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High prevalence of non-communicable diseases and associated risk factors amongst adults living with HIV in Cambodia.

ABSTRACT: With rapid expansion of antiretroviral therapy for HIV, there are rising life expectancies among people living with HIV. As a result, co-morbidity from non-communicable diseases in those living and aging with HIV is increasingly being reported. Published data on this issue have been limited in Cambodia. The aim of this study was to determine the prevalence of diabetes mellitus, hypertension and hypercholesterolemia and associated risk factors in adults living with HIV in Cambodia.This cross-sectional study was conducted in five provinces of Cambodia from May-June 2015. Information was obtained on socio-demographic and clinical characteristics through face-to-face interviews using a structured questionnaire, and anthropometric and biochemical measurements were performed. Diabetes mellitus was diagnosed with fasting blood glucose ?126 mg/dl, hypertension with systolic blood pressure ?140 mmHg and/or diastolic blood pressure ? 90 mmHg and hypercholesterolemia with fasting blood cholesterol ?190 mg/dl. Multivariable logistic regression analyses were used to explore risk factors.The study sample included 510 adults living with HIV; 67% were female, with a mean age of 45 (standard deviation = 8) years. Of these, 8.8% had diabetes mellitus, 15.1% had hypertension and 34.7% had hypercholesterolemia. Of the total participants with non-communicable diseases (n = 244), 47.8% had one or more diseases, and 75% were not aware of their diseases prior to the study: new disease was diagnosed in 90% of diabetes mellitus, 44% of hypertension and 90% of hypercholesterolemia. Single disease occurred in 81%, dual disease in 17% and triple disease in 2%. In adjusted analyses, those consuming 1 serving of fruit compare to 2 servings as significantly with diabetes mellitus, those eating 1 serving of fruit compare to 2 servings and using lard for cooking were significantly associated with hypertension, and those being unemployed, having monthly income less than 100 USD and being underweighted were significantly associated with hypercholesterolemia.The prevalence of diabetes mellitus, hypertension and hypercholesterolemia in adults living with HIV in this study was considerably high, with most of these diseases newly identified through active screening in the survey. These findings strongly suggest that screening of non-communicable diseases should be integrated into routine HIV care in Cambodia.

SUBMITTER: Chhoun P

PROVIDER: S-EPMC5679628 | biostudies-literature | 2017

REPOSITORIES: biostudies-literature

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High prevalence of non-communicable diseases and associated risk factors amongst adults living with HIV in Cambodia.

Chhoun Pheak P Tuot Sovannary S Harries Anthony D AD Kyaw Nang Thu Thu NTT Pal Khuondyla K Mun Phalkun P Brody Carrine C Mburu Gitau G Yi Siyan S

PloS one 20171109 11

<h4>Background</h4>With rapid expansion of antiretroviral therapy for HIV, there are rising life expectancies among people living with HIV. As a result, co-morbidity from non-communicable diseases in those living and aging with HIV is increasingly being reported. Published data on this issue have been limited in Cambodia. The aim of this study was to determine the prevalence of diabetes mellitus, hypertension and hypercholesterolemia and associated risk factors in adults living with HIV in Cambo ...[more]

PMID: 29121661

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Project description:BackgroundSince the beginning of the Syrian conflict in 2011, Jordan, Lebanon and Turkey have hosted large refugee populations, with a high pre-conflict burden of non-communicable diseases (NCDs).ObjectivesWe aimed to describe the ways in which these three host country health systems have provided NCD services to Syrian refugees over time, and to highlight the successes and challenges they encountered.MethodsWe conducted a descriptive review of the academic and grey literature, published between March 2011 and March 2017, using PubMed and Google searches complemented with documents provided by relevant stakeholders.ResultsForty-one articles and reports met our search criteria. Despite the scarcity of systematic population-level data, these documents highlight the high burden of reported NCDs among Syrian refugees, especially amongst older adults. The three host countries utilized different approaches to the design, delivery and financing of NCD services for these refugees. In Jordan and Lebanon, Ministries of Health and the United Nations High Commissioner for Refugees (UNHCR) coordinate a diverse group of health care providers to deliver health services to Syrian refugees at a subsidized cost. In Turkey, however, services are provided solely by the Disaster and Emergency Management Presidency (AFAD), a Turkish governmental agency, with no cost to patients for primary or secondary care. Access to NCD services varied both within and between countries, with no data available from Turkey. The cost of NCD treatment is the primary barrier to accessing healthcare, with high out-of-pocket payments required for medications and secondary and tertiary care services, despite the availability of free or subsidized primary health services. Financial impediments led refugees to adopt coping strategies, including returning to Syria to seek treatment, with associated frequent treatment interruptions. These gaps were compounded by health system related barriers such as complex referral systems, lack of effective guidance on navigating the health system, limited health facility capacity and suboptimal NCD health education.ConclusionAs funding shortages for refugee services continue, innovative service delivery models are needed to create responsive and sustainable solutions to the NCD burden among refugees in host countries.

