Chronic NCDs Research Articles

Main risk factors for the development of chronic non-communicable diseases among residents of the Altai Territory

Purpose of the study. analysis of the prevalence of the main risk factors for the development of chronic NCDs in the unorganized population of the Altai Territory aged 25–64 years.Materials and methods. The study involved 1,103 people aged 25–64 years, selected by random sampling from the population of the Altai Territory. The survey was conducted using a standard questionnaire. During the study, the blood pressure level, height, and weight of respondents were measured.Results. The study involved 1103 people, of whom 33.4 % were men (n = 368), women – 66.6 % (n = 735). Smoking was registered in 21.5 % (n = 234), among men – 45.7 % (n = 166), among women – 9.4 % (n = 68). IBP of salt was detected in 58.9 % (n = 650), among men – 63.6 % (n = 234), among women – 56.6 % (n = 416). Consumption of less than 5 servings of fruits and/or vegetables on average per day was noted in 55.7 % (n = 597), among men – 67.6 % (n = 244), among women – 49.6 % (n = 353). NFA occurs in 19.9% (n = 218), among men – 19.4 % (n = 71), women – 20.1 % (n = 47). Obesity occurs in 34.9 (n = 349), among men – 22.3 % (n = 73), women – 41% (n = 276). High blood pressure among all respondents was 50.3 %; in men this risk factor was lower than among women (45.4 % and 52.8 %, respectively).Conclusions. For the first time, the features of the main risk factors for the development of chronic non-diseases were studied in an unorganized sample of the region’s population aged 25–64. Residents of the region have a high incidence of salt IBP, NPOF and elevated blood pressure. The ESSE-RF study made it possible to identify gender and territorial characteristics of our region. Thus, the study demonstrated that both sexes have NPOF and salt IBP, but smoking was more common among men, and high blood pressure among women. This study is the starting point for epidemiological studies in the Altai region and can serve as a guide for further monitoring of the prevalence of risk factors and the effectiveness of preventive programs.

Results of a survey of medical students on key aspects of health preservation

Purpose: Study of the influence and assessment of risk factors for chronic non-infectious diseases in medical students through an online survey. Materials and methods: During the period from 03/19/24 to 04/08/24, an online survey was conducted at the Rostov State Medical University using the google platform. A group of 1232 people was formed, including students from 1st to 6th year of all faculties. The results of the survey were systematized and analyzed. Results: Вy analyzing the information received from respondents, several groups of risk factors for chronic NCDs were identified: 1. Sleep disturbances; 2. Indifference to compliance with healthy eating standards; 3. Susceptibility to chronic emotional stress. Conclusion: Based on the results of the study, risk factors for chronic non-diseases were identified among Rostov State Medical University students (the leading ones were: sleep disturbance, non-compliance with healthy eating standards, stress). It was also found that indicators such as physical activity and the presence of bad habits are not common risk factors in this group of respondents. From the above, we can conclude about the feasibility and importance of introducing preventive measures to increase the importance and significance of such aspects as healthy.

Multifactor Analysis Revealing Key Factors of Chronic NCDS Based on Random Forest Models

This article investigates chronic non-communicable diseases with a focus on lifestyle and dietary habits. By establishing separate models, eliminating the influence of highly correlated variables, and addressing data imbalance using the SMOTE algorithm, seven independent variables were identified, including basic information, lifestyle, and dietary habits. Random forest algorithm analysis revealed that smoking and alcohol consumption significantly impact the occurrence of chronic diseases, with different dietary factors associated with specific diseases. Occupational type, work intensity, and stress also have a notable influence on the risk of chronic diseases. Furthermore, increasing daily physical activity is associated with a lower disease risk. These findings contribute to a better understanding of the occurrence and management of chronic diseases, providing valuable information for prevention and treatment.

Insomnia and common mental disorder among patients with pre-existing chronic non-communicable diseases in southern Ethiopia: a survey during COVID-19 pandemic.

