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Wyche S, Olson J, Karanu M, Omondi E, Olonyo M. Limitations of Using Mobile Phones for Managing Type 1 Diabetes (T1D) Among Youth in Low and Middle-Income Countries: Implications for mHealth. PROCEEDINGS OF THE ACM ON HUMAN-COMPUTER INTERACTION 2024; 8:506. [PMID: 39886256 PMCID: PMC11780754 DOI: 10.1145/3687045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2025]
Abstract
The prevalence of Type 1 Diabetes (T1D) among youth is increasing worldwide. Mobile phones, particularly mHealth applications, can potentially improve youth's management of this chronic condition. However, the design of these services rarely accounts for users in low and middle-income countries (LMICs). In this paper, we investigate factors that influence the use of mobile phones for managing T1D among youth in rural and urban Kenya. Our analysis draws from 58 interviews conducted with T1D youth (between the ages of 11 and 18 years old), their caregivers, and other significant stakeholders, including doctors and schoolteachers. Our findings draw attention to a significant mismatch between the mobile phone features prioritized in mHealth apps and participants' usage practices. We discuss the practical implications of these findings for mHealth design and user research.
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Affiliation(s)
- Susan Wyche
- Michigan State University, Department of Media and Information, USA
| | - Jennifer Olson
- Michigan State University, Department of Media and Information, USA
| | | | - Eric Omondi
- Kenya Diabetes Management & Information Centre (DMI)
| | - Mike Olonyo
- County Government of Vihiga, Department of Health, Kenya
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Nikolovski S, Medic Brkic B, Vujovic KS, Cirkovic I, Jovanovic N, Reddy B, Iqbal O, Zhang C, Fareed J, Bansal V. Severe Hyporesponsiveness to Erythropoiesis-Stimulating Agents in Patients on Chronic Hemodialysis-Reconsidering the Relationship with Thrombo-Inflammation and Oxidative Stress. Diagnostics (Basel) 2024; 14:2406. [PMID: 39518373 PMCID: PMC11544906 DOI: 10.3390/diagnostics14212406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2024] [Revised: 10/23/2024] [Accepted: 10/26/2024] [Indexed: 11/16/2024] Open
Abstract
BACKGROUND/OBJECTIVES Besides a multitude of consequences patients on chronic renal replacement therapy have, anemia is one of the most prominent factors making a significant number of patients dependent on erythropoiesis-stimulating agent (ESA) therapy. The aim of this study was to examine the relationship between the levels of a broad spectrum of thrombo-inflammatory and oxidative stress-related biomarkers and the presence and level of ESA hyporesponsiveness in patients undergoing regular chronic hemodialysis. METHODS This cross-sectional study included 96 patients treated with chronic hemodialysis. Levels of several thrombo-inflammatory and oxidative stress-related biomarkers, as well as demographic, clinical, and laboratory analyses, were collected and analyzed based on the calculated value of the ESA-hyporesponsiveness index (EHRI). RESULTS In the analyzed sample, 58 patients received ESAs. Of all the investigated parameters, only body mass index (BMI), level of plasminogen activator inhibitor-1, and level of L-type fatty acid binding protein (L-FABP) were observed as significant predictors of EHRI. A significant diagnostic potential for ESA resistance has been observed in BMI and L-FABP between ESA-resistant and ESA-non-resistant groups of patients (p = 0.004, area under the curve 0.763 and p = 0.014, area under the curve 0.712, respectively) with the cut-off values of 25.46 kg/m2 and 5355.24 ng/mL, respectively. Having a BMI of 25.46 kg/m2 or less and an L-FABP level higher than 5355.24 ng/mL were observed as significant predictors of ESA resistance (odds ratio 9.857 and 6.125, respectively). CONCLUSIONS EHRI was positively predicted by low BMI and high levels of plasminogen activator inhibitor-1 and L-FABP. High levels of L-FABP and low BMI have been observed as strong predictors of ESA resistance.
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Affiliation(s)
- Srdjan Nikolovski
- Department of Pathology and Laboratory Medicine, Loyola University Medical Center, Maywood, IL 60153, USA; (O.I.)
| | - Branislava Medic Brkic
- Institute for Pharmacology, Clinical Pharmacology and Toxicology, University of Belgrade School of Medicine, 11000 Belgrade, Serbia
| | - Katarina Savic Vujovic
- Institute for Pharmacology, Clinical Pharmacology and Toxicology, University of Belgrade School of Medicine, 11000 Belgrade, Serbia
| | - Ivana Cirkovic
- Institute for Microbiology and Immunology, University of Belgrade School of Medicine, 11000 Belgrade, Serbia
| | | | - Bhavana Reddy
- DeBusk College of Osteopathic Medicine, Lincoln Memorial University, Harrogate, TN 37752, USA
| | - Omer Iqbal
- Department of Pathology and Laboratory Medicine, Loyola University Medical Center, Maywood, IL 60153, USA; (O.I.)
| | - Chongyu Zhang
- Department of Molecular Pharmacology and Neuroscience, Loyola University Medical Center, Maywood, IL 60153, USA
| | - Jawed Fareed
- Department of Pathology and Laboratory Medicine, Loyola University Medical Center, Maywood, IL 60153, USA; (O.I.)
- Department of Molecular Pharmacology and Neuroscience, Loyola University Medical Center, Maywood, IL 60153, USA
| | - Vinod Bansal
- Department of Nephrology, Loyola University Medical Center, Maywood, IL 60153, USA
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Owolabi EO, Ajayi AI. Adherence to medication, dietary and physical activity recommendations: Findings from a multicenter cross-sectional study among adults with diabetes in rural South Africa. J Eval Clin Pract 2024; 30:1261-1271. [PMID: 38838035 DOI: 10.1111/jep.14035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 04/18/2024] [Accepted: 05/19/2024] [Indexed: 06/07/2024]
Abstract
BACKGROUND Diabetes is a complex health condition requiring medical therapy and lifestyle modifications to attain treatment targets. Previous studies have not fully explored factors associated with adherence to medication, diets and physical activity recommendations among individuals living with diabetes in rural South Africa. We examined the association between knowledge, health belief and adherence to medication, dietary, and physical activity recommendations and explored self-reported reasons for non-adherence. METHODS This cross-sectional study was conducted among 399 individuals living with diabetes recruited over 12 weeks from six randomly selected primary healthcare centres in rural South Africa. Sociodemographic and clinical data were obtained by self-report. Health beliefs, knowledge, and adherence were assessed using validated measures. Descriptive and inferential statistics were carried out. RESULTS The majority (81.7%) of the participants were females, with a mean age of 62 ± 11 years. Only 39% reported adhering to their prescribed medication regimen, 25% reported adhering to dietary recommendations, and 32% reported adhering to physical activity recommendations. The most cited reasons for non-adherence were lack of access to (n = 64) and cost of drugs (n = 50), perceived high costs of healthy diets (n = 243), and lack of time (n = 181) for physical activity. Level of education was an independent predictor of medication adherence [odds ratio, OR = 2.02 (95% confidence interval, CI: 1.20-3.40)] while diabetes knowledge was independently associated with both medications [OR = 3.04 (95% CI: 1.78-45.12)]; and physical activity adherence [OR = 2.92 (95% CI: 1.04-2.96). Positive health belief was independently associated with adherence to medications [OR = 1.72 (95% CI: 1.15-2.57) and dietary recommendations [OR = 1.75 (95% CI: 1.04-2.96)]. CONCLUSION Adherence to three important self-care practices, medication, diet, and physical activity, was suboptimal in this study setting. Socioeconomic reasons and access barriers were significant drivers of non-adherence, while increased knowledge and positive health beliefs were potential facilitators. Efforts to improve medication adherence and foster engagement in healthy lifestyle behaviours must consider patients' knowledge and health beliefs. Primary healthcare providers should create awareness on the importance of adherence on health outcomes for people with diabetes. Likewise, efforts to increase the availability and affordability of medications for socioeconomically disadvantaged populations should be prioritised by the key health stakeholders.
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Affiliation(s)
- Eyitayo O Owolabi
- Center for Disease Prevention and Health Promotion, Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, USA
- Department of Nursing, University of Fort Hare, East London, South Africa
| | - Anthony Idowu Ajayi
- Sexual, Reproductive, Maternal, New-born, Child and Adolescent Health (SRMNCAH) Unit, Africa Population and Health Research Center, Nairobi, Kenya
- Department of Sociology, University of Fort Hare, East London, South Africa
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Okunlola AO, Ajao TO, Karim A, Sabi M, Kolawole O, Ugwoke K, Mahadevaswamysusheela MK. A Review of Peripheral Artery Disease in Diabetic Patients in Sub-Saharan Africa. Cureus 2024; 16:e69808. [PMID: 39429407 PMCID: PMC11491116 DOI: 10.7759/cureus.69808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2024] [Indexed: 10/22/2024] Open
Abstract
Peripheral artery disease (PAD) is an atherosclerotic occlusive disease of the lower extremities and is associated with an increased risk of amputation and cardiovascular events. The interplay between diabetes and PAD is complex, influenced by shared risk factors such as hypertension, dyslipidemia, and smoking. High rates of undiagnosed diabetes, coupled with barriers to accessing care, contribute to the complexity of managing PAD. Unique to the Sub-Sahara region is associations with communicable diseases such as human immunodeficiency virus and tuberculosis which further complicates the epidemiological landscape. Comprehensive management strategies, including lifestyle modifications, pharmacological interventions, and revascularization procedures, are essential. However, the region faces challenges such as inadequate healthcare infrastructure and high costs of treatment. This narrative review highlights the epidemiology of PAD in people with diabetes, the risk factors associated with PAD, the impact of PAD on the morbidity and mortality of individuals with diabetes, as well as the management of PAD in individuals with diabetes, with attention geared toward Sub-Saharan Africa These insights are critical for developing effective strategies to mitigate the burden of PAD in diabetes, especially in Sub-Saharan Africa. Further research is essential to understand the associations between diabetes and other diseases in the region.
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Affiliation(s)
| | - Temitope O Ajao
- General and Acute Medicine, United Lincolnshire Hospitals NHS Trust, Lincolnshire, GBR
| | - Abbas Karim
- Emergency Medicine, United Lincolnshire Hospitals NHS Trust, Lincolnshire, GBR
| | - Mwila Sabi
- Respiratory Medicine, United Lincolnshire Hospitals NHS Trust, Lincolnshire, GBR
| | - Olayinka Kolawole
- Internal Medicine, Hull University Teaching Hospitals NHS Trust, Hull, GBR
| | - Kenneth Ugwoke
- Vascular Surgery, United Lincolnshire Hospitals NHS Trust, Lincolnshire, GBR
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Annose RT, Asefa H, Gezahagn Y, Abebe G, Hailu Zewde T. Determinants of cardiovascular disease among type 2 diabetic patients attending diabetic follow-up clinic in Arba Minch general hospital, southern Ethiopia: an unmatched case-control study. Ann Med Surg (Lond) 2024; 86:2467-2473. [PMID: 38694275 PMCID: PMC11060215 DOI: 10.1097/ms9.0000000000001951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 03/04/2024] [Indexed: 05/04/2024] Open
Abstract
Background Cardiovascular disease (CVD) is a major cause of death and disability among patients with type 2 diabetes, especially in low-income and middle-income countries. Type 2 diabetes mellitus (T2DM) patients have a 2-4-fold increased risk of CVD. There is limited data about cardiovascular disease risks and its determinants among T2DM patients in Ethiopia. This study aimed to identify possible predictors of cardiovascular diseases among adults with T2DM in southern Ethiopia. Methods A hospital-based unmatched case-control study was conducted at southern Ethiopia Arbaminch Hospital on 196 randomly selected patients with type 2 diabetes on follow-up (98 cases and 98 controls). The authors collected data using a structured interviewer-administered questionnaire, laboratory checklist, and additional document review of T2DM patients. A multivariable binary logistic regression was fitted to identify cardiovascular disease determinants, and the findings were presented using an adjusted odds ratio (AOR) with a 95% CI. Result The mean reported age (±SD) of the cases and the controls was 56.3.3 (±8.9) and 52.3 (±9.3) years, respectively. The two identified independent determinants of cardiovascular disease with AOR [95% CI] were hypertension [AOR=4.953, 95% CI (2.47, 9.93) and persistent urine albuminuria [AOR=12.9, 95% CI (3.98, 41.7)]. Conclusion This study showed that having high blood pressure and persistent urine albuminuria are independent predictors of cardiovascular disease in T2DM patients. The current study setting needs an intervention for mitigating these cardiovascular disease determinants.
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Affiliation(s)
| | | | - Yenealem Gezahagn
- Faculty of Public Health, College of Medicine and Health Science, Jima University, Jima, Ethiopia
| | - Getachew Abebe
- Department of Anatomy, College of Medicine and Health Science, Arba Minch University, Arba Minch
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Balogun WO, Naylor R, Adedokun BO, Ogunniyi A, Olopade OI, Dagogo-Jack SE, Bell GI, Philipson LH. Implementing genetic testing in diabetes: Knowledge, perceptions of healthcare professionals, and barriers in a developing country. POPULATION MEDICINE 2024; 6:9. [PMID: 38681897 PMCID: PMC11052599 DOI: 10.18332/popmed/184210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 02/17/2024] [Indexed: 05/01/2024] Open
Abstract
INTRODUCTION Maturity-Onset Diabetes of the Young (MODY) is an unusual type of diabetes often missed in clinical practice, especially in Africa. Treatment decisions for MODY depend on a precise diagnosis, only made by genetic testing. We aimed to determine MODY knowledge among Nigerian healthcare professionals (HCPs), their perceptions, and barriers to the implementation of genetic testing in diabetes patients. METHODS A cross-sectional survey was conducted among doctors and nurses in three levels of public and private healthcare institutions in Ibadan, Nigeria, from December 2018 to June 2019. In all, 70% and 30% of a total 415 participants were recruited from public and private centers, respectively. HCPs were recruited in a 60:40% ratio, respectively. A 51-item instrument was used to assess MODY knowledge, perceptions of HCPs, and barriers to the implementation of genetic testing in diabetes patients. RESULTS In the survey, 43.4% self-rated their current MODY knowledge to be at least moderate. About 68%, 73% and 86%, respectively, correctly answered 3 of 5 questions on basic genetics' knowledge. However, only 1 of 7 MODY-specific questions was answered correctly by 72.7% of the respondents. The mean basic genetics and MODY-specific knowledge scores were 2.6/5 (SD=1.0) and 1.8/9 (SD=1.3), respectively. Multiple linear regression showed higher mean scores among those aged 30-49 years, those with degrees and fellowships (except PhD), and general practitioners; 360 (80.0%) perceived that genetic testing plays a central role in diabetes care. Barriers to genetic testing were lack of access to testing facilities, guidance on the use of and updates/educational materials on genetic testing (82.7%, 62.1% and 50.3%, respectively). CONCLUSIONS The level of MODY awareness and knowledge among Nigerian HCPs is unacceptably low with a lack of access to genetic testing facilities. These can hinder the implementation of precision diabetes medicine. Increased awareness, provision of decision support aids, and genetic testing facilities are urgently needed.
