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Aleem MA, Chughtai AA, Rahman B, Akhtar Z, Chowdhury F, Qadri F, Macintyre CR. Prevalence of influenza and other acute respiratory illnesses in patients with acute myocardial infarction in Bangladesh: A cross-sectional study. Health Sci Rep 2024; 7:e2234. [PMID: 38983680 PMCID: PMC11230924 DOI: 10.1002/hsr2.2234] [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: 11/17/2023] [Revised: 05/29/2024] [Accepted: 06/11/2024] [Indexed: 07/11/2024] Open
Abstract
Background and Aims Several studies imply that influenza and other respiratory illnesses could lead to acute myocardial infarction (AMI), but data from low-income countries are scarce. We investigated the prevalence of recent respiratory illnesses and confirmed influenza in AMI patients, while also exploring their relationship with infarction severity as defined by ST-elevation MI (STEMI) or high troponin levels. Methods This cross-sectional study, held at a Dhaka tertiary hospital from May 2017 to October 2018, involved AMI inpatients. The study examined self-reported clinical respiratory illnesses (CRI) in the week before AMI onset and confirmed influenza using baseline real-time reverse transcription polymerase chain reaction (qRT-PCR). Results Of 744 patients, 11.3% reported a recent CRI, most prominently during the 2017 influenza season (35.7%). qRT-PCR testing found evidence of influenza in 1.5% of 546 patients, with all positives among STEMI cases. Frequencies of CRI were higher in patients with STEMI and in those with high troponin levels, although these relationships were not statistically significant after adjusting for other variables. The risk of STEMI was significantly greater during influenza seasons in the unadjusted analysis (relative risk: 1.09, 95% confidence interval [CI]: 1.02-1.18), however, this relationship was not significant in the adjusted analysis (adjusted relative risk: 1.03, 95% CI: 0.91-1.16). Conclusion In Bangladesh, many AMI patients had a recent respiratory illness history, with some showing evidence of influenza. However, these illnesses showed no significant relationship to AMI severity. Further research is needed to understand these relationships better and to investigate the potential benefits of infection control measures and influenza vaccinations in reducing AMI incidence.
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Affiliation(s)
- Mohammad Abdul Aleem
- School of Population Health, Faculty of Medicine & Health, The University of New South Wales Sydney New South Wales Australia
- Infectious Diseases Division Program for Emerging Infections, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) Dhaka Bangladesh
| | - Abrar Ahmad Chughtai
- School of Population Health, Faculty of Medicine & Health, The University of New South Wales Sydney New South Wales Australia
| | - Bayzid Rahman
- Biosecurity Program, Faculty of Medicine & Health, The Kirby Institute, The University of New South Wales Sydney New South Wales Australia
| | - Zubair Akhtar
- Infectious Diseases Division Program for Emerging Infections, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) Dhaka Bangladesh
- Biosecurity Program, Faculty of Medicine & Health, The Kirby Institute, The University of New South Wales Sydney New South Wales Australia
| | - Fahmida Chowdhury
- Infectious Diseases Division Program for Emerging Infections, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) Dhaka Bangladesh
| | - Firdausi Qadri
- Infectious Diseases Division Respiratory and Enteric Infections, International Centre for Diarrhoeal Disease and Research, Bangladesh (icddr,b) Dhaka Bangladesh
| | - C Raina Macintyre
- Biosecurity Program, Faculty of Medicine & Health, The Kirby Institute, The University of New South Wales Sydney New South Wales Australia
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Song M, Zheng L, Chen L, Zhang C, Chen X, Zhao C. Epidemiological characteristics of chronic non-communicable diseases in Dongfang, China, 2021: a cross-sectional survey. BMJ Open 2024; 14:e081710. [PMID: 38803260 PMCID: PMC11129020 DOI: 10.1136/bmjopen-2023-081710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Accepted: 05/03/2024] [Indexed: 05/29/2024] Open
Abstract
OBJECTIVES The study aimed to understand the composition, epidemiological characteristics and disease burden of chronic non-communicable diseases and to evaluate the association between sociodemographic factors and chronic non-communicable diseases. DESIGN A cross-sectional study. SETTING AND PARTICIPANTS Medical records of 196 761 residents were collected from Dongfang disease surveillance system from January to December 2021. PRIMARY OUTCOME Prevalence and disability burden were recorded. Logistic regression was used to investigate the relationship between sociodemography factors and diseases. RESULTS Cardiovascular diseases, chronic lower respiratory diseases and other upper respiratory tract diseases were the main chronic non-communicable diseases. In multivariable