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Amirkafi A, Mohammadi F, Tehrani-Banihashemi A, Moradi-Lakeh M, Murray CJL, Naghavi M, Mokdad AH. Drug-use disorders in the Eastern Mediterranean Region: a glance at GBD 2019 findings. Soc Psychiatry Psychiatr Epidemiol 2024; 59:1113-1127. [PMID: 37999752 DOI: 10.1007/s00127-023-02587-w] [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: 05/09/2023] [Accepted: 10/30/2023] [Indexed: 11/25/2023]
Abstract
PURPOSE The aim of this study is to investigate drug use disorders which are a major cause of Disability Adjusted Life Years (DALYs) in the Eastern Mediterranean Region (EMR). METHODS This article is a part of the global burden of diseases (GBD), injuries, and risk factors 2019 study. The GBD modeling approach was used to estimate population-level prevalence of drug use disorders. We combined these estimates with disability weights to calculate years of life lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs) for 1990-2019. RESULTS It is estimated that in 2019 in EMR around 3.4 million people have drug use disorder which has increased by 137% compared to 1990. Also, in 2019, DALY number for drug use disorders was 1217.9 (95% UI: 940.4, 1528.9) thousand years and 7645 (95% UI: 6793.7, 8567.9) deaths occurred. The DALY rate increased 39.6% in the region since1990, whereas the global rate increased by 24.4%. United Arab Emirates, Libya, and Iran were most affected by drug use disorders with the highest rates of age-standardized DALY in EMR in 2019. The most prevalent drug use disorder in the region is opioid use which is accountable for 80% of all drug use disorders DALYs. CONCLUSION Despite many interventions, drug use disorders are still responsible for high rates of DALY in the region which has increased since 1990 in both males and females; more comprehensive policies, better control measures and proper education could reduce the adverse effects.
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Affiliation(s)
- Ali Amirkafi
- Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Faezeh Mohammadi
- Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran
- Occupational Medicine Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Arash Tehrani-Banihashemi
- Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran
- Department of Community and Family Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Maziar Moradi-Lakeh
- Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran.
| | - Christopher J L Murray
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Mohsen Naghavi
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Ali H Mokdad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
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Abdel-Rahman S, Khater E, Abdel Fattah MN, Hussein WA. Social determinants of chronic diseases reporting among slum dwellers in Egypt. J Biosoc Sci 2024; 56:590-608. [PMID: 38347812 DOI: 10.1017/s0021932024000014] [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] [Indexed: 04/19/2024]
Abstract
The high prevalence of chronic diseases in urban slums poses increasing challenges to future social and economic development for these disadvantaged areas. Assessing the health status of slum residents offers guidance for formulating appropriate policies and interventions to improve slum residents' health outcomes. This research aimed to identify the social determinants of chronic diseases reporting among slum dwellers in Egypt. A cross-sectional survey was conducted from March to December 2021 in three slum areas in Giza governorate, Egypt, including 3,500 individuals. We constructed an asset index and a welfare index to measure the economic status and living conditions of slum residents, respectively. We used these indices, along with demographic and socio-economic factors, as independent variables in the analysis. We modeled factors associated with health status using a two-level mixed logistic model to control the effects of slum areas and the potential correlation between household members. The study contributed significantly to a better understanding of the context in which slum dwellers live and the interlinkages among poor living conditions, low economic status, and health outcomes. The results showed a high rate of self-reported chronic diseases among adults aged 18 and older, reaching more than 22%, while it did not exceed 2.0% among children in the slum areas. Therefore, measuring the determinants of chronic diseases was limited to adults. The sample size was 2530 adults after excluding 970 children. The prevalence of chronic diseases among adults ranged between 16.3% in Zenin and 22.6% in Bein El Sarayat. Our findings indicated that low socio-economic status was significantly associated with reporting chronic diseases. Future policies should be dedicated to improving living conditions and providing necessary healthcare services for these vulnerable areas.
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Affiliation(s)
- Suzan Abdel-Rahman
- Biostatistics and Demography, Faculty of Graduate Studies for Statistical Research, Cairo University, Cairo, Egypt
| | - Elsayed Khater
- Biostatistics and Demography, Faculty of Graduate Studies for Statistical Research, Cairo University, Cairo, Egypt
| | - Mohamed N Abdel Fattah
- Biostatistics and Demography, Faculty of Graduate Studies for Statistical Research, Cairo University, Cairo, Egypt
| | - Wafaa A Hussein
- Biostatistics and Demography, Faculty of Graduate Studies for Statistical Research, Cairo University, Cairo, Egypt
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Saoud F, AlHenaidi M, AlOtaibi H, AlEnezi A, Mohammed M, AlOtaibi F, AlShammari D, AlKharqawi S, AlMayas H, AlMathkour H, Akhtar S. Prevalence of and factors associated with multimorbidity among adults in Kuwait. BMC Public Health 2024; 24:768. [PMID: 38475726 DOI: 10.1186/s12889-024-18298-z] [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: 08/15/2023] [Accepted: 03/06/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND This cross-sectional study aimed to assess the prevalence of morbidity i.e., one morbidity and multimorbidity (≥ 2 morbid conditions) among adults in Kuwait and to examine the sociodemographic and lifestyle factors associated with morbidity as a multinomial outcome in the study population. METHODS The data were collected from January 26, 2021, to February 3, 2021, using an electronic questionnaire, which was distributed on social media platforms. The consent form was attached with the questionnaire and the participants were requested to sign the consent form before completing the questionnaire. The prevalences (%) of each morbidity and multimorbidity were computed. Multivariable polychotomous logistic regression analysis was used to evaluate the association between the demographic and lifestyle factors with morbidity as a multinomial outcome. RESULTS Of 3572 respondents included, 89% were Kuwaiti, 78.3% females and 66% were 21- 40 years old. The prevalence of multimorbidity and one morbidity respectively was 27.4% and 29.7%. The prevalence of multimorbidity with two, three, four or five ill-health conditions were 14.3%, 7.4%, 3.5%, and 1.2%, respectively. A higher prevalence of multimorbidity was among respondents over 60 years of age (71%) and Kuwaiti nationals (28.9%). The final multivariable polychotomous logistic regression model revealed that age, sex, nativity, sedentary lifestyle, smoking, and alcohol drinking were significantly (p < 0.05) associated with multimorbidity. However, age and alcohol drinking were significant (p < 0.05) predictors of one morbidity. CONCLUSION This study provides evidence that multimorbidity is more prevalent among the elderly, females, and Kuwaiti nationals. Sedentary behaviour, smoking and alcohol consumption were significantly and independently associated with multimorbidity. These findings highlight the burden of multimorbidity and should be considered in the development of future prevention programs.
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Affiliation(s)
- Fajer Saoud
- Department of Community Medicine and Behavioural Sciences, College of Medicine, Kuwait University, PO Box 24923, 13110, Safat, Kuwait
| | - Maryam AlHenaidi
- Department of Community Medicine and Behavioural Sciences, College of Medicine, Kuwait University, PO Box 24923, 13110, Safat, Kuwait
| | - Hajer AlOtaibi
- Department of Community Medicine and Behavioural Sciences, College of Medicine, Kuwait University, PO Box 24923, 13110, Safat, Kuwait
| | - Asayel AlEnezi
- Department of Community Medicine and Behavioural Sciences, College of Medicine, Kuwait University, PO Box 24923, 13110, Safat, Kuwait
| | - Mariam Mohammed
- Department of Community Medicine and Behavioural Sciences, College of Medicine, Kuwait University, PO Box 24923, 13110, Safat, Kuwait
| | - Fatemah AlOtaibi
- Department of Community Medicine and Behavioural Sciences, College of Medicine, Kuwait University, PO Box 24923, 13110, Safat, Kuwait
| | - Danah AlShammari
- Department of Community Medicine and Behavioural Sciences, College of Medicine, Kuwait University, PO Box 24923, 13110, Safat, Kuwait
| | - Sebakah AlKharqawi
- Department of Community Medicine and Behavioural Sciences, College of Medicine, Kuwait University, PO Box 24923, 13110, Safat, Kuwait
| | - Hadil AlMayas
- Department of Community Medicine and Behavioural Sciences, College of Medicine, Kuwait University, PO Box 24923, 13110, Safat, Kuwait
| | - Hatoun AlMathkour
- Department of Community Medicine and Behavioural Sciences, College of Medicine, Kuwait University, PO Box 24923, 13110, Safat, Kuwait
| | - Saeed Akhtar
- Department of Community Medicine and Behavioural Sciences, College of Medicine, Kuwait University, PO Box 24923, 13110, Safat, Kuwait.
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Nasreddine L, Bakir MA, Al-Ati T, Alzaben AS, Barham R, Bawazeer N, Fares EJ, Hammad K, Kaestel P, Reilly JJ, Taktouk M. Nutrition and Health in Arab Adolescents (NaHAR): Study protocol for the determination of ethnic-specific body fat and anthropometric cut-offs to identify metabolic syndrome. PLoS One 2024; 19:e0298306. [PMID: 38394061 PMCID: PMC10889849 DOI: 10.1371/journal.pone.0298306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 01/23/2024] [Indexed: 02/25/2024] Open
Abstract
The prevalence of adolescent obesity in the Middle-East is considered among the highest in the world. Obesity in adolescents is associated with several cardiometabolic abnormalities, the constellation of which is referred to as the metabolic syndrome (MetS). This multi-country cross-sectional study aims to determine the optimal cut-off values for body fat (BF); body mass index (BMI) z-score; waist circumference (WC) percentile, and mid-upper arm circumference (MUAC) for the prediction of MetS among adolescents from Kingdom of Saudi-Arabia (KSA), Kuwait, Jordan, Lebanon and Syria. A secondary objective is to examine the validity of Bioelectrical Impendence Vector Analysis (BIVA) in estimating BF against the deuterium dilution technique (DDL). In each country, a sample of 210 adolescents will be recruited. Data collection will include demographics, socioeconomic, lifestyle and dietary data using a multi-component questionnaire; anthropometric measurements will be obtained and body composition will be assessed using the DDL and BIVA; blood pressure and biochemical assessment will be performed for the identification of the MetS. Receiver operating characteristic analyses will be undertaken to determine optimal cut-off values of BMI, WC, MUAC and BF in identifying those with MetS. Odds ratios (OR) and their respective 95% confidence interval (CI) for the association of the anthropometric measurements with MetS will be computed based on multiple logistic regression analysis models. The Bland and Altman approach will be adopted to compare BIVA against the reference DDL method for the determination of body composition parameters. This study responds to the need for ethnic-specific anthropometric cut-offs for the identification of excess adiposity and associated cardiometabolic risks in the adolescent population. The adoption of the generated cut-offs may assist policy makers, public health professionals and clinical practitioners in providing ethnic-specific preventive and curative strategies tailored to adolescents in the region.
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Affiliation(s)
- Lara Nasreddine
- Department of Nutrition and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Mohamad Adel Bakir
- Department of Radiation Medicine, Atomic Energy Commission, Damascus, Syrian Arab Republic
| | - Tareq Al-Ati
- Food and Nutrition Program, Environment and Life Sciences Research Institute Center, Kuwait Institute for Scientific Research, Safat, Kuwait
| | - Abeer Salman Alzaben
- Department of Health Sciences, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Rawhieh Barham
- Department of Nutrition, Ministry of Health, Amman, Jordan
| | - Nahla Bawazeer
- Department of Health Sciences, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Elie-Jacques Fares
- Department of Nutrition and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Kholoud Hammad
- Department of Radiation Medicine, Atomic Energy Commission, Damascus, Syrian Arab Republic
| | - Pernille Kaestel
- Department of Nuclear Sciences and Applications, Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - John J. Reilly
- Physical Activity for Health Group, School of Psychological Sciences and Health, University of Strathclyde, Glasgow, Scotland
| | - Mandy Taktouk
- Department of Nutrition and Food Sciences, American University of Beirut, Beirut, Lebanon
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Cruz-Ávila HA, Ramírez-Alatriste F, Martínez-García M, Hernández-Lemus E. Comorbidity patterns in cardiovascular diseases: the role of life-stage and socioeconomic status. Front Cardiovasc Med 2024; 11:1215458. [PMID: 38414921 PMCID: PMC10897012 DOI: 10.3389/fcvm.2024.1215458] [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: 05/02/2023] [Accepted: 01/29/2024] [Indexed: 02/29/2024] Open
Abstract
Cardiovascular diseases stand as a prominent global cause of mortality, their intricate origins often entwined with comorbidities and multimorbid conditions. Acknowledging the pivotal roles of age, sex, and social determinants of health in shaping the onset and progression of these diseases, our study delves into the nuanced interplay between life-stage, socioeconomic status, and comorbidity patterns within cardiovascular diseases. Leveraging data from a cross-sectional survey encompassing Mexican adults, we unearth a robust association between these variables and the prevalence of comorbidities linked to cardiovascular conditions. To foster a comprehensive understanding of multimorbidity patterns across diverse life-stages, we scrutinize an extensive dataset comprising 47,377 cases diagnosed with cardiovascular ailments at Mexico's national reference hospital. Extracting sociodemographic details, primary diagnoses prompting hospitalization, and additional conditions identified through ICD-10 codes, we unveil subtle yet significant associations and discuss pertinent specific cases. Our results underscore a noteworthy trend: younger patients of lower socioeconomic status exhibit a heightened likelihood of cardiovascular comorbidities compared to their older counterparts with a higher socioeconomic status. By empowering clinicians to discern non-evident comorbidities, our study aims to refine therapeutic designs. These findings offer profound insights into the intricate interplay among life-stage, socioeconomic status, and comorbidity patterns within cardiovascular diseases. Armed with data-supported approaches that account for these factors, clinical practices stand to be enhanced, and public health policies informed, ultimately advancing the prevention and management of cardiovascular disease in Mexico.
