1
|
Chhezom K, Gurung MS, Wangdi K. Comparison of Laboratory and Non-Laboratory-Based 2019 World Health Organization Cardiovascular Risk Charts in the Bhutanese Population. Asia Pac J Public Health 2024; 36:29-35. [PMID: 38116599 PMCID: PMC10863361 DOI: 10.1177/10105395231211997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Abstract
The World Health Organization (WHO) recommends the use of color-coded cardiovascular disease (CVD) risk charts for CVD management. This study evaluated the agreement between the laboratory and non-laboratory 10-year CVD risks based on 2019 WHO CVD risk-prediction charts. The agreement of CVD risk scores among 40- to 69-year-old Bhutanese population stratified by gender and age groups (<60 and ≥60 years) was determined via weighted kappa statistics. In the general population, there was substantial agreement between the two CVD risk score charts for all ages and <60 years but a moderate agreement for participants aged ≥60 years. In males, substantial agreement was observed in all ages and in <60 years and moderate agreement in ≥60 years. In females, both the predictions showed substantial agreement in all ages and <60, but a moderate agreement for ≥60 years. The non-laboratory-based risk charts can be used interchangeably with laboratory-based charts for predicting 10-year CVD risk in resource-constrained countries like Bhutan.
Collapse
Affiliation(s)
- Kuenzang Chhezom
- Faculty of Postgraduate Medicine, Khesar Gyalpo University of Medical Sciences of Bhutan, Thimphu, Bhutan
| | | | - Kinley Wangdi
- Department of Global Health, National Centre for Epidemiology and Population Health (NCEPH), College of Health and Medicine, Australian National University, Acton, ACT, Australia
| |
Collapse
|
2
|
Dem U, Letho Z, Dorji C, Nirola DK, Choki S, Dorji T, Chejor P. Aversive Reaction Between Disulfiram and Betel Quid Among Inpatients With Alcohol Use Disorder in Bhutan: A Preliminary Study. Asia Pac J Public Health 2023; 35:532-534. [PMID: 37837338 PMCID: PMC10644688 DOI: 10.1177/10105395231204801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2023]
Abstract
Betel quid (BQ) is commonly used in the Asia-Pacific region. Disulfiram is prescribed for people with alcohol use disorders (PwAUDs) after the completion of detoxification as an alternative to rehabilitation. This prospective observational study reported the aversive reactions and common symptoms of disulfiram and BQ in PwAUDs. Participants included PwAUDs admitted to the psychiatric ward at the Jigme Dorji Wangchuck National Referral Hospital for detoxification, who were on Disulfiram and using BQ at the same time. Aversive reactions between disulfiram and BQ were observed for 100 patients over a year. Twenty participants showed aversive reactions between BQ and disulfiram. Common symptoms included sweating, diarrhea, dizziness, tremors, palpitations, shortness of breath, nausea and vomiting, and headache. Since PwAUDs in Bhutan are inducted on disulfiram after detoxification, and most use BQ simultaneously, this study will help inform health care providers to educate people about the aversive reactions of disulfiram and BQ.
Collapse
Affiliation(s)
- Ugyen Dem
- Department of Psychiatry, Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan
| | - Zimba Letho
- Faculty of Nursing and Public Health, Khesar Gyalpo University of Medical Sciences of Bhutan, Thimphu, Bhutan
| | - Chencho Dorji
- Department of Psychiatry, Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan
| | - Damber K. Nirola
- Department of Psychiatry, Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan
| | - Sonam Choki
- Department of Psychiatry, Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan
| | - Tashi Dorji
- Department of Psychiatry, Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan
| | - Pelden Chejor
- Centre for Research in Aged Care, Edith Cowan University, Joondalup, Western Australia, Australia
| |
Collapse
|
3
|
