Pub Date : 2021-11-01DOI: 10.4103/2468-8827.330648
M. Farkouh, Arrti Bhasin, D. Ko, Aviral Roy, I. Khurana, A. Chockalingam
This white paper will summarize the key topics, outcomes, and recommendations from the Canada-India Healthcare Summit 2021 COVID-19 Pandemic Response and Initiatives sessions held on May 20–21, 2021. In particular, the authors have focused their attention on topics on the effect of COVID-19 on noncommunicable diseases, depression, research on substance abuse, and post COVID-19 pain management. The authors have developed a better understanding of these conditions' interplay with COVID-19 infection. The paper also deals with important topics around the effects of NCD on COVID-19 and vice versa, as well as key considerations around research and development, innovation, policy, and finally, summarizes the ways forward in which Canada and India could collaborate strategically. We also include key points raised during the summit.
{"title":"Chronic noncommunicable diseases and COVID-19: How they both interact","authors":"M. Farkouh, Arrti Bhasin, D. Ko, Aviral Roy, I. Khurana, A. Chockalingam","doi":"10.4103/2468-8827.330648","DOIUrl":"https://doi.org/10.4103/2468-8827.330648","url":null,"abstract":"This white paper will summarize the key topics, outcomes, and recommendations from the Canada-India Healthcare Summit 2021 COVID-19 Pandemic Response and Initiatives sessions held on May 20–21, 2021. In particular, the authors have focused their attention on topics on the effect of COVID-19 on noncommunicable diseases, depression, research on substance abuse, and post COVID-19 pain management. The authors have developed a better understanding of these conditions' interplay with COVID-19 infection. The paper also deals with important topics around the effects of NCD on COVID-19 and vice versa, as well as key considerations around research and development, innovation, policy, and finally, summarizes the ways forward in which Canada and India could collaborate strategically. We also include key points raised during the summit.","PeriodicalId":52935,"journal":{"name":"International Journal of Noncommunicable Diseases","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49457231","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}
Pub Date : 2021-11-01DOI: 10.4103/2468-8827.330657
K. Reddy
{"title":"India between the waves","authors":"K. Reddy","doi":"10.4103/2468-8827.330657","DOIUrl":"https://doi.org/10.4103/2468-8827.330657","url":null,"abstract":"","PeriodicalId":52935,"journal":{"name":"International Journal of Noncommunicable Diseases","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47916419","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: Cardiac arrhythmias are one of the leading causes of heart failure. In particular, atrial fibrillation (AFib) is a kind of arrhythmia that can lead to heart stroke and myocardial infarction. It is very important and crucial to predict AFib at an early stage to prevent heart disease. Electrocardiogram is one of the premium diagnostic tools which is used by most of the researchers for predicting irregular heartbeats. There are many works carried out in finding heart disease using machine learning classifiers. Aims and Objectives: Deep learning based hybrid Long Short Term Memory (LSTM) network is hybridized with Enhanced Whale Optimization (EWO) to minimize the network optimization and configuration issues faced in the existing models and proposed to increases the accuracy of predicting AFib. Materials and Methods: The proposed LSTM network is hybridized with a EWO technique for predicting AFib. This study uses a hybrid LSTM EWO network for classifying the various output labels of heart disease. EWO is used to predict the most relevant features from the raw dataset. Then, the LSTM model is used to predict the AFib of a patient from normal ECG data. Results: The DL based LSTM EWO achieves better results in all the performance metrics by analyzing the optimized features in feature space, training, and testing phase and successfully obtains better performance in an effective manner. LSTM improves the accuracy by reducing the number of units in the hidden layer which optimizes the network configuration. The proposed model achieves 96.12% accuracy which is 12.81% higher than RF, 15.01% higher than GB, 28.04% higher than CART, and 16.92% higher than SVM. Conclusion: The proposed model hybrid LSTM network integrated EWO for predicting the AFib. The EWO is applied for selecting the most appropriate features needed for the model to learn and produce improvised performance. The optimization and network configuration problems faced in the existing studies are avoided by choosing the suitable number of LSTM units and the size of the time window. This has been implemented through LSTM units and their window size. In addition, we made a statistical examination to prove the importance of proposed work against other models. It is observed that the experimental results attained with 96% of accuracy, better than conventional models.