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Affiliation(s)
- Héctor A Cruz-Ávila
- Graduate Program in Complexity Sciences, Autonomous University of México City, México City, Mexico
- Immunology Department, National Institute of Cardiology 'Ignacio Chávez', México City, Mexico
| | | | - Mireya Martínez-García
- Immunology Department, National Institute of Cardiology 'Ignacio Chávez', México City, Mexico
| | - Enrique Hernández-Lemus
- Computational Genomics Division, National Institute of Genomic Medicine, México City, Mexico
- Center for Complexity Sciences, Universidad Nacional Autónoma de México, México City, Mexico
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6
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Goel N, Biswas I, Chattopadhyay K. Risk factors of multimorbidity among older adults in India: A systematic review and meta-analysis. Health Sci Rep 2024; 7:e1915. [PMID: 38420204 PMCID: PMC10900089 DOI: 10.1002/hsr2.1915] [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: 02/24/2023] [Revised: 12/18/2023] [Accepted: 01/25/2024] [Indexed: 03/02/2024] Open
Abstract
Background Multimorbidity among older adults is a growing concern in India. Multimorbidity is defined as the coexistence of two or more chronic health conditions in an individual. Primary studies have been conducted on risk factors of multimorbidity in India, but no systematic review has been conducted on this topic. This systematic review aimed to synthesize the existing evidence on risk factors of multimorbidity among older adults in India. Methods The JBI and Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were followed. Several databases were searched for published and unpublished studies until August 03, 2022. The screening of titles and abstracts and full texts, data extraction, and quality assessment were conducted by two independent reviewers. Any disagreements were resolved through discussion or by involving a third reviewer. Data synthesis was conducted using narrative synthesis and random effects meta-analysis, where appropriate. Results Out of 8781 records identified from the literature search, 16 and 15 studies were included in the systematic review and meta-analysis, respectively. All included studies were cross-sectional, and 10 met a critical appraisal score of more than 70%. Broadly, sociodemographic, lifestyle, and health conditions-related factors were explored in these studies. The pooled odds of multimorbidity were higher in people aged ≥70 years compared to 60-69 years (odds ratio (OR) 1.51; 95% confidence interval (CI) 1.20-1.91), females compared to males (1.38; 1.09-1.75), single, divorced, separated, and widowed compared to married (1.29; 1.11-1.49), economically dependent compared to economically independent (1.54; 1.21-1.97), and smokers compared to non-smokers (1.33; 1.16-1.52) and were lower in working compared to not working (0.51; 0.36-0.72). Conclusion This systematic review and meta-analysis provided a comprehensive picture of the problem by synthesizing the existing evidence on risk factors of multimorbidity among older adults in India. These synthesized sociodemographic and lifestyle factors should be taken into consideration when developing health interventions for addressing multimorbidity among older adults in India.
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Affiliation(s)
- Nikita Goel
- Lifespan and Population Health, School of MedicineUniversity of NottinghamNottinghamUK
| | - Isha Biswas
- Lifespan and Population Health, School of MedicineUniversity of NottinghamNottinghamUK
| | - Kaushik Chattopadhyay
- Lifespan and Population Health, School of MedicineUniversity of NottinghamNottinghamUK
- The Nottingham Centre for Evidence‐Based Healthcare: A JBI Centre of ExcellenceNottinghamUK
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7
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Sadeghi M, Jamalian M, Mehrabani-Zeinabad K, Turk-Adawi K, Kopec J, AlMahmeed W, Abdul Rahim HF, Farhan HA, Anwar W, Manla Y, Fadhil I, Lui M, Roohafza H, Islam SMS, Sulaiman K, Bazargani N, Saade G, Hassen N, Alandejani A, Abdin A, Bokhari S, Roth GA, Johnson C, Stark B, Sarrafzadegan N, Mokdad AH. The burden of ischemic heart disease and the epidemiologic transition in the Eastern Mediterranean Region: 1990-2019. PLoS One 2023; 18:e0290286. [PMID: 37669274 PMCID: PMC10479892 DOI: 10.1371/journal.pone.0290286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 08/05/2023] [Indexed: 09/07/2023] Open
Abstract
It has been estimated that in the next decade, IHD prevalence, DALYs and deaths will increase more significantly in EMR than in any other region of the world. This study aims to provide a comprehensive description of the trends in the burden of ischemic heart disease (IHD) across the countries of the Eastern Mediterranean Region (EMR) from 1990 to 2019. Data on IHD prevalence, disability-adjusted life years (DALYs), mortality, DALYs attributable to risk factors, healthcare access and quality index (HAQ), and universal health coverage (UHC) were extracted from the Global Burden of Disease (GBD) database for EMR countries. The data were stratified based on the social demographic index (SDI). Information on cardiac rehabilitation was obtained from publications by the International Council of Cardiovascular Prevention and Rehabilitation (ICCPR), and additional country-specific data were obtained through advanced search methods. Age standardization was performed using the direct method, applying the estimated age structure of the global population from 2019. Uncertainty intervals were calculated through 1000 iterations, and the 2.5th and 97.5th percentiles were derived from these calculations. The age-standardized prevalence of IHD in the EMR increased from 5.0% to 5.5% between 1990 and 2019, while it decreased at the global level. In the EMR, the age-standardized rates of IHD mortality and DALYs decreased by 11.4% and 15.4%, respectively, during the study period, although both rates remained higher than the global rates. The burden of IHD was found to be higher in males compared to females. Bahrain exhibited the highest decrease in age-standardized prevalence (-3.7%), mortality (-65.0%), and DALYs (-69.1%) rates among the EMR countries. Conversely, Oman experienced the highest increase in prevalence (14.5%), while Pakistan had the greatest increase in mortality (30.0%) and DALYs (32.0%) rates. The top three risk factors contributing to IHD DALYs in the EMR in 2019 were high systolic blood pressure, high low-density lipoprotein cholesterol, and particulate matter pollution. The trend analysis over the 29-year period (1990-2019) revealed that high fasting plasma glucose (64.0%) and high body mass index (23.4%) exhibited increasing trends as attributed risk factors for IHD DALYs in the EMR. Our findings indicate an increasing trend in the prevalence of IHD and a decrease in mortality and DALYs in the EMR. These results emphasize the need for well-planned prevention and treatment strategies to address the risk factors associated with IHD. It is crucial for the countries in this region to prioritize the development and implementation of programs focused on health promotion, education, prevention, and medical care.
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Affiliation(s)
- Masoumeh Sadeghi
- Cardiovascular Research Institute, Cardiac Rehabilitation Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Marjan Jamalian
- Cardiovascular Research Institute, Hypertension Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Kamran Mehrabani-Zeinabad
- Cardiovascular Research Institute, Pediatric Cardiovascular Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Karam Turk-Adawi
- Department of Public Health, QU-Health, Qatar University, Doha, Qatar
| | - Jacek Kopec
- School of Population & Public Health, University of British Columbia, Vancouver, Canada
- Arthritis Research Canada, Vancouver, Canada
| | - Wael AlMahmeed
- Heart and Vascular Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Hanan F. Abdul Rahim
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Hasan Ali Farhan
- Scientific Council of Cardiology, Iraqi Board for Medical Specializations. Baghdad Heart Center, Baghdad, Iraq
| | - Wagida Anwar
- Faculty of Medicine, Community Medicine Department, Ain Shams University, Egypt and Armed Forces College of Medicine (AFCM), Cairo, Egypt
| | - Yosef Manla
- Heart and Vascular Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
- Faculty of Medicine, Aleppo University, Aleppo, Syria
| | | | - Michelle Lui
- School of Population & Public Health, University of British Columbia, Vancouver, Canada
| | - Hamidreza Roohafza
- Cardiovascular Research Institute, Interventional Cardiology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | | | | | - George Saade
- Department of Cardiology, Bellevue Medical Center, Beirut, Lebanon
| | - Nejat Hassen
- School of Population & Public Health, University of British Columbia, Vancouver, Canada
- Arthritis Research Canada, Vancouver, Canada
| | - Amani Alandejani
- School of Population & Public Health, University of British Columbia, Vancouver, Canada
| | - Amr Abdin
- Syrian Cardiovascular Association, Damascus, Syria
| | - Saira Bokhari
- Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - Gregory A. Roth
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, United States of America
- Department of Health Metrics Sciences, University of Washington, Seattle, United States of America
| | - Catherine Johnson
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, United States of America
| | - Benjamin Stark
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, United States of America
| | - Nizal Sarrafzadegan
- School of Population & Public Health, University of British Columbia, Vancouver, Canada
- Cardiovascular Research Institute, Isfahan Cardiovascular Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ali H. Mokdad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, United States of America
- Department of Health Metrics Sciences, University of Washington, Seattle, United States of America
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Ramesh S, Kosalram K, Srinivas V. Non-communicable diseases and their impact on depression, anxiety, and stress among the geriatric population residing in old age homes in Chennai, Tamil Nadu. J Family Med Prim Care 2023; 12:1931-1937. [PMID: 38024936 PMCID: PMC10657085 DOI: 10.4103/jfmpc.jfmpc_801_23] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 07/05/2023] [Accepted: 07/11/2023] [Indexed: 12/01/2023] Open
Abstract
Background Non-communicable diseases (NCDs) are most prevalent among the elderly population. Mental illness and chronic disease conditions are of utmost significance when considering their implications on various aspects such as well-being, quality of life, cost of treatment, and longevity of the affected individuals. There is a paucity of data from India to assess the prevalence of NCDs and their relation to depression, anxiety, and stress among the elderly population. Aim The present study aims to determine the prevalence of NCDs and their relationship with depression, anxiety, and stress (DASS) among the geriatric population that resides in senior citizen homes (Old age homes) in Chennai. Materials and Methods A cross-sectional study was conducted among the elderly population in old age homes located in Chennai. The research was carried out through offline methods during the period of January 2023 to April 2023. A total of 311 participants were involved in this study who were aged 60 and older. DASS 21 was used to study depression, anxiety, and stress. Results The overall prevalence of depression was 84.2%, anxiety was 49.2%, and stress was 55.9% among the study participants. The findings of the study show that there is a statistically significant association, the odds of diabetes were 2 times higher (OR- 2.082, 95% CI: 1.225-3.888), the presence of hypertension was nearly 4.1 times higher (OR- 4.116, 95% CI: 2.110-8.030) and the odds of the presence of visual impairment were nearly 1.8 times higher (OR-1.810, 95% CI: 0.976-3.357) in developing the symptoms of depression. Conclusion Screening of non-communicable diseases (NCDs) such as hypertension, diabetes, etc. for DASS among the elderly population is recommended at regular intervals, as elderly people are considered to be the most vulnerable age group population, worldwide.
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Affiliation(s)
- Swathi Ramesh
- School of Public Health, SRM Institute of Science and Technology, Kattankulathur, Tamil Nadu, India
| | - Kalpana Kosalram
- School of Public Health, SRM Institute of Science and Technology, Kattankulathur, Tamil Nadu, India
| | - V. Srinivas
- Geri Care Organization, Adyar, Chennai, Tamil Nadu, India
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9
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Khan ZUH, Gul NS, Mehmood F, Sabahat S, Muhammad N, Rahim A, Iqbal J, Khasim S, Salam MA, Khan TM, Wu J. Green synthesis of lead oxide nanoparticles for photo-electrocatalytic and antimicrobial applications. Front Chem 2023; 11:1175114. [PMID: 37601905 PMCID: PMC10435987 DOI: 10.3389/fchem.2023.1175114] [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: 03/20/2023] [Accepted: 07/03/2023] [Indexed: 08/22/2023] Open
Abstract
Synthesis of nanoparticles (NPs) for many different uses requires the development of environmentally friendly synthesis protocols. In this article, we present a simple and environmentally friendly method to synthesize lead oxide (PbO) NPs from the plant material of the Mangifera indica. Analytical techniques such as spectroscopy, X-ray diffraction, and microscopy were used to characterize the synthesized PbO NPs, and their photo-electrocatalytic and antifungal properties were also evaluated. H2O2 was used to investigate the efficacy of removing methylene blue dye. At a range of pH values, H2O2 was used to study the role of hydroxyl radicals in the breakdown of methylene blue dye. Methylene blue dyes are more easily eliminated due to increased generation of the *OH radical during removal. Dye degradation was also significantly affected by the aqueous medium's pH. Additionally, the electrocatalytic properties of the PbO NPs adapted electrode were studied in CH3COONa aqueous solution using cyclic voltammetry. Excellent electrocatalytic properties of the PbO NPs are shown by the unity of the anodic and cathodic peaks of the modified electrode in comparison to the stranded electrode. Aspergillus flavus, Aspergillus niger, and Candida glabrata were some fungi tested with the PbO NPs. Against A. flavus (40%) and A. niger (50%), and C. glabrata (75%), the PbO NPs display an excellent inhibition zone. Finally, PbO NPs were used in antioxidant studies with the powerful antioxidant 2, 2 diphenyl-1-picrylhydrazyl (DPPH). This study presents a simple and environmentally friendly method for synthesizing PbO NPs with multiple uses, including photo-electrocatalytic and antimicrobial activity.
