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Asgedom YS, Kebede TM, Gebrekidan AY, Koyira MM, Azeze GA, Lombebo AA, Efa AG, Haile KE, Kassie GA. Prevalence of metabolic syndrome among people living with human immunodeficiency virus in sub-Saharan Africa: a systematic review and meta-analysis. Sci Rep 2024; 14:11709. [PMID: 38777850 PMCID: PMC11111734 DOI: 10.1038/s41598-024-62497-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 05/17/2024] [Indexed: 05/25/2024] Open
Abstract
Metabolic syndrome (MetS) poses a significant clinical challenge for individuals living with HIV (PLHIV). In sub-Saharan Africa (SSA), this condition is becoming a growing concern, owing to lifestyle changes and an increasingly aging population. Several SSA countries have reported on the prevalence of MetS. However, these estimates may be outdated because numerous recent studies have updated MetS prevalence among PLHIV in these countries. Moreover, prior research has focused on various study designs to report the pooled prevalence, which is a methodological limitation. Therefore, this systematic review and meta-analysis aimed to determine the pooled estimates of MetS in PLHIV in SSA by addressing these gaps. We systematically searched Google Scholar, Science Direct, Scopus, Web of Sciences, EMBASE, and PubMed/Medline for the prevalence of MetS and its subcomponents among people with HIV in sub-Saharan Africa. The estimated pooled prevalence was presented using a forest plot. Egger's and Begg's rank regression tests were used to assess evidence of publication bias. Twenty-five studies fulfilled the inclusion criteria after review of the updated PRISMA guidelines. The pooled prevalence of MetS was 21.01% [95% CI: (16.50, 25.51)] and 23.42% [95% CI: (19.16, 27.08)] to the National Cholesterol Education Program Adult Treatment Panel III (NCEP/ATP III) and International Diabetes Federation (IDF) criteria, respectively. Low levels of high-density lipoprotein cholesterol (Low HDL) at 47.25% [95% CI: 34.17, 60.33)] were the highest reported individual subcomponent, followed by abdominal obesity at 38.44% [95% CI: (28.81, 48.88)]. The prevalence of MetS is high in sub-Saharan Africa. Low HDL levels and increased waist circumference/abdominal obesity were the most prevalent components of MetS. Therefore, early screening for MetS components and lifestyle modifications is required. Policymakers should develop strategies to prevent MetS before an epidemic occurs.PROSPERO: CRD42023445294.
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Segun A, Zhang B, Mary AM, Kibenja D, Ma J, Said S, Adeniyi I, Barrow LF. Exploring the relationship between dietary patterns and obesity among Nigerian adults: a cross-sectional study. BMC Public Health 2024; 24:1319. [PMID: 38750540 PMCID: PMC11094914 DOI: 10.1186/s12889-024-18792-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 05/08/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND/OBJECTIVE No previous study has investigated the association between dietary pattern and both general and abdominal obesity risk among adults in Nigeria. This study aimed to evaluate the associations between dietary patterns and the risk of obesity among adult age 18 and above in Ekiti State, Southwestern Nigeria. METHODS AND STUDY DESIGNS A total of 1003 adults were included in this cross-sectional study (males = 558; females = 445). Body mass index (BMI) and waist-to-hip (WHR) were used to assess general and abdominal obesity respectively and they were categorized using WHO recommendation. Partial correlation analyses were performed to assess the associations of dietary patterns with BMI and WHR. Prevalence ratio between dietary pattern and both general and abdominal obesity were calculated using Robust Poisson Regression. RESULTS The prevalence of general obesity among adults was 15.9%, (11.6% among men and 20.2% among women); abdominal obesity was 32.3% (28.9% among males and 44.5% among females). Four dietary patterns were identified; diversified traditional pattern; typical traditional pattern; milk and bread pattern and egg and fish pattern. Diversified traditional pattern was negatively associated with BMI (PR = 0.571, 95%CI: 0.360 ~ 0.905, p = 0.017), and typical traditional pattern was positively associated with BMI (PR = 1.561, 95% CI: 1.043 ~ 2.339, p = 0.031) and WHR in females (PR = 1.849, 95% CI: 1.256 ~ 2.721, p = 0.005). In comparison to those in the lowest quartile, adults with the highest quartile of the typical traditional pattern had a higher risk for abdominal obesity (PR = 1.849, 95%CI = 1.256 ~ 2.721, p = 0.020). CONCLUSION This study reports an alarming increase in Obesity prevalence among Nigeria adults which is greatly influence by their lifestyle and eating pattern. We found out that a typical traditional food pattern was associated with a higher risk of both general and abdominal obesity, but a diverse traditional food pattern was associated to a reduced risk of general obesity.
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Affiliation(s)
- Asaolu Segun
- Food Safety and Health Research Center, School of Public Health, Southern Medical University, Guangzhou, China
| | - Bo Zhang
- Food Safety and Health Research Center, School of Public Health, Southern Medical University, Guangzhou, China
| | - Abiona Modupe Mary
- Food Safety and Health Research Center, School of Public Health, Southern Medical University, Guangzhou, China
| | - Dennis Kibenja
- Food Safety and Health Research Center, School of Public Health, Southern Medical University, Guangzhou, China
| | - Jie Ma
- Food Safety and Health Research Center, School of Public Health, Southern Medical University, Guangzhou, China
| | - Seif Said
- Department Of Nursing and Public Health, Faculty of Health and Allied Science, Zanzibar University, Zanzibar, Tanzania
| | - Idowu Adeniyi
- Federal Ministry of Industry, Trade and Investment, Abuja, Nigeria
| | - Lamin F Barrow
- The Department of Public and Environmental Health, School of Medicine and Allied Health Science, University of Gambia, Serekunda, The Gambia.
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Shayan NA, Rahimi A, Stranges S, Thind A. Exploring Sex Differences in Risk Factors and Quality of Life Among Tuberculosis Patients in Herat, Afghanistan: A Case-Control Study. Int J Public Health 2024; 69:1606554. [PMID: 38711785 PMCID: PMC11070830 DOI: 10.3389/ijph.2024.1606554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 04/02/2024] [Indexed: 05/08/2024] Open
Abstract
Objectives: Tuberculosis (TB) is a significant public health concern in Afghanistan, with a high burden of disease in the western province of Herat. This study explored the risk factors of TB and TB's impact on the quality of life of patients in Herat. Methods: A total of 422 TB patients and 514 controls were recruited at Herat Regional Hospital and relevant TB laboratories between October 2020 and February 2021. Data was collected through interviews using a structured questionnaire and the SF-36 questionnaire. Descriptive statistics, chi-square tests, Multivariate General Linear Model, and logistic regression analysis were used to analyze the data. Results: The results showed that male sex (p = 0.023), chronic disease (p = 0.038), lower education levels (p < 0.001), and worse health status (p < 0.001) were significantly associated with higher odds of TB infection. The study also found that TB patients had significantly lower quality of life scores in almost all components (p < 0.05). Conclusion: This study provides important insights into the specific ways in which TB affects the wellbeing of patients in Afghanistan. The findings highlight the importance of addressing the psychological and social dimensions of TB.
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Affiliation(s)
- Nasar Ahmad Shayan
- Department of Public Health and Infectious Disease, Faculty of Medicine, Herat University, Herat, Afghanistan
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Ali Rahimi
- Department of Public Health and Infectious Disease, Faculty of Medicine, Herat University, Herat, Afghanistan
- Department of Curative Medicine, Faculty of Medicine, Jami University, Herat, Afghanistan
| | - Saverio Stranges
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
- Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
- Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Amardeep Thind
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
- Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
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Kanyara L, Lel R, Kageha S, Kinyua J, Matu S, Ongaya A, Matilu M, Mwangi P, Okoth V, Mwangi J, Olungae D. Diabetes mellitus and associated risk factors among HIV infected patients on HAART. BMC Public Health 2024; 24:846. [PMID: 38504229 PMCID: PMC10949814 DOI: 10.1186/s12889-024-18265-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 03/03/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND Understanding the impact of disease associations is becoming a priority in Kenya and other countries bearing the load of infectious diseases. With the increased incidences of non-communicable diseases and the endemicity of infectious diseases in Sub-Saharan Africa, their co-existence poses significant challenges to patients, health workers and an overwhelmed health sector. Classical risk factors for diabetes such as physical inactivity and unhealthy diet may not solely explain the current trends, suggesting the role of novel risk factors including infections/inflammation. HIV and its treatment have been identified as potential contributors especially to patients with family history of confirmed diabetes cases. Co-infections frequently observed during HIV infection also significantly influence both the epidemiological and pathophysiological of the link between HIV and diabetes. Understanding the correlates of HIV and diabetes is crucial to inform management and prevention strategies of the twin infections. We therefore aimed to determine the prevalence of diabetes mellitus and risk factors in a population of HIV infected patients on HAART. This study determined the association of diabetes/impaired glucose regulation in the context of HIV-1. A cross-sectional study was conducted at a comprehensive care clinic in Nairobi (Kenya). Participants were screened for diabetes and impaired glucose regulation using random blood glucose and glycated haemoglobin (HbA1c) This paper describes the prevalence of diabetes mellitus in Human Immunodeficiency Virus positive individuals and the associated risk factors. We have demonstrated that family history is a risk factor for diabetes. While age and BMI are known risk factors, they were not associated with diabetes in this study.
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Affiliation(s)
- Lucy Kanyara
- Kenya Medical Research Institute, Nairobi, Kenya.
| | - Rency Lel
- Kenya Medical Research Institute, Nairobi, Kenya
| | | | | | - Sophie Matu
- Kenya Medical Research Institute, Nairobi, Kenya
| | - Asiko Ongaya
- Kenya Medical Research Institute, Nairobi, Kenya
| | - Mary Matilu
- Kenya Medical Research Institute, Nairobi, Kenya
| | - Paul Mwangi
- Kenya Medical Research Institute, Nairobi, Kenya
| | | | | | - Dama Olungae
- Kenya Medical Research Institute, Nairobi, Kenya
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Badacho AS, Mahomed OH. Facilitators and barriers to integration of noncommunicable diseases with HIV care at primary health care in Ethiopia: a qualitative analysis using CFIR. Front Public Health 2023; 11:1247121. [PMID: 38145060 PMCID: PMC10748758 DOI: 10.3389/fpubh.2023.1247121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 11/23/2023] [Indexed: 12/26/2023] Open
Abstract
Background The rise in non-communicable diseases (NCD), such as hypertension and diabetes among people living with human immunodeficiency virus (PLWH), has increased the demand for integrated care due to multiple chronic care needs. However, there is a dearth of evidence on contextual factors implementing integrated hypertension and diabetes care with HIV care. This study aimed to identify facilitators and barriers that could affect the integration of hypertension and diabetes with HIV care at primary health care in Ethiopia. Methods Five primary health facilities from five districts of the Wolaita zone of South Ethiopia were included in the qualitative study. Fifteen key informant interviews were conducted with healthcare providers and managers from the zonal, district, and facility levels from October to November 2022. Data collection and analysis were guided by a consolidated framework of implementation research (CFIR). Results Ten CFIR constructs were found to influence the integration. Perceived benefit of integration to patients, healthcare providers, and organization; perceived possibilities of integration implementation; availability of NCD guidelines and strategies; a supportive policy of decentralization and integration; perceived leaders and healthcare provider commitment were found to be facilitators. Perceived increased cost, insufficient attention to NCD care needs, inadequate number of trained professionals, inadequate equipment and apparatus such as blood pressure measurement, glucometers, strips, and NCD drugs, inadequate allocation of budget and weak health financing system and poor culture of data capturing and reporting were identified as barriers to integration. Conclusion It is important to address contextual barriers through innovative implementation science solutions to address multiple chronic care needs of PLWH by implementing integrated hypertension and diabetes with HIV care in primary healthcare. Training and task shifting, pairing experienced professionals, and strengthening the health care financing system to implement evidence-based integration of hypertension and diabetes are recommended.
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Affiliation(s)
- Abebe Sorsa Badacho
- School Public Health, Wolaita Sodo University, Sodo, Ethiopia
- School of Nursing and Public Health, Public Health Medicine Discipline, Durban, South Africa
- Health Economics and HIV and AIDS Research Division (HEARD), University of KwaZulu-Natal, Durban, South Africa
| | - Ozayr Haroon Mahomed
- School of Nursing and Public Health, Public Health Medicine Discipline, Durban, South Africa
- Dasman Diabetes Institute, Kuwait City, Kuwait
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Khunti K, Chudasama YV, Gregg EW, Kamkuemah M, Misra S, Suls J, Venkateshmurthy NS, Valabhji J. Diabetes and Multiple Long-term Conditions: A Review of Our Current Global Health Challenge. Diabetes Care 2023; 46:2092-2101. [PMID: 38011523 DOI: 10.2337/dci23-0035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 07/26/2023] [Indexed: 11/29/2023]
Abstract
Use of effective treatments and management programs is leading to longer survival of people with diabetes. This, in combination with obesity, is thus contributing to a rise in people living with more than one condition, known as multiple long-term conditions (MLTC or multimorbidity). MLTC is defined as the presence of two or more long-term conditions, with possible combinations of physical, infectious, or mental health conditions, where no one condition is considered as the index. These include a range of conditions such as cardiovascular diseases, cancer, chronic kidney disease, arthritis, depression, dementia, and severe mental health illnesses. MLTC has major implications for the individual such as poor quality of life, worse health outcomes, fragmented care, polypharmacy, poor treatment adherence, mortality, and a significant impact on health care services. MLTC is a challenge, where interventions for prevention and management are lacking a robust evidence base. The key research directions for diabetes and MLTC from a global perspective include system delivery and care coordination, lifestyle interventions and therapeutic interventions.
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Affiliation(s)
- Kamlesh Khunti
- Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester, U.K
| | - Yogini V Chudasama
- Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester, U.K
| | - Edward W Gregg
- School of Population Health, Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland
| | - Monika Kamkuemah
- Innovation Africa and Department of Architecture, Faculty of Engineering, Built Environment and Information Technology, University of Pretoria, Pretoria, South Africa
| | - Shivani Misra
- Division of Metabolism, Digestion and Reproduction, Imperial College London, London, U.K
- Department of Diabetes and Endocrinology, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, U.K
| | - Jerry Suls
- Institute for Health System Science, Feinstein Institutes for Medical Research Northwell Health, New York, NY
| | - Nikhil S Venkateshmurthy
- Public Health Foundation of India, New Delhi, India
- Centre for Chronic Disease Control, New Delhi, India
| | - Jonathan Valabhji
- Division of Metabolism, Digestion and Reproduction, Imperial College London, London, U.K
- Department of Diabetes and Endocrinology, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, U.K
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Kalinjuma AV, Hussey H, Mollel GJ, Letang E, Battegay M, Glass TR, Paris D, Vanobberghen F, Weisser M. Body mass index trends and its impact of under and overweight on outcome among PLHIV on antiretroviral treatment in rural Tanzania: A prospective cohort study. PLoS One 2023; 18:e0290445. [PMID: 37607169 PMCID: PMC10443839 DOI: 10.1371/journal.pone.0290445] [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: 03/28/2023] [Accepted: 08/09/2023] [Indexed: 08/24/2023] Open
Abstract
INTRODUCTION Increased body weight is an important risk factor for cardiovascular disease and is increasingly reported as a health problem in people living with HIV (PLHIV). There is limited data from rural sub-Saharan Africa, where malnutrition usually presents with both over- and undernutrition. We aimed to determine the prevalence and risk factors of underweight and overweight/obesity in PLHIV enrolled in a cohort in rural Tanzania before the introduction of integrase inhibitors. METHODS This nested study of the prospective Kilombero and Ulanga Antiretroviral Cohort included adults aged ≥19 years initiated on antiretroviral therapy between 01/2013 and 12/2018 with follow-up through 06/2019. Body Mass Index (BMI) was classified as underweight (<18.5 kg/m2), normal (18.5-24.9 kg/m2), or overweight/obese (≥25.0 kg/m2). Stratified piecewise linear mixed models were used to assess the association between baseline characteristics and follow-up BMI. Cox proportional hazard models were used to assess the association between time-updated BMI and death/loss to follow-up (LTFU). RESULTS Among 2,129 patients, 22,027 BMI measurements (median 9 measurements: interquartile range 5-15) were analysed. At baseline, 398 (19%) patients were underweight and 356 (17%) were overweight/obese. The majority of patients were female (n = 1249; 59%), and aged 35-44 years (779; 37%). During the first 9 months, for every three additional months on antiretroviral therapy, BMI increased by 2% (95% confidence interval 1-2%, p<0.0001) among patients underweight at baseline and by 0.7% (0.5-0.6%, p<0.0001) among participants with normal BMI. Over a median of 20 months of follow-up, 107 (5%) patients died and 592 (28%) were LTFU. Being underweight was associated with >2 times the hazard of death/LTFU compared to participants with normal BMI. CONCLUSION We found a double burden of malnutrition, with underweight being an independent predictor of mortality. Monitoring and measures to address both states of malnutrition among PLHIV should be integrated into routine HIV care.