Project description:Background Schistosomiasis is a parasitic infectious disease caused by flatworms of the Schistosoma genus. The global burden of schistosomiasis is high. In Malawi, schistosomiasis is among the top 20 causes of outpatient department visits in health facilities. Schistosomiasis is among the most important but neglected causes of non-communicable diseases (NCD) peculiar to tropical endemic settings. While much is known about the contribution of S. haematobium to the NCD burden in Malawi, the role of S. mansoni remains largely unknown. Methods We conducted a cross-sectional study at Mangochi District Hospital. Adults over 18 years diagnosed with NCDs (n = 414), admitted or attending weekly outpatient clinics were recruited between August 2021 and February 2022. Data were collected on sociodemographic characteristics, medical history, body weight, blood pressure, and fasting blood glucose. Stool and midstream urine were collected for Kato–Katz (KK) microscopy and urine point of care-circulating cathodic antigen (POC-CCA) tests, respectively. We computed prevalence of S. mansoni as number of positive KK and CCA tests, each divided by total submitted samples. Univariate and multivariable logistic regression were done to evaluate risk factors of NCDs and association between S. mansoni infection and NCDs. Results We recruited 414 participants, mean age 57 years (SD 16), 67% of whom were female. Prevalence of S. mansoni based on urine CCA was 15% (95% CI: 11–19) and 0% on KK microscopy. Hypertension was the most common condition with a prevalence of 85% (95% CI: 81–89), followed by diabetes mellitus with a prevalence of 42% (95% CI: 37–46) and heart disease with a prevalence of 3% (95% CI: 2–5). S. mansoni infection was not significantly associated with hypertension (OR: 1.2, 95% CI: 0.5–3.1), diabetes (OR: 0.6, 95% CI: 0.3–1.10) or heart disease (OR: 2.0, 95% CI: 0.4–10). Conclusions We observed moderate prevalence of S. mansoni infection among adults in the study per WHO classification of endemicity. This is within the range observed in children in Mangochi from 10 to 56.7%. Supplementary Information The online version contains supplementary material available at 10.1186/s41182-022-00450-3.

Project description:BackgroundNon-communicable diseases (NCDs) are diseases that are not transmitted from one person to another. Currently, NCDs are the primary causes of morbidity and mortality globally. Truck driving is an occupation that prone drivers to risk factors for NCDs than other occupations. Eventhough risk of developing NCDs among these population is high, studies that showed the prevalence and associated factors of chronic NCDs among truck drivers in Ethiopia are not available. Therefore, this study aimed to assess the prevalence and associated factors of chronic NCDs among truck drivers in Ethiopia.MethodsA cross-sectional study was conducted among 422 cross-country truck drivers at the Modjo dry port in Ethiopia. The interviwer-administered questionnaire technique was used to collect the data. The body mass index of the study participants was measured using DHM-15A standardized scale (BMI Height and Weight body fat scale).ResultsOf the 400 truck drivers interviewed, the prevalence of chronic non-communicable diseases was 28.5, 95% CI (24.1-32.9%). Eighty (20%) had hypertension followed by 32(8%), and 22 (5.5%) had diabetes mellitus and asthma, respectively. The study also found that being married (AOR?=?3.14, 95%CI [1.78-5.86]) and Separated/Divorced/Widower (AOR?=?2.31, 95% CI [1.12-3.55]), having 3 or more family sizes (AOR?=?1.46, 95% CI [1.33-4.42]), BMI???25 (AOR?=?4.66, 95% CI [2.85-7.62]), smoking cigarettes [AOR?=?1.71, 95% CI [1.03-2.81]), driving 10 or more years (AOR?=?3.48, 95% CI [1.89-5.24]) and driving 9 or more hours daily (AOR?=?3.76, 95% CI [1.96-6.54]) were statistically associated with chronic non-communicable diseases.ConclusionThe prevalence of chronic NCDs among truck drivers was significant (28.5%), and we can conclude that chronic NCDs are of public health importance among truck drivers in Ethiopia. This may create a substantial load on the healthcare system as an end result of increased demand and contact with healthcare services. Therefore, a rigorous effort is needed to develop strategies for the prevention and management of NCDs.

