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Camelo ALM, Zamora Obando HR, Rocha I, Dias AC, Mesquita ADS, Simionato AVC. COVID-19 and Comorbidities: What Has Been Unveiled by Metabolomics? Metabolites 2024; 14:195. [PMID: 38668323 PMCID: PMC11051775 DOI: 10.3390/metabo14040195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 03/14/2024] [Accepted: 03/26/2024] [Indexed: 04/28/2024] Open
Abstract
The COVID-19 pandemic has brought about diverse impacts on the global population. Individuals with comorbidities were more susceptible to the severe symptoms caused by the virus. Within the crisis scenario, metabolomics represents a potential area of science capable of providing relevant information for understanding the metabolic pathways associated with the intricate interaction between the viral disease and previous comorbidities. This work aims to provide a comprehensive description of the scientific production pertaining to metabolomics within the specific context of COVID-19 and comorbidities, while highlighting promising areas for exploration by those interested in the subject. In this review, we highlighted the studies of metabolomics that indicated a variety of metabolites associated with comorbidities and COVID-19. Furthermore, we observed that the understanding of the metabolic processes involved between comorbidities and COVID-19 is limited due to the urgent need to report disease outcomes in individuals with comorbidities. The overlap of two or more comorbidities associated with the severity of COVID-19 hinders the comprehension of the significance of each condition. Most identified studies are observational, with a restricted number of patients, due to challenges in sample collection amidst the emergent situation.
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Affiliation(s)
- André Luiz Melo Camelo
- Laboratory of Analysis of Biomolecules Tiselius, Department of Analytical Chemistry, Institute of Chemistry, Universidade Estadual de Campinas (UNICAMP), Campinas 13083-970, São Paulo, Brazil; (A.L.M.C.); (H.R.Z.O.); (I.R.); (A.C.D.); (A.d.S.M.)
| | - Hans Rolando Zamora Obando
- Laboratory of Analysis of Biomolecules Tiselius, Department of Analytical Chemistry, Institute of Chemistry, Universidade Estadual de Campinas (UNICAMP), Campinas 13083-970, São Paulo, Brazil; (A.L.M.C.); (H.R.Z.O.); (I.R.); (A.C.D.); (A.d.S.M.)
| | - Isabela Rocha
- Laboratory of Analysis of Biomolecules Tiselius, Department of Analytical Chemistry, Institute of Chemistry, Universidade Estadual de Campinas (UNICAMP), Campinas 13083-970, São Paulo, Brazil; (A.L.M.C.); (H.R.Z.O.); (I.R.); (A.C.D.); (A.d.S.M.)
| | - Aline Cristina Dias
- Laboratory of Analysis of Biomolecules Tiselius, Department of Analytical Chemistry, Institute of Chemistry, Universidade Estadual de Campinas (UNICAMP), Campinas 13083-970, São Paulo, Brazil; (A.L.M.C.); (H.R.Z.O.); (I.R.); (A.C.D.); (A.d.S.M.)
| | - Alessandra de Sousa Mesquita
- Laboratory of Analysis of Biomolecules Tiselius, Department of Analytical Chemistry, Institute of Chemistry, Universidade Estadual de Campinas (UNICAMP), Campinas 13083-970, São Paulo, Brazil; (A.L.M.C.); (H.R.Z.O.); (I.R.); (A.C.D.); (A.d.S.M.)
| | - Ana Valéria Colnaghi Simionato
- Laboratory of Analysis of Biomolecules Tiselius, Department of Analytical Chemistry, Institute of Chemistry, Universidade Estadual de Campinas (UNICAMP), Campinas 13083-970, São Paulo, Brazil; (A.L.M.C.); (H.R.Z.O.); (I.R.); (A.C.D.); (A.d.S.M.)
