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Balouchi A, Rafsanjani MHAP, Al-Mutawaa K, Naderifar M, Rafiemanesh H, Ebadi A, Ghezeljeh TN, Shahraki-Mohammadi A, Al-Mawali A. Hypertension and pre-hypertension in Middle East and North Africa (MENA): A meta-analysis of prevalence, awareness, treatment, and control. Curr Probl Cardiol 2021; 47:101069. [PMID: 34843808 DOI: 10.1016/j.cpcardiol.2021.101069] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 11/11/2021] [Accepted: 11/21/2021] [Indexed: 01/03/2023]
Abstract
Hypertension (HTN) is one of the most important public health challenges, especially in developing countries. Despite individual studies, information on the exact prevalence of prehypertension (pre-HTN) and HTN in the Middle East and North Africa (MENA) is lacking. This meta-analysis was conducted to evaluate prevalence of pre-HTN and HTN, awareness, treatment, and control in the MENA region. PubMed, Web of Science, and Scopus databases were searched from inception to April 30, 2021. Keywords included hypertension, pre-hypertension, awareness, treatment, and control. The quality of the included studies was evaluated using the Hoy scale. A random-effects model was evaluated based on overall HTN. The heterogeneity of the preliminary studies was evaluated using the I2 test. A total of 147 studies involving 1,312,244 participants were included in the meta-analysis. Based on the results of the random-effects method (95% CI), the Prevalence of pre-HTN and HTN were 30.6% (95% CI: 25.2, 36.0%; I2 = 99.9%), and 26.2% (95% CI: 24.6, 27.9%; I2 = 99.8%), respectively. The prevalence of HTN awareness was 51.3% (95% CI: 47.7, 54.8; I2 = 99.0%). The prevalence of HTN treatment was 47.0% (95% CI: 34.8, 59.2; I2 = 99.9%). The prevalence of HTN control among treated patients was 43.1% (95% CI: 38.3, 47.9; I2 = 99.3%). Considering the high prevalence of HTN, very low awareness, and poor HTN control in the region, more attention should be paid to preventive programs for HTN reduction.
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Affiliation(s)
- Abbas Balouchi
- Nursing Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | | | - Kholoud Al-Mutawaa
- Senior consultant community Medicine, Head of Non-communicable Disease Department, Ministry of Public Health, Doha, Qatar
| | - Mahin Naderifar
- Department of Nursing, Zabol University of Medical Sciences, Zabol, Iran
| | | | - Abbas Ebadi
- Behavioral Sciences Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Tahereh Najafi Ghezeljeh
- Nursing Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Azita Shahraki-Mohammadi
- Assistant Professor of Medical Library and Information Sciences, Department of medical library and information sciences, Paramedical school, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Adhra Al-Mawali
- Director/Centre of Studies & Research, Ministry of Health, Oman.
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Dietary Management of Type 2 Diabetes in the MENA Region: A Review of the Evidence. Nutrients 2021; 13:nu13041060. [PMID: 33805161 PMCID: PMC8064070 DOI: 10.3390/nu13041060] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 03/21/2021] [Accepted: 03/21/2021] [Indexed: 12/11/2022] Open
Abstract
The alarmingly rising trend of type 2 diabetes constitutes a major global public health challenge particularly in the Middle Eastern and North African (MENA) region where the prevalence is among the highest in the world with a projection to increase by 96% by 2045. The economic boom in the MENA region over the past decades has brought exceptionally rapid shifts in eating habits characterized by divergence from the traditional Mediterranean diet towards a more westernized unhealthy dietary pattern, thought to be leading to the dramatic rises in obesity and non-communicable diseases. Research efforts have brought a greater understanding of the different pathways through which diet and obesity may affect diabetes clinical outcomes, emphasizing the crucial role of dietary interventions and weight loss in the prevention and management of diabetes. The purpose of this review is to explore the mechanistic pathways linking obesity with diabetes and to summarize the most recent evidence on the association of the intake of different macronutrients and food groups with the risk of type 2 diabetes. We also summarize the most recent evidence on the effectiveness of different macronutrient manipulations in the prevention and management of diabetes while highlighting the possible underlying mechanisms of action and latest evidence-based recommendations. We finally discuss the need to adequately integrate dietetic services in diabetes care specific to the MENA region and conclude with recommendations to improve dietetic care for diabetes in the region.
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Risk factors and visual outcome of Non-Arteritic Ischemic Optic Neuropathy (NAION): Experience of a tertiary center in Kuwait. PLoS One 2021; 16:e0247126. [PMID: 33600480 PMCID: PMC7891726 DOI: 10.1371/journal.pone.0247126] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 02/02/2021] [Indexed: 11/19/2022] Open
Abstract
Background Non-arteritic ischemic optic neuropathy (NAION) is the most common acute optic neuropathy over the age of 50 years. NAION is commonly associated with systemic vascular risk factors (diabetes, hypertension, hyperlipidemia) and small cup-to-disc-ratio. We have assessed the prevalence risk factors of NAION and the visual outcome in patients referred to a tertiary ophthalmology center in Kuwait. Materials and methods A retrospective review of new cases of NAION presenting within 2 weeks of onset were included and baseline clinical and demographics characteristic were determined. The prevalence of risk factors and the visual outcome (change in logMAR visual acuity, mean deviation of visual field) was compared between young NAION patients (below 50 years of age) and older NAION patients (over 50 years of age). The odds ratio of a final favorable visual outcome (visual acuity 20/40 or better) by age category was determined. Results Seventy-eight eyes of 78 patients with recent onset NAION were included in the study. The most prevalent risk factors for NAION in our subjects were diabetes (64.1%), small cup-to-disc ratio (61.5%), hyperlipidemia (51.3%) and hypertension (38.5%). Young NAION patients had better final logMAR visual acuity (0.55 +- 0.57) then older NAION patients (0.9 +- 0.73), (p = 0.03). Furthermore, young NAION patients were 2.8 times more likely to have a final visual acuity of 20/40 or better than older NAION patients, odds ratio (OR), 2.87; 95% confidence interval (CI), 1.12–7.40, Chi-square p-value = 0.03). Conclusion There is a high prevalence of systemic vascular risk factors and small cup-to-disc ratio in NAION patients referred to our center across different age groups (below and above 50 years). Patients below the age of 50 years with NAION are more likely to have a final visual acuity of 20/40 or better than NAION patients above the age of 50 years.
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Barriers and Facilitators Associated with Physical Activity in the Middle East and North Africa Region: A Systematic Overview. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041647. [PMID: 33572229 PMCID: PMC7914747 DOI: 10.3390/ijerph18041647] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 02/04/2021] [Accepted: 02/05/2021] [Indexed: 12/11/2022]
Abstract
Increasing physical inactivity levels in the Middle East and North Africa (MENA) region is a public health concern. We aimed to synthesize barriers and facilitators to physical activity and make appropriate recommendations to address physical inactivity. We conducted an overview of systematic reviews on physical activity barriers and facilitators in 20 MENA countries by systematically searching MEDLINE/PubMed and Google Scholar for systematic reviews published between 2008 and 2020. Our overview included four systematic reviews and 119 primary studies with data from 17 MENA countries. Lack of suitable sports facilities, time, social support and motivation, gender and cultural norms, harsh weather, and hot climate were the most commonly reported barriers to physical activity. Socio-demographic factors negatively associated with physical activity participation include advanced age, being female, less educated, and being married. Motivation to gain health benefits, losing/maintaining weight, being male, dietary habits, recreation, and increased Body Mass Index are positively associated with increased levels of physical activity. Interventions promoting physical activity in MENA should target schoolchildren, women and girls, working parents, and the elderly. Country-specific sociocultural and environmental factors influencing physical activity should be considered in the design of interventions. Current and future policies and national interventions must be consistently evaluated for effectiveness and desired outcomes.
