S. Behera, S. Pradhan, S. Pati, P. Behera, S. Kanungo, B. Patro
Background: With the advent of the COVID-19 pandemic, prevention and control of noncommunicable diseases (NCDs) have become even more critical as NCDs are major risk factors for patients with COVID-19. Therefore, this study was planned with the following objectives: (i) To assess adherence with chronic disease care among patients with NCDs. (ii) To determine the factors associated with adherence with chronic disease care among patients with NCDs during COVID-19 nationwide lockdown. Materials and Methods: This was a hospital-based cross-sectional study conducted in the NCD prevention clinic of All India Institute of Medical Sciences, Bhubaneswar, during July 2020–August 2020. A total of 210 patients were studied. Patients were interviewed both at the clinic and telephonically; those who had scheduled visits did not make it. Out of 210 patients, 105 participants were interviewed face to face in the hospital in the NCD prevention clinic. The other 105 patients were interviewed telephonically who did not attend the clinic during follow-up. Results: All the participants (210) had diabetes mellitus, and 44.8% of participants had accompanying hypertension. One-fourth of participants could not follow the dietary practices advised by the doctor during the lockdown. Similarly, 42% of participants could not maintain moderate-intensity physical activity (30 min) during the lockdown period. The period prevalence of nonadherence to prescribed drugs/medicines in our sample was 45.71% (95% confidence intervals [CI] 38.84–52.71). Participants with more than one NCDs had a 52% less chance to stop the drugs/medications during the national lockdown period than participants with one NCD (adjusted odds ratio 0.48, 95% CI 0.27–0.83). Conclusions: The continuum of chronic disease care of NCD patients has been affected by COVID-19 nationwide lockdown. Appropriate planning and provision of chronic disease care are essential during the lockdown and similar situations.
{"title":"Adherence of chronic disease care during COVID-19 pandemic: Results from eastern India","authors":"S. Behera, S. Pradhan, S. Pati, P. Behera, S. Kanungo, B. Patro","doi":"10.4103/jncd.jncd_37_21","DOIUrl":"https://doi.org/10.4103/jncd.jncd_37_21","url":null,"abstract":"Background: With the advent of the COVID-19 pandemic, prevention and control of noncommunicable diseases (NCDs) have become even more critical as NCDs are major risk factors for patients with COVID-19. Therefore, this study was planned with the following objectives: (i) To assess adherence with chronic disease care among patients with NCDs. (ii) To determine the factors associated with adherence with chronic disease care among patients with NCDs during COVID-19 nationwide lockdown. Materials and Methods: This was a hospital-based cross-sectional study conducted in the NCD prevention clinic of All India Institute of Medical Sciences, Bhubaneswar, during July 2020–August 2020. A total of 210 patients were studied. Patients were interviewed both at the clinic and telephonically; those who had scheduled visits did not make it. Out of 210 patients, 105 participants were interviewed face to face in the hospital in the NCD prevention clinic. The other 105 patients were interviewed telephonically who did not attend the clinic during follow-up. Results: All the participants (210) had diabetes mellitus, and 44.8% of participants had accompanying hypertension. One-fourth of participants could not follow the dietary practices advised by the doctor during the lockdown. Similarly, 42% of participants could not maintain moderate-intensity physical activity (30 min) during the lockdown period. The period prevalence of nonadherence to prescribed drugs/medicines in our sample was 45.71% (95% confidence intervals [CI] 38.84–52.71). Participants with more than one NCDs had a 52% less chance to stop the drugs/medications during the national lockdown period than participants with one NCD (adjusted odds ratio 0.48, 95% CI 0.27–0.83). Conclusions: The continuum of chronic disease care of NCD patients has been affected by COVID-19 nationwide lockdown. Appropriate planning and provision of chronic disease care are essential during the lockdown and similar situations.","PeriodicalId":52935,"journal":{"name":"International Journal of Noncommunicable Diseases","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47005198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: The epidemiological transition model, coined by Abdel Omran in 1971, building on the demographic transition theory developed by Frank Notestein in 1945, has been largely credited for describing epidemiological situations both globally and nationally in many parts of the world. However, owing to its origins in the United States of America (USA), scholars critique the model's applicability to various geographical, socioeconomic, and epidemiological contexts, which are diversely different from the USA and vary from region to region. It was imperative to test the applicability of this model in sub-Saharan Africa (SSA), particularly Zimbabwe to ascertain versatility in describing epidemiological transitions, predicting population health status and whether the assumption of a shift from communicable diseases (CDs) to noncommunicable diseases (NCDs) could be confirmed in a low-income developing nation focusing on Zimbabwe. Methods: The study was a retrospective document review case study, using the existing framework of the epidemiological transition model, as a guiding principle, applying the model to describe the demographic and epidemiological circumstances prevailing within Zimbabwe. The researcher reviewed, compared, analyzed, and described the existing literature on population dynamics and epidemiological profile of the country for the period 1990–2020. Results: The epidemiological transition model attempts to describe the changes in epidemiological circumstances both at national and global scales. The model presumes a shift in CDs to NCDs. However, many scholars question the applicability of the model to diverse contexts, particularly