Epidemiology of non-communicable diseases

Background-Junk food is the food that can easily and quickly prepared, rich in calories but deficient in most of nutrients. Due to increased urbanization, globalization and commercial advertisements as well as abundant junk food outlets, college going students are getting indulge in eating these types of food. In recent researches, it is clear that fast food is the one of the reasons for metabolic disorders such as obesity, diabetes and heart diseases etc. Present survey was there fore conducted to check the consumption pattern of junk food by university students of Dayalbagh Educational Institute. Methodology-Among all the university undergraduate students,198 undergraduate students (68 boys and 130 girls) were randomly selected and assessed by self-administration of structured questionnaire. Results and Conclusion-Present study revealed that about 51% students regularly consume fried/high fat food in the form of kachori, samosa, pizza, pasta, chole bhature etc. and almost 31% students regularly consume high sugar-based food like cold drinks, ice-cream, donuts, pastries and cakes etc. Most of the students revealed that taste of fast food is the sole reason for consumption of fast food. Present study also revealed that about 23% students were having adequate knowledge about effect of fast-food consumption on health whereas 42% students was having inadequate knowledge about ill effect of fast-food consumption on health. It is therefore necessary to create awareness about ill effects of fast food and benefits of balanced diet to the college going students.

Adolescents are generally thought to be healthier than other age groups having survived many of the diseases of early childhood and being decades away from the diseases associated with aging (WHO, 1998). However, some adolescents are affected by diseases while others die prematurely. A major threat to the health of the adolescents stems primarily from their sexual behavior which is partly influenced by lack of knowledge of reproductive health issues. The main objective of this study was to assess reproductive health knowledge and attitude among secondary school students in Nandi Hills Constituency. This was a cross-sectional study design of male and female secondary school students in Nandi Hills Constituency. Four classes of secondary level were involved in this study. The study assessed knowledge and attitudes of these students towards reproductive health. Data was collected from secondary school forms 1 to 4 students who were selected from 5 of the 10 co-educational secondary schools in Nandi Hills Constituency using a purposive sampling technique. 40 students were sampled from 5 schools using a 10% quota. This made the sample size of this study to be 200 respondents. The study found that majority (71.4%) of the female secondary students interviewed from the different schools had not learnt about puberty and maturation of girls. According to the study findings, majority of the female students believed that one can get pregnant half way between the end of one period and beginning of the next (48.0%). Other 26.5% and 10.3% of the female students interviewed in this study believed that they could get pregnant immediately before and after periods respectively. This study concludes that there are low knowledge levels on reproductive health among secondary school adolescents in Nandi Hills Constituency. It recommends a multi-sectoral approach to addressing of the adolescents reproductive health needs. Such approach should involve parents, peers, teachers and health departments.

Leaf tip burn in onion is a symptom of a number of biotic and abiotic stresses. It may appear in densely cultivated nursery transplants owing to one or the other simple or complex reasons. The present research work was planned to know the impact of rate and form of nitrogen (N) on post-transplantation recovery of tip burnt transplants, and signifcance of the disorder. Tip burn transplants were cultivated on sand culture  hydroponic system at 0, 4, 6 and 8 mM N. In second trial 4 mM N was maintained in nutrient solution as 4:0, 3:1, 2:2 and 0:4 mM NO3-N:
NH4-N ratios. N supply linearly increased total leaf length (TLL). Both high and low N levels and replacement of NO3-N with NH4-N in solution signifcantly increased burnt leaf length (BTL). Lowest BTL and highest bulb yield was noted at 4 mM N and at 4:0 mM NO3-N : NH4-N ratio. N induced increase in TLL signifcantly reduced BTL by 42% at 60 and 75 days after transplanting (DAT). In both the trials BTL, particularly at early growth stages, was linearly and negatively linked to bulb yield of onion. Depending upon the DAT, the suggested linear regression models described about 50% variation in bulb yield counted for BTL. It is concluded from the results that leaf tip burning in onion is of great importance regarding bulb yield and a reasonable recovery is possible through appropriate dose of nitrate nitrogen.

Objective Diabetes appears to be a growing problem in the African region. This study aims to estimate the prevalence of diabetes in Zimbabwe by collating and analyzing previously published data. Methods Systematic review and meta-analysis of data reporting prevalence of diabetes in Zimbabwe was conducted based on the random effects model. We searched for studies published between January 1960 and December 2013 using MEDLINE, EMBASE and Scopus and University of Zimbabwe electronic publication libraries. In the meta-analysis, sub-groups were created for studies conducted before 1980 and after 1980, to understand the potential effect of independence on prevalence.