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Alhuwail D. Information management practices in public tertiary health-care facilities: an empirical investigation from the state of Kuwait. RECORDS MANAGEMENT JOURNAL 2021. [DOI: 10.1108/rmj-10-2019-0062] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
This paper aims to gain insights about information management practices in public health-care organizations in Kuwait and offer recommendations to improve these practices.
Design/methodology/approach
This study involves secondary analysis of quantitative and qualitative accreditation-related data pertaining to the compliance with the Information Management standard at seven public tertiary health-care facilities over two accreditation cycles.
Findings
Overall, organizations improved their compliance with the Information Management standard. However, issues exist with effectively and efficiently transmitting data, aggregating clinical and administrative data and using the information for both strategic planning and quality improvement initiatives.
Research limitations/implications
The analysed data set does not provide information about the improvements done between the accreditation cycles. Caution should be applied before assuming generalizability of the results, considering the context and social constructs around the health-care system is essential.
Practical implications
Compliance with predetermined criteria through accreditation can improve information management practices. Without proper management of information at health-care facilities, achieving safe and effective patient care is futile. The role of health information technology (IT) should not be sidelined; robust health IT solutions can help support good information management practices thereby improving care quality and aiding health-care reform.
Originality/value
Concerning information management, health-care organizations providing focused services have clear advantages over organizations providing general care services. Considering the type of care organization (general vs specialized) can provide insights into how information management practices can affect the operations of the organization.
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Alali WQ, Longenecker JC, Alwotyan R, AlKandari H, Al-Mulla F, Al Duwairi Q. Prevalence of smoking in the Kuwaiti adult population in 2014: a cross-sectional study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:10053-10067. [PMID: 33161520 PMCID: PMC7648895 DOI: 10.1007/s11356-020-11464-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 10/28/2020] [Indexed: 05/06/2023]
Abstract
The study objective was to assess tobacco smoking prevalence in Kuwaiti adults in relation to sociodemographic characteristics. A cross-sectional study survey was conducted in 2014 on 3917 Kuwaiti citizens (18-69 years) following the World Health Organization (WHO) STEPwise Approach to Surveillance (STEPS) methodology. The study assessed prevalence of self-reported ever-smoking or currently smoking tobacco products and exposure to secondhand smoke in relation to demographic and smoking-related characteristics. The prevalence of "ever smoker" in men and women was 49.9% and 4.4%, respectively, whereas the prevalence of "current smoker" was 39.2% and 3.3%, respectively. Sex (adjusted OR [AOR], 19.2 [95% confidence interval (CI) 13.0-28.3], male versus female) was significantly associated with current smoking. Among daily smokers, 87.1% used manufactured cigarettes. The average daily number of manufactured cigarettes for men and women was 21.8 and 13.0, respectively. Mean age at smoking initiation was 17.5 years (95% CI 17.2-17.9). The prevalence of secondhand smoke at home and work was 38.6% and 29.9%, respectively. Half of Kuwaiti men have smoked at some point in their life with most of these being current smokers. Secondhand smoke is a common exposure at home and work, posing serious health risks to the population.
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Affiliation(s)
- Walid Q Alali
- Department of Epidemiology and Biostatistics, Faculty of Public Health, Kuwait University, Safat, Kuwait.
- Department of Population Health, Dasman Diabetes Institute, Kuwait City, Kuwait.
| | - Joseph C Longenecker
- Faculty of Medicine and Faculty of Public Health, Kuwait University, Safat, Kuwait
| | - Rehab Alwotyan
- Primary Health Care Department, Ministry of Health, Kuwait City, Kuwait
| | - Hessa AlKandari
- Department of Population Health, Dasman Diabetes Institute, Kuwait City, Kuwait
- Department of Pediatrics, Ministry of Health, Kuwait City, Kuwait
| | - Fahd Al-Mulla
- Department of Population Health, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Qais Al Duwairi
- Department of Population Health, Dasman Diabetes Institute, Kuwait City, Kuwait
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Gender differences in quality of life, physical activity, and risk of hypertension among sedentary occupation workers. Qual Life Res 2021; 30:1365-1377. [PMID: 33447960 DOI: 10.1007/s11136-020-02741-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2020] [Indexed: 12/28/2022]
Abstract
PURPOSE This study aimed to explore gender differences among sedentary occupation workers with regard to their quality of life (QoL), physical activity, and risk for high blood pressure, and to identify factors associated with QoL. METHODS A convenience sample of 2562 employees from randomly selected ten ministries in Kuwait completed self-administered questionnaires. Collected data included employees' socio-demographic characteristics, levels of QoL (using World Health Organization QoL-Brief tool), and physical activity (using the New Zealand Physical Activity Questionnaire Short Form), and anthropometric measures of weight, height, and blood pressure. Multinomial regression analysis, Chi-square, ANOVA, and student's t tests were implemented. A p value of 0.05 was considered significant. RESULTS Participants' mean age was 35.3 years. QoL mean scores were total QoL (74.7), physical health (81.1), psychological health (75.4), social relationship (71.1), and environment (70.8). Females showed worse level of QoL, better physical activity, and higher prevalence of hypertension relative to males. Multinomial regression analysis revealed that female gender, low educational attainability, poor income, high job ranks, shorter working years, obesity, physical inactivity, hypertension, or having at least one chronic illness significantly correlated to fair and poor QoL. CONCLUSION Sedentary occupation workers reported modest level of QoL and were at high risk of hypertension. Socio-demographic factors, physical activity, and health status were correlated to QoL. Gender differences existed in QoL, physical activity, and risk of hypertension. Improving employees' QoL through adopting strategies to promote healthy lifestyle in work settings should be activated. Further studies are recommended to explore cultural factors that drive gender differences in QoL.
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Alkandari A, Alarouj M, Elkum N, Sharma P, Devarajan S, Abu-Farha M, Al-Mulla F, Tuomilehto J, Bennakhi A. Adult Diabetes and Prediabetes Prevalence in Kuwait: Data from the Cross-Sectional Kuwait Diabetes Epidemiology Program. J Clin Med 2020; 9:E3420. [PMID: 33113867 PMCID: PMC7694112 DOI: 10.3390/jcm9113420] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Revised: 10/13/2020] [Accepted: 10/22/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND This study aimed to estimate the prevalence of diabetes and prediabetes in adults in Kuwait. METHODS The Kuwait Diabetes Epidemiology Program was a nationally representative, cross-sectional study of diabetes and obesity in Kuwait conducted between 2011 and 2014. The survey sampled 4937 adults in Kuwait aged 20 years or more and recorded participants' demographics, behaviours, medical history, physical measurements and blood biochemical measurements. Prediabetes was defined as fasting plasma glucose between 6.1 and 6.9 mmol/L or HbA1c between 6 and 6.4% (42-47 mmol/mol). Diabetes was defined as self-reported history with prescribed glucose-lowering medication or FPG ≥7mmol/L or HbA1c level ≥6.5% (≥48 mmol/mol). RESULTS The overall adjusted prevalence of diabetes was 19.1%. The overall adjusted prevalence of prediabetes was 13.5%. Diabetes prevalence was 5.4%, 14.2%, 38.7% and 64.8% in adults aged 20-29, 30-44, 45-59 and 60 years or more, respectively. Diabetes prevalence was 22.4% in men and 14.4% in women. Prediabetes prevalence was 14.8% in men and 11.5% in women. In Kuwaitis, diabetes and prediabetes prevalence was 21.8% and 11.1%, respectively, while prevalence in non-Kuwaitis was 18.2% for diabetes and 14.3% for prediabetes. CONCLUSION These findings illustrate the severe public health challenge posed by diabetes in Kuwait.