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Affiliation(s)
- Zia Ul Haq Khan
- Department of Chemistry, COMSATS University Islamabad, Islamabad, Pakistan
| | - Noor Shad Gul
- Drug Discovery Research Center, Southwest Medical University, Luzhou, China
- Department of Pharmacology, Laboratory of Cardiovascular Pharmacology, The School of Pharmacy, Southwest Medical University, Luzhou, China
| | - Faisal Mehmood
- Department of Environmental Sciences, COMSATS University Islamabad, Islamabad, Pakistan
| | - Sana Sabahat
- Department of Chemistry, COMSATS University Islamabad, Islamabad, Pakistan
| | - Nawshad Muhammad
- Department of Dental Materials, Institute of Basic Medical Sciences, Khyber Medical University, Peshawar, Pakistan
| | - Abdur Rahim
- Department of Chemistry, COMSATS University Islamabad, Islamabad, Pakistan
| | - Jibran Iqbal
- College of Natural and Health Sciences, Zayed University, Abu Dhabi, United Arab Emirates
| | - Syed Khasim
- Department of Physics, Faculty of Science, University of Tabuk, Tabuk, Saudi Arabia
| | - Mohamed Abdel Salam
- Department of Chemistry, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Taj Malook Khan
- Drug Discovery Research Center, Southwest Medical University, Luzhou, China
- Department of Pharmacology, Laboratory of Cardiovascular Pharmacology, The School of Pharmacy, Southwest Medical University, Luzhou, China
| | - Jianbo Wu
- Drug Discovery Research Center, Southwest Medical University, Luzhou, China
- Department of Pharmacology, Laboratory of Cardiovascular Pharmacology, The School of Pharmacy, Southwest Medical University, Luzhou, China
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Boutayeb A. Social determinants of health and adolescent childbearing in WHO Eastern Mediterranean countries. Int J Equity Health 2023; 22:78. [PMID: 37131177 PMCID: PMC10155383 DOI: 10.1186/s12939-023-01861-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 03/13/2023] [Indexed: 05/04/2023] Open
Abstract
OBJECTIVES Teenage pregnancy and motherhood is a crucial problem in countries of the World Health Organisation Eastern Mediterranean Region (WHO-EMR). The aim of this paper is to describe and analyse the phenomenon of adolescent childbearing in ten countries according to social determinants like milieu (rural-urban), education level, wealth quintiles, territoriality (countries, regions) and nationality. METHODS Inequity in terms of adolescent childbearing was analysed using disaggregated data given by Demographic Health Surveys (DHS), UNICEF Multiple Indicator Cluster Surveys (MICS) and the Pan Arab Project for Family Health (PAPFAM) surveys. Beside the absolute differences (gaps) and relative differences (ratios), the index of dissimilarity (ID) was used to compare the distributions of adolescent pregnancy and motherhood by social determinants in each country. RESULTS Data analysis indicates that the average percentage of adolescent women aged 15-19 years who have begun childbearing shows a large difference between countries, varying from 0.4% in Tunisia to 15.1% in Sudan, combined with huge gaps within each country as indicated by the values of the index of dissimilarity. Poor, rural and non-educated adolescent girls are more exposed to teenage childbearing than their counterparts-rich, urban and educated girls. CONCLUSION According to different social determinants, sensible variations are seen in terms of adolescent pregnancy and motherhood within the ten countries considered in this study. This is a clear appeal to decision makers to reduce child marriage and pregnancy by acting on social determinants of health, targeting disadvantaged girls coming mainly from marginalised groups and poor families living in remote rural zones.
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Affiliation(s)
- Abdesslam Boutayeb
- Laboratory of Stochastic and Deterministic Modelling, Department of Mathematics, Faculty of Sciences, University Mohamed Premier, Boulevard Mohamed VI, Oujda, 60 000, Morocco.
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11
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Hassannejad R, Shafie D, Turk-Adawi KI, Hajaj AM, Mehrabani-Zeinabad K, Lui M, Kopec JA, Abdul Rahim HF, Safiri S, Fadhil I, Anwar WA, Mokdad AH, Shariful Islam SM, Sarrafzadegan N. Changes in the burden and underlying causes of heart failure in the Eastern Mediterranean Region, 1990-2019: An analysis of the Global Burden of Disease Study 2019. EClinicalMedicine 2023; 56:101788. [PMID: 36593790 PMCID: PMC9803705 DOI: 10.1016/j.eclinm.2022.101788] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 11/23/2022] [Accepted: 11/28/2022] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND The burden of heart failure (HF) is high globally, but information on its burden in the Eastern Mediterranean Region (EMR) is limited. This study provides a systematic analysis of the burden and underlying causes of HF in the EMR, including at the country level, between 1990 and 2019. METHODS We used the 2019 Global Burden of Disease (GBD) data for estimates of prevalence, years lived with disability (YLDs), and underlying causes of HF in the EMR. Age-standardised prevalence, YLDs, and underlying causes of HF were compared by 5-year age groups (considering 15 years old and more), sex (male and female), and countries. FINDINGS In contrast with the decreasing trend of HF burden globally, EMR showed an increasing trend. Globally, the HF age-standardised prevalence and YLDs decreased by 7.06% (95% UI: -7.22%, -6.9%) and 6.82% (95% UI: -6.98%, -6.66%) respectively, from 1990 to 2019. The HF age-standardised prevalence and YLDs in the EMR in 2019 were 706.43 (95% UI: 558.22-887.87) and 63.46 (95% UI: 39.82-92.59) per 100,000 persons, representing an increase of 8.07% (95% UI: 7.9%, 8.24%) and 8.79% (95% UI: 8.61%, 8.97%) from 1990, respectively. Amongst EMR countries, the age-standardised prevalence and YLDs were highest in Kuwait, while Pakistan consistently had the lowest HF burden. The dramatic increase of the age-standardised prevalence and YLDs were seen in Oman (28.79%; 95% UI: 28.51%, 29.07% and 29.56%; 95% UI: 29.28%, 29.84%), while Bahrain witnessed a reduction over the period shown (-9.66%; 95% UI: -9.84%, -9.48% and-9.14%; 95% UI: -9.32%, -8.96%). There were significant country-specific differences in trends of HF burden from 1990 to 2019. Males had relatively higher rates than females in all age groups. Among all causes of HF in 2019, ischemic heart disease accounted for the highest age-standardised prevalence and YLDs, followed by hypertensive heart disease. INTERPRETATION The burden of HF in the EMR was higher than the global, with increasing age-standardised prevalence and YLDs in countries of the region. A more comprehensive approach is needed to prevent underlying causes and improve medical care to control the burden of HF in the region. FUNDING None.
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Affiliation(s)
- Razieh Hassannejad
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Davood Shafie
- Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Karam I. Turk-Adawi
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Ahmad Mohammad Hajaj
- QU Health Research and Graduate Studies, QU Health, Qatar University, Doha, Qatar
| | - Kamran Mehrabani-Zeinabad
- Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Michelle Lui
- Faculty of Medicine, School of Population & Public Health, University of British Columbia, Vancouver, Canada
| | - Jacek A. Kopec
- Faculty of Medicine, School of Population & Public Health, University of British Columbia, Vancouver, Canada
- Arthritis Research Canada, Vancouver, Canada
| | - Hanan F. Abdul Rahim
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Saeid Safiri
- Research Center for Integrative Medicine in Aging, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Community Medicine, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ibtihal Fadhil
- Eastern Mediterranean NCD Alliance, Dubai, United Arab Emirates
| | - Wagida A. Anwar
- Community Medicine Department, Faculty of Medicine, Ain Shams University, Egypt
- Armed Forces College of Medicine (AFCM), Egypt
| | - Ali H. Mokdad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, USA
- Department of Health Metrics Sciences, University of Washington, Seattle, USA
| | - Sheikh Mohammed Shariful Islam
- Institute for Physical Activity and Nutrition, Deakin University, Melbourne, Australia
- Corresponding author. Institute for Physical Activity and Nutrition, Deakin University, 221 Burwood Highway, Burwood, Melbourne, 3125, Victoria, Australia.
| | - Nizal Sarrafzadegan
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
- Faculty of Medicine, School of Population & Public Health, University of British Columbia, Vancouver, Canada
- Corresponding author. Isfahan Cardiovascular Research Institute, WHO Collaborating Center in the EMR, Isfahan University of Medical Sciences, Shahid Rahmani Alley, Moshtagh 3rd St., Isfahan, 8136747969, Iran.
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12
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Bentué-Martínez C, Mimbrero MR, Zúñiga-Antón M. Spatial patterns in sociodemographic factors explain to a large extent the prevalence of hypertension and diabetes in Aragon (Spain). Front Med (Lausanne) 2023; 10:1016157. [PMID: 36760398 PMCID: PMC9905822 DOI: 10.3389/fmed.2023.1016157] [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: 08/10/2022] [Accepted: 01/11/2023] [Indexed: 01/26/2023] Open
Abstract
Introduction The global burden of multi-morbidity has become a major public health challenge due to the multi stakeholder action required to its prevention and control. The Social Determinants of Health approach is the basis for the establishment of health as a cross-cutting element of public policies toward enhanced and more efficient decision making for prevention and management. Objective To identify spatially varying relationships between the multi-morbidity of hypertension and diabetes and the sociodemographic settings (2015-2019) in Aragon (a mediterranean region of Northeastern Spain) from an ecological perspective. Materials and methods First, we compiled data on the prevalence of hypertension, diabetes, and sociodemographic variables to build a spatial geodatabase. Then, a Principal Component Analysis (PCA) was performed to derive regression variables, i.e., aggregating prevalence rates into a multi-morbidity component (stratified by sex) and sociodemographic covariate into a reduced but meaningful number of factors. Finally, we applied Geographically Weighted Regression (GWR) and cartographic design techniques to investigate the spatial variability of the relationships between multi-morbidity and sociodemographic variables. Results The GWR models revealed spatial explicit relationships with large heterogeneity. The sociodemographic environment participates in the explanation of the spatial behavior of multi-morbidity, reaching maximum local explained variance (R2) of 0.76 in men and 0.91 in women. The spatial gradient in the strength of the observed relationships was sharper in models addressing men's prevalence, while women's models attained more consistent and higher explanatory performance. Conclusion Modeling the prevalence of chronic diseases using GWR enables to identify specific areas in which the sociodemographic environment is explicitly manifested as a driving factor of multi-morbidity. This is step forward in supporting decision making as it highlights multi-scale contexts of vulnerability, hence allowing specific action suitable to the setting to be taken.
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Affiliation(s)
- Carmen Bentué-Martínez
- Department of Geography and Territorial Planning, University of Zaragoza, Zaragoza, Spain,*Correspondence: Carmen Bentué-Martínez, ✉
| | - Marcos Rodrigues Mimbrero
- Department of Geography and Territorial Planning, University of Zaragoza, Zaragoza, Spain,Institute of Research Into Environmental Sciences of the University of Zaragoza, Zaragoza, Spain
| | - María Zúñiga-Antón
- Department of Geography and Territorial Planning, University of Zaragoza, Zaragoza, Spain,Institute of Research Into Environmental Sciences of the University of Zaragoza, Zaragoza, Spain,Health Research Institute of Aragon, Zaragoza, Spain
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13
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Somi M, Ostadrahimi A, Gilani N, Haji Kamanaj A, Hassannezhad S, Faramarzi E. Patterns and Predictors of Multimorbidity in the Azar Cohort. ARCHIVES OF IRANIAN MEDICINE 2023; 26:8-15. [PMID: 37543916 PMCID: PMC10685807 DOI: 10.34172/aim.2023.02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Accepted: 02/27/2022] [Indexed: 08/08/2023]
Abstract
BACKGROUND The co-existence of chronic diseases (CDs), a condition defined as multimorbidity (MM), is becoming a major public health issue. Therefore, we aimed to determine the patterns and predictors of MM in the Azar Cohort. METHODS We evaluated the prevalence of MM in 15,006 (35-70-year old) subjects of the Azar Cohort Study. MM was defined as the co-existence of two or more CDs. Data on the subjects' socioeconomic status, demographics, sleeping habits, and physical activity were collected using questionnaires. RESULTS The overall prevalence of MM was 28.1%. The most prevalent CDs, in decreasing order, were obesity, hypertension, depression, and diabetes. Obesity, depression, and diabetes were the most co-occurring CDs. The MM risk increased significantly with age, illiteracy, and in females. Also, the subjects within the lowest tertile of physical activity level (OR=1.89; 95% CI: 1.75-2.05) showed higher MM risk than those with the highest level of physical activity. Findings regarding current smoking status indicated that being an ex-smoker or smoker of other types of tobacco significantly increased the risk of MM. CONCLUSION The reduction of MM is possible by promoting public health from an early age among people of various socioeconomic conditions. It is vital to offer the necessary health support to the aging population of Iran.
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Affiliation(s)
- Mohammdhossein Somi
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Alireza Ostadrahimi
- Nutrition Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Neda Gilani
- Department of Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Arash Haji Kamanaj
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sina Hassannezhad
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Elnaz Faramarzi
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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14
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Health outcomes following retirement: a comparative study of health and non-health pensioners in Ghana. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-021-01557-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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15
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Wynter-Adams DM, Thomas-Brown PG, Williams M, Bromfield L, Bunting-Clarke J. Assessment of rational use of medicines for chronic non-communicable diseases: A cross-sectional design in a public access clinic in Jamaica. J Public Health Res 2022; 11:22799036221126348. [PMID: 36204195 PMCID: PMC9530563 DOI: 10.1177/22799036221126348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 08/26/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Rational use of medicines (RUM) offers a cost-saving strategy to maximize
therapeutic outcomes. The aims of this study were to assess RUM for chronic
non-communicable diseases (NCDs) using the World Health Organization’s (WHO)
prescribing indicators in a public access facility and to evaluate the
alignment of the use of drugs with therapeutic
recommendations/guidelines. Design and methods: In this retrospective cross-sectional study, prescriptions of adult patients
containing at least one drug for chronic NCDs, filled between January and
July 2019 were reviewed using the WHO prescribing indicators for RUM. Data
were analyzed and expressed as descriptive statistics. Associations were
determined using chi-square tests, correlations using Pearson’s correlation
and medians compared using Mann-Whitney U test. For all
analyses, significance was determined at p < 0.05. Results: Of the 571 prescriptions reviewed, most were for female, elderly patients
with mean age of 69 years, predominantly with hypertension and/or diabetes.
Polypharmacy was noted for 53.6% of prescriptions, primarily in elderly
patients (p < 0.001), with the median number of five
drugs prescribed and three dispensed. Of the drugs prescribed, 76.6% used
generic prescribing, 63.3% were dispensed as written and 3.9% were
antibiotics prescribed mainly for asthmatic patients (χ2 = 74.9,
p < 0.001). Drugs prescribed for NCDs were aligned
to therapeutic guidelines, but a significantly higher proportion of diabetes
medications, (metformin and gliclazide), and cardiovascular medications
(enalapril and losartan), were not dispensed as written
(χ2 = 40.0, p = 0.007). Conclusion: This research indicates that there is positive alignment with recommended
therapeutic guidelines, however, based on WHO prescribing factors,
strategies to improve RUM in this setting are highly recommended.
