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Hypertension and Diabetes Mellitus among Patients at Hawassa University Comprehensive Specialized Hospital, Hawassa, Southern Ethiopia. 埃塞俄比亚南部阿瓦萨阿瓦萨大学综合专科医院患者的高血压和糖尿病
Pub Date : 2019-04-08 eCollection Date: 2019-01-01 DOI: 10.1155/2019/2509242
Andargachew Kassa, Endrias Markos Woldesemayat

Background: The burden of noncommunicable disease (NCD) in Africa is on a remarkable rise exacerbating the poor public health status affected by the existing but yet unsolved communicable disease. In Ethiopia, there is a paucity of evidence regarding prevalence and risk factors to NCD.

Objective: This study sought to determine the prevalence of risk factors of NCDs, prevalence of DM and HTN, and risk factors associated with diabetes mellitus (DM) and hypertension (HTN).

Method: This is an institution based cross-sectional study conducted on a sample of 411 clients attending a university-based comprehensive specialized hospital in Southern Ethiopia. The data was collected by using a pretested interviewer-administered questionnaire and observational checklist. Frequency, proportions, bivariate and multivariate logistic regression analysis was conducted using SPSS software version 20.

Result: We identified 64.2% of the clients had at least one of the risk factors to the NCDs. One-third (33.3%) had physical inactivity, whereas 20.2% had a BMI of ≥ 25%. The prevalence of DM and HTN was 12.2% and 10.5%, respectively. The multivariate analysis demonstrated that age ≥ 60 years, physical inactivity, higher BMI, and cigarette smoking were risk factors for at least one of the NCDs.

Conclusion: The prevalence of DM and prevalence of HTN were high. The magnitudes of risk factors to NCDs among the study population were substantial. Higher BMI, physical inactivity, low fruit and vegetable consumption, alcohol use, khat chewing, and cigarette smoking were among the prevailing risk factors identified.

背景:非洲非传染性疾病(NCD)的负担正在显著上升,加剧了受现有但尚未解决的传染病影响的不良公共卫生状况。在埃塞俄比亚,关于非传染性疾病的流行和危险因素的证据不足。目的:本研究旨在确定非传染性疾病危险因素的患病率,糖尿病和HTN的患病率,以及与糖尿病(DM)和高血压(HTN)相关的危险因素。方法:这是一项基于机构的横断面研究,对埃塞俄比亚南部一所大学综合专科医院的411名患者进行了抽样调查。数据收集采用预先测试的访谈者管理的问卷和观察性检查表。采用SPSS软件20进行频率、比例、双变量和多变量logistic回归分析。结果:我们确定64.2%的客户至少有一种非传染性疾病的危险因素。三分之一(33.3%)的人缺乏身体活动,而20.2%的人BMI≥25%。DM和HTN患病率分别为12.2%和10.5%。多变量分析表明,年龄≥60岁、缺乏运动、较高的BMI和吸烟是至少一种非传染性疾病的危险因素。结论:糖尿病和HTN患病率较高。在研究人群中,非传染性疾病的危险因素的大小是可观的。较高的身体质量指数、缺乏身体活动、水果和蔬菜摄入量低、饮酒、咀嚼阿拉伯茶和吸烟是已确定的主要风险因素。
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引用次数: 19
Association of CCL2, CCR5, ELMO1, and IL8 Polymorphism with Diabetic Nephropathy in Malaysian Type 2 Diabetic Patients. 马来西亚2型糖尿病患者CCL2、CCR5、ELMO1和IL8多态性与糖尿病肾病的关系。
Pub Date : 2019-01-01 DOI: 10.1155/2019/2053015
Mohd Jokha Yahya, Patimah Binti Ismail, Norshariza Binti Nordin, Abdah Binti Md Akim, Wan Shaariah Binti Md Yusuf, Noor Lita Binti Adam, Maryam Jamielah Yusoff

The unique variants or biomarkers of individuals help to understand the pathogenesis as well as the potential risk of individuals or patients to diabetic nephropathy (DN). The aim of this study was to investigate the association of a genetic polymorphism of monocyte chemoattractant protein-1 (CCL2-rs3917887), chemokine receptor 5 (CCR5-rs1799987), engulfment and cell mortality (ELMO1-rs74130), and interleukin-8 (IL8-rs4073) with the development of DN among Malaysian type 2 diabetes mellitus (T2DM) patients. More than one thousand diabetic patients were examined and a total of 652 T2DM patients were tested comprising 227 Malays (nonnephrotic=96 and nephrotic=131), 203 Chinese (nonnephrotic=95 and nephrotic=108), and 222 Indians (nonnephrotic=136 and nephrotic=86). DNA Sequenom mass ARRAY was employed to identify polymorphisms in CCL2, CCR5, ELMO1, and IL8 genes. DNA was extracted from the secondary blood samples taken from the T2DM patients. The alleles and genotypes were tested using four genetic models and the best mode of inheritance was chosen. CCR5 rs1799987 (G>A) showed strong association with the development of diabetic nephropathy only among the Chinese with OR=6.71 (2.55-17.68) 95% CI while IL8 rs4073 (T>A) showed association with nephropathy only among the Indians with OR=1.57 (0.66-3.71) 95% CI. The additive model was the best model for the mode of inheritance of all the genes. The contribution of genetic variants differs across ethnic groups or background. Further studies which involve environmental risk factors should be taken into consideration.