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Affiliation(s)
- Abdullah Alkandari
- Dasman Diabetes Institute, Kuwait City 15462, Kuwait; (M.A.); (P.S.); (S.D.); (M.A.-F.); (F.A.-M.); (A.B.)
| | - Monira Alarouj
- Dasman Diabetes Institute, Kuwait City 15462, Kuwait; (M.A.); (P.S.); (S.D.); (M.A.-F.); (F.A.-M.); (A.B.)
| | - Naser Elkum
- Sidra Medical and Research Center, Doha 26999, Qatar;
| | - Prem Sharma
- Dasman Diabetes Institute, Kuwait City 15462, Kuwait; (M.A.); (P.S.); (S.D.); (M.A.-F.); (F.A.-M.); (A.B.)
| | - Sriraman Devarajan
- Dasman Diabetes Institute, Kuwait City 15462, Kuwait; (M.A.); (P.S.); (S.D.); (M.A.-F.); (F.A.-M.); (A.B.)
| | - Mohamed Abu-Farha
- Dasman Diabetes Institute, Kuwait City 15462, Kuwait; (M.A.); (P.S.); (S.D.); (M.A.-F.); (F.A.-M.); (A.B.)
| | - Fahd Al-Mulla
- Dasman Diabetes Institute, Kuwait City 15462, Kuwait; (M.A.); (P.S.); (S.D.); (M.A.-F.); (F.A.-M.); (A.B.)
| | - Jaakko Tuomilehto
- Public Health Prevention Unit, Finnish Institute for Health and Welfare, FI-00271 Helsinki, Finland;
| | - Abdullah Bennakhi
- Dasman Diabetes Institute, Kuwait City 15462, Kuwait; (M.A.); (P.S.); (S.D.); (M.A.-F.); (F.A.-M.); (A.B.)
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Alawadi F, Hassanein M, Suliman E, Hussain H, Mamdouh H, Ibrahim G, Al Faisal W, Monsef N, Farghaly M. The Prevalence of Diabetes and Pre-Diabetes among the Dubai Population: Findings from Dubai Household Health Surveys, 2014 and 2017. DUBAI DIABETES AND ENDOCRINOLOGY JOURNAL 2020. [DOI: 10.1159/000508833] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
<b><i>Background:</i></b> Diabetes mellitus is a leading cause of morbidity and mortality worldwide, imposing a considerable burden on health systems and societies as it affects both individuals and their families and has a large impact on the economic and social development of a country. <b><i>Objectives:</i></b> The purpose of this study was to study the prevalence of diabetes and pre-diabetes among the Dubai population and associations with diabetes risk factors. <b><i>Methodology:</i></b> A cross-sectional Diabetes Household Survey was carried out in the Emirates of Dubai during 2017 as a complementary stage of the Dubai Household Survey, 2014, which was a randomly selected, multistage, stratified, cluster survey. The sampling technique was selected to assess the rates of undiagnosed diabetes as well as the rates of pre-diabetes through screening with HbA1c. The size of the 2017 survey sample was estimated at 300 individuals for Emirati and 300 for non-Emirati. An additional 200 individuals were added to address non-response cases. These were added to those who were identified as diabetics in the 2014 Household Health Survey and then weighted to give a representative sample for the Dubai population. <b><i>Results:</i></b> The study revealed that the prevalence of diabetes in Dubai among UAE nationals was 19%, and it was 14.7% for expats. Consequently, the overall prevalence of diabetes in Dubai is 15.2%. Undiagnosed diabetes was 10% in UAE nationals and 10.9% in expats. Pre-diabetes in UAE national males was lower than in females, although this pattern was not observed among expats. Younger age, normal weight, and exercise were associated with lower rates of diabetes and pre-diabetes in UAE nationals and expats. Hypertension was associated with higher rates of diabetes regardless of nationality. <b><i>Conclusions:</i></b> The study concluded that the prevalence of diabetes among the Dubai population is alarmingly high and that a large proportion of the population are not aware of their diagnosis. A higher prevalence of diabetes is associated with multiple factors, such as age, male gender, hypertension, higher BMI, lack of exercise, and lower level or no education, as well as a family history of diabetes mellitus. Many of these factors can be easily modified, which could lead to a decrease in the burden of the disease.
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Zubaid M, Rashed W, Ridha M, Bazargani N, Hamad A, Banna RA, Asaad N, Sulaiman K, Al-Jarallah M, Mulla AA, Baslaib F, AlMahmeed W. Implementation of Guideline-Recommended Therapies for Patients With Heart Failure and Reduced Ejection Fraction: A Regional Arab Middle East Experience. Angiology 2020; 71:431-437. [PMID: 32066246 DOI: 10.1177/0003319720905742] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
We describe the characteristics of ambulatory patients with heart failure with reduced ejection fraction (HFrEF) in the Gulf region (Middle East) and the implementation of guideline-recommended treatments. We included 2427 HFrEF outpatients (mean age 59 ± 13 years, 75% males and median left ventricular ejection fraction [LVEF] of 30%). A high proportion of patients received guideline-recommended medications (angiotensin-converting enzyme inhibitor [ACEI]/angiotensin receptor blocker [ARB]/angiotensin receptor-neprilysin inhibitor [ARNI] 87%, β-blocker 91%, mineralocorticoid antagonist [MRA] 64%). However, only a minority of patients received guideline-recommended target doses (ACEI/ARB/ARNI 13%, β-blocker 27%, and MRA 4.4%). Old age was a significant independent predictor for not prescribing treatment (P < .001 for ACEI/ARB/ARNI and MRA; and P = .002 for β-blockers). Other independent predictors were chronic kidney disease (for both ACEI/ARB/ARNI and MRA, P < .001) and higher LVEF (P = .014 for β-blockers and P < .001 for MRA). Patients with HFrEF managed by heart failure specialists more often received recommended target doses of ACEI/ARB/ARNI (40% vs 11%, P < .001) and β-blockers (56% vs 26%, P < .001) compared to those treated by general cardiologists. Although the majority of our patients with HFrEF received guideline-recommended medications, the doses they were prescribed were suboptimal. Understanding the reasons behind this is important for improved practice.