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Affiliation(s)
- Aneth Vedastus Kalinjuma
- Department of Interventions and Clinical Trials, Ifakara Health Institute, Ifakara, Tanzania
- Department of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Hannah Hussey
- Department of Interventions and Clinical Trials, Ifakara Health Institute, Ifakara, Tanzania
- Division of Public Health, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Getrud Joseph Mollel
- Department of Interventions and Clinical Trials, Ifakara Health Institute, Ifakara, Tanzania
- St. Francis Referral Hospital, Ifakara, Tanzania
| | - Emilio Letang
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- Barcelona Institute for Global Health, Hospital Clínic-University of Barcelona, Barcelona, Spain
| | - Manuel Battegay
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Tracy R. Glass
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Daniel Paris
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Fiona Vanobberghen
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Maja Weisser
- Department of Interventions and Clinical Trials, Ifakara Health Institute, Ifakara, Tanzania
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University of Basel, Basel, Switzerland
- University of Basel, Basel, Switzerland
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Abstract
PURPOSE OF REVIEW The aim of this study was to provide an overview of the burden, pathogenesis, and recent recommendations for treating hypertension among people living with HIV (PLWH). This review is relevant because of the increase in the prevalence of HIV as a chronic disease and the intersection of the increasing prevalence of hypertension. RECENT FINDINGS The contribution of HIV to the pathogenesis of hypertension is complex and still incompletely understood. Evidence suggests that chronic inflammation from HIV, antiretroviral treatment (ART), and comorbidities such as renal disease and insulin resistance contribute to developing hypertension in PLWH. Treatment is not distinct from guidelines for HIV-noninfected people. Nonpharmacological guidelines such as decreasing blood pressure by promoting a healthy lifestyle emphasizing exercise, weight loss, and smoking cessation are still recommended in the literature. The pharmacological management of hypertension in PLWH is similar, but special attention must be given to specific drugs with potential interaction with ART regimens. Further research is needed to investigate the pathways and effects of hypertension on HIV. SUMMARY There are different pathways to the pathogenesis of hypertension in PLWH. Clinicians should take it into consideration to provide more precise management of hypertension in PLWH. Further research into the subject is still required.
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Affiliation(s)
- Ileana De Anda-Duran
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
| | - Alexander D. Kimbrough
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
| | - Lydia A. Bazzano
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
- Department of Internal Medicine, Ochsner Health System, New Orleans, Louisiana, USA
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Nguyen TT, Nguyen HT, Do HP, Ho CSH, Ho RCM. Characterizing the Development of Research Landscapes in Substance Use and HIV/AIDS During 1990 to 2021. Subst Abuse 2023; 17:11782218231177515. [PMID: 37304210 PMCID: PMC10251474 DOI: 10.1177/11782218231177515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 05/07/2023] [Indexed: 06/13/2023]
Abstract
Mitigating the impacts of Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) and substance use requires comprehensive and systematic thinking in designing interventions and developing policies. This study describes the growth of research publications from 1991 to 2021 in the Web of Science database and points out current research landscapes in the fields of HIV/AIDS and substance use. Latent Dirichlet Allocation was used for classifying 21 359 papers into corresponding topics. The most common topics were HIV transmission, HIV infection, quality of life and mental health of substance users, and the biomedical effect of substance use. Emerging research landscapes include vulnerabilities of people who inject drugs to HIV transmission and related health problems. This study found a lack of research on health services, interdisciplinary and inter-sectoral in combination with clinical evaluation and treatment services. Future investment and implementation of HIV/AIDS and substance use programs should focus on research of health services and clinical evaluation, especially context-specific interventions.
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Affiliation(s)
- Tham Thi Nguyen
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam
- Faculty of Medicine, Duy Tan University, Da Nang, Vietnam
| | - Hien Thu Nguyen
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam
- Faculty of Medicine, Duy Tan University, Da Nang, Vietnam
| | - Huyen Phuc Do
- Institute of Health Economics and Technology, Hanoi, Vietnam
| | - Cyrus SH Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Roger CM Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore
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Socioeconomic inequalities in diabetes prevalence: the case of South Africa between 2003 and 2016. BMC Public Health 2023; 23:324. [PMID: 36788553 PMCID: PMC9926686 DOI: 10.1186/s12889-023-15186-w] [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: 09/29/2022] [Accepted: 02/01/2023] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND Diabetes is a growing epidemic worldwide and the effect of socioeconomic status (SES) is frequently acknowledged in the literature. This study aims to compare the effect of SES on diabetes prevalence in South Africa between 2003 and 2016. In addition, vulnerable groups regarding diabetes development in 2016 will be identified. METHODS Using DHS data there were 8,006 participants (59.19% women) in 2003 and 10,292 participants (59.42% women) in 2016. Logistic regression and odds ratios (ORs) with 95% confidence intervals (CIs) were calculated for diabetes by age, gender, educational level and place of residence. To identify vulnerable groups with high risk of developing diabetes in 2016, the method of p-value based regression tree analysis was applied using "wealth index" and "weight perception" as additional variables. RESULTS There was an increase in diabetes prevalence from 3.86% in 2003 to 4.46% in 2016. Women had more risk of developing diabetes at both time points (27% in 2003 and 24% in 2016 more risk). Increase in age and living in urban areas were associated with more risk of developing diabetes at both time points. There was no specific pattern regarding risk of developing diabetes and educational level in case of women. However, men who completed secondary school or had a higher diploma or above had more risk of developing diabetes in 2016 (OR = 2.24 and 4.67 respectively). Vulnerable groups who have higher risk of developing diabetes in 2016 were participants aged "60 years or older" with a wealth index of "rich" or "richer", followed by participants from the same age group who were "poor" or "poorer" and participants aged "40-59 years" with a wealth index of "rich" or "richer". Subsequently were participants from the age group "15-39 years" with a weight perception of "overweight" or "obese". CONCLUSION Diabetes prevalence increased in South Africa between 2003 and 2016. Main risk factors were age, gender and living in urban areas. Men with high educational level were more at risk of developing diabetes in 2016. Vulnerable groups in 2016 were participants 40 years and older, particularly with high SES. This was followed by younger participants who were obese or overweight.
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Idowu AO, Omosun YO, Igietseme JU, Azenabor AA. The COVID-19 pandemic in sub-Saharan Africa: The significance of presumed immune sufficiency. Afr J Lab Med 2023; 12:1964. [PMID: 36756213 PMCID: PMC9900247 DOI: 10.4102/ajlm.v12i1.1964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 10/24/2022] [Indexed: 02/04/2023] Open
Abstract
A novel coronavirus known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first reported in China in 2019 and later ignited a global pandemic. Contrary to expectations, the effect of the pandemic was not as devastating to Africa and its young population compared to the rest of the world. To provide insight into the possible reasons for the presumed immune sufficiency to coronavirus disease 2019 (COVID-19) in Africa, this review critically examines literature published from 2020 onwards on the dynamics of COVID-19 infection and immunity and how other prevalent infectious diseases in Africa might have influenced the outcome of COVID-19. Studies characterising the immune response in patients with COVID-19 show that the correlates of protection in infected individuals are T-cell responses against the SARS-CoV-2 spike protein and neutralising titres of immunoglobin G and immunoglobin A antibodies. In some other studies, substantial pre-existing T-cell reactivity to SARS-CoV-2 was detected in many people from diverse geographical locations without a history of exposure. Certain studies also suggest that innate immune memory, which offers protection against reinfection with the same or another pathogen, might influence the severity of COVID-19. In addition, an initial analysis of epidemiological data showed that COVID‑19 cases were not severe in some countries that implemented universal Bacillus Calmette-Guerin (BCG) vaccination policies, thus supporting the potential of BCG vaccination to boost innate immunity. The high burden of infectious diseases and the extensive vaccination campaigns previously conducted in Africa could have induced specific and non-specific protective immunity to infectious pathogens in Africans.
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Affiliation(s)
- Abel O Idowu
- Department of Pharmaceutical Microbiology and Biotechnology, Faculty of Pharmacy, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Yusuf O Omosun
- Department of Microbiology, Biochemistry and Immunology, Morehouse School of Medicine, Atlanta, Georgia, United States
| | - Joseph U Igietseme
- Department of Microbiology, Biochemistry and Immunology, Morehouse School of Medicine, Atlanta, Georgia, United States
- Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, United States
| | - Anthony A Azenabor
- Department of Pharmaceutical Microbiology and Biotechnology, Faculty of Pharmacy, College of Medicine, University of Lagos, Lagos, Nigeria
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Mtintsilana A, Craig A, Mapanga W, Dlamini SN, Norris SA. Association between socio-economic status and non-communicable disease risk in young adults from Kenya, South Africa, and the United Kingdom. Sci Rep 2023; 13:728. [PMID: 36639432 PMCID: PMC9839722 DOI: 10.1038/s41598-023-28013-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 01/11/2023] [Indexed: 01/15/2023] Open
Abstract
There is a pressing need for global health preventions to curb the escalating burden of non-communicable diseases (NCDs). Utilising multi-country study designs can improve our understanding of how socio-economic context shapes the aetiology of NCDs, and this has great potential to advance global health interventions. We examined the association between socio-economic status (SES) and NCD risk, and the potential confounding effects of smoking and alcohol intake in young adults (18-35-year-olds) from Kenya, South Africa (SA), and the United Kingdom (UK). Our study was a cross-sectional online survey that included 3000 respondents (n = 1000 per country, 50% women) conducted in April 2022. We utilised information on twelve NCDs to classify respondents as having "no condition", "one condition", and "multimorbidity" (having two or more conditions). A total household asset score was calculated and used as a proxy of SES, and subsequently categorised into quintiles (Q1-Q5; lowest-highest). Ordered logistic regression was used to test the associations between NCD risk and exposure variables. In the UK sample, we found that those in the second lowest SES quintile (Q2) had lower odds of developing NCDs than their lowest SES counterparts (Q1). In contrast, South African and Kenyan youth with a SES score between middle and highest quintiles (Q3-Q5) were more likely to develop NCDs than the lowest SES quintile group. In all countries, smoking and/or alcohol intake were associated with higher odds of developing NCDs, and showed some confounding effects on the SES-NCD relationships. Specifically, in Kenya, the risk of developing NCD was more than two times higher in those in the middle (Q3) SES group (OR 2.493; 95% CI 1.519-4.091; p < 0.001) compared to their lowest (Q1) SES counterparts. After adjusting for smoking and alcohol, the ORs of middle (Q3) SES group changed from 2.493 to 2.241 (1.360-3.721; p = 0.002). Overall, we found that the strength and direction of SES-NCD associations differed within and between countries. This study highlights how different SES contexts shape the risk of NCDs among young adults residing in countries at different levels of economic development.
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Affiliation(s)
- Asanda Mtintsilana
- SA MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Private Bag X3, Johannesburg, 2050, South Africa.
| | - Ashleigh Craig
- SA MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Private Bag X3, Johannesburg, 2050, South Africa
| | - Witness Mapanga
- SA MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Private Bag X3, Johannesburg, 2050, South Africa
- Noncommunicable Diseases Research Division, Wits Health Consortium (PTY) Ltd, Johannesburg, South Africa
| | - Siphiwe N Dlamini
- SA MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Private Bag X3, Johannesburg, 2050, South Africa
| | - Shane A Norris
- SA MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Private Bag X3, Johannesburg, 2050, South Africa
- DSI-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
- Global Health Research Institute, School of Human Development and Health, University of Southampton, Southampton, UK
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Sodium Content and Labelling of Packaged Foods and Beverages in Nigeria: A Cross-Sectional Study. Nutrients 2022; 15:nu15010027. [PMID: 36615685 PMCID: PMC9823880 DOI: 10.3390/nu15010027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 12/11/2022] [Accepted: 12/12/2022] [Indexed: 12/24/2022] Open
Abstract
Increased consumption of unhealthy processed foods, particularly those high in sodium, is a major risk factor for cardiovascular diseases. The nutrition information on packaged foods can help guide consumers toward products with less sodium and support government actions to improve the healthiness of the food supply. The aims of this study were to estimate the proportion of packaged foods displaying nutrition information for sodium and other nutrients specified by Nigerian nutrition labelling regulations and to determine the amount of sodium in packaged foods sold in Nigeria using data from the nutritional information panel. Data were collected from November 2020 to March 2021 from in-store surveys conducted in supermarkets in three states. A total of 7039 products were collected. Overall, 91.5% (n = 6439) provided only partial nutrition information, 7.0% (n = 495) provided no nutritional information, and only 1.5% (n = 105) displayed a nutrient declaration that included all nutrients specified by 2019 Nigerian regulations. Some form of sodium content information was displayed for 86% of all products (n = 6032), of which around 45% (n = 2689) expressed this as 'salt' and 59% (n = 3559) expressed this as 'sodium', while a small number of food products had both 'salt' and 'sodium' content (3.6%). Provision of sodium or salt information on the label varied between food categories, ranging from 50% (vitamins and supplements, n = 2/4) to 96% (convenience foods, n = 44/46). Food categories with the highest median sodium content were 'meat and meat alternatives' (904 mg/100 g), 'sauces, dressings, spreads, and dips' (560 mg/100 g), and 'snack foods' (536 mg/100 g), although wide variation was often observed within categories. These findings highlight considerable potential to improve the availability and consistency of nutrition information on packaged products in Nigeria and to introduce further policies to reduce the amount of sodium in the Nigerian food supply.
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Paikray E, Das P, Pattnaik M, Mishra V. Adverse Drug Reaction Monitoring in Multidrug-Resistant Tuberculosis Patients Receiving Bedaquiline and Delamanid-Based Regimen. Cureus 2022; 14:e30764. [DOI: 10.7759/cureus.30764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2022] [Indexed: 11/05/2022] Open
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Salih MH, Mekonnen H, Derseh L, Lindgren H, Erlandsson K. Anticipated stigma and associated factors among chronic illness patients in Amhara Region Referral Hospitals, Ethiopia: A multicenter cross-sectional study. PLoS One 2022; 17:e0273734. [PMID: 36107943 PMCID: PMC9477324 DOI: 10.1371/journal.pone.0273734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 08/14/2022] [Indexed: 11/18/2022] Open
Abstract
Background Anticipated stigma related to chronic illness patients undermines diagnosis, treatment, and successful health outcomes. The study aimed to assess the magnitude and factors associated with anticipated stigma among patients with chronic illness attending follow-up clinics in Amhara Region Referral Hospitals, Ethiopia. Methods A cross-sectional institution-based study was conducted in Amhara Region Referral Hospitals from 01 March to 15 April 2021. A simple random sampling technique was used to select the three Referral Hospitals in the region and study subjects. Data were collected using a pre-tested interview-based questionnaire. Data were entered and cleaned with Epi-Info version 6 and exported for analysis STATA version 14. Multiple linear regression was used to show the association between anticipated stigma and potential factors. Associations were measured using ß coefficients and were considered statistically significant if the p-value > 0.05. Results A total of 779 patients were included for analysis with a response rate of 97%. Their mean (Standard deviation) of anticipated stigma was estimated at 1.86 and 0.5, respectively. After running an assumption test for multiple linear regression; educational status, cigarette smoking, psychological distress, medication adherence, alcohol consumption, and social part of the quality of life were statically significantly associated with anticipated stigma. Conclusion and recommendation The result showed a high level of anticipated stigma reported among the participants. Emphasizing improving their social part of the quality of life, avoiding risky behaviors like alcohol consumption and cigarette smoking, access to health education for chronically ill patients, integrating mental health in all types of chronic disease, and developing strategies and protocols which will help to improve patient medication adherence to their prescribed medication will be crucial. This can provide a foundation for government andnon-governmental organizations, and researchers implementing evidence-based interventions and strategies on chronic care to address factors related to anticipated stigma.