个体的独特变体或生物标志物有助于了解糖尿病肾病(DN)的发病机制以及个体或患者的潜在风险。本研究的目的是研究马来西亚2型糖尿病(T2DM)患者单核细胞趋化蛋白-1(CCL2-rs3917887)、趋化因子受体5(CCR5-rs1799987)、吞噬和细胞死亡率(ELMO1-rs74130)以及白细胞介素-8(IL8-rs4073)的遗传多态性与DN发展的关系。对1000多名糖尿病患者进行了检查,共对652名T2DM患者进行了检测,其中包括227名马来人(非肾病=96,肾病=131)、203名中国人(非糖尿病=95,肾病=108)和222名印度人(非肾病=136,肾病=86)。DNA序列质谱ARRAY用于鉴定CCL2、CCR5、ELMO1和IL8基因的多态性。从T2DM患者的二次血液样本中提取DNA。利用四个遗传模型对等位基因和基因型进行了检测,并选择了最佳遗传模式。CCR5 rs1799987(G>A)仅在OR=6.71(2.55-17.68)95%CI的中国人中与糖尿病肾病的发生有很强的相关性,而IL8 rs4073(T>A)只在OR=1.57(0.66-3.71)95%CI的印度人中与肾病有相关性。基因变异的贡献因种族或背景而异。应考虑到涉及环境风险因素的进一步研究。
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引用次数: 0
Association between Traffic Related Air Pollution and the Development of Asthma Phenotypes in Children: A Systematic Review. 交通相关空气污染与儿童哮喘表型发展之间的关系:一项系统综述。
Pub Date : 2018-12-02 eCollection Date: 2018-01-01 DOI: 10.1155/2018/4047386
Nelson Lau, Alex Norman, Mary Jane Smith, Atanu Sarkar, Zhiwei Gao

Introduction: Traffic related air pollution (TRAP) has long been associated with the onset of childhood asthma. The relationship between TRAP exposure and the development of childhood asthma phenotypes is less understood. To better understand this relationship, we performed a systematic review of the literature studying childhood TRAP exposure and the development of childhood asthma and wheezing phenotypes (transient, persistent, and late-onset asthma/wheezing phenotypes).

Methods: A literature search was performed in PubMed, Embase, and Scopus databases for current literature, returning 1706 unique articles. After screening and selection, 7 articles were included in the final review. Due to the low number of articles, no meta-analysis was performed.

Results: TRAP exposure appears to be associated with both transient and persistent asthma/wheezing phenotypes. However, there was little evidence to suggest a relationship between TRAP exposure and late-onset asthma/wheezing. The differing results may be in part due to the heterogeneity in study methods and asthma/wheezing phenotype definitions, in addition to other factors such as genetics.

Conclusion: TRAP exposure may be associated with transient and persistent asthma/wheezing phenotypes in children. The low number of studies and differing results suggest that further studies are warranted.

导言:交通相关的空气污染(TRAP)长期以来一直与儿童哮喘的发病有关。TRAP暴露与儿童哮喘表型发展之间的关系尚不清楚。为了更好地理解这种关系,我们对研究儿童TRAP暴露与儿童哮喘和喘息表型(短暂性、持续性和晚发性哮喘/喘息表型)发展的文献进行了系统回顾。方法:在PubMed, Embase和Scopus数据库中检索当前文献,返回1706篇独特的文章。经过筛选和选择,7篇文章被纳入最终评审。由于文章数量少,未进行meta分析。结果:TRAP暴露似乎与短暂性和持续性哮喘/喘息表型相关。然而,几乎没有证据表明TRAP暴露与迟发性哮喘/喘息之间存在关系。不同的结果可能部分是由于研究方法和哮喘/喘息表型定义的异质性,以及遗传等其他因素。结论:TRAP暴露可能与儿童短暂性和持续性哮喘/喘息表型有关。较少的研究和不同的结果表明有必要进行进一步的研究。
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引用次数: 22
Burden of Helicobacter pylori Infections and Associated Risk Factors among Women of Child Bearing Age in Addis Ababa, Ethiopia. 埃塞俄比亚亚的斯亚贝巴育龄妇女幽门螺杆菌感染负担及相关危险因素
Pub Date : 2018-11-12 eCollection Date: 2018-01-01 DOI: 10.1155/2018/5183713
Kumera Terfa Kitila, Lemi Mosisa Sori, Daniel Melese Desalegn, Kassu Desta Tullu

Background: Early detection and treatment of Helicobacter pylori (H. pylori) infection in women of child bearing ages may reduce the risk of maternal health disorder. This study was conducted to determine the burden of H. pylori infections and associated risk factors among women of child bearing ages in Kolfe Keranio Subcity Woreda 9 Health Centers, Addis Ababa, Ethiopia.