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Affiliation(s)
- Donna-Marie Wynter-Adams
- Caribbean School of Sport Sciences, University of Technology, Jamaica, Kingston, Jamaica
- School of Pharmacy, University of Technology, Jamaica, Kingston, Jamaica
| | | | - Marcia Williams
- School of Pharmacy, University of Technology, Jamaica, Kingston, Jamaica
| | - Lisa Bromfield
- School of Pharmacy, University of Technology, Jamaica, Kingston, Jamaica
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vismoradi ‑Aineh H, Alipour A, Ramezankhani A, Shakeri J, Yarmohammadi S, Marashi T. Investigating the relationship between satisfaction of basic psychological needs, general health, and some background variables in the Iranian older adults: a cross-sectional study. BMC Psychiatry 2022; 22:372. [PMID: 35650584 PMCID: PMC9158081 DOI: 10.1186/s12888-022-03979-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 05/06/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Promoting the health and mental health (MH) of the older adults making up a large part of the world's population in the coming years can provide the necessary conditions for their health and well-being of them. This study aimed to investigate the relationship between the satisfaction of basic psychological needs (BPNs), general health (GH), and some variables in Iranian older adults. METHODS The present descriptive-correlational study was conducted on 780 older adults from Sarpol-e Zahab (Kermanshah) in 2019 including the study by multi-stage cluster random sampling. The data collection tool was BPNs satisfaction and GH questionnaire and a researcher-made questionnaire of individual and background information. Was used for data analysis using the SPSS version 16 program and descriptive statistics and tests Pearson correlation coefficient, chi-square test, independent-sample T-test, and multivariate linear regression. RESULTS In the present study, participating a total of 780 older adult men aged 73.0 ± 29.32 years. There was a significant relationship between the satisfaction of BPNs and GH (p < 0.001). Also, 41% of the older adults were in poor GH and 30% were high in BPNs. Multiple logistic regression showed that the BPNs, age, income satisfaction, weather, and war zone were strong predictors of GH. the adjusted R2 value of 0.55 shows that the model described 55% of changes in the GH score. CONCLUSION According to the findings of the study on the relationship between the satisfaction of BPNs and GH, providing insurance, social and economic support by developing health policies, creating supportive health environments, strengthening community action, and developing individual skills in the older adults can help improve their MH and that of the community.
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Affiliation(s)
- Hassan vismoradi ‑Aineh
- grid.411600.2School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Abbas Alipour
- grid.411623.30000 0001 2227 0923Community Medicine Department, Medical Faculty, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ali Ramezankhani
- grid.411600.2Department of Public Health, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Jalal Shakeri
- grid.412112.50000 0001 2012 5829Department of Psychiatry, Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Soudabeh Yarmohammadi
- grid.411600.2Department of Public Health, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Tayebeh Marashi
- School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Odland ML, Ismail S, Sepanlou SG, Poustchi H, Sadjadi A, Pourshams A, Marshall T, Witham MD, Malekzadeh R, Davies JI. Multimorbidity and associations with clinical outcomes in a middle-aged population in Iran: a longitudinal cohort study. BMJ Glob Health 2022; 7:bmjgh-2021-007278. [PMID: 35550337 PMCID: PMC9109019 DOI: 10.1136/bmjgh-2021-007278] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 04/19/2022] [Indexed: 12/05/2022] Open
Abstract
Background As the populations of lower-income and middle-income countries age, multimorbidity is increasing, but there is little information on its long-term consequences. We aimed to show associations between multimorbidity and outcomes of mortality and hospitalisation in Iran, a middle-income country undergoing rapid economic transition. Methods We conducted a secondary analysis of longitudinal data collected in the Golestan Cohort Study. Data on demographics, morbidities and lifestyle factors were collected at baseline, and information on hospitalisations or deaths was captured annually. Logistic regression was used to analyse the association between baseline multimorbidity and 10-year mortality, Cox-proportional hazard models to measure lifetime risk of mortality and zero-inflation models to investigate the association between hospitalisation and multimorbidity. Multimorbidity was classified as ≥2 conditions or number of conditions. Demographic, lifestyle and socioeconomic variables were included as covariables. Results The study recruited 50 045 participants aged 40–75 years between 2004 and 2008, 47 883 were available for analysis, 416 (57.3%) were female and 12 736 (27.94%) were multimorbid. The odds of dying at 10 years for multimorbidity defined as ≥2 conditions was 1.99 (95% CI 1.86 to 2.12, p<0.001), and it increased with increasing number of conditions (OR of 3.57; 95% CI 3.12 to 4.08, p<0.001 for ≥4 conditions). The survival analysis showed the hazard of death for those with ≥4 conditions was 3.06 (95% CI 2.74 to 3.43, p<0.001). The number of hospital admissions increased with number of conditions (OR of not being hospitalised of 0.36; 95% CI 0.31 to 0.52, p<0.001, for ≥4 conditions). Conclusion The long-terms effects of multimorbidity on mortality and hospitalisation are similar in this population to those seen in high-income countries.
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Affiliation(s)
- Maria Lisa Odland
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK .,Department of Obstetrics and Gynecology, St. Olavs University Hospital, Trondheim, Norway.,Malawi-Liverpool-Wellcome Trust Research Institute, Blantyre, Malawi
| | - Samiha Ismail
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Sadaf G Sepanlou
- Digestive Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Poustchi
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Sadjadi
- Digestive Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Akram Pourshams
- Digestive Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Tom Marshall
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Miles D Witham
- AGE Research Group, NIHR Newcastle Biomedical Research Centre, Newcastle University, Newcastle upon Tyne, UK.,Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Reza Malekzadeh
- Digestive Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Justine I Davies
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK.,Medical Research Council/Wits University Rural Public Health and Health Transitions Research Unit, School of Public Health, University of the Witwatersrand, Johannesburg-Braamfontein, South Africa
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Chauhan S, Kumar S, Bharti R, Patel R. Prevalence and determinants of activity of daily living and instrumental activity of daily living among elderly in India. BMC Geriatr 2022; 22:64. [PMID: 35045809 PMCID: PMC8772104 DOI: 10.1186/s12877-021-02659-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 11/23/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The increase in life expectancy has proliferated the number of elderly and subsequently increased the prevalence of disability among the elderly. This study assesses the prevalence of Activity of Daily Living (ADL) and Instrumental Activity of Daily Living (IADL) and analyzes determinants of ADL and IADL among elderly aged 60 and over living in India. METHODS The study utilized the Longitudinal Ageing Study in India (LASI, 2017-18) data, and information was sought from 31,464 elderly aged 60 years and above. An index of ADL and IADL was created on a scale of three levels, exhibiting no, moderate, or severe levels of ADL/IADL disability. Multinomial logistic regression was used to determine the effect of socio-demographic parameters on ADL and IADL disability among the elderly. RESULTS Around 3% of the elderly reported severe ADL disability, and 6% elderly reported severe IADL disability. Elderly who were not involved in any physical activity than their counterparts were more likely to report severe ADL (RRR = 2.68, C.I. = 1.66-4.32) and severe IADL (RRR = 2.70, C.I. = 1.98-3.67) than no ADL and no IADL, respectively. CONCLUSION Amidst the study finding, the study emphasizes the importance of setting-up of geriatric care centers in rural and urban areas. It would be feasible to provide geriatric care under the umbrella of already functioning government health facilities in different parts of the country. Community interventions earmarking the elderly with a focus on physical activity, specifically based in group physical exercise and implemented through existing networks, are rewarding for the elderly.
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Affiliation(s)
- Shekhar Chauhan
- Department of Family and Generations, International Institute for Population Sciences, Mumbai, India
| | - Shubham Kumar
- Department of Mathematical Demography & Statistics, International Institute for Population Sciences, Mumbai, India
| | - Rupam Bharti
- District Information and data Manager (DIDM)- Monitoring, Evaluation, & Learning, Social & Economic Empowerment, Jaipur, Rajasthan, 302015, India
| | - Ratna Patel
- Department of Public Health and Mortality Studies, International Institute for Population Sciences, Mumbai, India.
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Askari M, Askari Z, Zarei Z, Farjam M, Homayounfar R, Mahmoudi Kohani HA. Prevalence of general and abdominal obesity and its relationship with opium, total opiate drugs, and chronic smoking: Fasa cohort study. Diabetes Metab Syndr 2022; 16:102357. [PMID: 34920194 DOI: 10.1016/j.dsx.2021.102357] [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: 06/09/2021] [Revised: 11/27/2021] [Accepted: 11/29/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND AND AIMS Obesity and drug use are two major global issues today. This study aimed to evaluate the relationship between alcohol and tobacco use with general and central obesity. METHODS The data of the longitudinal population-based study were collected from the basis of the Fasa Cohort Study (FACS). Participants were 10141 people with 35-70 years old. Data were analyzed by SPSS 20 software. Binary logistic regression (BLR) was used for modelling. A significance level (α) less than 0.05% was considered for hypothesis testing. RESULTS Of the total participants (N = 10104), 54.8% (n = 5539) were women. The prevalence of central obesity in terms of waist circumference (WC), waist to hip ratio (WHR), and waist to height ratio (WHtR) were calculated 48.20% (N = 4871), 79.50% (N = 8032), and 83.30% (N = 8314). The Odds Ratio (OR) adjusted of Abnormal body mass index (BMI) for Opium and chronic smoking were 0.54 (CI: 0.47-0.63) and 0.47 (CI:0.40-0.56). OR adjusted Abnormal WC for opium and chronic smoking were calculated 0.65 (CI: 0.53-0.80) and 0.57 (CI:0.46-0.72), respectively. Three variables of opium (OR = 0.54, CI: 0.46-0.64), total opiate drugs (OR = 1.46, CI:1.16-1.83) and chronic smoking (OR = 0.58, CI: 0.48-0.70) remained in the modeling for Abnormal WHR. Which were statistically significant. CONCLUSION Significant and inverse relationships were found between obesity and opium, total opiate drugs, and chronic smoking.
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Affiliation(s)
- Maryam Askari
- Genetic and Environmental Adventures Research Center, School of Abarkouh Paramedicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
| | - Zinab Askari
- Student Research Committee, Fasa University of Medical Sciences, Fasa, Iran.
| | - Zahra Zarei
- Student Research Committee, Fasa University of Medical Sciences, Fasa, Iran.
| | - Mojtaba Farjam
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran.
| | - Reza Homayounfar
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran; National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Liao J, Zhou M, Zhong C, Liang C, Hu N, Kuang L. Effect of Family Practice Contract Services on the Perceived Quality of Primary Care among Patients with Multimorbidity: A Cross-Sectional Study in Guangdong, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:157. [PMID: 35010417 PMCID: PMC8751177 DOI: 10.3390/ijerph19010157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 12/10/2021] [Accepted: 12/14/2021] [Indexed: 06/14/2023]
Abstract
Family practice contract services, an important primary-care reform policy for improving primary healthcare quality in China, incorporate patients with multiple chronic conditions into the priority coverage groups and focus on their management. This study aims to explore the family practice contract services' effectiveness in improving the quality of primary care experienced by this population. A cross-sectional study using a three-stage sampling was conducted from January to March 2019 in Guangdong, China. A multivariable linear regression, including interaction terms, was applied to examine the associations between the contract services and primary care quality among people with different chronic conditions. The process quality of primary care was measured in six dimensions using the validated assessment survey of primary care (ASPC) scale. People with contract services scored higher in terms of quality of primary care than those without contract services. Contract services moderated the association between chronic condition status and primary care quality. Significantly positive interactions were observed in the patient-centred care dimension and negative interactions were reflected in the accessibility dimension. Our findings suggest that family practice contract services play a crucial role in improving patient-perceived primary care quality and provide emerging evidence that patients with multimorbidity tend to benefit more from the services, especially in patient-centred care.
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Affiliation(s)
- Jingyi Liao
- Department of Health Administration, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (J.L.); (M.Z.)
| | - Mengping Zhou
- Department of Health Administration, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (J.L.); (M.Z.)
| | - Chenwen Zhong
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong 999077, China;
| | - Cuiying Liang
- Science Education Department, Dongguan People’s Hospital, Dongguan 523000, China;
| | - Nan Hu
- Department of Biostatistics, FIU Robert Stempel College of Public Health and Social Work, Miami, FL 33199, USA
- Department of Family and Preventive Medicine and Population Health Sciences, University of Utah School of Medicine, Salt Lake City, UT 84132, USA
| | - Li Kuang
- Department of Health Administration, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (J.L.); (M.Z.)
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Godongwana M, De Wet-Billings N, Milovanovic M. The comorbidity of HIV, hypertension and diabetes: a qualitative study exploring the challenges faced by healthcare providers and patients in selected urban and rural health facilities where the ICDM model is implemented in South Africa. BMC Health Serv Res 2021; 21:647. [PMID: 34217285 PMCID: PMC8254615 DOI: 10.1186/s12913-021-06670-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 06/10/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND PLWH are living longer as a result of advancement and adherence to antiretroviral therapy. As the life expectancy of PLWH increases, they are at increased risk of hypertension and diabetes. HIV chronic co-morbidities pose a serious public health concern as they are linked to increased use and need of health services, decreased overall quality of life and increased mortality. While research shows that integrated care approaches applied within primary care settings can significantly reduce hospital admissions and mortality levels among patients with comorbidities, the primary care system in South Africa continues to be challenged with issues about the delivery of quality care. METHODS This study applied a phenomenological qualitative research design. IDIs were conducted with 24 HCPs and adults living with the comorbidity of HIV and either hypertension or diabetes across two provinces in South Africa. The objective of the research was to understand the challenges faced by HCPs and patients in health facilities where the ICDM model is implemented. The health facilities were purposively sampled. However, the HCPs were recruited through snowballing and the patients through reviewing the facilities' clinic records for participants who met the study criteria. All participants provided informed consent. The data was collected between March and May 2020. The findings were analysed inductively using thematic content analysis. RESULTS The challenges experienced included lack of staff capacity, unclear guidelines on the delivery of integrated care for patients with HIV chronic comorbidities, pill burden, non-disclosure, financial burden, poor knowledge of treatments, relocation of patients and access to treatment. Lack of support and integrated chronic programmes including minimal information regarding the management of HIV chronic comorbidities were other concerns. CONCLUSION The outcomes of the ICDM model need to be strengthened and scaled up to meet the unique health needs and challenges of people living with HIV and other chronic conditions. Strengthening these outcomes includes providing capacity building and training on the delivery of chronic care treatment under the ICDM model, assisted self-management to improve patient responsibility of chronic disease management and strengthening activities for comorbidity health promotion.
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Affiliation(s)
- Motlatso Godongwana
- Programme in Demography and Population Studies, University of the Witwatersrand, Schools of Public Health and Social Sciences, Johannesburg, South Africa.