- National Institute of Science and Technology for Bioanalytics—INCTBio, Institute of Chemistry, Universidade Estadual de (UNICAMP), Campinas 13083-970, São Paulo, Brazil
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Luiz Bezerra1 A, da Silva Rezende Moreira1 A, Isidoro-Gonçalves2 L, F. dos Santos Lara1,3 C, Amorim4 G, C. Silva1,5,6,7 E, Lineu Kritski1 A, Cristina C. Carvalho1,2 A. Clinical, laboratory, and radiographic aspects of patients with pulmonary tuberculosis and dysglycemia and tuberculosis treatment outcomes. J Bras Pneumol 2022; 48:e20210505. [DOI: 10.36416/1806-3756/e20210505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 08/19/2022] [Indexed: 11/09/2022] Open
Abstract
Objective: To analyze the association of dysglycemia with clinical, laboratory, and radiographic characteristics of patients with pulmonary tuberculosis (PTB), as well as with their tuberculo-sis treatment outcomes. Methods: This was a longitudinal study involving 140 patients diag-nosed with PTB (positive cultures for Mycobacterium tuberculosis or positive Xpert MTB/RIF results from sputum samples). Patients were evaluated at diagnosis (M0), after completing the second month of treatment (M2), and at the end of treatment (MEND). At M0, the pati-ents were classified into three groups: normoglycemia+PTB (NGTB); pre-diabetes melli-tus+PTB (PDMTB), and diabetes mellitus+PTB (DMTB), in accordance with glycated hemoglo-bin levels (< 5.7%, 5.7%-6.4%, and = 6.5%, respectively). Treatment outcomes were classified as favorable (cure or treatment completion) and unfavorable (death, loss to follow-up, or treatment failure). Results: In our sample, 76 patients (61.4%) had dysglycemia, 20 of whom (14.3%) had DM at M0. The patients with dysglycemia, in comparison with those in the NGTB group, more frequently presented with positive sputum smear microscopy (94.2% vs. 75.9%; p = 0.003); cavities (80.2% vs. 63.0%; p = 0.03); bilateral lesions (67.4% vs. 46.0%; p = 0.02); and higher median of affected thirds of the lungs (3.0 vs. 2.0; p = 0.03) on chest radiography. No significant differences regarding outcomes were found among the groups, but tuberculosis lethality was higher in the DMTB group than in the PDMTB and NGTB groups (20% vs. 2.2%). Conclusions: PTB patients with dysglycemia had laboratory and radiographic manifestations indicative of more advanced disease, and the risk of death was higher in the DMTB group. These findings reinforce the recommendation for early screening for DM in patients with newly diagnosed tuberculosis in order to reduce the risk of death during treatment.
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Affiliation(s)
- André Luiz Bezerra1
- 1. Programa Acadêmico de Tuberculose, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ) Brasil
| | | | - Lorrayne Isidoro-Gonçalves2
- 2. Laboratório de Inovações em Terapias, Ensino e Bioprodutos – LITEB – Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro (RJ) Brasil
| | - Carla F. dos Santos Lara1,3
- 1. Programa Acadêmico de Tuberculose, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ) Brasil. 3. Serviço de Tisiologia, Centro Municipal de Saúde de Duque de Caxias, Secretaria Municipal de Duque de Caxias, Duque de Caxias (RJ) Brasil
| | - Gustavo Amorim4
- 4. Department of Biostatistics, Vanderbilt University Medical Center, Nashville (TN) USA
| | - Elisangela C. Silva1,5,6,7
- 1. Programa Acadêmico de Tuberculose, UFRJ, Rio de Janeiro (RJ) Brasil.5. Laboratório de Micobacteriologia Molecular, Hospital Universitário Clementino Fraga Filho, Instituto de Doenças do Tórax – HUCFF-IDT – Faculdade de Medicina, UFRJ, Rio de Janeiro (RJ) Brasil. 6. Laboratório Reconhecer Biologia, Centro de Biociência e Biotecnologia UENF, Campos dos Goytacases (RJ) Brasil. 7. Fundação Saúde do Estado do Rio de Janeiro, Secretaria de Saúde do Estado do Rio de Janeiro, Rio de Janeiro (RJ) Brasil
| | - Afrânio Lineu Kritski1
- 1. Programa Acadêmico de Tuberculose, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ) Brasil
| | - Anna Cristina C. Carvalho1,2
- 1. Programa Acadêmico de Tuberculose, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ) Brasil. 2. Laboratório de Inovações em Terapias, Ensino e Bioprodutos – LITEB – Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro (RJ) Brasil
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Adhikari C, Dhakal R, Adhikari LM, Parajuli B, Subedi KR, Aryal Y, Thapa AK, Shah K. Need for HTA supported risk factor screening for hypertension and diabetes in Nepal: A systematic scoping review. Front Cardiovasc Med 2022; 9:898225. [PMID: 35979024 PMCID: PMC9376353 DOI: 10.3389/fcvm.2022.898225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 07/12/2022] [Indexed: 11/13/2022] Open