Methods: Facility based cross sectional study design was conducted from April to October 2015. The study recruited 195 pregnant and 137 nonpregnant women with age range of 16-40 years. Sociodemographic data of study participants were collected by structured questionnaire. Venous blood was analyzed to determine hemoglobin, H. pylori stool antigen test kit was used to assess H. pylori infection, and fresh fecal (stool) was used to examine intestinal parasites among study subjects. Data was entered and analyzed using SPSS version 19. Bivariate and multivariate logistic regression model using odds ratio (OR) at 95% confidence interval (CI) were calculated. P-value less than 0.05 was taken as statistically significant.

Results: The overall burden of H. pylori infection among study participants was 29% (96/332). H. pylori infection was statistically significantly associated with pregnancy status (AOR: 1.825, CI (1.42-2.15), P=0.020), history of hyperemesis gravidarum (AOR=7.028, C.I (2.47-19.99), P=0.018), and low hemoglobin value (AOR=0.177, CI (0.083-0.379), p=0.003). There was no statistically significant association between H. pylori infection and sociodemographic characteristics and some expected risk factors like smoking, Khat chewing, alcohol drinking habit, and presence of intestinal parasites.

Conclusion: In this study, H. pylori infection was still a public health problem in the study area. H. pylori infected women also had high rate of anemia compared to women who had not H. pylori infected. Hence clinician and other responsible bodies should give a special attention for women who had been infected with H. pylori. Further large case control studies are warranted to understand more the role of H. pylori, HG, and other associated risk factors.

背景:育龄妇女早期发现和治疗幽门螺杆菌(h.p ylori)感染可降低产妇保健障碍的风险。本研究旨在确定埃塞俄比亚亚的斯亚贝巴Kolfe Keranio Subcity worreda 9卫生中心育龄妇女幽门螺杆菌感染负担及相关危险因素。方法:2015年4 - 10月采用基于设施的横断面研究设计。该研究招募了195名孕妇和137名非孕妇,年龄在16-40岁之间。采用结构化问卷法收集研究对象的社会人口学资料。静脉血检测血红蛋白,粪便幽门螺杆菌抗原检测试剂盒检测幽门螺杆菌感染,新鲜粪便(粪便)检测肠道寄生虫。数据输入和分析使用SPSS版本19。采用比值比(OR)在95%置信区间(CI)计算双变量和多变量logistic回归模型。p值小于0.05为有统计学意义。结果:研究参与者幽门螺杆菌感染的总体负担为29%(96/332)。幽门螺杆菌感染与妊娠状态(AOR= 1.825, CI (1.42 ~ 2.15), P=0.020)、妊娠吐吐史(AOR=7.028, CI (2.47 ~ 19.99), P=0.018)、低血红蛋白值(AOR=0.177, CI (0.083 ~ 0.379), P= 0.003)相关,具有统计学意义。幽门螺杆菌感染与社会人口学特征和一些预期的危险因素(如吸烟、咀嚼阿拉伯茶、饮酒习惯和肠道寄生虫的存在)之间没有统计学上的显著关联。结论:本研究区幽门螺旋杆菌感染仍是一个公共卫生问题。与未感染幽门螺旋杆菌的妇女相比,感染幽门螺旋杆菌的妇女贫血率也较高。因此,临床医生和其他负责机构应对感染幽门螺杆菌的妇女给予特别关注。进一步的大型病例对照研究有必要进一步了解幽门螺杆菌、汞柱和其他相关危险因素的作用。
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引用次数: 9
A Comparison of the Prevalence of the Metabolic Syndrome among Sri Lankan Patients with Type 2 Diabetes Mellitus Using WHO, NCEP-ATP III, and IDF Definitions. 使用WHO、NCEP-ATP III和IDF定义比较斯里兰卡2型糖尿病患者代谢综合征患病率
Pub Date : 2018-08-07 eCollection Date: 2018-01-01 DOI: 10.1155/2018/7813537
H M M Herath, N P Weerasinghe, T P Weerarathna, A Amarathunga

Background: Presence of metabolic syndrome (MetS) in patients with type 2 diabetes mellitus (type 2 DM) increases the risk of cardiovascular morbidity and mortality. Therefore, recognition of MetS in type 2 DM is important in initiating the appropriate preventive and therapeutic measures. The commonly used definitions have similarities and discrepancies. Aims of this study was to investigate the prevalence of MetS among patients with type 2DM using all three well known (WHO, IDF, and NCEP-ATP III) definitions and to identify the concordance and the difference of these three definitions.

Methods: This cross-sectional study included patients with type 2 DM who were followed up at the regional diabetes centre in Galle, Sri Lanka. A total of 2913 type 2 DM patients were recruited by convenient sampling method, and their clinical and biochemical data were collected.