Hipertensi merupakan penyebab berbagai penyakit berat dan komplikasi. Berbagai upaya penatalaksanaan hipertensi sudah dilakukan secara pengobatan medis maupun alternatif dan komplementer. Salah satu terapi komplementer yang dilakukan yaitu terapi bekam. Tujuan penelitian ini adalah mengetahui pengaruh terapi bekam terhadap tekanan darah pada pasien hipertensi di klinik bekam Debesh Center Ar Rahmah dan rumah sehat Sabbihisma kota Padang, dari bulan Mei 2011 -September 2012. Penelitian ini menggunakan desain pre eksperiment designs dengan model one group pretest posttest pada 20 responden hipertensi yang memenuhi kriteria inklusi dan eksklusi yang diperoleh secara acidental sampling. Pengumpulan data dilakukan dengan tensi meter digital dan lembar observasi. Hasil uji univariat menunjukkan rata-rata tekanan darah sistole sebelum terapi bekam 153,10 mmHg, dengan standar deviasi 21,361 mmHg, nilai minimum 132 mmHg, dan nilai maksimum 199 mmHg. Rata-rata tekanan darah sistole setelah terapi bekam 143,75 mmHg, dengan standar deviasi 19,740 mmHg, nilai minimum 124 mmHg, dan nilai maksimum 186 mmHg. Sedangkan rata-rata tekanan darah diastolik sebelum terapi bekam 94,50 mmHg, dengan standar deviasi 10.817 mmHg, nilai minimum 80 mmHg, dan nilai maksimum 120 mmHg. Rata-rata tekanan darah diastolik setelah terapi bekam 89,60 mmHg, dengan standar deviasi 10,923 mmHg, nilai minimum 80 mmHg, dan nilai maksimum 111 mmHg. Hasil uji Wilcoxon, terdapat pengaruh yang bermakna pada tekanan darah sistolik dan diastolik pasien hipertensi sebelum dan setelah terapi bekam dengan nilai p 0,000 (sistolik) dan 0,003 (diastolik) dimana p<0,05. Hal ini menunjukkan bahwa terapi bekam dapat menurunkan tekanan darah pada pasien hipertensi. Diharapkan bagi masyarakat dan dunia medis dapat menggunakan terapi bekam sebagai salah satu terapi komplementer dalam mengatasi hipertensi.

Background-Junk food is the food that can easily and quickly prepared, rich in calories but deficient in most of nutrients. Due to increased urbanization, globalization and commercial advertisements as well as abundant junk food outlets, college going students are getting indulge in eating these types of food. In recent researches, it is clear that fast food is the one of the reasons for metabolic disorders such as obesity, diabetes and heart diseases etc. Present survey was there fore conducted to check the consumption pattern of junk food by university students of Dayalbagh Educational Institute. Methodology-Among all the university undergraduate students,198 undergraduate students (68 boys and 130 girls) were randomly selected and assessed by self-administration of structured questionnaire. Results and Conclusion-Present study revealed that about 51% students regularly consume fried/high fat food in the form of kachori, samosa, pizza, pasta, chole bhature etc. and almost 31% students regularly consume high sugar-based food like cold drinks, ice-cream, donuts, pastries and cakes etc. Most of the students revealed that taste of fast food is the sole reason for consumption of fast food. Present study also revealed that about 23% students were having adequate knowledge about effect of fast-food consumption on health whereas 42% students was having inadequate knowledge about ill effect of fast-food consumption on health. It is therefore necessary to create awareness about ill effects of fast food and benefits of balanced diet to the college going students.

Background: Burkitt's lymphoma (BL) is the commonest tumour in Africa. It is a rapidly growing tumour. Its multi-organ involvement and complexity of signs and symptoms, call for an urgent diagnosis and treatment to achieve a better prognosis. Objective: To determine the occurrence of BL, a childhood tumour, in Abia State University Teaching Hospital in the years 2000 to 2010. Methodology: It was a descriptive cross sectional survey in which the case files of all the patients who presented at the paediatric clinic, children emergency room, ward and cancer registry for BL cases between January 2000 and December 2011 were evaluated. The BL occurrence was Chineke et al.; BJMMR, 6(5): 533-537, 2015; Article no.BJMMR.2015.230 534 manually worked out as the percentage of confirmed BL cases in relation to the total number of childhood tumours seen within that period. Results: The occurrence of BL (among the 40 pediatric cancer cases) was 65%, meaning that it was more common than the other childhood tumours seen within the same period. It was also commoner in males than in females, and also more in the lower socio-economic class than in the middle and upper socio-economic classes as assessed by the occupation of the parents of the patients. Conclusion: BL is a common childhood tumour in the tropics more commonly seen among the lower socio-economic group. Efforts should be made by caregivers to identify the disease in time for early treatment and follow-up because BL responds well to aggressive chemotherapy when started early.

The  main objective of our study is to examine the associations between hypertension and both nutritional status and dietary intake. A case control study was conducted at Primary Health Care centers in Gaza Strip. A proportional systematic random sample of 120 cases matched with sex, and locality to 120 healthy controls attended adult screening clinics. Participants
completed self-administered questionnaires included socio-demographic characteristics and food frequency intakes. Anthropometric measurements and physical examination were abstracted from the clinic files. Collected data was entered and analyzed using SPSS V20. Patients with Hypertension are older, more in lower socioeconomic and more obese. Cases and
controls were similar in following diet regimen; even control reported more frequent food regimens than cases (65.1% vs. 44%). Patients with hypertension were similar to controls in percentage of intake for milk products, white meat, eggs, fish, vegetables, grains, sweets and tea – coffee drinks. Cases presented higher frequent consumption of fruits (50.8% vs.
22.5%), and soft drinks (36.7% vs. 16.7 %). These associations reached a statistical significant level (P <0.001). Cases were less frequently consumed lean red meat trimmed from visible fat (80.8% for cases vs. 97.5% for controls) and the differences were statistically significant (P < 0.001). When adjusting for socio-demographic variables low intake of fruit, legumes, lean
red meat trimmed from visible fat, and high intake of fried food and soft drink were positively associated with hypertension. We recommend raising the public awareness towards following food based dietary guidelines to ensure hypertension control.
Keywords: Diet Intake, Gaza – Palestine, Hypertension, Nutritional Status