analysis, men were associated with increased risk of cardiovascular diseases (OR=1.210, 95% CI 1.162 to 1.261) and chronic lower respiratory diseases (OR=1.128, 95% CI 1.079 to 1.180). Older age was associated with increased risk of cardiovascular diseases (OR=83.952, 95% CI 58.954 to 119.550), whereas was associated with decreased risk of chronic lower respiratory diseases (OR=0.442, 95% CI 0.415 to 0.471) and other upper respiratory tract diseases (OR=0.450, 95% CI 0.411 to 0.493). The unemployed and poor household were associated with decreased risk of cardiovascular diseases (OR=0.463, 95% CI 0.412 to 0.521 and OR=0.390, 95% CI 0.342 to 0.444, respectively), whereas were associated with increased risk of chronic lower respiratory diseases (OR=12.219, 95% CI 6.343 to 23.539 and OR=10.954, 95% CI 5.666 to 21.177, respectively) and other upper respiratory tract diseases (OR=2.246, 95% CI 1.719 to 2.936 and OR=3.035, 95% CI 2.308 to 3.991, respectively). Gender and age moderated the association between personnel category and major diseases. CONCLUSIONS The spectrum and epidemiological characteristics of chronic diseases observed in Dongfang is good evidence for developing prevention guides and health policies for region.
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Affiliation(s)
- Meixuan Song
- Department of Nursing, Tongji University School of Medicine, Shanghai, China
- Research Center for Translational Medicine, Tongji University Affilliated East Hospital, Shanghai, China
| | - Liang Zheng
- Research Center for Translational Medicine, Tongji University Affilliated East Hospital, Shanghai, China
| | - Lan Chen
- Department of Internal Medicine, Dongfang People's Hospital, Dongfang, Hainan, China
| | - Chunmei Zhang
- Dongfang Municipal Health Commission, Dongfang, Hainan, China
| | - Xingyi Chen
- Department of Medical, Tongji University Affilliated East Hospital, Shanghai, China
| | - Chunyan Zhao
- Department of Nursing, Tongji University Affilliated East Hospital, Shanghai, China
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Müller SA, Elimian K, Rafamatanantsoa JF, Reichert F, Mosala F, Böff L, Touré SF, Boone I, Ravaoarisoa L, Nduenga S, Ortu G, Pozo-Martin F, Tomczyk S, Eckmanns T, Okwor T, Akoua-Koffi C, Diané B, Randriamanantany ZA, Ahuka S, Ochu CL, El-Bcheraoui C. The burden and treatment of non-communicable diseases among healthcare workers in sub-Saharan Africa: a multi-country cross-sectional study. Front Public Health 2024; 12:1375221. [PMID: 38803813 PMCID: PMC11128585 DOI: 10.3389/fpubh.2024.1375221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 04/16/2024] [Indexed: 05/29/2024] Open
Abstract
Introduction Non-communicable diseases (NCDs), the leading cause of death globally, are estimated to overtake communicable diseases in sub-Sahara Africa, where healthcare workers (HCWs) play a crucial role in prevention and treatment, but are in extreme shortage, thereby increasing the burden of NCDs among this specific population. To provide evidence for policy-making, we assessed the NCD burden, associated factors and treatment among HCWs in four sub-Saharan African countries. Materials and methods We conducted a cross-sectional study across four sub-Saharan African countries [Côte d'Ivoire (CIV), Democratic Republic of the Congo (DRC), Madagascar (MDG), and Nigeria (NIG)] between February and December 2022. In a standardized questionnaire, sociodemographic, chronic disease and treatment data were self-reported. We estimated the prevalence of (1) at least one chronic disease, (2) hypertension, and used backward elimination logistic regression model to identify risk factors. Results We recruited a total of 6,848 HCWs. The prevalence of at least one chronic disease ranged between 9.7% in NIG and 20.6% in MDG, the prevalence of hypertension between 5.4% in CIV and 11.3% in MDG. At most, reported treatment rates reached 36.5%. The odds of each of both outcomes increased with age (at least one chronic disease adjusted odds ratio: CIV: 1.04; DRC: 1.09; MDG: 1.06; NIG: 1.10; hypertension: CIV: 1.10; DRC: 1.31; MDG: 1.11; NIG: 1.11) and with BMI (at least one chronic disease: CIV: 1.10; DRC: 1.07; MDG: 1.06; NIG: 1.08; hypertension: CIV: 1.10; DRC: 1.66; MDG: 1.13; NIG: 1.07). Odds of both outcomes were lower among males, except in CIV. In NIG, the odds of both outcomes were higher among medical doctors and odds of hypertension were higher among those working in secondary care. In MDG, working in secondary care increased and working as auxiliary staff decreased the odds of at least one chronic disease. Conclusion The prevalence of self-reported chronic disease varied across the four sub-Saharan countries with potentially very low treatment rates. We identified several individual (age, sex, and BMI) and occupational (profession, level of healthcare) factors that influence the odds of NCDs. These factors should be taken into account when developing interventions addressing the burden and management of NCDs among HCWs.