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Affiliation(s)
- Williams O. Balogun
- Department of Medicine, College of Medicine, University of Ibadan, University College Hospital, Ibadan, Nigeria
| | - Rochelle Naylor
- Departments of Medicine and Pediatrics, Kovler Diabetes Center, University of Chicago, Chicago, Illinois, United States of America
| | - Babatunde O. Adedokun
- Department of Epidemiology and Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Adesola Ogunniyi
- Department of Medicine, College of Medicine, University of Ibadan, University College Hospital, Ibadan, Nigeria
| | - Olufunmilayo I. Olopade
- Center for Clinical Cancer Genetics and Global Health and Section of Haematology Oncology, University of Chicago, Chicago, Illinois, United States of America
| | - Samuel E. Dagogo-Jack
- Department of Internal Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, United States of America
- Division of Endocrinology and Metabolism, University of Tennessee Health Science Center, Tennessee, United States of America
| | - Graeme I. Bell
- Department of Medicine, University of Chicago, Chicago, Illinois, United States of America
- Department of Human Genetics, University of Chicago, Chicago, Illinois, United States of America
| | - Loui H. Philipson
- Departments of Medicine and Pediatrics, Kovler Diabetes Center, University of Chicago, Chicago, Illinois, United States of America
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Doumbia L, Findley S, Ba HO, Maiga B, Ba A, Béréthé RK, Sangaré HM, Kachur SP, Besançon S, Doumbia S. Formative research to adapt the 'Diabetes Prevention Program- Power to Prevent' for implementation in Bamako, Mali. BMC Health Serv Res 2024; 24:61. [PMID: 38212794 PMCID: PMC10785539 DOI: 10.1186/s12913-023-10515-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 12/21/2023] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND There are few community-level behaviors change interventions for reducing diabetes and hypertension risk in Africa, despite increasing cases of type 2 diabetes and cardiovascular diseases. Thus, this study was designed to adapt the United States Centers for Disease Control and Prevention's "Diabetes Prevention Program Power to Prevent" (DPP-P2P) for use in low-income urban communities of Bamako, Mali. METHODS Feedback was elicited on an initial French PowerPoint adaptation of the DPP-P2P session guidelines from stakeholders at the ministry of health, organizational partners, and medical care providers. Two community health centers in districts with high levels of diabetes or hypertension were selected to assist in developing the Malian adaptation. Focus groups were conducted with 19 community health workers (CHWs) of these centers. Based on feedback from these discussions, more graphics, demonstrations, and role plays were added to the PowerPoint presentations. The 19 CHWs piloted the proposed 12 sessions with 45 persons with diabetes or at-risk patients over a one-month period. Feedback discussions were conducted after each session, and changes in dietary and exercise habits were assessed pre and post participation in the program. This feedback contributed to finalization of a 14-session sequence. RESULTS The DPP-P2P session guidelines were adapted for use by low-literacy CHWs, converting the written English guidelines into French PowerPoint presentations with extensive use of pictures, role plays and group discussions to introduce diabetes, diet, and exercise concepts appropriately for the Bamako context. CHWs recommendations for a strong family-oriented program led to expanded sessions on eliciting support from all adults in the household. The 45 participants in the pilot adaptation were enthusiastic about the program. At the end of the program, there were significant increases in the frequency of daily exercise, efforts to limit fat intake, and goals for more healthy diets and exercise levels. CONCLUSION This study documents how an iterative process of developing the DPP-P2P adaptation led to the development of a culturally appropriate set of materials welcomed by participants and having promise for reaching the low-income, low-literacy population with or at risk for diabetes in Bamako, Mali.
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Affiliation(s)
- Lancina Doumbia
- University Clinical Research Center, Université des Sciences, des Techniques et des Technologies de Bamako, Point-G, Bamako, Bamako, Po Box 5445, Mali.
| | - Sally Findley
- Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Hamidou Oumar Ba
- University Clinical Research Center, Université des Sciences, des Techniques et des Technologies de Bamako, Point-G, Bamako, Bamako, Po Box 5445, Mali
| | - Bonkana Maiga
- University Clinical Research Center, Université des Sciences, des Techniques et des Technologies de Bamako, Point-G, Bamako, Bamako, Po Box 5445, Mali
| | - Aissata Ba
- University Clinical Research Center, Université des Sciences, des Techniques et des Technologies de Bamako, Point-G, Bamako, Bamako, Po Box 5445, Mali
| | - Rokiatou Koné Béréthé
- University Clinical Research Center, Université des Sciences, des Techniques et des Technologies de Bamako, Point-G, Bamako, Bamako, Po Box 5445, Mali
| | - Hadja Madjè Sangaré
- University Clinical Research Center, Université des Sciences, des Techniques et des Technologies de Bamako, Point-G, Bamako, Bamako, Po Box 5445, Mali
| | - S Patrick Kachur
- Mailman School of Public Health, Columbia University, New York, NY, USA
| | | | - Seydou Doumbia
- University Clinical Research Center, Université des Sciences, des Techniques et des Technologies de Bamako, Point-G, Bamako, Bamako, Po Box 5445, Mali
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Issaka A, Paradies Y, Cameron AJ, Stevenson C. The association between body weight indices, behavioral factors, and type 2 diabetes mellitus in Africa: A systematic review and meta-analysis of population-based epidemiological studies. Nutr Metab Cardiovasc Dis 2024; 34:1-18. [PMID: 38016892 DOI: 10.1016/j.numecd.2023.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 05/07/2023] [Accepted: 06/14/2023] [Indexed: 11/30/2023]
Abstract
BACKGROUND AND AIM Type 2 diabetes mellitus (T2DM) is a significant public health concern in Africa. While the associations between modifiable risk factors and T2DM are likely to be Africa-specific, their overall estimations have not been published. This study aimed to use systematic and meta-analytic methods to examine the strength of associations between modifiable risk factors and T2DM in Africa. METHODS AND RESULTS A systematic search of literature published between January 2000 to March 2022 was conducted. The review included only population-based studies and data extracted from 57 studies. Of these, unadjusted data from 50 studies were included in meta-analysis. With considerable heterogeneity between studies, random-effect models were calculated to ascertain the odds ratios (OR) and 95% confidence intervals (CI) for the associations between obesity (OB) and overweight (OV), defined by BMI; central obesity (waist circumference (OB-WC), waist-to-hip-ratio (OB-WHR)), alcohol, fruit and vegetable consumption, smoking, physical activity (PA) and T2DM. Moderator effects of age, African regions, and urban/rural location were assessed. Risk factors associated with T2DM include BMI-OB [OR = 3.05, 95% CI: (2.58, 3.61)], BMI-OV [OR = 2.38, 95% CI: (1.51, 3.75)], and BMI-OV/OB [OR = 2.07, 95% CI: (1.82, 2.34)]; OB-WC [OR = 2.58, 95% CI: (2.09, 3.18)] and OB-WHR [OR = 2.22, 95% CI: (1.69, 2.92)]; PA [OR = 1.85, 95% CI: (1.50, 2.30)]. Significant moderator effects were not observed. CONCLUSION Obesity defined by BMI and central obesity, but not behavioral risk factors were most strongly associated with T2DM in African populations, emphasizing the need for obesity prevention to limit the rise of T2DM. REGISTRATION The PROSPERO registration number is CRD42016043027.
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Affiliation(s)
- Ayuba Issaka
- Global Obesity Centre (GLOBE), School of Health and Social Development, Faculty of Health, Institute for Health Transformation, Deakin University, 1 Gheringhap St, Geelong, VIC 3220, Australia; Alfred Deakin Institute for Citizenship and Globalisation, Faculty of Arts and Education, Deakin University, 221 Burwood Highway, Burwood, VIC 3125, Australia; Baker Heart and Diabetes Institute, Non-Communicable Diseases and Implementation Science Unit, VIC, Australia.
| | - Yin Paradies
- Alfred Deakin Institute for Citizenship and Globalisation, Faculty of Arts and Education, Deakin University, 221 Burwood Highway, Burwood, VIC 3125, Australia
| | - Adrian J Cameron
- Global Obesity Centre (GLOBE), School of Health and Social Development, Faculty of Health, Institute for Health Transformation, Deakin University, 1 Gheringhap St, Geelong, VIC 3220, Australia
| | - Christopher Stevenson
- Global Obesity Centre (GLOBE), School of Health and Social Development, Faculty of Health, Institute for Health Transformation, Deakin University, 1 Gheringhap St, Geelong, VIC 3220, Australia
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Brennan AT, Vetter B, Masuku SD, Mtshazo B, Mashabane N, Sokhela S, Venter WD, Kao K, Meyer-Rath G. Integration of point-of-care screening for type 2 diabetes mellitus and hypertension into the COVID-19 vaccine programme in Johannesburg, South Africa. BMC Public Health 2023; 23:2291. [PMID: 37986070 PMCID: PMC10662646 DOI: 10.1186/s12889-023-17190-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 11/08/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND South Africa grapples with a substantial burden of non-communicable diseases (NCDs), particularly type 2 diabetes (diabetes) and hypertension. However, these conditions are often underdiagnosed and poorly managed, further exacerbated by the strained primary healthcare (PHC) system and the disruptive impact of the COVID-19 pandemic. Integrating NCD screening with large-scale healthcare initiatives, such as COVID-19 vaccination campaigns, offers a potential solution, especially in low- and middle-income countries (LMICs). We investigated the feasibility and effectiveness of this integration. METHODS A prospective cohort study was conducted at four government health facilities in Johannesburg, South Africa. NCD screening was incorporated into the COVID-19 vaccination campaign. Participants underwent COVID-19 rapid tests, blood glucose checks, blood pressure assessments, and anthropometric measurements. Those with elevated blood glucose or blood pressure values received referrals for diagnostic confirmation at local PHC centers. RESULTS Among 1,376 participants screened, the overall diabetes prevalence was 4.1%, combining previously diagnosed cases and newly identified elevated blood glucose levels. Similarly, the hypertension prevalence was 19.4%, comprising pre-existing diagnoses and newly detected elevated blood pressure cases. Notably, 46.1% of participants displayed waist circumferences indicative of metabolic syndrome, more prevalent among females. Impressively, 7.8% of all participants screened were potentially newly diagnosed with diabetes or hypertension. Approximately 50% of individuals with elevated blood glucose or blood pressure successfully linked to follow-up care within four weeks. CONCLUSION Our study underscores the value of utilizing even brief healthcare interactions as opportunities for screening additional health conditions, thereby aiding the identification of previously undiagnosed cases. Integrating NCD screenings into routine healthcare visits holds promise, especially in resource-constrained settings. Nonetheless, concerted efforts to strengthen care linkage are crucial for holistic NCD management and control. These findings provide actionable insights for addressing the NCD challenge and improving healthcare delivery in LMICs.
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Affiliation(s)
- Alana T Brennan
- Department of Global Health, Boston University School of Public Health, Boston, MA, USA.
- Health Economics and Epidemiology Research Office, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.
| | | | - Sithabiso D Masuku
- Health Economics and Epidemiology Research Office, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Bukelwa Mtshazo
- Wits Ezintsha, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Nkuli Mashabane
- Wits Ezintsha, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Simiso Sokhela
- Wits Ezintsha, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Willem Df Venter
- Wits Ezintsha, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Gesine Meyer-Rath
- Department of Global Health, Boston University School of Public Health, Boston, MA, USA
- Health Economics and Epidemiology Research Office, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Lee H, Moyo GT, Theophilus RJ, Oldewage-Theron W. Association of Dietary Changes with Risk Factors of Type 2 Diabetes among Older Adults in Sharpeville, South Africa, from 2004 to 2014. Nutrients 2023; 15:4751. [PMID: 38004145 PMCID: PMC10675501 DOI: 10.3390/nu15224751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 10/17/2023] [Accepted: 11/03/2023] [Indexed: 11/26/2023] Open
Abstract
This study aimed to evaluate the associations of dietary changes with risk factors of type 2 diabetes among older populations in Sharpeville, South Africa. A 24 h recall assessment, dietary diversity, and anthropometrics were measured. Blood samples were collected to assess fasting glucose and insulin. Regression analysis was performed using SPSS version 20. The mean BMI of the total of 103 participants was 30.63 kg/m2 at baseline and 29.66 kg/m2 at follow-up. Significantly higher BMI levels were reported in women than men both at baseline (p = 0.003) and follow-up (p = 0.009). Waist circumference significantly decreased from 96.20 cm to 93.16 cm (p = 0.046). The mean levels of HOMA-B significantly increased from 88.99 to 111.19 (p = 0.021). BMI was positively associated with intakes of total energy (p = 0.22), polyunsaturated fatty acids (p = 0.050), and cholesterol (p = 0.006). Waist circumference was strongly associated with total energy (p = 0.048), polyunsaturated fatty acids (p = 0.037), trans fatty acids (p = 0.039), and cholesterol (p = 0.000). HOMA-IR and HOMA-B were associated with intakes of fat (HOMA-IR: p = 0.013; HOMA-B: p = 0.040) and monounsaturated fatty acids (HOMA-IR: p = 0.003; HOMA-B: p = 0.040).
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Affiliation(s)
- Hyunjung Lee
- Department of Nutrition, Texas A&M University, College Station, TX 77843, USA
| | - Gugulethu T. Moyo
- Center for Health and Wellbeing, Princeton School of Public and International Affairs, Princeton University, Princeton, NJ 08544, USA;
| | - Rufus J. Theophilus
- Food Science and Human Nutrition Department, University of Florida, Gainesville, FL 32611, USA
| | - Wilna Oldewage-Theron
- Department of Nutritional Sciences, Texas Tech University, Lubbock, TX 79409, USA
- Department of Sustainable Food Systems and Development, University of the Free State, Bloemfontein 9301, South Africa
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11
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Issaka A, Stevenson C, Paradies Y, Houehanou YCN, Bosu WK, Kiwallo JB, Wesseh CS, Houinato DS, Nazoum DJP, Cameron AJ. Association between urban-rural location and prevalence of type 2 diabetes and impaired fasting glucose in West Africa: a cross-sectional population-based epidemiological study. BMJ Open 2023; 13:e063318. [PMID: 37734888 PMCID: PMC10514614 DOI: 10.1136/bmjopen-2022-063318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 07/13/2023] [Indexed: 09/23/2023] Open
Abstract
OBJECTIVES We investigated the association between urban/rural location and both type 2 diabetes mellitus (T2DM) and pre-diabetes among populations of five West African countries. DESIGN Cross-sectional studies, using the WHO Stepwise (STEPs) survey data. SETTING National representative data of both urban and rural areas from Benin, Burkina Faso, Ghana, Liberia and Mali. PARTICIPANTS Adults comprising 15 468 participants (6774 men and 8746 women; 7663 urban and 7805 rural residents) aged between 25 and 64 years. RESULTS The age and sex-adjusted prevalence of T2DM was 6.2% for urban areas and 2.5% for rural areas. The prevalence of impaired fasting glucose (IFG) was 6.6% for urban areas, and 3.0% for rural areas. No differences by sex were observed. The crude relative risk (RR) and 95% CI of T2DM and IFG in urban compared with rural areas were 2.69 (1.85 to 3.91) and 2.37 (1.53 to 3.66), respectively. This reduced to RR: 2.03, 95% CI (1.34 to 3.08) and RR: 2.04, 95% CI (1.27 to 3.28), respectively, after adjusting for covariables. CONCLUSION The prevalence of both T2DM and IFG was more than two times as high in urban areas compared with rural areas in West Africa. Behavioural risk factors are common among urban populations, with ongoing urbanisation expected to drive increases in the prevalence of T2DM. These results could guide planning for T2DM screening, preventive strategies and resource allocation in West Africa.