Abstract
Objective Health Technology Assessment (HTA) is a comprehensive and important tool for assessment and decision-making in public health and healthcare practice. It is recommended by the WHO and has been applied in practice in many countries, mostly the developed ones. HTA might be an important tool to achieve universal health coverage (UHC), especially beneficial to low-and-middle-income countries (LMIC). Even though the Package for Essential Non-communicable Diseases (PEN) has already been initiated, there is a clear policy gap in the HTA of any health device, service, or procedure, including the assessment of cardiovascular risk factors (CVRFs) in Nepal. Hence, we carried out the review to document the HTA supported evidence of hypertension and diabetes screening, as CVRFs in Nepal. Materials and methods We searched in PubMed, Cochrane, and Google Scholar, along with some gray literature published in the last 6 years (2016–2021) in a systematic way with a controlled vocabulary using a well-designed and pilot tested search strategy, screened them, and a total of 53 articles and reports that matched the screening criteria were included for the review. We then, extracted the data in a pre-designed MS-Excel format, first in one, and then, from it, in two, with more specific data. Results Of 53 included studies, we reported the prevalence and/or proportion of hypertension and diabetes with various denominators. Furthermore, HTA-related findings such as cost, validity, alternative tool or technology, awareness, and intervention effectiveness have been documented and discussed further, however, not summarized due to their sparingness. Conclusion Overall, the prevalence of DM (4.4–18.8%) and HTN (17.2–70.0%) was reported in most studies, with a few, covering other aspects of HTA of DM/HTN. A national policy for establishing an HTA agency and some immediately implementable actions are highly recommended.
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Affiliation(s)
- Chiranjivi Adhikari
- Department of Public Health, SHAS, Pokhara University, Pokhara, Nepal
- Indian Institute of Public Health Gandhinagar, Gandhinagar, India
- *Correspondence: Chiranjivi Adhikari
| | - Rojana Dhakal
- Department of Nursing, School of Health and Allied Sciences, Pokhara University, Pokhara, Nepal
- Department of Life and Health Sciences, University of Nicosia, Nicosia, Cyprus
| | - Lal Mani Adhikari
- Health Research and Social Development Forum International, Kathmandu, Nepal
| | - Bijaya Parajuli
- Ministry of Health and Population, Gandaki Province, Myagdi Health Office, Myagdi, Nepal
| | - Khem Raj Subedi
- Department of Economics, Far Western University, Tikapur Multiple Campus, Kailali, Nepal
| | | | - Arjun Kumar Thapa
- Department of Economics, School of Humanities and Social Sciences, Pokhara University, Pokhara, Nepal
| | - Komal Shah
- Indian Institute of Public Health Gandhinagar, Gandhinagar, India
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Gupta A, Marzook H, Ahmad F. Comorbidities and clinical complications associated with SARS-CoV-2 infection: an overview. Clin Exp Med 2022; 23:313-331. [PMID: 35362771 PMCID: PMC8972750 DOI: 10.1007/s10238-022-00821-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 03/12/2022] [Indexed: 01/08/2023]
Abstract
The novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) causes major challenges to the healthcare system. SARS-CoV-2 infection leads to millions of deaths worldwide and the mortality rate is found to be greatly associated with pre-existing clinical conditions. The existing dataset strongly suggests that cardiometabolic diseases including hypertension, coronary artery disease, diabetes and obesity serve as strong comorbidities in coronavirus disease (COVID-19). Studies have also shown the poor outcome of COVID-19 in patients associated with angiotensin-converting enzyme-2 polymorphism, cancer chemotherapy, chronic kidney disease, thyroid disorder, or coagulation dysfunction. A severe complication of COVID-19 is mostly seen in people with compromised medical history. SARS-CoV-2 appears to attack the respiratory system causing pneumonia, acute respiratory distress syndrome, which lead to induction of severe systemic inflammation, multi-organ dysfunction, and death mostly in the patients who are associated with pre-existing comorbidity factors. In this article, we highlighted the key comorbidities and a variety of clinical complications associated with COVID-19 for a better understanding of the etiopathogenesis of COVID-19.