- Perinatal and HIV Research Unit, Chris Hani Baragwanath Hospital, Johannesburg, South Africa.
| | - Nicole De Wet-Billings
- Programme in Demography and Population Studies, University of the Witwatersrand, Schools of Public Health and Social Sciences, Johannesburg, South Africa
| | - Minja Milovanovic
- Perinatal and HIV Research Unit, Chris Hani Baragwanath Hospital, Johannesburg, South Africa
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22
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Halvorson BD, McGuire JJ, Singh KK, Butcher JT, Lombard JH, Chantler PD, Frisbee JC. Can Myogenic Tone Protect Endothelial Function? Integrating Myogenic Activation and Dilator Reactivity for Cerebral Resistance Arteries in Metabolic Disease. J Vasc Res 2021; 58:286-300. [PMID: 33971663 PMCID: PMC8478702 DOI: 10.1159/000516088] [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: 02/02/2021] [Accepted: 03/22/2021] [Indexed: 11/19/2022] Open
Abstract
The obese Zucker rat (OZR) manifests multiple risk factors for impaired cerebrovascular function, including hypertension and insulin resistance although how they combine to produce integrated vascular function is unclear. As studies have suggested that myogenic activation (MA) severity for middle cerebral arteries (MCAs) may be proportional to hypertension severity, we hypothesized that MA will negatively correlate with dilator reactivity in OZR. MA of MCA from OZR was divided into low, medium, and high based on the slope of MA, while MCA reactivity and vascular metabolite bioavailability were assessed in all groups. Endothelium-dependent dilation of MCA in OZR was attenuated and correlated with the MA slope. Treatment of OZR MCA with TEMPOL (antioxidant) improved dilation in low or medium MA groups, but had less impact on high MA. Alternatively, treatment with gadolinium to normalize MA in OZR had reduced impact on dilator reactivity in MCA from low and medium MA groups, but improved responses in the high group. Treatment with both agents resulted in dilator responses that were comparable across all groups. These results suggest that, under conditions with stronger MA, endothelial function may receive some protection despite the environment, potentially from the ability of MCA to reduce wall tension despite increased pressure.
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MESH Headings
- Animals
- Antioxidants/pharmacology
- Cerebrovascular Circulation/drug effects
- Disease Models, Animal
- Endothelium, Vascular/drug effects
- Endothelium, Vascular/metabolism
- Endothelium, Vascular/physiopathology
- Male
- Metabolic Syndrome/metabolism
- Metabolic Syndrome/physiopathology
- Middle Cerebral Artery/drug effects
- Middle Cerebral Artery/metabolism
- Middle Cerebral Artery/physiopathology
- Muscle, Smooth, Vascular/drug effects
- Muscle, Smooth, Vascular/metabolism
- Muscle, Smooth, Vascular/physiopathology
- Rats, Zucker
- Vascular Resistance/drug effects
- Vasodilation/drug effects
- Vasodilator Agents/pharmacology
- Rats
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Affiliation(s)
- Brayden D. Halvorson
- Departments of Medical Biophysics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario
| | - John J. McGuire
- Departments of Medical Biophysics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario
| | - Krishna K. Singh
- Departments of Medical Biophysics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario
| | - Joshua T. Butcher
- Department of Physiological Sciences, Oklahoma State University, Stillwater, Oklahoma
| | - Julian H. Lombard
- Department of Physiology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Paul D. Chantler
- Division of Exercise Physiology, West Virginia University Health Sciences Center, Morgantown, West Virginia
| | - Jefferson C. Frisbee
- Departments of Medical Biophysics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario
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23
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Anindya K, Ng N, Atun R, Marthias T, Zhao Y, McPake B, van Heusden A, Pan T, Lee JT. Effect of multimorbidity on utilisation and out-of-pocket expenditure in Indonesia: quantile regression analysis. BMC Health Serv Res 2021; 21:427. [PMID: 33952273 PMCID: PMC8097787 DOI: 10.1186/s12913-021-06446-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 04/08/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Multimorbidity (the presence of two or more non-communicable diseases) is a major growing challenge for many low-income and middle-income countries (LMICs). Yet, its effects on health care costs and financial burden for patients have not been adequately studied. This study investigates the effect of multimorbidity across the different percentiles of healthcare utilisation and out-of-pocket expenditure (OOPE). METHODS We conducted a secondary data analysis of the 2014/2015 Indonesian Family Life Survey (IFLS-5), which included 13,798 respondents aged ≥40 years. Poisson regression was used to assess the association between sociodemographic characteristics and the total number of non-communicable diseases (NCDs), while multivariate logistic regression and quantile regression analysis was used to estimate the associations between multimorbidity, health service use and OOPE. RESULTS Overall, 20.8% of total participants had two or more NCDs in 2014/2015. The number of NCDs was associated with higher healthcare utilisation (coefficient 0.11, 95% CI 0.07-0.14 for outpatient care and coefficient 0.09 (95% CI 0.02-0.16 for inpatient care) and higher four-weekly OOPE (coefficient 27.0, 95% CI 11.4-42.7). The quantile regression results indicated that the marginal effect of having three or more NCDs on the absolute amount of four-weekly OOPE was smaller for the lower percentiles (at the 25th percentile, coefficient 1.0, 95% CI 0.5-1.5) but more pronounced for the higher percentile of out-of-pocket spending distribution (at the 90th percentile, coefficient 31.0, 95% CI 15.9-46.2). CONCLUSION Multimorbidity is positively correlated with health service utilisation and OOPE and has a significant effect, especially among those in the upper tail of the utilisation/costs distribution. Health financing strategies are urgently required to meet the needs of patients with multimorbidity, particularly for vulnerable groups that have a higher level of health care utilisation.
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Affiliation(s)
- Kanya Anindya
- The Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia.
| | - Nawi Ng
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, The University of Gothenburg, Gothenburg, Sweden
| | - Rifat Atun
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Tiara Marthias
- The Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia.,Department of Public Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Yang Zhao
- The George Institute for Global Health at Peking University Health Science Center, Beijing, China.,WHO Collaborating Centre on Implementation Research for Prevention and Control of Noncommunicable Diseases, Melbourne, VIC, Australia
| | - Barbara McPake
- The Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Alexander van Heusden
- The Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Tianxin Pan
- Centre for Health Policy, School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - John Tayu Lee
- The Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia.,Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK
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Mousa M, Al-Jefout M, Alsafar H, Kirtley S, Lindgren CM, Missmer SA, Becker CM, Zondervan KT, Rahmioglu N. Prevalence of Common Gynecological Conditions in the Middle East: Systematic Review and Meta-Analysis. FRONTIERS IN REPRODUCTIVE HEALTH 2021; 3:661360. [PMID: 36304010 PMCID: PMC9580651 DOI: 10.3389/frph.2021.661360] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 02/22/2021] [Indexed: 02/04/2023] Open
Abstract
Introduction: High prevalence of gynecological conditions in women of Middle Eastern origin is reported, likely due to regional risk factors and mediators. The objective of this systematic review and meta-analysis is to investigate the prevalence of polycystic ovary syndrome (PCOS), endometriosis, uterine fibroids, and adenomyosis in women of Middle Eastern origin. Methods: MEDLINE, EMBASE, PsycINFO, Global Health, and Google Scholar databases were searched from database inception until 14 February 2021 to identify relevant studies. Peer-reviewed research articles that reported the prevalence of PCOS, endometriosis, uterine fibroids, and adenomyosis in the Middle Eastern population were written in English or Arabic. The primary outcome was the estimated pooled prevalence of PCOS, endometriosis, uterine fibroids, and adenomyosis in the Middle Eastern populations. The secondary outcome was to assess the evidence in the data for the presence of heterogeneity, by conducting subtype-pooled analysis of prevalence estimates of the conditions. Total weighted prevalence was calculated via Freeman-Tukey arcsine transformation and heterogeneity through the I 2 statistic. Quality control was performed using GRADE criteria. Results: A total of 47 studies, 26 on PCOS, 12 on endometriosis, eight on uterine fibroids, and seven on adenomyosis, were included. The pooled prevalence of PCOS diagnosed according to the NIH criteria was 8.9% (95% CI: 6.5-11.7; prevalence range: 4.0-27.6%), with a higher prevalence from the Gulf Arab states (18.8%, 95% CI: 9.5-30.3; range: 12.1-27.6%). According to the Rotterdam criteria, the pooled prevalence of PCOS was 11.9% (95% CI: 7.1-17.7; range: 3.4-19.9%) with studies limited to the Persian and Levant regions. Endometriosis was diagnosed in 12.9% (95% CI: 4.2-25.4; range: 4.2-21.0%) of women undergoing laparoscopy, for any indication. Uterine fibroid and adenomyosis prevalence of women was 30.6% (95% CI: 24.9-36.7; range: 18.5-42.6%) and 30.8% (95% CI: 27.1-34.6, range: 25.6-37.7%), respectively. Heterogeneity was present between studies due to statistical and methodological inconsistencies between studies, and quality of evidence was low due to sample size and unrepresentative participant selection. Conclusion: This is the first review that has reported the prevalence of gynecological diseases in the Middle Eastern population, suggesting that gynecological morbidity is a public health concern. Due to the health disparities in women, further research is required to understand the relative roles of environmental and genetic factors in the region to serve as a benchmark for evaluation and comparative purposes with other populations.
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Affiliation(s)
- Mira Mousa
- Nuffield Department of Women's and Reproductive Health, Endometriosis CaRe Centre, University of Oxford, Oxford, United Kingdom
| | - Moamar Al-Jefout
- Department of Obstetrics and Gynaecology, College of Medical and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
- Department of Obstetrics and Gynaecology No. 1. Moscow, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Habiba Alsafar
- Center for Biotechnology, Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates
- Department of Genetics and Molecular Biology, College of Medicine and Health Sciences, Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates
| | - Shona Kirtley
- Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, Centre for Statistics in Medicine, University of Oxford, Oxford, United Kingdom
| | - Cecilia M. Lindgren
- Li Ka Shing Centre for Health Information and Discovery, The Big Data Institute, University of Oxford, Oxford, United Kingdom
- Nuffield Department of Medicine (C.M.L.), Wellcome Centre for Human Genetics, University of Oxford, Oxford, United Kingdom
| | - Stacey A. Missmer
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States
- Department of Obstetrics, Gynaecology, and Reproductive Biology, College of Human Medicine, Michigan State University, Grand Rapids, MI, United States
| | - Christian M. Becker
- Nuffield Department of Women's and Reproductive Health, Endometriosis CaRe Centre, University of Oxford, Oxford, United Kingdom
| | - Krina T. Zondervan
- Nuffield Department of Women's and Reproductive Health, Endometriosis CaRe Centre, University of Oxford, Oxford, United Kingdom
- Wellcome Centre for Human Genetics, University of Oxford, Oxford, United Kingdom
| | - Nilufer Rahmioglu
- Nuffield Department of Women's and Reproductive Health, Endometriosis CaRe Centre, University of Oxford, Oxford, United Kingdom
- Wellcome Centre for Human Genetics, University of Oxford, Oxford, United Kingdom
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25
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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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26
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Tosoni A, Gatto L, Franceschi E, Di Nunno V, Lodi R, Mura A, Di Battista M, Bartolini S, Brandes AA. Association between socioeconomic status and survival in glioblastoma: An Italian single-centre prospective observational study. Eur J Cancer 2021; 145:171-178. [PMID: 33486440 DOI: 10.1016/j.ejca.2020.12.027] [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] [Received: 10/24/2020] [Revised: 12/10/2020] [Accepted: 12/20/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND To date, no prospective study has been conducted to investigate the role of socioeconomic status (SES) on clinical outcome of glioblastoma (GBM) in Italy, where there is a National Health Service that provides universal coverage regardless of the patient's economic status. METHODS We performed a prospective observational study investigating the association between SES and survival in GBM patients at our institution, a hub centre for brain cancer research and treatment. We included GBM patients who underwent medical treatment or chemo-radiation between April 2017 and December 2017. The SES was measured using the income-brackets, attributed by the Italian Ministry of Finance on the basis of the income of the fiscal family unit, referring to the previous year. RESULTS One hundred and six patients were included in the study. In multivariate analysis, overall survival (OS) correlated significantly with higher-income (HR = 0.623.95% CI 0.467-0.832; p = 0.001) and MGMT methylation status (HR = 0.158.95% CI 0.082-0.304; P < 0.001). When adjusted for age, performance status and extension of surgery, survival benefit remained superior for higher-income HR = 0.641 (95% CI 0.478-0.858; p = 0.003) and MGMT methylated tumours HR = 0.167 (95% CI 0.084-0.331; p < 0.001). CONCLUSIONS SES is an important determinant of prognosis in GBM even in the Italian National Health Service, which provides universal, largely free and relatively comprehensive healthcare. Despite aspirations to achieve equality in healthcare, socioeconomic differences exist and may impact the clinical outcome.
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Affiliation(s)
- Alicia Tosoni
- Department of Medical Oncology, Azienda USL of Bologna, Bologna, Italy
| | - Lidia Gatto
- Department of Medical Oncology, Azienda USL of Bologna, Bologna, Italy
| | - Enrico Franceschi
- Department of Medical Oncology, Azienda USL of Bologna, Bologna, Italy.
| | - Vincenzo Di Nunno
- Department of Medical Oncology, Azienda USL of Bologna, Bologna, Italy
| | - Raffaele Lodi
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Antonella Mura
- Department of Medical Oncology, Azienda USL of Bologna, Bologna, Italy
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Hasanzad M, Sarhangi N, Nikfar S, Ostad SN, Aghaei Meybodi HR. A narrative review of current trends in liraglutide: insights into the unmet needs in management of type 2 diabetes and obesity. J Diabetes Metab Disord 2020; 19:1863-1872. [PMID: 33520865 PMCID: PMC7843728 DOI: 10.1007/s40200-020-00619-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 08/20/2020] [Indexed: 02/06/2023]
Abstract
Liraglutide is a long-acting human glucagon-like peptide-1 (GLP-1) analogue and an effective treatment for patients with metabolic diseases including type 2 diabetes mellitus (T2DM) and obesity. This review focuses on the mechanism of action of liraglutide as a well-known glucagon-like peptide-1 receptor agonist (GLP-1 RA) in patients with T2DM and obesity. The lower and the higher doses of GLP-1 RAs are used for glycaemic control in T2DM and in obesity respectively. GLP-1 RAs such as liraglutide enhance insulin secretion and inhibit glucagon release via the stimulation of glucagon-like peptide-1 receptors (GLP-1Rs). Liraglutide decreases hemoglobin A1c (HbA1c) in type 2 diabetes (T2D) patients when prescribes as monotherapy or in combination with one or more antidiabetic drugs. Usually, it is well tolerated with minor hypoglycemia in combination therapy. Liraglutide reduces cardiovascular events and related risk factors including improvement of lipid profile and control of blood pressure. Accordingly, it can be cost-effective and may be a budget neutral medication option by considering its protective effect on the cardiovascular system in long-term use in the health care plan. In the near future, by pharmacogenomics approach, prediction of the highest patient's response with the lowest adverse drug reactions and also rationality of drug development will be possible. Liraglutide can be used as a desirable medicine for glycemic control and obesity. It shows extensive evidence based benefits in diabetes complications. In this narrative review, we have summarized and evaluated studies related to the role of liraglutide in clinical practice.