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Affiliation(s)
- Mohammed Hassen Salih
- University of Gondar, College of Medicine and Health Sciences, School of Nursing, Gondar, Ethiopia
- * E-mail:
| | - Hussen Mekonnen
- Addis Ababa University, School of Nursing and Midwifery, College of Nursing and Midwifery, Addis Ababa, Ethiopia
| | - Lema Derseh
- University of Gondar, College of Medicine and Health Sciences, Institute of Public Health, Gondar, Ethiopia
| | - Helena Lindgren
- Department of Women’s and Children’s Health, Karolinska Institute, Solna, Sweden
| | - Kerstin Erlandsson
- Department of Women and Children’s Health, Karolinska Institute, Karolinska Institutet, Solna and School of Health and Welfare, Dalarna University, Falun, Sweden
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Rahman MM, Alam K. Effects of globalization, energy consumption and ICT on health status in Australia: the role of financial development and education. BMC Public Health 2022; 22:1565. [PMID: 35978423 PMCID: PMC9382624 DOI: 10.1186/s12889-022-13911-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 07/28/2022] [Indexed: 11/29/2022] Open
Abstract
Background The outbreak of COVID-19 has alerted governments around the world, including Australia, to think seriously about the health issues. Life expectancy is one of such issues. Therefore, this study tries to reveal the effects of globalization, energy consumption, information and communication technology, financial development, education rate, and economic growth on life expectancy at birth in Australia. Methods Using the data period of 1990–2018, a series of econometric techniques: the Dickey-Fuller generalized least square test, Autoregressive Distributive Lag bounds test, fully modified ordinary least square method and the pairwise Granger causality test, are applied. Results The findings disclose that globalization, renewable energy use, information and communication technology, per capita gross domestic product, education rate, and financial development increased during this period but non-renewable energy use reduced life expectancy at birth. Unidirectional causal associations of the studied variables with life expectancy at birth are also revealed. Conclusions All the outcomes are relevant and useful for articulating an innovative policy in the health sector. The prime policy implication of this work is: the effective, efficient, and inclusive policies considering globalization, renewable and non-renewable energy consumption, information and communication technology, financial development, education rate, and economic growth should be formulated and executed for guaranteeing health status.
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Affiliation(s)
| | - Khosrul Alam
- Department of Economics, Bangabandhu Sheikh Mujibur Rahman Science and Technology University, Gopalganj, 8100, Bangladesh.
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Bassil DT, Farrell MT, Wagner RG, Brickman AM, Glymour MM, Langa KM, Manly JJ, Salinas J, Tipping B, Tollman S, Berkman LF. Cohort Profile Update: Cognition and dementia in the Health and Aging in Africa Longitudinal Study of an INDEPTH community in South Africa (HAALSI dementia). Int J Epidemiol 2022; 51:e217-e226. [PMID: 34871405 PMCID: PMC9365629 DOI: 10.1093/ije/dyab250] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 11/16/2021] [Indexed: 11/12/2022] Open
Affiliation(s)
- Darina T Bassil
- Harvard Center for Population and Development Studies, Harvard University, Cambridge, MA, USA
| | - Meagan T Farrell
- Harvard Center for Population and Development Studies, Harvard University, Cambridge, MA, USA
| | - Ryan G Wagner
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Adam M Brickman
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
- Gertrude H. Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - M Maria Glymour
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Kenneth M Langa
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
- Veterans Affairs Center for Clinical Management Research, Ann Arbor, MI, USA
| | - Jennifer J Manly
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
- Gertrude H. Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Joel Salinas
- Department of Neurology, New York University Grossman School of Medicine, New York, NY, USA
| | - Brent Tipping
- Division of Geriatric Medicine, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Stephen Tollman
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Lisa F Berkman
- Harvard Center for Population and Development Studies, Harvard University, Cambridge, MA, USA
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Hennein R, Ggita J, Ssuna B, Shelley D, Akiteng AR, Davis JL, Katamba A, Armstrong-Hough M. Implementation, interrupted: Identifying and leveraging factors that sustain after a programme interruption. Glob Public Health 2022; 17:1868-1882. [PMID: 34775913 PMCID: PMC10570963 DOI: 10.1080/17441692.2021.2003838] [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: 03/26/2021] [Accepted: 10/27/2021] [Indexed: 10/19/2022]
Abstract
Many implementation efforts experience interruptions, especially in settings with developing health systems. Approaches for evaluating interruptions are needed to inform re-implementation strategies. We sought to devise an approach for evaluating interruptions by exploring the sustainability of a programme that implemented diabetes mellitus (DM) screening within tuberculosis clinics in Uganda in 2017. In 2019, we conducted nine interviews with clinic staff and observed clinic visits to determine their views and practices on providing integrated care. We mapped themes to a social ecological model with three levels derived from the Consolidated Framework for Implementation Research (CFIR): outer setting (i.e. community), inner setting (i.e. clinic), and individuals (i.e. clinicians). Respondents explained that DM screening ceased due to disruptions in the national supply chain for glucose test strips, which had cascading effects on clinics and clinicians. Lack of screening supplies in clinics limited clinicians' opportunities to perform DM screening, which contributed to diminished self-efficacy. However, culture, compatibility and clinicians' beliefs about DM screening sustained throughout the interruption. We propose an approach for evaluating interruptions using the CFIR and social ecological model; other programmes can adapt this approach to identify cascading effects of interruptions and target them for re-implementation.
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Affiliation(s)
- Rachel Hennein
- Uganda Tuberculosis Implementation Research Consortium, Makerere University, Kampala, Uganda
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, United States
- Yale School of Medicine, New Haven, Connecticut, United States
| | - Joseph Ggita
- Uganda Tuberculosis Implementation Research Consortium, Makerere University, Kampala, Uganda
| | - Bashir Ssuna
- Uganda Tuberculosis Implementation Research Consortium, Makerere University, Kampala, Uganda
| | - Donna Shelley
- Department of Public Health Policy and Management, New York University, New York, New York, United States
| | - Ann R. Akiteng
- Uganda Initiative for Integrated Management of Non-Communicable Diseases, Upper Mulago Hill, Kampala, Uganda
| | - J. Lucian Davis
- Uganda Tuberculosis Implementation Research Consortium, Makerere University, Kampala, Uganda
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, United States
- Pulmonary, Critical Care, and Sleep Medicine Section, Yale School of Medicine, New Haven, Connecticut, United States
- Center for Methods in Implementation and Prevention Science, Yale School of Public Health, New Haven, Connecticut, United States
| | - Achilles Katamba
- Uganda Tuberculosis Implementation Research Consortium, Makerere University, Kampala, Uganda
- Clinical Epidemiology and Biostatistics Unit, Department of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Mari Armstrong-Hough
- Uganda Tuberculosis Implementation Research Consortium, Makerere University, Kampala, Uganda
- Department of Social and Behavioral Sciences, New York University, New York, NY
- Department of Epidemiology, New York University, New York, New York, United States
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Rahman MM, Alam K, Khanam R. Socio-economic factors affecting high infant and child mortality rates in selected African countries: does globalisation play any role? Global Health 2022; 18:69. [PMID: 35799303 PMCID: PMC9261177 DOI: 10.1186/s12992-022-00855-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 06/08/2022] [Indexed: 11/14/2022] Open
Abstract
Background Despite the declining trends worldwide, infant and child mortality rates are still high in many African countries. These high rates are problematic; therefore, this study attempts to explore the contributing factors that cause high infant and child mortality rates in 14 African countries using panel data for the period of 2000–2018. In particular, the role globalisation is explored. Methods The panel corrected standard error (PCSE), the Feasible generalized least square (FGLS) models, and the pair-wise Granger causality test have been applied as methodological approaches. Results The public health expenditure, numbers of physicians, globalization, economic development, education, good governance, and HIV prevalence rate have been revealed as the determinants of infant and child mortality in these countries. All these variables except the HIV prevalence rate negatively affect the infant and child mortality rates, while the HIV prevalence rate is found to be positive. Bidirectional and unidirectional causal relationships between the variables are also attained. Conclusions Effective socio-economic policy priority with due consideration of globalization should be emphasized to reduce infant and child mortality rates in these countries.
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Affiliation(s)
- Mohammad Mafizur Rahman
- School of Business, Centre for Health Research, University of Southern Queensland, Toowoomba, Australia
| | - Khosrul Alam
- Department of Economics, Bangabandhu Sheikh Mujibur Rahman Science and Technology University, Gopalganj, 8100, Bangladesh.
| | - Rasheda Khanam
- School of Business, Centre for Health Research, University of Southern Queensland, Toowoomba, Australia
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Yanda Tongo S, Longo-Mbenza B, Molua Aundu A, Gombet R, Makulo Risasi JR, Kisoka Lusunsi C, Mawalala Malengele H, Nge Okwe A. Are Any Changes in Carotid Intima–Media Thickness Associated with Cardiometabolic Risk Among Adult Bantu Central African Hypertensive Patients from Monkole and Biamba Marie Mutombo Hospitals? Vasc Health Risk Manag 2022; 18:453-461. [PMID: 35800291 PMCID: PMC9255902 DOI: 10.2147/vhrm.s366339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 06/13/2022] [Indexed: 11/23/2022] Open
Abstract
Background Several classic/traditional risk factors are associated with intima–media thickness (IMT), a novel risk of cardio metabolic risk (CMR) in the literature but not in Kinshasa, a megacity prone to CMR. Thus, the objective of this study was to evaluate potential correlations between inflammation, kidney function, psychological stress, hemodynamics, and changes in IMT. Methods This cross-sectional study was carried out between 2018 and 2021 within Monkole and Biamba Marie Mutombo Hospitals, respectively, and randomly selected from 10 health structures from East and West of Kinshasa, Capital of Democratic Republic Congo (DRC). A random sample of adult hypertensive Bantu Central Africans was examined after bivariate correlations and multiple linear regression. Results Out of 280 patients with 140 men and 140 women aged 62 ± 11 years, the mean carotid intima–media thickness (CIMT) was 1.06 ± 0.5 mm and 73% (n = 204) patients had uncontrolled hypertension. After controlling for confounders, 52.9% variations (R2) of CIMT were independently and significantly (P = 0.037) predicted by CRP, 24-hour proteinuria, urinary albumin/creatinine ratio, duration of hypertension, heart rate, hip circumference, and psychological stress with Equation Y = 0.717 + 0.87 × CRP + 0.02 × 24 H – proteinuria + 0.005 × urinary albumin/creatinine ratio + 0.05 × duration of hypertension + 0.001 × heart rate + 0.006 × hip circumference + 0.017 × psychological stress. Conclusion There is an urgent need to control inflammation, impaired renal function, cardiac rhythm, peripheral obesity, longer duration of hypertension management, and stress, which are emerging as specific novel determinants of the subclinical atherosclerosis for those Bantu Central African hypertensive patients.
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Affiliation(s)
- Stéphane Yanda Tongo
- Radiology Service, Cliniques Universitaires de Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Benjamin Longo-Mbenza
- Cardiology Service, Cliniques Universitaires de Kinshasa, Kinshasa, Democratic Republic of Congo
- Department of Public Health, Lomo University for Research, Kinshasa, Democratic Republic of Congo
- Correspondence: Benjamin Longo-Mbenza, Faculty of Health Science, Private Bay XI, Mthatha, Eastern Cape, 5117, South Africa, Tel +243 814396257, Email
| | - Antoine Molua Aundu
- Radiology Service, Cliniques Universitaires de Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Raoul Gombet
- Marien Ngouabi University, Brazzaville, Democratic Republic of Congo
| | | | - Christian Kisoka Lusunsi
- Department of Public Health, Lomo University for Research, Kinshasa, Democratic Republic of Congo
| | | | - Augustin Nge Okwe
- Department of Public Health, Lomo University for Research, Kinshasa, Democratic Republic of Congo
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Health-Related Quality of Life of HIV Positive Patients with Hypertension: Is There an Association with Blood Pressure Control? High Blood Press Cardiovasc Prev 2022; 29:393-400. [PMID: 35723847 PMCID: PMC9207838 DOI: 10.1007/s40292-022-00527-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 05/19/2022] [Indexed: 10/29/2022] Open
Abstract
INTRODUCTION The presence of comorbidities could affect the health-related quality of life (HRQoL) of people living with HIV (PLHIV). AIM To assess the HRQoL of PLHIV and Hypertension, as well as its association with blood pressure (BP) control. METHODS This cross-sectional study was conducted in the HIV clinic of the University of Uyo Teaching Hospial in Akwa Ibom State, Nigeria, between August and October 2018. The EQ-5D-5L was administered to 201 eligible outpatients in the waiting area of the clinic before consulting the physician. Patients' socio-demographic and clinical data were obtained from the medical records. Blood pressure was measured using an automatic BP monitor. Data were analyzed with SPSS version 20.0. RESULTS Majority (58.6%) of the respondents were females; mean age was 49.59 ± 8.97 years; mean systolic and diastolic BP were 152.77 ± 19.38 mmHg and 90.28 ± 11.33 mmHg, respectively. EQ-VAS and EQ-5D index scores were 80.99 ± 15.97 and 0.86 ± 0.05, respectively. There were no significant differences in EQ-VAS score (z = - 0.113, p = 0.910) or EQ-5D utility (z = - 0.523, p = 0.601) between participants with controlled and uncontrolled BP. Duration on antihypertensive drugs was associated with EQ-VAS score (χ2(2) = 6.558, p = 0.038), while employment status was associated with EQ-5D utility (z = - 2.661, p = 0.008). CONCLUSIONS PLHIV and hypertension accessing care at a Nigerian hospital reported a high HRQoL, irrespective of BP control status. Nevertheless, there is a need to provide psychological support and employment for this population to maximise their HRQoL.
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Jackson IL, Lawrence SM, Igwe CN, Ukwe CV, Okonta MJ. Prevalence and control of hypertension among people living with HIV receiving care at a Nigerian hospital. Pan Afr Med J 2022; 41:153. [PMID: 35573426 PMCID: PMC9058987 DOI: 10.11604/pamj.2022.41.153.21809] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Accepted: 11/27/2021] [Indexed: 12/04/2022] Open
Abstract
INTRODUCTION with the introduction of newer and safer antiretroviral drugs, HIV positive persons are now living longer. Consequently, cardiovascular diseases associated with ageing and chronic low grade inflammation due to the presence of the virus are increasingly found in this population. This study aimed to assess the prevalence and control of hypertension among people living with HIV (PLHIV) receiving care at a Nigerian hospital. METHODS this cross-sectional study was conducted as part of the Patient´s HIV Knowledge Questionnaire (PHKQ) validation study among HIV positive outpatients at the University of Uyo Teaching Hospital, Uyo, Akwa Ibom State, Nigeria. Hypertension was self-reported and confirmed by a documented physician diagnosis in the patient´s case notes and/or self-reported use of antihypertensive medication. For each participant, the average of two close blood pressure (BP) measurements obtained using an automatic upper arm BP monitor was taken as the BP. Hypertension control was defined as SBP <140 mmHg and DBP <90 mmHg. Data were analysed using the Statistical Product and Service Solutions (SPSS) v.21.0. Results were considered significant at p < 0.05. RESULTS prevalence of hypertension among PLHIV was 24.9%. Age (OR = 1.112, CI = 1.074 - 1.151, p < 0.001), body mass index (OR = 1.087, CI = 1.024 - 1.154, p = 0.004) and duration on antiretroviral therapy (OR = 1.169, CI = 1.090 - 1.254, p < 0.001) significantly predicted hypertension. Only 19 (24.4%) participants had controlled hypertension. CONCLUSION hypertension is common among PLHIV seeking care at a Nigerian hospital. However, its control remains suboptimal. Regular screening for hypertension, its appropriate treatment and optimal control are essential in PLHIV.
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Affiliation(s)
- Idongesit Linus Jackson
- Department of Clinical Pharmacy and Biopharmacy, University of Uyo, Akwa Ibom State, Nigeria,,Corresponding author: Idongesit Linus Jackson, Department of Clinical Pharmacy and Biopharmacy, University of Uyo, Akwa Ibom State, Nigeria.
| | | | - Chioma Nneoma Igwe
- Department of Clinical Pharmacy and Biopharmacy, University of Uyo, Akwa Ibom State, Nigeria
| | - Chinwe Victoria Ukwe
- Department of Clinical Pharmacy and Pharmacy Management, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Matthew Jegbefume Okonta
- Department of Clinical Pharmacy and Pharmacy Management, University of Nigeria, Nsukka, Enugu State, Nigeria
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Tepekule B, Kusejko K, Zeeb M, Tarr PE, Calmy A, Battegay M, Furrer H, Cavassini M, Bernasconi E, Notter J, Günthard HF, Nemeth J, Kouyos RD. Impact of Latent Tuberculosis Infection on the Incidence of Type 2 Diabetes Mellitus in HIV-Infected Participants in the Swiss HIV Cohort Study. J Infect Dis 2022; 225:2229-2234. [PMID: 35172332 DOI: 10.1093/infdis/jiac054] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 02/14/2022] [Indexed: 11/13/2022] Open
Abstract
While an increased risk of active and latent tuberculosis infection (LTBI) in people with type-2 diabetes (DM) has been demonstrated, it is less well characterized whether LTBI is associated with an increased risk of developing DM. We investigated the link between LTBI and DM in people living with HIV (PHIV) in the Swiss HIV Cohort Study via time-dependent cox proportional hazards models. We found that LTBI significantly increased the risk of developing DM (HR=1.47), which was robust across different adjustment and censoring techniques. Our results thus suggest that LTBI may be associated with an increased risk of developing DM.