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Affiliation(s)
- Anamika Gupta
- Cardiovascular Research Group, Sharjah Institute for Medical Research, University of Sharjah, Sharjah, 27272, UAE
| | - Hezlin Marzook
- Cardiovascular Research Group, Sharjah Institute for Medical Research, University of Sharjah, Sharjah, 27272, UAE
| | - Firdos Ahmad
- Cardiovascular Research Group, Sharjah Institute for Medical Research, University of Sharjah, Sharjah, 27272, UAE. .,Department of Basic Medical Sciences, College of Medicine, University of Sharjah, Sharjah, 27272, UAE.
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Gradient association between pulmonary tuberculosis and diabetes mellitus among households with a tuberculosis case: a contact tracing-based study. Sci Rep 2022; 12:1854. [PMID: 35115583 PMCID: PMC8814182 DOI: 10.1038/s41598-022-05417-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 12/30/2021] [Indexed: 11/09/2022] Open
Abstract
Pulmonary tuberculosis (PTB) and diabetes mellitus (DM) remain high morbidity and mortality, especially when they are comorbid with each other. Screening for diabetes mellitus in tuberculosis is essential as the incidence and mortality of DM in the population with PTB are higher than in the general people. We aimed to examine the gradient association of tuberculosis on developing DM, the additional yield and the number needed to screen (NNS) to find a new diabetes case. A cross-sectional study was conducted on 801 tuberculosis cases and 972 household contacts in Guizhou, China, from April 2019 to October 2020. After screening for PTB among contacts, all participants were screened for DM and interviewed. Kendall's tau-b test and proportional odds logistic regression analysis were applied to identify the gradient associations. Among the 1773 subjects, the additional yield of screening was 21.8%. The NNSs of the non-PTB group, the sputum-culture negative and positive groups were 50, 60 and 113, respectively. The gradient incremental establishment of DM and PTB were positively correlated. The general trend on the gradient of DM significantly increased with the gradient increase of PTB. Age 35 years and over, excessive edible oil intake and DM family history were identified as significant predictors of diabetes. Integrated screening for DM targeted to different gradients of PTB combined with associated factors is necessitated to achieve a higher additional yield.
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Yield, NNS and prevalence of screening for DM and hypertension among pulmonary tuberculosis index cases and contacts through single time screening: A contact tracing-based study. PLoS One 2022; 17:e0263308. [PMID: 35089989 PMCID: PMC8797235 DOI: 10.1371/journal.pone.0263308] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Accepted: 01/18/2022] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION Diabetes mellitus (DM), hypertension and pulmonary tuberculosis (PTB) are catastrophic illnesses that collectively lead to increased mortality and premature death. However, the size of the problem and the appropriate approach to deal with the burden is still unclear. We aimed to evaluate the yield, number needed to screen (NNS) to prevent one death or adverse event for screening DM and hypertension and assess the prevalence and contributors to DM and/or hypertension. METHODS Based on PTB contact tracing, a cross-sectional study was conducted among 801 PTB index cases and 972 household contacts from April 2019 to October 2020 in Guizhou, China. All the participants were screened for DM and hypertension. The yield was calculated as the proportion of newly detected cases among the study subjects, excluding known cases. The NNS was computed by dividing the number needed to treat for risk factors by the prevalence of the unrecognized diseases. The univariate and multivariate logistic regression analyses were applied to determine the independent predictors of DM and/or hypertension. RESULTS Of the 1,773 participants, the prevalence of DM and hypertension was 8.7% (70/801) and 15.2% (122/801) in the PTB patients, 3.2% (31/972) and 14.0% (136/972) in the contacts, respectively. The prevalence of DM and/or hypertension was 21.2% (170/801) among the PTB patients and 15.4% (150/972) among their contacts. The screening yields to detect new cases of DM and hypertension among PTB patients were 1.9% and 5.2%, and that in the contacts were 0.8% and 4.8%, respectively. The NNS for DM was 359 for the PTB cases and 977 for the contacts, 299 for PTB cases and 325 for hypertension, respectively. Older age, under or overweight and obesity, family history hypertension and earlier diagnosis of other chronic conditions were the independent predictors for DM and/or hypertension among both PTB cases and their contacts. CONCLUSION Screening for DM and hypertension should be mandated in PTB patients and their household contacts to disclose undetected cases of these two conditions during TB contact tracing, which might reduce the potential cardiovascular disease deaths.
