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Abate TW, Genanew A, Gedamu H, Tegenaw A, Ayalew E, Berhie AY, Ergetie T, Shibesh BF. Unmasking the silent epidemic: a comprehensive systematic review and meta-analysis of undiagnosed diabetes in Ethiopian adults. Front Endocrinol (Lausanne) 2024; 15:1372046. [PMID: 39086906 PMCID: PMC11288971 DOI: 10.3389/fendo.2024.1372046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 07/03/2024] [Indexed: 08/02/2024] Open
Abstract
Background Undiagnosed diabetes mellitus poses a significant global public health concern, exerting a substantial impact on the well-being of individuals, their families, and societies at large. Those individuals with undiagnosed diabetes miss opportunities to maintain quality of life and prevent diabetes-related complications. Even if there are ample primary studies on undiagnosed diabetes in Ethiopia, the results reveal conflicting results. Therefore, a comprehensive national picture of undiagnosed diabetes is essential for designing effective strategies at the national level. Methods This study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for prevalence studies (PROSPERO ID: CRD42021266676). PubMed, Web of Science and the World Health Organization's Hinari portal were searched using a strategy developed in collaboration with Liberians. The inclusion criteria comprised studies reporting undiagnosed diabetes in Ethiopia. Two independent reviewers conducted a quality assessment using a 10-item appraisal tool. Meta-analysis and meta-regression were performed using a random-effects model. Result Twenty-five studies with 22,193 participants met the inclusion criteria. The pooled prevalence of undiagnosed diabetes among the Ethiopian adult population was 5.68% (95% CI: 4.53 - 6.83, I2 = 75.4). Factors significantly associated with undiagnosed diabetes include age, waist circumference, overweight, family history of diabetes, and a history of hypertension. Conclusion Our systematic review found a noteworthy prevalence of undiagnosed diabetes in Ethiopia. The majority of factors linked with undiagnosed diabetes in this review were modifiable. This underscores the importance of targeted factors and public health interventions to improve early detection and reduce the burden of undiagnosed diabetes and its complications in Ethiopia. Systematic review registration https://www.crd.york.ac.uk/prospero, identifier CRD42021266676.
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Affiliation(s)
- Teshager Woldegiyorgis Abate
- Faculty of Nursing University of Alberta, Edmonton Clinic Health Academy, Edmonton, AB, Canada
- Department of Adult Health Nursing, Scholl of Health Sciences, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Ashenafi Genanew
- Department of Pharmacy, School of Health Sciences, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Haileyesus Gedamu
- Department of Adult Health Nursing, School of Health Sciences, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Abebu Tegenaw
- Department of Adult Health Nursing, School of Health Sciences, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Emiru Ayalew
- Department of Adult Health Nursing, School of Health Sciences, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Alemeshet Yirga Berhie
- Department of Adult Health Nursing, School of Health Sciences, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Temesgen Ergetie
- Department of Psychiatry, School of Medicine, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Belayneh Fentahun Shibesh
- Faculty of Medicine and Health Sciences, University of Oviedo, Oviedo, Spain
- Department of Public Health, Medical School of the University of Nicosia, Nicosia, Cyprus
- Nature, Climate and Health, United Nations University CRIS, Bruges, Belgium
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Manyara AM, Mwaniki E, Gill JMR, Gray CM. Knowledge, perceptions and practices towards diabetes risk in sub-Saharan Africa: a mixed-methods scoping review. Public Health Nutr 2024; 27:e104. [PMID: 38533768 PMCID: PMC11010065 DOI: 10.1017/s1368980024000752] [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: 07/07/2023] [Revised: 03/03/2024] [Accepted: 03/19/2024] [Indexed: 03/28/2024]
Abstract
OBJECTIVE To synthesise current evidence on knowledge, perceptions and practices towards type 2 diabetes risk in sub-Saharan Africa. DESIGN Mixed-methods scoping review, which included 101 studies (seventy-three quantitative, twenty qualitative and eight mixed methods) from seven electronic databases. SETTING Sub-Saharan Africa, 2000-2023. PARTICIPANTS Men and women without diabetes with mean ages ranging from 20 to 63 years. RESULTS The majority of participants in most studies knew the three main diabetes modifiable risk factors - excess weight, unhealthy diet and physical inactivity. However, most people with excess weight in almost all studies underestimated their weight. Further, the self-described ideal body weight was between midpoint of normal weight and the upper limits of overweight in most quantitative studies and was described as not too skinny but not too fat in qualitative studies. In the majority of studies, participants reported low engagement in weight control, high regular sugar intake, and low regular fruit and vegetable intake but moderate to high engagement in physical activity. Barriers to reducing diabetes risk were social (e.g. societal perceptions promoting weight gain) and environmental (e.g. limited affordability of healthy foods, high accessibility of Western diets and lack of physical activity facilities). CONCLUSION There is a need for multicomponent type 2 diabetes prevention interventions that increase knowledge of identifying diabetes risk (e.g. what constitutes excess weight) and create social and physical environments that support healthy lifestyles (e.g. societal perceptions that promote healthy living, increased availability and affordability of healthy foods and physical activity facilities).