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Affiliation(s)
- Burcu Tepekule
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Switzerland.,Institute of Medical Virology, University of Zurich, Switzerland
| | - Katharina Kusejko
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Switzerland.,Institute of Medical Virology, University of Zurich, Switzerland
| | - Marius Zeeb
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Switzerland.,Institute of Medical Virology, University of Zurich, Switzerland
| | - Philip E Tarr
- Department of Medicine and Division of Infectious Diseases and Hospital Epidemiology, Kantonsspital Baselland, University of Basel, Bruderholz, Switzerland
| | - Alexandra Calmy
- Division of Infectious Diseases, University Hospital Geneva, University of Geneva, Geneva, Switzerland
| | - Manuel Battegay
- Division of Infectious Diseases & Hospital Hygiene, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Hansjakob Furrer
- Department of Infectious Diseases, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Matthias Cavassini
- Division of Infectious Diseases, University Hospital, Lausanne, Switzerland
| | - Enos Bernasconi
- Division of Infectious Diseases, Regional Hospital Lugano, Lugano, Switzerland
| | - Julia Notter
- Cantonal Hospital St Gallen, Division of Infectious Diseases and Hospital Epidemiology, St Gallen, Switzerland
| | - Huldrych F Günthard
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Switzerland
| | - Johannes Nemeth
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Switzerland
| | - Roger D Kouyos
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Switzerland.,Institute of Medical Virology, University of Zurich, Switzerland
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Obels I, Ninsiima S, Critchley JA, Huangfu P. Tuberculosis risk among people with diabetes mellitus in Sub-Saharan Africa: a systematic review. Trop Med Int Health 2022; 27:369-386. [PMID: 35146851 PMCID: PMC9303199 DOI: 10.1111/tmi.13733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Objectives People with diabetes mellitus (DM) have a higher tuberculosis (TB) risk, but the evidence from sub‐Saharan Africa (SSA) was scarce until recently and not included in earlier global summaries. Therefore, this systematic review aims to determine the risk of active TB disease among people with DM in SSA and whether HIV alters this association. Methods Medline, Embase, CINAHL, Web of Science, Global Health and African Index Medicus were searched between January 1980 and February 2021. Cohort, case‐control and cross‐sectional studies from SSA, which assessed the association between DM and active TB, were included if adjusted for age. Two researchers independently assessed titles, abstracts, full texts, extracted data and assessed the risk of bias. Estimates for the association between DM and TB were summarised using a random effects meta‐analysis. PROSPERO: CRD42021241743. Results Nine eligible studies were identified, which reported on 110,905 people from 5 countries. Individual study odds ratios (OR) of the TB–DM association ranged from 0.88 (95% CI 0.17–4.58) to 10.7 (95% CI 4.5–26). The pooled OR was 2.77 (95% CI 1.90–4.05). High heterogeneity was reduced in sensitivity analysis (from I2 = 57% to I2 = 6.9%), by excluding one study which ascertained DM by HbA1c. Risk of bias varied widely between studies, especially concerning the way in which DM status was determined. Conclusions There is a strong positive association between DM and active TB in SSA. More research is needed to determine whether HIV, a key risk factor for TB in SSA, modifies this relationship.
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Affiliation(s)
- Ilja Obels
- Master's student Biomedical Sciences, Radboud University Nijmegen, The Netherlands
| | - Sandra Ninsiima
- Makerere University College of Health Sciences, Kampala, Uganda
| | - Julia A Critchley
- Population Health Research Institute, St George's, University of London, UK
| | - Peijue Huangfu
- Population Health Research Institute, St George's, University of London, UK
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Awad SF, Critchley JA, Abu-Raddad LJ. Impact of diabetes mellitus on tuberculosis epidemiology in Indonesia: A mathematical modeling analysis. Tuberculosis (Edinb) 2022; 134:102164. [DOI: 10.1016/j.tube.2022.102164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 11/14/2021] [Accepted: 01/06/2022] [Indexed: 01/03/2023]
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Allali I, Abotsi RE, Tow LA, Thabane L, Zar HJ, Mulder NM, Nicol MP. Human microbiota research in Africa: a systematic review reveals gaps and priorities for future research. MICROBIOME 2021; 9:241. [PMID: 34911583 PMCID: PMC8672519 DOI: 10.1186/s40168-021-01195-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 11/14/2021] [Indexed: 05/11/2023]
Abstract
BACKGROUND The role of the human microbiome in health and disease is an emerging and important area of research; however, there is a concern that African populations are under-represented in human microbiome studies. We, therefore, conducted a systematic survey of African human microbiome studies to provide an overview and identify research gaps. Our secondary objectives were: (i) to determine the number of peer-reviewed publications; (ii) to identify the extent to which the researches focused on diseases identified by the World Health Organization [WHO] State of Health in the African Region Report as being the leading causes of morbidity and mortality in 2018; (iii) to describe the extent and pattern of collaborations between researchers in Africa and the rest of the world; and (iv) to identify leadership and funders of the studies. METHODOLOGY We systematically searched Medline via PubMed, Scopus, CINAHL, Academic Search Premier, Africa-Wide Information through EBSCOhost, and Web of Science from inception through to 1st April 2020. We included studies that characterized samples from African populations using next-generation sequencing approaches. Two reviewers independently conducted the literature search, title and abstract, and full-text screening, as well as data extraction. RESULTS We included 168 studies out of 5515 records retrieved. Most studies were published in PLoS One (13%; 22/168), and samples were collected from 33 of the 54 African countries. The country where most studies were conducted was South Africa (27/168), followed by Kenya (23/168) and Uganda (18/168). 26.8% (45/168) focused on diseases of significant public health concern in Africa. Collaboration between scientists from the United States of America and Africa was most common (96/168). The first and/or last authors of 79.8% of studies were not affiliated with institutions in Africa. Major funders were the United States of America National Institutes of Health (45.2%; 76/168), Bill and Melinda Gates Foundation (17.8%; 30/168), and the European Union (11.9%; 20/168). CONCLUSIONS There are significant gaps in microbiome research in Africa, especially those focusing on diseases of public health importance. There is a need for local leadership, capacity building, intra-continental collaboration, and national government investment in microbiome research within Africa. Video Abstract.
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Affiliation(s)
- Imane Allali
- Computational Biology Division, Department of Integrative Biomedical Sciences, University of Cape Town, Cape Town, South Africa
- Laboratory of Human Pathologies Biology, Department of Biology, Faculty of Sciences, and Genomic Centre of Human Pathologies, Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Rabat, Morocco
- Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Regina E Abotsi
- Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- Department of Molecular and Cell Biology, Faculty of Science, University of Cape Town, Cape Town, South Africa
- Department of Pharmaceutical Microbiology, School of Pharmacy, University of Health and Allied Sciences, Ho, Ghana
| | - Lemese Ah Tow
- Division of Medical Microbiology, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Lehana Thabane
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Biostatistics Unit, Father Sean O'Sullivan Research Centre, St Joseph's Healthcare, Hamilton, Ontario, Canada
- Departments of Paediatrics and Anaesthesia, McMaster University, Hamilton, Ontario, Canada
- Centre for Evaluation of Medicine, St Joseph's Healthcare, Hamilton, Ontario, Canada
- Population Health Research Institute, Hamilton Health Sciences, Hamilton, Ontario, Canada
- Centre for Evidence-based Health Care, Faculty of Health Sciences, Stellenbosch University, Tygerberg, South Africa
- Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Heather J Zar
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, Cape Town, South Africa
- MRC Unit on Child & Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - Nicola M Mulder
- Computational Biology Division, Department of Integrative Biomedical Sciences, University of Cape Town, Cape Town, South Africa
- Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Mark P Nicol
- Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
- Division of Medical Microbiology, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
- School of Biomedical Sciences, University of Western Australia, M504, Perth, WA, 6009, Australia.
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Foe-Essomba JR, Kenmoe S, Tchatchouang S, Ebogo-Belobo JT, Mbaga DS, Kengne-Ndé C, Mahamat G, Kame-Ngasse GI, Noura EA, Mbongue Mikangue CA, Feudjio AF, Taya-Fokou JB, Touangnou-Chamda SA, Nayang-Mundo RA, Nyebe I, Magoudjou-Pekam JN, Yéngué JF, Djukouo LG, Demeni Emoh CP, Tazokong HR, Bowo-Ngandji A, Lontchi-Yimagou E, Kaiyven AL, Donkeng Donfack VF, Njouom R, Mbanya JC, Mbacham WF, Eyangoh S. Diabetes mellitus and tuberculosis, a systematic review and meta-analysis with sensitivity analysis for studies comparable for confounders. PLoS One 2021; 16:e0261246. [PMID: 34890419 PMCID: PMC8664214 DOI: 10.1371/journal.pone.0261246] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 11/28/2021] [Indexed: 11/22/2022] Open
Abstract
Introduction Meta-analyses conducted so far on the association between diabetes mellitus (DM) and the tuberculosis (TB) development risk did not sufficiently take confounders into account in their estimates. The objective of this systematic review was to determine whether DM is associated with an increased risk of developing TB with a sensitivity analyses incorporating a wider range of confounders including age, gender, alcohol consumption, smoke exposure, and other comorbidities. Methods Pubmed, Embase, Web of Science and Global Index Medicus were queried from inception until October 2020. Without any restriction to time of study, geographical location, and DM and TB diagnosis approaches, all observational studies that presented data for associations between DM and TB were included. Studies with no abstract or complete text, duplicates, and studies with wrong designs (review, case report, case series, comment on an article, and editorial) or populations were excluded. The odds ratios (OR) and their 95% confidence intervals were estimated by a random-effect model. Results The electronic and manual searches yielded 12,796 articles of which 47 were used in our study (23 case control, 14 cross-sectional and 10 cohort studies) involving 503,760 cases (DM or TB patients) and 3,596,845 controls. The size of the combined effect of TB risk in the presence of DM was OR = 2.3, 95% CI = [2.0–2.7], I2 = 94.2%. This statistically significant association was maintained in cohort (OR = 2.0, CI 95% = [1.5–2.4], I2 = 94.3%), case control (OR = 2.4, CI 95% = [2.0–2.9], I2 = 93.0%) and cross-sectional studies (OR = 2.5, CI 95% = [1.8–3.5], I2 = 95.2%). The association between DM and TB was also maintained in the sensitivity analysis including only studies with similar proportions of confounders between cases and controls. The substantial heterogeneity observed was mainly explained by the differences between geographic regions. Conclusions DM is associated with an increased risk of developing latent and active TB. To further explore the role of DM in the development of TB, more investigations of the biological mechanisms by which DM increases the risk of TB are needed. Review registration PROSPERO, CRD42021216815.
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Affiliation(s)
- Joseph Rodrigue Foe-Essomba
- Camdiagnostic, Ministry of Scientific Research and Innovation, Yaounde, Cameroon
- Faculty of Medicine and Biomedical Sciences, The University of Yaounde I, Yaounde, Cameroon
- Department of Mycobacteriology, Centre Pasteur of Cameroon, Yaounde, Cameroon
| | - Sebastien Kenmoe
- Virology Department, Centre Pasteur of Cameroon, Yaounde, Cameroon
| | | | - Jean Thierry Ebogo-Belobo
- Medical Research Centre, Institute of Medical Research and Medicinal Plants Studies, Yaounde, Cameroon
| | | | - Cyprien Kengne-Ndé
- Evaluation and Research Unit, National AIDS Control Committee, Yaounde, Cameroon
| | - Gadji Mahamat
- Department of Microbiology, The University of Yaounde I, Yaounde, Cameroon
| | - Ginette Irma Kame-Ngasse
- Medical Research Centre, Institute of Medical Research and Medicinal Plants Studies, Yaounde, Cameroon
| | - Efietngab Atembeh Noura
- Medical Research Centre, Institute of Medical Research and Medicinal Plants Studies, Yaounde, Cameroon
| | | | | | | | | | | | - Inès Nyebe
- Department of Microbiology, The University of Yaounde I, Yaounde, Cameroon
| | | | | | | | | | | | - Arnol Bowo-Ngandji
- Department of Microbiology, The University of Yaounde I, Yaounde, Cameroon
| | - Eric Lontchi-Yimagou
- Laboratory for Molecular Medicine and Metabolism, The University of Yaounde I, Yaounde, Cameroon
| | - Afi Leslie Kaiyven
- Institute of Biomedical and Clinical Research, University of Exeter, Exeter, United Kingdom
| | | | - Richard Njouom
- Virology Department, Centre Pasteur of Cameroon, Yaounde, Cameroon
| | - Jean Claude Mbanya
- Laboratory for Molecular Medicine and Metabolism, The University of Yaounde I, Yaounde, Cameroon
| | | | - Sara Eyangoh
- Department of Mycobacteriology, Centre Pasteur of Cameroon, Yaounde, Cameroon
- * E-mail:
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van der Heijden TGW, Chilunga FP, Meeks KAC, Addo J, Danquah I, Beune EJ, Bahendeka SK, Klipstein-Grobusch K, Mockenhaupt FP, Waltz MM, Agyemang C. The Magnitude and Directions of the Associations between Early Life Factors and Metabolic Syndrome Differ across Geographical Locations among Migrant and Non-Migrant Ghanaians-The RODAM Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182211996. [PMID: 34831754 PMCID: PMC8622143 DOI: 10.3390/ijerph182211996] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 11/05/2021] [Accepted: 11/10/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Early-life factors (ELFs) such as childhood nutrition and childhood socio-economic status could be the drivers of the increase in metabolic syndrome (MetSyn) among African populations, but data are lacking. This study evaluated whether markers of childhood nutritional status and childhood socio-economic status were associated with MetSyn in adulthood among migrant Ghanaians living in Europe and non-migrant Ghanaians living in Ghana. METHODS Data from the Research on Obesity and Diabetes among African Migrants (RODAM) study, involving 2008 migrants and 2320 non-migrants aged ≥25 years, were analysed for this study. We used leg-length to height ratio (LHR), which is an anthropometric marker of childhood nutritional status, and parental education, which is a marker of childhood socio-economic status, as proxies. Adjusted odds ratios (AOR) and 95% confidence intervals (95% CI) were calculated by logistic regression with adjustments for demographic and lifestyle factors. RESULTS Parental education was higher among Ghanaians in Europe than among residents in rural and urban Ghana. The prevalence of MetSyn was 18.5%, 27.7% and 33.5% for rural, urban, and migrant residents, respectively. LHR was inversely associated with MetSyn among migrants. Compared with high paternal education, individuals with low paternal education had lower odds of MetSyn in migrants (AOR 0.71 95% CI 0.54-0.94). In contrast, compared with high maternal education, individuals with intermediate maternal education had higher odds of MetSyn in urban Ghanaians (AOR 4.53 95% CI 1.50-3.74). No associations were found among rural Ghanaians. CONCLUSION The magnitude and direction of the associations between ELFs and MetSyn differ across geographical locations. Intermediate maternal education was positively associated with MetSyn among urban Ghanaians, while LHR and low paternal education were inversely associated with MetSyn among migrant Ghanaians. Further research into the interplay of genetics, environment and behaviour is needed to elucidate the underlying pathological mechanisms of MetSyn amongst migrants.
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Affiliation(s)
- Thijs G. W. van der Heijden
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam University Medical Center, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands; (F.P.C.); (E.J.B.); (C.A.)