{"title":"Automated atrial fibrillation prediction using a hybrid long short-term memory network with enhanced whale optimization algorithm on electrocardiogram datasets","authors":"Chocko Valliappa, Revathi Kalyanasundaram, Sathiyabhama Balasubramaniam, Sankar Sennan, Nirmalesh K. Sampath Kumar","doi":"10.4103/2468-8827.330654","DOIUrl":"https://doi.org/10.4103/2468-8827.330654","url":null,"abstract":"Background: Cardiac arrhythmias are one of the leading causes of heart failure. In particular, atrial fibrillation (AFib) is a kind of arrhythmia that can lead to heart stroke and myocardial infarction. It is very important and crucial to predict AFib at an early stage to prevent heart disease. Electrocardiogram is one of the premium diagnostic tools which is used by most of the researchers for predicting irregular heartbeats. There are many works carried out in finding heart disease using machine learning classifiers. Aims and Objectives: Deep learning based hybrid Long Short Term Memory (LSTM) network is hybridized with Enhanced Whale Optimization (EWO) to minimize the network optimization and configuration issues faced in the existing models and proposed to increases the accuracy of predicting AFib. Materials and Methods: The proposed LSTM network is hybridized with a EWO technique for predicting AFib. This study uses a hybrid LSTM EWO network for classifying the various output labels of heart disease. EWO is used to predict the most relevant features from the raw dataset. Then, the LSTM model is used to predict the AFib of a patient from normal ECG data. Results: The DL based LSTM EWO achieves better results in all the performance metrics by analyzing the optimized features in feature space, training, and testing phase and successfully obtains better performance in an effective manner. LSTM improves the accuracy by reducing the number of units in the hidden layer which optimizes the network configuration. The proposed model achieves 96.12% accuracy which is 12.81% higher than RF, 15.01% higher than GB, 28.04% higher than CART, and 16.92% higher than SVM. Conclusion: The proposed model hybrid LSTM network integrated EWO for predicting the AFib. The EWO is applied for selecting the most appropriate features needed for the model to learn and produce improvised performance. The optimization and network configuration problems faced in the existing studies are avoided by choosing the suitable number of LSTM units and the size of the time window. This has been implemented through LSTM units and their window size. In addition, we made a statistical examination to prove the importance of proposed work against other models. It is observed that the experimental results attained with 96% of accuracy, better than conventional models.","PeriodicalId":52935,"journal":{"name":"International Journal of Noncommunicable Diseases","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43613996","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}
Pub Date : 2021-11-01DOI: 10.4103/2468-8827.330647
Rohin K. Iyer, V. Venkataramanan, G. Pierce, Nikita Thakkar, V. Natarajan, A. Chockalingam
This white paper summarizes the key outcomes, topics, and recommendations from the Canada-India Healthcare Summit 2021 Conference, Biotechnology Session, held on May 20–21, 2021. In particular, the authors have focused their attention on topics ranging from research and development into the etiology and treatment of COVID-19 to novel approaches, such as ultraviolet-C disinfection and cell and gene therapy. The paper also deals with important topics around the effects of food distribution and nutrition on COVID-19 and vice versa, as well as key considerations around research and development, innovation, policy, grants, and incentives, and finally, summarizes the ways in which Canada and India, being close allies, have already begun to partner to fight the pandemic (as well as future strategies to continue this excellent progress). We also include key points raised during the summit and summarize them as part of this white paper.