Pengpid S, Peltzer K. Trends in behavioral and biological risk factors for non-communicable diseases among adults in Bhutan: results from cross-sectional surveys in 2007, 2014, and 2019. Front Public Health 2023; 11:1192183. [PMID: 37593725 PMCID: PMC10430069 DOI: 10.3389/fpubh.2023.1192183] [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: 03/23/2023] [Accepted: 07/03/2023] [Indexed: 08/19/2023] Open
Abstract
Background The study aimed to evaluate trends in the prevalence and correlates of risk factors for non-communicable diseases (NCDs; low physical activity, insufficient fruit/vegetable intake, current tobacco use, problem alcohol use, diabetes, hypertension, increased total cholesterol, and obesity) in Bhutan. Methods Three repeat cross-sectional Bhutan STEPS surveys (N = 9,281) in 2007, 2014, and 2019 were analyzed. Results The proportion of people with 3-8 NCD risk factors significantly decreased from 62.8% in 2007 to 32.6% in 2019 (p < 0.001), and the mean number of NCD risk factors significantly decreased from 3.0 in 2007 to 2.1 in 2019 (p < 0.001). In linear regression analyses by study year, older age (p < 0.001) was positively associated with eight NCD risk factors across all study years. Furthermore, male subjects were negatively (p < 0.01) and positively (p < 0.001) associated with eight NCD risk factors, respectively. Higher education levels (p < 0.05) were positively associated with eight NCD risk factors in 2007 and negatively associated with eight NCD risk factors in 2019 (p < 0.05). Employment (p < 0.001) and urban residence (p < 0.001) were positively associated with eight risk factors for NCD in 2019, while urban residence (p < 0.001) was negatively associated with eight NCD risk factors in 2014. Conclusion The prevalence of eight NCD risk factors decreased in Bhutan over the past 13 years. Inadequate fruit and vegetable intake, problem alcohol use, and hypertension increased, current tobacco use, low physical activity, obesity, diabetes, and elevated total cholesterol decreased from 2007 to 2019. Several factors associated for eight and each individual NCD risk factor were identified, which can help guide interventions.
Collapse
Affiliation(s)
- Supa Pengpid
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand
- Department of Public Health, Sefako Makgatho Health Sciences University, Pretoria, South Africa
- Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Karl Peltzer
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand
- Department of Psychology, University of the Free State, Bloemfontein, South Africa
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan
| |
Collapse
|
4
|
Tsheten T, Chateau D, Dorji N, Pokhrel HP, Clements AC, Gray DJ, Wangdi K. Impact of COVID-19 on mental health in Bhutan: a way forward for action. THE LANCET REGIONAL HEALTH. SOUTHEAST ASIA 2023; 11:100179. [PMID: 37020787 PMCID: PMC10008798 DOI: 10.1016/j.lansea.2023.100179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 02/14/2023] [Accepted: 03/07/2023] [Indexed: 03/16/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic continues to impact mental health and wellbeing globally. There is a lack of scientific documentation highlighting the mental health impact of COVID-19 in Bhutan. We present the mental health burdens and control measures taken, and suggest ways to further strengthen mental health services in Bhutan. During the pandemic, a rise in depression and anxiety had been reported in Bhutan. Depression rose from an average prevalence of 9 per 10,000 between 2011 and 2019 to 16 per 10,000 in 2020 and 32 per 10,000 in 2021. Similarly, anxiety rose from an average prevalence of 18 per 10,000, to 29 per 10,000 in 2020, and 55 per 10,000 in 2021. Psychological impacts related to isolation due to lockdowns, economic losses, and poor coping abilities were associated with negative outcomes. Stigma and discrimination towards mental health disorders discouraged mentally distressed people from seeking care. In response to increased demand, Bhutan’s government initiated a range of interventions including home delivery of medicines and tele-counselling to people in need of urgent mental health care. Mental health care in Bhutan can be further improved through investment in services and human resources, and decentralization of services to the community.
