 0.001. Using BP > 130/80 mmHg prevalence of hypertension was 55.1%. Diabetes was detected in 3% of the subjects while 45.3% had hypercholesterolaemia. In total, 64.1% of the subjects were diagnosed with CVD risk factors for the first time. Conclusion Opportunistic screening for CVD risk factors is possible in community pharmacies and has the ability to detect previously undiagnosed risk factors. This community pharmacy based model could serve as a cost-effective approach to primary prevention of CVD.
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Pallangyo P, Misidai N, Komba M, Mkojera Z, Swai HJ, Hemed NR, Mayala H, Bhalia S, Millinga J, Mollel UW, Kusima HL, Chavala E, Joram Z, Abdallah H, Hamisi R, Janabi M. Knowledge of cardiovascular risk factors among caretakers of outpatients attending a tertiary cardiovascular center in Tanzania: a cross-sectional survey. BMC Cardiovasc Disord 2020; 20:364. [PMID: 32778068 PMCID: PMC7418378 DOI: 10.1186/s12872-020-01648-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 08/03/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Health literacy on cardiovascular diseases (CVDs) plays an effective role in preventing or delaying the disease onset as well as in impacting the efficacy of their management. In view of the projected low health literacy in Tanzania, we conducted this cross-sectional survey to assess for CVD risk knowledge and its associated factors among patient escorts. METHODS A total of 1063 caretakers were consecutively enrolled in this cross-sectional study. An adopted questionnaire consisting of 22 statements assessing various CVD risk behaviors was utilized for assessment of knowledge. Logistic regression analyses were performed to assess for factors associated with poor knowledge of CVD risks. RESULTS The mean age was 40.5 years and women predominated (55.7%). Over two-thirds had a body mass index (BMI) ≥25 kg/m2, 18.5% were alcohol drinkers, 3.2% were current smokers, and 47% were physically inactive. The mean score was 78.2 and 80.0% had good knowledge of CVD risks. About 16.3% believed CVDs are diseases of affluence, 17.4% thought CVDs are not preventable, and 56.7% had a perception that CVDs are curable. Low education (OR 2.6, 95%CI 1.9-3.7, p < 0.001), lack of health insurance (OR 1.5, 95%CI 1.1-2.3, p = 0.03), and negative family history of CVD death (OR 2.2, 95%CI 1.4-3.5, p < 0.001), were independently associated with poor CVD knowledge. CONCLUSIONS In conclusion, despite of a good level of CVD knowledge established in this study, a disparity between individual's knowledge and self-care practices is apparent.
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Affiliation(s)
- Pedro Pallangyo
- Unit of Research and Training, Jakaya Kikwete Cardiac Institute, P. O Box 65141, Dar es Salaam, Tanzania
- Department of Adult Cardiology, Jakaya Kikwete Cardiac Institute, P. O Box 65141, Dar es Salaam, Tanzania
| | - Nsajigwa Misidai
- Unit of Research and Training, Jakaya Kikwete Cardiac Institute, P. O Box 65141, Dar es Salaam, Tanzania
| | - Makrina Komba
- Unit of Research and Training, Jakaya Kikwete Cardiac Institute, P. O Box 65141, Dar es Salaam, Tanzania
| | - Zabella Mkojera
- Unit of Research and Training, Jakaya Kikwete Cardiac Institute, P. O Box 65141, Dar es Salaam, Tanzania
| | - Happiness J. Swai
- Unit of Research and Training, Jakaya Kikwete Cardiac Institute, P. O Box 65141, Dar es Salaam, Tanzania
| | - Naairah R. Hemed
- Unit of Research and Training, Jakaya Kikwete Cardiac Institute, P. O Box 65141, Dar es Salaam, Tanzania
| | - Henry Mayala
- Department of Adult Cardiology, Jakaya Kikwete Cardiac Institute, P. O Box 65141, Dar es Salaam, Tanzania
| | - Smita Bhalia
- Department of Adult Cardiology, Jakaya Kikwete Cardiac Institute, P. O Box 65141, Dar es Salaam, Tanzania
| | - Jalack Millinga
- Department of Nursing, Jakaya Kikwete Cardiac Institute, P. O Box 65141, Dar es Salaam, Tanzania
| | - Upendo W. Mollel
- Outpatient Department, Jakaya Kikwete Cardiac Institute, P. O Box 65141, Dar es Salaam, Tanzania
| | - Happiness L. Kusima
- Department of Adult Cardiology, Jakaya Kikwete Cardiac Institute, P. O Box 65141, Dar es Salaam, Tanzania