Results: The mean age (SD) of the sample was 49.9 (10.2) years and the mean duration of diabetes was 5.04 (5.71). Prevalence of MetS was highest by WHO (70%) followed by IDF (44%) and NCEP-ATP III (29%) definitions. The prevalence was significantly higher in women according to all three definitions, and the difference was most marked with NCEP-ATP III and IDF definitions. Around 25% were identified as having MetS by all three definitions whereas around 45% were recognized with MetS by two definitions. While concordances between WHO with IDF (0.37, p < 0.001) and NCEP-ATP III (0.24, p < 0.001) criteria were poor, they were average (0.53, p < 0.001) between NCEP-ATP III and IDF criteria.

Conclusions: The prevalence of MetS among patients with type 2 DM can significantly be varied based on the definition used and the three definitions of MetS recognized different set of individuals. The highest prevalence of MetS was observed with WHO (70.6%) whereas lowest was observed with NCEP-ATP III definition.

背景:2型糖尿病(type 2 DM)患者代谢综合征(MetS)的存在增加了心血管疾病发病率和死亡率的风险。因此,在2型糖尿病中识别MetS对于启动适当的预防和治疗措施是重要的。常用的定义既有相似之处,也有差异。本研究的目的是使用所有三种众所周知的定义(WHO、IDF和NCEP-ATP III)来调查2型dm患者中MetS的患病率,并确定这三种定义的一致性和差异。方法:这项横断面研究纳入了在斯里兰卡加勒地区糖尿病中心随访的2型糖尿病患者。采用方便抽样法,共招募2913例2型糖尿病患者,收集其临床及生化资料。结果:样本的平均年龄(SD)为49.9(10.2)岁,平均糖尿病病程为5.04(5.71)岁。WHO定义的met患病率最高(70%),其次是IDF(44%)和NCEP-ATP III(29%)。根据所有三种定义,女性的患病率明显更高,其中NCEP-ATP III和IDF定义的差异最为明显。约25%的人被所有三种定义认定为患有MetS,而约45%的人被两种定义认定为患有MetS。虽然WHO与IDF (0.37, p < 0.001)和NCEP-ATP III (0.24, p < 0.001)标准的一致性较差,但NCEP-ATP III与IDF标准的一致性为平均(0.53,p < 0.001)。结论:根据所使用的定义和三种定义所识别的不同个体,2型糖尿病患者中MetS的患病率可能存在显著差异。WHO定义的met患病率最高(70.6%),而NCEP-ATP III定义的met患病率最低。
{"title":"A Comparison of the Prevalence of the Metabolic Syndrome among Sri Lankan Patients with Type 2 Diabetes Mellitus Using WHO, NCEP-ATP III, and IDF Definitions.","authors":"H M M Herath,&nbsp;N P Weerasinghe,&nbsp;T P Weerarathna,&nbsp;A Amarathunga","doi":"10.1155/2018/7813537","DOIUrl":"https://doi.org/10.1155/2018/7813537","url":null,"abstract":"<p><strong>Background: </strong>Presence of metabolic syndrome (MetS) in patients with type 2 diabetes mellitus (type 2 DM) increases the risk of cardiovascular morbidity and mortality. Therefore, recognition of MetS in type 2 DM is important in initiating the appropriate preventive and therapeutic measures. The commonly used definitions have similarities and discrepancies. Aims of this study was to investigate the prevalence of MetS among patients with type 2DM using all three well known (WHO, IDF, and NCEP-ATP III) definitions and to identify the concordance and the difference of these three definitions.</p><p><strong>Methods: </strong>This cross-sectional study included patients with type 2 DM who were followed up at the regional diabetes centre in Galle, Sri Lanka. A total of 2913 type 2 DM patients were recruited by convenient sampling method, and their clinical and biochemical data were collected.</p><p><strong>Results: </strong>The mean age (SD) of the sample was 49.9 (10.2) years and the mean duration of diabetes was 5.04 (5.71). Prevalence of MetS was highest by WHO (70%) followed by IDF (44%) and NCEP-ATP III (29%) definitions. The prevalence was significantly higher in women according to all three definitions, and the difference was most marked with NCEP-ATP III and IDF definitions. Around 25% were identified as having MetS by all three definitions whereas around 45% were recognized with MetS by two definitions. While concordances between WHO with IDF (0.37, <i>p</i> < 0.001) and NCEP-ATP III (0.24, <i>p</i> < 0.001) criteria were poor, they were average (0.53, <i>p</i> < 0.001) between NCEP-ATP III and IDF criteria.</p><p><strong>Conclusions: </strong>The prevalence of MetS among patients with type 2 DM can significantly be varied based on the definition used and the three definitions of MetS recognized different set of individuals. The highest prevalence of MetS was observed with WHO (70.6%) whereas lowest was observed with NCEP-ATP III definition.</p>","PeriodicalId":13831,"journal":{"name":"International Journal of Chronic Diseases","volume":"2018 ","pages":"7813537"},"PeriodicalIF":0.0,"publicationDate":"2018-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2018/7813537","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36456197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 22
Medication Noncompliance among Patients with Chronic Diseases Attending a Primary Health Facility in a Periurban District in Ghana. 加纳城市周边地区初级卫生机构慢性病患者的药物不依从性。
Pub Date : 2018-06-07 DOI: 10.1155/2018/7187284
Bright Addo, Sally Sencherey, Michael N K Babayara