Collapse
Affiliation(s)
- Tsheten Tsheten
- National Centre for Epidemiology and Population Health, College of Health and Medicine, Australian National University, Canberra, Australia,Royal Centre for Disease Control, Ministry of Health, Bhutan,Corresponding author: (Address: 62 Mills Road, Acton, ACT 2601, Australia; Contact number: +61 0401206070; )
| | - Dan Chateau
- National Centre for Epidemiology and Population Health, College of Health and Medicine, Australian National University, Canberra, Australia
| | - Nima Dorji
- Punakha District Hospital, Ministry of Health, Bhutan
| | | | - Archie C.A. Clements
- Telethon Kids Institute, Nedlands, Australia,Peninsula Medical School, University of Plymouth, Plymouth, United Kingdom
| | - Darren J Gray
- National Centre for Epidemiology and Population Health, College of Health and Medicine, Australian National University, Canberra, Australia
| | - Kinley Wangdi
- National Centre for Epidemiology and Population Health, College of Health and Medicine, Australian National University, Canberra, Australia
| |
Collapse
|
5
|
Stomach Cancer Screening Services in Bhutan. Indian J Surg 2022. [DOI: 10.1007/s12262-022-03543-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022] Open
|
6
|
Dorji T, Srichan P, Apidechkul T, Sunsern R, Suttana W. Factors associated with different forms of alcohol use behaviors among college students in Bhutan: a cross-sectional study. SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY 2020; 15:70. [PMID: 32928241 PMCID: PMC7491155 DOI: 10.1186/s13011-020-00315-0] [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: 06/09/2020] [Accepted: 09/08/2020] [Indexed: 11/10/2022]
Abstract
Background Alcohol use has impacts on several dimensions of health, including physical health and mental health, particularly in college-age populations. Therefore, this study aimed to estimate the prevalence and to determine factors associated with alcohol use behaviors among college students in Bhutan. Methods A cross-sectional design was applied to collect data from the participants. A simple random method was used to select the participants from the lists of students who were attending the four selected colleges in Bhutan in the academic year of 2019. A questionnaire was developed, and validity and reliability were verified before use. Descriptive statistics were applied to describe the general characteristics of participants, while logistic regression was used to detect the associations between variables at the significance level of α = 0.05. Results A total of 432 college students were recruited into the study, of whom 62.0% were females. The average age was 20.0 years, 40.7% were the third-year students, and 79.9% lived in college dormitories. The prevalence of current drinking was 51.6% and that of binge drinking was 19.4%. After controlling for all potential confounder factors, three variables were found to be associated with current drinking: students who had low income were more likely to be current drinkers than those who had high income (AOR = 2.59, 95% CI = 1.29–5.21); students who did not use tobacco were more likely to be current drinkers than those students who used tobacco (AOR = 6.99, 95% CI = 2.90–16.81); and students who had close friends who did not use alcohol were more likely to be current drinkers than those who had close friends who used alcohol (AOR = 5.14, 95% CI = 3.04–8.69). Four factors were found to be associated with binge drinking after controlling for all possible confounder factors: students who had high income were more likely to be binge drinkers than those who had low income (AOR = 3.03, 95% CI = 1.72–5.31); students who used tobacco were more likely to be binge drinkers than those students who did not use tobacco (AOR = 2.28, 95% CI = 1.35–3.87); students whose parents used alcohol were more likely to be binge drinkers than those students whose parents did not use alcohol (AOR = 1.75, 95% CI = 1.02–3.01); and students whose close friends used alcohol were more likely to be binge drinkers than those who had close friends who did not use alcohol (AOR = 2.26, 95% CI = 1.05–4.87). Conclusions There is a high prevalence in alcohol use among the college students in Bhutan. Effective health promotion programs should be implemented by focusing on reducing the alcohol consumption among college students.
Collapse
Affiliation(s)
- Tandin Dorji
- School of Health Science, Mae Fah Luang University, Chiang Rai, Thailand.,District Health Sector, District Administration, Trashigang, Bhutan
| | - Peeradone Srichan
- School of Health Science, Mae Fah Luang University, Chiang Rai, Thailand. .,Center of Excellence for the Hill tribe Health Research, Mae Fah Luang University, Chiang Rai, Thailand.
| | - Tawatchai Apidechkul
- School of Health Science, Mae Fah Luang University, Chiang Rai, Thailand.,Center of Excellence for the Hill tribe Health Research, Mae Fah Luang University, Chiang Rai, Thailand
| | - Rachanee Sunsern
- School of Health Science, Mae Fah Luang University, Chiang Rai, Thailand
| | - Wipob Suttana
- School of Health Science, Mae Fah Luang University, Chiang Rai, Thailand
| |
Collapse
|
7
|
Eashwar VMA, Umadevi R, Gopalakrishnan S. Alcohol consumption in India- An epidemiological review. J Family Med Prim Care 2020; 9:49-55. [PMID: 32110564 PMCID: PMC7014857 DOI: 10.4103/jfmpc.jfmpc_873_19] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 11/23/2019] [Accepted: 12/04/2019] [Indexed: 11/18/2022] Open
Abstract
One of the most important products of global addiction demand is an alcoholic beverage. In developing countries like India, alcohol consumption tends to be a major problem because of the various socio-cultural practices across the nation, different alcohol policies and practices across the various states, lack of awareness of alcohol-related problems among the community, false mass media propaganda about alcohol use, various alcohol drinking patterns among the alcohol consumers and the emergence of social drinking as a habit because of the widespread urbanisation across the country. Stringent alcohol policies are needed across the various states to reduce alcohol consumption, and alcohol consumers have to be educated about the various harmful effects of alcohol consumption and the effects it can have on their mind, body and soul. This review article focuses on the burden of alcohol consumption in context with its various harmful effects on the mind and body with a note on the alcohol policies in the country.