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Affiliation(s)
- Mohammad Zubaid
- Faculty of Medicine, Department of Medicine, Kuwait University, Kuwait
| | - Wafa Rashed
- Department of Medicine, Mubarak Al-Kabeer Hospital, Kuwait
| | - Mustafa Ridha
- Department of Cardiology, Al Dabbous Cardiac Centre, Kuwait
| | - Nooshin Bazargani
- Department of Cardiology, Dubai Hospital, Dubai, United Arab Emirates
| | - Adel Hamad
- Mohammed bin Salman Al Khalifa Cardiac Centre, Bahrain Defense Force Hospital, Manama, Bahrain
| | - Rashed Al Banna
- Department of Cardiology, Salmaniya Medical Complex, Manama, Bahrain
| | - Nidal Asaad
- Department of Cardiology, Hamad Medical Corporation, Doha, Qatar
| | | | | | - Arif Al Mulla
- Department of Cardiology, Cardiac Sciences Institute, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
| | - Fahad Baslaib
- Department of Cardiology, Rashid Hospital, Dubai, United Arab Emirates
| | - Wael AlMahmeed
- Heart and Vascular Institute, Cleveland Clinic, Abu Dhabi, United Arab Emirates
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Weiderpass E, Botteri E, Longenecker JC, Alkandari A, Al-Wotayan R, Al Duwairi Q, Tuomilehto J. The Prevalence of Overweight and Obesity in an Adult Kuwaiti Population in 2014. Front Endocrinol (Lausanne) 2019; 10:449. [PMID: 31338067 PMCID: PMC6629831 DOI: 10.3389/fendo.2019.00449] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Accepted: 06/21/2019] [Indexed: 01/22/2023] Open
Abstract
Background: According to World Health Organization (WHO) estimates, Kuwait is ranked amongst the top countries in the world in obesity prevalence. This study aims to describe the prevalence of overweight, obesity, and various types of adiposity in Kuwaiti adults. Methods: This cross-sectional study of 3,915 Kuwaiti adults aged 18-69 years used the STEP-wise approach to surveillance of non-communicable diseases, a WHO Instrument for Chronic Disease Risk Factor Surveillance. We assessed demographic information, lifestyle, personal and family history of diseases and physical measurements (height, weight, waist, and hip circumferences). All participants with valid height and weight measurements (n = 3,589) were included in the present analysis. Overweight was defined as BMI 25-29.9 kg/m2 and obesity as BMI ≥30 kg/m2. Results: Obesity prevalence was 40.3% [95% confidence interval, 38.6-42.0%] (men, 36.5%; women, 44.0%); and overweight prevalence was 37% [35.4-38.7%] (men, 42%; women, 32.1%). The median BMI was 28.4 kg/m2 among men and 29.1 kg/m2 among women. Obesity prevalence was directly associated with female sex, age, history of diabetes, and being married in both men and women; and was inversely associated with education level in women. The prevalence of elevated waist-to-hip ratio was 46.9% among men and 37.9% among women. Waist circumference, waist-hip and waist-height ratios were directly associated with diabetes in both men and women, and inversely associated with education level in women. Conclusion: Almost eight in ten Kuwaiti adults were overweight or obese. Urgent public health action is warranted to tackle the obesity epidemic in Kuwait.
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Affiliation(s)
- Elisabete Weiderpass
- International Agency for Research on Cancer, The World Health Organization, Lyon, France
| | - Edoardo Botteri
- Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
- Norwegian National Advisory Unit for Women's Health, Women's Clinic, Oslo University Hospital, Oslo, Norway
| | - Joseph C. Longenecker
- Primary Health Care Department, Ministry of Health, Kuwait City, Kuwait
- Faculty of Public Health, Kuwait University, Kuwait City, Kuwait
| | | | - Rihab Al-Wotayan
- Primary Health Care Department, Ministry of Health, Kuwait City, Kuwait
| | - Qais Al Duwairi
- Research Sector, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Jaakko Tuomilehto
- Research Sector, Dasman Diabetes Institute, Kuwait City, Kuwait
- Department of Public Health, University of Helsinki, Helsinki, Finland
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Nassif A, Katoue MG, Wake DJ, George J. Management of Low Density Lipoprotein Cholesterol at a primary care diabetes clinic in Kuwait. Prim Care Diabetes 2019; 13:259-265. [PMID: 30578166 DOI: 10.1016/j.pcd.2018.11.003] [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: 08/28/2018] [Revised: 11/07/2018] [Accepted: 11/15/2018] [Indexed: 11/17/2022]
Abstract
AIMS To evaluate the impact of clinical audit and focused interventions on reducing cardiovascular diseases risk by treating Low Density Lipoprotein Cholesterol (LDL-C) in patients with type 2 diabetes attending a primary care clinic in Kuwait. METHODS Using LDL as a surrogate for cardiovascular risk, the audit team performed a clinical audit with focus on the care process indicator of statin prescription. The basic audit reviewed 100 patients' medical records retrospectively to assess patients' lipid profiles and statin prescription. A lipid management protocol and algorithm based on national clinical practice guidelines distributed to all healthcare professionals and was implemented for 3 months followed by re-audit of another 100 records. Descriptive and comparative statistics (pre and post) were performed using SPSS, version 22. RESULTS Statin prescription increased significantly from (26%) in the basic audit to (85%) in the post-intervention audit (p<0.001). The mean LDL-C value decreased significantly from 3.37±0.67mmol/L to 2.71±0.79mmol/L, p<0.001. Mean total cholesterol was significantly reduced from 5.15±0.73mmol/L to 4.68±0.88mmol/L, p<0.001. Ten years CHD risk decreased from 18.46±11.1% to 16.8±12.23%, p=0.152. CONCLUSIONS Implementing a clinical audit coupled with focused intervention was successful in improving management of LDL-C among patients with type 2 diabetes mellitus attending the primary healthcare sector in Kuwait.
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Affiliation(s)
- Alfred Nassif
- Al-Naeem Diabetes Clinic, Primary Health Care, Jahra, Kuwait.
| | - Maram Gamal Katoue
- Department of Pharmacology and Therapeutics, Faculty of Pharmacy, Kuwait University, Kuwait
| | - Deborah Jane Wake
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, UK
| | - Jacob George
- University of Dundee Ninewells Hospital, Dundee, Scotland, UK
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Alhuwail D. Understanding health information management practices in public hospitals in Kuwait. Health Inf Manag 2019; 49:127-136. [PMID: 30894029 DOI: 10.1177/1833358319837247] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Health information technology (IT) solutions can aid healthcare reform efforts, but without proper information management, these efforts are futile. In this study, we used Kuwait as an example of a high per-capita gross domestic product country that faces information management challenges to draw insights that can be generalised to other developed countries. OBJECTIVE (i) to uncover the status quo of information management practices in public hospitals and (ii) to offer recommendations to improve them. METHOD This study analysed qualitative and quantitative accreditation-related data pertaining to the compliance with the information management standard at all secondary care public hospitals over two accreditation cycles. RESULTS Overall, public hospitals had made positive progress in their compliance with the information management standard. However, issues still existed with (i) developing and implementing an information management plan, (ii) involving the appropriate stakeholders in selecting health IT solutions and (iii) access to the Internet by staff and patients. CONCLUSION Evidence underscored the importance of proper information management driven by clear centralised strategic plans. IMPLICATIONS With the rapid adoption of digital health systems, the role of health information management leaders should not be undervalued. Embracing health IT solutions with strong information management practices can aid healthcare reform efforts.