Background: Despite the growing interest in understanding the aetiology of chronic diseases, limited studies exist on medication noncompliance, especially, among periurban and rural dwellers in Ghana. In this study, we determined the prevalence of medication noncompliance and explored the medication intake behaviour of patients with chronic diseases. The relative influence of cost on medication noncompliance and the risk factors for noncompliance were also assessed.

Methods: The design was a cross-sectional study of 200 patients from ages below 40 years to ages above 60 years sampled from the Offinso South Municipality, a periurban district of the Ashanti region of Ghana. Data collected through the administration of structured questionnaires was coded, cleaned, and analysed using the SPSS (v20) software programme. Descriptive and multivariate analyses using binary logistic regression were performed.

Results: Medication noncompliance was high (55.5%), with patients living with HIV/AIDS and those with psychological disorders being the most noncompliant. Majority of patients took at least 2 medications (81.5%), did so twice daily (79.0%), did not experience side effects with intake (67.0%), considered their medication to be effective (88.5%), and were aware of the complications that could arise from noncompliance. The dominant route of medication intake was oral (86.8%) and a lesser proportion of patients (22.5%) took herbal preparation alongside their prescribed medications. The cost of medication did not prevent patients from adhering to their medication regimen as most of these drugs were covered by the National Health Insurance Scheme (NHIS). Age, duration of diagnosis and difficulty in remembering medication instructions were identified as significant predictors of noncompliance.

Conclusion: Educating patients on the need to be compliant with their medication regimen, the complications that could arise from noncompliance and avoidance of intake of herbal medications during their treatment should form part of the clinical sessions organized for patients with chronic conditions.

背景:尽管人们对了解慢性病的病因越来越感兴趣,但对药物不依从性的研究有限,尤其是在加纳的城市和农村居民中。在这项研究中,我们确定了药物不依从性的患病率,并探讨了慢性病患者的药物摄入行为。还评估了费用对药物依从性的相对影响以及依从性的风险因素。方法:该设计是对200名年龄在40岁以下至60岁以上的患者进行的横断面研究,这些患者来自加纳阿散蒂地区的城市周边地区奥芬索南部市。使用SPSS(v20)软件程序对通过结构化问卷管理收集的数据进行编码、清理和分析。使用二元逻辑回归进行描述性和多变量分析。结果:药物依从性高(55.5%),其中艾滋病患者和心理障碍患者最不依从。大多数患者至少服用了2种药物(81.5%),每天服用两次(79.0%),摄入后没有出现副作用(67.0%),认为自己的药物有效(88.5%),并意识到不依从可能引起的并发症。主要的药物摄入途径是口服(86.8%),少数患者(22.5%)在服用处方药的同时服用草药制剂。药物费用并没有阻止患者坚持他们的用药方案,因为这些药物大多由国家健康保险计划(NHIS)承保。年龄、诊断持续时间和难以记住药物说明书被确定为不依从性的重要预测因素。结论:在为慢性病患者组织的临床会议中,应教育患者遵守用药方案的必要性、治疗期间不遵守和避免服用草药可能产生的并发症。
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引用次数: 17
Cervical Cancer Awareness among Women in Tanzania: An Analysis of Data from the 2011-12 Tanzania HIV and Malaria Indicators Survey. 坦桑尼亚妇女对宫颈癌的认识:2011-12年坦桑尼亚艾滋病毒和疟疾指标调查数据分析
Pub Date : 2018-05-02 eCollection Date: 2018-01-01 DOI: 10.1155/2018/2458232
Fabiola V Moshi, Elisa B Vandervort, Stephen M Kibusi

Background: Awareness about cervical cancer is a first step in the process of screening and early treatment. The purpose of this study was to provide better understanding of basic knowledge about cervical cancer among women of reproductive age in Tanzania.

Method: Data were analyzed from the 2011-2012 Tanzania HIV and Malaria Indicators Survey (THMIS) and a sample of 5542 sexually active women from 15 to 49 years of age were included in the analysis.

Results: Overall knowledge about cervical cancer was high among interviewed women. Only 30.9% of women had never heard about cervical cancer. The predictors of awareness were having secondary or more level of education (AOR = 3.257, 95% CI 2.328-4.557, p < 0.001), residing in urban (AOR = 1.365, 95% CI 1.093-1.705, p < 0.01), being affluent (AOR = 2.685, 95% CI 2.009-3.587, p < 0.001), having one to four children (AOR = 1.36, 95% CI 1.032-1.793), and age of 30-34 years (AOR = 3.15, 95% CI 2.353-4.220, p < 0.001), 35-39 years (AOR = 2.46, 95% CI 1.831-3.308, p < 0.001), and 40-44 years (AOR = 3.46, 95% CI 2.497-4.784, p < 0.001).