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Affiliation(s)
- Ayuba Issaka
- School of Health and Social Development, Global Obesity Centre (GLOBE), Institute for Health Transformation (IHT), Faculty of Health, Deakin University, Geelong, Victoria, Australia
- Non-Communicable Diseases and Implementation Science Unit, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
- Alfred Deakin Institute for Citizenship and Globalisation, Faculty of Arts and Education, Deakin University, Geelong, Victoria, Australia
| | - Christopher Stevenson
- School of Health and Social Development, Global Obesity Centre (GLOBE), Institute for Health Transformation (IHT), Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Yin Paradies
- Alfred Deakin Institute for Citizenship and Globalisation, Faculty of Arts and Education, Deakin University, Geelong, Victoria, Australia
| | - Yessito Corine N Houehanou
- National School of Senior Technicians Training in Public Health and Epidemiological Surveillance, University of Parakou, Parakou, Borgou, Benin
| | - William K Bosu
- Department of Public Health and Research, West African Health Organisation, Bobo-Dioulasso, Haut-Bassin, Burkina Faso
| | - Jean Baptiste Kiwallo
- Directorate of Population Health Protection (DPSP) of Burkina Faso, Ministry of Health, Ouagadougou, Burkina Faso
| | - Chea Sanford Wesseh
- Republic of Liberia Ministry of Health, Congo Town, Monrovia, Montserrado, Liberia
| | - Dismand Stephan Houinato
- Laboratory of Epidemiology of Chronic and Neurological Diseases (LEMACEN), Faculty of Health Sciences, University of Abomey Calavi, Cotonou, Benin
| | - Diarra J P Nazoum
- Non-Communicable Diseases and National Directorate of Health, Ministry of Health and Public Hygiene, Bamako, Mali
| | - Adrian J Cameron
- School of Health and Social Development, Global Obesity Centre (GLOBE), Institute for Health Transformation (IHT), Faculty of Health, Deakin University, Geelong, Victoria, Australia
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12
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Brennan AT, Vetter B, Majam M, T. Msolomba V, Venter F, Carmona S, Kao K, Gordon A, Meyer-Rath G. Integration of point-of-care screening for type 2 diabetes mellitus and hypertension with COVID-19 rapid antigen screening in Johannesburg, South Africa. PLoS One 2023; 18:e0287794. [PMID: 37418394 PMCID: PMC10328308 DOI: 10.1371/journal.pone.0287794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 06/13/2023] [Indexed: 07/09/2023] Open
Abstract
AIMS We sought to evaluate the yield and linkage-to-care for diabetes and hypertension screening alongside a study assessing the use of rapid antigen tests for COVID-19 in taxi ranks in Johannesburg, South Africa. METHODS Participants were recruited from Germiston taxi rank. We recorded results of blood glucose (BG), blood pressure (BP), waist circumference, smoking status, height, and weight. Participants who had elevated BG (fasting ≥7.0; random ≥11.1mmol/L) and/or BP (diastolic ≥90 and systolic ≥140mmHg) were referred to their clinic and phoned to confirm linkage. RESULTS 1169 participants were enrolled and screened for elevated BG and elevated BP. Combining participants with a previous diagnosis of diabetes (n = 23, 2.0%; 95% CI:1.3-2.9%) and those that had an elevated BG measurement (n = 60, 5.2%; 95% CI:4.1-6.6%) at study enrollment, we estimated an overall indicative prevalence of diabetes of 7.1% (95% CI:5.7-8.7%). When combining those with known hypertension at study enrollment (n = 124, 10.6%; 95% CI:8.9-12.5%) and those with elevated BP (n = 202; 17.3%; 95% CI:15.2-19.5%), we get an overall prevalence of hypertension of 27.9% (95% CI:25.4-30.1%). Only 30.0% of those with elevated BG and 16.3% of those with elevated BP linked-to-care. CONCLUSION By opportunistically leveraging existing COVID-19 screening in South Africa to screen for diabetes and hypertension, 22% of participants received a potential new diagnosis. We had poor linkage-to-care following screening. Future research should evaluate options for improving linkage-to-care, and evaluate the large-scale feasibility of this simple screening tool.
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Affiliation(s)
- Alana T. Brennan
- Department of Global Health, Boston University School of Public Health, Boston, MA, United States of America
- Health Economics and Epidemiology Research Office, University of the Witwatersrand, Johannesburg, South Africa
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, United States of America
| | | | - Mohammed Majam
- Ezintsha, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Vanessa T. Msolomba
- Ezintsha, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Francois Venter
- Ezintsha, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | | | | | - Adena Gordon
- Department of Global Health, Boston University School of Public Health, Boston, MA, United States of America
| | - Gesine Meyer-Rath
- Department of Global Health, Boston University School of Public Health, Boston, MA, United States of America
- Health Economics and Epidemiology Research Office, University of the Witwatersrand, Johannesburg, South Africa
- South African DSI-NRF Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA), Stellenbosch University, Stellenbosch, South Africa
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13
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Oyewole OO, Ale AO, Ogunlana MO, Gurayah T. Burden of disability in type 2 diabetes mellitus and the moderating effects of physical activity. World J Clin Cases 2023; 11:3128-3139. [PMID: 37274052 PMCID: PMC10237122 DOI: 10.12998/wjcc.v11.i14.3128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 03/02/2023] [Accepted: 04/06/2023] [Indexed: 05/16/2023] Open
Abstract
The growing diabetic epidemic has created a substantial burden, not only on the people with diabetes but also on society at large. This mini-review discussed the limitations and patterns of disability in type 2 diabetes mellitus and put forward a case for the moderating effects of physical activity (PA) in the management of diabetes. The limitations and impairments associated with diabetes include vascular, neurological, cardiac, and renal impairments. Moreover, individuals participate less in their daily lives and in their instrumental activities of daily living, which negatively impacts the quality of life of individuals with diabetes. This often leads to a loss of quality of life due to disabilities, resulting in an increased rate of disability-adjusted life years among people with type 2 diabetes mellitus. Moreover, there are psychosocial sequelae of diabetes mellitus. This necessitates looking for moderating factors that may reduce the burden of the disease. PA has been shown to be one of the factors that can mitigate these burdens. PA does this in several ways, including through the benefits it confers, such as a reduction of hemoglobin A1c, a reduction of excess fat in the liver and pancreas, and the reduction of cardiovascular risk factors, all of which favorably affect glycemic parameters. Specifically, PA regulates or moderates diabetes disability through two mechanisms: The regulation of glucolipid metabolism disorders and the optimization of body mass index and systemic conditions. Therefore, efforts should be directed at PA uptake through identified strategies. This will not only prevent diabetes or diabetes complications but will reduce its burden.
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Affiliation(s)
- Olufemi O Oyewole
- Department of Physiotherapy, Olabisi Onabanjo University Teaching Hospital, Sagamu 201101, Ogun, Nigeria
- College of Health Sciences, University of KwaZulu-Natal, Durban 3629, South Africa
| | - Ayotunde O Ale
- Department of Medicine, Olabisi Onabanjo University, Sagamu 121101, Ogun, Nigeria
- Department of Endocrinology, Diabetes and Metabolism Unit, Medicine, Olabisi Onabanjo University Teaching Hospital, Sagamu 121101, Ogun, Nigeria
| | - Michael O Ogunlana
- College of Health Sciences, University of KwaZulu-Natal, Durban 3629, South Africa
- Department of Physiotherapy, Federal Medical Centre, Abeokuta 110101, Ogun, Nigeria
| | - Thavanesi Gurayah
- Occupational Therapy, School of Health Sciences, University of Kwazulu Natal, Private Bag X54001, Durban, 4000
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14
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Tegegne KD, Gebeyehu NA, Kassaw MW. Depression and determinants among diabetes mellitus patients in Ethiopia, a systematic review and meta-analysis. BMC Psychiatry 2023; 23:209. [PMID: 36991387 PMCID: PMC10052826 DOI: 10.1186/s12888-023-04655-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 03/06/2023] [Indexed: 03/31/2023] Open
Abstract
INTRODUCTION Primary studies have estimated the prevalence of depression and its determinants among diabetes patients. However, studies synthesizing this primary evidence are limited. Hence, this systematic review aimed to determine the prevalence of depression and identify determinants of depression among diabetes in Ethiopia. METHODS This systematic review and meta-analysis included a search of PubMed, Google Scholar, Scopus, Science Direct, PsycINFO, and Cochrane library. Data were extracted using Microsoft Excel and analyzed using STATA statistical software (v. 14). Data were pooled using a random-effects model. Forest plots, and Egger's regression test were all used to check for publication bias. Heterogeneity (I)2 was computed. Subgroup analysis was done by region, publication year, and depression screening instrument. In addition, the pooled odds ratio for determinants was calculated. RESULTS Sixteen studies, including 5808 participants were analyzed. The prevalence of depression in diabetes was estimated to be 34.61% (95% CI: 27.31-41.91). According to subgroup analysis by study region, publication year, and screening instrument, the highest prevalence was observed in Addis Ababa (41.98%), studies published before 2020 (37.91%), and studies that used Hospital Anxiety and Depression Scale (HADS-D) (42.42%,) respectively. Older age > 50 years (AOR = 2.96; 95% CI: 1.71-5.11), being women (AOR = 2.31; 95% CI: 1.57, 3.4), longer duration with diabetes (above 5 years) (AOR = 1.98; 95% CI: 1.03-3.8), and limited social support (AOR = 2.37; 95% CI: 1.68-3.34), were the determinants of depression in diabetic patients. CONCLUSION The results of this study suggest that the prevalence of depression in diabetes is substantial. This result underscores the importance of paying particular attention to prevent depression among diabetes. Being older, not attending formal education, longer duration with diabetes, having comorbidity, and low adherence to diabetes management were all associated. These variables may help clinicians identify patients at high risk of depression. Future studies focusing on the causal association between depression and diabetes are highly recommended.
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Affiliation(s)
- Kirubel Dagnaw Tegegne
- Department of Nursing, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia.
| | - Natnael Atnafu Gebeyehu
- Department of Midwifery, College of Medicine and Health Science, Wolaita Sodo University, Wolita Sodo, Ethiopia
| | - Mesfin Wudu Kassaw
- School of Nursing, College of Health Science, Woldia University, Woldia, Ethiopia
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15
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Diawara A, Coulibaly DM, Hussain TYA, Cisse C, Li J, Wele M, Diakite M, Traore K, Doumbia SO, Shaffer JG. Type 2 diabetes prevalence, awareness, and risk factors in rural Mali: a cross-sectional study. Sci Rep 2023; 13:3718. [PMID: 36878951 PMCID: PMC9987397 DOI: 10.1038/s41598-023-29743-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 02/09/2023] [Indexed: 03/08/2023] Open
Abstract
Diabetes is currently a crisis in sub-Saharan West Africa (SSWA) with dramatic implications for public health and national budgets prioritizing infectious diseases. There is limited recent literature about the prevalence, awareness, and risk factors for type 2 diabetes (T2D) in rural parts of SSWA. This study characterized T2D prevalence and risk factors for the rural Malian community of Nièna, which is situated in Mali's second-largest province of Sikasso. Between December 2020 and July 2021, a cross-sectional study of 412 participants was conducted in the Nièna community using clinical questionnaires and rapid diagnostic tests. Among 412 participants, there were 143 (34.7%) and 269 (65.3%) males and females, respectively. The overall prevalence of T2D in Nièna was 7.5% (31/412), and prevalence rates were 8.6% (23/269) and 5.6% (8/143) for females and males, respectively. Age, family history of diabetes, hypertension, waist circumference, and fetal macrosomia were significantly associated with T2D (p = 0.007, p < 0.001, p = 0.003, p = 0.013, and p < 0.001, respectively). Notably, 61.3% (19/31) of T2D subjects were unaware of their diabetic status before the study. Field surveys have considerable utility in driving T2D awareness in rural African settings.
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Affiliation(s)
- Abdoulaye Diawara
- University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali.
| | | | | | - Cheickna Cisse
- University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Jian Li
- Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Mamadou Wele
- University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Mahamadou Diakite
- University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | | | - Seydou O Doumbia
- University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali.
| | - Jeffrey G Shaffer
- Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA.
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16
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Madimenos FC, Gildner TE, Eick GN, Sugiyama LS, Snodgrass JJ. Bringing the lab bench to the field: Point-of-care testing for enhancing health research and stakeholder engagement in rural/remote, indigenous, and resource-limited contexts. Am J Hum Biol 2022; 34:e23808. [PMID: 36166487 DOI: 10.1002/ajhb.23808] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 08/03/2022] [Accepted: 09/12/2022] [Indexed: 01/25/2023] Open
Abstract
Point-of-care testing (POCT) allows researchers and health-care providers to bring the lab bench to the field, providing essential health information that can be leveraged to improve health care, accessibility, and understanding across clinical and research settings. Gaps in health service access are most pronounced in what we term RIR settings-rural/remote regions, involving Indigenous peoples, and/or within resource-limited settings. In these contexts, morbidity and mortality from infectious and non-communicable diseases are disproportionately higher due to numerous geographic, economic, political, and sociohistorical factors. Human biologists and global health scholars are well-positioned to contribute on-the-ground-level insights that can serve to minimize global health inequities and POCT has the potential to augment such approaches. While the clinical benefits of POCT include increasing health service access by bringing testing, rapid diagnosis, and treatment to underserved communities with limited pathways to centralized laboratory testing, POCT also provides added benefits to both health-focused researchers and their participants. Through portable, minimally invasive devices, researchers can provide actionable health data to participants by coupling POCT with population-specific health education, discussing results and their implications, creating space for participants to voice concerns, and facilitating linkages to treatment. POCT can also strengthen human biology research by shedding light on questions of evolutionary and biocultural importance. Here, we expand on the epidemiological and research value, as well as practical and ethical challenges of POCT across stakeholders (i.e., participant, community, health researcher, and trainee). Finally, we emphasize the immense opportunities of POCT for fostering collaborative research and enhancing access to health delivery and information and, by extension, helping to mitigate persistent global health inequities.
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Affiliation(s)
- Felicia C Madimenos
- Department of Anthropology, Queens College (CUNY), New York, USA.,New York Consortium of Evolutionary Primatology (NYCEP), CUNY Graduate Center, New York, USA
| | - Theresa E Gildner
- Department of Anthropology, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Geeta N Eick
- Department of Anthropology, University of Oregon, Eugene, Oregon, USA
| | | | - James J Snodgrass
- Department of Anthropology, University of Oregon, Eugene, Oregon, USA.,Center for Global Health, University of Oregon, Eugene, Oregon, USA.,Global Station for Indigenous Studies and Cultural Diversity, Hokkaido University, Sapporo, Japan
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17
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Katte JC, Agoons BB, Akem Dimala C, Bigna JJ, Sobngwi E. Incidence and prevalence of type 1 diabetes in Africa: a systematic review and meta-analysis protocol. BMJ Open 2022; 12:e061605. [PMID: 36109031 PMCID: PMC9478842 DOI: 10.1136/bmjopen-2022-061605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Type 1 diabetes is reported to have significant mortality in Africa. However, there is a paucity of data on pooled estimates of its incidence and prevalence in Africa. This first systematic review and meta-analysis will be conducted to determine the incidence and prevalence of this condition in Africa. METHODS Based on predefined criteria, electronic databases, including PubMed, Excerpta Medica database, Africa Journal Online and Web of Science, will be searched for relevant studies involving paediatric and adult patients, with no language restrictions. Quality assessment of the individual studies will be performed, and the Q-statistic test and I2 statistic test will be used to assess statistical heterogeneity. Appropriate meta-analysis will then be used to pool studies judged to be clinically homogenous. Egger's test will be used to detect publication bias. The planned search dates for the eligible articles are from 1 September to 30 September 2022. ETHICS AND DISSEMINATION Since this review will use previously published studies, it will not require the consent of an ethics committee. The results will be prepared and disseminated through a peer-reviewed journal and will be presented in relevant conferences. PROSPERO REGISTRATION NUMBER CRD42021278227.
