1
|
Yang L, Bovet P, Ma C, Zhao M, Liang Y, Xi B. Prevalence of underweight and overweight among young adolescents aged 12-15 years in 58 low-income and middle-income countries. Pediatr Obes 2019; 14:e12468. [PMID: 30156015 DOI: 10.1111/ijpo.12468] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 07/14/2018] [Accepted: 07/16/2018] [Indexed: 12/01/2022]
Abstract
BACKGROUND The co-existence of underweight and overweight is a great challenge for public health in low-income and middle-income countries (LMICs). OBJECTIVES The objective of the study is to report the prevalence of underweight, overweight and obesity among young adolescents in 58 LMICs. METHODS Data were from the Global School-based Student Health Survey (2007-2013) in 57 LMICs and from the Chinese National Surveys on Students' Constitution and Health (2010). A total of 177 325 young adolescents aged 12-15 years from 58 LMICs were included. Weight status was defined based on both the updated International Obesity Task Force (IOTF) and World Health Organization (WHO) criteria. RESULTS Based on the IOTF/WHO criteria, the overall prevalence of weight categories among young adolescents in LMICs was 13.4%/4.7% for underweight, 15.4%/17.3% for overweight and 5.6%/8.6% for obesity. However, the prevalence varied largely across countries and regions. Based on the IOTF criteria, the prevalence of underweight ranged from 0.0% in Niue to 48.8% in Sri Lanka and obesity ranged from 0.1% in Vanuatu to 35.0% in Niue; a prevalence exceeding 10.0% for both underweight and excess weight (overweight and obesity combined) was found in 29.3% of these countries. Underweight was more prevalent in Southeast Asia and Africa, while obesity was more frequent in Central and South Americas. There were no age and sex differences in the prevalence of weight categories for most countries. CONCLUSIONS Our data confirm the continued dual burden of underweight and overweight in young adolescents in many LMICs and the need for policy and programmes to address both conditions.
Collapse
Affiliation(s)
- L Yang
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, China
| | - P Bovet
- Institute of Social and Preventive Medicine, University of Lausanne, Lausanne, Switzerland
| | - C Ma
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, China
| | - M Zhao
- Department of Nutrition and Food Hygiene, School of Public Health, Shandong University, Jinan, China
| | - Y Liang
- Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden
| | - B Xi
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, China
| |
Collapse
|
2
|
Leyvraz M, Bovet P, Tabin R, Genin B, Russo M, Rossier M, Bochud M, Chiolero A. Urinary spots in children: a public health surveillance tool to estimate sodium intake? Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky212.711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- M Leyvraz
- Lausanne University Hospital, Lausanne, Switzerland
| | - P Bovet
- Lausanne University Hospital, Lausanne, Switzerland
| | - R Tabin
- Hospital of Valais, Sion, Switzerland
- Geneva University Hospital, Geneva, Switzerland
| | - B Genin
- Hospital of Valais, Sion, Switzerland
- Geneva University Hospital, Geneva, Switzerland
| | - M Russo
- Hospital of Valais, Sion, Switzerland
| | - M Rossier
- Hospital of Valais, Sion, Switzerland
| | - M Bochud
- Lausanne University Hospital, Lausanne, Switzerland
| | - A Chiolero
- Lausanne University Hospital, Lausanne, Switzerland
- University of Bern, Bern, Switzerland
- McGill University, Montréal, Québec, Canada
| |
Collapse
|
3
|
Ekoru K, Murphy GAV, Young EH, Delisle H, Jerome CS, Assah F, Longo–Mbenza B, Nzambi JPD, On'Kin JBK, Buntix F, Muyer MC, Christensen DL, Wesseh CS, Sabir A, Okafor C, Gezawa ID, Puepet F, Enang O, Raimi T, Ohwovoriole E, Oladapo OO, Bovet P, Mollentze W, Unwin N, Gray WK, Walker R, Agoudavi K, Siziya S, Chifamba J, Njelekela M, Fourie CM, Kruger S, Schutte AE, Walsh C, Gareta D, Kamali A, Seeley J, Norris SA, Crowther NJ, Pillay D, Kaleebu P, Motala AA, Sandhu MS. Deriving an optimal threshold of waist circumference for detecting cardiometabolic risk in sub-Saharan Africa. Int J Obes (Lond) 2017; 42:ijo2017240. [PMID: 29087388 PMCID: PMC5880575 DOI: 10.1038/ijo.2017.240] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2017] [Revised: 08/12/2017] [Accepted: 09/04/2017] [Indexed: 02/02/2023]
Abstract
BACKGROUND Waist circumference (WC) thresholds derived from western populations continue to be used in sub-Saharan Africa (SSA) despite increasing evidence of ethnic variation in the association between adiposity and cardiometabolic disease and availability of data from African populations. We aimed to derive a SSA-specific optimal WC cut-point for identifying individuals at increased cardiometabolic risk. METHODS We used individual level cross-sectional data on 24 181 participants aged ⩾15 years from 17 studies conducted between 1990 and 2014 in eight countries in SSA. Receiver operating characteristic curves were used to derive optimal WC cut-points for detecting the presence of at least two components of metabolic syndrome (MS), excluding WC. RESULTS The optimal WC cut-point was 81.2 cm (95% CI 78.5-83.8 cm) and 81.0 cm (95% CI 79.2-82.8 cm) for men and women, respectively, with comparable accuracy in men and women. Sensitivity was higher in women (64%, 95% CI 63-65) than in men (53%, 95% CI 51-55), and increased with the prevalence of obesity. Having WC above the derived cut-point was associated with a twofold probability of having at least two components of MS (age-adjusted odds ratio 2.6, 95% CI 2.4-2.9, for men and 2.2, 95% CI 2.0-2.3, for women). CONCLUSION The optimal WC cut-point for identifying men at increased cardiometabolic risk is lower (⩾81.2 cm) than current guidelines (⩾94.0 cm) recommend, and similar to that in women in SSA. Prospective studies are needed to confirm these cut-points based on cardiometabolic outcomes.International Journal of Obesity advance online publication, 31 October 2017; doi:10.1038/ijo.2017.240.
Collapse
Affiliation(s)
- K Ekoru
- Sandhu Group, Department of Medicine, University of Cambridge, Cambridge, UK
- Global Health and Populations Group, Wellcome Trust Sanger Institute, Hinxton, Cambridge, UK
| | - G A V Murphy
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - E H Young
- Sandhu Group, Department of Medicine, University of Cambridge, Cambridge, UK
- Global Health and Populations Group, Wellcome Trust Sanger Institute, Hinxton, Cambridge, UK
| | - H Delisle
- Department of Nutrition, Faculty of Medicine, University of Montreal, Montreal, Canada
| | - C S Jerome
- Regional Institute of Public Health, University of Abomey-Calavi, Cotonou, Benin
| | - F Assah
- Department of Public Health, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon
| | - B Longo–Mbenza
- Faculty of Health Sciences, Walter Sisulu University, Eastern Cape, South Africa
| | - J P D Nzambi
- Department of Basic Sciences, Unit of Clinical Pharmacology and Pharmacovigilance, Faculty of Medicine, University of Kinshasa, Kinshasa, DR Congo
| | - J B K On'Kin
- Department of Internal Medicine, Faculty of Medicine, University of Kinshasa, Kinshasa, DR Congo
| | - F Buntix
- Department of General Practice, KU Leuven, Leuven, Belgium
| | - M C Muyer
- Department of Public Health, University of Kinshasa, Kinshasa, DR Congo
| | - D L Christensen
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - C S Wesseh
- Ministry of Health and Social Welfare, Monrovia, Liberia
| | - A Sabir
- Department of Medicine, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria
| | - C Okafor
- Department of Medicine & Physiology, Faculty of Medical Sciences, University of Nigeria, Enugu Campus/University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu, Nigeria
| | - I D Gezawa
- Department of Medicine, College of Health Sciences, Bayero University Kano/Aminu Kano Teaching Hospital, Kano State, Kano, Nigeria
| | - F Puepet
- Department of Medicine, College of Medical Sciences, University of Jos, Jos, Nigeria
| | - O Enang
- Department of Internal Medicine, University of Calabar/University of Calabar Teaching Hospital, Calabar, Nigeria
| | - T Raimi
- Department of Medicine, Ekiti State University, Ado-Ekiti, Nigeria
| | - E Ohwovoriole
- Department of Medicine, College of Medicine, University of Lagos, Lagos, Nigeria
| | - O O Oladapo
- Division of Cardiovascular Medicine, Department of Medicine (University College Hospital), College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - P Bovet
- Institute of Social and Preventive Medicine, University of Lausanne, Lausanne, Switzerland
| | - W Mollentze
- University of the Free State, Bloemfontein, Republic of South Africa
| | - N Unwin
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - W K Gray
- Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, Tyne and Wear, UK
| | - R Walker
- Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, Tyne and Wear, UK
- Institute of Health and Society, Newcastle University, Newcastle, UK
| | - K Agoudavi
- National NCD Program, Ministry Of Health, Lome, Togo
| | - S Siziya
- School of Medicine, The Copperbelt University, Ndola, Zambia
| | - J Chifamba
- Physiology Department, University of Zimbabwe, College of Health Sciences, Harare, Zimbabwe
| | - M Njelekela
- Department of Physiology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - C M Fourie
- HART (Hypertension in Africa Research Team), North-West University, Potchefstroom, South Africa
| | - S Kruger
- Africa Unit for Transdisciplinary Health Research (AUTHeR), North-West University, Potchefstroom, South Africa