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Affiliation(s)
- Dari Alhuwail
- Kuwait University, Kuwait; Dasman Diabetes Institute, Kuwait
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Review of Non-Communicable Disease Research Activity in Kuwait: Where is the Evidence for the Best Practice? Ann Glob Health 2019; 85. [PMID: 30924616 PMCID: PMC6634600 DOI: 10.5334/aogh.2392] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Background: Kuwait, a small country in the Middle East, is now facing rapid development, with non-communicable diseases (NCDs) accounting for the majority of deaths. Objectives: In this study, we review trends in NCD research productivity in Kuwait and examine to what extent it is aligned with disease burden. Methods: Systematic mapping of NCD papers produced between January 2000 and December 2013 yielded 893 publications. These were defined according to study design, study focus, and risk factors examined. Research gaps were assessed by examining disparities between literature produced and cause-specific proportional mortality rates (PMR) and disability-adjusted life years (DALYs). Findings: While annual publication rates increased more than two-fold during the study period, many of the study methodologies were descriptive (58%). Only 2.6% were based on high-evidence interventional studies. Cancer, CVD, and diabetes featured in 38.1%, 15.1%, and 9.2% of the publications, respectively. Compared to PMR and DALYs, there was a surplus of cancer research, most of which were laboratory-based studies (27.6%) or of the case-report/case-series study type (26.5%). Smoking was more likely to be addressed in relation to CVD (32.6%) than diabetes (6.1%) or cancer (2.1%). Physical inactivity was mostly examined in its relation to diabetes (14.6%), with negligible representation in the remaining study focus (range 0.3% to 2.2%). Conclusion: NCD research production in Kuwait is not aligned with disease burden or health priorities. We recommend a coordinated action between funding agencies, universities, and researchers in Kuwait to guide development of a comprehensive research agenda that is responsive to the country’s emerging needs.
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Nizam R, Al-Ozairi E, Goodson JM, Melhem M, Davidsson L, Alkhandari H, Al Madhoun A, Shamsah S, Qaddoumi M, Alghanim G, Alhasawi N, Abu-Farha M, Abubaker J, Shi P, Hartman ML, Tavares M, Bitar M, Ali H, Arefanian H, Devarajan S, Al-Refaei F, Alsmadi O, Tuomilehto J, Al-Mulla F. Caveolin-1 Variant Is Associated With the Metabolic Syndrome in Kuwaiti Children. Front Genet 2018; 9:689. [PMID: 30622557 PMCID: PMC6308323 DOI: 10.3389/fgene.2018.00689] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 12/11/2018] [Indexed: 12/18/2022] Open
Abstract
Caveolin-1 (CAV1) variants have been suggested to be associated with obesity and related metabolic disorders, but information based on human studies is limited. In the present study, we aimed to investigate the potential association between the CAV1 rs1997623 C/A variant and metabolic syndrome (MetS) in Kuwaiti children. DNA from saliva samples collected from 1313 Kuwaiti children (mean age: 12 years) were genotyped using the TaqMan SNP genotyping assay. The classification of MetS was based on the presence/absence of four indicators; (1) central obesity, (2) elevated systolic or diastolic blood pressure, (3) low salivary high-density lipoprotein cholesterol (HDLC), and (4) high salivary glucose. In this study, children with MetS scored ≥3, children in the intermediate metabolic group scored 1 or 2 and children without MetS scored 0. About one-third of the children were obese. A total of 246 children (18.7%) were classified as having MetS; 834 children (63.5%) were in the intermediate metabolic group, and 233 children (17.7%) had no indication of MetS. Obesity was highly prevalent in the MetS group (91.9%) while 26.8% of children were obese in the intermediate metabolic group. None of the children were obese in the group without MetS. Analysis of the CAV1 rs1997623 variant revealed a significant association of the A-allele (p = 0.01, Odds Ratio (OR) = 1.66) and the heterozygous CA-genotype (p = 0.005, OR = 1.88) with MetS. Consistently, the A-allele (p = 0.002, OR = 1.71) and CA-genotype (p = 0.005, OR = 1.70) also showed significant association with the intermediate metabolic group. Furthermore, the A-allele (p = 0.01, OR = 1.33) and the CA-genotype (p = 0.008, OR = 1.55) were associated with low levels of saliva HDLC. Individuals who were heterozygous or homozygous for the variant (CA/AA) showed significantly lower levels of high HDLC compared to those harboring the CC-genotype (p = 0.023). Our study revealed a novel association of the CAV1 rs1997623 variant with the MetS and with low saliva HDLC levels in young Kuwaiti children and indicated the need for further in-depth studies to unravel the role of CAV1 gene in the genetic etiology of MetS.
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Affiliation(s)
- Rasheeba Nizam
- Functional Genomics Unit, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Ebaa Al-Ozairi
- Clinical Division, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Jo Max Goodson
- Applied Oral Sciences, The Forsyth Institute, Cambridge, MA, United States
| | - Motesam Melhem
- Functional Genomics Unit, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Lena Davidsson
- Family Medicine and Pediatric Unit, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Hessa Alkhandari
- Family Medicine and Pediatric Unit, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Ashraf Al Madhoun
- Functional Genomics Unit, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Sara Shamsah
- Faculty of Allied Health Sciences, Kuwait University, Kuwait City, Kuwait
| | - Malak Qaddoumi
- Functional Genomics Unit, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Ghazi Alghanim
- Functional Genomics Unit, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Nouf Alhasawi
- Functional Genomics Unit, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Mohamed Abu-Farha
- Biochemistry and Molecular Biology Unit, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Jehad Abubaker
- Biochemistry and Molecular Biology Unit, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Ping Shi
- Applied Oral Sciences, The Forsyth Institute, Cambridge, MA, United States
| | - Mor-Li Hartman
- Applied Oral Sciences, The Forsyth Institute, Cambridge, MA, United States
| | - Mary Tavares
- Applied Oral Sciences, The Forsyth Institute, Cambridge, MA, United States
| | - Milad Bitar
- Faculty of Medicine, Kuwait University, Kuwait City, Kuwait
| | - Hamad Ali
- Faculty of Allied Health Sciences, Kuwait University, Kuwait City, Kuwait
| | | | - Sriraman Devarajan
- National Dasman Diabetes Biobank, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Faisal Al-Refaei
- Clinical Division, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Osama Alsmadi
- Cell Therapy and Applied Genomics, King Hussein Cancer Center, Amman, Jordan
| | | | - Fahd Al-Mulla
- Functional Genomics Unit, Dasman Diabetes Institute, Kuwait City, Kuwait
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Channanath AM, AlWotayan R, Alkandari H, Davidsson L, Tuomilehto J, Thanaraj TA. Glycaemic control in native Kuwaiti Arab patients with type 2 diabetes. Prim Care Diabetes 2018; 12:526-532. [PMID: 30115526 DOI: 10.1016/j.pcd.2018.07.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 06/28/2018] [Accepted: 07/23/2018] [Indexed: 01/26/2023]
Abstract
AIMS To evaluate the influence of age at diabetes diagnosis, diabetes duration, BMI, comorbidity with hypertension and medication regimen on glycaemic control in native Kuwaiti Arab patients with T2D. METHODS This cross-sectional study considered 7657 patients from Kuwait Diabetes Registry and analysed data from their laboratory and hospital records. RESULTS HbA1c and prevalence of hypertension increased significantly with diabetes duration. Duration of diabetes (β=0.034; P<0.001) and age at diagnosis (β=-0.03; P<0.001) were independently associated with HbA1c. Inadequate glycaemic control was more likely in patients diagnosed at <60 than in those ≥60 years of age (OR:1.80, 95%-CI:1.39-2.31). Increasing duration of diabetes witnessed decrease in metformin prescription and increase in sulfonylureas prescription; proportion of patients treated with insulin increased from 5.6% to 44.4% in 9 years of diagnosis. Patients with 9-years duration of diabetes or with combination therapy of insulin-metformin-sulfonylureas differed in mean BMI for adequate or inadequate glycaemic control (29.5 versus 31.2kg/m2; P<0.001 and 29.8 versus 33.2; P<0.01, respectively). CONCLUSIONS Only 25.6% of the T2D patients in this ethnic cohort exhibited adequate glycaemic control. The delineated relationship of inadequate glycaemic control with diabetes duration, onset age, obesity and hypertension prevalence has a bearing on diabetes management programs for Arabs.