within the SSA context. The Zimbabwean case was considered in light to its rising population growth, dual burden characterized by a high burden of communicable and rising NCDs. Findings from this study indicate that NCDs are on the rise in Zimbabwe. However, owing to a high burden of CDs, a dual disease burden model is the best fit to explain the epidemiological transition currently obtaining within Zimbabwe. Conclusions: Consequentially, funding streams targeting CDs should take heed of the currently obtaining epidemiological situation in the country and respond by challenging funding to public health interventions with a view to address the rising NCDs. Further, public health authorities should craft Public health policies that create supporting environments conducive for the populace to fight NCDs. Informed by the Ottawa charter, reorientation of health services to ensure more health systems responsiveness in the face of emerging NCDs is imperative. In addition, developing interpersonal skills for individuals to be able to act against NCD's risk behaviors and factors is key; at the same time, strengthening community action by capacitating community health workers to address risk behaviors and factors associated with NCDs at community level is imperative. Finally, the inadequacy of the epidemiological
{"title":"Epidemiological transition and the dual burden of communicable and noncommunicable diseases in Zimbabwe","authors":"Prosper Nyabani","doi":"10.4103/jncd.jncd_69_21","DOIUrl":"https://doi.org/10.4103/jncd.jncd_69_21","url":null,"abstract":"Background: The epidemiological transition model, coined by Abdel Omran in 1971, building on the demographic transition theory developed by Frank Notestein in 1945, has been largely credited for describing epidemiological situations both globally and nationally in many parts of the world. However, owing to its origins in the United States of America (USA), scholars critique the model's applicability to various geographical, socioeconomic, and epidemiological contexts, which are diversely different from the USA and vary from region to region. It was imperative to test the applicability of this model in sub-Saharan Africa (SSA), particularly Zimbabwe to ascertain versatility in describing epidemiological transitions, predicting population health status and whether the assumption of a shift from communicable diseases (CDs) to noncommunicable diseases (NCDs) could be confirmed in a low-income developing nation focusing on Zimbabwe. Methods: The study was a retrospective document review case study, using the existing framework of the epidemiological transition model, as a guiding principle, applying the model to describe the demographic and epidemiological circumstances prevailing within Zimbabwe. The researcher reviewed, compared, analyzed, and described the existing literature on population dynamics and epidemiological profile of the country for the period 1990–2020. Results: The epidemiological transition model attempts to describe the changes in epidemiological circumstances both at national and global scales. The model presumes a shift in CDs to NCDs. However, many scholars question the applicability of the model to diverse contexts, particularly within the SSA context. The Zimbabwean case was considered in light to its rising population growth, dual burden characterized by a high burden of communicable and rising NCDs. Findings from this study indicate that NCDs are on the rise in Zimbabwe. However, owing to a high burden of CDs, a dual disease burden model is the best fit to explain the epidemiological transition currently obtaining within Zimbabwe. Conclusions: Consequentially, funding streams targeting CDs should take heed of the currently obtaining epidemiological situation in the country and respond by challenging funding to public health interventions with a view to address the rising NCDs. Further, public health authorities should craft Public health policies that create supporting environments conducive for the populace to fight NCDs. Informed by the Ottawa charter, reorientation of health services to ensure more health systems responsiveness in the face of emerging NCDs is imperative. In addition, developing interpersonal skills for individuals to be able to act against NCD's risk behaviors and factors is key; at the same time, strengthening community action by capacitating community health workers to address risk behaviors and factors associated with NCDs at community level is imperative. Finally, the inadequacy of the epidemiological ","PeriodicalId":52935,"journal":{"name":"International Journal of Noncommunicable Diseases","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41861486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objectives: A cross-sectional survey was done to find out the prevalence and control status of cardiovascular risk factors among stroke survivors within a post-stroke period of 3 months to 1 year. Methodology: The data on the prevalence of risk factors were taken from past medical history and medical records. The risk factor control is defined as achieving the targeted levels of blood pressure, blood sugars and cholesterol. Data on a diet, physical activity, tobacco use, and alcohol consumption were also collected. Standard instruments were used to measure blood pressure, weight, height, and waist circumference (WC). The blood sugar and lipid values were taken from labratory reports. Results: Stroke survivors (N = 240) participated. Around 75% of the participants were obese or overweight. Normal WC was found only in 25% of the participants. Majority of the participants were not following a healthy diet (62.5%) or doing recommended physical activity (87.1%). The prevalence of diabetes (61.2%), hypertension (88.6%), and dyslipidemia (96%) were high among stroke survivors. The targeted level of diabetic control and hypertension control level was achieved by 26% and 36.2, respectively, while around 72% attained lipid control. Conclusion: The prevalence of cardiovascular risk factors is very high among stroke survivors, and it is poorly controlled.