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Affiliation(s)
- Jean Claude Katte
- National Obesity Centre and Endocrinology and Metabolic Diseases Unit, Yaounde Central Hospital, Yaounde, Cameroon
- RSD Institute, Yaounde, Cameroon
| | - Batakeh B Agoons
- Department of Internal Medicine and Specialities, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon
- Bafang District Hospital, Bafang, Cameroon
| | | | - Jean Joel Bigna
- Department of Epidemiology and Public Health, Centre Pasteur of Cameroon, Yaoundé, Cameroon
| | - Eugene Sobngwi
- National Obesity Centre and Endocrinology and Metabolic Diseases Unit, Yaounde Central Hospital, Yaounde, Cameroon
- RSD Institute, Yaounde, Cameroon
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18
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Duvenage H, Gericke GJ, Muchiri JW. Diet quality of adults with poorly controlled type 2 diabetes mellitus at a tertiary hospital outpatient clinic in Tshwane District, South Africa. SOUTH AFRICAN JOURNAL OF CLINICAL NUTRITION 2022. [DOI: 10.1080/16070658.2022.2114406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Hanel Duvenage
- Department of Consumer & Food Sciences, University of Pretoria, South Africa
| | - Gerda J Gericke
- Department of Human Nutrition, University of Pretoria, South Africa
| | - Jane W Muchiri
- Department of Human Nutrition, University of Pretoria, South Africa
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19
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Health-related quality of life and associated factors among type 2 diabetic adult patients in Debre Markos Referral Hospital, Northwest Ethiopia. Heliyon 2022; 8:e10182. [PMID: 36033286 PMCID: PMC9403364 DOI: 10.1016/j.heliyon.2022.e10182] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 06/05/2021] [Accepted: 07/29/2022] [Indexed: 01/09/2023] Open
Abstract
Health-related quality of life (HRQOL) is a multifaceted concept that is strongly impacted by Type II diabetes in developing countries. The majority of studies indicate diabetes mellitus prevalence without looking at people's quality of life. This study was conducted using an Institution-based cross-sectional design in Debre Markos Referral Hospital from March 03 to March 31, 2020. We evaluated HRQOL using the WHO quality of life BREF and data were obtained through face-to-face interviews. We used a systematic random sampling technique to select study participants. Data were entered into Epi data version 3.1 and exported to STATA version 14.0. Candidates for multivariable analysis were variables with a P-value less than 0.25 in the bivariable analysis and P-value less than 0.05 were considered to declare a statistically significant association. The final model was tested for its goodness of fit using Hosmer and Lemeshow's statistics. The analysis included a total of 368 adult individuals with type II diabetes and 206 (56%) had a good HRQOL. Being male (AOR = 4.28, 95%CI:2.36, 7.78), having duration of disease of more than 59 months (AOR = 2.93, 95%CI:1.61, 5.34), doing a physical exercise (AOR = 2.33,95%CI:1.34, 4.05) and got counseling (AOR = 3.33; 95%CI:1.82, 5.94) were directly associated with good HRQOL whereas the presence of diabetic complications (AOR = 0.46, 95%CI:0.26, 0.80), comorbidity (AOR = 0.45; 95%CI:0.25, 0.84) and drinking alcohol (AOR = 0.27, 95%CI:0.16, 0.48) had an inverse relationship with good HRQOL. More than half of type 2 diabetic adult patients had a good HRQOL. Being male, drinking alcohol, getting counseling, doing physical exercise, absence of diabetic complications, and comorbidity and long duration of disease were predictors of good HRQOL. Therefore, avoiding drinking alcohol and promoting physical exercise and counseling should be encouraged.
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20
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Anyasodor AE, Nwose EU, Bwititi PT, Richards RS. Cost-effectiveness of community diabetes screening: Application of Akaike information criterion in rural communities of Nigeria. Front Public Health 2022; 10:932631. [PMID: 35958851 PMCID: PMC9357922 DOI: 10.3389/fpubh.2022.932631] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 06/28/2022] [Indexed: 11/13/2022] Open
Abstract
Background The prevalence of diabetes mellitus (DM) is increasing globally, and this requires several approaches to screening. There are reports of alternative indices for prediction of DM, besides fasting blood glucose (FBG) level. This study, investigated the ability of combination of biochemical and anthropometric parameters and orodental disease indicators (ODIs) to generate models for DM prediction, using Akaike information criterion (AIC) to substantiate health economics of diabetes screening. Methods Four hundred and thirty-three subjects were enrolled in the study in Ndokwa communities, Delta State, Nigeria, and their glycaemic status was determined, using the CardioChek analyser® and previous data from the Prediabetes and Cardiovascular Complications Study were also used. The cost of screening for diabetes (NGN 300 = $0.72) in a not-for-profit organization/hospital was used as basis to calculate the health economics of number of individuals with DM in 1,000 participants. Data on the subjects' anthropometric, biochemical and ODI parameters were used to generate different models, using R statistical software (version 4.0.0). The different models were evaluated for their AIC values. Lowest AIC was considered as best model. Microsoft Excel software (version 2020) was used in preliminary analysis. Result The cost of identifying <2 new subjects with hyperglycemia, in 1,000 people was ≥NGN 300,000 ($ 716). A total of 4,125 models were generated. AIC modeling indicates FBG test as the best model (AIC = 4), and the least being combination of random blood sugar + waist circumference + hip circumference (AIC ≈ 34). Models containing ODI parameters had AIC values >34, hence considered as not recommendable. Conclusion The cost of general screening for diabetes in rural communities may appear high and burdensome in terms of health economics. However, the use of prediction models involving AIC is of value in terms of cost-benefit and cost-effectiveness to the healthcare consumers, which favors health economics.
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Affiliation(s)
- Anayochukwu Edward Anyasodor
- School of Dentistry and Medical Sciences, Charles Sturt University, Orange, NSW, Australia
- *Correspondence: Anayochukwu Edward Anyasodor
| | - Ezekiel Uba Nwose
- School of Dentistry and Medical Sciences, Charles Sturt University, Orange, NSW, Australia
- Department of Public and Community Health, Novena University, Kwale, Nigeria
| | | | - Ross Stuart Richards
- School of Dentistry and Medical Sciences, Charles Sturt University, Orange, NSW, Australia
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21
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Owiredu WKBA, Obirikorang C, Agoe AB, Acheampong E, Anto EO, Amanquah SD, Agbodzakey H, Adu EA, Owusu H. Elevated Serum Sialic Acid Levels May be Associated With Diabetes Retinopathy: A Cross-Sectional Study in Ghana. FRONTIERS IN CLINICAL DIABETES AND HEALTHCARE 2022; 3:871051. [PMID: 36992772 PMCID: PMC10012103 DOI: 10.3389/fcdhc.2022.871051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 04/25/2022] [Indexed: 11/13/2022]
Abstract
This study determined the association between serum sialic acid (SSA) and metabolic risk factors in Ghanaian Type 2 diabetes (T2DM) with and without micro vascular complications. This cross-sectional study recruited 150 T2DM out-patients visiting the diabetic Clinic at the Tema General Hospital, Ghana. Fasting blood samples were collected and analyzed for Total Cholesterol (TC), Triglyceride (TG), Low Density Lipoprotein Cholesterol (LDL-C), High Density Lipoprotein Cholesterol (HDL-C), Fasting Plasma Glucose (FPG), Glycated Haemoglobin (HbA1c), SSA and C-Reactive Protein. SSA levels were significantly higher in diabetics with retinopathy (210.12 ± 85.09mg/dl) compared with those with nephropathy and those without complication (p-value= 0.005). Body adiposity index (BAI) (r= -0.419, p-value = 0.037) and Triglyceride (r= -0.576, p-value = 0.003), had a moderate negative correlation with SSA levels. In a One-Way Analysis of Covariance (Adjusted for TG and BAI), SSA could distinguish between diabetics with retinopathy and those without complications (p-value = 0.004) but not nephropathy (p-value = 0.099). Within group linear regression analysis showed that Elevated serum sialic acid was found in type 2 diabetic patients with retinopathic micro-vascular complications. Therefore, estimation of sialic acid levels may help with the early prediction and prevention of microvascular complications occurring due to diabetes, thereby decreasing the mortality and morbidity.
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Affiliation(s)
- William K. B. A Owiredu
- Department of Molecular Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
| | - Christian Obirikorang
- Department of Molecular Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
- *Correspondence: Christian Obirikorang,
| | - Alberta Boye Agoe
- Medical Laboratory Unit, Greater Accra Regional Hospital, Accra, Ghana
| | - Emmanuel Acheampong
- Department of Molecular Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
- Centre for Precision Health, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - Enoch Odame Anto
- Centre for Precision Health, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Seth D. Amanquah
- Department of Chemical Pathology, University of Ghana Medical School, Korle-Bu, Accra, Ghana
| | - Hope Agbodzakey
- Department of Molecular Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
| | - Evans Asamoah Adu
- Department of Molecular Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
| | - Hubert Owusu
- Department of Molecular Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
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Sarfo-Kantanka O, Asamoah-Boaheng M, Arthur J, Agyei M, Barnes NA, Tenkorang EY, Midodzi W. Trends in type 1 diabetes diagnosis in Ghana. Int Health 2022; 14:442-446. [PMID: 32050027 PMCID: PMC9248061 DOI: 10.1093/inthealth/ihz096] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Revised: 08/26/2019] [Accepted: 09/13/2019] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Despite the fact that the rate of type 1 diabetes (T1D) is increasing worldwide, there exists a dearth of information on the disease in most sub-Saharan African countries. The goal of this study was to determine the enrolment trend of T1D using data compiled over 28 y from a teaching hospital in Kumasi, Ghana. METHODS Information collected included sex, age at diagnosis and date of T1D diagnosis. We identified trends from 1992 to 2018, divided into 3 y intervals. RESULTS From 1992 to 2018, 1717 individuals with T1D were enrolled in the diabetes clinic at the Komfo Anokye Teaching Hospital. The male:female ratio was 1:1.2. The number of individuals diagnosed with T1D decreased among the 10-19 y age group during the 1992-1994 period, followed by a progressive increase within the same age group during the subsequent period (from 35.4% in 1995-1997 to 63.2% in 2016-2018). There was a decline in the proportion of children 0-9 y of age diagnosed during the study period (from 5.1% in 1992-1994 to 3.6% in 2016-2018). CONCLUSIONS In our study population, a decreasing trend of T1D enrolments was observed in general while among adolescents an increasing trend was observed.
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Affiliation(s)
- Osei Sarfo-Kantanka
- Directorate of Internal Medicine, Komfo Anokye Teaching Hospital, PO Box 1934, Kumasi, Ghana
| | - Michael Asamoah-Boaheng
- Faculty of Medicine, Clinical Epidemiology Unit, Memorial University of Newfoundland, St John’s, NL, Canada
| | - Joshua Arthur
- Public Health Unit, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Martin Agyei
- Directorate of Internal Medicine, Komfo Anokye Teaching Hospital, PO Box 1934, Kumasi, Ghana
- Department of Medicine, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Nana Ama Barnes
- Department of Internal Medicine, School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Eric Y Tenkorang
- Department of Sociology, Memorial University of Newfoundland, St Johns, NL, Canada
| | - William Midodzi
- Faculty of Medicine, Clinical Epidemiology Unit, Memorial University of Newfoundland, St John’s, NL, Canada
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Nuhu JM, Yakasai AM, Danazumi MS, Nazeef F, Zakari UU, Usman Z, Mohammed J. Effect of aerobic exercise and burst-modulated biphasic pulsed current on glycemic control, central obesity and body image in individuals with type 2 diabetes mellitus: study protocol for a randomized controlled trial. ADVANCES IN INTEGRATIVE MEDICINE 2022. [DOI: 10.1016/j.aimed.2022.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Qubekile Y, Paruk S, Paruk F. Prevalence of depressive symptoms and quality of life among patients with diabetes mellitus with and without HIV infection: A South African study. S Afr J Psychiatr 2022; 28:1762. [PMID: 35281969 PMCID: PMC8905418 DOI: 10.4102/sajpsychiatry.v28i0.1762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 09/22/2021] [Indexed: 11/16/2022] Open
Abstract
Background Diabetes mellitus (DM) and human immunodeficiency virus (HIV) infection are both associated with increased risk of mood disorders and poorer quality of life (QOL). This association has not been explored in patients living with comorbid DM and HIV. Aim To describe the prevalence of depressive symptoms and impact on the QOL in patients with DM living with and without HIV attending a public sector hospital in South Africa. Setting A medical outpatient clinic at a state regional hospital. Methods A cross-sectional questionnaire pilot survey was conducted amongst 101 patients with DM attending a specialist medical outpatient service. The assessment was conducted using a structured socio-demographic and clinical questionnaire, the patient health questionnaire 9 (PHQ-9) for depressive symptoms and the World Health Organization QOL scale. The HIV status was confirmed from the clinical records. The correlates of depressive symptomatology in the participants with DM living with and without HIV were identified using t-tests. Results The prevalence of depressive symptoms in the participants with DM was 36%. Moderate to severe depression was associated with female gender (p = 0.03) and low educational level (p = 0.02) but not with HIV comorbidity or clinical characteristics of DM. The QOL was influenced by moderate to severe depressive symptoms (QOL in physical p < 0.218 and environmental p < 0.001 domains), but not HIV status (p = 0.218). Conclusion A substantial proportion of people with DM reported depressive symptoms, which is slightly higher than the average reported in other out-patient studies. The association of depression with poor QOL highlights the need for integrated mental health access in medical outpatient services. The lack of association between comorbid HIV status and DM with depression or QOL needs to be further explored.
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Affiliation(s)
- Yonela Qubekile
- Department of Internal Medicine, Faculty of Health Science, University of KwaZulu-Natal, Durban, South Africa
| | - Saeeda Paruk
- Department of Psychiatry, Faculty of Health Science, University of KwaZulu-Natal, Durban, South Africa
| | - Farhanah Paruk
- Department of Rheumatology, Faculty of Health Science, University of KwaZulu-Natal, Durban, South Africa
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25
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A systematic review of diabetes risk assessment tools in sub-Saharan Africa. Int J Diabetes Dev Ctries 2022. [DOI: 10.1007/s13410-022-01045-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Abstract
Objectives
To systematically review all current studies on diabetes risk assessment tools used in SSA to diagnose diabetes in symptomatic and asymptomatic patients.
Methods
Tools were identified through a systematic search of PubMed, Ovid, Google Scholar, and the Cochrane Library for articles published from January 2010 to January 2020. The search included articles reporting the use of diabetes risk assessment tool to detect individuals with type 2 diabetes in SSA. A standardized protocol was used for data extraction (registry #177726).
Results
Of the 825 articles identified, 39 articles met the inclusion criteria, and three articles reported tools used in SSA population but developed for the Western population. None was validated in SSA population. All but three articles were observational studies (136 and 58,657 study participants aged between the ages of 15 and 85 years). The Finnish Medical Association risk tool, World Health Organization (WHO) STEPS instrument, General Practice Physical Activity Questionnaire (GPPAQ), Rapid Eating and Activity Assessment for Patients (REAP), and an anthropometric tool were the most frequently used non-invasive tools in SSA. The accuracy of the tools was measured using sensitivity, specificity, or area under the receiver operating curve. The anthropometric predictor variables identified included age, body mass index, waist circumference, positive family of diabetes, and activity levels.
Conclusions
This systematic review demonstrated a paucity of validated diabetes risk assessment tools for SSA. There remains a need for the development and validation of a tool for the rapid identification of diabetes for targeted interventions.