Introduction: Non-communicable diseases (NCDs) are also known as chronic diseases of long duration. Globally, 40 million deaths are caused by NCDs in each year, representing 70% of all annual deaths. Besides, the socio-economic impact of NCDs are also significant. Therefore, the present study was done to determine the prevalence and risk factors of NCDs among elders in Yangon, Myanmar. Materials and Methods: A cross-sectional study was conducted in Thanlyin township, Yangon city during 2016. A total of 411 elder persons were recruited into the study using systematic random sampling. Informed consent was taken from every respondent and interview method was utilized in data collection. The presence of any NCDs has been confirmed by observing medical records and reports. Results: The overall self-reported prevalence of NCDs was 24.8% (95% CI: 20.7%, 29.3%). The prevalence was higher among females, those with low education status and respondents whose age was equal or more than 70 years. Based on multiple logistic regression analysis, having regular exercise was identified as a significant protective factor for the development of NCDs (p < 0.001). Diabetes mellitus (15.6%) was the commonest type of NCDs among elders followed by hypertension (8.5%) and heart disease (4.9%). Conclusion: The prevalence of NCDs among elder population is high. Prevention and control activities of NCDs as well as elderly health care program should be intensified. Practicing regular exercise should be promoted and strengthened.
KEYWORDS: Elders; exercise; Myanmar, NCDs, Yangon.

OBJECTIVES: The objective of the study was to examine explanatory models of diabetes and diabetes complications among urban poor Ghanaians living with diabetes and implications for developing secondary prevention strategies.
DESIGN: Twenty adults with type 2 diabetes were recruited from three poor communities in Accra. Qualitative data were obtained using interviews that run between 40 and 90 minutes. The interviews were audio-taped, transcribed and analysed thematically, informed by the 'explanatory model of disease' concept.
RESULTS: Respondents associated diabetes and its complications with diet, family history, lifestyle factors (smoking, excessive alcohol consumption and physical inactivity), psychological stress and supernatural factors (witchcraft and sorcery). These associations were informed by biomedical and cultural models of diabetes and disease. Subjective experience, through a process of 'body-listening,' constituted a third model on which respondents drew to theorise diabetes complications. Poverty was an important mediator of poor self-care practices, including treatment non-adherence.
CONCLUSIONS: The biomedical model of diabetes was a major source of legitimate information for self-care practices. However, this was understood and applied through a complex framework of cultural theories of chronic disease, the biopsychological impact of everyday illness experience and the disempowering effects of poverty. An integrated biopsychosocial approach is proposed for diabetes intervention in this research community.

Estimating the prevalence and severity of asthma symptoms with standardized methods of population-based surveys is a critical step in reducing asthma burden. However, no sufficient surveys have been conducted in most countries of the Middle East especially at the national level. In this survey, we applied sound measures to estimate the prevalence and severity of asthma symptoms and related risk factors in adults in Saudi Arabia. Patients and methods: In this national cross-sectional study, the prevalence and severity of asthma symptoms were estimated throughout the country. Overall, 7955 adult individuals were selected from 20 regions across Saudi Arabia through their children at schools using a multistage, stratified cluster-sampling technique. A validated questionnaire, including the core and environmental questions of the Global Asthma Network questionnaires, was applied from March 4 to April 25, 2019. In addition, multivariate logistic regression analysis was performed to investigate the independent relationships between current wheeze and related risk factors. Results: The overall prevalence of current wheeze (wheeze during the past 12 months) was 14.2%. Among persons with current wheeze, 38.1% were affected by severe asthma symptoms. Although a high percentage of those who had experienced asthma-ever reported that their asthma was diagnosed by doctors (83.3%), only 38.4% had a written plan for controlling their asthma. Women were more likely to develop current wheeze (adjusted odds ratio (aOR) 1.4; 95% CI: 1.1-1.7), while other statistically significant factors associated with current wheeze were jobs (aOR 11.8; 95% CI: 7.3-18.9), current exposure to moisture or damp spots (aOR 2.2; 95% CI: 1.5-3.4), heating the house when it is cold (aOR 1.7; 95% CI: 1.3-2.1), and ever using tobacco daily (aOR 2.7; 95% CI: 2.0-3.5).

Dyslipidemia is a high level of lipids (cholesterol, triglycerides or both) carried by lipoproteins in the blood. The condition is rapidly spreading globally and has even riven the age bar. It is now swaying in young people too. The persistent dyslipidemias are often associated with many complexities. The most available and accessible therapies for dyslipidemias include Statins, the long use of which may be detrimental to human health. Natural plants have always been used to prevent and treat various diseases for thousands of years. India is a home to innumerous medicinal plants, many of which remain underutilized. Murraya Koenigii (curry leaf) a medicinal plant native to India, Sri Lanka and other South Asian countries, is one such plant. The therapeutic potential of the plant is one beyond measure and thus it can truly be called 'The Indian Panacea'. A screening of research reviews on curry leaves highlights its importance as a potent hypocholesterolemic herbal alternative. Dehydrated leaf powder and crude extracts of Murraya Koenigii supports its role in food processing industry and as value addition component in health and nutrition. The present stands on vintage pillars. The review covers contemporary as well as established data on therapeutic potential of Murraya Koenigii in Dyslipidemia.