| | - Ester Chavala
- Department of Nursing, Jakaya Kikwete Cardiac Institute, P. O Box 65141, Dar es Salaam, Tanzania
- Outpatient Department, Jakaya Kikwete Cardiac Institute, P. O Box 65141, Dar es Salaam, Tanzania
| | - Ziada Joram
- Department of Nursing, Jakaya Kikwete Cardiac Institute, P. O Box 65141, Dar es Salaam, Tanzania
- Outpatient Department, Jakaya Kikwete Cardiac Institute, P. O Box 65141, Dar es Salaam, Tanzania
| | - Halifa Abdallah
- Outpatient Department, Jakaya Kikwete Cardiac Institute, P. O Box 65141, Dar es Salaam, Tanzania
| | - Rajabu Hamisi
- Quality Assurance Unit, Jakaya Kikwete Cardiac Institute, P. O Box 65141, Dar es Salaam, Tanzania
| | - Mohamed Janabi
- Department of Adult Cardiology, Jakaya Kikwete Cardiac Institute, P. O Box 65141, Dar es Salaam, Tanzania
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Godman B, Basu D, Pillay Y, Mwita JC, Rwegerera GM, Anand Paramadhas BD, Tiroyakgosi C, Okwen PM, Niba LL, Nonvignon J, Sefah I, Oluka M, Guantai AN, Kibuule D, Kalemeera F, Mubita M, Fadare J, Ogunleye OO, Distiller LA, Rampamba EM, Wing J, Mueller D, Alfadl A, Amu AA, Matsebula Z, Kalungia A, Zaranyika T, Masuka N, Wale J, Hill R, Kurdi A, Timoney A, Campbell S, Meyer JC. Review of Ongoing Activities and Challenges to Improve the Care of Patients With Type 2 Diabetes Across Africa and the Implications for the Future. Front Pharmacol 2020; 11:108. [PMID: 32265688 PMCID: PMC7098994 DOI: 10.3389/fphar.2020.00108] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 01/28/2020] [Indexed: 12/20/2022] Open
Abstract
Background There has been an appreciable increase in the number of people in Africa with metabolic syndrome and Type 2 diabetes (T2DM) in recent years as a result of a number of factors. Factors include lifestyle changes, urbanisation, and the growing consumption of processed foods coupled with increasing levels of obesity. Currently there are 19 million adults in Africa with diabetes, mainly T2DM (95%), estimated to grow to 47 million people by 2045 unless controlled. This has a considerable impact on morbidity, mortality and costs in the region. There are a number of issues to address to reduce the impact of T2DM including improving detection rates and current access to services alongside addressing issues of adherence to prescribed medicines. There are also high rates of co-morbidities with infectious diseases such as HIV and tuberculosis in patients in Africa with T2DM that require attention. Objective Document ongoing activities across Africa to improve the care of patients with T2DM especially around issues of identification, access, and adherence to changing lifestyles and prescribed medicines. In addition, discussing potential ways forward to improve the care of patients with T2DM based on ongoing activities and experiences including addressing key issues associated with co-morbidities with infectious diseases. Our Approach Contextualise the findings from a wide range of publications including internet based publications of national approaches coupled with input from senior level government, academic and other professionals from across Africa to provide future guidance. Ongoing Activities A number of African countries are actively instigating programmes to improve the care of patients with T2DM starting with improved diagnosis. This recognises the growing burden of non-communicable diseases across Africa, which has been neglected in the past. Planned activities include programmes to improve detection rates and address key issues with diet and lifestyle changes, alongside improving monitoring of care and activities to enhance adherence to prescribed medicines. In addition, addressing potential complexities involving diabetes patients with infectious disease co-morbidities. It is too early to fully assess the impact of such activities. Conclusion There are a number of ongoing activities across Africa to improve the management of patients with diabetes including co-morbidities. However, more needs to be done considering the high and growing burden of T2DM in Africa. Ongoing research will help further benefit resource allocation and subsequent care.