{"title":"Poor risk factor control among stroke survivors - A cross-sectional survey","authors":"S. Shani, P. Sylaja, P. Sarma, Kutty Raman","doi":"10.4103/jncd.jncd_36_21","DOIUrl":"https://doi.org/10.4103/jncd.jncd_36_21","url":null,"abstract":"Objectives: A cross-sectional survey was done to find out the prevalence and control status of cardiovascular risk factors among stroke survivors within a post-stroke period of 3 months to 1 year. Methodology: The data on the prevalence of risk factors were taken from past medical history and medical records. The risk factor control is defined as achieving the targeted levels of blood pressure, blood sugars and cholesterol. Data on a diet, physical activity, tobacco use, and alcohol consumption were also collected. Standard instruments were used to measure blood pressure, weight, height, and waist circumference (WC). The blood sugar and lipid values were taken from labratory reports. Results: Stroke survivors (N = 240) participated. Around 75% of the participants were obese or overweight. Normal WC was found only in 25% of the participants. Majority of the participants were not following a healthy diet (62.5%) or doing recommended physical activity (87.1%). The prevalence of diabetes (61.2%), hypertension (88.6%), and dyslipidemia (96%) were high among stroke survivors. The targeted level of diabetic control and hypertension control level was achieved by 26% and 36.2, respectively, while around 72% attained lipid control. Conclusion: The prevalence of cardiovascular risk factors is very high among stroke survivors, and it is poorly controlled.","PeriodicalId":52935,"journal":{"name":"International Journal of Noncommunicable Diseases","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70808033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aims: This study was done to compare the prevalence of hypertension in oil-polluted and non-oil polluted communities in Rivers State Subjects and Methods: A community-based household analytical cross-sectional study was conducted on oil-polluted communities in Ogoni local government areas and nonoil polluted communities in Abua/Odua LGA both in Rivers State. An interviewer-administered structured World Health Organization STEPS instrument/questionnaire for NCD/chronic disease surveillance was used, and the sample size of 1000 participants was recruited via multistage sampling. Odds ratio (OR) and corresponding 95% confidence intervals (95% CI) we calculated through bivariate and multivariate regression analysis. Results: The prevalence of hypertension among persons resident in oil-polluted and nonoil-polluted communities was 59.8% and 46.6%, respectively. The comparison of prevalence showed statistical significance between both categories (χ2 = 16.97, P = 0.001). The regression model on crude analysis found residence (OR 1.69, 95% CI 1.32–2.17) and cigarette smoking (OR 1.65, 95% CI 1.19–2.29) were related to being hypertensive. Conclusions: The study revealed that participants who were residents in oil-polluted areas had 1.69 times higher odds of having hypertension over those in areas without oil pollution. However, moderate and vigorous physical activity reduced the chances of having hypertension by 95%, and 99%, respectively.