{"title":"Biomedical advances in the treatment of COVID-19: An Indo-Canadian perspective","authors":"Rohin K. Iyer, V. Venkataramanan, G. Pierce, Nikita Thakkar, V. Natarajan, A. Chockalingam","doi":"10.4103/2468-8827.330647","DOIUrl":"https://doi.org/10.4103/2468-8827.330647","url":null,"abstract":"This white paper summarizes the key outcomes, topics, and recommendations from the Canada-India Healthcare Summit 2021 Conference, Biotechnology Session, held on May 20–21, 2021. In particular, the authors have focused their attention on topics ranging from research and development into the etiology and treatment of COVID-19 to novel approaches, such as ultraviolet-C disinfection and cell and gene therapy. The paper also deals with important topics around the effects of food distribution and nutrition on COVID-19 and vice versa, as well as key considerations around research and development, innovation, policy, grants, and incentives, and finally, summarizes the ways in which Canada and India, being close allies, have already begun to partner to fight the pandemic (as well as future strategies to continue this excellent progress). We also include key points raised during the summit and summarize them as part of this white paper.","PeriodicalId":52935,"journal":{"name":"International Journal of Noncommunicable Diseases","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44903587","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}
{"title":"History of public health-distorted Indian contribution although significant for addressing noncommunicable diseases","authors":"J. Thakur, H. Kaur","doi":"10.4103/jncd.jncd_84_21","DOIUrl":"https://doi.org/10.4103/jncd.jncd_84_21","url":null,"abstract":"","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":"49387719","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: Glycemic control in diabetes can be achieved by adopting self-care practices. It also leads to reduction of complications and improvement in the quality of life. Identification of barriers to adopting these practices can help devise strategies to overcome them. This study was conducted to understand the self-care practices among diabetics and the barriers affecting those practices among diabetics in the urban slum area. Materials and Methods: This qualitative study using Focus Group Discussions (FGDs) was conducted in a chronic disease Outpatient clinic in Mumbai, in November 2020. Four FGDs with 32 participants were conducted. Thematic analysis of the transcripts was done. Results: Three major themes were identified – living with diabetes, practices to maintain glycemic control, and potential barriers. Barriers for self-care practices were - confusing advice provided by family and doctors, feeling rejected (stigmatized), lack of motivation for exercise, complications of diabetes, lack of family cooperation, lack of knowledge on foot care, physical constraints, nonavailability of medications, lack of social and financial support, suboptimal knowledge regarding diabetes, and misconceptions. Conclusions: Motivating diabetic patients for regular physical activity by starting from simple indoor exercises to outdoor exercises are necessary. Counseling the family members on the complications of diabetes due to inappropriate dietary practices should be advocated. Improvement in doctor-patient communication and providing information on the foot care practices is the need of the hour.
{"title":"Exploration of barriers to self-care practices among diabetic patients attending chronic disease clinic in an urban slum","authors":"A. Shah, Sandeep Mishra, P. Ravichandran","doi":"10.4103/jncd.jncd_40_21","DOIUrl":"https://doi.org/10.4103/jncd.jncd_40_21","url":null,"abstract":"Background: Glycemic control in diabetes can be achieved by adopting self-care practices. It also leads to reduction of complications and improvement in the quality of life. Identification of barriers to adopting these practices can help devise strategies to overcome them. This study was conducted to understand the self-care practices among diabetics and the barriers affecting those practices among diabetics in the urban slum area. Materials and Methods: This qualitative study using Focus Group Discussions (FGDs) was conducted in a chronic disease Outpatient clinic in Mumbai, in November 2020. Four FGDs with 32 participants were conducted. Thematic analysis of the transcripts was done. Results: Three major themes were identified – living with diabetes, practices to maintain glycemic control, and potential barriers. Barriers for self-care practices were - confusing advice provided by family and doctors, feeling rejected (stigmatized), lack of motivation for exercise, complications of diabetes, lack of family cooperation, lack of knowledge on foot care, physical constraints, nonavailability of medications, lack of social and financial support, suboptimal knowledge regarding diabetes, and misconceptions. Conclusions: Motivating diabetic patients for regular physical activity by starting from simple indoor exercises to outdoor exercises are necessary. Counseling the family members on the complications of diabetes due to inappropriate dietary practices should be advocated. Improvement in doctor-patient communication and providing information on the foot care practices is the need of the hour.","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":"46493200","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}
The prevalence of noncommunicable diseases (NCDs) has increased drastically over recent decades, with 41 million deaths each year, equivalent to 71% of all deaths globally. Unhealthy food choices and food habits, excessive calories, and inactivity are apparent factors to NCDs, namely obesity, diabetes mellitus, cancer, and cardiovascular disease. Healthy dietary intake and calorie restrictions have a promising effect on longevity. Eventually, adopting these strategies may delay the onset and decrease the burden of NCDs. Recent findings proved that nutrition has a strong association with the prevalence of NCDs. American Institute for Cancer Research and the World Cancer Research Fund says 30%–40% of cancers are preventable by adopting healthy food choices, dietary restrictions, engaging in physical activity, and maintaining body mass index. This review focuses on dietary intake and dietary restrictions and finally leads to understand the vital role of gut microbiome in managing NCDs.