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26
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Meeks KAC, Adeyemo A, Agyemang C. Beta-cell dysfunction and insulin resistance in relation to abnormal glucose tolerance in African populations: can we afford to ignore the diversity within African populations? BMJ Open Diabetes Res Care 2022; 10:10/1/e002685. [PMID: 35210285 PMCID: PMC8883230 DOI: 10.1136/bmjdrc-2021-002685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 02/05/2022] [Indexed: 11/21/2022] Open
Affiliation(s)
- Karlijn A C Meeks
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, USA
- Department of Public and Occupational Health, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Adebowale Adeyemo
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Charles Agyemang
- Department of Public and Occupational Health, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
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Katte JC, Lemdjo G, Dehayem MY, Jones AG, McDonald TJ, Sobngwi E, Mbanya JC. Mortality amongst children and adolescents with type 1 diabetes in sub-Saharan Africa: The case study of the Changing Diabetes in Children program in Cameroon. Pediatr Diabetes 2022; 23:33-37. [PMID: 34820965 DOI: 10.1111/pedi.13294] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 09/28/2021] [Accepted: 11/15/2021] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Type 1 diabetes in Africa has been associated with high mortality attributed mainly to poor insulin access. Free insulin provision programs for people with type 1 diabetes have been introduced across Africa recently. We aimed to determine the mortality rate and associated factors in a cohort of children and adolescents with type 1 diabetes who receive free insulin treatment in sub-Saharan Africa. METHODS We conducted a retrospective analysis using the Changing Diabetes in Children (CDiC) medical records in Cameroon between 2011 and 2015. RESULTS The overall mortality rate was 33.0 per 1000 person-years (95% CI 25.2-43.2). Most deaths (71.7%) occurred outside of the hospital setting, and the cause of death was known only in 13/53 (24.5%). Mortality was substantially higher in CDiC participants followed up in regional clinics compared to the main urban CDiC clinic in Yaounde; 41 per 1000 years (95% CI 30.8-56.0) versus 17.5 per 1000 years (95% CI 9.4-32.5), and in those with no formal education compared to those who had some level of education; 68.0 per 1000 years (95% CI 45.1-102.2) versus 23.6 per 1000 years (95% CI 16.5-33.8). In Cox proportional multivariable analysis, urban place of care (HR = 0.23, 95% CI 0.09-0.57; p = 0.002) and formal education (HR = 0.42, 95% CI 0.22-0.79; p = 0.007) were independently associated with mortality. CONCLUSION Despite free insulin provision, mortality remains high in children and adolescents with type 1 diabetes in Cameroon and is substantially higher in rural settings and those with no formal education.
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Affiliation(s)
- Jean Claude Katte
- National Institute for Health Research (NIHR) Global Health Research, University of Exeter Medical School, Exeter, UK.,National Obesity Centre and Endocrinology and Metabolism Diseases Unit, Yaounde Central Hospital, Yaounde, Cameroon
| | - Gaelle Lemdjo
- National Obesity Centre and Endocrinology and Metabolism Diseases Unit, Yaounde Central Hospital, Yaounde, Cameroon
| | - Mesmin Y Dehayem
- National Obesity Centre and Endocrinology and Metabolism Diseases Unit, Yaounde Central Hospital, Yaounde, Cameroon.,Department of Internal Medicine and Specialities, Faculty of Medicine and Biomedical Sciences, University of Yaounde 1, Yaounde, Cameroon
| | - Angus G Jones
- National Institute for Health Research (NIHR) Global Health Research, University of Exeter Medical School, Exeter, UK
| | - Timothy J McDonald
- National Institute for Health Research (NIHR) Global Health Research, University of Exeter Medical School, Exeter, UK
| | - Eugene Sobngwi
- National Obesity Centre and Endocrinology and Metabolism Diseases Unit, Yaounde Central Hospital, Yaounde, Cameroon.,Department of Internal Medicine and Specialities, Faculty of Medicine and Biomedical Sciences, University of Yaounde 1, Yaounde, Cameroon
| | - Jean Claude Mbanya
- National Obesity Centre and Endocrinology and Metabolism Diseases Unit, Yaounde Central Hospital, Yaounde, Cameroon.,Department of Internal Medicine and Specialities, Faculty of Medicine and Biomedical Sciences, University of Yaounde 1, Yaounde, Cameroon
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Nyirenda JLZ, Wagner D, Ngwira B, Lange B. Bidirectional screening and treatment outcomes of diabetes mellitus (DM) and Tuberculosis (TB) patients in hospitals with measures to integrate care of DM and TB and those without integration measures in Malawi. BMC Infect Dis 2022; 22:28. [PMID: 34983434 PMCID: PMC8725264 DOI: 10.1186/s12879-021-07017-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 12/24/2021] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION There are efforts in low and middle-income countries (LMICs) to integrate Tuberculosis (TB) and Diabetes mellitus (DM) healthcare services, as encouraged by WHO and other international health organizations. However, evidence on actual effect of different integration measures on bidirectional screening coverages and or treatment outcomes for both diseases in LMICs is scarce. OBJECTIVES AND METHODS Retrospective chart review analysis was conducted to determine effects of integrated care on bidirectional screening and treatment outcomes for both TB patients and people with DM (PWD) recruited in eight Malawian hospitals. Data of ≥ 15 years old patients registered between 2016 to August 2019 were collected and analysed. RESULTS 557 PWDs (mean age 54) and 987 TB patients (mean age 41) were recruited. 64/557 (11.5%) PWDs and 105/987 (10.6%) of TB patients were from an integrating hospital. 36/64 (56.3%) PWDs were screened for TB in integrated healthcare as compared to 5/493 (1.0%) in non-integrated care; Risk Difference (RD) 55.2%, (95%CI 43.0, 67.4), P < 0.001, while 10/105 (9.5%) TB patients were screened for DM in integrated healthcare as compared to 43/882 (4.9%) in non-integrated care; RD 4.6%, (95%CI - 1.1, 10.4), P = 0.065. Of the PWDs screened, 5/41 (12.2%) were diagnosed with TB, while 5/53 (9.4%) TB patients were diagnosed with DM. On TB treatment outcomes, 71/508 (14.8%) were lost to follow up in non-integrated care and none in integrated care were lost to follow-up; RD - 14.0%, (95%CI: - 17.0,-11.0), p < 0.001. Among PWDs, 40/493 (8.1%) in non-integrated care and 2/64 (3.1%) were lost to follow up in integrated care; RD - 5.0%, (95%CI:-10.0, - 0.0); P = 0.046. After ≥ 2 years of follow up, 62.5% PWDs in integrated and 41.8% PWDs in non-integrated care were retained in care, RD 20.7, (95%CI: 8.1, 33.4), P = 0.001. CONCLUSION We found higher bidirectional screening coverage and less loss to follow-up in one centre that made more efforts to implement integrated measures for TB and DM care than in 7 others that did not make these efforts. Decisions on local programs to integrate TB/DM care should be taken considering currently rather weak evidence and barriers faced in the local context as well as existing guidelines.
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Affiliation(s)
- John L Z Nyirenda
- University Hospital Freiburg. Medical Faculty. University of Freiburg, Freiburg, Germany. .,Public Health Department, Faculty of Applied Sciences, University of Livingstonia, Mzuzu, Malawi.
| | - Dirk Wagner
- University Hospital Freiburg. Medical Faculty. University of Freiburg, Freiburg, Germany
| | - Bagrey Ngwira
- The Polytechnic College, University of Malawi, Blantyre, Malawi
| | - Berit Lange
- Helmholtz Centre for Infectious Research, Epidemiology, Braunschweig, Germany
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Mbamognoua N, Osseni RA, Ongoth FEM, Ohouna RLM, Bouenizabila E, Moko AO, Monabeka HG. Psychosocial Experience of Parents of Children, Adolescents and Young Adults with Type 1 Diabetes in Brazzaville. Health (London) 2022. [DOI: 10.4236/health.2022.146045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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30
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Maphumulo SC, Pretorius E. Role of Circulating Microparticles in Type 2 Diabetes Mellitus: Implications for Pathological Clotting. Semin Thromb Hemost 2021; 48:188-205. [PMID: 34959250 DOI: 10.1055/s-0041-1740150] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Type 2 diabetes mellitus (T2DM) is a multifactorial chronic metabolic disease characterized by chronic hyperglycemia due to insulin resistance and a deficiency in insulin secretion. The global diabetes pandemic relates primarily to T2DM, which is the most prevalent form of diabetes, accounting for over 90% of all cases. Chronic low-grade inflammation, triggered by numerous risk factors, and the chronic activation of the immune system are prominent features of T2DM. Here we highlight the role of blood cells (platelets, and red and white blood cells) and vascular endothelial cells as drivers of systemic inflammation in T2DM. In addition, we discuss the role of microparticles (MPs) in systemic inflammation and hypercoagulation. Although once seen as inert by-products of cell activation or destruction, MPs are now considered to be a disseminated storage pool of bioactive effectors of thrombosis, inflammation, and vascular function. They have been identified to circulate at elevated levels in the bloodstream of individuals with increased risk of atherothrombosis or cardiovascular disease, two significant hallmark conditions of T2DM. There is also general evidence that MPs activate blood cells, express proinflammatory and coagulant effects, interact directly with cell receptors, and transfer biological material. MPs are considered major players in the pathogenesis of many systemic inflammatory diseases and may be potentially useful biomarkers of disease activity and may not only be of prognostic value but may act as novel therapeutic targets.
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Affiliation(s)
| | - Etheresia Pretorius
- Department of Physiological Sciences, Faculty of Science, Stellenbosch University, Stellenbosch, South Africa
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31
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Li M, Chen T, Hua Z, Yan H, Wang D, Li Z, Kang Y, Zhu N, Li C. Global, regional, and national prevalence of diabetes mellitus in patients with pulmonary tuberculosis: a systematic review and meta-analysis. Diabetol Metab Syndr 2021; 13:127. [PMID: 34717728 PMCID: PMC8557479 DOI: 10.1186/s13098-021-00743-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 10/17/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Both pulmonary tuberculosis (PTB) and diabetes mellitus (DM) are major global public health problems. We estimated the global, regional, and national prevalence of diabetes mellitus in a population with PTB. METHODS We searched for observational studies of DM in people with PTB using the PubMed and Embase electronic bibliographic databases, focusing on articles published in the English language from database inception until March 31, 2021. We included original research that reported the prevalence of DM in PTB or those that had sufficient data to compute these estimates. Studies were excluded if they did not provide primary data or were case studies or reviews. Two authors independently extracted the articles and collected detailed information using a predefined questionnaire. A country-specific random-effects meta-analysis was used for countries with two or more available studies, and a fractional response regression model was employed to predict the prevalence of DM in PTB for countries with one or no study. The study was registered with the International Prospective Register of Systematic Reviews, using the registration number CRD42018101989. RESULTS We identified 22,658 studies, and 153, across 51 countries, were retained for data extraction. The global prevalence of DM among patients with PTB was estimated to be 13.73% (95% confidence interval [CI] 12.51-14.95). The prevalence rates were 19.32% (95% CI 13.18-25.46) in the region of the Americas, 17.31% (95% CI 12.48-22.14) in the European region, 14.62% (95% CI 12.05-17.18) in Southeast Asia, 13.59% (95% CI 7.24-19.95) in the western Pacific region, 9.61% (95% CI 4.55-14.68) in the eastern Mediterranean region, and 9.30% (95% CI 2.83-15.76) in the African region. The country with the highest estimated prevalence was the Marshall Islands (50.12%; 95% CI 4.28-95.76). CONCLUSION Comorbid PTB and DM remain prevalent worldwide.
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Affiliation(s)
- Minmin Li
- Shaanxi Provincial Center for Disease Control and Prevention, No. 3 East Jian Road, PO Box 46, Xi'an, 710041, Shaanxi, People's Republic of China
| | - Tao Chen
- Department of Clinical Sciences, Liverpool School of Tropical Medicine Pembroke Place, Liverpool, UK
| | - Zhongqiu Hua
- Wuxi Early Intervention Center for Children with Special Needs, Wuxi, China
| | - Hong Yan
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, No. 76 West Yanta Road, PO Box 46, Xi'an, 710061, Shaanxi, People's Republic of China
- Nutrition and Food Safety Engineering Research Center of Shaanxi Province, Xi'an, China
| | - Duolao Wang
- Department of Clinical Sciences, Liverpool School of Tropical Medicine Pembroke Place, Liverpool, UK
| | - Zhaoqing Li
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, No. 76 West Yanta Road, PO Box 46, Xi'an, 710061, Shaanxi, People's Republic of China
| | - Yijun Kang
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, No. 76 West Yanta Road, PO Box 46, Xi'an, 710061, Shaanxi, People's Republic of China
| | - Ni Zhu
- Shaanxi Provincial Center for Disease Control and Prevention, No. 3 East Jian Road, PO Box 46, Xi'an, 710041, Shaanxi, People's Republic of China.
| | - Chao Li
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, No. 76 West Yanta Road, PO Box 46, Xi'an, 710061, Shaanxi, People's Republic of China.
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Pillay S, Magula NP. Treatment outcomes of Gene Xpert positive tuberculosis patients in KwaMashu Community Health Centre, KwaZulu-Natal, South Africa: A retrospective review. S Afr J Infect Dis 2021; 36:217. [PMID: 34485494 PMCID: PMC8378003 DOI: 10.4102/sajid.v36i1.217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 01/11/2021] [Indexed: 11/04/2022] Open
Abstract
Background We sought to investigate the relationship between tuberculosis (TB) treatment outcomes and its predictors in the KwaMashu region in KwaZulu-Natal (KZN). This area is currently a hotbed for TB and human immunodeficiency virus (HIV) co-infection. Method A retrospective study design was adopted to characterise adult patients diagnosed with Gene Expert (GXP) positive pulmonary TB from 01 January 2016 to 31 December 2017. Tuberculosis treatment outcomes were assessed after two months and five months according to the standard World Health Organization (WHO) criteria. Multiple logistic regression analysis was used to calculate the odds ratio (OR) of the possible determinants associated with unsuccessful treatment outcomes. Results Amongst the 596 patients diagnosed, 57.4% (95% confidence interval [CI]: 53.3–61.4; 342 of 596) had successful treatment outcomes. Of these reported cases, 88.89% (85.1–92.0; 304 of 342) were cured. For the unsuccessful treatment outcomes, 52.4% (46.0–58.6; 133 of 254) patients were lost to follow-up, 20.9% (16.0–26.4; 53 of 254) failed treatment, 1.2% (0.2–3.4; 3 of 254) died and 25.6% (20.3–31.4; 65 of 254) of the patients could not be accounted for. Patients with unknown HIV status were more likely to have unsuccessful treatment outcomes (adjusted OR [aOR] = 4.94 [1.83–13.36]). Patients who had sputum conversion at 2 months (aOR = 1.94 [1.27–2.96]) were significantly more likely to exhibit unsuccessful treatment outcomes. Conclusion Treatment success rate was 57.4% which was below the target set by the WHO. This underscores the urgent need to strengthen treatment adherence strategies to improve outcomes, especially in high HIV burden settings.
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Affiliation(s)
- Sarusha Pillay
- Internal Medicine, Faculty of Health Sciences, University of KwaZulu-Natal Durban, South Africa
| | - Nombulelo P Magula
- Internal Medicine, Faculty of Health Sciences, University of KwaZulu-Natal Durban, South Africa
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Kumah E, Otchere G, Ankomah SE, Fusheini A, Kokuro C, Aduo-Adjei K, A. Amankwah J. Diabetes self-management education interventions in the WHO African Region: A scoping review. PLoS One 2021; 16:e0256123. [PMID: 34403455 PMCID: PMC8370626 DOI: 10.1371/journal.pone.0256123] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 08/01/2021] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION Diabetes mellitus (DM) is one of the commonest chronic diseases worldwide. Self-Management Education (SME) is regarded as a critical element of treatment for all people with diabetes, as well as those at risk of developing the condition. While a great variety of diabetes self-management education (DSME) interventions are available in high-income countries, limited information exists on educational programs for the prevention and management of diabetes complications in Africa. This study, therefore, aimed at synthesizing information in the literature to describe the state of the science of DSME interventions in the WHO African Region. MATERIALS AND METHODS The study is a scoping review, which followed the standard PRISMA guidelines for conducting and reporting scoping reviews. A systematic keyword and subject headings searches were conducted on six electronic databases (PubMed, Scopus, MEDLINE, EMBASE, PsychINFO and the Cochrane Central Register of Controlled Trials) to identify relevant English language publications on DSME from 2000 through 2020. Titles and abstracts of the search results were screened to select eligible papers for full text reading. All eligible papers were retrieved and full text screening was done by three independent reviewers to select studies for inclusion in the final analysis. RESULTS Nineteen studies were included in the review. The interventions identified were individually oriented, group-based, individually oriented & group-based, and information technology-based DSME programs. Outcomes of the interventions were mixed. While the majority yielded significant positive results on HbA1c, diabetes knowledge, blood pressure, blood sugar and foot care practices; few demonstrated positive outcomes on self-efficacy, BMI, physical activity; self-monitoring of blood glucose, medication adherence, smoking and alcohol consumption. CONCLUSIONS The limited studies available indicate that DSME interventions in the WHO African Region have mixed effects on patient behaviors and health outcomes. That notwithstanding, the majority of the interventions demonstrated statistically significant positive effects on HbA1c, the main outcome measure in most DSME intervention studies.