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Affiliation(s)
- Arshad M Channanath
- Research Division, Dasman Diabetes Institute, P.O. Box 1180, Dasman 15462, Kuwait
| | - Rihab AlWotayan
- Research Division, Dasman Diabetes Institute, P.O. Box 1180, Dasman 15462, Kuwait; Department of Primary Health Care, Ministry of Health, Kuwait
| | - Hessa Alkandari
- Research Division, Dasman Diabetes Institute, P.O. Box 1180, Dasman 15462, Kuwait; Department of Pediatrics, Farwaniya Hospital, Farwaniya, Kuwait
| | - Lena Davidsson
- Research Division, Dasman Diabetes Institute, P.O. Box 1180, Dasman 15462, Kuwait
| | - Jaakko Tuomilehto
- Research Division, Dasman Diabetes Institute, P.O. Box 1180, Dasman 15462, Kuwait
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Alkandari A, Longenecker JC, Barengo NC, Alkhatib A, Weiderpass E, Al-Wotayan R, Al Duwairi Q, Tuomilehto J. The prevalence of pre-diabetes and diabetes in the Kuwaiti adult population in 2014. Diabetes Res Clin Pract 2018; 144:213-223. [PMID: 30179683 DOI: 10.1016/j.diabres.2018.08.016] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 08/09/2018] [Accepted: 08/29/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND Kuwait ranks among the top 20 countries worldwide in diabetes prevalence. This study's objectives were to assess the prevalence of pre-diabetes and diabetes in Kuwaiti adults. METHODS Kuwaiti citizens aged 18-69 years (n = 3915) were studied using the WHO's STEPwise survey methodology, including its Instrument for Chronic Disease Risk Factor Surveillance. Participants' demographics, medical history, physical measurements and blood biochemistry were assessed. A subset of 2561 individuals completed all three survey steps, including fasting plasma glucose (FPG) and HbA1c assays. The study assessed the prevalence of pre-diabetes (FPG 6.1-6.9 mmol/L or HbA1c level 5.7-6.4%) and diabetes (self-reported history of diabetes with prescription of diabetes medications or FPG ≥ 7 mmol/L or HbA1c level ≥6.5%). RESULTS The prevalence of pre-diabetes was 19.4% [95% CI: 17.9-21.0%] (By sex: Men, 19.3%; Women, 19.5%; p = 0.92; By age (years): 18-29 y, 13.9%; 30-44 y, 22.6%; 45-59 y, 25.8%; 60-69 y, 16.4%; p < 0.001). The prevalence of diabetes was 18.8% [17.3-20.4%] (By sex: Men, 20.4%; Women, 17.4%; p = 0.055; By age: 18-29 y, 6.6%; 30-44 y, 14.0%; 45-59 y, 36.7%; 60-69 y, 62.8%; p < 0.001), of whom 41.5% were previously undiagnosed. Diabetes prevalence was 27.4% among those with body mass index (BMI) ≥ 30 kg/m2, 29% among those with elevated waist-hip ratio and 36% among those with hypertension. Diabetes was positively associated with BMI, waist-hip ratio and blood pressure level. Pre-diabetes was positively associated with BMI and waist-hip ratio, but not blood pressure level. CONCLUSIONS Almost 40% of Kuwaiti citizens had pre-diabetes or diabetes. Urgent public health action is needed to decrease diabetes prevalence and thus avoid associated morbidity and mortality.
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Affiliation(s)
| | | | - Noël C Barengo
- Medical and Population Health Sciences Research, Herbert Wertheim College of Medicine, Florida International University, USA
| | | | - Elisabete Weiderpass
- Dasman Diabetes Institute, Kuwait City, Kuwait; Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway; Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland
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Physical inactivity, gender and culture in Arab countries: a systematic assessment of the literature. BMC Public Health 2018; 18:639. [PMID: 29776343 PMCID: PMC5960209 DOI: 10.1186/s12889-018-5472-z] [Citation(s) in RCA: 121] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 04/17/2018] [Indexed: 01/08/2023] Open
Abstract
Background Physical inactivity is associated with excess weight and adverse health outcomes. We synthesize the evidence on physical inactivity and its social determinants in Arab countries, with special attention to gender and cultural context. Methods We searched MEDLINE, Popline, and SSCI for articles published between 2000 and 2016, assessing the prevalence of physical inactivity and its social determinants. We also included national survey reports on physical activity, and searched for analyses of the social context of physical activity. Results We found 172 articles meeting inclusion criteria. Standardized data are available from surveys by the World Health Organization for almost all countries, but journal articles show great variability in definitions, measurements and methodology. Prevalence of inactivity among adults and children/adolescents is high across countries, and is higher among women. Some determinants of physical inactivity in the region (age, gender, low education) are shared with other regions, but specific aspects of the cultural context of the region seem particularly discouraging of physical activity. We draw on social science studies to gain insights into why this is so. Conclusions Physical inactivity among Arab adults and children/adolescents is high. Studies using harmonized approaches, rigorous analytic techniques and a deeper examination of context are needed to design appropriate interventions. Electronic supplementary material The online version of this article (10.1186/s12889-018-5472-z) contains supplementary material, which is available to authorized users.
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Al-Sejari M. Sociocultural Characteristic, Lifestyle, and Metabolic Risk Factors Among a Sample of Kuwaiti Male University Students. Am J Mens Health 2016; 11:308-317. [PMID: 27903953 PMCID: PMC5675283 DOI: 10.1177/1557988316680937] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
In the past six decades, the Kuwaiti population has been exposed to rapid transformation in the quality of diet intake, daily activities, and career types. This major socioeconomic shift was accompanied by the introduction of both communicable and noncommunicable chronic diseases afflicting people of all ages. This article aims to detect a relationship between sociocultural characteristics—such as physical activity, dietary habits, and smoking—and the prevalence of metabolic syndrome (MetS). A descriptive, cross-sectional survey was conducted among 262 male university students in Kuwait; participants were selected by using a convenient nonrandom opportunistic sample. Associated social and health factors were obtained using a closed-ended questionnaire. BMI and blood tests that include clusters of MetS risk components were drawn from participants in primary health care clinics. More than half of the participants were overweight and obese; 74.4% of the participants reported they did not visit a nutritionist; 69.8% said that they are currently not on a diet; 53.4% of the students were nonsmokers; 42.7% reported moderate to very low daily physical activity. The prevalence of MetS components increased among students with older age, employed, and married (p < .001), higher BMI, higher income, smoking, fewer number of family members living, and belonging to the Shia religious sect (p < .05). The high frequency of MetS among younger students needs to be considered by Kuwaiti community members and the government to highlight the risk factors of MetS on individuals’ well-being, quality of life, and life expectation.