{"title":"Dietary approaches in management of noncommunicable diseases: A review","authors":"Janeline Lunghar, A. Banu","doi":"10.4103/jncd.jncd_63_21","DOIUrl":"https://doi.org/10.4103/jncd.jncd_63_21","url":null,"abstract":"The prevalence of noncommunicable diseases (NCDs) has increased drastically over recent decades, with 41 million deaths each year, equivalent to 71% of all deaths globally. Unhealthy food choices and food habits, excessive calories, and inactivity are apparent factors to NCDs, namely obesity, diabetes mellitus, cancer, and cardiovascular disease. Healthy dietary intake and calorie restrictions have a promising effect on longevity. Eventually, adopting these strategies may delay the onset and decrease the burden of NCDs. Recent findings proved that nutrition has a strong association with the prevalence of NCDs. American Institute for Cancer Research and the World Cancer Research Fund says 30%–40% of cancers are preventable by adopting healthy food choices, dietary restrictions, engaging in physical activity, and maintaining body mass index. This review focuses on dietary intake and dietary restrictions and finally leads to understand the vital role of gut microbiome in managing NCDs.","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":"42991865","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 and Objective : This study aimed to estimate the prevalence and correlates of underweight and overweight/obesity among middle aged and older adults in India. Materials and Methods : The cross-sectional sample consisted of 72,262 individuals (≥45 years) from the Longitudinal Aging Study in India Wave 1 in 2017–2018. Multinomial logistic regression was used to estimate the factors associated with underweight and overweight/obesity relative to normal weight. Results : The prevalence of normal weight (18.5–22.9 kg/m2) was 36.7%, underweight (<18.5 kg/m2) 20.8%, overweight (23.0–24.9 kg/m2) 14.2%, Class I obesity (25.0–29.9 kg/m2) 20.8%, and Class II obesity (≥30.0 kg/m2) 7.4%. In adjusted multinomial logistic regression, the factors positively associated with underweight were older age (≥70 years) (adjusted relative risk ratio [ARRR]: 1.94, confidence interval [CI]: 1.75–2.14), food insecurity (ARRR: 1.19, CI: 1.07–1.33), poor or fair self-rated health status (ARRR: 1.14, CI: 1.05–1.33), and current tobacco use (ARRR: 1.42, CI: 1.31–1.53). The factors negatively associated with underweight were higher education (≥10 years) (ARRR: 0.67, CI: 0.48–0.92), high subjective socioeconomic status (ARRR: 0.78, CI: 0.67–0.92), urban residence (ARRR: 0.72, CI: 0.61–0.84), high life satisfaction (ARRR: 0.83, CI: 0.75–0.91), hypertension (ARRR: 0.64, CI: 0.58–0.69), diabetes (ARRR: 0.50, CI: 0.42–0.59), and heart disease or stroke (ARRR: 0.74, CI: 0.61–0.89). The factors positively associated with overweight/obesity were higher education (≥10 years) (ARRR: 2.09, CI: 1.87–2.33), high subjective socioeconomic status (ARRR: 1.44, CI: 1.31–1.59), urban residence (ARRR: 1.94, CI: 1.79–2.11), high life satisfaction (ARRR: 1.12, CI: 1.04–1.20), hypertension (ARRR: 1.89, CI: 1.76–2.02), type 2 diabetes (ARRR: 1.80, CI: 1.59–2.04), and raised cholesterol (ARRR: 2.75, CI: 2.11–3.58). The factors negatively associated with overweight/obesity were older age (≥70 years) (ARRR: 0.44, CI: 0.39–0.49), male sex (ARRR: 0.59, CI: 0.54–0.64), food insecurity (ARRR: 0.85, CI: 0.76–0.94), vigorous physical activity (>once/week) (ARRR: 0.91, CI: 0.84–0.99), current tobacco use (ARRR: 0.69, CI: 0.64–0.74), and heavy episodic alcohol use (ARRR: 0.70, CI: 0.58–0.85). Conclusion : One in five middle-aged and older adults in India were underweight and more than two in five were overweight/obese, confirming a dual burden of malnutrition in India.