- MRC Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
| | - A E Schutte
- HART (Hypertension in Africa Research Team), North-West University, Potchefstroom, South Africa
- MRC Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
| | - C Walsh
- Department of Nutrition and Dietetics, University of the Free State, Bloemfontein, South Africa
| | - D Gareta
- Wellcome Trust Africa Centre for Health and Population Studies, University of KwaZulu-Natal, KwaZulu-Natal, South Africa
| | - A Kamali
- MRC/UVRI Uganda Research Unit on AIDS, Entebbe, Uganda
| | - J Seeley
- MRC/UVRI Uganda Research Unit on AIDS, Entebbe, Uganda
| | - S A Norris
- MRC/Wits Developmental Pathways for Health Research Unit (DPHRU), University of the Witwatersrand, Johannesburg, South Africa
| | - N J Crowther
- Department of Chemical Pathology, National Health Laboratory Service, University of the Witwatersrand Medical School, Johannesburg, South Africa
| | - D Pillay
- Wellcome Trust Africa Centre for Health and Population Studies, University of KwaZulu-Natal, KwaZulu-Natal, South Africa
| | - P Kaleebu
- MRC/UVRI Uganda Research Unit on AIDS, Entebbe, Uganda
| | - A A Motala
- Department of Diabetes and Endocrinology, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - M S Sandhu
- Sandhu Group, Department of Medicine, University of Cambridge, Cambridge, UK
- Global Health and Populations Group, Wellcome Trust Sanger Institute, Hinxton, Cambridge, UK
| |
Collapse
|
4
|
Abstract
OBJECTIVES To examine the longitudinal association between body mass index (BMI) and waist circumference (WC) with mortality and incident disability in Lc65+ cohort. DESIGN Population-based cohort of non-institutionalized adults with up to 8.9 years of follow-up. SETTING City of Lausanne, Switzerland. PARTICIPANTS 1,293 individuals aged 65 to 70 at baseline (58% women). MEASUREMENTS BMI, WC and covariates were measured at baseline in 2004-2005. Vital status was obtained up to the 31st December 2013 and difficulty with basic activities of daily living (BADL) was reported in a self-administered questionnaire sent to participants every year. Main outcomes were total mortality and disability, defined as difficulty with BADL for ≥2 years or institutionalization. Cox regression was used with BMI/WC quintiles 2 as the reference. RESULTS 130 persons died over a median follow-up of 8.47 years (crude mortality rate, men: 16.5/1,000 person-years, women: 9.7/1,000 person-years). In Cox regression adjusted for age, sex, education, financial situation, smoking and involuntary weight loss (IWL) at baseline, mortality was significantly associated with neither BMI nor WC, but there were trends towards non-significant J-curves across both BMI and WC quintiles. Disability (231 cases) tended to increase monotonically across both BMI and WC quintiles and was significantly associated with BMI quintile 5 (HR=2.44, 95% CI [1.65-3.63]), and WC quintiles 4 (HR=1.81 [1.15-2.85]) and 5 (HR=2.58, [1.67-4.00]). CONCLUSION Almost half of the study population had a substantially increased HR of disability, as compared to the reference BMI/WC categories. This observation emphasizes the need for life-long strategies aimed at preventing excess weight, muscle loss and functional decline through adequate nutrition and regular physical activity, starting at early age and extending throughout life.
Collapse
Affiliation(s)
- N Danon-Hersch
- Nadia Danon-Hersch, Institute of Social and Preventive Medicine (IUMSP), University and University Hospital Center, Biopole 2, Route de la Corniche 10, 1010 Lausanne, Switzerland, Tel : +41 21 314 91 09; Fax: +41 21 314 97 67; ;
| | | | | | | | | |
Collapse
|
5
|
Bovet P, Gamra H, Gatumia E, Houinato D, Mondo C, Mohamed A, Mungal-Singh V, Ojo B. PT207 Availability of Guidelines, Medications and Equipment for Cardiovascular Disease Management at Primary Health Care Level in 7 African Countries. Glob Heart 2016. [DOI: 10.1016/j.gheart.2016.03.559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
|
6
|
Yin X, Liu Q, Bovet P, Ma C, Xi B. Performance of blood pressure-to-height ratio as a screening tool for elevated blood pressure in pediatric population: a systematic meta-analysis. J Hum Hypertens 2016; 30:697-702. [PMID: 26935285 DOI: 10.1038/jhh.2016.12] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2015] [Revised: 12/11/2015] [Accepted: 01/29/2016] [Indexed: 11/09/2022]
Abstract
The aim of this study was to assess the performance of the blood pressure-to-height ratio (BPHR) for screening elevated blood pressure (BP) in children and adolescents using a meta-analysis of eligible published studies. We retrieved studies that investigated the performance of the BPHR for identifying elevated BP from Pubmed and other databases. We performed meta-analyses by subgroups of sex, age and ethnicity using a fixed or random effect model based on whether there was between-study heterogeneity. A total of 13 publications including 262 830 children and adolescents aged 6-18 years on BPHR and a total of three publications including 95 343 children on the modified BPHR were included in this meta-analysis. The summary results suggested that BPHR performed well to identify pre-high BP and high BP for children aged 6-11 years and adolescents aged 12-18 years. The performance of BPHR was perfect for identifying severe high BP in adolescents aged 12-18 years. However, the modified BPHR did not improve accuracy for screening high BP in children aged 6-12 years. In summary, BPHR performed well for identifying elevated BP in children and adolescents, independently of sex, age and ethnicity group. In addition, the modified BPHR performed similarly with BPHR for screening high BP in childhood.
Collapse
Affiliation(s)
- X Yin
- Department of Maternal and Child Health, School of Public Health, Shandong University, Jinan, China
| | - Q Liu
- Department of Ultrasound, Children's Hospital of the Capital Institute of Pediatrics, Beijing, China
| | - P Bovet
- Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - C Ma
- Department of Maternal and Child Health, School of Public Health, Shandong University, Jinan, China
| | - B Xi
- Departments of Epidemiology and Health Statistics, School of Public Health, Shandong University, Jinan, China
| |
Collapse
|
7
|
Mizehoun C, Desport JC, Houehanou Y, Chianea T, Bigot A, Bovet P, Dalmay F, Preux PM, Houinato D. MON-LB015: Sodium and Potassium Intake in Urban and Rural Areas Using 24-Hours Urine Collection in Benin. Clin Nutr 2015. [DOI: 10.1016/s0261-5614(15)30779-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
8
|
Mizehoun C, Desport JC, Houehanou C, Chianea T, Bovet P, Dalmay F, Preux PM, Houinato D. Consommation alimentaire de sodium (Na) et de potassium (K) en population urbaine et rurale au Bénin. Rev Epidemiol Sante Publique 2015. [DOI: 10.1016/j.respe.2015.03.080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
|
9
|
Stringhini S, Haba-Rubio J, Marques-Vidal P, Waeber G, Preisig M, Guessous I, Bovet P, Vollenweider P, Tafti M, Heinzer R. Association of socioeconomic status with sleep disturbances in the Swiss population-based CoLaus study. Eur J Public Health 2014. [DOI: 10.1093/eurpub/cku151.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
10
|
Bloetzer C, Paccaud F, Burnier M, Bovet P, Chiolero A. Performance of parental history of hypertension for the screening of hypertension in children. Eur J Public Health 2014. [DOI: 10.1093/eurpub/cku166.132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
11
|
Bovet P, Gédéon J, Louange M, Durasnel P, Aubry P, Gaüzère BA. Health situation and issues in the Seychelles in 2012. Med Sante Trop 2013:mst.2013.0225. [PMID: 24280339 DOI: 10.1684/mst.2013.0225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Located off the coast of Kenya, the Republic of the Seychelles is an island archipelago nation whose citizens are mostly of African origin. The population, independent from the United Kingdom since 1976, has largely completed its demographic and epidemiological transitions. Major investments in infrastructure and social services have fostered a steady economic growth. Health services and education are free. The predominance of chronic non-communicable diseases and rapid aging of the population cause significant new challenges for public health and the health system. However, like the other small island states in the region, the Seychelles remains under the threat of outbreaks, particularly of arboviruses. Health indicators from 2012 are generally very good. There are concerns, however, about the future of health care in the country. Geographic isolation, the small and aging population and limited resources provide major challenges for maintaining and sustaining an effective workforce of health professionals, a constantly evolving technical platform and an increasing number of available medications. This is true particularly in view of the increasing burden of chronic diseases and the continued threat to the population of current or emerging infectious diseases. The purpose of this article is to provide a brief introduction to the geography, history, and political context of Seychelles to provide an account of the current situation regarding major diseases in the Seychelles and to review health priorities of the last few decades. To our knowledge, no comprehensive inventory of sporadic, endemic or epidemic events has been attempted before, except for a remarkable report from the 1950s [1]. Using health data from the past few decades, information from health personnel who live and practice in the Indian Ocean, we attempt to identify major current and future health challenges in the Seychelles.