Conclusion: While the cervical cancer landscape in Tanzania has evolved since this survey, coverage has not yet been achieved and access to cervical cancer prevention services for rural women and girls remains a concern. Women who were least likely to be aware of cervical cancer were rural women, less affluent women, those with limited education, and those with limited access to the formal economy. Arguably, these are the women who are most at risk for cervical cancer. To close this gap, Tanzania's ongoing efforts to increase access to high-quality cervical cancer prevention services for all women at risk are commendable.

背景:了解宫颈癌是筛查和早期治疗的第一步。这项研究的目的是为了更好地了解坦桑尼亚育龄妇女宫颈癌的基本知识。方法:分析2011-2012年坦桑尼亚艾滋病毒和疟疾指标调查(THMIS)的数据,并将5542名15 - 49岁的性活跃女性纳入分析。结果:受访妇女对宫颈癌的总体知晓率较高。只有30.9%的女性从未听说过子宫颈癌。意识的预测在中等以上水平的教育(AOR = 3.257, 95% CI 2.328 - -4.557, p < 0.001),居住在城市(AOR = 1.365, 95% CI 1.093 - -1.705, p < 0.01),富裕(AOR = 2.685, 95% CI 2.009 - -3.587, p < 0.001),有一个四个孩子(优势比= 1.36,95% CI 1.032 - -1.793),和34岁(AOR = 3.15, 95% CI 2.353 - -4.220, p < 0.001), 35-39年(AOR = 2.46, 95% CI 1.831 - -3.308, p < 0.001), 40-44年(AOR = 3.46, 95% CI 2.497 - -4.784, p < 0.001)。结论:虽然自本次调查以来坦桑尼亚的宫颈癌情况有所变化,但尚未实现覆盖,农村妇女和女孩获得宫颈癌预防服务仍然是一个问题。最不可能了解子宫颈癌的妇女是农村妇女、较不富裕的妇女、受教育程度有限的妇女以及进入正规经济的机会有限的妇女。可以说,这些女性患宫颈癌的风险最大。为了缩小这一差距,坦桑尼亚正在努力增加所有高危妇女获得高质量宫颈癌预防服务的机会,这是值得赞扬的。
{"title":"Cervical Cancer Awareness among Women in Tanzania: An Analysis of Data from the 2011-12 Tanzania HIV and Malaria Indicators Survey.","authors":"Fabiola V Moshi,&nbsp;Elisa B Vandervort,&nbsp;Stephen M Kibusi","doi":"10.1155/2018/2458232","DOIUrl":"https://doi.org/10.1155/2018/2458232","url":null,"abstract":"<p><strong>Background: </strong>Awareness about cervical cancer is a first step in the process of screening and early treatment. The purpose of this study was to provide better understanding of basic knowledge about cervical cancer among women of reproductive age in Tanzania.</p><p><strong>Method: </strong>Data were analyzed from the 2011-2012 Tanzania HIV and Malaria Indicators Survey (THMIS) and a sample of 5542 sexually active women from 15 to 49 years of age were included in the analysis.</p><p><strong>Results: </strong>Overall knowledge about cervical cancer was high among interviewed women. Only 30.9% of women had never heard about cervical cancer. The predictors of awareness were having secondary or more level of education (AOR = 3.257, 95% CI 2.328-4.557, <i>p</i> < 0.001), residing in urban (AOR = 1.365, 95% CI 1.093-1.705, <i>p</i> < 0.01), being affluent (AOR = 2.685, 95% CI 2.009-3.587, <i>p</i> < 0.001), having one to four children (AOR = 1.36, 95% CI 1.032-1.793), and age of 30-34 years (AOR = 3.15, 95% CI 2.353-4.220, <i>p</i> < 0.001), 35-39 years (AOR = 2.46, 95% CI 1.831-3.308, <i>p</i> < 0.001), and 40-44 years (AOR = 3.46, 95% CI 2.497-4.784, <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>While the cervical cancer landscape in Tanzania has evolved since this survey, coverage has not yet been achieved and access to cervical cancer prevention services for rural women and girls remains a concern. Women who were least likely to be aware of cervical cancer were rural women, less affluent women, those with limited education, and those with limited access to the formal economy. Arguably, these are the women who are most at risk for cervical cancer. To close this gap, Tanzania's ongoing efforts to increase access to high-quality cervical cancer prevention services for all women at risk are commendable.</p>","PeriodicalId":13831,"journal":{"name":"International Journal of Chronic Diseases","volume":"2018 ","pages":"2458232"},"PeriodicalIF":0.0,"publicationDate":"2018-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2018/2458232","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36183056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 26
Tenofovir-Based Highly Active Antiretroviral Therapy Is Associated with Superior CD4 T Cells Repopulation Compared to Zidovudine-Based HAART in HIV 1 Infected Adults. 与以齐多夫定为基础的HAART相比,以替诺福韦为基础的高活性抗逆转录病毒治疗与HIV 1感染成人中更高的CD4 T细胞再生相关
Pub Date : 2018-04-18 eCollection Date: 2018-01-01 DOI: 10.1155/2018/3702740
Vitus Sambo Badii, Kwame Ohene Buabeng, Thomas Agyarko Poku, Arnold Donkor Forkuo, Bright Boafo Boamah, Stephen Mensah Arhin, Daniel Edem Kpewou