{"title":"Underweight and overweight/obesity among middle aged and older adults in India: Prevalence and correlates from a national survey in 2017–2018","authors":"S. Pengpid, K. Peltzer","doi":"10.4103/jncd.jncd_9_21","DOIUrl":"https://doi.org/10.4103/jncd.jncd_9_21","url":null,"abstract":"Background and Objective : This study aimed to estimate the prevalence and correlates of underweight and overweight/obesity among middle aged and older adults in India. Materials and Methods : The cross-sectional sample consisted of 72,262 individuals (≥45 years) from the Longitudinal Aging Study in India Wave 1 in 2017–2018. Multinomial logistic regression was used to estimate the factors associated with underweight and overweight/obesity relative to normal weight. Results : The prevalence of normal weight (18.5–22.9 kg/m2) was 36.7%, underweight (<18.5 kg/m2) 20.8%, overweight (23.0–24.9 kg/m2) 14.2%, Class I obesity (25.0–29.9 kg/m2) 20.8%, and Class II obesity (≥30.0 kg/m2) 7.4%. In adjusted multinomial logistic regression, the factors positively associated with underweight were older age (≥70 years) (adjusted relative risk ratio [ARRR]: 1.94, confidence interval [CI]: 1.75–2.14), food insecurity (ARRR: 1.19, CI: 1.07–1.33), poor or fair self-rated health status (ARRR: 1.14, CI: 1.05–1.33), and current tobacco use (ARRR: 1.42, CI: 1.31–1.53). The factors negatively associated with underweight were higher education (≥10 years) (ARRR: 0.67, CI: 0.48–0.92), high subjective socioeconomic status (ARRR: 0.78, CI: 0.67–0.92), urban residence (ARRR: 0.72, CI: 0.61–0.84), high life satisfaction (ARRR: 0.83, CI: 0.75–0.91), hypertension (ARRR: 0.64, CI: 0.58–0.69), diabetes (ARRR: 0.50, CI: 0.42–0.59), and heart disease or stroke (ARRR: 0.74, CI: 0.61–0.89). The factors positively associated with overweight/obesity were higher education (≥10 years) (ARRR: 2.09, CI: 1.87–2.33), high subjective socioeconomic status (ARRR: 1.44, CI: 1.31–1.59), urban residence (ARRR: 1.94, CI: 1.79–2.11), high life satisfaction (ARRR: 1.12, CI: 1.04–1.20), hypertension (ARRR: 1.89, CI: 1.76–2.02), type 2 diabetes (ARRR: 1.80, CI: 1.59–2.04), and raised cholesterol (ARRR: 2.75, CI: 2.11–3.58). The factors negatively associated with overweight/obesity were older age (≥70 years) (ARRR: 0.44, CI: 0.39–0.49), male sex (ARRR: 0.59, CI: 0.54–0.64), food insecurity (ARRR: 0.85, CI: 0.76–0.94), vigorous physical activity (>once/week) (ARRR: 0.91, CI: 0.84–0.99), current tobacco use (ARRR: 0.69, CI: 0.64–0.74), and heavy episodic alcohol use (ARRR: 0.70, CI: 0.58–0.85). Conclusion : One in five middle-aged and older adults in India were underweight and more than two in five were overweight/obese, confirming a dual burden of malnutrition in India.","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":"46202913","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: Hypertension is known to affect more than one billion of the world's population with complications such as stroke and myocardial infarction. Compliance with hypertension therapy is the extent to which one's behavior in following a diet plan, taking medications, or making lifestyle changes corresponds to the agreed recommendations from a health-care provider. This research explores factors influencing noncompliance to hypertension treatment in the North Dayi District of the Volta Region, Ghana. Aims: To determine the prevalence of noncompliance to hypertension therapy in patients diagnosed with hypertension in the study population. 1. To evaluate the knowledge of patients on hypertension. 