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Affiliation(s)
- Anthony Muchai Manyara
- School of Health and Wellbeing, University of
Glasgow, Glasgow, UK
- Department of Health Systems Management and Public Health,
Technical University of Kenya, Nairobi,
Kenya
- Global Health and Ageing Research Unit, Bristol Medical School,
University of Bristol, Bristol,
UK
| | - Elizabeth Mwaniki
- Department of Health Systems Management and Public Health,
Technical University of Kenya, Nairobi,
Kenya
| | - Jason MR Gill
- School of Cardiovascular and Metabolic Health, University of
Glasgow, Glasgow, UK
| | - Cindy M Gray
- School of Health and Wellbeing, University of
Glasgow, Glasgow, UK
- School of Social and Political Sciences, University of
Glasgow, Glasgow, UK
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Albalawi ARSA, Ahmed EME. Knowledge of Household Contacts of Diabetic Patients about the Disease. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.10935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background: Diabetes is a complex, chronic illness requiring continuous medical care with multifactorial risk-reduction strategies beyond glycemic control. Ongoing patients and their household care givers self-management education and support are critical to preventing acute complications and reducing the risk of long-term complications
Objectives: To assess the knowledge of household contacts about different aspects of diabetes and determine factors affecting it.
Subjects and methods: Cross sectional analytic design was conducted in Buraidah city, North central Saudi Arabia among a sample of household contacts of diabetic patients (Type 1 or 2) attending Buraidah diabetic center throughout the period of the study. A valid self-administered questionnaire including question about socio-demographic characteristics of the participants, patient’s diabetic characteristics and knowledge questions regarding diabetes was used for data collection.
Results: The study included 422 household contacts of diabetic patients. The age of 44% of the participants was ranging between 20 and 39 years. Females represent 55.2% of them. Almost two-thirds of the participants (64.4%) expressed adequate level of knowledge about diabetes whereas 12.6% had poor level of knowledge. Their main source of information about diabetes was physicians (56.9%), followed by books/social media (23.9%). Household contacts aged between 20 and 39 years, singles, postgraduate educated, working, being sons and parents of patients were more knowledgeable about diabetes compared to their counterparts. Participants whose patients had more duration of diabetes, family support, and no foot fungal infection were more knowledgeable about the disease. With increasing in the level of HbA1c% among diabetic patients, the knowledge of household contacts about the disease decreased, p<0.001.
Conclusion: Knowledge of household contacts of diabetic patients in Buraidh city, Saudi Arabia about diabetes was overall adequate with some identified deficient facts. The increase in the level of knowledge was accompanied with more glycemic control.