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Shrestha DB, Budhathoki P, Sedhai YR, Marahatta A, Lamichhane S, Nepal S, Adhikari A, Poudel A, Nepal S, Atreya A. Type 2 Diabetes Mellitus in Nepal from 2000 to 2020: A systematic review and meta-analysis. F1000Res 2021; 10:543. [PMID: 34621512 PMCID: PMC8459622 DOI: 10.12688/f1000research.53970.2] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/31/2021] [Indexed: 11/20/2022] Open
Abstract
Aims: To evaluate the prevalence and risk factors of type 2 diabetes mellitus (T2DM) from 2000-2020 in various parts of Nepal. Methods: PubMed, Embase, Scopus, and Google Scholar were searched using the appropriate keywords. All Nepalese studies mentioning the prevalence of T2DM and/or details such as risk factors were included. Studies were screened using Covidence. Two reviewers independently selected studies based on the inclusion criteria. Meta-analysis was conducted using Comprehensive Meta-Analysis Software v.3. Results: A total of 15 studies met the inclusion criteria. The prevalence of T2DM, pre-diabetes, and impaired glucose tolerance in Nepal in the last two decades was 10% (CI, 7.1%- 13.9%), 19.4% (CI, 11.2%- 31.3%), and 11.0% (CI, 4.3%- 25.4%) respectively. The prevalence of T2DM in the year 2010-15 was 7.75% (CI, 3.67-15.61), and it increased to 11.24% between 2015-2020 (CI, 7.89-15.77). There were 2.19 times higher odds of having T2DM if the body mass index was ≥24.9 kg/m 2. Analysis showed normal waist circumference, normal blood pressure, and no history of T2DM in a family has 64.1%, 62.1%, and 67.3% lower odds of having T2DM, respectively. Conclusion: The prevalence of T2DM, pre-diabetes, and impaired glucose tolerance in Nepal was estimated to be 10%, 19.4%, and 11% respectively.
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Affiliation(s)
| | - Pravash Budhathoki
- Department of Emergency Medicine, Dr. Iwamura Memorial Hospital, Bhaktapur, 44800, Nepal
| | - Yub Raj Sedhai
- Department of Internal Medicine, Virginia Commonwealth University, School of Medicine, Richmond, Virginia, 23298, USA
| | - Achyut Marahatta
- Chitwan Medical College Teaching Hospital, Chitwan, 44200, Nepal
| | - Samit Lamichhane
- Chitwan Medical College Teaching Hospital, Chitwan, 44200, Nepal
| | - Sarbin Nepal
- Chitwan Medical College Teaching Hospital, Chitwan, 44200, Nepal
| | - Anurag Adhikari
- Department of Emergency Medicine, Nepal National Hospital, Kathmandu, Bagmati, 44600, Nepal
| | - Ayusha Poudel
- Department of Emergency Medicine, Alka Hospital, Lalitpur, Bagmati, 44600, Nepal
| | - Samata Nepal
- Department of Community Medicine, Lumbini Medical College, Palpa, Lumbini, 32500, Nepal
| | - Alok Atreya
- Department of Forensic Medicine, Lumbini Medical College, Palpa, Lumbini, 32500, Nepal
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Knowledge, Practice and Attitude towards Foot Ulcers and Foot Care among Adults Living with Diabetes in Tobago: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18158021. [PMID: 34360314 PMCID: PMC8345419 DOI: 10.3390/ijerph18158021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 07/14/2021] [Accepted: 07/26/2021] [Indexed: 12/15/2022]
Abstract
Globally, the prevalence of diabetes has risen significantly by 62% over the last ten years. A complication of unmanaged diabetes is diabetic foot ulcer (DFU), which adversely affects the quality of life of individuals with diabetes and inflicts a huge economic burden on the family, government, and health care services. However, this complication is preventable with adequate patient knowledge and practice regarding DFU and foot care. The present study was aimed at assessing the knowledge, attitude, and practice of adults with diabetes on foot ulcers and foot care in Tobago using a qualitative exploratory design. Purposeful sampling technique was used to recruit 20 participants from the lifestyle and diabetes foot clinics of Scarborough Health Centre, Tobago. Telephone interviews were conducted with the use of a semi-structured interview guide. The data obtained from participants were analyzed using thematic content analysis. Four major themes, namely foot ulcer problems, participants’ knowledge on DFU, knowledge on foot care, and practice and attitude of foot care, emerged from the study. The findings from the study revealed that the majority of participants had poor knowledge regarding DFU but exhibited awareness about foot care, especially on foot cleaning and inspection, preventing irritation after washing, appropriate footwear, and not walking barefooted. The participants had good attitudes and practices of foot care despite their poor knowledge of DFU. However, participants reported inadequate health education on DFU and foot care from healthcare personnel. There should be improved health education, information, and communication on DFU and foot care centred and tailored to the understanding of people living with diabetes. This will prevent DFU and reduce the mortality arising from this complication, which is a major target of the sustainable development goals (SDG) in mitigating the burden of non-communicable diseases (NCD) such as diabetes.