2. To ascertain contributing factors influencing noncompliance to the treatment of hypertension. Settings and Design: A cross-sectional study. Methodology: A cross-sectional study was conducted from January 2021 to February 2021 in the North Dayi District. A sample of 191 respondents diagnosed with hypertension for at least 1 month with or without comorbidities and on treatment were selected using the systematic sampling method. An Adherence Barrier Questionnaire was adopted to assess reliability in the responses. Bivariate and multivariate analyses were done using noncompliance to hypertension therapy as the outcome of interest. Statistical Analysis Used: Fisher's Exact, logistic regression, Cronbach's alpha analysis. Results: Data were collected from 191 study participants between the ages of 25 and 101 years with an average age estimated at (62.2 ± 13.5) years. The prevalence of nonadherence to hypertension treatment in this study was 31.4% in the North Dayi District Hospital. The reported Marital status and Default review were statistically significant predictors of adherence to hypertension treatment at a chosen 95% Confidence Level. Conclusion: The degree of non-compliance to hypertension treatment was less than fifty per cent among respondents. The data suggests that strategies should be developed to help reduce waiting times for consultation at the Hypertension Clinic by the District Hospital in collaboration with other stakeholders.
{"title":"Factors associated with noncompliance to hypertension treatment in adults in a district health facility in north Dayi in the Volta Region of Ghana","authors":"Stephen Manortey, Sedinam Adamaley","doi":"10.4103/jncd.jncd_51_21","DOIUrl":"https://doi.org/10.4103/jncd.jncd_51_21","url":null,"abstract":"Context: Hypertension is known to affect more than one billion of the world's population with complications such as stroke and myocardial infarction. Compliance with hypertension therapy is the extent to which one's behavior in following a diet plan, taking medications, or making lifestyle changes corresponds to the agreed recommendations from a health-care provider. This research explores factors influencing noncompliance to hypertension treatment in the North Dayi District of the Volta Region, Ghana. Aims: To determine the prevalence of noncompliance to hypertension therapy in patients diagnosed with hypertension in the study population. 1. To evaluate the knowledge of patients on hypertension. 2. To ascertain contributing factors influencing noncompliance to the treatment of hypertension. Settings and Design: A cross-sectional study. Methodology: A cross-sectional study was conducted from January 2021 to February 2021 in the North Dayi District. A sample of 191 respondents diagnosed with hypertension for at least 1 month with or without comorbidities and on treatment were selected using the systematic sampling method. An Adherence Barrier Questionnaire was adopted to assess reliability in the responses. Bivariate and multivariate analyses were done using noncompliance to hypertension therapy as the outcome of interest. Statistical Analysis Used: Fisher's Exact, logistic regression, Cronbach's alpha analysis. Results: Data were collected from 191 study participants between the ages of 25 and 101 years with an average age estimated at (62.2 ± 13.5) years. The prevalence of nonadherence to hypertension treatment in this study was 31.4% in the North Dayi District Hospital. The reported Marital status and Default review were statistically significant predictors of adherence to hypertension treatment at a chosen 95% Confidence Level. Conclusion: The degree of non-compliance to hypertension treatment was less than fifty per cent among respondents. The data suggests that strategies should be developed to help reduce waiting times for consultation at the Hypertension Clinic by the District Hospital in collaboration with other stakeholders.","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":"44286060","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}
