Non-communicable disease risk factors and treatment preference of obese patients in Cape Town

Prevalence of Non-communicable Disease Risk Factors Among Adults in a Rural Field Practice Area of a Tertiary Care Medical Center in Karnataka

Background Non-communicable diseases (NCDs), also referred to as chronic diseases, typically have a long duration and arise from a combination of genetic, physiological, environmental, and behavioral factors. Each year, 17 million people under the age of 70 die from non-communicable diseases (NCDs), with 86% of these premature deaths occurring in low- and middle-income countries. Objectives To estimate the prevalence of NCD risk factors among adults (18-65 years) in a rural population. Methods A cross-sectional study was conducted by selecting 200 participants from 200 households using convenience sampling. Participants aged 18-65 years were included, and locked households were excluded. Sociodemographic profiles were assessed using semi-structured questionnaires, and NCD risk factors were assessed using a Community-Based Assessment Checklist (CBAC). Descriptive statistics and associations were analyzed. Results The majority of participants were men (53.5%), married (89.5%), and belonged to the class 2 socioeconomic classification. The prevalence of NCD risk factors was 17%, with smoking (12.5%), alcohol consumption (6%), and waist circumference (1.8% for men and 27.9% for women) being the most common risk factors. Older age, lower educational attainment, unemployment, and lower-income classes were associated with a higher risk of NCDs. Conclusion The study identifies key risk factors for non-communicable diseases (NCDs) as family history, waist circumference over 90 cm, daily alcohol consumption, and tobacco use, all significantly increasing the risk. Physical activity under 150 minutes per week and occupational exposure to crop residue showed no significant effect.

Exploring dietitians' views on digital nutrition educational tools in Malaysia: a qualitative study

BACKGROUND/OBJECTIVES

Dietitians frequently use nutrition education tools to facilitate dietary counselling sessions. Nevertheless, these tools may require adaptation to keep pace with technological advancements. This study had a 2-fold purpose: first, to identify the types of nutrition education tools currently in use, identify their limitations, and explore dietitians' perspectives on the importance of these tools; second, to investigate the features that dietitians prefer in digital nutrition education tools.

SUBJECTS/METHODS

A semi-structured face-to-face interview was conducted among 15 dietitians from selected public hospitals, primary care clinics, and teaching hospitals in Malaysia. Inductive thematic analysis of the responses was conducted using NVivo version 12 software.

RESULTS

Most dietitians used physical education tools including the healthy plate model, pamphlets, food models, and flip charts. These tools were perceived as important as they facilitate the nutrition assessment process, deliver nutrition intervention, and are time efficient. However, dietitians described the current educational tools as impersonal, outdated, limited in availability due to financial constraints, unhandy, and difficult to visualise. Alternatively, they strongly favoured digital education tools that provided instant feedback, utilised an automated system, included a local food database, were user-friendly, developed by experts in the field, and seamlessly integrated into the healthcare system.

CONCLUSION

Presently, although dietitians have a preference for digital educational tools, they heavily rely on physical nutrition education tools due to their availability despite the perception that these tools are outdated, impersonal, and inconvenient. Transitioning to digital dietary education tools could potentially address these issues.

Prevalence of hypertension in a sample of community members in a low-income peri-urban setting in Gaborone, Botswana

Background: Cardiovascular disease remains the leading cause of death worldwide. Hypertension is a primary risk factor for the development of cardiovascular disease and affects more than a quarter of the global adult population. Africa is a continent where the prevalence of non-communicable diseases including cardiovas- cular disease and hypertension, is increasing rapidly. Botswana is a developing country in Sub-Saharan Africa. In such contexts the early identification of hypertension, through community screening initiatives, is an important tool for the management of cardiovas- cular disease in the population. Objective: To investigate and describe the prevalence of hypertension in a sample of community members residing in a low-income peri-urban setting in Gaborone, Botswana. Method: 364 adult participants had their blood pressures mea- sured during a community health screening exercise. The values were analysed and categorised using the American Heart Association classification scale as either being normal, elevated, hypertensive stage 1 or hypertensive stage 2. Results: 234/364 (64%) of participants were found to have blood pressures within normal limits. 53/364 (15%) had elevated blood pressures, 57/364 (16%) were in hypertensive stage 1 and 20/364 (5%) were in hypertensive stage 2. Conclusions: Hypertension in Africa is a growing concern. Botswana appears to be no exception with a 36% prevalence of abnormal blood pressures being recorded. However, the majority of these were classified as elevated or stage 1. Early identification and treatment of hypertension in these early stages can significant- ly decrease the risk of developing stage 2 hypertension and the related systemic complications.

Pre-morbid cardiometabolic risks among South Africans living in informal settlements

AIM

Numerous studies have been conducted on cardiometabolic risk factors in South Africa. However, not much has been done in informal settlement populations faced with their own set of health risks. This study screened for pre-morbid cardiometabolic risks and associated factors among adults living in informal settlements in South Africa.