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Shrestha DB, Budhathoki P, Sedhai YR, Marahatta A, Lamichhane S, Nepal S, Adhikari A, Poudel A, Nepal S, Atreya A. Type 2 Diabetes Mellitus in Nepal from 2000 to 2020: A systematic review and meta-analysis. F1000Res 2021; 10:543. [PMID: 34621512 PMCID: PMC8459622 DOI: 10.12688/f1000research.53970.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/31/2021] [Indexed: 04/19/2024] Open
Abstract
Aims: To evaluate the prevalence and risk factors of type 2 diabetes mellitus (T2DM) from 2000-2020 in various parts of Nepal. Methods: PubMed, Embase, Scopus, and Google Scholar were searched using the appropriate keywords. All Nepalese studies mentioning the prevalence of T2DM and/or details such as risk factors were included. Studies were screened using Covidence. Two reviewers independently selected studies based on the inclusion criteria. Meta-analysis was conducted using Comprehensive Meta-Analysis Software v.3. Results: A total of 15 studies met the inclusion criteria. The prevalence of T2DM, pre-diabetes, and impaired glucose tolerance in Nepal in the last two decades was 10% (CI, 7.1%- 13.9%), 19.4% (CI, 11.2%- 31.3%), and 11.0% (CI, 4.3%- 25.4%) respectively. The prevalence of T2DM in the year 2010-15 was 7.75% (CI, 3.67-15.61), and it increased to 11.24% between 2015-2020 (CI, 7.89-15.77). There were 2.19 times higher odds of having T2DM if the body mass index was ≥24.9 kg/m 2. Analysis showed normal waist circumference, normal blood pressure, and no history of T2DM in a family has 64.1%, 62.1%, and 67.3% lower odds of having T2DM, respectively. Conclusion: The prevalence of T2DM, pre-diabetes, and impaired glucose tolerance in Nepal was estimated to be 10%, 19.4%, and 11% respectively.
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Affiliation(s)
| | - Pravash Budhathoki
- Department of Emergency Medicine, Dr. Iwamura Memorial Hospital, Bhaktapur, 44800, Nepal
| | - Yub Raj Sedhai
- Department of Internal Medicine, Virginia Commonwealth University, School of Medicine, Richmond, Virginia, 23298, USA
| | - Achyut Marahatta
- Chitwan Medical College Teaching Hospital, Chitwan, 44200, Nepal
| | - Samit Lamichhane
- Chitwan Medical College Teaching Hospital, Chitwan, 44200, Nepal
| | - Sarbin Nepal
- Chitwan Medical College Teaching Hospital, Chitwan, 44200, Nepal
| | - Anurag Adhikari
- Department of Emergency Medicine, Nepal National Hospital, Kathmandu, Bagmati, 44600, Nepal
| | - Ayusha Poudel
- Department of Emergency Medicine, Alka Hospital, Lalitpur, Bagmati, 44600, Nepal
| | - Samata Nepal
- Department of Community Medicine, Lumbini Medical College, Palpa, Lumbini, 32500, Nepal
| | - Alok Atreya
- Department of Forensic Medicine, Lumbini Medical College, Palpa, Lumbini, 32500, Nepal
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Thapa DK, Visentin D, Kornhaber R, Cleary M. Psychometric properties of the Nepali language version of the Depression Anxiety Stress Scales (DASS-21). Nurs Open 2021; 9:2608-2617. [PMID: 34161668 PMCID: PMC9584496 DOI: 10.1002/nop2.959] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 02/18/2021] [Accepted: 05/27/2021] [Indexed: 11/30/2022] Open
Abstract
Aim To assess the psychometric properties of the Nepali language version of the Depression Anxiety Stress Scales (DASS‐21). Design Descriptive, cross‐sectional survey. Methods The DASS‐21 was administered (May–July 2019) among 794 randomly selected older adults aged ≥60 years. Factor structure was evaluated using exploratory and confirmatory factor analyses. Cronbach's alpha was calculated, and correlation analyses with quality of life evaluated convergent validity. Results Exploratory factor analysis indicated that the 21 items loaded on three factors, with factor loadings ranging from 0.50–0.88. Confirmatory factor analysis suggested a four‐factor model including the three subscales and an additional common 'general distress’ factor, which demonstrated a better overall fit. Good reliability was found for each subscale, with Cronbach's alphas 0.79 for Anxiety, 0.91 for Stress, and 0.93 for Depression. The Nepali language version of the DASS‐21 satisfied convergent validity with all subscales depicting significant negative correlations with quality of life demonstrating adequate psychometric properties.