Tenofovir-based highly active antiretroviral therapy (HAART) is one of the preferred first-line therapies in the management of HIV 1 infection. Ghana has since 2014 adopted this recommendation; however there is paucity of scientific data that reflects the safety and efficacy of the tenofovir-based therapy compared to zidovudine in the Ghanaian health system. This study sought to assess the comparative immune reconstitution potential between tenofovir and zidovudine-based HAART regimens, which includes lamivudine and efavirenz in combination therapy. It also aimed to investigate the adverse drug reactions/events (ADREs) associated with pharmacotherapy with these agents in a total of 106 HAART naïve HIV patients. The study included 80 patients in the tenofovir cohort while 26 patients were on the zidovudine regimen. The occurrence of HIV comorbidities profile was assessed at diagnosis and throughout the study period. The baseline CD4 T cells count of the participants was also assessed at diagnosis and repeated at a median period of five months (range 4-6 months), after commencing treatment with either tenofovir- or zidovudine-based HAART. After five months of the HAART, the tenofovir cohort recorded higher CD4 T cell count change from baseline compared to the zidovudine cohort (p < 0.0001). The patients on the tenofovir-based HAART and female sex however appeared to be associated with more multiple ADREs.

以替诺福韦为基础的高效抗逆转录病毒疗法(HAART)是治疗HIV - 1感染的首选一线疗法之一。加纳自2014年起采纳了这一建议;然而,在加纳卫生系统中,缺乏反映以替诺福韦为基础的治疗与齐多夫定相比的安全性和有效性的科学数据。本研究旨在评估替诺福韦和以齐多夫定为基础的HAART方案(包括拉米夫定和依非韦伦联合治疗)之间的免疫重建潜力的比较。它还旨在调查106名HAART naïve HIV患者中与这些药物治疗相关的药物不良反应/事件(ADREs)。该研究包括替诺福韦组的80例患者和齐多夫定组的26例患者。在诊断时和整个研究期间评估HIV合并症的发生率。参与者的基线CD4 T细胞计数也在诊断时进行评估,并在开始使用替诺福韦或齐多夫定为基础的HAART治疗后的中位5个月(范围4-6个月)重复。在HAART治疗5个月后,与齐多夫定组相比,替诺福韦组的CD4 T细胞计数从基线变化更高(p < 0.0001)。然而,接受替诺福韦为基础的HAART治疗的患者和女性似乎与更多的多重不良反应相关。
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引用次数: 9
Reduction of Liver Span and Parameters of Inflammation in Nonalcoholic Fatty Liver Disease Patients Treated with Lycosome Formulation of Phosphatidylcholine: A Preliminary Report. 磷脂酰胆碱糖原体制剂治疗非酒精性脂肪肝患者肝跨度缩小和炎症参数:初步报告
Pub Date : 2018-04-01 eCollection Date: 2018-01-01 DOI: 10.1155/2018/4549614
Ivan M Petyaev, Pavel Y Dovgalevsky, Natalia E Chalyk, Victor A Klochkov, Nigel H Kyle, Yuriy K Bashmakov

Twenty-nine newly diagnosed individuals with Nonalcoholic Fatty Liver Disease (NAFLD) remaining on habitual dietary regimen were supplemented with regular or lycosome formulations of phosphatidylcholine (PC) during a pilot, randomized, double-blinded clinical study. After two months of oral PC intake (450 mg daily) the liver size as well as serum levels of hepatic enzymes and markers of inflammation were evaluated by ultrasonography and biochemical analysis. It was shown that there was a statistically significant reduction of medians for the Mid-Clavicular liver size from 16.0 cm (95/5% CI: 17.1/15.5) to 15.1 cm (95/5% CI: 17.2/14.4, P = 0.021) in participants ingesting the lycosome-formulated PC (L-PC) whereas regular formulation of PC (R-PC) had only a marginal effect on this parameter (P = 0.044). A similar tendency was observed in the Mid-Sternal liver size. Moreover, there was a reduction of medians for ALT values at the end point of the study (P = 0.026) after ingestion of L-PC, while R-PC had no statistically significant effect. On the other hand, ingestion of both formulations was accompanied by reductions in values for Inflammatory Oxidative Damage (IOD) and oxidized LDL in serum. However, L-PC had superior activity in these terms, presumably due to the presence of lycopene, a powerful antioxidant, in the L-PC-Lycosome structure. C-reactive protein level was moderately decreased (reduction of medians from 6.5 [95/5% CI: 7.7/5.8] mg/L to 5.1 [95/5% CI: 5.6/4.3] mg/L) only after ingestion of L-PC. The greater efficacy of L-PC seen in NAFLD volunteers may reflect improved bioavailability of PC owing to better protection of the microencapsulated PC from gastrointestinal enzymes and possibly enhanced hepatic delivery of L-PC particles.