Introduction: Uncontrolled hypertension is a leading modifiable risk factor for cardiovascular disease morbidity and mortality. Data on adequacy of blood pressure control in Kenya is scarce. This study aimed at assessing the level of blood pressure control among hypertensive patients on follow-up in a regional referral hospital. Methods: Data regarding blood pressure, antihypertensive medication use, and comorbidities was abstracted from medical records of 452 hypertensive patients seen in Nyeri Adequate blood pressure control was defined as a systolic pressure < 140 mmHg (< 130 mmHg for diabetic hypertensive patients) and a diastolic pressure < 90 mmHg (< 80 mmHg for diabetic hypertensive patients). Data was entered and analyzed using STATA 9 (StataCorp, Inc, Texas, USA). Results: Only 33.4% of patients had a blood pressure within the recommended limits. In multivariate analysis, using a calcium channel blocker was significantly associated with good blood pressure control (OR, 2.1; 95% CI, 1.4, 3.3). On the other hand, old age (≥ 60 years), being diabetic, and the use of three or more antihypertensive drugs were associated with reduced odds of good blood pressure control (OR, 0.64; 95% CI, 0.43; OR, 0.54; 95% CI, 0.36, 0.81; and OR, 0.41; 95% CI, 0.26, 0.64, respectively). Conclusion: Poorly controlled blood pressure is an important public health concern among hypertensive patients in this region. Elderly patients, those with diabetes, and those on multidrug regimens are at higher risk for poor blood pressure control and warrant closer attention.

Background: The growing burden of non-communicable diseases (NDC), particularly in low-and middle-income countries, poses a significant threat to global health. Obesity and overweight constitute major risk factors of NCDs such as heart diseases, diabetes, and kidney disease, and as a result, contribute significantly to the development of chronic morbidities, reduced quality of life, and increased risk of premature death. This study described evidence on the prevalence, incidence, and trends of childhood overweight and obesity in sub-Sahara Africa (SSA). Methods: We conducted a systematic scoping review employing the Arksey and O'Malley framework, Levac et al. recommendations, and the Joanna Briggs Institute guidelines. To obtain relevant published articles for this review, we performed a comprehensive keywords search in PubMed, Google Scholar, Web of Science, and CINAHL via EBSCOhost platform for studies published between 2009 and June 2019. Guided by the eligibility criteria, title and abstracts, as well as the full-text articles were independently screened in parallel by two investigators. All relevant data were independently extracted by two investigators using a piloted form designed in Microsoft and thematic analysis conducted. Results: Of the 81 included studies obtained from 250,148 potentially eligible articles, the majority (25) conducted in South Africa followed by 18 in Nigeria. Six studies were conducted in Ethiopia (6), Tanzania (5), Kenya (4), Cameroon (4), Ghana (3), Uganda (2), Mozambique (2), and Sudan (2). One study each was conducted in Botswana, Gambia, Lesotho, Mauritius, Seychelles, Togo, and Zimbabwe. The remaining three articles were multi-country studies. Most (81.5%) of the included studies were cross-sectional surveys and the majority (79) focused on both male and female participants. The majority (80/ 81) of the included studies reported on the prevalence of childhood overweight/obesity, 8 on the trends of childhood overweight/obesity, and one presented evidence on the incidence of childhood overweight and obesity in SSA.

Breast cancer is one of the most prevalent types of cancer in women, and its incidence is on the increase. Knowledge and practice of breast self-examination are important strategies for early detection of the disease. The general objective of this study was to determine the effectiveness of health education on breast self-examination amongst secondary school girls in Anambra State, Nigeria. It was a before and after interventional study with control, in which 261 school girls were selected by multi-stage sampling method. The study group (197) which received health education was assessed contemporaneously with the control (64) at the pre-and post-intervention stages. Data was collected via self-administered questionnaire. Before health education, questionnaires were administered to assess their baseline knowledge, attitude and practice of breast self-examination. The study group received information on breast self-examination, but the control group had health talk on the basics of hand washing technique. Questionnaires were administered again to both groups to assess the effectiveness of education on breast self-examination. Data was analyzed and presented in tables. Results Showed a significant increase in the percentage score for knowledge from 40.9% to 85% for the study group as opposed to the control group which percentage score remained unchanged at 47.1%. The attitudescores of respondents in both groups which were almost the same before education (93.4% and 87.5% respectively) before education, did not record significant changes following education (98% and 84.4% respectively).Overall the practice score reduced markedly from 67% to 39.6% among study group (p<0.001)but among those who continued BSE after education, significant improvements in specific practice item scores were recorded among them: (frequency-p<0.01; time-p<0.001; and place-p<0.001). The results demonstrated the effectiveness of education on the-knowledge, attitude and practice of breast self-examination among the students.