- Correspondence:
| | - Felix P. Chilunga
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam University Medical Center, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands; (F.P.C.); (E.J.B.); (C.A.)
| | - Karlijn A. C. Meeks
- Center for Research on Genomics & Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD 20894, USA;
| | - Juliet Addo
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK;
| | - Ina Danquah
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, 69120 Heidelberg, Germany;
| | - Erik J. Beune
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam University Medical Center, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands; (F.P.C.); (E.J.B.); (C.A.)
| | - Silver K. Bahendeka
- Mother Kevin Postgraduate Medical School (MKPGMS), Uganda Martyrs University, Kampala 32297, Uganda;
| | - Kerstin Klipstein-Grobusch
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Centre, Utrecht University, 3584 CG Utrecht, The Netherlands;
- Division of Epidemiology and Biostatistics, Department of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2193, South Africa
| | - Frank P. Mockenhaupt
- Institute of Tropical Medicine and International Health, Charité-University Medicine Berlin, 13353 Berlin, Germany;
| | - Mitzi M. Waltz
- Athena Institute, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands;
| | - Charles Agyemang
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam University Medical Center, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands; (F.P.C.); (E.J.B.); (C.A.)
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Mabula PL, Kazinyingia KI, Chavala EC, Mosha V, Msuya SE, Leyaro BJ. Prevalence and risk factors for diabetes mellitus among tuberculosis patients in Moshi Municipal Council, Kilimanjaro Tanzania. East Afr Health Res J 2021; 5:69-74. [PMID: 34308247 PMCID: PMC8291211 DOI: 10.24248/eahrj.v5i1.653] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Accepted: 05/20/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Diabetes Mellitus (DM) is a worldwide public health problem and its prevalence has been rising rapidly in low and middle income countries (LMICs) including Tanzania. According to WHO report 2015, DM is ranked number six as a leading cause of death worldwide. Strong evidence suggests that DM may be associated with Tuberculosis (TB) and could affect TB treatment outcomes. Tanzania is among the 22 countries that have a high burden of TB and currently facing increased epidemic of DM. The increasing diabetes prevalence may be a threat to TB control and counteract strategies to end TB by 2030 as proposed by WHO. OBJECTIVE To determine proportion of TB patients who are co-infected with DM in Moshi municipal council, Kilimanjaro Tanzania. METHODOLOGY This study was a hospital based cross-sectional study conducted in April to July 2018 at 4 health facilities; Mawenzi Regional Referral hospital, St. Joseph District Designated hospital, Pasua Health center and Majengo Health centre in Moshi municipal. The study included adults aged 18 years and above attending either of the 4 health facilities for TB care. The study included newly diagnosed and those who were on TB treatment. Interviews were conducted followed by blood glucose testing. Data was entered and analysed using SPSS. RESULTS A total of 153 TB patients were enrolled, their mean age was 42.5 (±14.75) years and 46 (30.1%) were females. The prevalence of DM among TB patients in this study was 9.2%. Factors associated with TB-DM comorbidity were: age (OR 4.43, 95% CI: 1.18-16.55), HIV status (OR 3.88, 95% CI: 1.06-14.11), and family history of DM (OR 6.50, 95% CI 0.67-25.56). CONCLUSION One in ten patients with TB had confirmed DM. There is a need for future studies to assess if DM influences TB treatment and outcomes in this setting.
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Affiliation(s)
- Patrick L. Mabula
- Kilimanjaro Christian Medical University College (KCMUCo), Tanzania
- Kilimanjaro Christian Medical Centre (KCMC), Moshi, Tanzania
| | | | | | - Victor Mosha
- Department of Community Health, Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Sia E. Msuya
- Department of Community Health, Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania
- Department of Epidemiology and Biostatistics, Institute of Public Health, Kilimanjaro Christian Medical University College (KCMUCo), Tanzania
- Community Health Department, Kilimanjaro Christian Medical Centre (KCMC), Moshi, Tanzania
| | - Beatrice John Leyaro
- Department of Epidemiology and Biostatistics, Institute of Public Health, Kilimanjaro Christian Medical University College (KCMUCo), Tanzania
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Gottlieb-Stroh T, Souares A, Bärnighausen T, Sié A, Zabre SP, Danquah I. Seasonal and socio-demographic patterns of self-reporting major disease groups in north-west Burkina Faso: an analysis of the Nouna Health and Demographic Surveillance System (HDSS) data. BMC Public Health 2021; 21:1101. [PMID: 34107895 PMCID: PMC8191198 DOI: 10.1186/s12889-021-11076-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 05/17/2021] [Indexed: 11/19/2022] Open
Abstract
Background Sub-Saharan Africa (SSA) is facing a rapid growth of non-communicable diseases (NCDs), while communicable diseases still prevail. For rural SSA, evidence for this development is scarce. We aimed at quantifying self-reported major disease groups according to season, and determining the associations with socio-economic factors in rural Burkina Faso. Methods This study used data of 4192 adults (age range: 18–101 years; male: 49.0%) from the Nouna Health and Demographic Surveillance System (HDSS) in north-west Burkina Faso, rainy season of 2010 and dry season of 2011. We assessed the proportions and their 95% confidence intervals (CIs) of self-reported major disease groups as defined by the World Health Organization. For their associations with socio-economic factors, odds ratios (OR), 95% CIs and p-values were calculated by logistic regression. Results The surveys were completed by 3949 adults in 2010 (mean age: 37.5 ± 14.9 years, male: 48.8%) and by 4039 adults in 2011 (mean age: 37.3 ± 16.2 years, male: 49.1%). The proportions of self-reported communicable diseases were 20.7% (95% CI: 19.4–21.9%) in the rainy season and 11.0% (10.0–11.9%; McNemar’s p < 0.0001) in the dry season. Self-reported NCDs amounted to 5.3% (4.6–6.0%) and 4.5% (3.8–5.1%; p = 0.08), respectively. In each year, less than 1% reported injuries (p = 0.57). Few individuals reported an overlap of communicable diseases and NCDs: 1.4% in 2010 and 0.6% in 2011. In the multiple-adjusted models, formal education (vs. lack of education) showed the strongest association with self-reporting of communicable diseases in both seasons. For NCD-reporting, non-manual occupation (vs. manual) was positively associated, only in the rainy season. Conclusions Self-reporting of communicable diseases is subject to seasonal variation in this population in north-west Burkina Faso. The exact reasons for the low overall self-reporting of NCDs and injuries, apart from a low socio-demographic position, require further investigation.
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Affiliation(s)
- Tobias Gottlieb-Stroh
- Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Aurélia Souares
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany
| | - Till Bärnighausen
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany
| | - Ali Sié
- Centre de Recherche en Santé de Nouna (CRSN), Nouna, Burkina Faso
| | | | - Ina Danquah
- Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany. .,Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany.
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Petry N, Rohner F, Phall MC, Jallow B, Ceesay AA, Sawo Y, Darboe MK, Barrow S, Sarr A, Ceesay PO, Fofana MN, Prentice AM, Wegmüller R, Wirth JP. Prevalence and co-existence of cardiometabolic risk factors and associations with nutrition-related and socioeconomic indicators in a national sample of Gambian women. Sci Rep 2021; 11:12057. [PMID: 34103653 PMCID: PMC8187481 DOI: 10.1038/s41598-021-91592-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 05/11/2021] [Indexed: 01/25/2023] Open
Abstract
Cardiovascular diseases (CVD) are on the rise in Sub-Saharan Africa, and a large proportion of the adult population is thought to suffer from at least one cardiometabolic risk factor. This study assessed cardiometabolic risk factors and the contribution of nutrition-related indicators in Gambian women. The prevalence and co-existence of diabetes (elevated glycated hemoglobin (HbA1c ≥ 6.5%) or prediabetes (HbA1c ≥ 5.7% to < 6.5%), hypertension (systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg), obesity (body mass index (BMI) ≥ 30.0) and inflammation (C-reactive protein (CRP) > 3 mg/L or alpha-1-acid glycoprotein (AGP) > 1 g/L) and the contribution of nutrition related and socioeconomic indicators were measured in non-pregnant women 15-49 years of age in the Gambia using data from a nationally representative cross-sectional stratified survey. Nationally, 54.5% (95% CI: 47.4, 61.4) of 1407 women had elevated HbA1c. Of these, 14.9% were diabetic and 85.1% were prediabetic. Moreover, 20.8% (95% CI 17.8, 20.0) of 1685 women had hypertension, 11.1% (95% CI 9.0, 13.7) of 1651 were obese and 17.2% (95% CI 5.1, 19.6) of 1401 had inflammation. At least one of the aforementioned cardiometabolic risk factor was present in 68.3% (95% CI 63.0, 73.1) of women. Obesity increased the risk of hypertension (aRR 1.84; 95% CI 1.40, 2.41), diabetes (aRR 1.91; 95% CI 1.29, 2.84), elevated HbA1c (aRR 1.31; 95% CI 1.14, 1.51) and inflammation (aRR 3.47; 95% CI 2.61, 4.61). Inflammation increased the risk of hypertension (aRR 1.42; 95% CI 1.14, 1.78). Aging increased the risk of hypertension, obesity and inflammation. Further, inadequate sanitation increased the risk for diabetes (aRR 1.65; 95% CI 1.17, 2.34) and iron deficiency increased the risk of elevated HbA1c (aRR 1.21; 95% CI 1.09, 1.33). The high prevalence of cardiometabolic risk factors and their co-existence in Gambian women is concerning. Although controlling obesity seems to be key, multifaceted strategies to tackle the risk factors separately are warranted to reduce the prevalence or minimize the risk of CVD.
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Affiliation(s)
| | | | | | | | | | | | - Momodou K Darboe
- Medical Research Council Unit the Gambia at London, School of Hygiene and Tropical Medicine, Atlantic Boulevard, Fajara, Banjul, The Gambia
| | | | | | | | | | - Andrew M Prentice
- Medical Research Council Unit the Gambia at London, School of Hygiene and Tropical Medicine, Atlantic Boulevard, Fajara, Banjul, The Gambia
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Fouda Mbarga N, Epee E, Mbarga M, Ouamba P, Nanda H, Nkengni A, Guekeme J, Eyong J, Tossoukpe S, Noumedem Sosso S, Ngono Ngono E, Ntsama LM, Bonyomo L, Tchatchoua P, Vogue N, Metomb S, Ale F, Ousman M, Job D, Moussi C, Tamakloe M, Haberer JE, Ndeso Atanga S, Halle-Ekane G, Boum Y. Clinical profile and factors associated with COVID-19 in Yaounde, Cameroon: A prospective cohort study. PLoS One 2021; 16:e0251504. [PMID: 33979402 PMCID: PMC8115782 DOI: 10.1371/journal.pone.0251504] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 04/28/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND A year after the COVID-19 pandemic started, there are still few scientific reports on COVID-19 in Africa. This study explores the clinical profiles and factors associated with COVID-19 in Cameroon. MATERIALS AND METHODS In this prospective cohort study, we followed patients admitted for suspicion of COVID-19 at Djoungolo Hospital between 01st April and 31st July 2020. Patients were categorised by age groups and disease severity: mild (symptomatic without clinical signs of pneumonia), moderate (with clinical signs of pneumonia without respiratory distress) and severe cases (clinical signs of pneumonia and respiratory distress not requiring invasive ventilation). Demographic information and clinical features were summarised. Multivariable analysis was performed to predict risk. FINDINGS A total of 313 patients were admitted during the study period; 259 were confirmed cases of COVID-19 by Polymerase Chain Reaction (PCR). Among the confirmed cases, the male group aged 40 to 49 years (13.9%) was predominant. Disease severity ranged from mild (26.2%; n = 68) to moderate (59%; n = 153) to severe (14.7%; n = 38); the case fatality rate was 1% (n = 4). Dysgusia (46%; n = 119) and hyposmia/anosmia (37.8%; n = 98) were common features of COVID-19. Nearly one-third of patients had comorbidities (29%; n = 53), of which hypertension was the most common (18.9%; n = 49). Participation in mass gatherings (Odds Ratio (OR) = 2.37; P = 0.03) and dysgusia (OR = 2.09, P = 0.02) were predictive of diagnosis of COVID-19. Age groups 60 to 69 (OR = 7.41; P = 0.0001), 50 to 59 (OR = 4.09; P = 0.03), 40 to 49 (OR = 4.54; P = 0.01), male gender (OR = 2.53; P = 0.04), diabetes (OR = 4.05; P = 0.01), HIV infection (OR = 5.57; P = 0.03), lung disease (OR = 6.29; P = 0.01), dyspnoea (OR = 3.70; P = 0.008) and fatigue (OR = 3.35; P = 0.02) significantly predicted COVID-19 severity. CONCLUSIONS Most COVID-19 cases in this study were benign with low fatality. Age (40-70), male gender, HIV infection, lung disease, dyspnoea and fatigue are associated with severe COVID-19. Such findings may guide public health decision-making.
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Affiliation(s)
| | - Emilienne Epee
- Public Health Emergency and Operations Centre (PHEOC), Ministry of Public Health, Yaounde, Cameroon
| | | | | | | | | | | | - Justin Eyong
- Catholic University of Central Africa, Yaounde, Cameroon
| | | | | | | | | | | | | | - Noel Vogue
- Regional Delegation of Public Health for the Centre, Yaounde, Cameroon
| | - Steve Metomb
- Regional Delegation of Public Health for the Centre, Yaounde, Cameroon
| | - Franck Ale
- Medecins Sans Frontieres, Dakar, Senegal
| | | | - Dorian Job
- Medecins Sans Frontieres, Dakar, Senegal
| | - Charlotte Moussi
- Regional Delegation of Public Health for the Centre, Yaounde, Cameroon
| | | | - Jessica E. Haberer
- Center for Global Health, Massachusetts General Hospital, Boston, Massachusetts, United States of America
- Department of Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
| | | | | | - Yap Boum
- Public Health Emergency and Operations Centre (PHEOC), Ministry of Public Health, Yaounde, Cameroon
- Epicentre, Medecins Sans Frontieres, Yaounde, Cameroon
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Nordholm AC, Lillebaek T. It is time to optimise the management of latent tuberculosis infection in children. Eur Respir J 2021; 57:57/4/2004438. [PMID: 33888534 DOI: 10.1183/13993003.04438-2020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 12/11/2020] [Indexed: 11/05/2022]
Affiliation(s)
- Anne Christine Nordholm
- International Reference Laboratory of Mycobacteriology, Statens Serum Institut, Copenhagen, Denmark
| | - Troels Lillebaek
- International Reference Laboratory of Mycobacteriology, Statens Serum Institut, Copenhagen, Denmark
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Akindele MO, Useh U. Multimorbidity of chronic diseases of lifestyle among South African adults. Pan Afr Med J 2021; 38:332. [PMID: 34285755 PMCID: PMC8265261 DOI: 10.11604/pamj.2021.38.332.15109] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Accepted: 02/22/2021] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION the prevalence of non-communicable and chronic diseases has been on the increase globally and has been a major factor responsible for high morbidity and mortality. Multimorbidity of the chronic diseases in low/medium income countries should be a major concern for public health practitioners because of the communicable diseases they also battle with. This study was carried out to determine the prevalence of multi-morbidity of chronic diseases of lifestyle (CDL) among adult South Africans. METHODS we employed General House Survey (GHS) data released by Statistics South Africa (Stats SA) in December 2015 with a response rate was 90.5%. Data on diabetes mellitus, high cholesterol, stroke, heart attack/myocardial infarction, hypertension were analysed using descriptive and inferential statistics. RESULTS the outcome of this secondary data analysis showed that about 16.3% of South Africans respondents aged 18 years and above had a single/or multiple CDL. The majority of the respondents with CDL were females (10.9%), older adults (9.4%), married (8.5%), of the black racial extract (11.9%), and reside in urban areas (3.4%). Also, high blood pressure (13.7%) was the most reported prevalent chronic disease while heart attack (1.1%) was the least reported chronic disease. The outcome of regression analysis after adjustment showed that gender (OR=0.56, CI=0.53-0.60, p<0.001), age [middle-aged adult (R=0.003, CI=0.003-0.004, p=0.001), older adult (R=0.25, CI=0.23-0.26, p=0.001)] and marital status [divorced (OR=1.55, CI=1.44-1.67, p<0.001), separated (OR=1.71, CI=1.46-2.00, p=0.001), single (R=1.88, CI=1.71-2.07, p=0.001)] were among the correlates of chronic diseases of lifestyle for the 1st step of the adjustment. However, White population group (OR=1.17, CI=0.96-1.41, p=0.113), residing in farm settlement (OR=0.99, CI=0.84-1.16, p=0.910) and all the sub-scales of educational status were not correlates of the CDLs for the 2nd adjustment of regression analysis. CONCLUSION the findings of the study suggest that CDL is endemic among the South African population and that the most susceptible groups are the older adults, females, the married, the uneducated and the coloured individuals.