Collapse
Affiliation(s)
- P Bovet
- Ministry of Health, Victoria, The Republic of Seychelles, Institut universitaire de médecine sociale et préventive (IUMSP), Centre hospitalier universitaire vaudois, Lausanne, Suisse
| | | | | | | | | | | |
Collapse
|
12
|
Glaus J, Vandeleur C, Gholam-Rezaee M, Castelao E, Perrin M, Rothen S, Bovet P, Marques-Vidal P, von Känel R, Merikangas K, Mooser V, Waterworth DM, Waeber G, Vollenweider P, Preisig M. Atypical depression and alcohol misuse are related to the cardiovascular risk in the general population. Acta Psychiatr Scand 2013; 128:282-93. [PMID: 23216242 DOI: 10.1111/acps.12057] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/02/2012] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The aims of the present study were to assess the associations between mood, anxiety and substance use disorders, including their subtypes, and the prevalence of cardiovascular risk factors (CVRFs). METHOD Thorough physical investigations, biological measures and standardized interview techniques were used to assess 3716 subjects of an urban area, aged 35-66 years. RESULTS Atypical depression was associated with increased prevalence of overweight, diabetes and the metabolic syndrome (OR = 1.5, 95% C.I. 1.1-2.0; OR = 2.0, 95% C.I. 1.1-3.5, OR = 1.6, 95% C.I. 1.0-2.4 respectively), whereas decreased prevalence of overweight was found in melancholic (OR = 0.7, 95% C.I. 0.6-0.9) and unspecified depression (OR = 0.8, 95% C.I. 0.7-1.0). Alcohol abuse was associated with diabetes (OR = 1.8, 95% C.I. 1.1-2.9) and dyslipidemia (OR = 1.3, 95% C.I. 1.0-1.8), alcohol dependence with dyslipidemia only (OR = 1.4, 95% C.I. 1.0-2.0). Almost all mental disorders were associated with a lifetime history of regular cigarette smoking, and atypical depression, alcohol misuse and drug dependence were associated with inactivity. CONCLUSION To conclude results emphasize the need to subtype depression and to pay particular attention to the atypical subtype. Comorbid alcohol misuse may further increase the cardiovascular risk. Efforts to diminish smoking in subjects with mental disorders could be crucial measures to reduce their high incidence of cardiovascular disease.
Collapse
Affiliation(s)
- J Glaus
- Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
13
|
Stringhini S, Bovet P. Commentary: The social transition of cardiovascular disease in low- and middle-income countries: wait and see is not an option. Int J Epidemiol 2013; 42:1429-31. [DOI: 10.1093/ije/dyt084] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
14
|
Luke A, Bovet P, Forrester TE, Lambert EV, Plange-Rhule J, Dugas LR, Durazo-Arvizu RA, Kroff J, Richie WN, Schoeller DA. Prediction of fat-free mass using bioelectrical impedance analysis in young adults from five populations of African origin. Eur J Clin Nutr 2013; 67:956-60. [PMID: 23881006 PMCID: PMC3766444 DOI: 10.1038/ejcn.2013.123] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2012] [Revised: 05/30/2013] [Accepted: 06/03/2013] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES Bioelectrical impedance analysis (BIA) is used in population and clinical studies as a technique for estimating body composition. Because of significant under-representation in existing literature, we sought to develop and validate predictive equation(s) for BIA for studies in populations of African origin. SUBJECTS/METHODS Among five cohorts of the Modeling the Epidemiologic Transition Study, height, weight, waist circumference and body composition, using isotope dilution, were measured in 362 adults, ages 25-45 with mean body mass indexes ranging from 24 to 32. BIA measures of resistance and reactance were measured using tetrapolar placement of electrodes and the same model of analyzer across sites (BIA 101Q, RJL Systems). Multiple linear regression analysis was used to develop equations for predicting fat-free mass (FFM), as measured by isotope dilution; covariates included sex, age, waist, reactance and height(2)/resistance, along with dummy variables for each site. Developed equations were then tested in a validation sample; FFM predicted by previously published equations were tested in the total sample. RESULTS A site-combined equation and site-specific equations were developed. The mean differences between FFM (reference) and FFM predicted by the study-derived equations were between 0.4 and 0.6 kg (that is, 1% difference between the actual and predicted FFM), and the measured and predicted values were highly correlated. The site-combined equation performed slightly better than the site-specific equations and the previously published equations. CONCLUSIONS Relatively small differences exist between BIA equations to estimate FFM, whether study-derived or published equations, although the site-combined equation performed slightly better than others. The study-derived equations provide an important tool for research in these understudied populations.
Collapse
Affiliation(s)
- A Luke
- Department of Public Health Sciences, Stritch School of Medicine, Loyola University Chicago, Maywood, IL, USA.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
15
|
Cardoso I, Bovet P, Viswanathan B, Luke A, Marques-Vidal P. Nutrition transition in a middle-income country: 22-year trends in the Seychelles. Eur J Clin Nutr 2012; 67:135-40. [PMID: 23249880 DOI: 10.1038/ejcn.2012.199] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES There is little objective information regarding nutrition transition in African countries. We assessed trends in nutrition patterns in the Seychelles between 1989 and 2011. SUBJECTS/METHODS Population-based samples were obtained in 1989, 1994 and 2011 and participants aged 25-44 are considered in this study (n=493, 599 and 471, respectively). Similar, although not identical, food frequency questionnaires (FFQs) were used in each survey and the variables were collapsed into homogenous categories for the purpose of this study. RESULTS Between 1989 and 2011, consumption frequency of fish (5+/week) decreased from 93 to 74%, whereas the following increased: meat (5+/week) 25 to 51%, fruits (1+/week) 48 to 94%, salty snacks (1+/week) 22 to 64% and sweet snacks (1+/week) 38 to 67% (P<0.001 for all). Consumption frequency decreased for home-brewed alcoholic drinks (1+/week) 16 to 1%, but increased for wine (1+/week) 5 to 33% (both P<0.001). Between 2004 and 2011, consumption frequency decreased for rice (2/day) 62 to 57% and tea (1+/day) 72 to 68%, increased for poultry (1+/week) 86 to 96% (all P<0.01), and did not change for vegetables (70.3 to 69.8%, P=0.65). CONCLUSIONS Seychelles is experiencing nutrition transition characterized by a decreased consumption frequency of traditional staple foods (fish, polished rice), beverages (tea) and of inexpensive home brews, and increased consumption frequency of meat, poultry and snacks. Food patterns also became more varied along with a broader availability of products in the 22-year interval. The health impact of these changes should be further studied.
Collapse
Affiliation(s)
- I Cardoso
- Institute of Preventive Medicine, Lisbon, Portugal
| | | | | | | | | |
Collapse
|
16
|
Parnas J, Møller P, Kircher T, Thalbitzer J, Jansson L, Handest P, Zahavi D, Cermolacce M, Bovet P. EASE : Évaluation des Anomalies de l’Expérience de Soi#. Encephale 2012; 38 Suppl 3:S121-45. [DOI: 10.1016/s0013-7006(12)70090-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
17
|
Buso DL, Longo-Mbenza B, Bovet P, van den Borne B, Okwe AN, Mzingelwa M. Deaths rates in public hospitals of eastern cape province of South Africa. Iran J Public Health 2012; 41:19-25. [PMID: 23641386 PMCID: PMC3640777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2012] [Accepted: 11/18/2012] [Indexed: 11/10/2022]
Abstract
BACKGROUND South Africa (SA) is experiencing a rapid epidemiologic transition as a consequence of political, economic and social changes. In this study we described, based on hospital data, the mortality patterns of Non communicable Diseases (NCD), Communicable Diseases (CD), the NCD/CD ratios, and the trends of deaths. METHODS We conducted a cross-sectional survey of all deaths occurring in several public hospitals in the Eastern Cape Province of SA between 2002 and 2006. Causes of deaths were coded according to the ICD 10 Edition. RESULTS A total of 107380 admissions responded to the inclusion criteria between 2002 and 2006. The crude death rate was 4.3% (n=4566) with a mean age of 46±21 years and a sex ratio of 3.1 men (n=3453): 1 woman (n=1113). Out of all deaths, there were 62.9% NCD (n=2872) vs. 37.1% CD (n=1694) with NCD/CD ratio of 1.7. The ratio NCD/CD deaths in men was 1.3 (n=1951/1502) vs. NCD/CD deaths in women of 1.9 (n=735/378). The peak of deaths was observed in winter season. The majority of NCD deaths were at age of 30-64 years, whereas the highest rate of CD deaths was at age< 30 years. The trend of deaths including the majority of NCD, increased from 2002 to 2006. There was a tendency of increase in tuberculosis deaths, but a tendency of decrease in HIV/AIDS deaths was from 2002 to 2006. CONCLUSION Non-communicable diseases are the leading causes of deaths in rural Eastern Cape province of SA facing Post-epidemiologic transition stages. We recommend overarching priority actions for the response to the Non-communicable Diseases: policy change, prevention, treatment, international cooperation, research, monitoring, accountability, and re-orientation of health systems.