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Affiliation(s)
- Emmanuel Kumah
- Department of Health Administration and Education, Faculty of Science Education, University of Education, Winneba, Ghana
| | - Godfred Otchere
- Policy, Planning, Monitoring and Evaluation Unit, Komfo Anokye Teaching Hospital, Kumasi, Ghana
- Faculty of Humanities, Center for Medicine and Society, University of Freiburg, Freiburg im Breisgau, Germany
| | - Samuel Egyakwa Ankomah
- Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Adam Fusheini
- Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
- Center for Health Literacy and Rural Health Promotion, Accra, Ghana
| | - Collins Kokuro
- Department of Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Kofi Aduo-Adjei
- Center for Health Services Management, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Joseph A. Amankwah
- Department of Administration, Ankaase Methodist Hospital, Ankaase, Ghana
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Bedane DA, Tadesse S, Bariso M, Reta W, Desu G. Assessment of electrocardiogram abnormality and associated factors among apparently healthy adult type 2 diabetic patients on follow-up at Jimma Medical Center, Southwest Ethiopia: Cross-sectional study. BMC Cardiovasc Disord 2021; 21:312. [PMID: 34167465 PMCID: PMC8223340 DOI: 10.1186/s12872-021-02110-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 06/07/2021] [Indexed: 11/10/2022] Open
Abstract
Background Diabetes mellitus is a group of metabolic disorders causing long-term damage to the cardiovascular system which remains asymptomatic among diabetic patients. An electrocardiograph is a simple and first-line tool in the screening of cardiovascular diseases. Objective To assess electrocardiogram abnormality and associated factors among apparently healthy adult type 2 diabetes patients on follow-up at Jimma Medical Center, 2019. Materials and methods Institutional based cross-sectional study was conducted from April 1 to May 30, 2019, at Jimma Medical Center among selected type 2 diabetes patients. Systematic random sampling was employed to select the study participants. The World Health Organization stepwise approach and interviewer-administered semi-structured questionnaires were employed to collect basic data. Resting Electrocardiography was done using a standard 12-lead electrocardiograph machine. The collected data were checked for completeness, coded, entered into the Epi-data Version 4.0.2. and exported to SPSS Version 21. Descriptive statistics like frequencies, percentages, mean and standard deviations were carried out. Binary and multiple logistic regression was done and a p value of less than 0.05 was used as a level of significance. Results A total of 344 type 2 diabetes patients were interviewed and underwent electrocardiography making a 100% response rate. Electrocardiographic abnormality was identified among 209 (61%) of the respondents. Not attending formal education [AOR = 3.07, 95%, CI = 1.37–6.87], solid oil use, [AOR = 1.79, 95%, CI = 1.07–2.98], body mass index ≥ 25 kg/m2 [AOR = 2.74, 95%, CI = 1.67–4.50] and long duration of diabetes ≥ 10 years [AOR = 3.36, 95%, CI = 1.46–7.71] were associated with electrocardiogram abnormality. Conclusions and recommendation In this study, the majority (3/5th) of the participant had electrocardiogram abnormality. Not attending formal education, longer duration of diabetes ≥ 10 years, solid oil use, and increased body mass index ≥ 25 kg/m2 were independent predictors of electrocardiographic abnormality. Integrating electrocardiogram screening in routine diabetic management can pick cardiac complications of diabetes. Supplementary Information The online version contains supplementary material available at 10.1186/s12872-021-02110-6.
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Affiliation(s)
- Deriba A Bedane
- Department of Biomedical Sciences, Physiology Unit, College of Medical Sciences, Institute of Health, Jimma University, Jimma, Ethiopia.
| | - Samuel Tadesse
- Department of Biomedical Sciences, Physiology Unit, College of Medical Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Moyeta Bariso
- Department of Biomedical Sciences, Physiology Unit, College of Medical Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Wondu Reta
- Department of Biomedical Sciences, Physiology Unit, College of Medical Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Gaddisa Desu
- Jimma Medical Center, Department of Internal Medicine, College of Medical Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
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Akrofi B, Tetteh J, Amissah-Arthur KN, Buxton ENA, Yawson A. Utilization of eye health services and diabetic retinopathy: a cross-sectional study among persons living with diabetes visiting a tertiary eye care facility in Ghana. BMC Health Serv Res 2021; 21:590. [PMID: 34147100 PMCID: PMC8214777 DOI: 10.1186/s12913-021-06594-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 05/24/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There have been a major advance made in screening, early diagnosis, and prompt treatment of Diabetic Retinopathy among Person living with diabetes (PLWD). However, screening services remain a challenge in Low-Middle-Income-Countries where access to eye care professionals is inadequate. This study assesses the utilization of Eye Health Service prevalence (UEHS) among PLWD and associated factors and further quantifies its association with Non-Proliferative Diabetic Retinopathy (NPDR). METHODS A cross-sectional study design with a random sample of 360 PLWD was conducted at Korle-Bu Teaching Hospital, a National Referral Centre in Ghana from May to July 2019. UEHS and DR were the study outcomes. We adopted Poisson and Probit regression analysis to assess factors associated with UEHS over the past year. We employed pairwise and phi correlation (fourfold correlational analysis) to assess the relationship between UEHS and DR (ordinal and binary respectively). Ordered Logistic and Poisson regression were applied to assess the association between the UEHS and DR. Stata 16.1 was used to perform the analyses and a p-value ≤ 0.05 was deemed significant. RESULTS The prevalence of UEHS over the past year and DR was 21.7 %(95 %CI = 17.7-26.2) and 65.0 %(95 %CI = 59.9-69.8 respectively. The prevalence of severe NPDR with Clinically Significant Macular Edema (CSME) was 23.9 %(19.8-28.6). Type of diabetes, increasing age, educational level, mode of payment for healthcare services, marital status, years since diagnosis, and current blood glucose significantly influenced UEHS. There was a negative relationship between DR and UEHS (Pairwise and φ correlation were - 20 and - 15 respectively; p < 0.001). Non-UEHS among PLWD doubles the likelihood of experiencing severe NPDR with CSME compared with UEHS among PLWD [aOR(95 %CI) = 2.05(1.03-4.08)]. Meanwhile, the prevalence of DR among patients per non-UEHS was insignificantly higher [12 %; aPR(95 %CI) = 0.89-1.41)] compared with patients who utilized eye care health service. CONCLUSIONS Most of the PLWD did not utilize the eye health service even once in a year and that was highly influenced by type of diabetes and increasing age. Type 2 diabetes patients and middle age decreased the likelihood of UEHS. There was a negative relationship between DR and UEHS among PLWD and this doubled the likelihood of experiencing severe NPDR with CSME. Structured health education and screening interventions are key to improving UEHS.
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Affiliation(s)
- Bridgid Akrofi
- Eye Clinic of National Diabetes Management and Research Centre, Korle-Bu Teaching Hospital, Accra, Ghana
| | - John Tetteh
- Department of Community Health, College of Health Sciences, University of Ghana Medical School, University of Ghana, Accra, Ghana.
| | - Kwesi N Amissah-Arthur
- Department of Surgery (Eye), College of Health Sciences, University of Ghana Medical School, University of Ghana, Accra, Ghana.,Eye clinic department, Korle-Bu Teaching Hospital, Accra, Ghana
| | | | - Alfred Yawson
- Department of Community Health, College of Health Sciences, University of Ghana Medical School, University of Ghana, Accra, Ghana
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Petry N, Rohner F, Phall MC, Jallow B, Ceesay AA, Sawo Y, Darboe MK, Barrow S, Sarr A, Ceesay PO, Fofana MN, Prentice AM, Wegmüller R, Wirth JP. Prevalence and co-existence of cardiometabolic risk factors and associations with nutrition-related and socioeconomic indicators in a national sample of Gambian women. Sci Rep 2021; 11:12057. [PMID: 34103653 PMCID: PMC8187481 DOI: 10.1038/s41598-021-91592-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 05/11/2021] [Indexed: 01/25/2023] Open
Abstract
Cardiovascular diseases (CVD) are on the rise in Sub-Saharan Africa, and a large proportion of the adult population is thought to suffer from at least one cardiometabolic risk factor. This study assessed cardiometabolic risk factors and the contribution of nutrition-related indicators in Gambian women. The prevalence and co-existence of diabetes (elevated glycated hemoglobin (HbA1c ≥ 6.5%) or prediabetes (HbA1c ≥ 5.7% to < 6.5%), hypertension (systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg), obesity (body mass index (BMI) ≥ 30.0) and inflammation (C-reactive protein (CRP) > 3 mg/L or alpha-1-acid glycoprotein (AGP) > 1 g/L) and the contribution of nutrition related and socioeconomic indicators were measured in non-pregnant women 15-49 years of age in the Gambia using data from a nationally representative cross-sectional stratified survey. Nationally, 54.5% (95% CI: 47.4, 61.4) of 1407 women had elevated HbA1c. Of these, 14.9% were diabetic and 85.1% were prediabetic. Moreover, 20.8% (95% CI 17.8, 20.0) of 1685 women had hypertension, 11.1% (95% CI 9.0, 13.7) of 1651 were obese and 17.2% (95% CI 5.1, 19.6) of 1401 had inflammation. At least one of the aforementioned cardiometabolic risk factor was present in 68.3% (95% CI 63.0, 73.1) of women. Obesity increased the risk of hypertension (aRR 1.84; 95% CI 1.40, 2.41), diabetes (aRR 1.91; 95% CI 1.29, 2.84), elevated HbA1c (aRR 1.31; 95% CI 1.14, 1.51) and inflammation (aRR 3.47; 95% CI 2.61, 4.61). Inflammation increased the risk of hypertension (aRR 1.42; 95% CI 1.14, 1.78). Aging increased the risk of hypertension, obesity and inflammation. Further, inadequate sanitation increased the risk for diabetes (aRR 1.65; 95% CI 1.17, 2.34) and iron deficiency increased the risk of elevated HbA1c (aRR 1.21; 95% CI 1.09, 1.33). The high prevalence of cardiometabolic risk factors and their co-existence in Gambian women is concerning. Although controlling obesity seems to be key, multifaceted strategies to tackle the risk factors separately are warranted to reduce the prevalence or minimize the risk of CVD.
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Affiliation(s)
| | | | | | | | | | | | - Momodou K Darboe
- Medical Research Council Unit the Gambia at London, School of Hygiene and Tropical Medicine, Atlantic Boulevard, Fajara, Banjul, The Gambia
| | | | | | | | | | - Andrew M Prentice
- Medical Research Council Unit the Gambia at London, School of Hygiene and Tropical Medicine, Atlantic Boulevard, Fajara, Banjul, The Gambia
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Okaiyeto K, Oguntibeju OO. Trends in diabetes research outputs in South Africa over 30 years from 2010 to 2019: A bibliometric analysis. Saudi J Biol Sci 2021; 28:2914-2924. [PMID: 34025169 PMCID: PMC8117024 DOI: 10.1016/j.sjbs.2021.02.025] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 01/05/2021] [Accepted: 02/04/2021] [Indexed: 11/25/2022] Open
Abstract
Diabetes mellitus (DM) is one of the leading causes of mortality in South Africa, which is impelled by people's consumption of unhealthy diets and lifestyles, negligence about an individual's health status, and increased urbanization. DM can be linked to several human diseases and thus, making it an important public health issue in the South African health sector. Therefore, it is necessary to assess the level of research that has been conducted in the country on diabetes, in a quest for solutions against the deadly disease. Hence, the present study aimed to map diabetes-related research in South Africa from 2010 to 2019. Data on the subject was retrieved from the Web of Science Core Collection (WoSCC) and bibliometrix package in Rstudio statistical software was used to analyze the data while VOSviewer was explored for data visualization networks. Our analysis revealed that the annual growth rate of publication trends was 23.2%. The authors per document were 23.3 with a collaboration index of 23.4. From the 416 articles analyzed, Islam MS (n = 34) was the most prolific author and the top active institution was University of KwaZulu-Natal (n = 165) and the top journal was Diabetes Research and Clinical Practice (n = 20). Findings from this study reveal that the quantity of research on diabetes has significantly increased over the decade, and the outcomes of this scientific progress can guide future research and substantially provide the basic needs for improving management procedures for diabetes in the country.
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Affiliation(s)
- Kunle Okaiyeto
- Phytomedicine and Phytochemistry Group, Oxidative Stress Research Centre, Department of Biomedical Sciences, Faculty of Health and Wellness Sciences, Cape Peninsula University of Technology, Bellville 7535, South Africa
| | - Oluwafemi Omoniyi Oguntibeju
- Phytomedicine and Phytochemistry Group, Oxidative Stress Research Centre, Department of Biomedical Sciences, Faculty of Health and Wellness Sciences, Cape Peninsula University of Technology, Bellville 7535, South Africa
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Byberg S, Bundesen C, Rudolf F, Haraldsdottir TL, Indjai L, Barai R, Beck-Nielsen H, Sodemann M, Jensen DM, Bjerregaard-Andersen M. Diabetes in urban Guinea-Bissau; patient characteristics, mortality and prevalence of undiagnosed dysglycemia. Glob Health Action 2021; 13:1802136. [PMID: 32814520 PMCID: PMC7480585 DOI: 10.1080/16549716.2020.1802136] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Background The burden of diabetes mellitus in Sub-Saharan Africa is growing rapidly, and yet the prevalence and patient characteristics are still largely unknown. Objectives We analyzed clinical and demographic characteristics of Type 2 diabetes (T2DM) patients attending a diabetes clinic in Guinea-Bissau from February 2008 to April 2014, and estimated the prevalence and risk factors of unknown-impaired fasting plasma glucose (FPG) and diabetes, as well as excess mortality associated with T2DM. Methods We characterized T2DM patients attending the national diabetes clinic in Bissau. Diabetes was diagnosed based on FPG. We matched T2DM patients 1:1 with non-diabetes community controls on age and sex to determine relevant risk factors for T2DM using logistic regression. Furthermore, we matched patients 1:6 with community controls to assess long-term survival (until February 2019) in a Cox regression using calendar time as the underlying timescale. Verbal autopsies determined the cause of death among T2DM patients and controls. Results The mean age among T2DM was 50.6 (SD 11.1), and the mean FPG at first consultation was high (13.2 mmol/L (SD 5.1)). Ethnicity, family history of diabetes, hypertension, and anthropometrics differed among T2DM patients, community controls with impaired FPG, and healthy controls. Family history of diabetes (OR = 5.65, 95% CI: 3.10–10.3) and elevated waist circumference (2.33, 1.26–4.29) were significant risk factors for T2DM. 20.4% (59/289) of community controls had abnormal FPG. T2DM patients had an excess mortality hazard ratio of 3.53 (95%CI: 1.92–6.52). Deaths caused by bacterial infections, including foot ulcers, were more common among T2DM patients, compared with community controls (54% (7/13) vs. 19% (5/27) (P = 0.02)). Conclusion Several risk factors including were associated with T2DM in Guinea-Bissau. We found a high prevalence of elevated FPG among randomly selected community controls. In combination with higher mortality among T2DM patients, an urgent need for better treatment options and increased awareness.