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Affiliation(s)
- Mandana Hasanzad
- Medical Genomics Research Center, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
- Personalized Medicine Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Negar Sarhangi
- Personalized Medicine Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shekoufeh Nikfar
- Personalized Medicine Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Pharmacoeconomics and Pharmaceutical Administration, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Naser Ostad
- Personalized Medicine Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Toxicology and Pharmacology, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamid Reza Aghaei Meybodi
- Personalized Medicine Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Abstract
BACKGROUND To address the neglect of depression in multimorbidity measurement and the lack of focus on rural population in previous literature about China, this paper aimed to estimate the prevalence of multimorbidity (including depressive disorders) among the country's rural and urban population. METHODS We used a cross-sectional design and data from a nationally representative survey conducted in 2015-2016 among Chinese people aged 45 years or older involving 19 656 participants. Multimorbidity was measured with a cut-off point of having two or more among 14 chronic illnesses. In that 13 of them were based on self-reported physician diagnosis. In addition, depressive disorders were assessed with the 10-item Centre for Epidemiologic Studies Depression Scale. The weighted prevalence of multimorbidity was calculated, with a non-response adjustment. Multivariate logistic regression was applied to analyse the relation between covariates and multimorbidity. FINDINGS Multimorbidity was highly prevalent (54.3%) among the studied population. Contrary to previous studies, we found the prevalence of multimorbidity to be higher among the rural dwellers (58.3%) than among the urban population (50.4%). After adjustment for covariates, rural residents had 7.5% higher odds (95% CI of OR (1.003 to 1.151)) of having multimorbidity than their urban counterparts. Above 70% of patients with any of the 14 chronic illnesses above 45 years old had multimorbidity, while 80.6%-97.9% of chronic patients had multimorbidity. INTERPRETATION Future health system development in China should transform from preventing and controlling non-communicable diseases as individual diseases to addressing people's comprehensive health needs under multimorbidity. The rural population should be prioritised as they suffered more from multimorbidity than the urban population.
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Affiliation(s)
- Xiaochen Ma
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Yu He
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Jin Xu
- China Center for Health Development Studies, Peking University, Beijing, China
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Al-Jawaldeh A, Almamary S, Mahmoud L, Nasreddine L. Leveraging the Food System in the Eastern Mediterranean Region for Better Health and Nutrition: A Case Study from Oman. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E7250. [PMID: 33020386 PMCID: PMC7579389 DOI: 10.3390/ijerph17197250] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 09/19/2020] [Accepted: 09/30/2020] [Indexed: 11/17/2022]
Abstract
The adoption of a food system approach is vital for the Eastern Mediterranean Region (EMR) in achieving the 2030 Agenda. The objective of this paper is to present a case-study from Oman, where a roadmap of context-specific entry points within the food system was proposed, with the overarching aim of fostering healthier diets in the population. A four-staged process was adopted: (1) selection of potential target food groups; (2) assessment of self-sufficiency and sustainability considerations related to the target foods; (3) characterization of challenges, opportunities and potential interventions related to the target food groups and (4) identification of specific entry points within the three elements of the food system (food supply chain; food environment; and consumer behavior). Data collection was based on a review of pertinent literature as well as a participatory approach involving policy makers and stakeholders. Findings showed that fruit, vegetables, fish and foods that are high in fat, sugar and salt are priority targets for intervention. Specific entry points within the food system were identified and a realistic roadmap of activities was outlined. Findings and recommendations presented in this paper may facilitate policy convergence efforts in Oman and serve as a case-study for other EMR countries.
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Affiliation(s)
- Ayoub Al-Jawaldeh
- World Health Organization (WHO), Regional Office for the Eastern Mediterranean (EMRO), 7608 Cairo, Egypt;
| | | | | | - Lara Nasreddine
- Nutrition and Food Sciences Department, Faculty of Agriculture and Food Sciences, American University of Beirut, 11-0236 Beirut, Lebanon
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Non-Communicable Diseases-Related Stigma: A Mixed-Methods Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186657. [PMID: 32932667 PMCID: PMC7559120 DOI: 10.3390/ijerph17186657] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 09/08/2020] [Accepted: 09/10/2020] [Indexed: 12/23/2022]
Abstract
This systematic review examines and consolidates existing evidence on stigma associated with the top four non-communicable diseases (NCDs)—cancers, cardiovascular diseases, chronic respiratory diseases, and diabetes—and its impact on the lives of people affected. We conducted a systematic literature search in PubMed, PsycINFO, JSTOR, Science Direct, and Web of Science for original research in English that explored health-related stigma among people living with either of the four NCDs. A three-step integrative synthesis of data was conducted. Twenty-six articles (qualitative = 15; quantitative = 11) were selected, with most (n = 15) related to cancers, followed by diabetes (n = 7), chronic respiratory diseases (n = 3), and cardiovascular diseases (n = 1). Blame, shame, and fear were the main causes of stigma, the origin and nature of which differed according to the disease-specific features. The manifestations (enacted and felt stigma) and consequences (social, behavioral, psychological, and medical) of stigma across NCDs were similar. Inconsistencies existed in the conceptualization of stigma processes. To fill this gap, we developed an NCD-related stigma framework. People living with NCDs can experience stigma, which can negatively impact their health, management of their disease, and quality of life. The new framework can help in improving the understanding of the processes and experiences of stigma related to NCDs.
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31
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Comorbidity Risk Score in Association with Cancer Incidence: Results from a Cancer Screenee Cohort. Cancers (Basel) 2020; 12:cancers12071834. [PMID: 32650429 PMCID: PMC7408682 DOI: 10.3390/cancers12071834] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 07/07/2020] [Indexed: 01/20/2023] Open
Abstract
The combined effects of comorbidities can cause cancer incidence, while the effects of individual conditions, alone, might not. This study was conducted to investigate the joint impact of comorbidities on cancer incidence. The dietary score for energy-adjusted intake was calculated by applying a Gaussian graphical model and was then categorized into tertiles representing light, normal, and heavy eating behaviors. The risk point for cancer, according to the statuses of blood pressure, total cholesterol, fasting glucose, and glomerular filtration rate was computed from a Cox proportional hazard model adjusted for demographics and eating behavior. The comorbidity risk score was defined as the sum of the risk points for four comorbidity markers. We finally quantified the hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between the strata of the comorbidity risk score and cancer incidence. A total of 13,644 subjects were recruited from the Cancer Screenee Cohort from 2007–2014. The comorbidity risk score was associated with cancer incidence in a dose-dependent manner (HR = 2.15, 95% CI = 1.39, 3.31 for those scoring 16–30 vs. those scoring 0–8, P-trend < 0.001). Subgroup analysis still showed significant dose-dependent relationships (HR = 2.39, 95% CI = 1.18, 4.84 for males and HR = 1.99, 95% CI = 1.11, 3.59 for females, P-trend < 0.05). In summary, there was a dose-dependent impact of comorbidities on cancer incidence; Highlights: Previous studies have generally reported that hypertension, hypercholesterolemia, diabetes, and chronic kidney disease might predispose patients to cancer. Combining these chronic diseases into a single score, this study found a dose-dependent association between the data-driven comorbidity risk score and cancer incidence.
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32
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Relation between obesity prevalence and the human development index and its components: an updated study on the Asian population. J Public Health (Oxf) 2020. [DOI: 10.1007/s10389-020-01230-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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33
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Prevalence of Multimorbidity among Asian Indian, Chinese, and Non-Hispanic White Adults in the United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17093336. [PMID: 32403412 PMCID: PMC7246600 DOI: 10.3390/ijerph17093336] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 05/04/2020] [Accepted: 05/08/2020] [Indexed: 11/23/2022]
Abstract
Asian Americans are the fastest-growing minority group in the United States, yet little is known about their multimorbidity. This study examined the association of Asian Indians, Chinese and non-Hispanic whites (NHWs) to multimorbidity, defined as the concurrent presence of two or more chronic conditions in the same individual. We used a cross-sectional design with data from the National Health Interview Survey (2012–2017) of Asian Indians, Chinese, and NHWs (N = 132,666). Logistic regressions were used to examine the adjusted association of race/ethnicity to multimorbidity. There were 1.9% Asian Indians, 1.8% Chinese, and 96.3% NHWs. In unadjusted analyses (p < 0.001), 17.1% Asian Indians, 17.9% Chinese, and 39.0% NHWs had multimorbidity. Among the dyads, high cholesterol and hypertension were the most common combination of chronic conditions among Asian Indians (32.4%), Chinese (41.0%), and NHWs (20.6%). Asian Indians (AOR = 0.73, 95% CI = (0.61, 0.89)) and Chinese (AOR = 0.63, 95% CI = (0.53, 0.75)) were less likely to have multimorbidity compared to NHWs, after controlling for age, sex, and other risk factors. However, Asian Indians and Chinese were more likely to have high cholesterol and hypertension, risk factors for diabetes and heart disease.
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Khorrami Z, Rezapour M, Etemad K, Yarahmadi S, Khodakarim S, Mahdavi Hezaveh A, Kameli M, Khanjani N. The patterns of Non-communicable disease Multimorbidity in Iran: A Multilevel Analysis. Sci Rep 2020; 10:3034. [PMID: 32080215 PMCID: PMC7033095 DOI: 10.1038/s41598-020-59668-y] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 01/28/2020] [Indexed: 11/08/2022] Open
Abstract
The prevalence of non-communicable diseases is increasing worldwide. Multimorbidity and long-term medical conditions is common among these patients. This study aimed to investigate the patterns of non-communicable disease multimorbidity and their risk factors at the individual and aggregated level. Data was inquired from the nationwide survey performed in 2011, according to the WHO stepwise approach on NCD risk factors. A latent class analysis on multimorbidity components (11 chronic diseases) was performed and the association of some individual and aggregated risk factors (urbanization) with the latent subclasses was accessed using multilevel multinomial logistic regression. Latent class analysis revealed four distinct subclasses of multimorbidity among the Iranian population (10069 participants). Musculoskeletal diseases and asthma classes were seen in both genders. In males, the odds of membership in the diabetes class was 41% less by increasing physical activity; but with increased BMI, the odds of membership in the diabetes class was 1.90 times higher. Tobacco smoking increased the odds of membership in the musculoskeletal diseases class, 1.37 and 2.30 times for males and females, respectively. Increased BMI and low education increased the chances of females' membership in all subclasses of multimorbidity. At the province level, with increase in urbanization, the odds of membership in the diabetes class was 1.28 times higher among males (P = 0.027). Increased age, higher BMI, tobacco smoking and low education are the most important risk factors associated with NCD multimorbidity among Iranians. Interventions and policies should be implemented to control these risk factors.
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Affiliation(s)
- Zahra Khorrami
- Neurology Research Center, Kerman University of Medical Sciences, Kerman, Iran
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maysam Rezapour
- School of Nursing and Midwifery Amol, Mazandaran University of Medical Sciences, Sari, Iran
| | - Koorosh Etemad
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shahin Yarahmadi
- Endocrine and Metabolic Diseases Office, Center for Noncommunicable Disease Control, Ministry of Health and Medical Education, Tehran, Iran
| | - Soheila Khodakarim
- School of Allied Medical Sciences, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Alireza Mahdavi Hezaveh
- Center for Noncommunicable Disease Control, Ministry of Health and Medical Education, Tehran, Iran
| | - Mohammadesmail Kameli
- Department of Community Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Narges Khanjani
- Neurology Research Center, Kerman University of Medical Sciences, Kerman, Iran.
- Environmental Health Engineering Research Center, Kerman University of Medical Sciences, Kerman, Iran.
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The Determinants of Household Food Waste Generation and its Associated Caloric and Nutrient Losses: The Case of Lebanon. PLoS One 2019; 14:e0225789. [PMID: 31794574 PMCID: PMC6890253 DOI: 10.1371/journal.pone.0225789] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 11/12/2019] [Indexed: 11/19/2022] Open
Abstract
Food waste has a great impact on food and nutrition security, the environment, and global, regional as well as national economies. However, little is known about the associated nutrient loss embedded in wasted foods, especially in developing countries, with Lebanon being a case in point. The present paper uses data gathered from a survey of 250 households conducted in Beirut, Lebanon, in which respondents filled 7-day food waste diaries in order to investigate the drivers of food waste generation at the household level and its dietary content. The results show that food waste is approximately 0.2 kg per capita per day in urban Lebanon. This wasted food contains on average 451.2 kcal, 37.5 g carbohydrates, 14.9 g protein, 2.9 g dietary fiber, 2.4 μg vitamin D, 165.2 mg calcium and 343.2 mg potassium. Furthermore, a Tobit analysis of the socio-demographic and behavioral drivers of food waste generation was conducted. This analysis shows that being the sole homeowner, spending more on food, having a larger number of household members, being ready to eat everything prepared, and tending not to buy special offers, significantly increases household food waste generation, at least in terms of physical weight. This is the first study conducted in Lebanon and the Middle East aiming at investigating food waste, and the associated nutrient loss as well as the drivers of food waste generation at the household level. This work could help provide evidence for policymakers to address both food and nutrition security issues in Lebanon.