METHODS

A cross-sectional study used the WHO STEPwise questionnaire to collect data on demography, anthropometry, blood pressure, and glucose and cholesterol levels (n = 329). Cardiometabolic risks were based on the criteria considered by the International Diabetes Federation and the National Cholesterol Education Program Adult Treatment Panel III. Data were analysed using STATA 14.

RESULTS

The median age of the participants was 35 (25-42) years. Cardiometabolic risk factors among the participants were hypertension (66%), overweight/obesity (45%), abdominal obesity (46%), and elevated cholesterol (15%) and glucose levels (7%). The metabolic syndrome was found in 17% of the participants, with a high prevalence observed among participants aged 35-59 years (28%) and ≥ 60 years (40%). The metabolic syndrome was significantly associated with gender [males, adjusted odds ratio (AOR) = 0.4, 95% CI: 0.20-0.90] and age, 35-59 years (AOR = 5.07, 95% CI: 2.24-11.23) and ≥ 60 years (AOR = 6.57, 95% CI; 1.57-27.54).

CONCLUSIONS

Prevalent cardiometabolic risk factors in informal settlements indicate the need for routine screening for all the components of the metabolic syndrome at the primary healthcare level.

Chronic Disease Patterns and Their Relation With Age, Gender, and Number of Visits in Three Primary Care Centers of Riyadh, Saudi Arabia

Background and objective Chronic disease is a major health burden and is a leading cause of both morbidity and mortality. However, there is little information regarding this topic in the region of Riyadh, Saudi Arabia. The objective of this study is to assess the pattern of chronic diseases and the role of age, gender, and number of visits in three primary care centers in this region. Methods This cross-sectional study was conducted with patients treated at large three primary care centers in Riyadh, Saudi Arabia. The study included all patients who attended one of the three centers within the past four years with one or more chronic diseases, and both genders were included. Results There were 700 patients included, of which 437 (62.4%) were female, 263 (37.6%) were male, 327 (31.8%) were diagnosed with type 2 diabetes mellitus (T2DM), and 212 (20.6%) were diagnosed with primary hypertension. There was a significant association between the number of visits and number of diseases and between age and the number of visits. The mean age of patients was 50.7 ± 16.3 years. There was no significant association between gender and the number of diagnoses or number of visits. Conclusion This study found a significant relationship between age and the number of visits and number of diseases. T2DM was the most common disease in the population. There was no significant association between gender and the number of diseases or number of visits.

Metabolic Syndrome and Its Components among Taxi Drivers in the City of Tshwane, South Africa

The occupation of taxi driving predisposes drivers to health risks, including obesity, cardiovascular and metabolic disorders. Although individual components of metabolic syndrome (MetS) are documented, data is scarce on concurrent metabolic disturbances among commercial drivers. The prevalence of MetS and its components were determined in a cross-sectional study among taxi drivers (n = 362) in the City of Tshwane, South Africa. Sociodemographic, occupational, and lifestyle factors were assessed using a structured questionnaire. Anthropometry, blood pressure, and glucose were measured. MetS was defined based on BMI strata, hypertension, and glucose levels. Data was analyzed using SPSS. The mean age of taxi drivers was 42 ± 10.9 years. Overall prevalence of MetS was 17.1%, with higher prevalence observed among older taxi drivers (24.2%) and those with longer experience in the industry (22.9%). Individual components of MetS were obesity (36%), hypertension (36%) and diabetes (46%), while smoking (30%), alcohol use (59%), and physical inactivity (71%) were observed. MetS was associated with duration in the taxi industry, and family history of diabetes among taxi drivers. The presence of MetS and its components among taxi drivers calls for early identification of cardiometabolic risks in the taxi industry and efforts towards achieving a healthier workforce.

The Socio-Demographic Characteristics Associated with Non-Communicable Diseases among the Adult Population of Dubai: Results from Dubai Household Survey 2019

BACKGROUND

Non-communicable diseases (NCDs) are the leading causes of death worldwide. In the UAE, NCDs account for nearly 77% of all deaths. There is limited empirical research on this topic in the UAE. We aimed to examine the association of non-communicable diseases and the sociodemographic characteristics among the adult population of Dubai.

METHODS

The study used secondary data from the Dubai Household Health Survey (DHHS), 2019. DHHS is a cross-sectional complex design, stratified by geographic area, and uses multistage probability sampling. In this survey, 2247 families were interviewed and only adults aged 18+ were included for the analysis. The quasi-binomial distribution was used to identify the socio-demographic characteristics association with NCDs.

RESULTS

The prevalence of NCDs among the adult population of Dubai was 15.01%. Individuals aged 60+, local Arabs (Emirati), divorced and widowed individuals, and individuals who were not currently working reported NCDs more than the other groups. In the regression analysis, the association with NCDs were reported among elderly people, males, unmarried individuals, older individuals who are unmarried, and Emiratis.

CONCLUSION

The study identified several socio-demographic characteristics associated with reporting NCDs. This is one of the few studies related to NCDs in Dubai. Allocating appropriate resources to the population groups identified is crucial to reduce the incidence of NCDs in the Emirate.