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L McCrory-Churchill S, Hill E. Prevention of type 2 diabetes in sub-Saharan Africa, a review. Glob Health Promot 2022; 29:40-44. [PMID: 35081827 DOI: 10.1177/17579759211065058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Type 2 diabetes (T2D) is a significant factor in the overall burden of non-communicable diseases (NCDs) in sub-Saharan Africa (SSA). While many health organizations call for increased attention to this disease, far fewer resources are being allocated to evidence-based prevention programs. The literature demonstrates a lack of reporting on prevention programs, interventions targeted to decrease the development of T2D, and success stories. METHODS This review followed the recommendations in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Databases searched were PubMed, Google Scholar, Ovid, Medline, World Health Organization (WHO) Library Information System, and African Journals Online. The following terms were searched individually and in multiple combinations: prevention, intervention, type 2 diabetes, sub-Saharan Africa, education, strategy, strategic plan, risk factors. In total, 253 articles were found and 17 were removed as duplicates. Of these, 78 abstracts were reviewed, with 20 being excluded for not meeting criteria, one was excluded as it was not available in English and one was excluded for lack of availability. After the remaining 56 full-text studies were assessed, seven were included in the review. RESULTS Throughout the review, the common theme between articles was a lack of resources, lack of prevention strategies, and increasing risk factors. The review highlights the fact that while there are WHO guidelines and packages targeted at primary care level interventions for the prevention and treatment of NCDs, they remain underutilized. Included studies looked at the knowledge level of family members, social marketing and sugar consumption, and primary prevention strategies. CONCLUSION There is an overall lack of reporting on interventions targeting the prevention of type 2 diabetes in SSA. Further research is warranted on interventions, prevention strategies, and implementation of the WHO package targeted at NCDs.
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Affiliation(s)
| | - Ellen Hill
- Old Dominion University, Norfolk, VA, USA
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Enang OE, Omoronyia OE, Ayuk AE, Nwafor KN, Legogie AO. Diabetes knowledge among non-diabetic hypertensive patients in Calabar, Nigeria. Pan Afr Med J 2020; 36:198. [PMID: 32952842 PMCID: PMC7467622 DOI: 10.11604/pamj.2020.36.198.20522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 06/29/2020] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION among hypertensive patients, the comorbidity of diabetes is not uncommon. Yet, little is known about diabetes prevention among non-diabetic hypertensive patients. This study sought to assess such patients' knowledge about diabetes and its risk factors. METHODS a cross-sectional descriptive study design and random sampling were used to recruit non-diabetic hypertensive patients from University of Calabar Teaching Hospital. A pretested 33-item questionnaire was used to assess various aspects of diabetes knowledge. Participants' alcohol consumption, smoking habits, physical activity, and fresh fruit consumption were also assessed. The p-value was set to 0.05. RESULTS of 212 respondents with a mean age of 45.5 ± 10.8 years, approximately half (49.1%) had inadequate knowledge of diabetes. Most participants demonstrated poor knowledge of diabetes' clinical features (81.1%) and complications (59.4%), while fewer participants showed poor knowledge of causes and risk factors (24.5%) and diabetes management (40.6%). Older subjects, those in the wards, non-drinkers, physically active people, and those who frequently consumed fresh fruit had a significantly greater understanding of diabetes symptoms and complications (p<0.05). CONCLUSION hypertensive patients' diabetes knowledge is generally suboptimal, with greater knowledge deficiencies being apparent in specific areas. More strategic health education initiatives are required, about minimizing the risk of developing diabetes comorbidities.