Collapse
Affiliation(s)
- DL Buso
- Walter Sisulu University, Faculty of Health Sciences, Mthatha, Eastern Cap, South Africa
| | - B Longo-Mbenza
- Walter Sisulu University, Faculty of Health Sciences, Mthatha, Eastern Cap, South Africa,Corresponding Author: Tel: +27732822843
| | - P Bovet
- Institute of Social and Preventive Medicine, University of Lausanne, Switzerland
| | - B van den Borne
- Dept. of Health Promotion, Faculty of Medicine, Maastricht University, The Nederland
| | - A Nge Okwe
- Biostatistics Unit, LOMO MEDICAL Center and Heart of Africa Center of Cardiology DRC, South Africa
| | - M Mzingelwa
- Walter Sisulu University, Faculty of Health Sciences, Mthatha, Eastern Cap, South Africa
| |
Collapse
|
18
|
|
19
|
Bovet P, Cornuz J, Paccaud F. [The Framework Convention for Tobacco Control (FCTC): a powerful public health instrument]. Rev Med Suisse 2012; 8:1438-1441. [PMID: 22934470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The Framework Convention on Tobacco Control (FCTC) isa global and comprehensive legal framework for reducing demand for tobacco (e.g. price measures; ban on smoking in enclosed places; contents of tobacco products; packaging and labeling; advertising, promotion and sponsorship; liability, tobacco cessation, etc.) and supply (e.g. illicit trade; sales to/by minors, etc.). Adopted in 2003, the FCTC has been ratified by 174 countries so far. Switzerland has signed the treaty in 2004 but ratification will necessitate the implementation of stronger tobacco control measures at the national level. The FCTC is a priority of any strategy to reduce noncommunicable diseases in populations. Broad implementation of the FCTC has the potential to prevent a substantial proportion of the billion of tobacco-related deaths expected in the 21st century.
Collapse
Affiliation(s)
- P Bovet
- Prs Pascal Bovet et Fred Paccaud Institut universitaire de médecine sociale et préventive, CHUV Biopôle 2, Route de la Corniche 10, 1010 Lausanne.
| | | | | |
Collapse
|
20
|
Viswanathan B, Plumettaz C, Gedeon J, Bovet P. Impact of a smoking ban in public places: a rapid assessment in the Seychelles. Tob Control 2011; 20:427-30. [DOI: 10.1136/tc.2010.041590] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
21
|
Cammoun L, Gigandet X, Sporns O, Thiran JP, Deppen P, Krieger E, Maeder P, Meuli R, Hagmann P, Bovet P, Do KQ. Connectome alterations in schizophrenia. Neuroimage 2009. [DOI: 10.1016/s1053-8119(09)71653-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
22
|
Affiliation(s)
- P Bovet
- Institute of Social and Preventive Medicine, Faculty of Medicine and University Hospital Center, rue de Bugnon 17, 1005 Lausanne, Switzerland
| | | |
Collapse
|
23
|
Bovet P, Gabriel A, Shamlaye C, Paccaud F. Diabetes in Africa: the situation in the Seychelles. Heart 2009; 95:506-507. [PMID: 19252012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
|
24
|
Abstract
We assessed the 15-year trends in the distribution of body mass index (BMI) and the prevalence of overweight in the Seychelles (Indian Ocean, African Region) and the relationship with socio-economic status (SES). Three population-based examination surveys were conducted in 1989, 1994 and 2004. Occupation was categorized as 'labourer', 'intermediate' or 'professional'. Education was also assessed in 1994 and 2004. Between 1989 and 2004, mean BMI increased markedly in all sex and age categories (overall: 0.16 kg m(-2) per calendar year, which corresponds to 0.46 kg per calendar year). The prevalence of overweight (including obesity, BMI >or= 25 kg m(-2)) increased from 29% to 52% in men and from 50% to 67% in women. The prevalence of obesity (BMI >or= 30 kg m(-2)) increased from 4% to 15% in men and from 23% to 34% in women. Overweight was associated inversely with occupation in women and directly in men in all surveys. In multivariate analysis, overweight was associated similarly (direction and magnitude) to occupation and education. In conclusion, the increasing prevalence of overweight and obesity over time in all age, sex and SES categories suggests large-scale changes in societal obesogenic factors. The sex-specific association of SES with overweight suggests that prevention measures should be tailored accordingly.
Collapse
Affiliation(s)
- P Bovet
- Ministry of Health and Social Development, Victoria, Republic of Seychelles.
| | | | | | | |
Collapse
|
25
|
Chiolero A, Lasserre AM, Paccaud F, Bovet P. [Childhood obesity: definition, consequences, and prevalence]. Rev Med Suisse 2007; 3:1262-9. [PMID: 17585631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Since the 1980s, an epidemic of obesity is occurring worldwide among adults and children. The body mass index (BMI) is useful to determine whether a child is overweight or obese because BMI relates strongly to body fat mass. However, contrary to adults, BMI changes with sex and age in children. Sex- and age-specific norms for BMI of the International obesity task force (IOTF) are now widely used. Approximately 15-20% of schoolchildren in Switzerland are currently overweight (or obese) and 2-5% are obese. Obesity is a major public health challenge. It is associated with numerous short and long term health hazards (in particular cardiovascular and metabolic disorders, e.g. diabetes) and it tracks form childhood throughout adulthood. This emphasizes the need for programs and polices aimed at preventing paediatric obesity.
Collapse
Affiliation(s)
- A Chiolero
- Institut universitaire de médecine sociale et preventive (IUMSP), Groupe cardiovasculaire et transition sanitaire, 1004 Lausanne.
| | | | | | | |
Collapse
|
26
|
Affiliation(s)
- A Chiolero
- Institute of Social and Preventive Medicine (IUMSP), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland.
| | | |
Collapse
|
27
|
Chiolero A, Madeleine G, Gabriel A, Burnier M, Paccaud F, Bovet P. Prevalence of elevated blood pressure and association with overweight in children of a rapidly developing country. J Hum Hypertens 2006; 21:120-7. [PMID: 17136104 DOI: 10.1038/sj.jhh.1002125] [Citation(s) in RCA: 78] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
We assessed the prevalence of elevated blood pressure (BP) and the association with excess body weight among a large sample of children in the Seychelles, a middle-income rapidly developing country in the African region. Weight, height and BP were measured in all children of four school grades in the Seychelles (Indian Ocean). Excess weight categories ('overweight' and 'obesity') were defined according to the criteria of the International Obesity Task Force. Two BP readings were obtained on one occasion. 'Elevated BP' was defined based on US reference tables. Data were available in 15,612 (86%) of 18,119 eligible children aged 5-16 years in 2002-2004. In all, 13.0% of Boys and 18.8% of girls were overweight or obese. The prevalence of elevated BP was 9.1% in boys and 10.1% in girls. Both systolic and diastolic BP were strongly associated with body mass index (BMI) in boys and in girls. In children with 'normal weight', 'overweight (and not obesity)' and 'obesity', respectively, proportions with elevated BP were 7.5, 16.9 and 25.2% in boys, and 7.5, 16.1 and 33.2% in girls. Overweight (including obesity) could account for 18% of cases of elevated BP in boys and 26% in girls. Further studies should examine the impact of the relationship between BMI and elevated BP on the burden of hypertension in the context of the epidemic of paediatric obesity.
Collapse
Affiliation(s)
- A Chiolero
- Institute of Social and Preventive Medicine, University of Lausanne, Switzerland
| | | | | | | | | | | |
Collapse
|
28
|
Conen D, Wietlisbach V, Bovet P, Shamlaye C, Riesen W, Paccaud F, Burnier M. Prevalence of hyperuricemia and relation of serum uric acid with cardiovascular risk factors in a developing country. BMC Public Health 2004; 4:9. [PMID: 15043756 PMCID: PMC406506 DOI: 10.1186/1471-2458-4-9] [Citation(s) in RCA: 203] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2003] [Accepted: 03/25/2004] [Indexed: 11/17/2022] Open
Abstract
Background The prevalence of hyperuricemia has rarely been investigated in developing countries. The purpose of the present study was to investigate the prevalence of hyperuricemia and the association between uric acid levels and the various cardiovascular risk factors in a developing country with high average blood pressures (the Seychelles, Indian Ocean, population mainly of African origin). Methods This cross-sectional health examination survey was based on a population random sample from the Seychelles. It included 1011 subjects aged 25 to 64 years. Blood pressure (BP), body mass index (BMI), waist circumference, waist-to-hip ratio, total and HDL cholesterol, serum triglycerides and serum uric acid were measured. Data were analyzed using scatterplot smoothing techniques and gender-specific linear regression models. Results The prevalence of a serum uric acid level >420 μmol/L in men was 35.2% and the prevalence of a serum uric acid level >360 μmol/L was 8.7% in women. Serum uric acid was strongly related to serum triglycerides in men as well as in women (r = 0.73 in men and r = 0.59 in women, p < 0.001). Uric acid levels were also significantly associated but to a lesser degree with age, BMI, blood pressure, alcohol and the use of antihypertensive therapy. In a regression model, triglycerides, age, BMI, antihypertensive therapy and alcohol consumption accounted for about 50% (R2) of the serum uric acid variations in men as well as in women. Conclusions This study shows that the prevalence of hyperuricemia can be high in a developing country such as the Seychelles. Besides alcohol consumption and the use of antihypertensive therapy, mainly diuretics, serum uric acid is markedly associated with parameters of the metabolic syndrome, in particular serum triglycerides. Considering the growing incidence of obesity and metabolic syndrome worldwide and the potential link between hyperuricemia and cardiovascular complications, more emphasis should be put on the evolving prevalence of hyperuricemia in developing countries.