Abstract'‘Road traffic accidents (RTAs) represent a major epidemic ofnon communicable disease in the country and has since escalated with the introduction of the new phenomenon of commercial motorcycle transportation such as is found in the two stics Were collected from a sample of commercial motorcyclists selected by systematic sampling technique. Their knowledge of and attitude towards road trafi'ic and safety codes were elicited. The result showed that the all-male commercial motorcyclists had a mean age of 3 039.9 years. One hundred and seventy six (32. 6%) possessed good knowledge of road ‘trafi ‘ic codes and safety, while 35 (6. 5%) exhibited good attitude towards them.

The article is devoted to identifying the peculiarities of poetics of lyric and lyric-epic works of B. Kuashev. The specifi city of the artistic organization of his poems and poems has not yet become the subject of a separate study, which initiated an appeal to the indicated problem. This fact determines the scientifi c novelty of the presented article. The relevance of the study is due to the need to restore the pages of the history of the Adyghe (Kabardino-Circassian) literature, in particular, to fi ll the gap in the study of the poetic heritage of B. Kuashev with an emphasis on the artistic skill and individual author's style of the poet. In it, for the fi rst time, an attempt is made to comprehensively analyze the poetic language of the specifi ed author. In the course of the study, the artistic and graphic means and structural-compositional and stylistic techniques inherent in the works of B. Kuashev were identifi ed. The article uses a number of scientifi c methods, including analysis (literary, linguistic), description and hermeneutic methods. The theoretical basis of the article includes the works of North Caucasian literary critics, in which, to one degree or another, problems relevant to our research are touched upon: essays and articles by Z.M. Naloev, H.G. Karmokov and others. The results obtained can fi nd application in the study of the history of the Adyghe literature, the creative heritage of B. Kuashev, as well as in research in the fi eld of national philology, writing qualifi cation and other types of research work.

Diabetes mellitus has become a serious and chronic metabolic disorder that results from a complex interaction of genetic and environmental factors, principally characterized by hyperglycemia, polyuria, and polyphagia. Uncontrolled high blood sugar can result in a host of diabetic complications. Prolonged diabetes leads to serious complications some of which are life-threatening. The prevalence of diabetes patients is rising at epidemic proportions throughout the world. Every year, a major portion of the annual health budget is spent on diabetes and related illnesses. Multiple risk factors are involved in the etiopathogenesis of the disease and turning the disease into an epidemic. Diabetes, for which there is no cure, apparently can be kept under control by maintaining self-care in daily living, effective diabetes education, with comprehensive improvements in knowledge, attitudes, skills, and management. In this review, we focused on the biochemical aspects of diabetes, risk factors...

Background The incidence of retinopathy of prematurity (ROP) is higher in Indonesia than in high-income countries. In order to reduce the incidence of the disease, a protocol on preventing, screening and treating ROP was published in Indonesia in 2010. To assist the practical implementation of the protocol, meetings were held in all Indonesia regions, calling attention to the high incidence of ROP and the methods to reduce it. In addition, national health insurance was introduced in 2014, making ROP screening and treatment accessible to more infants. Objective To evaluate whether the introduction of both the guideline drawing attention to the high incidence of ROP and national health insurance may have influenced the incidence of the disease in Indonesia. Setting Data were collected from 34 hospitals with different levels of care: national referral centres, universitybased hospitals, and public and private hospitals. Methods A survey was administered with questions on admission numbers, mortality rates, ROP incidence, and its stages for 2016-2017 in relation to gestational age and birth weight. Results We identified 12 115 eligible infants with a gestational age of less than 34 weeks. Mortality was 24% and any stage ROP 6.7%. The mortality in infants aged less than 28 weeks was 67%, the incidence of all-stage ROP 18% and severe ROP 4%. In the group aged 28-32 weeks, the mortality was 24%, all-stage ROP 7% and severe ROP 4%-5%. Both mortality and the incidence of ROP were highest in university-based hospitals. Conclusions In the 2016-2017 period, the infant mortality rate before 32 weeks of age was higher in Indonesia than in high-income countries, but the incidence of ROP was comparable. This incidence is likely an underestimation due to the high mortality rate. The ROP incidence in 2016-2017 is lower than in surveys conducted before 2015. This decline is likely due to a higher practitioner awareness about ROP and national health insurance implementation in Indonesia. HKWCHC, Harapan Kita Women and Children's Hospital (National Centre for Women and Children's Health); OH, other hospitals; ROP, retinopathy of prematurity; RSCM/NRH, Ciptomangunkusumo Hospital (national referral hospital); UBH, university-based hospital.

Background: Implementing an evidence-based hypertension program in primary healthcare centers (PHCs) in the Federal Capital Territory, Nigeria is an opportunity to improve hypertension diagnosis, treatment, and control and reduce deaths from cardiovascular diseases. This qualitative research study was conducted in Nigerian PHCs with patients, non-physician health workers, administrators and primary care physicians to inform contextual adaptations of Kaiser Permanente Northern California's hypertension model and the World Health Organization's HEARTS technical package for the system-level, Hypertension Treatment in Nigeria (HTN) Program. Methods: Purposive sampling in 8 PHCs identified patients (n = 8), non-physician health workers (n = 12), administrators (n = 3), and primary care physicians (n = 6) for focus group discussions and interviews. The Primary Health Care Performance Initiative (PHCPI) conceptual framework and Consolidated Framework for Implementation Research (CFIR) domains were used to develop semi-structured interviews (Appendix 1, Supplemental Materials) and coding guides. Content analysis identified multilevel factors that would influence program implementation.