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Abuyassin B, Laher I. Diabetes epidemic sweeping the Arab world. World J Diabetes 2016; 7:165-174. [PMID: 27114755 PMCID: PMC4835661 DOI: 10.4239/wjd.v7.i8.165] [Citation(s) in RCA: 101] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Revised: 01/23/2016] [Accepted: 02/17/2016] [Indexed: 02/05/2023] Open
Abstract
The prevalence of type-2 diabetes mellitus (T2DM) has increased dramatically during the last 2 decades, a fact driven by the increased prevalence of obesity, the primary risk factor for T2DM. The figures for diabetes in the Arab world are particularly startling as the number of people with diabetes is projected to increase by 96.2% by 2035. Genetic risk factors may play a crucial role in this uncontrolled raise in the prevalence of T2DM in the Middle Eastern region. However, factors such as obesity, rapid urbanization and lack of exercise are other key determinants of this rapid increase in the rate of T2DM in the Arab world. The unavailability of an effective program to defeat T2DM has serious consequences on the increasing rise of this disease, where available data indicates an unusually high prevalence of T2DM in Arabian children less than 18 years old. Living with T2DM is problematic as well, since T2DM has become the 5th leading cause of disability, which was ranked 10th as recently as 1990. Giving the current status of T2DM in the Arab world, a collaborative international effort is needed for fighting further spread of this disease.
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Borai A, Ichihara K, Al Masaud A, Tamimi W, Bahijri S, Armbuster D, Bawazeer A, Nawajha M, Otaibi N, Khalil H, Kawano R, Kaddam I, Abdelaal M. Establishment of reference intervals of clinical chemistry analytes for the adult population in Saudi Arabia: a study conducted as a part of the IFCC global study on reference values. ACTA ACUST UNITED AC 2016; 54:843-55. [DOI: 10.1515/cclm-2015-0490] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2015] [Accepted: 08/26/2015] [Indexed: 11/15/2022]
Abstract
AbstractBackground:This study is a part of the IFCC-global study to derive reference intervals (RIs) for 28 chemistry analytes in Saudis.Method:Healthy individuals (n=826) aged ≥18 years were recruited using the global study protocol. All specimens were measured using an Architect analyzer. RIs were derived by both parametric and non-parametric methods for comparative purpose. The need for secondary exclusion of reference values based on latent abnormal values exclusion (LAVE) method was examined. The magnitude of variation attributable to gender, ages and regions was calculated by the standard deviation ratio (SDR). Sources of variations: age, BMI, physical exercise and smoking levels were investigated by using the multiple regression analysis.Results:SDRs for gender, age and regional differences were significant for 14, 8 and 2 analytes, respectively. BMI-related changes in test results were noted conspicuously for CRP. For some metabolic related parameters the ranges of RIs by non-parametric method were wider than by the parametric method and RIs derived using the LAVE method were significantly different than those without it. RIs were derived with and without gender partition (BMI, drugs and supplements were considered).Conclusions:RIs applicable to Saudis were established for the majority of chemistry analytes, whereas gender, regional and age RI partitioning was required for some analytes. The elevated upper limits of metabolic analytes reflects the existence of high prevalence of metabolic syndrome in Saudi population.
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Gender-specific association of oxidative stress and inflammation with cardiovascular risk factors in Arab population. Mediators Inflamm 2015; 2015:512603. [PMID: 25918477 PMCID: PMC4397026 DOI: 10.1155/2015/512603] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2015] [Accepted: 03/08/2015] [Indexed: 02/08/2023] Open
Abstract
Background. The impact of gender difference on the association between metabolic stress and cardiovascular disease (CVD) remains unclear. We have investigated, for the first time, the gender effect on the oxidative and inflammatory stress responses and assessed their correlation with classical cardiometabolites in Arab population. Methods. A total of 378 adult Arab participants (193 females) were enrolled in this cross-sectional study. Plasma levels of CRP, IL-6, IL-8, TNF-α, ROS, TBARs, and PON1 were measured and correlated with anthropometric and cardiometabolite parameters of the study population. Results. Compared to females, males had significantly higher FBG, HbA1c, TG, and blood pressure but lower BMI, TC, and HDL (P < 0.05). After adjustment for BMI and WC, females had higher levels of ROS, TBARS, and CRP (P < 0.001) whereas males had increased levels of IL-8, IL-6, and TNF-α (P < 0.05). Moreover, after adjustment for age, BMI, and gender, the levels of TNF-α, IL-6, and ROS were associated with central obesity but not general obesity. Conclusion. Inflammation and oxidative stress contribution to CVD risk in Arab population linked to gender and this risk is better reflected by central obesity. Arab females might be at risk of CVD complications due to increased oxidative stress.
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Awad A, Al-Nafisi H. Public knowledge of cardiovascular disease and its risk factors in Kuwait: a cross-sectional survey. BMC Public Health 2014; 14:1131. [PMID: 25367768 PMCID: PMC4237772 DOI: 10.1186/1471-2458-14-1131] [Citation(s) in RCA: 81] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Accepted: 10/21/2014] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) is estimated to cause 46% of all mortalities in Kuwait. To design effective primary and secondary prevention programs, an assessment of a population's prior CVD knowledge is of paramount importance. There is scarcity of data on the existing CVD knowledge among the general Kuwaiti population. Hence, this study was performed to assess the level of knowledge towards CVD types, warning symptoms of heart attack or stroke, and CVD risk factors. It also explored public views on the community pharmacists' role in CVD prevention and management. METHODS A descriptive cross-sectional survey was performed using a pretested self-administered questionnaire on a sample of 900 randomly selected Kuwaiti individuals. Descriptive and multivariate logistic regression analysis were used in data analysis. RESULTS The response rate was 90.7%. Respondents' knowledge about types of CVD, heart attack or stroke symptoms was low. Almost 60% of respondents did not know any type of CVD, and coronary heart disease was the commonest identified type (29.0%). Two-fifths of participants were not aware of any heart attack symptoms, and the most commonly known were chest pain (50.4%) and shortness of breath (48.0%). Approximately half of respondents did not recognize any stroke symptoms, and the most commonly recognized were 'confusion or trouble speaking' (36.4%) and 'numbness or weakness' (34.7%). Respondents' knowledge regarding CVD risk factors was moderate. The commonest factors identified by over four-fifths of participants were smoking, obesity, unhealthy diet and physical inactivity. In the multivariate logistic regression analysis, independent predictors of better level of CVD knowledge were females, age 50-59 years, high level of education, regular eating of healthy diet, and had a family history of CVD. Most of respondents only identified the role that pharmacists had to play is to help patients manage their medications, with a minimal role in other aspects of CVD prevention and management. CONCLUSIONS There are deficiencies in CVD knowledge among Kuwaiti population, which could turn into insufficient preventative behaviours and suboptimal patient outcomes. There is an apparent need to establish more wide-spread and effective educational interventions, which should be sensitive to the perceptions, attitudes, and abilities of targeted individuals.