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Affiliation(s)
- Deependra Kaji Thapa
- Nepal Public Health Research and Development Center, Kathmandu, Nepal.,College of Health and Medicine, University of Tasmania, Sydney, NSW, Australia
| | - Denis Visentin
- College of Health and Medicine, University of Tasmania, Sydney, NSW, Australia
| | - Rachel Kornhaber
- College of Health and Medicine, University of Tasmania, Sydney, NSW, Australia
| | - Michelle Cleary
- School of Nursing, Midwifery and Social Sciences, Central Queensland University, Sydney, NSW, Australia
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Gautam S, Shrestha N, Mahato S, Nguyen TPA, Mishra SR, Berg-Beckhoff G. Diabetes among tuberculosis patients and its impact on tuberculosis treatment in South Asia: a systematic review and meta-analysis. Sci Rep 2021; 11:2113. [PMID: 33483542 PMCID: PMC7822911 DOI: 10.1038/s41598-021-81057-2] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 12/18/2020] [Indexed: 01/30/2023] Open
Abstract
The escalating burden of diabetes is increasing the risk of contracting tuberculosis (TB) and has a pervasive impact on TB treatment outcomes. Therefore, we conducted this systematic review and meta-analysis to examine the burden of diabetes among TB patients and assess its impact on TB treatment in South Asia (Afghanistan, Bangladesh, Bhutan, Maldives, Nepal, India, Pakistan, and Sri Lanka). PubMed, Excerpta Medica Database (EMBASE), and CINAHL databases were systematically searched for observational (cross-sectional, case-control and cohort) studies that reported prevalence of diabetes in TB patients and published between 1 January 1980 and 30 July 2020. A random-effect model for computing the pooled prevalence of diabetes and a fixed-effect model for assessing its impact on TB treatment were used. The review was registered with PROSPERO number CRD42020167896. Of the 3463 identified studies, a total of 74 studies (47 studies from India, 10 from Pakistan, four from Nepal and two from both Bangladesh and Sri-Lanka) were included in this systematic review: 65 studies for the prevalence of diabetes among TB patients and nine studies for the impact of diabetes on TB treatment outcomes. The pooled prevalence of diabetes in TB patients was 21% (95% CI 18.0, 23.0; I2 98.3%), varying from 11% in Bangladesh to 24% in Sri-Lanka. The prevalence was higher in studies having a sample size less than 300 (23%, 95% CI 18.0, 27.0), studies conducted in adults (21%, 95% CI 18.0, 23.0) and countries with high TB burden (21%, 95% CI 19.0, 24.0). Publication bias was detected based on the graphic asymmetry of the funnel plot and Egger's test (p < 0.001). Compared with non-diabetic TB patients, patients with TB and diabetes were associated with higher odds of mortality (Odds Ratio (OR) 1.7; 95% CI 1.2, 2.51; I2 19.4%) and treatment failure (OR 1.7; 95% CI 1.1, 2.4; I2 49.6%), but not associated with Multi-drug resistant TB (OR 1.0; 95% CI 0.6, 1.7; I2 40.7%). This study found a high burden of diabetes among TB patients in South Asia. Patients with TB-diabetes were at higher risk of treatment failure and mortality compared to TB alone. Screening for diabetes among TB patients along with planning and implementation of preventive and curative strategies for both TB and diabetes are urgently needed.
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Affiliation(s)
- Sanju Gautam
- Faculty of Health Science, University of Southern Denmark, Odense, Denmark
| | | | - Sweta Mahato
- Faculty of Health Science, University of Southern Denmark, Odense, Denmark
| | - Tuan P A Nguyen
- Faculty of Health Science, University of Southern Denmark, Odense, Denmark
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