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36
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Christofoletti M, Duca GFD, Umpierre D, Malta DC. Chronic noncommunicable diseases multimorbidity and its association with physical activity and television time in a representative Brazilian population. CAD SAUDE PUBLICA 2019; 35:e00016319. [PMID: 31691775 DOI: 10.1590/0102-311x00016319] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Accepted: 05/20/2019] [Indexed: 11/21/2022] Open
Abstract
Lifestyle behaviors need to be more explored within the context of chronic noncommunicable disease (NCD) multimorbidity. This study aimed to investigate the association of multimorbidity with physical activity and sedentary behavior in a representative Brazilian population (n = 52,929). A cross-sectional survey (VIGITEL in the Portuguese acronym) was conducted in 2013 in the 27 Brazilian federal units. Multimorbidity is defined as the presence of two or more NCDs, that is, the outcome variable; and physical activity (commuting, domestic chores, leisure, and work domains) and sedentary behavior (television time < 2 hours/day and ≥ 2 hours/day) were the exposure variables. Poisson and multinomial logistic regressions (odds ratio - OR) stratified by age and their respective 95% confidence intervals were used, adopting a significance level of 5%. Among 37,947 adults, the presence of three chronic diseases was less frequent in subjects active in the work domain (OR = 0.60) and more frequent among those with longer daily television time (OR = 1.25). The presence of four diseases was less frequent in subjects active in the commuting (OR = 0.52) and work (OR = 0.42) domains. Among 14,982 older adults, the presence of two, three, and four chronic diseases was consistently more frequent in those with longer daily television time (OR = 1.33; 1.55 and 1.93, respectively). Finally, interactions between total physical activity level and daily television time were statistically significant in the multimorbidity in both age groups. Physical activity and sedentary behavior are associated with multimorbidity and should be considered independent factors for health promotion and for the treatment of patients with multimorbidity.
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Affiliation(s)
| | | | - Daniel Umpierre
- Universidade Federal de Pelotas, Pelotas, Brasil.,Hospital das Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brasil
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Nasreddine L, Ayoub JJ, Hachem F, Tabbara J, Sibai AM, Hwalla N, Naja F. Differences in Dietary Intakes among Lebanese Adults over a Decade: Results from Two National Surveys 1997-2008/2009. Nutrients 2019; 11:nu11081738. [PMID: 31357600 PMCID: PMC6723904 DOI: 10.3390/nu11081738] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 05/20/2019] [Accepted: 06/04/2019] [Indexed: 11/16/2022] Open
Abstract
Amidst the ongoing societal and economic shifts in the Eastern Mediterranean region (EMR), this study aims at investigating temporal trends in food consumption and nutrient intakes among Lebanese adults, by age and sex. Data were derived from two national cross-sectional surveys conducted in Lebanon during two time periods (1997; 2008/2009). In both surveys, dietary assessment was based on 24-h recalls. The results, expressed as % energy intake (%EI), revealed a significant decrease (p < 0.001) in the consumption of bread, fruits, fresh fruit juices, milk and eggs, whereas the consumption of added fats and oils, poultry, cereals and cereal-based products, chips and salty crackers, sweetened milk and hot beverages increased over time (p < 0.001). A significant increase in dietary energy (kcal/day) and fat intake (%EI) was observed, coupled with decreases in carbohydrate intake (%EI) and dietary density of vitamin A and vitamin C (per 1000 kcal) (p < 0.001). These changes were noted in both genders and across age groups, albeit there were some disparities between groups. In conclusion, based on national nutrition surveys, this study is the first to characterize the nutrition transition in a middle-income country of the EMR, shedding light on priority areas for nutrition policies and interventions.
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Affiliation(s)
- Lara Nasreddine
- Nutrition and Food Sciences Department, Faculty of Agriculture and Food Sciences, American University of Beirut, P.O. Box 11-0236, Riad El Solh, Beirut 11072020, Lebanon
| | - Jennifer J Ayoub
- Nutrition and Food Sciences Department, Faculty of Agriculture and Food Sciences, American University of Beirut, P.O. Box 11-0236, Riad El Solh, Beirut 11072020, Lebanon
| | - Fatima Hachem
- Nutrition and Food Systems Division, Food and Agricultural Organization of the United Nations, 00153 Rome, Italy
| | - Jiana Tabbara
- Epidemiology and Population Health Department, Faculty of Health Sciences, American University of Beirut, P.O. Box 11-0236, Riad El Solh, Beirut 11072020, Lebanon
| | - Abla M Sibai
- Epidemiology and Population Health Department, Faculty of Health Sciences, American University of Beirut, P.O. Box 11-0236, Riad El Solh, Beirut 11072020, Lebanon
| | - Nahla Hwalla
- Nutrition and Food Sciences Department, Faculty of Agriculture and Food Sciences, American University of Beirut, P.O. Box 11-0236, Riad El Solh, Beirut 11072020, Lebanon
| | - Farah Naja
- Nutrition and Food Sciences Department, Faculty of Agriculture and Food Sciences, American University of Beirut, P.O. Box 11-0236, Riad El Solh, Beirut 11072020, Lebanon.
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38
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Affiliation(s)
- Yousser Mohammad
- Syrian Private University, Damascus, Syria.,National Center for Research in Chronic Respiratory Diseases and Comorbidities, Tishreen University School of Medicine, Tishreen University, Latakia, Syria
| | - Grace Brough
- Global Violence Prevention Special Interest Group, London, UK.,Faculty of Public Health UK, London, UK.,Public Health Specialty Registrar University Hospital of Derby and Burton Foundation Trust, Derby, UK
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Ba NV, Minh HV, Quang LB, Chuyen NV, Ha BTT, Dai TQ, Duc DM, Quynh NT, Khanh PG. Prevalence and correlates of multimorbidity among adults in border areas of the Central Highland Region of Vietnam, 2017. JOURNAL OF COMORBIDITY 2019; 9:2235042X19853382. [PMID: 31192142 PMCID: PMC6542113 DOI: 10.1177/2235042x19853382] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Accepted: 04/26/2019] [Indexed: 12/12/2022]
Abstract
Introduction: The objectives of this study are to estimate the prevalence of multimorbidity (MM) among adults in the Central Highland Region (a poor region) of Vietnam in 2017 and to identify the sociodemographic correlates of these conditions. Methods: We used data from a cross-sectional study conducted in 2018 on health status among people in four provinces in the Central Highlands Region (Tay Nguyen) of Vietnam. A sample of 1680 adults (aged 15 years and older) were randomly selected for this study. Respondents were asked whether they had been told by a health worker that they had cancer, heart and circulatory conditions, chronic joint problems, chronic pulmonary diseases, chronic kidney problems, chronic digestive problems, psychological illness, diabetes, and/or other chronic conditions. Results: The prevalence of MM among the study participants was 16.4% (95% confidence interval (CI): 14.6%–18.2%). By looking at the 95% CIs, the differences in MM prevalence between the groups classified by gender, age, education, and occupation were not statistically significant. Only the difference in MM prevalence between farmers and government staff was statistically significant. Multivariate logistic analyses show education and occupations were shown to be significant correlates of MM. Conclusion: MMs were quite common among the adult populations in the study area, especially among people with lower socioeconomic status. Given the evidence, actions to reduce levels of MM in the setting are clearly urgent. The interventions should address all people in society, with focus on disadvantaged groups, like those with lower education and farmers.
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Affiliation(s)
- Nguyen Van Ba
- Department of Science and Technology Management, Vietnam Military Medical University, Hanoi, Vietnam
| | - Hoang Van Minh
- Department of Science and Technology Management, Hanoi University of Public Health, Hanoi, Vietnam
| | - Le Bach Quang
- Department of Science and Technology Management, Vietnam Military Medical University, Hanoi, Vietnam
| | - Nguyen Van Chuyen
- Department of Science and Technology Management, Vietnam Military Medical University, Hanoi, Vietnam
| | - Bui Thi Thu Ha
- Department of Science and Technology Management, Hanoi University of Public Health, Hanoi, Vietnam
| | - Tran Quoc Dai
- Department of Science and Technology Management, Hanoi University of Public Health, Hanoi, Vietnam
| | - Duong Minh Duc
- Department of Science and Technology Management, Hanoi University of Public Health, Hanoi, Vietnam
| | - Nguyen Thuy Quynh
- Department of Science and Technology Management, Hanoi University of Public Health, Hanoi, Vietnam
| | - Pham Gia Khanh
- Department of Science and Technology Management, Vietnam Military Medical University, Hanoi, Vietnam
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40
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Swain S, Chowdhury S. Trends of nutritional status among rural adults in six states of India: findings from national survey data. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2018. [DOI: 10.1016/j.cegh.2017.12.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
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41
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Saleh S, El Harakeh A, Baroud M, Zeineddine N, Farah A, Sibai AM. Costs associated with management of non-communicable diseases in the Arab Region: a scoping review. J Glob Health 2018; 8:020410. [PMID: 30546867 PMCID: PMC6287209 DOI: 10.7189/jogh.08.020410] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Global mortality rates resulting from non-communicable diseases (NCDs) are reaching alarming levels, especially in low- and middle-income countries, imposing a considerable burden on individuals and health systems as a whole. This scoping review aims at synthesizing the existing literature evaluating the cost associated with the management and treatment of major NCDs across all Arab countries; at evaluating the quality of these studies; and at identifying the gap in existing literature. METHODS A systematic search was conducted using Medline electronic database to retrieve articles evaluating costs associated with management of NCDs in Arab countries, published in English between January 2000 and April 2016. 55 studies met the eligibility criteria and were independently screened by two reviewers who extracted/calculated the following information: country, theme (management of NCD, treatment/medication, or procedure), study design, setting, population/sample size, publication year, year for cost data cost conversion (US$), costing approach, costing perspective, type of costs, source of information and quality evaluation using the Newcastle-Ottawa Scale (NOS). RESULTS The reviewed articles covered 16 countries in the Arab region. Most of the studies were observational with a retrospective or prospective design, with a relatively low to very low quality score. Our synthesis revealed that NCDs' management costs in the Arab region are high; however, there is a large variation in the methods used to quantify the costs of NCDs in these countries, making it difficult to conduct any type of comparisons. CONCLUSIONS The findings revealed that data on the direct costs of NCDs remains limited by the paucity of this type of evidence and the generally low quality of studies published in this area. There is a need for future studies, of improved and harmonized methodology, as such evidence is key for decision-makers and directs health care planning.
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Affiliation(s)
- Shadi Saleh
- Department of Health Management and Policy, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Amena El Harakeh
- Department of Health Management and Policy, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Maysa Baroud
- Refugee Research and Policy Program, Issam Fares Institute for Public Policy and International Affairs. American University of Beirut, Beirut, Lebanon
| | - Najah Zeineddine
- Department of Health Management and Policy, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Angie Farah
- Department of Health Management and Policy, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Abla Mehio Sibai
- Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
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Socio-economic status and chronic disease in the West Bank and the Gaza Strip: in and outside refugee camps. Int J Public Health 2018; 63:875-882. [DOI: 10.1007/s00038-018-1122-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 05/17/2018] [Accepted: 05/22/2018] [Indexed: 10/14/2022] Open
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Nutritional status and dietary intakes of children amid the nutrition transition: the case of the Eastern Mediterranean Region. Nutr Res 2018; 57:12-27. [PMID: 30122192 DOI: 10.1016/j.nutres.2018.04.016] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 04/13/2018] [Accepted: 04/20/2018] [Indexed: 11/23/2022]
Abstract
The Eastern Mediterranean Region (EMR) is undergoing social and economic changes that may impact the nutritional status of children living in its countries. The objective of this review is to evaluate the nutritional status and dietary intakes of children (0-12 years) in selected EMR countries, namely, Jordan, Lebanon, Kingdom of Saudi Arabia (KSA), and the United Arab Emirates. MedLine, PubMed, Scopus, and Google Scholar were searched for relevant articles published between 1990 and 2016; international organizations and governmental websites were also searched. Stunting in the region was estimated at 7.3% to 9.3%, wasting at 1.1% to 11.8%, and underweight at 1.6% to 5.3%. In contrast, overweight and obesity affected 19% to 21% of school-aged children from Lebanon and KSA. Available biochemical data showed that pediatric anemia, vitamin A, and vitamin D deficiencies remain a challenge in the region. Dietary intake studies have identified inadequate intakes of iron, calcium, zinc, folic acid, vitamin A, and vitamin D, concurrently with high intakes of fat, saturated fat, and sugar. This review provides valuable insight into the nutrition situation of children in 2 major areas of the EMR, the Levant and the Gulf, and identified several gaps and challenges in existing nutritional assessment studies. Key issues include the triple burden of malnutrition in this age group (underweight, nutrient inadequacies, and overweight/obesity), while calling for integrated action to improve the nutritional status of children in countries of the region. Opportunities for future research include nationwide nutritional and dietary surveys in countries where the largest data gaps remain such as the United Arab Emirates and KSA.
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Adherence to the Qatar dietary guidelines: a cross-sectional study of the gaps, determinants and association with cardiometabolic risk amongst adults. BMC Public Health 2018; 18:503. [PMID: 29661175 PMCID: PMC5902923 DOI: 10.1186/s12889-018-5400-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 04/04/2018] [Indexed: 11/12/2022] Open
Abstract
Background The Qatar Dietary Guidelines (QDGs) were developed as part of the national strategy to prevent chronic diseases. This study aims at characterizing gaps between the QDGs and usual dietary and lifestyle patterns in Qatar, identifying demographic and socioeconomic determinants of adherence to the QDGs and investigating the association between adherence and cardiometabolic risk. Methods This study is based on the Qatar National STEPwise cross-sectional survey which was conducted on a nationally representative sample of Qatari adults, aged 18 to 64 years (n = 1109). Data collection included socio-demographic characteristics, lifestyle factors, anthropometric (weight, height and waist circumference (WC)), and blood pressure measurements. The dietary intake of participants was evaluated using a non-quantitative food frequency questionnaire (FFQ). Biochemical assessment was performed to measure the fasting levels of blood sugar, triglycerides (TG) and HDL cholesterol. The metabolic syndrome (MetS) was defined as the presence of three or more cardiometabolic risk factors. To examine adherence to the guidelines, each specifc recommendation was matched to corresponding data drawn from the survey. To investigate the association of sociodemographic, lifestyle and cardiometabolic characteristics with adherence to the QDGs, an adherence score was calculated. Results More than 83% of adults did not meet the recommendations for vegetables, fruits, whole grains, legumes and high fibre intakes, 70% were overweight or obese, 50–72% reported frequent consumption of sweetened beverages and sweets, and 47% reported frequent consumption of fast foods. Younger adults, the unemployed, the least educated and those not married had lower adherence to the QDGs. Adherence was inversely associated with elevated WC (OR: 0.88, 95% CI:0.82–0.95) and the MetS (OR:0.84,95% CI:0.74–0.96). Conclusions Building on the identified gaps and vulnerable population groups, the study findings should provide a road map for the prioritization of interventions and the development of culture- specific programs aiming at promoting adherence to dietary guidelines in Qatar, while serving as a model to other countries in the region.