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Affiliation(s)
| | - Kelly Elimian
- Nigeria Centre for Disease Control and Prevention, Abuja, Nigeria
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | | | | | - Francis Mosala
- Institut National de la Recherche Biomédicale, Kinshasa, Democratic Republic of Congo
| | - Lena Böff
- Robert Koch Institute, Berlin, Germany
| | | | | | | | - Sagesse Nduenga
- Institut National de la Recherche Biomédicale, Kinshasa, Democratic Republic of Congo
| | | | | | | | | | - Tochi Okwor
- Nigeria Centre for Disease Control and Prevention, Abuja, Nigeria
| | | | - Bamourou Diané
- Center Hospitalier et Universitaire de Bouaké, Bouaké, Côte d'Ivoire
| | | | - Steve Ahuka
- Institut National de la Recherche Biomédicale, Kinshasa, Democratic Republic of Congo
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Davtalab Esmaeili E, R. Kalankesh L, Zeinalzadeh AH, Ghaffari A, Dastgiri S. Development, Validation, and Cross Cultural Adoption of Persian Version of Behavioral Risk Factor Tool. Med J Islam Repub Iran 2024; 38:21. [PMID: 38783977 PMCID: PMC11114187 DOI: 10.47176/mjiri.38.21] [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: 08/05/2023] [Indexed: 05/25/2024] Open
Abstract
Background One of the most crucial objectives of policymakers is to enhance the population's overall health. Establishing a surveillance system is a way to achieve this goal. The Behavioral Risk Factor Surveillance System (BRFSS) is a national system that collects data on the health-related behaviors of the United States residents using the Behavioral Risk Factor Questionnaire (BRFSSQ). This survey is aimed at reducing risk behaviors and their consequences. Regarding the fact that the cultural environment within each country may affect how behaviors are assessed, this study aimed to develop a Persian version, cross-cultural adaptation, and assess the validity and reliability of the PBRFSSQ. Methods In this cross-sectional study, 250 individuals were enrolled using the stratified sampling method between August 2022 and April 2023. Six steps of translation and test method proposed by Sousa et al was used. Content and face validity were calculated. Also, the Cronbach's alpha and test-retest were computed. Results Of all participants, 54.5% were male and aged 30 to 65 years old (69%). The Scale Content Validity Index was equal to 0.95. The Intra class Correlation Coefficient (ICC) was computed as 0.86, 0.88, and 0.87 for the core, optional, and total components, respectively. Furthermore, the Cronbach's alpha coefficient of 0.85 was obtained overall. Conclusion This tool was highly valid and reliable for assessing risky behaviors among the Iranian general population.