Introduction: Most adults who should be screened for dyslipidemia do not undergo lipid testing in low- to middle-income countries due to lack of resources and clinical inertia. Those eligible for statin therapy for cardiovascular disease (CVD) prevention are under treated possibly due to clinical inertia. This study aimed to find out the present lipid screening practices and prescribing of statins for primary prevention in a low- to middle-income country. Methods: This study was conducted at medical wards of Colombo South Teaching Hospital in patients with a first-time acute coronary syndrome (ACS), who have not been on treatment with statins and not diagnosed with dyslipidemia prior to this admission. Eligibility for lipid screening was assessed using U.S. preventive services task force recommendations. CVD risk prior to ACS was assessed by QRISK2 score. Lipid profile was done within 24 h. Results: Out of 125 participants, 70.4% had a QRISK2 >10 and were eligible for statins prior to their first episode of ACS. Eighty-four percent have not had a lipid screening and 91.4% were not aware of the need for it. 54.4% were not aware that the elevation of certain types of cholesterol leads to ACS. Of 125 patients (100 males/25 females), mean age 55.78 (26–82). Body mass index >23kg/m2 in 65.6%. 65.6% had some lipid abnormality. Total cholesterol >200 in 29.6%, low-density lipoprotein cholesterol >130 in 28.8%, triglyceride >150 in 31.2%, high-density lipoprotein cholesterol suboptimal in 67.2%. Discussion: Lipid screening is suboptimal. Most patients who were eligible for statins based on their CVD risk prior to their first episode of ACS, were not receiving statins prior to their first ACS. Patients should have their CVD risk estimated and statins should be given to eligible patients for prevention of ACS.
{"title":"Clinical inertia in lipid screening and prescribing statins for primary prevention: Experience from a low-to-middle income country","authors":"A. Matthias, Mathotage Nihari Padmasiri, Batheegama Kavindi Somathilake, Nethrani Wijesekara Pathirana","doi":"10.4103/jncd.jncd_38_21","DOIUrl":"https://doi.org/10.4103/jncd.jncd_38_21","url":null,"abstract":"Introduction: Most adults who should be screened for dyslipidemia do not undergo lipid testing in low- to middle-income countries due to lack of resources and clinical inertia. Those eligible for statin therapy for cardiovascular disease (CVD) prevention are under treated possibly due to clinical inertia. This study aimed to find out the present lipid screening practices and prescribing of statins for primary prevention in a low- to middle-income country. Methods: This study was conducted at medical wards of Colombo South Teaching Hospital in patients with a first-time acute coronary syndrome (ACS), who have not been on treatment with statins and not diagnosed with dyslipidemia prior to this admission. Eligibility for lipid screening was assessed using U.S. preventive services task force recommendations. CVD risk prior to ACS was assessed by QRISK2 score. Lipid profile was done within 24 h. Results: Out of 125 participants, 70.4% had a QRISK2 >10 and were eligible for statins prior to their first episode of ACS. Eighty-four percent have not had a lipid screening and 91.4% were not aware of the need for it. 54.4% were not aware that the elevation of certain types of cholesterol leads to ACS. Of 125 patients (100 males/25 females), mean age 55.78 (26–82). Body mass index >23kg/m2 in 65.6%. 65.6% had some lipid abnormality. Total cholesterol >200 in 29.6%, low-density lipoprotein cholesterol >130 in 28.8%, triglyceride >150 in 31.2%, high-density lipoprotein cholesterol suboptimal in 67.2%. Discussion: Lipid screening is suboptimal. Most patients who were eligible for statins based on their CVD risk prior to their first episode of ACS, were not receiving statins prior to their first ACS. Patients should have their CVD risk estimated and statins should be given to eligible patients for prevention of ACS.","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":"44611581","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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