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Affiliation(s)
- Abdelmoneim Awad
- Department of Pharmacy Practice, Faculty of Pharmacy, Kuwait University, P.O. Box 24923, Safat, 13110 Kuwait
| | - Hala Al-Nafisi
- Department of Pharmacy Practice, Faculty of Pharmacy, Kuwait University, P.O. Box 24923, Safat, 13110 Kuwait
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Alsheikh-Ali AA, Omar MI, Raal FJ, Rashed W, Hamoui O, Kane A, Alami M, Abreu P, Mashhoud WM. Cardiovascular risk factor burden in Africa and the Middle East: the Africa Middle East Cardiovascular Epidemiological (ACE) study. PLoS One 2014; 9:e102830. [PMID: 25090638 PMCID: PMC4121128 DOI: 10.1371/journal.pone.0102830] [Citation(s) in RCA: 84] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Accepted: 06/24/2014] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Increased urbanization in the developing world parallels a rising burden of chronic diseases. Developing countries account for ∼ 80% of global cardiovascular (CV) deaths, but contribute a paucity of systematic epidemiological data on CV risk factors. OBJECTIVE To estimate the prevalence of CV risk factors in rural and urban cohorts attending general practice clinics in the Africa and Middle East (AfME) region. METHODS In a cross-sectional epidemiological study, the presence of CV risk factors (hypertension, diabetes mellitus (diabetes), dyslipidemia, obesity, smoking and abdominal obesity) were evaluated in stable adult outpatients attending general practice primary care clinics. A rural population was defined as isolated (>50 km or lack of easy access to commuter transportation) from urban centers. RESULTS 4,378 outpatients were systematically recruited from 94 clinics across 14 AfME countries. Mean age was 46 ± 14 years and 52% of outpatients were female. A high prevalence of dyslipidemia (70%) and abdominal obesity (68%) were observed, followed by hypertension (43%) and diabetes (25%). The vast majority of outpatients (92%) had at least one modifiable CV risk factor, many (74%) had more than one, and half (53%) had 3 or more. These findings were observed in both genders and across urban and rural centers. Among outpatients with pre-existing hypertension or dyslipidemia, many were not at their target blood pressure or LDL-cholesterol goals. CONCLUSION Cardiovascular risk factors are highly prevalent among relatively young, stable outpatients attending general practice clinics across AfME. The findings support opportunistic screening for CV risk factors whenever outpatients visit a general practitioner and provide an opportunity for early identification and management of CV risk factors, including lifestyle interventions.
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Affiliation(s)
- Alawi A. Alsheikh-Ali
- Institute of Cardiac Sciences, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
| | | | - Frederick J. Raal
- Department of Medicine, Faculty of Health Sciences, Johannesburg Hospital, Johannesburg, South Africa
| | - Wafa Rashed
- Mubarak Al Kabeer Hospital, Al Jabriya, Kuwait
| | | | - Abdoul Kane
- L'Hopital General de Grand Yoff, Dakar, Senegal
| | | | - Paula Abreu
- Pfizer Inc., New York, New York, United States of America
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Elkum N, Al-Arouj M, Sharifi M, Behbehani K, Bennakhi A. Cardiovascular disease risk factors in the South Asian population living in Kuwait: a cross-sectional study. Diabet Med 2014; 31:531-9. [PMID: 24344774 DOI: 10.1111/dme.12386] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Revised: 09/24/2013] [Accepted: 10/22/2013] [Indexed: 11/26/2022]
Abstract
BACKGROUND High rates of diabetes and cardiovascular disease have been reported in South Asian immigrants in many countries. However, the prevalence and characteristics of cardiovascular disease risk factors among a South Asian population living in Kuwait have not yet been investigated. This study was therefore designed to estimate the prevalence of cardiovascular disease risk factors and determine whether they are independently associated with diabetes in such a population. METHODS A population-based cross-sectional study was conducted on 1094 South Asians (781 men and 313 women), mainly Indian and Pakistani (≥ 18 years of age), of whom 75.1% were Indians. Interviews were carried out, during which socio-demographic and anthropometric data were collected, followed by a physical examination and collection of fasting blood samples for laboratory investigations. Diabetes was defined by fasting plasma glucose ≥ 7 mmol/l, or being on treatment, and/or self-reported previously diagnosed Type 2 diabetes. RESULTS The prevalence of diabetes was 21.1%, with 3.4% of that percentage of people being newly diagnosed. Using BMI measurements, 24.0% of those who participated in the study were obese and 46.1% were overweight. Dyslipidaemia was found in 77.6% and hypertension in 44.8%. Advancing age (≥ 40 years), male gender, high LDL, high total cholesterol, hypertension and positive family history of diabetes were significantly associated with increased risk of diabetes. CONCLUSION Our study shows that the prevalence of cardiovascular disease risk factors in South Asian expatriates in Kuwait exceeds prevalence rates reported in their homeland and other countries. This may suggest the added stress of environmental factors on the development of cardiovascular disease risk factors in such populations. Specialized prevention programmes targeting such high-risk ethnic populations are paramount and need to be implemented.
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Affiliation(s)
- N Elkum
- Dasman Diabetes Institute, Kuwait City, Kuwait
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Karageorgi S, Alsmadi O, Behbehani K. A review of adult obesity prevalence, trends, risk factors, and epidemiologic methods in Kuwait. J Obes 2013; 2013:378650. [PMID: 24455212 PMCID: PMC3877637 DOI: 10.1155/2013/378650] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Accepted: 10/17/2013] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE Kuwait is among the countries with the highest obesity rates worldwide; however, little is known about the state of obesity epidemiology research in Kuwait. In this paper, we therefore review the findings and methodology of studies on the prevalence, trends and risk factors of obesity in Kuwait. METHODS The PubMed database was searched using the keyword combination: obesity and adults and Kuwait. Out of 111 articles, 39 remained after abstract review, and 18 were selected after full-text review. RESULTS The studies were all cross-sectional and published in the last fifteen years (1997-2012). The sample size ranged from 177 to 38,611 individuals. Only 30% of studies used random sampling. The prevalence (BMI ≥ 30) in studies with a nationally representative sample ranged from 24% to 48% overall and in adults >50 years was greater than 52%. Rates were significantly higher in women than those in men. Studies that examined trends showed an increase in obesity prevalence between 1980 and 2009. Multiple risk factors including sociocultural factors were investigated in the studies; however, factors were only crudely assessed. CONCLUSION There is a need for future studies, particularly surveillance surveys and prospective cohort studies utilizing advanced methods, to monitor trends and to comprehensively assess the factors contributing to the obesity epidemic in Kuwait.
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Affiliation(s)
- Stalo Karageorgi
- Genome Centre, Dasman Diabetes Institute, P.O. Box 1180, Dasman, 15462 Kuwait City, Kuwait
- *Stalo Karageorgi:
| | - Osama Alsmadi
- Genome Centre, Dasman Diabetes Institute, P.O. Box 1180, Dasman, 15462 Kuwait City, Kuwait
| | - Kazem Behbehani
- Dasman Diabetes Institute, P.O. Box 1180, Dasman 15462, Kuwait
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