BackgroundThe last evaluation to assess outcomes for patients receiving antiretroviral therapy (ART) through the Zimbabwe public sector was conducted in 2011, covering the 2007-2010 cohorts. The reported retention at 6, 12, 24 and 36 months were 90.7%, 78.1%, 68.8% and 64.4%, respectively. We report findings of a follow up evaluation for the 2012-2015 cohorts to assess the implementation & impact of recommendations from this prior evaluation.MethodsA nationwide retrospective study was conducted in 2016. Multi-stage proportional sampling was used to select health facilities and study participants records. The data extracted from patient manual records included demographic, baseline clinical characteristics and patient outcomes (active on treatment, died, transferred out, stopped ART and lost to follow-up (LFTU)) at 6, 12, 24 and 36 months. The data were analysed using Stata/IC 14.2. Retention was estimated using survival analysis. The predictors associated with attrition were determi...

Background The growing burden of non-communicable diseases (NDC), particularly in low-and middle-income countries, poses a significant threat to global health. Obesity and overweight constitute major risk factors of NCDs such as heart diseases, diabetes, and kidney disease, and as a result, contribute significantly to the development of chronic morbidities, reduced quality of life, and increased risk of premature death. This study described evidence on the prevalence, incidence, and trends of childhood overweight and obesity in sub-Sahara Africa (SSA). Methods We conducted a systematic scoping review employing the Arksey and O’Malley framework, Levac et al. recommendations, and the Joanna Briggs Institute guidelines. To obtain relevant published articles for this review, we performed a comprehensive keywords search in PubMed, Google Scholar, Web of Science, and CINAHL via EBSCOhost platform for studies published between 2009 and June 2019. Guided by the eligibility criteria, title a...

High blood pressure is on the rise globally, affecting more women than men in many developing countries. It is the leading cause of mortality worldwide, and hospitalization in sub-Saharan Africa. Many known risk factors to hypertension, though prevalent in Nigeria, are controllable. Prevention, however, is diffi cult where there is poor awareness, attitude, and practices. Objectives: The study aims at determining the level of knowledge of hypertension and its associated factors, attitudes, practices, and prevalence among rural Nigerian women. Materials and Methods: Cross-sectional design was used to study 252 subjects in Sanga Local Government Area. Subject selection was by purposive and stratifi ed sampling techniques. Data were collected using self-administered, semi-structured questionnaire after informed consents were obtained both verbally and in writing. Data were analyzed using SPSS statistical package. Level of signifi cant was taken at 0.05. Results: Prevalence of hypertension was 24.2%. Average level of risk factor awareness was 65.4% with excessive salt intake (77.4%) being the most recognized. Asymptomatic nature of hypertension was recognized by 61.5% of the respondents, while 44.4% only knew the standard method for hypertension detection. While 17.5% strongly believed that hypertension can be managed effectively with drugs, it was only 9.1% that strongly disagreed that it could be caused by evil spirits. The average number of those with good preventive life style practices was 61.3%. Knowledge was associated with several factors and seems to affect practices (P < 0.05). Conclusion: Fair but inadequate level of knowledge and attitudes affected by several factors, as well as moderately high prevalence was recorded.

Coronary artery disease (CAD) is the leading cause of death in both sexes worldwide, and becomes
number one killer in women due to many factors including increase in traditional risk factors, delays
in apparition of symptoms, under estimation of diagnosis test and treatment. Our study aims
to identify risk factors for coronary artery disease among women with chest pain underwent coronary
angiography during years (2010-2013) in cardiology center. The study design is an observational
among 688 women-aged 32 - 96 years; the mean age of our study population is 61 years.
Risk factors are abstracted from patients’ files. Women with documented coronaries disease tend
to be older, have higher, systolic blood pressure, serum level of triglyceride, and impaired clearance
creatinine. 59.4% of them are menopause with higher prevalence of hypertension and diabetes
(58.6% and 63.6%). Significant positive association is found in women with myocardial infarction,
unstable angina, stable angina and presence of obstructive coronary artery disease respectively
(89.6%, 82.3%, 59.1%) in opposite women presented with atypical chest pain have high
prevalence of normal coronaries (95.7%). About 57.6% have more than three risk factors, and
55.3% are obese or overweight. In addition, 42.1% of them have impaired systolic function. We
conclude that cardiovascular risk factors are highly prevalent among Palestinians women in Gaza
and the combination of risk factors is common. Interventions to minimize CAD in our population
are needed.
Keywords
Coronary Artery Disease, Risk Factors, Chest Pain, Coronary Angiography, Gaza, Palestine

Background: The rising prevalence of diabetes mellitus imposes great burden on health worldwide. The burden is enormous in terms of pressure on existing human and material health resources. Diabetes is insidious in onset and has many patterns of presentation which often militates against early detection and diagnosis. Thus most patients present late with the exacerbation of symptoms and complications. Objective: To determine the prevalence and pattern of presentation of diabetes mellitus among patients attending Imo State University Teaching Hospital (IMSUTH) Orlu and Imo State Specialist Hospital (IMSSH) Umuguma Owerri, both in Imo State, Nigeria. Methodology: A retrospective study of the prevalence and pattern of presentation of diabetes mellitus. A total of 2028 patients had diabetes mellitus. Using data collection proforma,