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Affiliation(s)
- Mukadas Oyeniran Akindele
- Diseases of Lifestyle Niche Area, Faculty of Health Sciences, North West University, Mafikeng Campus, Mahikeng, South Africa
- Department of Physiotherapy, Faculty of Allied Health Sciences, Bayero University, Kano State, Kano, Nigeria
| | - Ushotanefe Useh
- Diseases of Lifestyle Niche Area, Faculty of Health Sciences, North West University, Mafikeng Campus, Mahikeng, South Africa
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Jackson IL, Ukwe CV. Clinical outcomes of pharmaceutical care intervention in HIV positive patients with hypertension: A randomized controlled study. J Clin Pharm Ther 2021; 46:1083-1094. [PMID: 33666264 DOI: 10.1111/jcpt.13400] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 02/11/2021] [Accepted: 02/13/2021] [Indexed: 11/26/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE Pharmaceutical care (PC) has been shown to improve clinical outcomes in hypertensive patients as well as in people living with HIV (PLWHV). The objective of this study was to evaluate the impact of PC on blood pressure (BP) control, viral load and adherence to medications in hypertensive PLWHV. METHODS This was a prospective, randomized controlled study conducted in the University of Uyo Teaching Hospital, Uyo, Akwa Ibom State, Nigeria. Eligible ambulatory patients were randomized equally to two study arms. The control arm (CA) received the traditional care offered at the HIV clinic; the intervention arm (IA) received the traditional care in addition to PC by the research pharmacist, which included structured education/counselling. BP and self-reported medication adherence were measured at baseline, 6 months and 12 months. Viral load was obtained at baseline and after 12 months. Data were analysed with spss, version 25.0. RESULTS AND DISCUSSION Of the 206 participants initially randomized, 182 (91 in each study arm) completed the 12-month follow-up. No significant differences existed in both arms concerning socio-demographic/clinical characteristics of participants at baseline (p > 0.05). After 12 months, BP control was significantly higher in the IA (53.4% vs. 25.2%; p < 0.001, adjusted odds ratio, aOR = 3.20 (95% CI 1.59-6.44). Systolic BP reduced by 0.9 mmHg from baseline in the CA (p = 0.668) and by 16.67 mmHg from baseline value in the IA (p < 0.001). Diastolic BP increased by 1.9 mmHg in the CA (p = 0.444), but reduced by 7.0 mmHg in the IA (p < 0.001). No significant differences were observed in the change from baseline in the proportion with undetectable plasma viral load (UPVL) in both groups (p > 0.05). PC led to an increase in mean adherence to antiretroviral drugs (Δ = 0.55; p = 0.015), and an increase in mean adherence to antihypertensive drugs (Δ = 2.32; p < 0.001) in the IA. WHAT IS NEW AND CONCLUSION To our knowledge, this is the first prospective randomized controlled study evaluating the impacts of PC on clinical outcomes in hypertensive PLWHV with a 12-month follow-up. Our results show that PC significantly improved BP control and adherence to antiretroviral and antihypertensive medications, but had no significant effect on viral load in HIV positive patients with hypertension. Providers of care for PLWHV should leverage the established HIV treatment successes for promoting adherence to treatment for common comorbidities like hypertension in PLWHV in order to improve clinical outcomes.
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Affiliation(s)
- Idongesit L Jackson
- Department of Clinical Pharmacy and Biopharmacy, University of Uyo, Uyo, Nigeria
| | - Chinwe V Ukwe
- Department of Clinical Pharmacy and Pharmacy Management, University of Nigeria, Nsukka, Nigeria
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Gu M, Lu CJ, Lee TS, Chen M, Liu CK, Chen CL. Prevalence and Risk Factors of Metabolic Syndrome among the Homeless in Taipei City: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041716. [PMID: 33578940 PMCID: PMC7916725 DOI: 10.3390/ijerph18041716] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 01/30/2021] [Accepted: 02/05/2021] [Indexed: 12/14/2022]
Abstract
The safety and health of homeless people are important social issues. Metabolic syndrome (MetS) is a sub-health-risk phenomenon that has been severely aggravated worldwide in recent years. The purpose of this study was to investigate the prevalence and risk factors of MetS among the homeless in Taipei City, Taiwan. In this study, a convenience sampling was conducted at homeless counseling agencies in Taipei City from April 2018 to September 2018. A total of 297 homeless participants were recruited, from whom clinical indicators and questionnaire information were collected. Through statistical verification, analysis of variance (ANOVA), and logistic regression, we found the following main conclusions for homeless adults in Taipei: (1) The prevalence of MetS was estimated to be 53%, with 50% meeting four or more diagnostic conditions. (2) Dyslipidemia (high-density lipoprotein (HDL) deficiency and elevated triglyceride (TG)) showed the strongest association with the prevalence of MetS; more than 83% of people with HDL deficiency or hypertriglyceridemia had MetS. For the patient groups meeting more MetS diagnostic conditions, the values of high-density lipoprotein cholesterol (HDL-C), TG, and total cholesterol (TC) increased significantly. (3) The deterioration of MetS was significantly related to the high prevalence of hyperlipidemia (HL). (4) The homeless who were divorced, separated or widowed were more likely to suffer from MetS.
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Affiliation(s)
- Ming Gu
- Graduate Institute of Business Administration, Fu Jen Catholic University, New Taipei City 242304, Taiwan; (M.G.); (C.-J.L.); (T.-S.L.); (M.C.); (C.-K.L.)
| | - Chi-Jie Lu
- Graduate Institute of Business Administration, Fu Jen Catholic University, New Taipei City 242304, Taiwan; (M.G.); (C.-J.L.); (T.-S.L.); (M.C.); (C.-K.L.)
- Artificial Intelligence Development Center, Fu Jen Catholic University, New Taipei City 242304, Taiwan
- Department of Information Management, Fu Jen Catholic University, New Taipei City 242304, Taiwan
| | - Tian-Shyug Lee
- Graduate Institute of Business Administration, Fu Jen Catholic University, New Taipei City 242304, Taiwan; (M.G.); (C.-J.L.); (T.-S.L.); (M.C.); (C.-K.L.)
- Artificial Intelligence Development Center, Fu Jen Catholic University, New Taipei City 242304, Taiwan
| | - Mingchih Chen
- Graduate Institute of Business Administration, Fu Jen Catholic University, New Taipei City 242304, Taiwan; (M.G.); (C.-J.L.); (T.-S.L.); (M.C.); (C.-K.L.)
- Artificial Intelligence Development Center, Fu Jen Catholic University, New Taipei City 242304, Taiwan
| | - Chih-Kuang Liu
- Graduate Institute of Business Administration, Fu Jen Catholic University, New Taipei City 242304, Taiwan; (M.G.); (C.-J.L.); (T.-S.L.); (M.C.); (C.-K.L.)
- Artificial Intelligence Development Center, Fu Jen Catholic University, New Taipei City 242304, Taiwan
- Department of Urology, Fu-Jen Catholic University Hospital, New Taipei City 242304, Taiwan
| | - Ching-Lin Chen
- Graduate Institute of Business Administration, Fu Jen Catholic University, New Taipei City 242304, Taiwan; (M.G.); (C.-J.L.); (T.-S.L.); (M.C.); (C.-K.L.)
- Taipei City Hospital, Taipei City 103012, Taiwan
- Correspondence:
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Vancampfort D, Byansi PK, Namutebi H, Kinyanda E, Bbosa RS, Ward PB, Lukwata H, Mugisha J. The efficacy of a lay health workers – led physical activity counselling program in patients with HIV and mental health problems: a real-world intervention from Uganda. AIDS Care 2021; 33:1189-1195. [PMID: 33487031 DOI: 10.1080/09540121.2021.1874268] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
ABSTRACTThis study explored the efficacy of a lay health worker (LHW)-led physical activity (PA) counselling program for inactive patients with HIV/AIDS and mental health problems living in a Ugandan farming community. In total 49 (35 women) community patients (40.0 ± 11.2 years) followed an 8-week once weekly LHW-led PA counselling program based on a self-determination theory and motivational interviewing framework. Participants completed the Simple Physical Activity Questionnaire, Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, HIV/AIDS Stress Scale and World Health Organization Disability Assessment Schedule 2 (WHODAS 2) pre- and immediately post-intervention. Small, significant (P < 0.05) effect sizes were found for reductions in HIV/AIDS-related stress (Cohen's d = 0.26) and in global disability (Cohen's d = 0.46). Large effect sizes were observed for reductions in time spent sedentary (Cohen's d = 1.97) and reductions in depressive (Cohen's d = 2.04) and anxiety (Cohen's d = 1.47) symptoms and increases in time spent active (Cohen's d = 1.98). Greater decrease in sedentary time was associated with greater anxiety symptoms reduction (r = 0.32, P = 0.021). In physically inactive patients with HIV/AIDS and mental health problems, an LHW-led PA counselling program reduced stress, anxiety, depression and disability. Randomized controlled trials are needed to confirm these preliminary positive findings.
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Affiliation(s)
- Davy Vancampfort
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium
- University Psychiatric Centre KU Leuven, Kortenberg, Belgium
| | - Peter Kayiira Byansi
- Africa Social Development & Health Initiatives, Kampala, Uganda
- Uganda Martyrs University, Faculty of Health Sciences, Kampala, Uganda
| | - Hilda Namutebi
- Africa Social Development & Health Initiatives, Kampala, Uganda
| | - Eugene Kinyanda
- Department of Psychiatry, Makerere University, Kampala, Uganda
- Mental Health Project, MRC/LSHTM/UVRI and Senior Wellcome Trust Fellow, Entebbe, Uganda
| | | | - Philip B. Ward
- University of New South Wales, School of Psychiatry, Sydney, Australia
- Ingham Institute of Applied Medical Research, Liverpool, Australia
| | - Hafsa Lukwata
- Mental Health Unit, Ministry of Health, Kampala, Uganda
| | - James Mugisha
- Butabika National Referral and Mental Health Hospital, Kampala, Uganda
- Kyambogo University, Kampala, Uganda
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Rwegerera GM, Shailemo DHP, Pina Rivera Y, Mokgosi KO, Bale P, Oyewo TA, Luis BD, Habte D, Godman B. Metabolic Control and Determinants Among HIV-Infected Type 2 Diabetes Mellitus Patients Attending a Tertiary Clinic in Botswana. Diabetes Metab Syndr Obes 2021; 14:85-97. [PMID: 33469326 PMCID: PMC7810972 DOI: 10.2147/dmso.s285720] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 11/19/2020] [Indexed: 12/15/2022] Open
Abstract
PURPOSE We primarily aimed at determining the prevalence of metabolic syndrome and abnormal individual metabolic control variables in HIV-infected participants as compared to HIV-uninfected participants given current concerns. Our secondary objective was to determine the predictors of metabolic syndrome and individual metabolic control variables among the study participants to guide future management. PATIENTS AND METHODS A descriptive, case-matched cross-sectional study for four months from 15th June 2019 to 15th October 2019 at Block 6 Diabetes Reference Clinic in Gaborone, Botswana. We compared the proportions of metabolic syndrome and individual metabolic control variables based on gender and HIV status by means of bivariate analysis (Chi-squared test or Fisher's exact test) to determine factors associated with metabolic control. A p-value of less than 0.05 was considered statistically significant. RESULTS Overall, 86% of the study participants were found to have metabolic syndrome by International Diabetes Federation (IDF) criteria with 79.8% among HIV-infected and 89.1% among HIV-negative participants (p-value = 0.018). Older age was significantly associated with metabolic syndrome (p-value = 0.008). Female gender was significantly associated with metabolic syndrome as compared to male gender (P-value < 0.001), and with a statistically significant higher proportion of low HDL-C compared to males (P-value < 0.001). Female participants were significantly more likely to be obese as compared to males (P-value < 0.001). High triglycerides were more common in HIV-infected compared to HIV-negative participants (P-value = 0.004). HIV-negative participants were more likely to be obese as compared to HIV-infected participants (P-value = 0.003). CONCLUSION Metabolic syndrome is an appreciable problem in this tertiary clinic in Botswana for both HIV-infected and HIV-negative participants. Future prospective studies are warranted in our setting and similar sub-Saharan settings to enhance understanding of the role played by HAART in causing the metabolic syndrome, and the implications for future patient management.
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Affiliation(s)
- Godfrey Mutashambara Rwegerera
- Department of Internal Medicine, Faculty of Medicine, University of Botswana, Gaborone, Botswana
- Department of Medicine, Princess Marina Hospital, Gaborone, Botswana
| | - Dorothea H P Shailemo
- Department of Pharmacology and Therapeutics, School of Pharmacy, University of Namibia, Windhoek, Namibia
| | | | - Kathryn O Mokgosi
- Department of Obstetrics and Gynaecology, Nyangabgwe Referral Hospital, Francistown, Botswana
| | - Portia Bale
- Otse Outpatient Clinic, District Health Management Team, Lobatse, Botswana
| | - Taibat Aderonke Oyewo
- Department of Medicine, Princess Marina Hospital, Gaborone, Botswana
- Department of Family Medicine, University of Botswana, Gaborone, Botswana
| | - Bruno Diaz Luis
- Department of Medicine, Princess Marina Hospital, Gaborone, Botswana
| | - Dereje Habte
- Consultant Public Health Specialist, Addis Ababa, Ethiopia
| | - Brian Godman
- School of Pharmacy, Sefako Makgatho Health Sciences University, Ga-Rankuwa, Pretoria0208, South Africa
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, GlasgowG4 0RE, UK
- Division of Clinical Pharmacology, Karolinska Institute, Karolinska University Hospital Huddinge, Stockholm, Sweden
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Tladi D, Mokgatlhe L, Nell T, Shaibu S, Mitchell R, Mokgothu C, Gabonthone T, Hubona O. Prevalence of the Metabolic Syndrome Among Batswana Adults in Urban and Semi-Urban Gaborone. Diabetes Metab Syndr Obes 2021; 14:2505-2514. [PMID: 34113142 PMCID: PMC8186999 DOI: 10.2147/dmso.s285898] [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: 10/08/2020] [Accepted: 04/07/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE The metabolic syndrome (MetS) is on the rise in Sub-Saharan Africa, attributed to increased and uncontrollable urbanization accompanied by its lifestyle changes. Non-communicable diseases, such as hypertension, diabetes, and obesity, which are components of the (MetS) are also on the increase in Botswana. To date, no study has determined the prevalence of the MetS in the apparently healthy Batswana adults. The objective of the study was to determine the prevalence of the MetS among the 25-65-year-old Batswana residing in urban and neighboring semi-urban areas of Gaborone. PARTICIPANTS AND METHODS A cross-sectional study was used to collect data from N=794 participants, n=383 men and n=411 women, residing in Gaborone and two surrounding semi-urban areas. Data collected included demographic, anthropometric measurements, blood pressure (BP), blood glucose, triglycerides, high-density lipoprotein cholesterol (HDL-C) and total cholesterol. RESULTS A high prevalence of 26.8% was reported, with women mostly afflicted (35.0% vs 18.0%). The MetS risk factors found to be common in women were low HDL-C at (50% vs 48.7%) compared to men, while proportions with elevated BP (50.3% vs 39.4%) were prominent in men. The prevalence increased with age, with the oldest age group showing a higher prevalence in both women and men, respectively (55-65 years; 38.5% vs 41.2%). CONCLUSION An unprecedented high MetS prevalence was revealed among perceived to be healthy Batswana adults, with women at a higher risk. This public health concern creates an opportunity to establish evidence of risk factors, develop guidelines and strategies with appropriate public health measures to prevent and control the MetS.