{"title":"Oil pollution and hypertension prevalence in Rivers State, Nigeria: A comparative study","authors":"J. Paul, O. Maduka","doi":"10.4103/jncd.jncd_18_21","DOIUrl":"https://doi.org/10.4103/jncd.jncd_18_21","url":null,"abstract":"Aims: This study was done to compare the prevalence of hypertension in oil-polluted and non-oil polluted communities in Rivers State Subjects and Methods: A community-based household analytical cross-sectional study was conducted on oil-polluted communities in Ogoni local government areas and nonoil polluted communities in Abua/Odua LGA both in Rivers State. An interviewer-administered structured World Health Organization STEPS instrument/questionnaire for NCD/chronic disease surveillance was used, and the sample size of 1000 participants was recruited via multistage sampling. Odds ratio (OR) and corresponding 95% confidence intervals (95% CI) we calculated through bivariate and multivariate regression analysis. Results: The prevalence of hypertension among persons resident in oil-polluted and nonoil-polluted communities was 59.8% and 46.6%, respectively. The comparison of prevalence showed statistical significance between both categories (χ2 = 16.97, P = 0.001). The regression model on crude analysis found residence (OR 1.69, 95% CI 1.32–2.17) and cigarette smoking (OR 1.65, 95% CI 1.19–2.29) were related to being hypertensive. Conclusions: The study revealed that participants who were residents in oil-polluted areas had 1.69 times higher odds of having hypertension over those in areas without oil pollution. However, moderate and vigorous physical activity reduced the chances of having hypertension by 95%, and 99%, respectively.","PeriodicalId":52935,"journal":{"name":"International Journal of Noncommunicable Diseases","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44037170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
B. Kwasi, T. Koranteng, Brenyah Florence, Edusei Anthony
Context: Noncommunicable diseases (NCDs) such as cardiovascular diseases, cancers, hypertension, kidney diseases, and diabetes account for sizeable proportion of global deaths. The proximate causes aside biological and genetics are behavioral risk factors include dietary practices. Unhealthy dietary practice leading to the occurrence of NCDs blamed for the drawback of social and economic development of lower- and middle-income countries. Aims: This research focuses on establishing links among the political economy framework (education, occupation, income, residential place, and mass media), dietary practices, and the occurrence of NCDs in Ghana. Settings and Design: It adopted a mixed method approach using the Ghana Demographic and Health Survey (2014), with a sample of 4122 and 32 qualitative interviews from four regions. Subjects and Methods: In-depth, key informant interviews, focus groups discussions, and secondary data were used. The qualitative arm was analyzed using the thematic content analysis. Statistical Analysis Used: Descriptive statistics and probit regression were used to ascertain the influences of the constituents of political economy using individual's dietary intakes. Results: The present study found that, differences in income levels (P < 0.05), residential place of stay (P < 0.05), and access to mass media (P < 0.05) were statistically significant to dietary practices and had major implications for NCDs occurrence. The qualitative outcome revealed that, educational and occupational status of individuals may influence dietary practices. The regression revealed that females are exposed to unhealthy dietary practices by 6.2% points. Moreover, rural dwelling had moderate influence on unhealthy dietary practices (3.3% points) than urban dwelling. Again, professionals, sales, and service categories have 5.8%, 5.7%, and 7.6% points unhealthy practices, respectively.
{"title":"Political economy framework and the occurrence of noncommunicable diseases. “Framing dietary practices in Ghana as the receptacle”","authors":"B. Kwasi, T. Koranteng, Brenyah Florence, Edusei Anthony","doi":"10.4103/jncd.jncd_30_21","DOIUrl":"https://doi.org/10.4103/jncd.jncd_30_21","url":null,"abstract":"Context: Noncommunicable diseases (NCDs) such as cardiovascular diseases, cancers, hypertension, kidney diseases, and diabetes account for sizeable proportion of global deaths. The proximate causes aside biological and genetics are behavioral risk factors include dietary practices. Unhealthy dietary practice leading to the occurrence of NCDs blamed for the drawback of social and economic development of lower- and middle-income countries. Aims: This research focuses on establishing links among the political economy framework (education, occupation, income, residential place, and mass media), dietary practices, and the occurrence of NCDs in Ghana. Settings