Group-based intervention in a primary healthcare setting was more effective for weight loss than usual care

BACKGROUND

Literature and practice recommendations for lifestyle interventions to treat the increasing number of obese patients with non-communicable diseases (NCDs) or risk factors for NCDs attending resource-constrained public healthcare facilities in South Africa are scarce.

AIM

To compare the impact of a facility-based therapeutic group (FBTG) intervention with usual care on weight in obese participants, with NCDs or risk factors for NCDs.

SETTING

Public healthcare facility providing primary healthcare services in Cape Town, South Africa.

METHODS

A quasi-experimental study design was used where participants chose to receive weight loss treatment with either the FBTG or usual care interventions. Both interventions involved a one-on-one medical and dietetic consultation, while FBTG participants had six additional group sessions. Follow-up assessments took place 6 months after baseline. Socio-demographic variables, blood pressure, smoking status, weight, height, waist circumference, dietary intake, physical activity and stage of change were measured.

RESULTS

Of the 193 obese adults enrolled, 96 selected the FBTG and 97 selected usual care. There were no significant differences at baseline between the two groups. Weight loss over 6 months was greater (p < 0.001) in FBTG (median [IQR] of -2.9 [-5.1; -0.3] kg) than usual care (-0.9 [-0.9; 0.6] kg) participants. At 6 months, more FBTG completers reached the weekly target of 150 min (p = 0.009), while both groups showed improvements in dietary intake. More FBTG (74%) than usual care (49%) participants were in the action stage of change by 6 months (p = 0.010).

CONCLUSIONS

The group-based intervention was more effective than usual care in weight reduction as well as improvements in physical activity and stage of change.

Prevalence of non-communicable diseases by age, gender and nationality in publicly funded primary care settings in Qatar

Background

In Qatar, as with other countries, non-communicable diseases (NCDs) have been the leading cause of death. This study aims to describe the prevalence of four NCDs clusters (cardiovascular diseases (coronary heart disease, stroke and peripheral vascular disease), cancers, chronic obstructive pulmonary diseases (COPD) and type 2 diabetes (T2DM)) by age, gender and nationality (Qataris and non-Qataris) accessing publicly funded primary care services to inform healthcare planning and strategies.

Methods

Cross-sectional study design was used. Data for individuals aged ≥18 and who visited a publicly funded primary health centre in Qatar during 2017 were extracted from electronic medical records and analysed.

Results

The findings showed that approximately 16.2 % of the study population (N = 68 421) had one or more of the four NCDs. The prevalence of NCDs showed an increasing trend with increasing age. Highest increases in the prevalence of NCDs were seen in a relatively young age group (30–49 years). The prevalence of all NCDs except cancers was higher in men. Prevalence rates of CHD and cancers in the study were found to be similar in both Qataris and non-Qataris; however, COPD and T2DM rates were higher in Qataris compared with non-Qataris. T2DM accounted for the highest prevalence of any NCD among both Qataris (230/1000) and non-Qataris (183/1000).

Conclusions

Although not comprehensive and nationally representative, this study is suggestive of a higher prevalence of NCDs among a younger population, men and in Qatari, Western Asian, Southern Asian, Sub-Saharan Africans, South-Eastern Asians Northern African and Western European nationalities. Prevention, treatment and control of NCDs and their risk factors are a public health problem in Qatar, and resources need to be invested towards targeted interventions with a multisectoral approach.

Awareness, treatment, and control of dyslipidemia in rural South Africa: The HAALSI (Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa) study

Dyslipidemia is a primary driver for chronic cardiovascular conditions and there is no comprehensive literature about its management in South Africa. The objective of this study was to assess the prevalence, awareness, treatment, and control of dyslipidemia in rural South Africa and how they are impacted by different behaviors and non-modifiable factors. To fulfill this objective we recruited for this cohort study adults aged ≥40 years residing in the Agincourt sub-district of Mpumalanga Province. Data collection included socioeconomic and clinical data, anthropometric measures, blood pressure (BP), HIV-status, point-of-care glucose and lipid levels. Framingham CVD Risk Score was ascribed to patients based upon categories for 10 year cardiovascular risk of low (<3%), moderate (≥3% and <15%), high (≥15% and <30%), and very high (≥30%).LDL cholesterol control by risk category was defined according to South African Guidelines. Multivariable logistic regression models were built to identify factors that were significantly associated with dyslipidemia and awareness of dyslipidemia From 5,059 respondents a total of 4247 subjects (83.9%) had their cholesterol levels measured and were included in our analysis. Overall, 67.3% (2860) of these met criteria for dyslipidemia, only 30 (1.05%) were aware of their condition, and only 21 subjects (0.73%) were on treatment. The majority have abnormalities in triglycerides (59.3%). As cardiovascular risk increased the rates of lipid control according to LDL level dropped. Multivariate logistic regression analyses showed that being overweight was predictive of dyslipidemia (OR 1.76; 95%CI 1.51-2.05, p<0.001) and dyslipidemia awareness (OR 2.58; 95%CI 1.19-5.58; p = 0.017). In conclusion, the very low awareness and treatment of dyslipidemia in this cohort indicate a greater need for systematic screening and education within the population and demonstrate that there are multiple opportunities to allay this burden.