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Affiliation(s)
- Stine Byberg
- Bandim Health Project, INDEPTH Network , Bissau, Guinea-Bissau.,Research Center for Vitamins and Vaccines (CVIVA), Statens Serum Institute , Copenhagen, Denmark.,Department of Clinical Epidemiology, Steno Diabetes Center Copenhagen , Gentofte, Denmark
| | - Camilla Bundesen
- Bandim Health Project, INDEPTH Network , Bissau, Guinea-Bissau.,Department of Infectious Diseases, Odense University Hospital , Odense, Denmark
| | - Frauke Rudolf
- Bandim Health Project, INDEPTH Network , Bissau, Guinea-Bissau.,Department of Infectious Diseases, Aarhus University Hospital Skejby , Aarhus, Denmark
| | - Thorny Linda Haraldsdottir
- Bandim Health Project, INDEPTH Network , Bissau, Guinea-Bissau.,Department of Infectious Diseases, Aarhus University Hospital Skejby , Aarhus, Denmark
| | - Lamine Indjai
- The Diabetes Clinic, The National Diabetes Association (ANDD) , Bissau, Guinea-Bissau
| | - Rui Barai
- The Diabetes Clinic, The National Diabetes Association (ANDD) , Bissau, Guinea-Bissau
| | | | - Morten Sodemann
- Bandim Health Project, INDEPTH Network , Bissau, Guinea-Bissau.,Department of Infectious Diseases, Odense University Hospital , Odense, Denmark
| | - Dorte Møller Jensen
- Steno Diabetes Center Odense, Odense University Hospital , Odense, Denmark.,Department of Gynecology and Obstetrics, Odense University Hospital , Odense, Denmark
| | - Morten Bjerregaard-Andersen
- Bandim Health Project, INDEPTH Network , Bissau, Guinea-Bissau.,Research Center for Vitamins and Vaccines (CVIVA), Statens Serum Institute , Copenhagen, Denmark.,Steno Diabetes Center Odense, Odense University Hospital , Odense, Denmark.,Department of Endocrinology, Hospital of Southwest Denmark , Esbjerg, Denmark
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Adam HMI, Elmosaad YM, Ahmed AEE, Khan A, Mahmud I. Dietary knowledge, attitude and practice among type 2 diabetes mellitus patients in Sudan: a hospital-based cross-sectional study. Afr Health Sci 2021; 21:32-40. [PMID: 34394278 PMCID: PMC8356582 DOI: 10.4314/ahs.v21i1.6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background In Sudan, the prevalence of diabetes in adults was estimated at 19.1% in 2015. This study assessed dietary knowledge, attitude, and practices (KAP) of type 2 diabetes mellitus (T2DM) patients in Sudan. Methods We randomly selected 238 T2DM patients from a list of 2460 patients from the Jabber Abulizz Hospital. We interviewed them face-to-face using a structured questionnaire. Multivariate logistic regression analyses were performed to investigate the determinants of KAP regarding the recommended diets for T2DM patients. Results Majority of the patients demonstrated good knowledge (54.6%), positive attitude (79%); and good practice (58%). The result revealed that patients with formal education had 3.0 (95% CI: 1.6–5.7) times higher odds of having good diabetic dietary knowledge than those with informal education. While patients who had good knowledge and a positive attitude were respectively 4.7 (95% CI: 2.4–8.9) and 3.2 (95% CI: 1.5–6.7) times more likely to follow dietary recommendations than the patients with poor knowledge and negative attitudes. Conclusion Irrespective of the socio-demographic position, the good knowledge and the positive attitude towards the recommended diet, all the T2DM patients complied with the dietary recommendations. These findings highlight the need for improving knowledge and promoting positive attitudes towards the recommended diet among T2DM patients.
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Affiliation(s)
- Halla Mahagoub Idrees Adam
- Department of Health Education, Faculty of Public and Environmental Health, University of Khartoum, Khartoum, Sudan
| | | | - Abd Elbasit Elawad Ahmed
- Department of Health Education, Faculty of Public and Environmental Health, University of Khartoum, Khartoum, Sudan
| | - Asif Khan
- Department of Public Health, College of Public Health and Health Informatics, Qassim University, Bukayriyah, Qassim, Saudia Arabia
| | - Ilias Mahmud
- Department of Public Health, College of Public Health and Health Informatics, Qassim University, Bukayriyah, Qassim, Saudia Arabia
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Gebabo TF, Zewdie TH, Shagaro SS, Haile F. Determinants of peripheral neuropathy among diabetic patients under follow-up in chronic care clinics of public hospitals at Gamo and Gofa zones, southern Ethiopia. PLoS One 2021; 16:e0246722. [PMID: 33592011 PMCID: PMC7886204 DOI: 10.1371/journal.pone.0246722] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 01/25/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Peripheral neuropathy is a leading cause of morbidity and increased mortality among diabetic patients. It is characterized by significant deficits in vibration and tactile sensation. With an annual incidence of 2%, it affects as many as 110 million people worldwide. The aim of this study was to assess factors associated with peripheral neuropathy among diabetic patients in chronic care clinic in Gamo and Gofa zone, South Ethiopia. METHODS An institution- based unmatched case control study was employed among 528 randomly selected participants using a pre-tested, interviewer-administered, and structured questionnaire. Bivariate and multivariable logistic regression analysis was conducted to identifiy determinants of peripheral neuropathy using IBM SPSS version 25. RESULT The odds of being an urban dweller was 2.67 times higher among cases than controls [AOR = 2.67 (1.27, 5.63)]. The likelihood of fasting blood glucose level between 203 and 282 and 282 and above was 2.55 and 3.88 times higher among cases than controls [AOR = 2.55 (1.91, 7.16)] and [AOR = 3.88 (1.42, 10.60)] respectively. The probability of living with diabetes mellitus for 10 and more years was 3.88 times higher among cases than controls [AOR = 3.88 (1.42, 10.60)]. The odds of controlling glucose level after developing symptom was 5.33 times higher among cases than controls [AOR = 5.33 (1.28, 12.24)]. The probability of having high blood pressure was 2.36 times higher among cases than controls [AOR = 2.36 (1.26, 4.43)]. The likelihood of having a family history of complication from diabetes mellitus was 5.60 times higher among cases than controls [AOR = 5.60 (2.03, 15.43)]. The odds of exercising 3 times per week for 15 to 30 minutes and for less than 15 minutes were 2.96 and 4.92 times higher among cases than controls respectively [AOR = 2.96 (1.32, 6.61)] and AOR = 4.92, 95% CI (1.85, 13.04) respectively. The likelihood of having a waist circumference greater than or equal to 40 inch was 2.72 times higher among cases than controls [AOR = 2.72 (1.07, 6.94)]. CONCLUSION This study showed that residence, duration of diabetic mellitus, family history of complication from diabetic mellitus, level of fasting blood glucose, method of glycemic control, having a high blood pressure/hypertension/, frequency and duration of physical activity and waist circumference were found to be determinants of peripheral neuropathy. Thus, the concerned health authorities and health professionals should target on these factors in their efforts to prevent peripheral neuropathy among diabetics in the study area.
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Affiliation(s)
- Teshale Fikadu Gebabo
- School of Public Health, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
| | - Tadiwos Hailu Zewdie
- School of Medicine, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
| | - Sewunet Sako Shagaro
- School of Public Health, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
| | - Firehiwot Haile
- School of Public Health, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
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Gonfa FT, Lemu YK, Koricha ZB. Predictors of Women's awareness of common non-communicable diseases screening during preconception period in Manna District, Southwest Ethiopia: implication for wellness check-up. BMC Health Serv Res 2021; 21:56. [PMID: 33435962 PMCID: PMC7802272 DOI: 10.1186/s12913-021-06067-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 01/07/2021] [Indexed: 12/11/2022] Open
Abstract
Background Non-communicable diseases (NCDs) are the dominant cause of global morbidity and mortality, especially in developing countries. Tackling NCDs is central to advancing women’s and child health, and future generations. Many NCDs can be prevented with appropriate approaches across the maternal and child health life-cycle, throughout the years of reproductive age especially before conception and continuing through pregnancy. However, women’s awareness of NCDs screening during the preconception period was not well known in many countries including Ethiopia. Therefore, this study aimed to assess women’s awareness of common NCDs screening during the preconception period and associated factors in Manna District, Jimma Zone, Oromia Region, Ethiopia, 2019. Methods A community-based cross-sectional study was conducted from March 02 to April 10, 2019. The sample size was 636 pregnant women from eight randomly selected rural kebeles and a purposively taken urban kebele. The data were collected using a pre-tested structured questionnaire and entered into Epi data manager version 4.0.2 and exported to SPSS version 21. Descriptive, binary, and multivariable logistic regression analyses were carried out. Results Of the total of 623 respondents, 459 (73.7%) of them had good awareness of common NCDs screening during the preconception period. Women who had formal education [AOR = 1.95, 95% CI: (1.31–2.89)], those who had planned pregnancy [AOR = 2.17, 95% CI: (1.47–3.19)], on ANC follow up [AOR = 1.79, 95% CI: (1.16–2.74], and those who had media (radio and/or television) in their house [AOR = 1.55, 95% CI: (1.05–2.29)] had good awareness on common NCDs screening during the preconception period compared to their counterparts. Conclusions In this study, nearly three-quarters of respondents had a good awareness of common NCDs screening during the preconception period. Women’s educational status, pregnancy planning status, ANC visit, and having radio and/or television in the house were predictors of women’s good awareness of common NCDs screening during the preconception period. Therefore, all concerned bodies are recommended to work toward increasing women’s awareness using different approaches like awareness creation campaigns and counseling clients attending health facilities.
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Affiliation(s)
- Firanbon Teshome Gonfa
- Department of Health, Behavior, and Society, Faculty of Public Health, Jimma University, Jimma, Ethiopia.
| | - Yohannes Kebede Lemu
- Department of Health, Behavior, and Society, Faculty of Public Health, Jimma University, Jimma, Ethiopia
| | - Zewdie Birhanu Koricha
- Department of Health, Behavior, and Society, Faculty of Public Health, Jimma University, Jimma, Ethiopia
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Cock IE, Ndlovu N, Van Vuuren SF. The use of South African botanical species for the control of blood sugar. JOURNAL OF ETHNOPHARMACOLOGY 2021; 264:113234. [PMID: 32768640 DOI: 10.1016/j.jep.2020.113234] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 07/07/2020] [Accepted: 07/29/2020] [Indexed: 06/11/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Diabetes mellitus (DM) is one of the most prevalent diseases globally and is of considerable concern to global health. Approximately 425 million people are estimated to have DM globally and this is predicted to increase to >642 million by 2040. Whilst the prevalence of DM in South Africa is slightly lower than the global average, it is expected to rise rapidly in future years as more South Africans adopt a high calorie "westernised" diet. Traditional medicines offer an alternative for the development of new medicines to treat DM and the usage of South African plants is relatively well documented. AIM OF THE STUDY To critically review the literature on the anti-diabetic properties of South African plants and to document plant species used for the treatment of DM. Thereafter, a thorough examination of the related research will highlight where research is lacking in the field. MATERIALS AND METHODS A review of published ethnobotanical books, reviews and primary scientific studies was undertaken to identify plants used to treat DM in traditional South African healing systems and to identify gaps in the published research. The study was non-biased, without taxonomic preference and included both native and introduced species. To be included, species must be recorded in the pharmacopeia of at least one South African ethnic group for the treatment of DM. RESULTS One hundred and thirty-seven species are recorded as therapies for DM, with leaves and roots most commonly used. The activity of only 43 of these species have been verified by rigorous testing, and relatively few studies have examined the mechanism of action. CONCLUSION Despite relatively extensive ethnobotanical records and a diverse flora, the anti-diabetic properties of South African medicinal plants is relatively poorly explored. The efficacy of most plants used traditionally to treat DM are yet to be verified and few mechanistic studies are available. Further research is required in this field.
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Affiliation(s)
- I E Cock
- School of Environment and Science, Nathan Campus, Griffith University, 170 Kessels Rd, Nathan, Queensland, 4111, Australia; Environmental Futures Research Institute, Nathan Campus, Griffith University, 170 Kessels Rd, Nathan, Queensland, 4111, Australia
| | - N Ndlovu
- Department of Pharmacy and Pharmacology, Faculty of Health Sciences, University of the Witwatersrand, Parktown, Gauteng, 2193, South Africa
| | - S F Van Vuuren
- Department of Pharmacy and Pharmacology, Faculty of Health Sciences, University of the Witwatersrand, Parktown, Gauteng, 2193, South Africa.
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Managa MG, Shai J, Thi Phan AD, Sultanbawa Y, Sivakumar D. Impact of Household Cooking Techniques on African Nightshade and Chinese Cabbage on Phenolic Compounds, Antinutrients, in vitro Antioxidant, and β-Glucosidase Activity. Front Nutr 2021; 7:580550. [PMID: 33409289 PMCID: PMC7779405 DOI: 10.3389/fnut.2020.580550] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 11/10/2020] [Indexed: 11/13/2022] Open
Abstract
Different household cooking techniques (boiling, steaming, stir frying, and microwave) were tested on the changes of targeted phenolic compounds, antioxidant property (ferric reducing-antioxidant power (FRAP) activity), α-glucosidase activity, antinutritive compounds, and sensory properties in commonly consumed traditional leafy vegetables in Southern Africa, the non-heading Chinese cabbage (Brassica rapa L. subsp. chinensis) and African nightshade (Solanum retroflexum Dun). Stir frying increased kaempferol-3-O-hydroxyferuloyl-trihexoside, kaempferol-dihexoside, sinapoyl malate, rutin, and isorhamnetin-O-dihexoside in Chinese cabbage leaves, followed by steaming. Similarly, stir frying increased kaempferol-3-O-rutinoside, chlorogenic acid, caffeoylmalic acid, and quercetin-3-O-xylosyl-rutinoside in nightshade, followed by steaming. Biomarkers, sinapoyl malate (Chinese cabbage) and caffeoylmalic acid (nightshade), separated the stir frying from the other cooking techniques. Steaming and stir-frying techniques significantly increased the FRAP activity; whereas boiling and microwaving reduced the tannin, oxalate, and phytate contents in both leafy vegetables and steroidal saponins in nightshade. Stir-fried nightshade leaf extract showed the most effective inhibition against α-glucosidase activity, with an IC50 of 26.4 μg ml-1, which was higher than acarbose, a synthetic compound (positive control; IC50 69.83 μg ml-1). Sensory panelists preferred the stir-fried Chinese cabbage and nightshade leaves, followed by steamed, microwaved, and boiled vegetables.