and Design: It adopted a mixed method approach using the Ghana Demographic and Health Survey (2014), with a sample of 4122 and 32 qualitative interviews from four regions. Subjects and Methods: In-depth, key informant interviews, focus groups discussions, and secondary data were used. The qualitative arm was analyzed using the thematic content analysis. Statistical Analysis Used: Descriptive statistics and probit regression were used to ascertain the influences of the constituents of political economy using individual's dietary intakes. Results: The present study found that, differences in income levels (P < 0.05), residential place of stay (P < 0.05), and access to mass media (P < 0.05) were statistically significant to dietary practices and had major implications for NCDs occurrence. The qualitative outcome revealed that, educational and occupational status of individuals may influence dietary practices. The regression revealed that females are exposed to unhealthy dietary practices by 6.2% points. Moreover, rural dwelling had moderate influence on unhealthy dietary practices (3.3% points) than urban dwelling. Again, professionals, sales, and service categories have 5.8%, 5.7%, and 7.6% points unhealthy practices, respectively.","PeriodicalId":52935,"journal":{"name":"International Journal of Noncommunicable Diseases","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46843392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
William A. Castro-Vera, Sofia Esther Fernández-de la Rosa, José Villarreal-Escorcia, I. Lozada-Martinez
{"title":"Chronic noncommunicable diseases and post-COVID 19 syndrome: The need to create specialized centers for primary care","authors":"William A. Castro-Vera, Sofia Esther Fernández-de la Rosa, José Villarreal-Escorcia, I. Lozada-Martinez","doi":"10.4103/jncd.jncd_48_21","DOIUrl":"https://doi.org/10.4103/jncd.jncd_48_21","url":null,"abstract":"","PeriodicalId":52935,"journal":{"name":"International Journal of Noncommunicable Diseases","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49272234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D. Munodawafa, Adele Webb, P. Barango, David Houerto, Mosoka P. Fallah, A. Kobie
{"title":"Noncommunicable diseases and COVID-19 in Africa: A call for universal health coverage","authors":"D. Munodawafa, Adele Webb, P. Barango, David Houerto, Mosoka P. Fallah, A. Kobie","doi":"10.4103/jncd.jncd_47_21","DOIUrl":"https://doi.org/10.4103/jncd.jncd_47_21","url":null,"abstract":"","PeriodicalId":52935,"journal":{"name":"International Journal of Noncommunicable Diseases","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43324325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
G. Nazar, M. Arora, Vinay K. Gupta, Tina Rawal, Aastha Chugh, Surbhi Shrivastava, P. Dhore, A. Bhatt, S. Deshpande, A. Unnikrishnan
Objective: Inadequate knowledge about diabetes leads to its under-diagnosis and sub-optimal control. We studied the impact of project diabetes with dignity (DWD) intervention on knowledge and quality of life (QoL) among adults with diabetes in a rural Indian setting. Methods: DWD was a community-based, quasi-experimental trial conducted with 416 participants (30–70 years) with diabetes across two Primary Health Centers (one intervention; one control) in Western India, over a year. The intervention involved monthly home visits, patient/caregiver, and community-based awareness-raising activities by trained accredited social health activists (ASHAs) workers. Differences in changes in knowledge about: Diabetes, symptoms, management, and complications, and QoL between participants in the intervention versus control areas, from baseline to end-line, were assessed using a questionnaire and analyzed via mixed-effects regression models. Results: About 52% of patients belonged to the intervention group. There was a significant increase in knowledge about diagnosis/management among participants in intervention group (31.48% [95% confidence interval (CI) 24.52–38.43] to 59.55% [52.52–66.58]) versus a decline in the control group (40.73% [33.40–48.07] to 27.95% [19.40–34.50]) (P < 0.001). Similar improvements in intervention group were observed for knowledge about symptoms/complications of diabetes. For QoL, percentage of patients having some self-care problems showed a higher decline in intervention group (29.46% to 6.98%) versus control group (4.85% to 3.55%) (P = 0.005). Reduction in anxiety/depression was significant in the intervention versus control group (P < 0.001). Conclusion: DWD was effective in improving QoL and diabetes knowledge which are key to prevent disease progression/complications in the intervention compared to the control group. Capacity-building of community health workers such as ASHAs, for the prevention and management of diabetes in rural settings, is recommended.