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Affiliation(s)
- Ofem Egbe Enang
- Department of Internal Medicine, University of Calabar, Calabar, Nigeria
| | | | - Agam Ebaji Ayuk
- Department of Family Medicine, University of Calabar, Calabar, Nigeria
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Tesema DG, Gobena T, Ayalew A. Pulmonary Function Tests and Their Associated Factors Among Type 2 Diabetic Patients at Jimma Medical Center, in 2019; Comparative Cross-Sectional Study. Int J Gen Med 2020; 13:111-119. [PMID: 32308467 PMCID: PMC7152549 DOI: 10.2147/ijgm.s249683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 03/18/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The presence of widespread lung microvascular circulation and abundant connective tissue with a large reserve raises the possibility that the lung may be a target organ of the pathologic processes induced by type 2 diabetes. Pulmonary function tests (PFTs) are noninvasive medical tests that show how well the lungs are working. OBJECTIVE The aim was to compare pulmonary function tests (PFTs) and their associated factors among type 2 diabetic patients and non-diabetics at Jimma Medical Center (JMC). METHODS A comparative cross-sectional study was conducted at JMC, Jimma, Southwest Ethiopia among 298 study participants from April 1 to May 30, 2019. A face-to-face interview with semi-structured questionnaire was conducted. Forced vital capacity (FVC), forced expiratory volume in one second (FEV1), ratio of FEV1/FVC, peak expiratory flow (PEF), and forced expiratory flow (FEF25-75) were recorded by using a digital Spirometer. Independent samples t-test, simple and multiple linear regression analysis were used. RESULTS The present study indicated that means of the PFTs among type 2 diabetics were significantly reduced when compared to their matched non-diabetics (FVC (%) (m=73.7±13.8 vs m=93.8±12.3), FEV1 (%) (m=76.4±13.4 vs m=93.3±12.4), FEV1/FVC (%) (m=78.99±11.4 vs m=96.6±9.33), PEF (L/s) (m=3.91±0.28 vs m=5.03±0.35), and FEF25-75 (L/s) (m=2.89±0.75 vs m=3.39±0.82)). This study also indicated that body mass index (BMI) (β=-1.93, P<0.001) and fasting blood sugar (FBS) (β=-0.22, P<0.001) were negative predictors of FVC%. BMI (β=-1.93, P<0.001) and FBS (β=-0.29, P<0.001) were negative predictors of FEV1%. BMI (β=-1.403, P<0.001) was a negative predictor of mean FEV1/FVC. BMI (β=-1.39 P<0.001) and FBS (β=-0.15, P<0.001) were negative predictors of mean PEF (L/s). BMI (β=-0.075, P<0.001) and FBS (β=-0.075, P<0.001) were negative predictors of FEF25-75 (L/s). CONCLUSION The present study showed that there were significantly reduced mean scores of FVC, FEV1, FEV1/FVC, PEF, and FEF25-75 among type 2 diabetic patients as compared to non-diabetic participants. The FBS and BMI were independent risk factors of the PFTs among the diabetics, unlike among non-diabetic participants.
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Affiliation(s)
- Dereje Gemeda Tesema
- Mettu University, Faculty of Medical Sciences, Department of Biomedical Sciences, Mettu, Ethiopia
| | - Teshome Gobena
- Jimma University, Institute of Health, Faculty of Medical Sciences, Department of Biomedical Sciences, Jimma, Ethiopia
| | - Almaz Ayalew
- Jimma University, Institute of Health, Faculty of Medical Sciences, Department of Biomedical Sciences, Jimma, Ethiopia
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Alemayehu AM, Dagne H, Dagnew B. Knowledge and associated factors towards diabetes mellitus among adult non-diabetic community members of Gondar city, Ethiopia 2019. PLoS One 2020; 15:e0230880. [PMID: 32214398 PMCID: PMC7098606 DOI: 10.1371/journal.pone.0230880] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 03/10/2020] [Indexed: 11/24/2022] Open
Abstract
Introduction Diabetes mellitus is a metabolic disorder resulting from either loss of insulin producing cells, insufficient insulin action, or both. Knowledge can play an important role in preventing diabetes mellitus and its complications. There is limited information regarding knowledge and related factors regarding diabetes mellitus among non-diabetic adult community members in the study area. Therefore, the current study aimed to determine knowledge and associated factors towards diabetes mellitus among non-diabetes community members of Gondar city. Methods Community-based cross-sectional study was conducted on non-diabetic community members from July 1–29, 2019 in Gondar city. The participants were selected randomly from each households. A structured questionnaire was used to collect the data. EpiData version 3.1 was used for data entry and SPSS version 20 was used for data processing and analysis. Descriptive statistics were calculated for most variables. Multivariable logistic regression was used to identify the associated factors. A variable was considered significantly associated at p-value<0.05. Result A total of 633 study subjects participated in this study with a mean age of 36.12 (± 12.87) years. Of these study participants, 572 had awareness about diabetes mellitus and 51.4% (95% CI: 47.4%, 55.8%) had good knowledge. Being male [Adjusted odds ratio = 1.62 (95% CI: 1.05, 2.48)], monthly income of 3000–5000 birr [Adjusted odds ratio = 1.88 (95% CI: 1.03, 3.41)], monthly income of ≥5001 birr [Adjusted odds ratio = 2.37 (95% CI: 1.17, 4.78)], previous training on diabetes mellitus [Adjusted odds ratio = 4.37 (95% CI; 3.04, 7.37)], being grade 9–12 [Adjusted odds ratio = 3.1 (95% CI: 1.09, 8.66)], having college and above educational qualification [Adjusted odds ratio = 3.70 (95% CI: 1.26, 10.85)] were significantly associated with good knowledge towards diabetes mellitus. Conclusion The level of knowledge regarding diabetes mellitus was low among study participants which indicates a need for health education intervention. Previous training on diabetes mellitus, educational status and average monthly income and being male were the factors associated with good knowledge of participants about diabetes mellitus.