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Affiliation(s)
| | - Leila R. Kalankesh
- Medical Philosophy and History Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Health Information Technology, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ali Hossein Zeinalzadeh
- Social Determinants of Health Research Center, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Alireza Ghaffari
- Department of Internal Medicine, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Saeed Dastgiri
- Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Permanyer I, Calazans JA. On the measurement of cause of death inequality. Int J Epidemiol 2024; 53:dyae016. [PMID: 38365965 PMCID: PMC10873278 DOI: 10.1093/ije/dyae016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 01/25/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND Attempts at assessing heterogeneity in countries' mortality profiles often rely on measures of cause of death (CoD) diversity. Unfortunately, such indicators fail to take into consideration the degree of (dis)similarity among pairs of causes (e.g. 'transport injuries' and 'unintentional injuries' are implicitly assumed to be as dissimilar as 'transport injuries' and 'Alzheimer's disease')-an unrealistic and unduly restrictive assumption. DEVELOPMENT We extend diversity indicators proposing a broader class of heterogeneity measures that are sensitive to the similarity between the causes of death one works with. The so-called 'CoD inequality' measures are defined as the average expected 'dissimilarity between any two causes of death'. A strength of the approach is that such measures are decomposable, so that users can assess the contribution of each cause to overall CoD heterogeneity levels-a useful property for the evaluation of public health policies. APPLICATION We have applied the method to 15 low-mortality countries between 1990 and 2019, using data from the Global Burden of Disease project. CoD inequality and CoD diversity generally increase over time across countries and sex, but with some exceptions. In several cases (notably, Finland), both indicators run in opposite directions. CONCLUSIONS CoD inequality and diversity indicators capture complementary information about the heterogeneity of mortality profiles, so they should be analysed alongside other population health metrics, such as life expectancy and lifespan inequality.
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Affiliation(s)
- Iñaki Permanyer
- Centre for Demographic Studies, Centres de Recerca de Catalunya (CERCA), Universitat Autònoma de Barcelona, Bellaterra, Spain
- ICREA, Passeig LLuís Companys 23, Barcelona, Spain
| | - Júlia Almeida Calazans
- Centre for Demographic Studies, Centres de Recerca de Catalunya (CERCA), Universitat Autònoma de Barcelona, Bellaterra, Spain
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Tomas N, Mandume AM. Nurses' barriers to the pressure ulcer risk assessment scales implementation: A phenomenological study. Nurs Open 2024; 11:e2079. [PMID: 38268250 PMCID: PMC10782216 DOI: 10.1002/nop2.2079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 12/10/2023] [Accepted: 12/21/2023] [Indexed: 01/26/2024] Open
Abstract
AIM The aim of the study was to explore nurses' barriers to the pressure ulcer risk assessment scales implementation. DESIGN A qualitative descriptive phenomenological study. METHODS The research participants comprised of 10 nurses at various medical and surgical departments in a teaching hospital northeast of Namibia. Data were collected between August and September 2022 through in-depth, semi-structured face-to-face individual interviews and analysed using Colaizzi's 7-step method. RESULTS The interviews with nurses, led to two major themes being discovered: (1) factors hindering the effective prevention of pressure ulcers; (2) suggestions for improvements in the utilization of risk assessment scales. The participants noted that they had inadequate knowledge of the formal risk assessment scales; there were inadequate resources and insufficient staff; there were no policies or guidelines regarding the management of pressure ulcers, all of which influenced their utilization of pressure risk assessment scales. Education and training, the provision of equipment, the hiring of new staff and the formulation of policies/guidelines would thus improve the nurses' utilization of the scales. CONCLUSION The findings of this study have uncovered three primary factors that have a detrimental impact on the utilization of risk assessment scales by nurses, that is their lack knowledge on pressure ulcer risk assessment scales; a shortage of staff and equipment; and an absence of policies/guidelines. The findings from this study provide valuable implications for guiding quality improvement initiatives aimed at enhancing the standard of care in Namibia and other resource-limited settings.
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Affiliation(s)
- Nestor Tomas
- Department of General Nursing Science, School of Nursing and Publish Health, Faculty of Health Sciences and Veterinary MedicineUniversity of Namibia (UNAM)RunduNamibia
| | - Annalisa M. Mandume
- Department of General Nursing Science, School of Nursing, Faculty of Health Sciences and Veterinary MedicineUniversity of Namibia (UNAM)RunduNamibia
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Konkor I, Kuuire VZ. Epidemiologic transition and the double burden of disease in Ghana: What do we know at the neighborhood level? PLoS One 2023; 18:e0281639. [PMID: 36827236 PMCID: PMC9956066 DOI: 10.1371/journal.pone.0281639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 01/27/2023] [Indexed: 02/25/2023] Open
Abstract
Many developing countries including Ghana are currently experiencing dual disease burdens emerging from an unprecedented risk overlap that drive their epidemiological transitions. Yet, siloed and disintegrated approaches continue to take precedence in health research and policy programs that drive competition for limited resources to address competing health problems. The objective of this study was to offer empirical evidence in support of a cogent argument for an integrated framework for the study and management of infectious and chronic health conditions in Ghana. We did so by examining the prevalence, determinants, and neighborhoods trajectories of the double burden of disease using data from a cross-sectional neighborhood-based study in Ghana. We fitted multinomial multilevel multivariate models to a sample of 1377 individual surveys and the results presented as odds ratios. Findings show that amidst a rising burden of NCDs, infectious diseases remain the most common health condition and participants in deprived neighborhoods were significantly more likely to report poor health outcomes. Risk factors such as tobacco and alcohol consumption were significantly associated with NCDs and infectious diseases and respondents who reported being diagnosed with NCDs and infectious diseases in the past year were likely to engage in leisure time physical activities and eat healthy. Based on our findings, we recommend health reforms in Ghana and argue for the design and implementation of an integrated framework for the study and management of the double burden of disease in Ghana and similar developing country settings.