在一项试验性、随机、双盲临床研究中,29名新诊断的非酒精性脂肪性肝病(NAFLD)患者在常规饮食方案下补充常规或糖体配方的磷脂酰胆碱(PC)。口服PC(每天450 mg)两个月后,通过超声和生化分析评估肝脏大小、血清肝酶和炎症标志物水平。研究表明,在摄入糖酶制剂PC (L-PC)的参与者中,锁骨中部肝脏大小的中位数从16.0 cm (95/5% CI: 17.1/15.5)减少到15.1 cm (95/5% CI: 17.2/14.4, P = 0.021),而常规制剂PC (R-PC)对该参数只有边际效应(P = 0.044)。胸骨中肝大小也有类似的趋势。此外,摄入L-PC后,研究结束时ALT值中位数降低(P = 0.026),而R-PC无统计学意义。另一方面,摄入这两种制剂都伴随着血清中炎症性氧化损伤(IOD)和氧化LDL值的降低。然而,L-PC在这些方面具有优越的活性,可能是由于在L-PC-糖苷体结构中存在番茄红素,一种强大的抗氧化剂。c -反应蛋白水平仅在摄入L- pc后才中度下降(中位数从6.5 [95/5% CI: 7.7/5.8] mg/L降至5.1 [95/5% CI: 5.6/4.3] mg/L)。在NAFLD志愿者中观察到的L-PC更大的疗效可能反映了PC的生物利用度的提高,因为微胶囊化的PC可以更好地保护胃肠道酶,并可能增强L-PC颗粒的肝脏递送。
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引用次数: 2
Limitations of Serum Ferritin in Diagnosing Iron Deficiency in Inflammatory Conditions. 血清铁蛋白在诊断炎症性缺铁症中的局限性
Pub Date : 2018-03-18 eCollection Date: 2018-01-01 DOI: 10.1155/2018/9394060
Axel Dignass, Karima Farrag, Jürgen Stein

Patients with inflammatory conditions such as inflammatory bowel disease (IBD), chronic heart failure (CHF), and chronic kidney disease (CKD) have high rates of iron deficiency with adverse clinical consequences. Under normal circumstances, serum ferritin levels are a sensitive marker for iron status but ferritin is an acute-phase reactant that becomes elevated in response to inflammation, complicating the diagnosis. Proinflammatory cytokines also trigger an increase in hepcidin, which restricts uptake of dietary iron and promotes sequestration of iron by ferritin within storage sites. Patients with inflammatory conditions may thus have restricted availability of iron for erythropoiesis and other cell functions due to increased hepcidin expression, despite normal or high levels of serum ferritin. The standard threshold for iron deficiency (<30 μg/L) therefore does not apply and transferrin saturation (TSAT), a marker of iron availability, should also be assessed. A serum ferritin threshold of <100 μg/L or TSAT < 20% can be considered diagnostic for iron deficiency in CHF, CKD, and IBD. If serum ferritin is 100-300 μg/L, TSAT < 20% is required to confirm iron deficiency. Routine surveillance of serum ferritin and TSAT in these at-risk groups is advisable so that iron deficiency can be detected and managed.

炎症性疾病(如炎症性肠病(IBD)、慢性心力衰竭(CHF)和慢性肾病(CKD))患者的缺铁率很高,会造成不良的临床后果。在正常情况下,血清铁蛋白水平是铁状态的敏感指标,但铁蛋白是一种急性期反应物,在炎症反应时会升高,从而使诊断变得复杂。促炎细胞因子也会引发血红素增加,从而限制对食物中铁的吸收,并促进铁蛋白将铁螯合在储存部位。因此,炎症患者尽管血清铁蛋白水平正常或较高,但由于血红素表达增加,红细胞生成和其他细胞功能所需的铁可能受到限制。因此,铁缺乏症的标准阈值(μg/L)并不适用,还应评估转铁蛋白饱和度(TSAT)这一铁可用性指标。血清铁蛋白阈值为 μg/L 或 TSAT < 20% 可诊断为慢性阻塞性肺病、慢性肾脏病和 IBD 患者缺铁。如果血清铁蛋白为 100-300 μg/L,则需要 TSAT < 20% 才能确诊缺铁。建议对这些高危人群的血清铁蛋白和 TSAT 进行常规监测,以便发现和控制铁缺乏症。
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引用次数: 0
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International Journal of Chronic Diseases
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