{"title":"The impact of project diabetes with dignity intervention on knowledge and quality of life among adults with diabetes in a rural Indian setting","authors":"G. Nazar, M. Arora, Vinay K. Gupta, Tina Rawal, Aastha Chugh, Surbhi Shrivastava, P. Dhore, A. Bhatt, S. Deshpande, A. Unnikrishnan","doi":"10.4103/jncd.jncd_31_21","DOIUrl":"https://doi.org/10.4103/jncd.jncd_31_21","url":null,"abstract":"Objective: Inadequate knowledge about diabetes leads to its under-diagnosis and sub-optimal control. We studied the impact of project diabetes with dignity (DWD) intervention on knowledge and quality of life (QoL) among adults with diabetes in a rural Indian setting. Methods: DWD was a community-based, quasi-experimental trial conducted with 416 participants (30–70 years) with diabetes across two Primary Health Centers (one intervention; one control) in Western India, over a year. The intervention involved monthly home visits, patient/caregiver, and community-based awareness-raising activities by trained accredited social health activists (ASHAs) workers. Differences in changes in knowledge about: Diabetes, symptoms, management, and complications, and QoL between participants in the intervention versus control areas, from baseline to end-line, were assessed using a questionnaire and analyzed via mixed-effects regression models. Results: About 52% of patients belonged to the intervention group. There was a significant increase in knowledge about diagnosis/management among participants in intervention group (31.48% [95% confidence interval (CI) 24.52–38.43] to 59.55% [52.52–66.58]) versus a decline in the control group (40.73% [33.40–48.07] to 27.95% [19.40–34.50]) (P < 0.001). Similar improvements in intervention group were observed for knowledge about symptoms/complications of diabetes. For QoL, percentage of patients having some self-care problems showed a higher decline in intervention group (29.46% to 6.98%) versus control group (4.85% to 3.55%) (P = 0.005). Reduction in anxiety/depression was significant in the intervention versus control group (P < 0.001). Conclusion: DWD was effective in improving QoL and diabetes knowledge which are key to prevent disease progression/complications in the intervention compared to the control group. Capacity-building of community health workers such as ASHAs, for the prevention and management of diabetes in rural settings, is recommended.","PeriodicalId":52935,"journal":{"name":"International Journal of Noncommunicable Diseases","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41364605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Context: The global burden and threat of noncommunicable diseases (NCDs) constitutes a major public health challenge that undermines social and economic development throughout the world. NCDs are one of the leading causes of adult morbidity and mortality globally. The disease burden in India due to NCDs has increased from 30% to 55% between 1990 and 2016. Aims: We aimed to assess the effect of nutrition education intervention on dietary awareness, practices, and anthropometry. Settings and Design: This design was a facility-based before-and-after intervention study without control. Materials and Methods: This study was conducted in five phases: planning and recruitment, preintervention, intervention, washout, and postintervention. Data were collected using a pretested, semi-structured interview schedule under the following heads – personal, sociodemographic, and behavioral risk factors of NCDs. Anthropometric examination included weight, height, waist, and hip circumference measurement. Statistical Analysis: Collected data were entered into MS Excel and analyzed using IBM SPSS 25 for descriptive and inferential statistics. Results: There was a significant increase in mean score for dietary practices and knowledge regarding different food items in the study group. The mean number of servings of fruits and vegetables increased significantly following intervention in the study group (P = 0.001). Significant change in body mass index before and after intervention was found to be in the age group of >60 years (P = 0.041). Conclusions: The study has shown the usefulness of intervention aimed at improving dietary behavior among patients of NCDs. With growing burden, there is a need for such innovative and cost-effective measures for halting the rising burden.