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Masjedi M, Ainy E, Zayeri F, Paydar R. Assessing the Prevalence and Incidence of Asthma and Chronic Obstructive Pulmonary Disease in the Eastern Mediterranean Region. Turk Thorac J 2018; 19:56-60. [PMID: 29755807 PMCID: PMC5937810 DOI: 10.5152/turkthoracj.2018.17051] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2017] [Accepted: 11/06/2017] [Indexed: 11/22/2022]
Abstract
OBJECTIVES This study conducted in 2016 aimed to assess the prevalence and incidence of asthma and chronic obstructive pulmonary disease (COPD) in the Eastern Mediterranean Region (EMR). MATERIAL AND METHODS A meta-analysis to evaluate the published research relating to asthma and COPD was conducted using data from 23 EMR Office (EMRO) countries and searching using the web of science, PubMed, SciVerse Scopus, Google scholar, and MEDLINE databases. The keywords entered were all EMRO countries (Afghanistan, Bahrain, Djibouti, Egypt, Islamic republic Iran, Iraq, Jordan, Kuwait, Lebanon, Libyan Arab Jamahiriya, Morocco, Oman, Pakistan, Palestine, Qatar, Saudi Arab, Somalia, Sudan, Syrian Arab Republic, Tunisia, the United Arab Emirates, Yemen republic, and Cyprus) and asthma OR chronic obstructive pulmonary disease (COPD) OR (chronic bronchitis). Our definition of asthma and COPD was according to the World Health Organization (WHO). RESULTS A total of 92 published articles were identified. The pooled prevalence of asthma and COPD was 9.38 (confidence interval [CI]: 9.20-9.55) and 5.39 (CI: 5.17-5.62), respectively. There were no articles about COPD and asthma in Bahrain and Djibouti; no articles about asthma in Jordan and Libyan Arab Jamahiriya; and no articles about COPD in Afghanistan, Iraq, Oman, Palestine, Somalia, Sudan, and Yemen republic. The highest prevalence of asthma was observed in Kuwait, and the highest prevalence of COPD was observed in Pakistan. CONCLUSION The EMRO countries have inadequate research and data in the areas of asthma and COPD. More efforts and relevant studies must be conducted to understand the countrywide prevalence and real burden of these diseases.
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Affiliation(s)
- Mohammadreza Masjedi
- Department of Pulmonology and Internal Medicine, Tobacco Control Research Center, Iranian Anti-Tobacco Association. Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Elaheh Ainy
- Department of Injury Epidemiology, Safety Promotions and Injury Prevention Research Center of Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Faried Zayeri
- Department of Biostatistics, Proteomics Research Center, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Rogayeh Paydar
- Tobacco Control Research Center, Iranian Anti-Tobacco Association, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Wang Z, Li X, Chen M. Socioeconomic Factors and Inequality in the Prevalence and Treatment of Diabetes among Middle-Aged and Elderly Adults in China. J Diabetes Res 2018; 2018:1471808. [PMID: 30687763 PMCID: PMC6327275 DOI: 10.1155/2018/1471808] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 10/28/2018] [Accepted: 11/14/2018] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND In China, the prevalence of diabetes has increased significantly over recent decades, owing to the county's rapidly aging population. Although many studies have examined the prevalence of diabetes worldwide, there has been little analysis of the inequalities in its prevalence and treatment among middle-aged and elderly people. OBJECTIVES This study evaluates influence factors and inequality in respect to the prevalence of diabetes and medication treatment among middle-aged and elderly Chinese adults. METHODS Data were obtained from the China Health and Retirement Longitudinal Study, a nationally representative household survey of middle-aged and elderly people (i.e., 45 years of age or older). Logistic regression models and the concentration index were used to estimate socioeconomic factors and inequalities in diabetes prevalence and treatment. RESULTS The prevalence of self-reported diabetes among middle-aged and elderly Chinese adults was 8.4%; this figure was significantly higher in urban areas than in rural areas. Concentrations of prevalence were observed among the poor in urban areas and among the rich in rural areas. Overall, the incidence of receiving antidiabetic medication among diabetes patients was 64.3%; this was significantly higher for individuals in urban areas than those in rural areas, suggesting that awareness of diabetes treatment in urban areas is better than that in rural areas. A disproportionate concentration of incidence of receiving antidiabetic medication was observed among the rich in both urban and rural areas. Socioeconomic factors significantly affected the prevalence of diabetes and the likelihood of receiving medication and are major contributors to inequality. CONCLUSION In China, policies and strategies regarding diabetes prevention and control should further focus on associated socioeconomic factors and major contributors to reduce diabetes prevalence, improve diabetes treatment and management, and alleviate current inequality in the prevalence and treatment of diabetes among middle-aged and elderly adults.
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Affiliation(s)
- Zhonghua Wang
- School of Health Policy & Management, Nanjing Medical University, 211166 Nanjing, China
- Creative Health Policy Research Group, Nanjing Medical University, 211166 Nanjing, China
| | - Xiangjun Li
- School of Health Economics and Management, Nanjing University of Chinese Medicine, 210023 Nanjing, China
| | - Mingsheng Chen
- School of Health Policy & Management, Nanjing Medical University, 211166 Nanjing, China
- Creative Health Policy Research Group, Nanjing Medical University, 211166 Nanjing, China
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Tripathy JP, Thakur JS, Jeet G, Jain S. Prevalence and determinants of comorbid diabetes and hypertension: Evidence from non communicable disease risk factor STEPS survey, India. Diabetes Metab Syndr 2017; 11 Suppl 1:S459-S465. [PMID: 28395951 DOI: 10.1016/j.dsx.2017.03.036] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 03/31/2017] [Indexed: 11/15/2022]
Abstract
PROBLEM STATEMENT Comorbidity of non-communicable diseases carries a significant risk of cardiovascular events and mortality. With the rising burden of diabetes, hypertension and other risk factors, and ageing population in India, this is likely to pose a major threat to the health system. It is therefore essential to understand this high risk group. This article reports prevalence of comorbid diabetes and hypertension and its associated risk factors in the North Indian state of Punjab. METHODS A household NCD STEPS survey was done in Punjab, India in a multistage stratified sample of 5127 individuals. All the subjects were administered the WHO STEPS questionnaire, anthropometric and blood pressure measurements. Every alternate respondent in the sample (n=2499) were assayed for blood glucose and lipid parameters. RESULTS The prevalence of comorbid DM and HTN was 4.5% in the general adult population. DM, HTN and dyslipidemia co-existed in 1.8% of the population. Obesity and dyslipidemia are the most common comorbidities among persons with DM and HTN alone and comorbid DM and HTN. Factors strongly associated with comorbid DM and HTN include elderly age group, dyslipidemia, obesity and family history of DM. CONCLUSIONS The study reported high burden of comorbid diabetes and hypertension among the elderly, strongly associated with obesity and dyslipidemia. This emphasizes the role of nonpharmacological intervention such as weight reduction, physical activity, and dietary modification.
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Affiliation(s)
- Jaya Prasad Tripathy
- Operational Research Fellow, International Union Against Tuberculosis and Lung Disease, The Union South East Asia Office, New Delhi, India.
| | - J S Thakur
- Professor of Community Medicine, School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
| | - Gursimer Jeet
- Research Fellow, School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
| | - Sanjay Jain
- Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
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Khan I, Ul-Haq Z, Taj AS, Iqbal AZ, Basharat S, Shah BH. Prevalence and Association of Obesity with Self-Reported Comorbidity: A Cross-Sectional Study of 1321 Adult Participants in Lasbela, Balochistan. BIOMED RESEARCH INTERNATIONAL 2017; 2017:1076923. [PMID: 29159174 PMCID: PMC5660751 DOI: 10.1155/2017/1076923] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 07/31/2017] [Indexed: 11/17/2022]
Abstract
Association of fatness with chronic metabolic diseases is a well-established fact, and a high prevalence of risk factors for these disorders has increasingly been reported in the third world. In order to incorporate any preventive strategies for such risk factors into clinical practice, decision-makers require objective evidence about the associated burden of disease. A cross-sectional study of 1321 adults from one of the districts of Balochistan, among the most economically challenged areas of Pakistan, was carried out for the measures of fatness and self-reported comorbidities. Body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) were measured and demographic information and self-reported comorbidities were documented. The prevalence of obesity was 4.8% (95% CI: [3.8, 6.1]) and 21.7% (95% CI: [19.5, 24.0]), as defined by the World Health Organization (WHO) international and Asia/Asia-Pacific BMI cut-offs, respectively. The proportion exhibiting comorbidity increased with increasing levels of fatness in a dose-response relationship (p value < .001). An interaction of weight status with gender was observed to produce a significantly (p = .033) higher comorbidity among overweight women (odds ratio (OR) = 6.1 [1.2, 31.7]) compared with overweight men (OR = 1.1 [0.48, 2.75], p = .762).
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Affiliation(s)
- I. Khan
- Institute of Public Health & Social Sciences, Khyber Medical University, Peshawar, Pakistan
- Institute of Public Health, Quetta, Balochistan, Pakistan
| | - Z. Ul-Haq
- Institute of Public Health & Social Sciences, Khyber Medical University, Peshawar, Pakistan
- Institute of Health and Wellbeing, University of Glasgow, Glasgow G12 8RZ, UK
| | - A. S. Taj
- Institute of Public Health & Social Sciences, Khyber Medical University, Peshawar, Pakistan
| | - A. Z. Iqbal
- Peshawar Institute of Medical Sciences, Peshawar, Pakistan
| | - S. Basharat
- Health Services Academy, Islamabad, Pakistan
| | - B. H. Shah
- Institute of Public Health & Social Sciences, Khyber Medical University, Peshawar, Pakistan
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A minimally processed dietary pattern is associated with lower odds of metabolic syndrome among Lebanese adults. Public Health Nutr 2017; 21:160-171. [PMID: 28965534 PMCID: PMC5729841 DOI: 10.1017/s1368980017002130] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To (i) estimate the consumption of minimally processed, processed and ultra-processed foods in a sample of Lebanese adults; (ii) explore patterns of intakes of these food groups; and (iii) investigate the association of the derived patterns with cardiometabolic risk. DESIGN Cross-sectional survey. Data collection included dietary assessment using an FFQ and biochemical, anthropometric and blood pressure measurements. Food items were categorized into twenty-five groups based on the NOVA food classification. The contribution of each food group to total energy intake (TEI) was estimated. Patterns of intakes of these food groups were examined using exploratory factor analysis. Multivariate logistic regression analysis was used to evaluate the associations of derived patterns with cardiometabolic risk factors. SETTING Greater Beirut area, Lebanon. SUBJECTS Adults ≥18 years (n 302) with no prior history of chronic diseases. RESULTS Of TEI, 36·53 and 27·10 % were contributed by ultra-processed and minimally processed foods, respectively. Two dietary patterns were identified: the 'ultra-processed' and the 'minimally processed/processed'. The 'ultra-processed' consisted mainly of fast foods, snacks, meat, nuts, sweets and liquor, while the 'minimally processed/processed' consisted mostly of fruits, vegetables, legumes, breads, cheeses, sugar and fats. Participants in the highest quartile of the 'minimally processed/processed' pattern had significantly lower odds for metabolic syndrome (OR=0·18, 95 % CI 0·04, 0·77), hyperglycaemia (OR=0·25, 95 % CI 0·07, 0·98) and low HDL cholesterol (OR=0·17, 95 % CI 0·05, 0·60). CONCLUSIONS The study findings may be used for the development of evidence-based interventions aimed at encouraging the consumption of minimally processed foods.
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Paul K, Singh J. Emerging trends and patterns of self-reported morbidity in India: Evidence from three rounds of national sample survey. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2017; 36:32. [PMID: 28793930 PMCID: PMC5550946 DOI: 10.1186/s41043-017-0109-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2016] [Accepted: 07/27/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND India is rapidly undergoing an epidemiological transition with a sudden change in the disease profile of its population. It is important to understand the changing nature of the burden of disease across the states of India for adequate policy intervention. METHODS We analyzed the trend and pattern of self-reported morbidity across states of India using three rounds of (52nd, 60th and 71st) National Sample Survey Organization (NSSO) data. Descriptive analysis was carried out to understand the prevalence of self-reported morbidity variation over a period of two decades (1995-2014) and multivariate analysis was performed to identify the significant determinants of various types of self-reported morbidities. RESULTS The results indicated an increasing trend of infectious disease, Cardio Vascular Diseases (CVDs) and Non-Communicable Diseases (NCDs) over the last two decades (1995-2014). CVDs increased by a whopping eight-fold and the NCDs increased by three times during this period. A higher prevalence of self-reported morbidity was observed among the elderly and female, particularly in the urban locality. The growing incidence of CVDs and NCDs, especially among the elderly were reported from Kerala, Tamil Nadu, Punjab and West Bengal. CONCLUSIONS The already constrained public health system in India is likely to face serious challenges with a double burden of communicable and non-communicable diseases. An effective and responsive public health system needs to be in place to make health care services available for NCDs and CVDs at the primary level. In order to ameliorate caregiving, the involvement of family will be critical. Informing the people inculcate healthy habits may be an effective health promotion measure.
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Affiliation(s)
- Kalosona Paul
- School of Development Studies, Tata Institute of Social Sciences, Opp. Deonar Depot, Mumbai, 400088 India
| | - Jayakant Singh
- School of Health Systems Studies, Tata Institute of Social Sciences, Opp. Deonar Depot, Mumbai, 400088 India
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