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Affiliation(s)
- Millicent G Managa
- Phytochemical Food Network Research Group, Department of Crop Sciences, Tshwane University of Technology, Pretoria, South Africa
| | - Jerry Shai
- Department of Biomedical Sciences, Tshwane University of Technology, Pretoria, South Africa
| | - Anh Dao Thi Phan
- Agricultural Research Council Industrial Transformation Training Centre for Uniquely Australian Foods, Queensland Alliance for Agriculture and Food Innovation, The University of Queensland, Brisbane, QLD, Australia
| | - Yasmina Sultanbawa
- Agricultural Research Council Industrial Transformation Training Centre for Uniquely Australian Foods, Queensland Alliance for Agriculture and Food Innovation, The University of Queensland, Brisbane, QLD, Australia
| | - Dharini Sivakumar
- Phytochemical Food Network Research Group, Department of Crop Sciences, Tshwane University of Technology, Pretoria, South Africa.,Agricultural Research Council Industrial Transformation Training Centre for Uniquely Australian Foods, Queensland Alliance for Agriculture and Food Innovation, The University of Queensland, Brisbane, QLD, Australia
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Mtshali S, Mahomed O. Prevalence, Patient Predictors, and Referral Patterns for Diabetes-Related Complications Treated at a Central Hospital in KwaZulu Natal. Diabetes Metab Syndr Obes 2021; 14:4181-4188. [PMID: 34675570 PMCID: PMC8504864 DOI: 10.2147/dmso.s320652] [Citation(s) in RCA: 3] [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: 05/19/2021] [Accepted: 07/17/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Poor diabetes control can result in short- and long-term neuropathic, microvascular, and macrovascular complications. In addition to the socioeconomic impact that diabetes and its complications has on patients, incremental financial costs are added to health-care systems. This study aimed to assess prevalence, patient-related factors, and referral patterns for patients with diabetes-related complications managed at Inkosi Albert Luthuli Central Hospital (IALCH) betweenJanuary 1, 2014 and December 31, 2015. METHODS The retrospective cross-sectional study was done on all adult patients (aged >18 years) with diabetes consulted at IALCH. Primary outcome measures were the proportion with diabetes-related complications and the source of referrals. Logistic regression analysis was done to identify predictors of diabetes complications. RESULTS Of all adult diabetes patients consulted, 7,761 (47.4%) presented with one or more diabetes-related complications and 56% (4,321) had experienced macrovascular complications. Cardiovascular complications (2,576, 33%) were the most common complications, followed by peripheral vascular disease (1,755, 23%). Microvascular complications included retinopathy (1,656, 21%), nephropathy (118, 14%), and neuropathy (702, 9%). After multivariate analysis, all four factors (age >58 years, male sex, Indian ancestry, and non-insulin dependent diabetes mellitus remained statistically significant for an increased likelihood of developing cardiovascular complications. Indian ancestry was not associated with increased odds of peripheral vascular disease. CONCLUSION Macrovascular diseases were the main complications. Older age, male sex, Indian ancestry, and non-insulin dependent diabetes mellitus were associated with macrovascular complications. A combination of health-promotion and behaviour-modification programs is required prior to or early in the disease course. Appropriate and more aggressive management at primary-care level using evidence-based clinical guidelines is essential to prevent complications.
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Affiliation(s)
- Sifiso Mtshali
- Discipline of Public Health Medicine, University of KwaZulu Natal, Durban, South Africa
- Correspondence: Sifiso Mtshali Discipline of Public Health Medicine, University of KwaZulu Natal, 227 George Campbell Building, Howard College Campus, Durban4001, South AfricaTel +27-31 260-4382Fax +2731 2604111 Email
| | - Ozayr Mahomed
- Discipline of Public Health Medicine, University of KwaZulu Natal, Durban, South Africa
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Timm L, Harcke K, Karlsson I, Sidney Annerstedt K, Alvesson HM, Stattin NS, Forsberg BC, Östenson CG, Daivadanam M. Early detection of type 2 diabetes in socioeconomically disadvantaged areas in Stockholm - comparing reach of community and facility-based screening. Glob Health Action 2020; 13:1795439. [PMID: 32746747 PMCID: PMC7480601 DOI: 10.1080/16549716.2020.1795439] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 07/07/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Type 2 diabetes and its high-risk stage, prediabetes, are often undiagnosed. Early detection of these conditions is of importance to avoid organ complications due to the metabolic disturbances associated with diabetes. Diabetes screening can detect persons unaware of diabetes risk and the elevated glucose levels can potentially be reversed through lifestyle modification and medication. There are mainly two approaches to diabetes screening: opportunistic facility-based screening at health facilities and community screening. OBJECTIVE To determine the difference in population reach and participant characteristics between community- and facility-based screening for detection of type 2 diabetes and persons at high risk of developing diabetes. METHODS Finnish diabetes risk score (FINDRISC) is a risk assessment tool used by two diabetes projects to conduct community- and facility-based screenings in disadvantaged suburbs of Stockholm. In this study, descriptive and limited inferential statistics were carried out analyzing data from 2,564 FINDRISC forms from four study areas. Community- and facility-based screening was compared in terms of participant characteristics and with population data from the respective areas to determine their reach. RESULTS Our study found that persons born in Africa and Asia were reached through community screening to a higher extent than with facility-based screening, while persons born in Sweden and other European countries were reached more often by facility-based screening. Also, younger persons were reached more frequently through community screening compared with facility-based screening. Both types of screening reached more women than men. CONCLUSION Community-based screening and facility-based screening were complementary methods in reaching different population groups at high risk of developing type 2 diabetes. Community screening in particular reached more hard-to-reach groups with unfavorable risk profiles, making it a critical strategy for T2D prevention. More men should be recruited to intervention studies and screening initiatives to achieve a gender balance.
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Affiliation(s)
- Linda Timm
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Katri Harcke
- Academic Primary Health Care Centre, Region Stockholm, Stockholm, Sweden
| | - Ida Karlsson
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | | | | | - Nouha Saleh Stattin
- Academic Primary Health Care Centre, Region Stockholm, Stockholm, Sweden
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Birger C Forsberg
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Claes-Göran Östenson
- Department of Molecular Medicine and Surgery, Endocrine and Diabetes Unit, Karolinska Institutet, Karolinska University Hospital, Solna, Sweden
| | - Meena Daivadanam
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
- International Maternal and Child Health Division, Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
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Assessment of Absorption of Glycated Nail Proteins in Patients with Diabetes Mellitus and Diabetic Retinopathy. ACTA ACUST UNITED AC 2020; 56:medicina56120658. [PMID: 33260342 PMCID: PMC7760767 DOI: 10.3390/medicina56120658] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 11/17/2020] [Accepted: 11/27/2020] [Indexed: 12/12/2022]
Abstract
Background and objectives: Glycation occurs in a variety of human tissues and organs. Knowledge about the relationship between predictive biochemical factors such as absorption of glycated nail proteins and severity of type 2 diabetes mellitus (DM) and diabetic retinopathy (DR) remains limited. Materials and Methods: The study group consisted of patients with type 2 DM and DR (n = 32) and a control group (n = 28). Each patient underwent a comprehensive ophthalmic examination. The glycation process in nail clippings was evaluated in stages of in vitro glycation and deglycation stages. ATR–FTIR spectroscopy was used to calculate the infrared absorption in the region of interest. The absorption of solutions with nail clippings was evaluated by NanoDrop spectrophotometry. Absorption spectra differences before and after the exposure to fructosamine 3-kinase were compared between DM patients with DR and the control group. Results: The absorption of glycated nail protein greater than 83.00% increased the chance of developing DM and DR (OR = 15.909, 95% CI 3.914–64.660, p < 0.001). Absorption of glycated nail protein by ATR–FTIR spectroscopy in patients with DM and DR in vitro glycation was statistically significantly higher than in the control group; also absorption of solution with nails by NanoDrop spectroscopy was statistically significantly higher than in controls in vitro glycation and in vitro deglycation. After exposure to fructosamine 3-kinase, absorption of nail protein in DM + severe/proliferative DR group was statistically significantly lower in comparison with DM + mild/moderate group DR. Conclusions: Evaluation of glycated nail protein could be applied to evaluate the risk of having DM and for long-term observation of DM control.
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Knowledge, attitude, and practice towards self-management among diabetic patients at Debre Tabor General Hospital chronic diseases follow-up clinic, Northwest Ethiopia. Int J Diabetes Dev Ctries 2020. [DOI: 10.1007/s13410-020-00896-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
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Simo N, Kuate-Tegueu C, Ngankou-Tchankeu S, Doumbe J, Maiga Y, Cesari M, Dartigues JF, Kengne AP, Tabue-Teguo M. Correlates of diabetic polyneuropathy of the elderly in Sub-Saharan Africa. PLoS One 2020; 15:e0240602. [PMID: 33119646 PMCID: PMC7595408 DOI: 10.1371/journal.pone.0240602] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 09/29/2020] [Indexed: 02/02/2023] Open
Abstract
Background Diabetic polyneuropathy is associated with significant physical disability among older adults. However, their frequency and correlates are not well known in the older adults in Sub-Saharan-Africa. The objectives were to evaluate the hospital-based prevalence of diabetic polyneuropathy and identify its correlates in older adults. Methods Over a period of 5 months, a cross-sectional survey was carried out at Douala Laquintinie Hospital (DLH), a main reference hospital in Douala, the economic capital of Cameroon. Participants in our study group comprised all patients with type 2 diabetes, whatever the reason for their reporting to the hospital. Diabetic Polyneuropathy was defined according to a Diabetic Neuropathy Examination score > 3/16. Results A total of 159 older adults with diabetes were examined during this recruitment period, among whom 106 (66.7%) were women. The mean age was 68.3 ± 6.5 years. Diabetes median duration was 108 months. For all patients assessed using the Diabetic Neuropathy Examination score, polyneuropathy was reported in 31.4%; among them, polyneuropathy proved symptomatic in 78% of them. Correlates of polyneuropathy were glycated hemoglobin (p = 0.049), HIV infection (p = 0.031) and albuminuria (p< 0.001), even after adjustment for age, gender and duration of diabetes. Conclusion A third of older adults with diabetes who visited our hospital were diagnosed with prevalent diabetes-related polyneuropathy. It shows that early detection is required through routine screening and regular follow-up examinations in order to reduce the risk of disability and improve the quality of life in elderly diabetics.
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Affiliation(s)
- Nadine Simo
- CHU de Guadeloupe, Equipe LAMIA, Université des Antilles, Fouillole, Guadeloupe
| | - Callixte Kuate-Tegueu
- Faculty of Medicine and Biomedical Sciences, The University of Yaoundé 1, Yaounde, Cameroon
| | - Steve Ngankou-Tchankeu
- Institut Supérieur des Sciences de la Santé, Université des Montagnes, Bangangté, Cameroun
| | - Jacques Doumbe
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Youssoufa Maiga
- Service de Neurologie, Hôpital Gabriel Toure (CHU), Bamako, Mali
| | - Matteo Cesari
- Geriatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milano, Italy
| | | | - Andre-Pascal Kengne
- South African Medical Research Council of South Africa, Cape Town, South Africa
| | - Maturin Tabue-Teguo
- CHU de Guadeloupe, Equipe LAMIA, Université des Antilles, Fouillole, Guadeloupe
- INSERM U 1219, Université de Bordeaux, Bordeaux, France
- * E-mail:
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Naville R, Subtil F, Sy M, Marquis M, Costes P, Letrilliart L. Scope of health problems managed by general practitioners in Mali and France: awaiting practice transition in sub-Saharan Africa? Fam Pract 2020; 37:668-674. [PMID: 32531028 DOI: 10.1093/fampra/cmaa035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Minimal data are available on the clinical activity of general practitioners (GPs) in Africa. OBJECTIVE To describe the health problems managed by GPs in Mali as compared with France where epidemiological transition is already advanced. METHODS A retrospective, multicenter study, conducted in five Malian Community Health Centers. We compared their consultation data to those of the ECOGEN (Eléments de la COnsultation en médecine GENérale) study conducted in 128 French general practices, after data standardization for age and sex. RESULTS Malian and French databases included 19 068 and 19 341 consultations, respectively. Patients had an average of 1.2 health problems managed per consultation in Mali, versus 2.2 in France. They were dominated by infections (51.3%) in Mali, including malaria (24.9%), pneumonia (9.0%) and gastrointestinal infections (5.0%). In comparison with French GPs, Malian GPs more frequently managed cardiovascular (20.2% versus 13.5%), respiratory (15.0% versus 12.4%) and digestive (13.3% versus 7.8%) problems, and less frequently musculoskeletal (3.1% versus 12.6%), endocrine/metabolic (1.5% versus 10.7%) and psychological (0.2% versus 8.2%) problems. The main activity performed by French GPs was prevention (11.0%), which was nominal in Mali. Apart from hypertension, which accounted for 18.9% of the health problems managed in Mali, chronic conditions were less often managed by Malian GPs than by French GPs (12.3% versus 39.6%). CONCLUSIONS Africa is currently at the crossroads where chronic conditions carried with the epidemiological transition are progressing, while the burden of communicable diseases is still overwhelming. Along with the enhancing medicalization of primary care in Mali, the transition of practices is just emerging.
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Affiliation(s)
- Raphaël Naville
- Collège universitaire de médecine générale, Université Claude Bernard Lyon 1, Univ. Lyon, Lyon, France
| | - Fabien Subtil
- Service de Biostatistique-Bioinformatique, Hospices Civils de Lyon, Lyon, France
| | | | - Michel Marquis
- Agence régionale de santé Auvergne-Rhône-Alpes, Direction de la Santé Publique, Lyon, France
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Moloto MR, Phan ADT, Shai JL, Sultanbawa Y, Sivakumar D. Comparison of Phenolic Compounds, Carotenoids, Amino Acid Composition, In Vitro Antioxidant and Anti-Diabetic Activities in the Leaves of Seven Cowpea ( Vigna unguiculata) Cultivars. Foods 2020; 9:foods9091285. [PMID: 32932725 PMCID: PMC7554895 DOI: 10.3390/foods9091285] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 09/04/2020] [Accepted: 09/05/2020] [Indexed: 02/06/2023] Open
Abstract
Cowpea is a well-known nutrition rich African leafy vegetable that has potential to sustain food and nutrition insecurity in sub-Saharan Africa. Consumption of cowpea legumes is associated with reduced risk of type 2 diabetes mellitus. Therefore, the present study was designed to evaluate the (i) variation in phenolic metabolites in seven cowpea cultivars (VOP1, VOP2, VOP3, VOP4, VOP5, VOP7, and VOP8 using UHPLC coupled with high resolution Q-TOF-MS technique, (ii) in vitro antioxidant activity using ferric reducing/antioxidant capacity (FRAP) assay (iii) in vitro anti-diabetic effects and (iv) composition of carotenoids and amino acids of theses cowpea cultivars. The results of this study demonstrated that gentisic acid 5-O-glucoside, quercetin 3-(2G-xylosylrutinoside) and Quercetin 3-glucosyl-(1->2)-galactoside were highest in VOP1 VOP4 and VOP5, respectively. High inhibition (>50%) of α-glucosidase and α-amylase activities was shown by the leaf extracts (50 and 25 mg/mL) of VOP1 and VOP4. Cowpea cultivars VOP1 and VOP4 demonstrated the highest gene expression levels of regulation of glucose transporter GLUT4 in C2C12 skeletal muscle cells, similar to insulin. A positive correlation exited between the phenolic components and the inhibitory effect of antidiabetic enzymes and FRAP activity. Cytotoxic effect was not detected in vitro in any cowpea cultivar. Lutein (124.6 mg/100 g) and all-trans-beta-carotene (92.6 mg/100 g) levels were highest in VOP2 and VOP1, respectively. Cowpea cultivars VOP3 and VOP4 showed potential to fulfil the daily requirements of essential amino acids. Thus, based on this information, cowpea (leaves) genotypes/cultivars can be selected and propagated for the further development of supplementary foods or functional food ingredients.
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Affiliation(s)
- Mapula R. Moloto
- Phytochemical Food Network Research Group, Department of Crop Sciences, Tshwane University of Technology, Pretoria West 0001, South Africa;
| | - Anh Dao T. Phan
- ARC Industrial Transformation Training Centre for Uniquely Australian Foods, Queensland Alliance for Agriculture and Food Innovation, The University of Queensland, St. Lucia, QLD 4108, Australia; (A.D.T.P.); (Y.S.)
| | - Jerry L. Shai
- Department of Biomedical Sciences, Tshwane University of Technology, Arcadia, Pretoria 0001, South Africa;
| | - Yasmina Sultanbawa
- ARC Industrial Transformation Training Centre for Uniquely Australian Foods, Queensland Alliance for Agriculture and Food Innovation, The University of Queensland, St. Lucia, QLD 4108, Australia; (A.D.T.P.); (Y.S.)
| | - Dharini Sivakumar
- Phytochemical Food Network Research Group, Department of Crop Sciences, Tshwane University of Technology, Pretoria West 0001, South Africa;
- ARC Industrial Transformation Training Centre for Uniquely Australian Foods, Queensland Alliance for Agriculture and Food Innovation, The University of Queensland, St. Lucia, QLD 4108, Australia; (A.D.T.P.); (Y.S.)
- Correspondence:
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