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Affiliation(s)
- Irenius Konkor
- Department of Geography, Geomatics and Environment, University of Toronto Mississauga, Mississauga, Canada
- * E-mail:
| | - Vincent Z. Kuuire
- Department of Geography, Geomatics and Environment, University of Toronto Mississauga, Mississauga, Canada
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Evaluation of Two Different Strategies for Schistosomiasis Screening in High-Risk Groups in a Non-Endemic Setting. Trop Med Infect Dis 2023; 8:tropicalmed8010044. [PMID: 36668951 PMCID: PMC9862038 DOI: 10.3390/tropicalmed8010044] [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: 11/30/2022] [Revised: 12/23/2022] [Accepted: 12/30/2022] [Indexed: 01/09/2023] Open
Abstract
A consensus on the recommended screening algorithms for schistosomiasis in asymptomatic high-risk subjects in non-endemic areas is lacking. The objective of this study was to evaluate the real-life performance of direct microscopy and ELISA serology for schistosomiasis screening in a high-risk population in a non-endemic setting. A retrospective cohort study was conducted in two out-patient Tropical Medicine units in Barcelona (Spain) from 2014 to 2017. Asymptomatic adults arriving from the Sub-Saharan region were included. Schistosomiasis screening was conducted according to clinical practice following a different strategy in each setting: (A) feces and urine direct examination plus S. mansoni serology if non-explained eosinophilia was present and (B) S. mansoni serology plus uroparasitological examination as the second step in case of a positive serology. Demographic, clinical and laboratory features were collected. Schistosomiasis cases, clinical management and a 24 month follow-up were recorded for each group. Four-hundred forty individuals were included. The patients were mainly from West African countries. Fifty schistosomiasis cases were detected (11.5% group A vs. 4 % group B, p = 0.733). When both microscopic and serological techniques were performed, discordant results were recorded in 18.4% (16/88). Schistosomiasis cases were younger (p < 0.001) and presented eosinophilia and elevated IgE (p < 0.001) more frequently. Schistosomiasis is a frequent diagnosis among high-risk populations. Serology achieves a similar performance to direct diagnosis for the screening of schistosomiasis in a high-risk population.