Collapse
Affiliation(s)
- D Conen
- Division of Hypertension and Vascular Medicine, CHUV, Lausanne, Switzerland
| | - V Wietlisbach
- University Institute of Social and Preventive Medicine, Lausanne, Switzerland
| | - P Bovet
- University Institute of Social and Preventive Medicine, Lausanne, Switzerland
- Ministry of Health, Republic of Seychelles
| | - C Shamlaye
- Ministry of Health, Republic of Seychelles
| | - W Riesen
- Kantonalspital St Gallen, Switzerland
| | - F Paccaud
- University Institute of Social and Preventive Medicine, Lausanne, Switzerland
| | - M Burnier
- Division of Hypertension and Vascular Medicine, CHUV, Lausanne, Switzerland
| |
Collapse
|
29
|
Caldara R, Thut G, Servoir P, Michel CM, Bovet P, Renault B. Face versus non-face object perception and the 'other-race' effect: a spatio-temporal event-related potential study. Clin Neurophysiol 2003; 114:515-28. [PMID: 12705432 DOI: 10.1016/s1388-2457(02)00407-8] [Citation(s) in RCA: 109] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To investigate a modulation of the N170 face-sensitive component related to the perception of other-race (OR) and same-race (SR) faces, as well as differences in face and non-face object processing, by combining different methods of event-related potential (ERP) signal analysis. METHODS Sixty-two channel ERPs were recorded in 12 Caucasian subjects presented with Caucasian and Asian faces along with non-face objects. Surface data were submitted to classical waveforms and ERP map topography analysis. Underlying brain sources were estimated with two inverse solutions (BESA and LORETA). RESULTS The N170 face component was identical for both race faces. This component and its topography revealed a face specific pattern regardless of race. However, in this time period OR faces evoked significantly stronger medial occipital activity than SR faces. Moreover, in terms of maps, at around 170 ms face-specific activity significantly preceded non-face object activity by 25 ms. These ERP maps were followed by similar activation patterns across conditions around 190-300 ms, most likely reflecting the activation of visually derived semantic information. CONCLUSIONS The N170 was not sensitive to the race of the faces. However, a possible pre-attentive process associated to the relatively stronger unfamiliarity for OR faces was found in medial occipital area. Moreover, our data provide further information on the time-course of face and non-face object processing.
Collapse
Affiliation(s)
- R Caldara
- Faculty of Psychology and Educational Sciences. University of Geneva, 40 boulevard du Pont d'Arve, 1211 Geneva 4, Switzerland.
| | | | | | | | | | | |
Collapse
|
30
|
|
31
|
Darwiche J, Bovet P, Corboz-Warnery A, Germond M, Rais M, Real del Sarte O, Guex P. [Which psychological support for couples seeking medical assistance for procreation?]. Gynecol Obstet Fertil 2002; 30:394-404. [PMID: 12087935 DOI: 10.1016/s1297-9589(02)00339-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVES The objective of our qualitative study was to define modalities of psychological support to be offered to couples seeking medically assisted procreation. MATERIAL AND METHODS Forty couples participated in a semi-structured videotaped interview, which touched on themes such as personal and family histories, the couple's relationship, etc. We focused on the "narrative mobility", that is the way in which the couples transmit their personal and family history during the interview and the interviewer's impression that he may or may not share this with the couples. RESULTS Observed differences in narrative mobility led us to distinguish three groups of couples and to propose various types of psychological support. DISCUSSION AND CONCLUSION This exploratory study, with its interest for the narrative mobility, concerns the couples' capacity to stand back from their own story as responsible interlocutors. We made the hypothesis that this capacity is linked to their capacity to handle their emotional stress, to act as partners to the medical team and to prepare themselves for their future parenthood.
Collapse
Affiliation(s)
- J Darwiche
- Service de psychiatrie de liaison, département universitaire de psychiatrie adulte, Les Allières, CHUV, 1011 Lausanne, Suisse.
| | | | | | | | | | | | | |
Collapse
|
32
|
Stettler N, Bovet P, Shamlaye H, Zemel BS, Stallings VA, Paccaud F. Prevalence and risk factors for overweight and obesity in children from Seychelles, a country in rapid transition: the importance of early growth. Int J Obes (Lond) 2002; 26:214-9. [PMID: 11850753 DOI: 10.1038/sj.ijo.0801860] [Citation(s) in RCA: 70] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2001] [Revised: 06/29/2001] [Accepted: 07/24/2001] [Indexed: 11/08/2022]
Abstract
OBJECTIVES To establish the prevalence of overweight and obesity and related risk factors in children from Seychelles (Indian Ocean), a country in rapid economic and epidemiological transition. DESIGN Cross-sectional study with retrospective access to early life data. SUBJECTS All children from all schools of Seychelles, in four selected school grades (kindergarten, fourth, seventh and tenth year of obligatory school) in 1999. A total of 5514 children aged 4.5-17.4 y were measured, corresponding to 83.5% of the eligible population. MEASUREMENTS Overweight and obesity, using age- and sex-specific body mass index (BMI) cut-off points as defined by the International Obesity Task Force. RESULTS Some 12.6% (95% confidence interval: 11.8-13.5%) of the children were overweight and 3.8% (3.3-4.4%) were obese. Weight gain (kg) during the first year of life was strongly associated with subsequent overweight (odds ratio 1.46, 95% confidence interval 1.27-1.67) and obesity (1.59, 1.29-1.97) in childhood, independently of birth weight. Increased maternal BMI (kg/m(2)) was also associated with overweight (1.07, 1.03-1.10) and obesity (1.09, 1.04-1.14) in the offspring. CONCLUSION Prevalence of overweight and obesity among school children in Seychelles was as high as or higher than in some industrialized countries. If confirmed in other environments, the strong association between weight gain during the first year of life and subsequent obesity in childhood could affect the way optimal infant weight gain is defined in countries where public health priorities are changing.
Collapse
Affiliation(s)
- N Stettler
- The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
| | | | | | | | | | | |
Collapse
|
33
|
Doll S, Paccaud F, Bovet P, Burnier M, Wietlisbach V. Body mass index, abdominal adiposity and blood pressure: consistency of their association across developing and developed countries. Int J Obes (Lond) 2002; 26:48-57. [PMID: 11791146 DOI: 10.1038/sj.ijo.0801854] [Citation(s) in RCA: 172] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2001] [Revised: 06/08/2001] [Accepted: 07/12/2001] [Indexed: 11/09/2022]
Abstract
BACKGROUND Obesity is increasing worldwide because developing countries are adopting Western high-fat foods and sedentary lifestyles. In parallel, in many of them, hypertension is rising more rapidly, particularly with age, than in Western countries. OBJECTIVE To assess the relationship between adiposity and blood pressure (BP) in a developing country with high average BP (The Seychelles, Indian Ocean, population mainly of African origin) in comparison to a developed country with low average BP (Switzerland, population mainly of Caucasian origin). DESIGN Cross-sectional health examination surveys based on population random samples. SETTING The main Seychelles island (Mahé) and two Swiss regions (Vaud-Fribourg and Ticino). SUBJECTS Three thousand one hundred and sixteen adults (age range 35-64) untreated for hypertension. MEASUREMENTS Body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), systolic and diastolic blood pressure (SBP and DBP, mean of two measures). METHODS Scatterplot smoothing techniques and gender-specific linear regression models. RESULTS On average, SBP and DBP were found to increase linearly over the whole variation range of BMI, WHR and WC. A modest, but statistically significant linear association was found between each indicator of adiposity and BP levels in separate regression models controlling for age. The regression coefficients were not significantly different between the Seychelles and the two Swiss regions, but were generally higher in women than in men. For the latter, a gain of 1.7 kg/m(2) in BMI, of 4.5 cm in WC or of 3.4% in WHR corresponded to an elevation of 1 mmHg in SBP. For women, corresponding figures were 1.25 kg/m(2), 2.5 cm and 1.8% respectively. Regression coefficients for age reflected a higher effect of this variable on both SBP and DBP in the Seychelles than in Switzerland. CONCLUSION These findings suggest a stable linear relation of adiposity with BP, independent of age and body fat distribution, across developed and developing countries. The more rapid increase of BP with age observed in the latter countries are likely to reflect higher genetic susceptibility and/or higher cumulative exposure to another risk factor than adiposity.