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Affiliation(s)
- Dawn Tladi
- Department of Sport Science, University of Botswana, Gaborone, Botswana
- Correspondence: Dawn Tladi Department of Sport Science, Private Bag 00702, Gaborone, BotswanaTel +267 71896028Fax +267 3185096 Email
| | - Lucky Mokgatlhe
- Department of Statistics, University of Botswana, Gaborone, Botswana
| | - Theo Nell
- Centre for Cardio-metabolic Research in Africa (CARMA), Integrated Metabolic Research Group, Department of Physiological Sciences, Faculty of Natural Sciences, University of Stellenbosch, Stellenbosch, 7600, South Africa
| | - Sheila Shaibu
- School of Nursing and Midwifery, The Aga Khan University, Nairobi, Kenya
| | | | - Comfort Mokgothu
- Department of Sport Science, University of Botswana, Gaborone, Botswana
| | - Tebogo Gabonthone
- Department of Sport Science, University of Botswana, Gaborone, Botswana
| | - Omphile Hubona
- Department of Sport Science, University of Botswana, Gaborone, Botswana
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Jackson IL, Okonta JM, Ukwe CV. HIV- and hypertension-related knowledge and medication adherence in HIV seropositive persons with hypertension. J Public Health (Oxf) 2020; 44:e79-e87. [DOI: 10.1093/pubmed/fdaa221] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 11/07/2020] [Indexed: 11/13/2022] Open
Abstract
AbstractBackgroundThere is increasing prevalence of diseases associated with ageing such as hypertension, among people living with HIV (PLWHV). This study sought to assess: (1) knowledge related to HIV infection and hypertension, (2) adherence to prescribed medications and (3) clinical outcomes among HIV-positive persons with hypertension at a Nigerian hospital.MethodsThe Patient’s HIV Knowledge Questionnaire (PHKQ), Hypertension Knowledge-Level Scale (HK-LS) and Adherence to Refills and Medication Scale (ARMS) were administered to 220 eligible patients through the HIV clinic. Demographic and clinical data were also obtained.ResultsParticipants were predominantly females (57.3%), with a median (IQR) age of 46 (38–58) years; majority were married (67.8%) and employed (60.8%). Participants reported a higher hypertension-related knowledge compared with HIV-related knowledge (63.6% versus 33.3%, Z = −10.263, P < 0.001), but better adherence to antiretroviral medications compared to antihypertensives (100.0% versus 89.3%, Z = −9.118, P < 0.001). Of the 98 participants with documented viral load, 55 (56.1%) had undetectable (<40 copies/ml) values; however, only four (2.0%) of the entire sample had controlled (<140/90 mmHg) blood pressure.ConclusionsDespite having a higher hypertension-related knowledge, adherence to antihypertensive medications and blood pressure control were poor. There is a need for increased attention to HIV education and comorbidities in PLWHV.
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Affiliation(s)
- I L Jackson
- Department of Clinical Pharmacy and Biopharmacy, University of Uyo, Uyo 520103, Nigeria
| | - J M Okonta
- Department of Clinical Pharmacy and Pharmacy Management, University of Nigeria, Nsukka 410001, Nigeria
| | - C V Ukwe
- Department of Clinical Pharmacy and Pharmacy Management, University of Nigeria, Nsukka 410001, Nigeria
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Ambachew S, Endalamaw A, Worede A, Tegegne Y, Melku M, Biadgo B. The Prevalence of Metabolic Syndrome in Ethiopian Population: A Systematic Review and Meta-analysis. J Obes 2020; 2020:2701309. [PMID: 33489358 PMCID: PMC7803160 DOI: 10.1155/2020/2701309] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 11/05/2020] [Accepted: 11/30/2020] [Indexed: 01/02/2023] Open
Abstract
Background The metabolic syndrome is a clustering of hyperglycemia/insulin resistance, hypertension, dyslipidemia, and obesity which are risk factors for cardiovascular disease, type 2 diabetes and stroke, and all-cause mortality. The burden of metabolic syndrome is emerging alarmingly in low- and middle-income countries such as Ethiopia; however, there is lack of comprehensive estimation. This study aimed to determine the pooled prevalence of metabolic syndrome in Ethiopia. Methods This systematic review and meta-analysis included original articles of observational studies published in the English language. Searches were carried out in PubMed, Google Scholar, and Africa Journals from conception to August 2020. A random-effects model was used to estimate the pooled prevalence of metabolic syndrome in Ethiopia. Heterogeneity was assessed using the I 2 statistic. Subgroup analysis was also conducted based on sex/gender and study subjects. Egger's test was used to assess publication bias. Results Electronic and gray literature search retrieved 942 potentially relevant papers. After removing duplicates and screening with eligibility criteria, twenty-eight cross-sectional studies were included in this meta-analysis. The pooled prevalence of metabolic syndrome in Ethiopia was found to be 34.89% (95% CI: 26.77, 43.01) and 27.92% (95% CI: 21.32, 34.51) by using NCEP/ATP III and IDF criteria, respectively. The weighted pooled prevalence of metabolic syndrome was higher in females 36.74% (95% CI: 20.72, 52.75) and 34.09% (95% CI: 26.68, 41.50) compared to males 22.22% (95% CI: 14.89, 29.56) and 24.82% (95% CI: 18.34, 31.31) by using IDF and NCEP/ATP III criteria, respectively. Subgroup analysis based on the study subjects using NCEP/ATP III showed that the weighted pooled prevalence was 63.78%(95% CI: 56.17, 71.40), 44.55% (95% CI: 30.71, 52.38), 23.09% (95% CI: 19.74, 26.45), 20.83% (95% CI: 18.64, 23.01), and 18.45% (95% CI: 13.89, 23.01) among type 2 diabetes patients, hypertensive patients, psychiatric patients, HIV patients on HAART, and working adults, respectively. The most frequent metabolic syndrome components were low HDL-C 51.0% (95% CI: 42.4, 59.7) and hypertriglyceridemia 39.7% (95% CI: 32.8, 46.6). Conclusions The findings revealed an emerging high prevalence of metabolic syndrome in Ethiopia. Therefore, early intervention is required for the primary prevention of the occurrence of metabolic syndrome and the further reduction of the morbidity and mortality related to it.
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Affiliation(s)
- Sintayehu Ambachew
- Department of Clinical Chemistry, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Aklilu Endalamaw
- Departement of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Abebaw Worede
- Department of Clinical Chemistry, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Yalewayker Tegegne
- Department of Parasitology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mulugeta Melku
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Belete Biadgo
- Department of Clinical Chemistry, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Adedia D, Boakye AA, Mensah D, Lokpo SY, Afeke I, Duedu KO. Comparative assessment of anthropometric and bioimpedence methods for determining adiposity. Heliyon 2020; 6:e05740. [PMID: 33385081 PMCID: PMC7770549 DOI: 10.1016/j.heliyon.2020.e05740] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 09/27/2020] [Accepted: 12/11/2020] [Indexed: 11/29/2022] Open
Abstract
Background Obesity is a risk factor for different chronic conditions. Over the years, obesity has become a pandemic and it is therefore important that effective diagnostic tools are developed. Obesity is a measure of adiposity and it has become increasingly evident that anthropometric measures such as body mass index (BMI) used to estimate adiposity are inadequate. This study therefore examined the ability of different anthropometric measurements to diagnose obesity within a cross-section of Ghanaian women. Methods We obtained anthropometric measurements and used that to generate derived measures of adiposity such as body adiposity index (BAI) and conicity index. Furthermore we also measured adiposity using a bioimpedance analyser. Associations between these measurements and percentage body fat (%BF) were drawn in order to determine the suitability of the various measures to predict obesity. The prevalence of obesity was determined using both %BF and BMI. Results BMI, Waist and hip circumference and visceral fat (VF) were positively correlated with % BF whereas skeletal muscle mass was negatively correlated. Prevalence of obesity was 16% and 31.6% using BMI and %BF respectively. Receiver operating characteristic (ROC) analysis showed that these differences in prevalence was due to BMI based misclassification of persons who have obesity as overweight. Similar, shortfalls were observed for the other anthropometric measurements using ROC. Conclusions No single measure investigated could adequately predict obesity as an accumulation of fat using current established cut-off points within our study population. Large scale epidemiological studies are therefore needed to define appropriate population based cut-off points if anthropometric measurements are to be employed in diagnosing obesity within a particular population.
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Affiliation(s)
- David Adedia
- Department of Basic Sciences, School of Basic & Biomedical Sciences, University of Health and Allied Sciences, Ho, Ghana
| | - Adjoa A Boakye
- Department of Biomedical Sciences, School of Basic & Biomedical Sciences, University of Health and Allied Sciences, Ho, Ghana
| | - Daniel Mensah
- Department of Nutrition and Dietetics, School of Allied Health Sciences, University of Health and Allied Sciences, Ho, Ghana
| | - Sylvester Y Lokpo
- Department of Medical Laboratory Sciences, School of Allied Health Sciences, University of Health and Allied Sciences, Ho, Ghana
| | - Innocent Afeke
- Department of Medical Laboratory Sciences, School of Allied Health Sciences, University of Health and Allied Sciences, Ho, Ghana
| | - Kwabena O Duedu
- Department of Biomedical Sciences, School of Basic & Biomedical Sciences, University of Health and Allied Sciences, Ho, Ghana
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Chinaeke EE, Li M, Bookstaver B, Love BL, Li X, Reeder G, Lu K. Management of infection among Medicare beneficiaries with HIV/AIDS: risk of diabetes with protease inhibitors and associated racial disparities using big data approach. AIDS Care 2020:1-9. [PMID: 33174443 DOI: 10.1080/09540121.2020.1840503] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Association between protease inhibitors (PI) and Type II diabetes mellitus (T2DM) in human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) patients is largely debated. This study examined the odds of developing T2DM among HIV/AIDS Medicare beneficiaries treated with PI and possible racial disparities in the odds. We performed a nested casecontrol study of Medicare database 2013-2017. We included HIV/AIDS positive beneficiaries who were enrolled continuously in Medicare Part A/B with no previous history of T2DM. PI-users were matched to non-PI users and non-anti-retroviral therapies (ART) users using a1:1 greedy propensity score (PS) matching . Multivariablee logistic regressions were performed to assess the odds of developing T2DM. The analysis included 2,353 HIV/AIDS beneficiaries. Matched samples were generated for PI vs. non-PI groups (n = 484) and PI vs. non-ART groups (n = 490). Compared to the non-PI group, the odds of developing T2DM were higher in PI-users (AOR: 1.76; 95% CI: 1.17-2.64), in Caucasian PI-users (AOR: 1.81; 95% CI: 1.02-3.22) and in African-American PI-users (AOR: 1.86; 95% CI: 1.03-3.36). Compared to the non-ART group, the odds of developing T2DM were higher in PI-users (AOR: 1.87; 95% CI: 1.25-2.81), in Caucasian PI-users (AOR: 1.96; 95% CI: 1.14-3.39) and in African-American PI-users (AOR: 2.05; 95% CI: 1.03-4.09). The use of PI is associated with higher odds of T2DM; odds were higher among African-Americans than Caucasians.
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Affiliation(s)
- Eric E. Chinaeke
- Department of Clinical Pharmacy and Outcomes Sciences (CPOS), University of South Carolina College of Pharmacy, Columbia, South Carolina
| | - Minghui Li
- Department of Clinical Pharmacy and Translational Science, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Brandon Bookstaver
- Department of Clinical Pharmacy and Outcomes Sciences (CPOS), University of South Carolina College of Pharmacy, Columbia, South Carolina
| | - Bryan L. Love
- Department of Clinical Pharmacy and Outcomes Sciences (CPOS), University of South Carolina College of Pharmacy, Columbia, South Carolina
| | - Xiaoming Li
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Gene Reeder
- Kennedy Pharmacy Innovation Center (KPIC), University of South Carolina College of Pharmacy, Columbia, South Carolina
| | - Kevin Lu
- Department of Clinical Pharmacy and Outcomes Sciences (CPOS), University of South Carolina College of Pharmacy, Columbia, South Carolina
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Horberg MA, Certa JM, Rubenstein KB, Hurley LB, Satre DD, Kadlecik PM, Silverberg MJ. Beyond the HIV Care Continuum and Viral Suppression: Broadening the Scope of Quality Metrics for Total HIV Patient Care. AIDS Patient Care STDS 2020; 34:461-469. [PMID: 33147087 PMCID: PMC7698986 DOI: 10.1089/apc.2020.0145] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Assessing quality care for people with HIV (PWH) should not be limited to reporting on HIV Care Continuum benchmarks, particularly viral suppression rates. At Kaiser Permanente Mid-Atlantic States (KPMAS), an integrated health system providing HIV care in the District of Columbia, Maryland, and Virginia, we created a comprehensive measure of HIV quality care, including both preventative measures and clinical outcomes. We included PWH ≥18 years old with ≥6 months KPMAS membership between 2015 and 2018. Process quality metrics (QMs) include: pneumococcal vaccination and influenza vaccination; primary care physician (PCP) and/or HIV/infectious disease (HIV/ID) visits with additional HIV/ID visit; antiretroviral treatment medication fills; and syphilis and gonorrhea/chlamydia screenings. Outcome QMs include HIV RNA <200/mL and other measurements within normal range [blood pressure, body mass index (BMI), hemoglobin, blood sugar, alanine transaminase, low-density lipoproteins, estimated glomerular filtration rate]; no hospitalization/emergency department visit; no new depression diagnosis; remaining or becoming a nonsmoker. Logistic models estimated odds of achieving QMs associated with sex, age, race/ethnicity, insurance type, and HIV risk. A total of 4996 observations were analyzed. 45.6% met all process QMs, while 19.6% met all outcome QMs. Least frequently met process QM was PCP or HIV/ID visit (74.5%); least met outcome QM was BMI (60.2%). Significantly lower odds of achieving all QMs among women {odds ratio (OR) = 0.63 [95% confidence interval (CI): 0.49-0.81]} and those with Medicaid and Medicare [vs. commercial; OR = 0.48 (95% CI: 0.30-0.76) and 0.47 (95% CI: 0.31-0.71)]. Broadening the scope of HIV patient care QMs beyond viral suppression helps identify opportunities for improvement. Successful process metrics do not necessarily coincide with greater outcome metrics.
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Affiliation(s)
- Michael A. Horberg
- Kaiser Permanente Mid-Atlantic States Mid-Atlantic Permanente Research Institute, Rockville, Maryland, USA
- Kaiser Permanente Mid-Atlantic Permanente Medical Group, Rockville, Maryland, USA
| | - Julia M. Certa
- Kaiser Permanente Mid-Atlantic States Mid-Atlantic Permanente Research Institute, Rockville, Maryland, USA
| | - Kevin B. Rubenstein
- Kaiser Permanente Mid-Atlantic States Mid-Atlantic Permanente Research Institute, Rockville, Maryland, USA
| | - Leo B. Hurley
- Kaiser Permanente Northern California Division of Research, Oakland, California, USA
| | - Derek D. Satre
- Kaiser Permanente Northern California Division of Research, Oakland, California, USA
- Department of Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco, California, USA
| | - Peter M. Kadlecik
- Kaiser Permanente Mid-Atlantic Permanente Medical Group, Rockville, Maryland, USA
| | - Michael J. Silverberg
- Kaiser Permanente Northern California Division of Research, Oakland, California, USA
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Effects of Aerobic and Resistance Exercise on Cardiovascular Parameters for People Living With HIV: A Meta-analysis. J Assoc Nurses AIDS Care 2020; 30:186-205. [PMID: 30822291 DOI: 10.1097/jnc.0000000000000006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
People living with HIV (PLWH) have limited exercise capacity because of anemia, neuromuscular disorders, and pulmonary limitations. We used a meta-analysis to examine the effect of aerobic and resistance exercise alone and in combination on cardiovascular parameters. Subgroup meta-analyses were conducted and long-term effects of exercise were investigated. A systematic literature search was conducted up to July/August 2017. The Physiotherapy Evidence Database-scale was used to rate quality and assess the risk of bias on the papers. Standardized mean differences (SMDs) were calculated to assess the effect of exercise. Posttreatment comparison between the exercise and control groups revealed moderate and large effect sizes in favor of the intervention group for VO2max (SMD = 0.66, p < .0001) and the 6-minute walk test (SMD = 1.11, p = .0001). Exercise had a positive effect on cardiovascular parameters in PLWH. Exercise can be a prevention factor for PLWH dealing with multiple comorbidities.