Objective: Diabetes Mellitus (DM) is an emerging global public health concerned. The overwhelming problems due DM have significant impact on Health Related Quality of Life (HRQoL). This study aimed to assess the HRQoL of type 2 diabetes patients and to identify the determinants affecting HRQoL of the patients.
Methods: A cross-sectional study was conducted among the randomly selected 324 subjects with type 2 diabetes attending at urban and rural primary health care centres. Face-to-face interview was undertaken using the latest version of Medical Outcomes Study Short Form 36 (SF-36v2) questionnaire to measure HRQoL which yields eight subscales scores, Physical Component Summary (PCS) scores and Mental Component Summary (MCS) scores. The scores were compared by non-parametric Mann-Whitney and Kruskal-Wallis tests, and Multiple Linear Regression (MLR) analyses were used to identify the socio-demographic and diabetes-related factors having effects on HRQOL.
Results: The mean PCS and MCS scores were 49.65% and 52.68% respectively.  Analysis revealed that most of the 8 subscales scores were higher among the rural patients than the urban patients (p<0.001) except PF and GH (p>0.05).The advancing age, low education level, being single, jobless, longer duration of diabetes, co-morbidity (hypertension and hyperlipidaemia), micro-vascular complications, poor glycaemia control and obesity had negative influences on physical and mental subscales. The MLR models explained significant variance in SF-36v2 subscales specially, physical functioning (R2 = 41%), Role Physical (R2 = 41%); and PCS (R2=36%) and MCS (R2=28%) respectively.
Conclusions: The research findings could have potential implication for achieving higher HRQoL of DM patients. In order to achieving targeted HRQoL, early prevention of complications is an important strategy and it would be possible by managing diabetic patient by following clinical guidelines. Measuring HRQoL could be an effective indicator in evaluating the quality of diabetes management in primary health care settings. 
Keywords: Determinants; HRQoL; Type 2 Diabetes; Primary Health Care; SF-36v2

The prevalence of diabetes mellitus in Kenya is estimated to be 4.66%. The comorbidity of diabetes and depression is associated with poor outcomes. The study aimed at determining the prevalence and factors associated with depression among diabetics. A cross-sectional survey was conducted among 181 diabetics attending clinic at a referral hospital in western Kenya. A questionnaire was used to collect data on the independent variables. Beck’s Depression Inventory (BDI-II) was used to assess depression symptoms. Depression was observed in 19% of the participants. Female gender, being single, urban residence, low income and no family support were significantly associated with depression. Others are; longer duration of illness, difficulties adhering to treatment and alcohol consumption (p&lt;0.05). A significant proportion of diabetic patients have comorbid depression. Integration of mental health services into diabetics care setting will lead to detection and early treatment of depression.

Background Implementing an evidence-based hypertension program in primary healthcare centers (PHCs) in the Federal Capital Territory, Nigeria is an opportunity to improve hypertension diagnosis, treatment, and control and reduce deaths from cardiovascular diseases. This qualitative research study was conducted in Nigerian PHCs with patients, non-physician health workers, administrators and primary care physicians to inform contextual adaptations of Kaiser Permanente Northern California&#39;s hypertension model and the World Health Organization’s HEARTS technical package for the system-level, Hypertension Treatment in Nigeria (HTN) Program. Methods Purposive sampling in 8 PHCs identified patients (n = 8), non-physician health workers (n = 12), administrators (n = 3), and primary care physicians (n = 6) for focus group discussions and interviews. The Primary Health Care Performance Initiative (PHCPI) conceptual framework and Consolidated Framework for Implementation Research (CFIR) do...

Context: The burden of non-communicable diseases will sooner overwhelm the health system of the country and could curtail future economic development. Hypertension causes highest cardiovascular morbidities. To attain target Blood Pressure (BP), different strategies are required, which are area specific. The validity of rule of halves of hypertension in various settings needs to be studied for developing strategies for that particular geographical area. To utilize the resources in more efficient way, strategies need to differ in rural-urban and underserved-well-served areas. Aims: The present study aims at exploring whether the rule of halves holds good in the city of Mumbai as the findings of such research may have implications on strategies to control hypertension in communities. Hence, the objectives of this study are to ascertain the proportion of persons with hypertension with respect to the status of diagnosis, treatment, adequate treatment, and validate it with existing rule of halves. Setting and Design: Study was conducted in the urban field practice area of a teaching hospital and medical college of Mumbai that comprises 42 chawl (housing structures); study design-cross-sectional observational study. Materials and Methods: This observational cross-sectional study was conducted over a period of 18 months in the field practice area of a teaching hospital and medical college of Mumbai with a total population of 43,069. Sample size was 667. After ethical clearance, participants were interviewed using pretested semi-structured interview schedule that included socio-demographic factors, risk factor evaluation, clinical examination, and anthropometry. Subjects with diagnosed hypertension were questioned thoroughly about hypertension adherence. Statistical Analysis: Descriptive statistics was applied on quantitative data. Results: A total of 667 people from five chawls of age more than 35 years were included into the study. The mean age of study subjects was 50.84 ± 11.47 years. Out of total 667 respondents, 20.3% respondents were normotensive, 50.3% respondents were pre-hypertensive, 25.3% respondents were in stage 1 hypertension, and 4% respondents were in stage 2 hypertension. In contrary to the classical rule of halves, the present study shows only 31% of the diagnosed hypertensives are adequately treated. Conclusions: The strategies in the national programs are from the traditional understanding of rule of halves and emphasize increasing awareness and treatment. Family physician should actively involve in regular screening, treatment, and adherence of hypertension treatment. As a part of primary care, community participation is required for effectively achieving the target BP goal of the population.