Collapse
Affiliation(s)
- S Doll
- Institute for Social and Preventive Medicine, University of Lausanne, Switzerland
| | | | | | | | | |
Collapse
|
34
|
Bovet P, Paccaud F. Race and responsiveness to drugs for heart failure. N Engl J Med 2001; 345:766; author reply 767-8. [PMID: 11547750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
|
35
|
Affiliation(s)
- P Bovet
- University Institute of Social and Preventive Medicine, Bugnon 17, 1005 Lausanne, Switzerland
| | | |
Collapse
|
36
|
Abstract
OBJECTIVE The study tests the hypothesis that intramodal visual binding is disturbed in schizophrenia and should be detectable in all illness stages as a stable trait marker. METHOD Three groups of patients (rehospitalized chronic schizophrenic, first admitted schizophrenic and schizotypal patients believed to be suffering from a pre-schizophrenic prodrome) and a group of normal control subjects were tested on three tasks targeting visual 'binding' abilities (Muller-Lyer's illusion and two figure detection tasks) in addition to control parameters such as reaction time, visual selective attention, Raven's test and two conventional cortical tasks of spatial working memory (SWM) and a global local test. RESULTS Chronic patients had a decreased performance on the binding tests. Unexpectedly, the prodromal group exhibited an enhanced Gestalt extraction on these tests compared both to schizophrenic patients and to healthy subjects. Furthermore, chronic schizophrenia was associated with a poor performance on cortical tests of SWM, global local and on Raven. This association appears to be mediated by or linked to the chronicity of the illness. CONCLUSION The study confirms a variety of neurocognitive deficits in schizophrenia which, however, in this sample seem to be linked to chronicity of illness. However, certain aspects of visual processing concerned with Gestalt extraction deserve attention as potential vulnerability- or prodrome- indicators. The initial hypothesis of the study is rejected.
Collapse
Affiliation(s)
- J Parnas
- Copenhagen University Department of Psychiatry, Hvidovre Hospital, Denmark
| | | | | | | | | | | |
Collapse
|
37
|
Abstract
Cardiovascular disease is rapidly increasing in developing countries experiencing epidemiological transition. We investigated the prevalence of peripheral atherosclerosis in a rapidly developing country and compared our findings with data previously reported in Western populations. A cardiovascular risk factor survey was conducted in 1067 individuals aged 25-64 randomly selected from the general population of Seychelles. High-resolution ultrasonography of the right and left carotid and femoral arteries was performed in a random subgroup of 503 subjects (245 men and 258 women). In each of the four arteries, arterial wall thickness (in plaque-free segments) and atherosclerotic plaques (i.e. focal wall thickening at least 1.0 mm thick) were measured separately. The prevalence of peripheral atherosclerosis was high in this population. For instance, at least one plaque > or =1.0 mm was found in, respectively, 34.9 and 27.5% of men and women aged 25-34 and at least one plaque > or =2.5 mm was found in, respectively, 58.2 and 36.9% of men and women aged 55-64. With reference to data found in the literature, the prevalence of carotid atherosclerosis appeared to be significantly higher in Seychelles than in Western populations. This study provides further evidence for the importance of cardiovascular disease in developing countries. Determinants should be identified and relevant prevention and control programs implemented.
Collapse
Affiliation(s)
- F Perret
- Division of Cardiology, Department of Internal Medicine, University Hospital, Lausanne, Switzerland
| | | | | | | | | |
Collapse
|
38
|
Jaggy C, Perret F, Bovet P, van Melle G, Zerkiebel N, Madeleine G, Kappenberger L, Paccaud F. Performance of classic electrocardiographic criteria for left ventricular hypertrophy in an African population. Hypertension 2000; 36:54-61. [PMID: 10904012 DOI: 10.1161/01.hyp.36.1.54] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
ECG criteria for left ventricular hypertrophy (LVH) have been almost exclusively elaborated and calibrated in white populations. Because several interethnic differences in ECG characteristics have been found, the applicability of these criteria to African individuals remains to be demonstrated. We therefore investigated the performance of classic ECG criteria for LVH detection in an African population. Digitized 12-lead ECG tracings were obtained from 334 African individuals randomly selected from the general population of the Republic of Seychelles (Indian Ocean). Left ventricular mass was calculated with M-mode echocardiography and indexed to body height. LVH was defined by taking the 95th percentile of body height-indexed LVM values in a reference subgroup. In the entire study sample, 16 men and 15 women (prevalence 9.3%) were finally declared to have LVH, of whom 9 were of the reference subgroup. Sensitivity, specificity, accuracy, and positive and negative predictive values for LVH were calculated for 9 classic ECG criteria, and receiver operating characteristic curves were computed. We also generated a new composite time-voltage criterion with stepwise multiple linear regression: weighted time-voltage criterion=(0.2366R(aVL)+0.0551R(V5)+0.0785S(V3)+ 0.2993T(V1))xQRS duration. The Sokolow-Lyon criterion reached the highest sensitivity (61%) and the R(aVL) voltage criterion reached the highest specificity (97%) when evaluated at their traditional partition value. However, at a fixed specificity of 95%, the sensitivity of these 10 criteria ranged from 16% to 32%. Best accuracy was obtained with the R(aVL) voltage criterion and the new composite time-voltage criterion (89% for both). Positive and negative predictive values varied considerably depending on the concomitant presence of 3 clinical risk factors for LVH (hypertension, age >/=50 years, overweight). Median positive and negative predictive values of the 10 ECG criteria were 15% and 95%, respectively, for subjects with none or 1 of these risk factors compared with 63% and 76% for subjects with all of them. In conclusion, the performance of classic ECG criteria for LVH detection was largely disparate and appeared to be lower in this population of East African origin than in white subjects. A newly generated composite time-voltage criterion might provide improved performance. The predictive value of ECG criteria for LVH was considerably enhanced with the integration of information on concomitant clinical risk factors for LVH.
Collapse
Affiliation(s)
- C Jaggy
- Division of Cardiology, Department of Internal Medicine, University Hospital, Lausanne, Switzerland
| | | | | | | | | | | | | | | |
Collapse
|
39
|
Abstract
Several studies show a relationship between abdominal obesity and cardiovascular diseases, partially mediated through an altered metabolism of dyslipidemia. The present study was aimed at testing the robustness of this association across three contrasted populations and at assessing the performances of abdominal obesity as a screening tool for dyslipidemia. Data were drawn from three population health surveys recently conducted in two regions of a developed country (Switzerland, mostly of Caucasian origin, n = 2650) and in a less developed country (Seychelles, Indian Ocean, mostly of black descent, n = 806). Dyslipidemia was defined as a ratio of total cholesterol to high-density lipoprotein cholesterol (TC-HDL) greater than 5. Two anthropometric circumference measurements, waist-to-hip ratio (WHR) and waist circumference (WC), were used to define abdominal obesity either as WHR >/= 0.9 in men and WHR >/= 0.8 in women or as WC >/= 94 cm and WC >/= 80 cm, respectively. A consistent direct association between abdominal obesity and dyslipidemia (odds ratios varying from 1.85 to 4.56) was found in the three populations, independently of gender, age, body mass index, blood pressure, and smoking. This consistency across ethnicities and environments strengthens the hypothesis of a common etiopathological mechanism. The sensitivity for detecting dyslipidemia was generally higher for abdominal obesity, based on either WHR or WC, than for criteria based on the other risk factors under study. In addition, the sensitivity was higher in the study populations with a low prevalence of dyslipidemia (Swiss women and Seychellois of both sexes) than in the others. These findings support that WHR and WC may be useful as simple and inexpensive screening tools to select individuals eligible for more sophisticated and costly serum lipid determinations, especially in developing countries.
Collapse
Affiliation(s)
- F Paccaud
- Institute for Social and Preventive Medicine, University of Lausanne, 17, rue du Bugnon, 1005, Lausanne, Switzerland.
| | | | | | | |
Collapse
|
40
|
Yersin C, Bovet P, Mérien F, Clément J, Laille M, Van Ranst M, Perolat P. Pulmonary haemorrhage as a predominant cause of death in leptospirosis in Seychelles. Trans R Soc Trop Med Hyg 2000; 94:71-6. [PMID: 10748905 DOI: 10.1016/s0035-9203(00)90445-0] [Citation(s) in RCA: 65] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
We examined the cause of death during a 12-month period (1995/96) in all consecutive patients admitted to hospital with leptospiral infection in Seychelles (Indian Ocean), where the disease is endemic. Leptospirosis was diagnosed by use of the microscopic agglutination test and a specific polymerase chain reaction assay on serum samples. Seventy-five cases were diagnosed and 6 patients died, a case fatality of 8%. All 6 patients died within 9 days of onset of symptoms and within 2 days of admission for 5 of them (5 days for the 6th). On autopsy, diffuse bilateral pulmonary haemorrhage (PH) was found in all fatalities. Renal, cardiac, digestive and cerebral haemorrhages were also found in 5, 3, 3 and 1 case(s), respectively. Incidentally, haemoptysis and lung infiltrate on chest radiographs, which suggest PH, were found in 8 of the 69 non-fatal cases. Dengue and hantavirus infections were ruled out. In conclusion, PH appeared to be a main cause of death in leptospirosis in this population, although haemorrhage in other organs may also have contributed to fatal outcomes. This cause of death contrasts with the findings generally reported in endemic settings.