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Affiliation(s)
- Brian Godman
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, United Kingdom.,Division of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria, South Africa.,Division of Clinical Pharmacology, Karolinska Institute, Karolinska University Hospital Huddinge, Stockholm, Sweden.,Health Economics Centre, University of Liverpool Management School, Liverpool, United Kingdom
| | - Debashis Basu
- Department of Public Health Medicine, Steve Biko Academic Hospital, University of Pretoria, Pretoria, South Africa
| | - Yogan Pillay
- HIV & AIDS, TB and Maternal, Child and Women's Health, National Department of Health, Pretoria, South Africa
| | - Julius C Mwita
- Department of Internal Medicine, Faculty of Medicine, University of Botswana, Gaborone, Botswana
| | - Godfrey Mutashambara Rwegerera
- Department of Internal Medicine, Faculty of Medicine, University of Botswana, Gaborone, Botswana.,Department of Medicine, Princess Marina Hospital, Gaborone, Botswana
| | | | - Celda Tiroyakgosi
- Botswana Essential Drugs Action Program, Ministry of Health and Wellness, Gaborone, Botswana
| | - Patrick Mbah Okwen
- Effective Basic Services (eBASE) Africa, Bamenda, Cameroon.,Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia
| | - Loveline Lum Niba
- Effective Basic Services (eBASE) Africa, Bamenda, Cameroon.,Department of Public Health, University of Bamenda, Bambili, Cameroon
| | | | - Israel Sefah
- Department of Pharmacy, Keta Municipal Hospital, Ghana Health Service, Keta, Ghana
| | - Margaret Oluka
- Department of Pharmacology and Pharmacognosy, School of Pharmacy, University of Nairobi, Nairobi, Kenya
| | - Anastasia N Guantai
- Department of Pharmacy Practice and Policy, Faculty of Health Sciences, University of Namibia, Windhoek, Namibia
| | - Dan Kibuule
- Department of Pharmacy Practice and Policy, Faculty of Health Sciences, University of Namibia, Windhoek, Namibia
| | - Francis Kalemeera
- Department of Pharmacy Practice and Policy, Faculty of Health Sciences, University of Namibia, Windhoek, Namibia
| | - Mwangana Mubita
- Department of Pharmacy Practice and Policy, Faculty of Health Sciences, University of Namibia, Windhoek, Namibia
| | - Joseph Fadare
- Department of Pharmacology and Therapeutics, Ekiti State University, Ado-Ekiti, Nigeria.,Department of Medicine, Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria
| | - Olayinka O Ogunleye
- Department of Pharmacology, Therapeutics and Toxicology, Lagos State University College of Medicine, Lagos, Nigeria.,Department of Medicine, Lagos State University Teaching Hospital, Lagos, Nigeria
| | - Larry A Distiller
- Centre for Diabetes & Endocrinology (Pty) Ltd, Johannesburg, South Africa
| | - Enos M Rampamba
- Division of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria, South Africa.,Department of Pharmacy, Tshilidzini Regional Hospital, Limpopo Department Of Health, Shayandima, South Africa
| | - Jeffrey Wing
- School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Debjani Mueller
- Department of Public Health Medicine, Steve Biko Academic Hospital, University of Pretoria, Pretoria, South Africa.,Charlotte Maxeke Medical Research Cluster, Johannesburg, South Africa
| | - Abubakr Alfadl
- National Medicines Board, Federal Ministry of Health, Khartoum, Sudan.,Unaizah College of Pharmacy, Qassim University, Unaizah, Saudi Arabia
| | | | | | - Aubrey Kalungia
- Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka, Zambia
| | - Trust Zaranyika
- Department of Medicine, University of Zimbabwe College of Health Sciences, Harare, Zimbabwe
| | - Nyasha Masuka
- Independent Health Systems Consultant, Harare, Zimbabwe
| | - Janney Wale
- Independent Consumer Advocate, Brunswick, VIC, Australia
| | - Ruaraidh Hill
- Liverpool Reviews and Implementation Group, Liverpool University, Liverpool, United Kingdom
| | - Amanj Kurdi
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, United Kingdom.,Department of Pharmacology, College of Pharmacy, Hawler Medical University, Erbil, Iraq
| | - Angela Timoney
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, United Kingdom.,NHS Lothian Director of Pharmacy, NHS Lothian, Edinburgh, United Kingdom
| | - Stephen Campbell
- Centre for Primary Care, Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, United Kingdom.,NIHR Greater Manchester Patient Safety Translational Research Centre, School of Health Sciences, University of Manchester, Manchester, United Kingdom
| | - Johanna C Meyer
- Division of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria, South Africa
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