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Affiliation(s)
- Abiy Maru Alemayehu
- Department of Optometry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Henok Dagne
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Baye Dagnew
- Department of Human Physiology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Thandar MM, Kiriya J, Shibanuma A, Ong KIC, Tin KN, Win HH, Jimba M. Women's knowledge on common non-communicable diseases and nutritional need during pregnancy in three townships of Ayeyarwaddy region, Myanmar: a cross-sectional study. Trop Med Health 2019; 47:12. [PMID: 30723383 PMCID: PMC6352420 DOI: 10.1186/s41182-019-0137-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Accepted: 01/14/2019] [Indexed: 12/02/2022] Open
Abstract
Background Health systems in many countries do not adequately address non-communicable diseases (NCDs) during pregnancy, especially in low- and middle-income countries. In Myanmar, most studies on NCDs have investigated risk factors and prevalence of NCDs in the general population. This study aimed to assess the level of knowledge of common NCDs and nutritional need during pregnancy and to identify the factors associated with such knowledge, in three townships of Ayeyarwaddy region in Myanmar. Methods A cross-sectional study was conducted among pregnant women aged between 18 and 49 years. We interviewed 630 pregnant women by using a pretested structured questionnaire. Knowledge questionnaire had five categories: general knowledge in NCDs, hypertension, diabetes, anemia, and nutritional need during pregnancy. Knowledge scores ranged from 0 to 56. We used Bloom’s cut-off point to classify the knowledge into three levels: low level as 59% or below (0–33 scores), moderate level as 60–80% (34–49 scores), and high level as 80–100% (50–56 scores). We conducted multiple linear regression analyses to find the association between different exposure variables (behavioral risk factors, pre-existing NCDs in pregnant women, and family history of NCDs) and knowledge on common NCDs and nutritional need during pregnancy adjusted for socioeconomic factors. Results Among pregnant women, 64.8% had moderate level of knowledge, 22.7% had low level, and only 12.5% had high level. The mean knowledge scores were 39.6 (standard deviation 10.2). Pregnant women with the following factors were more likely to have higher knowledge: their belonging to the second, middle, and fourth quintiles of wealth index and their family members’ status of having some kind of NCDs. Conclusions Majority of pregnant women had low to moderate level of knowledge on common NCDs and nutritional need during pregnancy. Wealth and family history of NCDs were significantly associated with their knowledge. Prevention and promotion of NCDs should be integrated in maternal and child health programs and should emphasize for the pregnant women who are in the poorest or richest wealth quintiles and who do not have family history of NCDs.
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Affiliation(s)
- Moe Moe Thandar
- 1Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Junko Kiriya
- 1Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Akira Shibanuma
- 1Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Ken Ing Cherng Ong
- 1Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Khaing Nwe Tin
- 2Maternal and Reproductive Health Division, Department of Public Health, Ministry of Health and Sports, Nay Pyi Taw, Myanmar
| | - Hla Hla Win
- 3Department of Preventive and Social Medicine, University of Medicine 1, Yangon, Myanmar
| | - Masamine Jimba
- 1Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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