Collapse
|
41
|
Zerkiebel N, Perret F, Bovet P, Abel M, Jaggy C, Paccaud F, Kappenberger L. Electrocardiographic findings in a middle-aged African population in the Seychelles islands. J Electrocardiol 2000; 33:1-15. [PMID: 10691169 DOI: 10.1016/s0022-0736(00)80095-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This study describes major electrocardiogram (ECG) measurements and diagnoses in a population of African individuals; most reference data have been collected in Caucasian populations and evidence exists for interethnic differences in ECG findings. This study was conducted in the Seychelles islands (Indian Ocean) and included 709 black individuals (343 men and 366 women) aged 25 to 64 years randomly selected from the general population. Resting ECG were recorded by using a validated ECG unit equipped with a measurement and interpretation software (Cardiovit AT-6, Schiller, Switzerland). The epidemiology of 14 basic ECG measurements, 6 composite criteria for left ventricular hypertrophy and 19 specific ECG diagnoses including abnormal rhythms, conduction abnormalities, repolarization abnormalities, and myocardial infarction were examined. Substantial gender and age differences were found for several ECG parameters. Moreover, tracings recorded in African individuals of the Seychelles differed from those collected similarly in Caucasian populations in many respects. For instance, heart rate was approximately 5 beats per minute lower in the African individuals than in selected Caucasian populations, prevalence of first degree atrio-ventricular block was especially high (4.8%), and the average Sokolow-Lyon voltage was markedly higher in African individuals of the Seychelles compared with black and white Americans. The integrated interpretation software detected "old myocardial infarction" in 3.8% of men and 0% of women and "old myocardial infarction possible" in 6.1% and 3%, respectively. Cardiac infarction injury scores are also provided. In conclusion, the study provides reference values for ECG findings in a specific population of people of African descent and stresses the need to systematically consider gender, age, and ethnicity when interpreting ECG tracings in individuals.
Collapse
Affiliation(s)
- N Zerkiebel
- Department of Internal Medicine, University Hospital, Lausanne, Switzerland
| | | | | | | | | | | | | |
Collapse
|
42
|
Geddes JR, Verdoux H, Takei N, Lawrie SM, Bovet P, Eagles JM, Heun R, McCreadie RG, McNeil TF, O'Callaghan E, Stöber G, Willinger U, Murray RM. Schizophrenia and complications of pregnancy and labor: an individual patient data meta-analysis. Schizophr Bull 1999; 25:413-23. [PMID: 10478777 DOI: 10.1093/oxfordjournals.schbul.a033389] [Citation(s) in RCA: 219] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Several epidemiological studies have reported an association between complications of pregnancy and delivery and schizophrenia, but none have had sufficient power to examine specific complications that, individually, are of low prevalence. We, therefore, performed an individual patient meta-analysis using the raw data from case control studies that used the Lewis-Murray scale. Data were obtained from 12 studies on 700 schizophrenia subjects and 835 controls. There were significant associations between schizophrenia and premature rupture of membranes, gestational age shorter than 37 weeks, and use of resuscitation or incubator. There were associations of borderline significance between schizophrenia and birthweight lower than 2,500 g and forceps delivery. There was no significant interaction between these complications and sex. We conclude that some abnormalities of pregnancy and delivery may be associated with development of schizophrenia. The pathophysiology may involve hypoxia and so future studies should focus on the accurate measurement of this exposure.
Collapse
Affiliation(s)
- J R Geddes
- University Department of Psychiatry, Warneford Hospital, Oxford, UK.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
43
|
Abstract
Self-reported drinking habits were examined in a random sample of 1067 persons aged 25-64 years in the Seychelles, a country in epidemiological transition where consumption of home-brewed, mostly unregistered beverages has been traditionally high. Alcohol consumption was calculated from respondents reporting at least one drink per week ('regular drinkers'). Among men, 51.1% were regular drinkers and had average intake of 112.1 ml alcohol a day. Among women, 5.9% were regular drinkers and had 49.7 ml alcohol a day. Frequency of drinking, but not amount per drinker, was slightly less in the 25-34-year than older-age categories. Home-brews (mostly palm toddy and fermented sugar cane juice) were consumed by 52% of regular drinkers and accounted for 54% of the total alcohol intake reported by all regular drinkers. Based on the reported consumption by regular drinkers only, the average annual alcohol consumption amounted respectively to 20.7 litres and 1.2 litres per man and woman aged 25-64 years, or, using extrapolation, 13.2 litres and 0.8 litres per man and woman respectively of the total population. These values may underestimate the true figures by half, since reported beer consumption accounted for 53% of beer sales. Socio-economic status was associated strongly and inversely with home-brew consumption, but slightly and positively with consumption of commercially marketed beverages. Alcohol intake was associated with smoking, high-density lipoprotein cholesterol, carbohydrate-deficient transferrin and blood pressure, but not with age and body mass index. In conclusion, these data show high alcohol consumption in the Seychelles with an important gender difference, a large proportion of alcohol derived from home-brews, and opposite tendencies for the relationships between socio-economic status and home-made or commercially marketed beverages.
Collapse
Affiliation(s)
- J Perdrix
- University Institute of Social and Preventive Medicine, Lausanne, Switzerland
| | | | | | | | | | | |
Collapse
|
44
|
Bovet P, Yersin C, Merien F, Davis CE, Perolat P. Factors associated with clinical leptospirosis: a population-based case-control study in the Seychelles (Indian Ocean). Int J Epidemiol 1999; 28:583-90. [PMID: 10405868 DOI: 10.1093/ije/28.3.583] [Citation(s) in RCA: 68] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND In Western countries, leptospirosis is uncommon and mainly occurs in farmers and individuals indulging in water-related activities. In tropical countries, leptospirosis can be up to 1000 times more frequent and risk factors for this often severe disease may differ. METHODS We conducted a one-year population-based matched case-control study to investigate the frequency and associated factors of leptospirosis in the entire population of Seychelles. RESULTS A total of 75 patients had definite acute leptospirosis based on microagglutination test (MAT) and polymerase chain reaction (PCR) assay (incidence: 101 per 100,000 per year; 95% confidence interval [CI]: 79-126). Among the controls, MAT was positive in 37% (past infection) and PCR assay in 9% (subclinical infection) of men aged 25-64 with manual occupation. Comparing cases and controls with negative MAT and PCR, leptospirosis was associated positively with walking barefoot around the home, washing in streams, gardening, activities in forests, alcohol consumption, rainfall, wet soil around the home, refuse around the home, rats visible around the home during day time, cats in the home, skin wounds and inversely with indoor occupation. The considered factors accounted for as much as 57% of the variance in predicting the disease. CONCLUSION These data indicate a high incidence of leptospirosis in Seychelles. This suggests that leptospires are likely to be ubiquitous and that effective leptospirosis control in tropical countries needs a multifactorial approach including major behaviour change by large segments of the general public.
Collapse
Affiliation(s)
- P Bovet
- University Institute of Social and Preventive Medicine, Lausanne, Switzerland.
| | | | | | | | | |
Collapse
|
45
|
Fontana P, Mooser V, Bovet P, Shamlaye C, Burnand B, Lenain V, Marcovina SM, Riesen W, Darioli R. Dose-dependent inverse relationship between alcohol consumption and serum Lp(a) levels in black African males. Arterioscler Thromb Vasc Biol 1999; 19:1075-82. [PMID: 10195938 DOI: 10.1161/01.atv.19.4.1075] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Serum or plasma levels of Lp(a) vary widely between individuals and are higher in Africans and their descendants compared with white persons. In whites, high serum levels of Lp(a) are associated with the premature development of atherosclerosis. In both ethnic groups, serum Lp(a) levels are highly genetically determined and only a few environmental or physiological factors, like testosterone or estrogen, have been shown to lower serum Lp(a) levels. In whites, alcohol consumption is associated with lower serum Lp(a) levels. However, the mechanism underlying this association and whether it holds true for blacks is not known. To address these questions, we analyzed serum Lp(a) levels in 333 middle-aged males of African descent from the Seychelles Islands (Indian Ocean). In addition, we analyzed the size of the apo(a) isoforms and the serum levels of albumin and sex hormones in a subset of 279 subjects. Serum Lp(a) levels were similar in teetotalers (median, 32.5 mg/dL; n=42) and occasional drinkers (median, 34.1 mg/dL; n=112). In contrast, individuals consuming 10 to 80 g of ethanol/d (n=83) and heavy drinkers (>80 g of ethanol/d, n=96) had a 9% and 32% lower median Lp(a) level than teetotalers, respectively (P=0.01). The size distribution of the apo(a) isoforms and the mean serum levels of albumin, estradiol, and luteinizing hormone were similar in teetotalers and occasional drinkers compared with moderate and heavy drinkers. These latter 2 groups had lower serum levels of testosterone and sex hormone-binding globulin. These data indicate that alcohol intake is associated in a dose-dependent manner with lower serum Lp(a) levels in males of African descent and that this association is not related to the size of the apo(a) isoforms, to the synthetic function of the liver, or to sex hormone biochemical status.