Collapse
Affiliation(s)
- V M Anantha Eashwar
- Department of Community Medicine, Saveetha Medical College and Hospital, Thandalam, Chennai, Tamil Nadu, India
| | - R Umadevi
- Department of Community Medicine, Sree Balaji Medical College and Hospital, Chrompet, Chennai, Tamil Nadu, India
| | - S Gopalakrishnan
- Department of Community Medicine, Sree Balaji Medical College and Hospital, Chrompet, Chennai, Tamil Nadu, India
| |
Collapse
|
8
|
Abstract
Background: Chewing of betel quid, popularly known as doma khamdo, is prevalent in Bhutan and is associated with Bhutanese customs and traditions. The objective of this paper was to determine the prevalence and explore the correlates of current betel quid use in Bhutan. Materials and methods: This is a retrospective study of secondary data from the National Health Survey 2012 (NHS 2012) of Bhutan. The outcome variable of interest was current betel quid use. The self-reported demographic characteristics were obtained using a questionnaire developed following the WHO STEPwise approach to the surveillance of non-communicable diseases (STEP). Univariate and multivariate logistic regression were performed to identify correlates for betel quid use. Results: The prevalence of current betel quid use in this study was 45.0%. The correlates associated with current betel quid use were: being female; having a primary, high school or a monastic education; being professionals in the armed forces, managers, technicians, service and sales workers, and machine operators; being current smokers; alcohol consumption; and intake of drugs. Correlates associated with decreased betel quid use were: having a diploma/certificate-level and non-formal education, and living in urban areas. Conclusion: The findings indicate that betel quid was consumed by nearly half of the Bhutanese population. Bhutan should immediately initiate national prevention programs targeting these correlates of betel quid use.
Collapse
Affiliation(s)
- Kinley Wangdi
- Department of Global Health, Research School of Population Health, College of Health and Medicine, The Australian National University, Canberra, ACT, Australia.,Phuentsholing General Hospital, Phuentsholing, Bhutan
| | - Tshering Jamtsho
- School of Demography, ANU College of Arts & Social Sciences, The Australian National University, Canberra, ACT, Australia
| |
Collapse
|
9
|
Wangdi K, Jamtsho T. Drug use among Teenagers and Young Adults in Bhutan. Indian J Psychol Med 2019; 41:535-540. [PMID: 31772440 PMCID: PMC6875841 DOI: 10.4103/ijpsym.ijpsym_348_19] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 10/05/2019] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Use, possession, and illegal transactions of controlled substances have increased in recent years in Bhutan. This study aimed to determine the national prevalence of ever drug use and identify its associated factors amongst teenagers and young adults. METHODS This study was conducted using data from the National Health Survey 2012 of Bhutan. The outcome variable of interest was ever drug use in teenagers and young adults. The questionnaire was developed following the WHO STEPwise approach to surveillance of non-communicable diseases (STEP). Univariate and multivariate logistic regression were performed to identify correlates of ever drug use. RESULTS The prevalence of ever drug use among teenagers and young adults was 3.2% (n = 672). The factors associated with ever drug use were: being men; being single; being in age group of 18-24 years; having a primary school, high school, monastic, university, or diploma education; being technicians or salespersons; feeling always lonely; having ever consumed alcohol, and having ever smoked. CONCLUSION Compared to the other countries in the WHO South-east Asia region, the prevalence of ever drug use in Bhutan is low. Use of other substances, including smoking and alcohol use, was associated with ever drug use. For greater effect, drug use prevention strategies should include prevention of smoking and alcohol use.
Collapse
Affiliation(s)
- Kinley Wangdi
- Department of Global Health, Research School of Population Health, The Australian National University, 62 Mills Road, Acton, Canberra, Australia.,Phuentsholing General Hospital, Phuentsholing, Chukha, Bhutan
| | - Tshering Jamtsho
- School of Demography, ANU College of Arts and Social Sciences, The Australian National University, Australia
| |
Collapse
|