Project description:BackgroundThe World Health Organization (WHO) recommends ongoing surveillance of non-communicable diseases (NCDs) and their risk factors, using the WHO STEPwise approach to surveillance (STEPS). The aim of this study was to assess the distribution and determinants of NCD risk factors in Nepal, a low-income country, in which two-thirds (66%) of annual deaths are attributable to NCDs.MethodsA nationally representative NCD risk factors STEPS survey (instrument version 3.2), was conducted between February and May 2019, among 6,475 eligible participants of age 15-69 years sampled from all 7 provinces through multistage sampling process. Data collection involved assessment of behavioral and biochemical risk factors. Complex survey analysis was completed in STATA 15, along with Poisson regression modelling to examine associations between covariates and risk factor prevalence.ResultsThe most prevalent risk factor was consumption of less than five servings of fruit and vegetables a day (97%; 95% CI: 94.3-98.0). Out of total participants, 17% (95% CI: 15.1-19.1) were current smoker, 6.8% (95% CI: 5.3-8.2) were consuming ≥60g/month alcohol per month and 7.4% (95% CI:5.7-10.1) were having low level of physical activity. Approximately, 24.3% (95% CI: 21.6-27.2) were overweight or obese (BMI≥25kg/m2) while 24.5% (95% CI: 22.4-26.7) and 5.8% (95% CI: 4.3-7.3) had raised blood pressure (BP) and raised blood glucose respectively. Similarly, the prevalence of raised total cholesterol was 11% (95% CI: 9.6-12.6). Sex and education level of participants were statistically associated with smoking, harmful alcohol use and raised BP. Participants of age 30-44 years and 45-69 years were found to have increased risk of overweight, raised BP, raised blood sugar and raised blood cholesterol. Similarly, participants in richest wealth quintile had higher odds of insufficient physical inactivity, overweight and raised blood cholesterol. On average, each participant had 2 NCD related risk factors (2.04, 95% CI: 2.02-2.08).ConclusionA large portion of the Nepalese population are living with a variety of NCD risk factors. These surveillance data should be used to support and monitor province specific NCD prevention and control interventions throughout Nepal, supported by a multi-sectoral national coordination mechanism.

Project description:BackgroundNon-communicable diseases (NCD) represent a major public health issue and currently cause 185.75 deaths per 100,000 population in Oman. Hence, there is a need for comprehensive, up-to-date and internationally comparable data on NCD risk factors in order to evaluate the effectiveness of ongoing public health policies and to develop further NCD prevention and control interventions. The aim of the study was to provide evidence-based, up-to-date, extensive, and reliable baseline data on the behavioural and biological risk factors of NCDs in the Sultanate of Oman.MethodsA cross-sectional, prospective, observational community-based survey designed to be nationally representative of the Sultanate of Oman was conducted based on the WHO STEPwise approach to Surveillance (STEPS). Multi-stage stratified random sampling according to geographical distribution selected a total of 9053 households (Omani nationals and non-Omani residents). Cluster sampling was used to randomly select equal clusters from each governorate. 823 households were randomly selected from the list of all households in all selected clusters from each governorate and one eligible adult selected from each household randomly accounting for 6582 consenting participants. The survey used demographic and behavioural information questionnaires along with physical and biochemical measurements among adults aged 18 years and above.ResultsThe prevalence of behavioural risk factors such as tobacco use was 9%, alcohol consumption was 2%, insufficient fruit or vegetable intake was 61%, and insufficient physical activity was 39%. The prevalence of biological risk factors such as overweight and obesity was 66%, raised blood pressure was 33%, raised blood glucose was 16%, and raised blood cholesterol was 36%. The prevalence of multiple risk factors was also determined and 95% of the population were found to have more than one risk factor. Three or more risk factors were found among 33% of population aged 18 years and above and 45% of the population aged 45 years and above.ConclusionA high prevalence of various NCD risk factors was found which needs to be addressed through health promotion, education, and policy. The findings are important to support the formulation and implementation of NCD-related policies and action plans that improve health status and prevent mortality due to NCDs in Oman.

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High prevalence of non-communicable diseases and associated risk factors amongst adults living with HIV in Cambodia.

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High prevalence of non-communicable diseases and associated risk factors amongst adults living with HIV in Cambodia.

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