Collapse
Affiliation(s)
- P Fontana
- Medical Policlinic, Institute of Social and Preventive Medicine, University of Lausanne, Switzerland
| | | | | | | | | | | | | | | | | |
Collapse
|
46
|
Abstract
OBJECTIVE AND METHOD To compare the response of a dipstick assay (DSA) detecting Leptospira-specific immunoglobulin M (IgM) antibodies with that of an enzyme-linked immunosorbent assay (ELISA), an indirect haemagglutination assay (IHA), the microagglutination test (MAT) and a polymerase chain reaction assay (PCR) in patients with leptospirosis confirmed by MAT alone or by MAT and/or PCR (MAT/PCR). RESULT In 75 patients with acute leptospirosis diagnosed by MAT (respectively, 90 patients diagnosed by MAT/PCR), the response in paired early and convalescent sera was positive in 78.9% (67.9%) by DSA, 76.0% (67.8%) by ELISA, 58.7% (55.6%) by IHA, 44.0% (53.3%) by PCR, and 100% (90.0%) by MAT. In early serum only, the response in patients diagnosed by MAT (respectively by MAT/PCR) was positive in 36.0% (38.9%) by DSA, 36.0% (37.8%) by ELISA, 14.7% (18.9%) by IHA, 39.2% (48.3%) by PCR, and 53.3% (58.9%) by MAT titre > or =1:100. DSA detected the main serogroups implicated in human leptospirosis in Seychelles and demonstrated sensitivity comparable to ELISA. In 124 single sera from control subjects without overt disease, the response was positive in 4.8% by DSA, 3.2% by ELISA, 3.2% by IHA, 13.8% by PCR, 37.9% by MAT titre > or =1:100, and 2.4% by MAT titre > or =1:800, giving evidence of the frequency of both past and current subclinical infection in Seychelles and that DSA was less sensitive than MAT to detect moderate levels of leptospiral antibodies. CONCLUSION DSA is a simple and reproducible assay well adapted to field conditions and could usefully contribute to the evaluation of leptospirosis in areas devoid of serological laboratory facilities.
Collapse
Affiliation(s)
- C Yersin
- Victoria Hospital, Ministry of Health, Seychelles.
| | | | | | | |
Collapse
|
47
|
Bovet P, Yersin C, Herminie P, Lavanchy D, Frei PC. Decrease in the prevalence of hepatitis B and a low prevalence of hepatitis C virus infections in the general population of the Seychelles. Bull World Health Organ 1999; 77:923-8. [PMID: 10612888 PMCID: PMC2557757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023] Open
Abstract
A serological survey of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections was carried out on a random sex- and age-stratified sample of 1006 individuals aged 25-64 years in the Seychelles islands. Anti-HBc and anti-HCV antibodies were detected using commercially available enzyme-linked immunosorbent assays (ELISA), followed by a Western blot assay in the case of a positive result for anti-HCV. The age-adjusted seroprevalence of anti-HBc antibodies was 8.0% (95% CI: 6.5-9.9%) and the percentage prevalence among males/females increased from 7.0/3.1 to 19.1/13.4 in the age groups 25-34 to 55-64 years, respectively. Two men and three women were positive for anti-HCV antibodies, with an age-adjusted seroprevalence of 0.34% (95% CI: 0.1-0.8%). Two out of these five subjects who were positive for anti-HCV also had anti-HBc antibodies. The seroprevalence of anti-HBc was significantly higher in unskilled workers, persons with low education, and heavy drinkers. The age-specific seroprevalence of anti-HBc in this population-based survey, which was conducted in 1994, was approximately three times lower than in a previous patient-based survey carried out in 1979. Although there are methodological differences between the two surveys, it is likely that the substantial decrease in anti-HBc prevalence during the last 15 years may be due to significant socioeconomic development and the systematic screening of blood donors since 1981. Because hepatitis C virus infections are serious and the cost of treatment is high, the fact that the prevalence of anti-HCV antibodies is at present low should not be an argument for not screening blood donors for anti-HCV and eliminating those who are positive.
Collapse
Affiliation(s)
- P Bovet
- University Institute for Social and Preventive Medicine, Lausanne, Switzerland
| | | | | | | | | |
Collapse
|
48
|
Yersin C, Bovet P, Mérien F, Wong T, Panowsky J, Perolat P. Human leptospirosis in the Seychelles (Indian Ocean): a population-based study. Am J Trop Med Hyg 1998; 59:933-40. [PMID: 9886203 DOI: 10.4269/ajtmh.1998.59.933] [Citation(s) in RCA: 65] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
A leptospirosis surveillance program was carried out for 12 months on the entire population of the Seychelles. Diagnosis was assessed by both microagglutination test and polymerase chain reaction (PCR) assay. In this population of 74,331, leptospirosis was clinically suspected in 125 subjects and confirmed in 75 patients (incidence of 101 per 100,000; 95% confidence interval = 79-126). Leptospirosis was more frequent in middle-aged males with environmental exposure. Eight serogroups were identified and Icterohaemorrhagiae (31%) and Hurstbridge (20%) were the most frequent. Hurstbridge, a recently identified new serogroup, was implicated in severe cases and death. Influenza-like forms accounted for 37% of the cases while jaundice, acute renal failure, and pulmonary hemorrhage occurred in 52%, 28%, and 19%, respectively. Death occurred in six patients and was related to pulmonary hemorrhage. The PCR result was positive after completion of treatment in eight patients, suggesting that the administered five-day course of penicillin may be inadequate to eradicate the bacteria.
Collapse
Affiliation(s)
- C Yersin
- Ministry of Health, Victoria, Seychelles
| | | | | | | | | | | |
Collapse
|
49
|
Aubert L, Bovet P, Gervasoni JP, Rwebogora A, Waeber B, Paccaud F. Knowledge, attitudes, and practices on hypertension in a country in epidemiological transition. Hypertension 1998; 31:1136-45. [PMID: 9576126 DOI: 10.1161/01.hyp.31.5.1136] [Citation(s) in RCA: 47] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Assessment of knowledge, attitudes, and practices (KAP) is a crucial element of hypertension control, but little information is available from developing countries where hypertension has lately been recognized as a major health problem. Therefore, we examined KAP on hypertension in a random sample of 1067 adults aged 25 to 64 years from the Seychelles Islands (Indian Ocean). KAP were assessed from an administered structured questionnaire. The age-standardized prevalence of hypertension (screening blood pressure [BP] > or = 160/95 mm Hg or taking antihypertensive medication) was 36% in men and 25% in women aged 25 to 64 years. Among hypertensive persons, 50% were aware of the condition, 34% were treated, and 10% had controlled BP (ie, BP <160/95 mm Hg). Most persons, whether nonhypertensive, unaware hypertensive, or aware hypertensive, had good basic knowledge related to hypertension determinants and consequences, possibly an effect of a nationwide cardiovascular disease prevention program over the last years. However, favorable outcome expectation, positive attitudes, and appropriate practices for hypertension and relevant healthy lifestyles were found in smaller proportions of participants, with little difference between aware hypertensives, unaware hypertensives, and nonhypertensives. Furthermore, hypertensive persons with other concurrent cardiovascular risk factors affecting the overall heart risk knew well the detrimental effects of these other factors but reported making little actual change to control them (particularly regarding overweight and sedentary habits). These data point to the need to maximize the efficiency of hypertension prevention and control programs so that delay in achieving effective hypertension control is minimized in countries experiencing recent emergence of hypertension as a major public health problem.
Collapse
Affiliation(s)
- L Aubert
- Institute of Social and Preventive Medicine, Faculty of Medicine, University of Lausanne, Switzerland
| | | | | | | | | | | |
Collapse
|
50
|
Abstract
Conflicting results have been published about suicidality among HIV+ subjects; part of the alleged increased risk may be linked to premorbid risk factors such as drug addiction and homosexuality. In order to cope with these confounding factors, we assessed the degree of suicidal ideation in a sample of Swiss male homo- and bisexuals, comparing HIV- and HIV+ subjects. A total of 164 subjects returned a self-administered, home-completed questionnaire, which had been circulated among homosexuals in the French speaking part of Switzerland. Suicidal ideation was assessed through Pöldinger's scale. Serostatus was known for 149 subjects, among whom 65 were HIV+. A high rate of suicide attempts was found among homosexuals, both HIV- and HIV+. Scores on Pöldinger's scale are significantly, though moderately, higher among HIV+ subjects, and this finding seems to be a direct consequence of HIV infection.
Collapse
Affiliation(s)
- P Cochand
- Department of Adult Psychiatry, University of Lausanne, Switzerland
| | | |
Collapse
|