Background: Head injury is trauma to the brain and/or its coverings as a result of an externally applied mechanical force. Study of epidemiological pattern of head injuries is essential in developing necessary preventive strategies and control. To compare the prevalence and pattern of head injuries during the non-festive (February – September) and the festive (October – January) periods in our environment. Methods: Patients’ case files at the Accidents and Emergency unit of Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, were reviewed. Results: Two hundred and sixty-six out of 4,846 met the inclusion criteria for traumatic head injury and were recruited for the study, giving a prevalence of 5.5%. About 77.4% of these presentations were males while 22.6% were females. Both males and females were affected more in the festive period (52.4% and 48.3%) than in the nonf_estive period (51.7% and 47.6%). The &gt;20 – 30 year group recorded the highest presentation at 30.5%. Trad...

BackgroundThe last evaluation to assess outcomes for patients receiving antiretroviral therapy (ART) through the Zimbabwe public sector was conducted in 2011, covering the 2007-2010 cohorts. The reported retention at 6, 12, 24 and 36 months were 90.7%, 78.1%, 68.8% and 64.4%, respectively. We report findings of a follow up evaluation for the 2012-2015 cohorts to assess the implementation & impact of recommendations from this prior evaluation.MethodsA nationwide retrospective study was conducted in 2016. Multi-stage proportional sampling was used to select health facilities and study participants records. The data extracted from patient manual records included demographic, baseline clinical characteristics and patient outcomes (active on treatment, died, transferred out, stopped ART and lost to follow-up (LFTU)) at 6, 12, 24 and 36 months. The data were analysed using Stata/IC 14.2. Retention was estimated using survival analysis. The predictors associated with attrition were determi...

Background: Road traffic accidents, injuries and deaths remain important public health problems in both developed and developing countries. These problems have since escalated with the introduction of the new phenomenon of commercial motorcycle transportation such as is found in the urbanizing slum of Nnewi, Anambra state of Nigeria. Method: Using a semi-structured, interviewer-administered questionnaire, relevant data on socio-demographic and motorcycle characteristics were collected from a sample of 291 commercial motorcyclists selected by systematic sampling technique. Data on RTA, RTI and death were also collected from them over a period of three months. Result: The result showed that young commercial motorcyclists {<30 years of age}, experienced higher fatal injury rate than older ones {>30 years of age}, {p<0.01}. Motorcyclists with some formal education experienced RTA and RTI incidence rates that were significantly lower than those of motorcyclists with no formal education, {p<0.01}. In the same vein, medical condition and social vices such as alcohol intake among the motorcyclists were found to be obvious predictors of RTA, RTI and death. Furthermore, motorcyclists who used >100cc engine capacity motorcycles had significantly higher RTA incidence rate {478.8/100 MCY}, RTI rate {223.2/100MCY}and FIR {410/100MCY} than users of <100cc engine motorcycles who recorded RTA incidence of 258.9/100MCY, RTI rate of 49/100MCY and zero fatal injury respectively {p<0.01, p<0.001, p<0.001 respectively}. Conclusion: A careful consideration of all these predictors individually and collectively, will enable stakeholders in transport industry

Road traffic accidents (rtas) represent a major epidemic of non communicable disease in the country and has since escalated with the introduction of the new phenomenon of commercial motorcycle transportation such as is found in the two urban towns of nnewi and Awka of Anambra state, Nigeria. making use of a pre-tested, semi structured, interviewer administered questionnaire, relevant data on socio demographic and motorcycle characteristics were collected from a sample of commercial motorcyclists selected by systematic sampling technique. their knowledge of and attitude towards road traffic and safety codes were elicited. The result showed that the all-male commercial motorcyclists had a mean age of 30+8.9 years. one hundred and seventy six (32.6%) possessed good knowledge of road traffic codes and safety, while 35 (6.5%) exhibited good attitude towards them. both knowledge of and attitude towards traffic codes and safety improved with increase in educational level (p<0.005, p<0.001 respectively). the younger motorcyclists also possessed statistically significant better knowledge of traffic codes than their older counterparts (p<0.025). attitude to traffic codes and safety had no association with age of the motorcyclists (p>0.25). the study has provided useful information on the knowledge of and attitude towards road traffic and safety codes among commercial motorcyclists in nigeria. pursuit of knowledge through formal and informal education should run pari pasu with efforts to improve the nigerian economy in order to ensure a sustainable positive attitudinal change towards road traffic codes and safety among commercial motorcyclists.