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Gouda HN, Charlson F, Sorsdahl K, Ahmadzada S, Ferrari AJ, Erskine H, Leung J, Santamauro D, Lund C, Aminde LN, Mayosi BM, Kengne AP, Harris M, Achoki T, Wiysonge CS, Stein DJ, Whiteford H. Burden of non-communicable diseases in sub-Saharan Africa, 1990-2017: results from the Global Burden of Disease Study 2017. LANCET GLOBAL HEALTH 2020; 7:e1375-e1387. [PMID: 31537368 DOI: 10.1016/s2214-109x(19)30374-2] [Citation(s) in RCA: 411] [Impact Index Per Article: 102.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 06/19/2019] [Accepted: 08/09/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Although the burden of disease in sub-Saharan Africa continues to be dominated by infectious diseases, countries in this region are undergoing a demographic transition leading to increasing prevalence of non-communicable diseases (NCDs). To inform health system responses to these changing patterns of disease, we aimed to assess changes in the burden of NCDs in sub-Saharan Africa from 1990 to 2017. METHODS We used data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 to analyse the burden of NCDs in sub-Saharan Africa in terms of disability-adjusted life-years (DALYs)-with crude counts as well as all-age and age-standardised rates per 100 000 population-with 95% uncertainty intervals (UIs). We examined changes in burden between 1990 and 2017, and differences across age, sex, and regions. We also compared the observed NCD burden across countries with the expected values based on a country's Socio-demographic Index. FINDINGS All-age total DALYs due to NCDs increased by 67·0% between 1990 (90·6 million [95% UI 81·0-101·9]) and 2017 (151·3 million [133·4-171·8]), reflecting an increase in the proportion of total DALYs attributable to NCDs (from 18·6% [95% UI 17·1-20·4] to 29·8% [27·6-32·0] of the total burden). Although most of this increase can be explained by population growth and ageing, the age-standardised DALY rate (per 100 000 population) due to NCDs in 2017 (21 757·7 DALYs [95% UI 19 377·1-24 380·7]) was almost equivalent to that of communicable, maternal, neonatal, and nutritional diseases (26 491·6 DALYs [25 165·2-28 129·8]). Cardiovascular diseases were the second leading cause of NCD burden in 2017, resulting in 22·9 million (21·5-24·3) DALYs (15·1% of the total NCD burden), after the group of disorders categorised as other NCDs (28·8 million [25·1-33·0] DALYs, 19·1%). These categories were followed by neoplasms, mental disorders, and digestive diseases. Although crude DALY rates for all NCDs have decreased slightly across sub-Saharan Africa, age-standardised rates are on the rise in some countries (particularly those in southern sub-Saharan Africa) and for some NCDs (such as diabetes and some cancers, including breast and prostate cancer). INTERPRETATION NCDs in sub-Saharan Africa are posing an increasing challenge for health systems, which have to date largely focused on tackling infectious diseases and maternal, neonatal, and child deaths. To effectively address these changing needs, countries in sub-Saharan Africa require detailed epidemiological data on NCDs. FUNDING Bill & Melinda Gates Foundation, National Health and Medical Research Centre (Australia).
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Affiliation(s)
- Hebe N Gouda
- School of Public Health, University of Queensland, Brisbane, QLD, Australia; Queensland Centre for Mental Health Research, Brisbane, QLD, Australia.
| | - Fiona Charlson
- School of Public Health, University of Queensland, Brisbane, QLD, Australia; Queensland Centre for Mental Health Research, Brisbane, QLD, Australia; Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Katherine Sorsdahl
- Alan J Fisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Sanam Ahmadzada
- School of Public Health, University of Queensland, Brisbane, QLD, Australia; Queensland Centre for Mental Health Research, Brisbane, QLD, Australia
| | - Alize J Ferrari
- School of Public Health, University of Queensland, Brisbane, QLD, Australia; Queensland Centre for Mental Health Research, Brisbane, QLD, Australia; Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Holly Erskine
- School of Public Health, University of Queensland, Brisbane, QLD, Australia; Queensland Centre for Mental Health Research, Brisbane, QLD, Australia; Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Janni Leung
- School of Public Health, University of Queensland, Brisbane, QLD, Australia; Queensland Centre for Mental Health Research, Brisbane, QLD, Australia; Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Damian Santamauro
- School of Public Health, University of Queensland, Brisbane, QLD, Australia; Queensland Centre for Mental Health Research, Brisbane, QLD, Australia; Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Crick Lund
- Centre for Global Mental Health, King's Global Health Institute, Health Service and Population Research Department, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | | | - Bongani M Mayosi
- Dean's Office and Department of Medicine, Faculty of Health Sciences, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa
| | - Andre Pascal Kengne
- Dean's Office and Department of Medicine, Faculty of Health Sciences, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa; Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Meredith Harris
- School of Public Health, University of Queensland, Brisbane, QLD, Australia; Queensland Centre for Mental Health Research, Brisbane, QLD, Australia
| | - Tom Achoki
- MIT Sloan School of Management, Boston, MA, USA
| | - Charles S Wiysonge
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa; Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa; School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Dan J Stein
- Department of Psychiatry and Mental Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa; South Africa Medical Research Council Unit on Risk and Resilience in Mental Disorders, Cape Town, South Africa
| | - Harvey Whiteford
- School of Public Health, University of Queensland, Brisbane, QLD, Australia; Queensland Centre for Mental Health Research, Brisbane, QLD, Australia; Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
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Jeremiah K, Filteau S, Faurholt-Jepsen D, Kitilya B, Kavishe BB, Krogh-Madsen R, Olsen MF, Changalucha J, Rehman AM, Range N, Kamwela J, Ramaiya K, Andersen AB, Friis H, Heimburger DC, PrayGod G. Diabetes prevalence by HbA1c and oral glucose tolerance test among HIV-infected and uninfected Tanzanian adults. PLoS One 2020; 15:e0230723. [PMID: 32267855 PMCID: PMC7141607 DOI: 10.1371/journal.pone.0230723] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 03/06/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The burden of diabetes is increasing in sub-Saharan Africa, including among people living with HIV. We assessed the prevalence of diabetes and the roles of HIV, antiretroviral therapy (ART) and traditional risk factors among adults in Tanzania. METHODS We analysed diabetes-relevant baseline data from 1,947 adult participants in the CICADA study in Mwanza, Tanzania: 655 HIV-uninfected, 956 HIV-infected ART-naïve, and 336 HIV-infected persons on ART. WHO guidelines for haemoglobin A1c (HbA1c) and oral glucose tolerance test (OGTT) were used to define diabetes and prediabetes. Risk factors were evaluated using multinomial logistic regression analysis. Relative risk ratios (RRR) were generated comparing participants with diabetes and prediabetes against the reference of those with no diabetes. RESULTS Mean age was 41 (SD 12) years; 59% were women. The prevalence of diabetes was 13% by HbA1c and 6% by OGTT, with partial overlap among participants identified by the two tests. Relative to HIV-uninfected, HIV-infected ART-naïve persons had increased relative risks of diabetes (HbA1c: RRR = 1.95, 95% CI 1.25-3.03; OGTT: RRR = 1.90, 95% CI 0.96-3.73) and prediabetes (HbA1c: RRR = 2.89, 95% CI 1.93-4.34; OGTT: RRR = 1.61, 95% CI 1.22-2.13). HIV-infected participants on ART showed increased risk of prediabetes (RRR 1.80, 95% CI 1.09, 2.94) by HbA1c, but not diabetes. CD4 count < 200 cell/μL at recruitment increased risk and physical activity decreased risk of diabetes by both HbA1c and OGTT. CONCLUSIONS The prevalence of diabetes was high, especially among HIV-infected ART-naïve adults. Being more physically active was associated with lower risk of diabetes. HbA1c and OGTT identified different participants as having diabetes or prediabetes. Overall, the finding of high burden of diabetes among HIV-infected persons suggests that health systems should consider integrating diabetes screening and treatment in HIV clinics to optimize the care of HIV patients and improve their health outcomes.
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Affiliation(s)
- Kidola Jeremiah
- Mwanza Research Centre, National Institute for Medical Research, Mwanza, Tanzania
| | - Suzanne Filteau
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | | | - Brenda Kitilya
- Mwanza Research Centre, National Institute for Medical Research, Mwanza, Tanzania
| | - Bazil B. Kavishe
- Mwanza Research Centre, National Institute for Medical Research, Mwanza, Tanzania
| | - Rikke Krogh-Madsen
- Centre of Inflammation and Metabolism and Centre for Physical Activity Research, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Mette F. Olsen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - John Changalucha
- Mwanza Research Centre, National Institute for Medical Research, Mwanza, Tanzania
| | - Andrea M. Rehman
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Nyagosya Range
- Muhimbili Medical Research Centre, National Institute for Medical Research, Dar es Salaam, Tanzania
| | | | | | - Aase B. Andersen
- Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark
| | - Henrik Friis
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Douglas C. Heimburger
- Vanderbilt Institute for Global Health and Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States of America
| | - George PrayGod
- Mwanza Research Centre, National Institute for Medical Research, Mwanza, Tanzania
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Getahun Z, Azage M, Abuhay T, Abebe F. Comorbidity of HIV, hypertension, and diabetes and associated factors among people receiving antiretroviral therapy in Bahir Dar city, Ethiopia. JOURNAL OF COMORBIDITY 2020; 10:2235042X19899319. [PMID: 32206632 PMCID: PMC7076577 DOI: 10.1177/2235042x19899319] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Accepted: 12/10/2019] [Indexed: 12/28/2022]
Abstract
Background: People living with human immunodeficiency virus (HIV) are facing an increased burden of noncommunicable diseases (NCDs) comorbidity. There is, however, paucity of information on the magnitude of HIV-NCDs comorbidity, its associated factors, and how the health system is responding to the double burden in Ethiopia. Objective: To determine the magnitude of comorbidity between HIV and hypertension or diabetes and associated factors among HIV-positive adults receiving antiretroviral therapy (ART) in Bahir Dar city, Ethiopia. Methods: A facility-based cross-sectional study was conducted among 560 randomly selected HIV-positive adults taking ART. Data were collected using a structured questionnaire and analyzed using SPSS version 23. Descriptive statistics were used to describe the data. A logistic regression model was fit to identify associated factors with comorbidity of HIV and NCDs. Results: The magnitude of comorbidity was 19.6% (95% confidence interval (CI): 16.0–23.0). Being older (55 and above years) adjusted odds ratio (AOR: 8.5; 95% CI: 3.2–15.1), taking second-line ART regimen containing tenofovir (AOR: 2.7; 95% CI: 1.3–5.6), and increased body mass index (BMI) ≥25 (AOR: 2.7; 95% CI: 1.2–6.5) were the factors associated with comorbidity. Participants reported that they were not managed in an integrated and coordinated manner. Conclusions: The magnitude of comorbidity among adults was high in the study area. Being older, second-line ART regimen and high BMI ≥25 increased the odds of having NCDs among HIV-positive adults. Targeted screening for the incidences of NCDs, addressing modifiable risk factors, and providing integrated care would help to improve the quality of life comorbid patients.
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Affiliation(s)
| | - Muluken Azage
- School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Taye Abuhay
- School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Fantu Abebe
- School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.,Jhpiego Corporation, Addis Ababa, Ethiopia
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Awad SF, Huangfu P, Ayoub HH, Pearson F, Dargham SR, Critchley JA, Abu-Raddad LJ. Forecasting the impact of diabetes mellitus on tuberculosis disease incidence and mortality in India. J Glob Health 2020; 9:020415. [PMID: 31673336 PMCID: PMC6815875 DOI: 10.7189/jogh.09.020415] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background In context of the rapidly expanding diabetes mellitus (DM) epidemic in India and slowly declining tuberculosis (TB) incidence, we aimed to estimate the past, current, and future impact of DM on TB epidemiology. Methods An age-structured TB-DM dynamical mathematical model was developed and analyzed to assess the DM-on-TB impact. The model was calibrated using a literature review and meta-analyses. The DM-on-TB impact was analyzed using population attributable fraction metrics. Sensitivity analyses were conducted by accommodating less conservative effect sizes for the TB-DM interactions, by factoring the age-dependence of the TB-DM association, and by assuming different TB disease incidence rate trajectories. Results In 1990, 11.4% (95% uncertainty interval (UI) = 6.3%-14.4%) of new TB disease incident cases were attributed to DM. This proportion increased to 21.9% (95% UI = 12.1%-26.4%) in 2017, and 33.3% (95% UI = 19.0%-44.1%) in 2050. Similarly, in 1990, 14.5% (95% UI = 9.5%-18.2%) of TB-related deaths were attributed to DM. This proportion increased to 28.9% (95% UI = 18.9%-34.1%) in 2017, and 42.8% (95% UI = 28.7%-53.1%) in 2050. The largest impacts originated from the effects of DM on TB disease progression and infectiousness. Sensitivity analyses suggested that the impact could be even greater. Conclusions The burgeoning DM epidemic is predicted to become a leading driver of TB disease incidence and mortality over the coming decades. By 2050, at least one-third of TB incidence and almost half of TB mortality in India will be attributed to DM. This is likely generalizable to other Asian Pacific countries with similar TB-DM burdens. Targeting the impact of the increasing DM burden on TB control is critical to achieving the goal of TB elimination by 2050.
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Affiliation(s)
- Susanne F Awad
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar.,Population Health Research Institute, St George's, University of London, London, UK
| | - Peijue Huangfu
- Population Health Research Institute, St George's, University of London, London, UK
| | - Houssein H Ayoub
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar.,Department of Mathematics, Statistics, and Physics, Qatar University, Doha, Qatar.,Department of Healthcare Policy and Research, Weill Cornell Medicine, Cornell University, New York, New York, USA
| | - Fiona Pearson
- Population Health Research Institute, St George's, University of London, London, UK
| | - Soha R Dargham
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar
| | - Julia A Critchley
- Population Health Research Institute, St George's, University of London, London, UK.,Joint senior authors
| | - Laith J Abu-Raddad
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar.,Department of Healthcare Policy and Research, Weill Cornell Medicine, Cornell University, New York, New York, USA.,College of Health and Life Sciences, Hamad bin Khalifa University, Doha, Qatar.,Joint senior authors
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50
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Onanuga IO, Jegede AI, Offor U, Ogedengbe OO, Naidu EC, Peter AI, Azu OO. Hypoxis hemerocallidea alters metabolic parameters and hepatic histomorphology in streptozotocin-nicotinamide-induced diabetic male rats under antiretroviral therapy. Arch Med Sci 2020; 16:212-224. [PMID: 32051726 PMCID: PMC6963141 DOI: 10.5114/aoms.2018.75220] [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: 04/04/2017] [Accepted: 06/23/2017] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION Highly active antiretroviral therapy (HAART) and HIV/AIDS have been demonstrated to induce endocrine/metabolic dysfunction with a consequential increase in morbidity/mortality due to organ toxicities. This study aimed at investigating the possible protective effect of Hypoxis hemerocallidea (HH) against metabolic and hepatic histomorphology of diabetic rats under HAART. MATERIAL AND METHODS Sixty-two adult male Sprague-Dawley rats were divided into a normoglycemic group A (n = 6) and 7 diabetic (110 mg/kg nicotinamide + 45 mg/kg streptozotocin) groups (B-H) (n = 8) and treated according to protocols. Concomitant treatment with adjuvant HH and HAART resulted in the least %body weight gain as the liver weight decreased in all treated animals. RESULTS Significant changes in serum lipids were aggravated by treatment with HH and HAART, triglycerides and total cholesterol levels were elevated (p < 0.001/0.05), but changes in high-density lipoprotein (HDL) and total protein levels were insignificant. While artherosclerotic and cardiopulmonary indexes remained insignificant, concomitant use of HH with HAART in diabetes resulted in reduction of low-density lipoprotein (LDL) (p < 0.001), and increased triglyceride (p < 0.05) and total cholesterol (p < 0.001). The parameters of liver injury showed a significant (p < 0.05) increase in ALT of animals treated with HH alone, HAART + HH and melatonin; however, an insignificant decline in AST level was recorded. Treatment with adjuvant HAART, HH and melatonin resulted in significant (p < 0.005/0.0001) up-regulation of ALP and total bilirubin levels. Histopathology derangement ranged from severe hepatocellular distortions, necrosis with reduced glycogen expression following co-treatment of HAART+melatonin, HH and HAART alone in diabetes. CONCLUSIONS Presumptive hypoglycemic use of HH with HAART by people living with HIV/AIDS requires caution as implications for hepatocellular injuries are suspected with further uncontrolled metabolic disorder.
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Affiliation(s)
- Ismail Olasile Onanuga
- Discipline of Clinical Anatomy, School of Laboratory Medicine and Medical Sciences, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
- Department of Anatomy, Faculty of Biomedical Sciences, Kampala International University, Dar es Salaam, Tanzania
| | - Ayoola Isaac Jegede
- Discipline of Clinical Anatomy, School of Laboratory Medicine and Medical Sciences, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
- Anatomy Department, Faculty of Basic Medical Sciences, College of Health Sciences, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
| | - Ugochukwu Offor
- Discipline of Clinical Anatomy, School of Laboratory Medicine and Medical Sciences, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Oluwatosin O. Ogedengbe
- Discipline of Clinical Anatomy, School of Laboratory Medicine and Medical Sciences, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Edwin C.S. Naidu
- Discipline of Clinical Anatomy, School of Laboratory Medicine and Medical Sciences, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Anetkan I. Peter
- Discipline of Clinical Anatomy, School of Laboratory Medicine and Medical Sciences, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Onyemaechi Okpara Azu
- Discipline of Clinical Anatomy, School of Laboratory Medicine and Medical Sciences, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
- Department of Anatomy, School of Medicine, Windhoek, Namibia
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