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Borges PCC, Spencer HB, Barbosa C, Costa V, Furtado A, Leal MC, Lopes C, Ferreira D, Carvalho AL, Dos-Santos-Silva I, Santos LL. XPERT ® breast cancer STRAT4 as an alternative method of identifying breast cancer phenotype in Cape Verde (preliminary results). Ecancermedicalscience 2023; 17:1530. [PMID: 37138965 PMCID: PMC10151082 DOI: 10.3332/ecancer.2023.1530] [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: 11/06/2022] [Indexed: 05/05/2023] Open
Abstract
Introduction Breast cancer (BC) is a public health problem in developing countries, including Cape Verde. Immunohistochemistry (IHC) is the gold standard technique used for BC phenotypic characterisation to support efficient therapeutic decisions. However, IHC is a demanding technique that requires knowledge, trained technicians, expensive antibodies and reagents, controls, and results validation. The low number of cases in Cape Verde increases the risk of expiring the validity of the antibodies, and manual procedures often jeopardise the quality of the results. Thus, IHC is limited in Cape Verde, and an alternative technically easy solution is needed. A point-of-care messenger RNA (mRNA) STRAT4 BC assay to assess estrogen (ER), progesterone (PR), hormone growth factor 2 receptor (HER2), and Ki67, using the GeneXpert platform, has been recently validated on tissues from internationally accredited laboratories, showing excellent concordance with IHC results.To assess whether this technology can be implemented in Cape Verde to guide BC treatment we decided to study the level of agreement between the findings yielded by BC STRAT4 and the results are the same cases obtained by IHC. Methods Formalin-fixed and paraffin-embedded (FFPE) tissue samples from 29 Cabo Verdean BC patients diagnosed in Agostinho Neto University Hospital were analysed by applying IHC and BC STRAT4 assay. The time between sample collection and pre-analytic procedures is unknown. All the samples were pre-processed in Cabo Verde (fixed in formalin and embedded in paraffin). IHC studies were performed in referenced laboratories in Portugal. STRAT4 and IHC result concordance was assessed by calculating the percentage of results agreement and Cohen's Kappa (K) statistics. Results STRAT4 assay failed in 2 out of the 29 analysed samples. Of the 27 successfully analysed samples, STRAT4/IHC results for ER, PR, HER2, and Ki67 were concordant in 25, 24, 25, and 18 cases, respectively. Ki67 was indeterminate in three cases, and PR was indeterminate once.The percentage of agreement between STRAT4 and IHC results for ER, PR, HER2, and Ki67 was 92.59%, 92.31%, 92.59% and 81.82%, respectively. The Cohen's K statistic coefficients for each biomarker were 0.809, 0.845, 0.757 and 0.506, respectively. Conclusions According to our preliminary results, a point-of-care mRNA STRAT4 BC assay may be an alternative in laboratories unable to provide quality and/or cost-efficient IHC services. However, more data and improvement on sample pre-analytic processes are required to implement this BC STRAT4 Assay in Cape Verde.
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Affiliation(s)
- Pamela C C Borges
- Laboratório Biologia Molecular, Hospital Universitário Agostinho Neto, Praia, Plateau 112, Cabo Verde
| | | | - Carla Barbosa
- Hospital Universitário Agostinho Neto, Praia, Plateau 112, Cabo Verde
| | - Victor Costa
- Hospital Universitário Agostinho Neto, Praia, Plateau 112, Cabo Verde
| | - Antónia Furtado
- IMP Diagnostics, Molecular and Anatomic Pathology Lab, 4150-146, Porto, Portugal
| | - Maria Conceição Leal
- Anatomia Patológica, Instituto Português de Oncologia, 4200-072, Porto, Portugal
| | - Carlos Lopes
- Unilabs | Laboratório Anatomia Patológica, 4250-170, Porto, Portugal
| | - Dylan Ferreira
- Experimental Pathology and Therapeutics Group, Research Center of IPO Porto (CI-IPOP)/RISE@CI-IPOP (Health Research Network), Portuguese Oncology Institute of Porto (IPO Porto)/Porto Comprehensive Cancer Center (Porto.CCC), 4200-072, Porto, Portugal
| | | | | | - Lúcio Lara Santos
- Experimental Pathology and Therapeutics Group, Research Center of IPO Porto (CI-IPOP)/RISE@CI-IPOP (Health Research Network), Portuguese Oncology Institute of Porto (IPO Porto)/Porto Comprehensive Cancer Center (Porto.CCC), 4200-072, Porto, Portugal
- Surgical Oncology Department, Portuguese Institute of Oncology, 4200-072, Porto, Portugal
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Fernández LG, Firima E, Robinson E, Ursprung F, Huber J, Amstutz A, Gupta R, Gerber F, Mokhohlane J, Lejone T, Ayakaka I, Xu H, Labhardt ND. Community-based care models for arterial hypertension management in non-pregnant adults in sub-Saharan Africa: a literature scoping review and framework for designing chronic services. BMC Public Health 2022; 22:1126. [PMID: 35658850 PMCID: PMC9167524 DOI: 10.1186/s12889-022-13467-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 05/13/2022] [Indexed: 12/12/2022] Open
Abstract