{"title":"Effect of nutrition education package on dietary modification and anthropometry among attendees of a noncommunicable disease clinic at a rural primary health-care facility in Delhi","authors":"R. Katre, B. Banerjee, P. Lal, Pragya Sharma","doi":"10.4103/jncd.jncd_22_21","DOIUrl":"https://doi.org/10.4103/jncd.jncd_22_21","url":null,"abstract":"Context: The global burden and threat of noncommunicable diseases (NCDs) constitutes a major public health challenge that undermines social and economic development throughout the world. NCDs are one of the leading causes of adult morbidity and mortality globally. The disease burden in India due to NCDs has increased from 30% to 55% between 1990 and 2016. Aims: We aimed to assess the effect of nutrition education intervention on dietary awareness, practices, and anthropometry. Settings and Design: This design was a facility-based before-and-after intervention study without control. Materials and Methods: This study was conducted in five phases: planning and recruitment, preintervention, intervention, washout, and postintervention. Data were collected using a pretested, semi-structured interview schedule under the following heads – personal, sociodemographic, and behavioral risk factors of NCDs. Anthropometric examination included weight, height, waist, and hip circumference measurement. Statistical Analysis: Collected data were entered into MS Excel and analyzed using IBM SPSS 25 for descriptive and inferential statistics. Results: There was a significant increase in mean score for dietary practices and knowledge regarding different food items in the study group. The mean number of servings of fruits and vegetables increased significantly following intervention in the study group (P = 0.001). Significant change in body mass index before and after intervention was found to be in the age group of >60 years (P = 0.041). Conclusions: The study has shown the usefulness of intervention aimed at improving dietary behavior among patients of NCDs. With growing burden, there is a need for such innovative and cost-effective measures for halting the rising burden.","PeriodicalId":52935,"journal":{"name":"International Journal of Noncommunicable Diseases","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48907683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Namrata Kharat, P. Sivanantham, G. Kumar, James T. Devasia, S. Kar
Background: Hypertension is a global public health issue. Geographic information systems (GIS) are increasingly being used by health-care systems as an emerging tool to address the public health burden of hypertension. Objective: The objective of the study is to describe the geographic distribution of adults with known hypertension residing in the urban field practice area of a tertiary care institution and to assess the factors associated with its control status. Materials and Methods: We conducted a cross-sectional analytical study in an urban health center (UHC) with adults with hypertension (n = 343) seeking care from the NCD clinic of UHC and private clinics were included. Geo-coding was done (n = 343) using digital GPS device by house-to-house visit and average of the three blood pressure recordings using digital sphygmomanometer taken for assessing control status (n = 277) of hypertension. A structured questionnaire was used to collect sociodemographic, risk factors distribution, and medication adherence. Geospatial analysis was done using QGIS 3.0, ArcGIS 10.2 and SPSS version 22 (IBM Corp. Armonk, NY, USA) was used for statistical analysis. Results: The geographic distribution showed clusters and hotspots in the study area. Of the 277 study participants, 57.4% (51.6–63.5) had blood pressure under control and 41% were male. Patients with age ≥60 years (prevalence ratios [PR]: 1.2, 95% CI: 1–1.6), with no comorbidity (PR: 1.3, 95% CI: 1–1.7), high medicine adherence (PR: 7.6, 95% CI: 3.9–14.6) were independent factors associated with control status. Conclusion: The study identified the clustering and hotspot areas of known patients with hypertension. Around three-fifth of known hypertensives had their blood pressure under control.
{"title":"Spatial distribution and control status of hypertension in urban field practice area of a tertiary medical care institution of South India: A cross-sectional analytical study","authors":"Namrata Kharat, P. Sivanantham, G. Kumar, James T. Devasia, S. Kar","doi":"10.4103/jncd.jncd_28_21","DOIUrl":"https://doi.org/10.4103/jncd.jncd_28_21","url":null,"abstract":"Background: Hypertension is a global public health issue. Geographic information systems (GIS) are increasingly being used by health-care systems as an emerging tool to address the public health burden of hypertension. Objective: The objective of the study is to describe the geographic distribution of adults with known hypertension residing in the urban field practice area of a tertiary care institution and to assess the factors associated with its control status. Materials and Methods: We conducted a cross-sectional analytical study in an urban health center (UHC) with adults with hypertension (n = 343) seeking care from the NCD clinic of UHC and private clinics were included. Geo-coding was done (n = 343) using digital GPS device by house-to-house visit and average of the three blood pressure recordings using digital sphygmomanometer taken for assessing control status (n = 277) of hypertension. A structured questionnaire was used to collect sociodemographic, risk factors distribution, and medication adherence. Geospatial analysis was done using QGIS 3.0, ArcGIS 10.2 and SPSS version 22 (IBM Corp. Armonk, NY, USA) was used for statistical analysis. Results: The geographic distribution showed clusters and hotspots in the study area. Of the 277 study participants, 57.4% (51.6–63.5) had blood pressure under control and 41% were male. Patients with age ≥60 years (prevalence ratios [PR]: 1.2, 95% CI: 1–1.6), with no comorbidity (PR: 1.3, 95% CI: 1–1.7), high medicine adherence (PR: 7.6, 95% CI: 3.9–14.6) were independent factors associated with control status. Conclusion: The study identified the clustering and hotspot areas of known patients with hypertension. Around three-fifth of known hypertensives had their blood pressure under control.","PeriodicalId":52935,"journal":{"name":"International Journal of Noncommunicable Diseases","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42628836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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