Background Arterial hypertension (aHT) is the leading cardiovascular disease (CVD) risk factor in sub-Saharan Africa; it remains, however, underdiagnosed, and undertreated. Community-based care services could potentially expand access to aHT diagnosis and treatment in underserved communities. In this scoping review, we catalogued, described, and appraised community-based care models for aHT in sub-Saharan Africa, considering their acceptability, engagement in care and clinical outcomes. Additionally, we developed a framework to design and describe service delivery models for long-term aHT care. Methods We searched relevant references in Embase Elsevier, MEDLINE Ovid, CINAHL EBSCOhost and Scopus. Included studies described models where substantial care occurred outside a formal health facility and reported on acceptability, blood pressure (BP) control, engagement in care, or end-organ damage. We summarized the interventions’ characteristics, effectiveness, and evaluated the quality of included studies. Considering the common integrating elements of aHT care services, we conceptualized a general framework to guide the design of service models for aHT. Results We identified 18,695 records, screened 4,954 and included twelve studies. Four types of aHT care models were identified: services provided at community pharmacies, out-of-facility, household services, and aHT treatment groups. Two studies reported on acceptability, eleven on BP control, ten on engagement in care and one on end-organ damage. Most studies reported significant reductions in BP values and improved access to comprehensive CVDs services through task-sharing. Major reported shortcomings included high attrition rates and their nature as parallel, non-integrated models of care. The overall quality of the studies was low, with high risk of bias, and most of the studies did not include comparisons with routine facility-based care. Conclusions The overall quality of available evidence on community-based aHT care is low. Published models of care are very heterogeneous and available evidence is insufficient to recommend or refute further scale up in sub-Sahara Africa. We propose that future projects and studies implementing and assessing community-based models for aHT care are designed and described according to six building blocks: providers, target groups, components, location, time of service delivery, and their use of information systems. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13467-4.
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Ciccacci F, Majid N, Petrolati S, Agy M, Massango C, Orlando S, Guidotti G, Scarcella P, Marazzi MC. Hypercholesterolemia and related risk factors in a cohort of patients with diabetes and hypertension in Maputo, Mozambique. Pan Afr Med J 2021; 38:102. [PMID: 33889268 PMCID: PMC8035689 DOI: 10.11604/pamj.2021.38.102.27284] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 12/05/2020] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION some studies reported that 25.5% of African population presents hypercholesterolemia; however, epidemiology of hypercholesterolemia in Africa is poorly described. Mozambique is experiencing a constant growth of non-communicable diseases, but scarce data are available about hypercholesterolemia. Our study aims at describing the prevalence of hypercholesterolemia in patients with diabetes and hypertension in Mozambique and investigate possible risk factors. METHODS we conducted a cross-sectional study involving all the patients diagnosed with hypertension and/or diabetes from June 2018 to November 2020 in the Zimpeto DREAM Centre (Maputo, Mozambique). For each patient, anthropometric, clinical and laboratory data were collected. Hypercholesterolemia was defined as total blood cholesterol >200 mg/dL. Univariable and multivariable analysis were perfumed. RESULTS a total of 885 patients were included, 76.2% (n=674) female. Hypertension alone was diagnosed in 670 (75.7%) patients, diabetes in 109 (12.3%) patients and 106 (11.9%) both diseases. Hypercholesterolemia was present in 410 (46.3%) patients and it was more prevalent in patients diagnosed with both diabetes and hypertension (52.8%), as compared to the patients diagnosed with hypertension (46.9%) or diabetes alone (36.7%). In the multivariable analysis, the only factors independently associated with hypercholesterolemia were female sex (aOR 1.77, 95% CI 1.26-2.48, p=0.001) and a body mass index >25kg/m2 (aOR 1.50, 95% CI 1.11-2.04, p=0.008). CONCLUSION our results highlight the need for a specific focus on female and obese/overweight patients, especially if diagnosed with both hypertension and diabetes, to promptly detect metabolic disorders and establish temporary preventive measures for cardiovascular events.
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Affiliation(s)
- Fausto Ciccacci
- UniCamillus, Saint Camillus International University of Health Sciences, Rome, Italy
| | - Noorjehan Majid
- Disease Relief through Excellence and Advanced Means (DREAM) Program, Community of Sant'Egidio, Maputo, Mozambique
| | | | - Mustafa Agy
- Disease Relief through Excellence and Advanced Means (DREAM) Program, Community of Sant'Egidio, Maputo, Mozambique
| | - Cacilda Massango
- Disease Relief through Excellence and Advanced Means (DREAM) Program, Community of Sant'Egidio, Maputo, Mozambique
| | - Stefano Orlando
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | | | - Paola Scarcella
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
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