COVID-19 has been causing significant mental health problems and other health-related issues. Despite the fact that COVID-19 has a significant impact on chronic disease patients, there is scant research on insomnia, common mental health disorders (CMD), and their associated factors among chronic disease patients. The purpose of this study was to assess the prevalence of insomnia and common mental disorders (CMD) and their associated factors among patients with pre-existing chronic NCDs in Sidama, southern Ethiopia. A multicenter cross-sectional study was undertaken between June 1 and September 1, 2021. The study included 633 participants. CMD and insomnia were assessed using a 20-item Self-Reported Questionnaire (SRQ-20) and a 7-item Insomnia Severity Index (ISI) scale, respectively. To describe the various variables, descriptive statistics were used. We performed multivariable logistic regression analysis to identify independent factors associated with CMD and insomnia. A value of p < 0.05 was considered statistically significant at a 95% confidence interval. The prevalence of insomnia and CMD was found to be 39.3% and 46.8%, respectively. Being merchant (AOR = 0.33; 95% CI = 0.13, 0.82), having a diagnosis of diabetes mellitus (AOR = 1.89; 95% CI = 1.04, 3.46), comorbid diagnosis (AOR = 3.96; 95% CI = 2.27, 6.89), low social support (poor (AOR = 3.37; 95% CI = 1.51, 7.57) and moderate (AOR = 3.13; 95% CI = 1.46, 6.69)), symptoms of insomnia (AOR = 12.08; 95% CI = 7.41, 19.72) and poor quality of life (QOL) (AOR = 1.67; 95% CI = 1.04, 2.72) were independent predictors of CMD. We also found out that, having cardiovascular disorders (CVDs) (AOR = 2.48; 95% CI = 1.18, 5.19), CMD (AOR = 12.09; 95% CI = 7.46, 19.61), and poor QOL (AOR = 2.04; 95% CI = 1.27, 3.26) were significantly associated with insomnia symptoms. Our study suggests that substantially high prevalence of CMD and insomnia. Significant association between CMD and occupation, diagnosis, comorbidity, social support, insomnia, and QOL were found. We also revealed that having CVDs, CMD, and poor QOL were significantly associated with insomnia symptoms. Therefore, dealing with the mental health problems of patients with chronic NCDs is an essential component of public health intervention during the COVID-19 pandemic.

Acute myocardial infarction and brain infarction morbidity as a quality indicator of the chronic non-communicable diseases overcoming in Turkmenistan

Improving the provision of medical care to patients with chronic non-communicable diseases should be based on objective indicators of the effectiveness of preventive measures and medical examinations. Such an indicator can be the incidence of acute myocardial infarction and cerebral infarction. Objective: to characterize the trends in the dynamics of the incidence of myocardial infarction and acute disorders of cerebral circulation in Turkmenistan. Materials and methods. A retrospective descriptive epidemiological study was performed. The dynamics, spatial and temporal characteristics of the incidence of myocardial infarction (ICD-10 code I21–I23), cerebral infarction (ICD-10 code I63) in the period 2016– 2020 in Turkmenistan as a whole and by administrative-territorial units were studied. Results. During the study period, Turkmenistan has seen a decrease in the overall incidence of acute myocardial infarction from 10.9 per 100 thousand in 2016 to 7.8 per 100 thousand in 2020. Currently, the highest level of total incidence of myocardial infarction is registered in Ashgabat and the Balkan Velayat (9.0 per 100 thousand people), the smallest is in the Mary Velayat (6.9 per 100 thousand people). There is also a decrease in the overall incidence of acute disorders of cerebral circulation. In the whole country from 2016 to 2020, the indicator decreased from 5.6 to 4.7 per 100 thousand population. At the level of individual administrative-territorial units, significant fluctuations in indicators were observed during the study period, and in the city of Ashgabat, an increase in the overall incidence of brain infarction. Conclusion. The decrease in the overall incidence of acute cerebral circulatory disorders and acute myocardial infarction indicates the high quality of the work of the national health system in the aspect of prevention of chronic NCDs. In some administrative-territorial units of Turkmenistan, the peculiarities of the dynamics of morbidity were revealed, requiring special organizational approaches.

Study of the feasibility of using an enriched product based on goat’s milk in the nutrition of vulnerable groups of the population

The diet of the majority of the adult population does not meet the principles of a healthy diet. Modifiable factors are associated with lifestyle and diet, which play an important role in the development of diseases. Sufficient intake of energy, protein and micronutrients from food serves as a prophylactic factor for a number of chronic non-communicable NCDs. Among all groups of the adult population, the most sensitive to unbalanced, deficient nutrition of women during pregnancy and breastfeeding, as well as the elderly. As a result, the prevalence of protein-energy malnutrition among the elderly and senile is from 15 to 90 %. The physiological course of pregnancy and the adequate formation of the fetus are impossible in conditions of a lack of nutrients. Protein-energy insufficiency and a lack of microelements in the body of a pregnant woman leads to complications of the gestational process, deterioration of the fetus, and can cause the development of a significant spectrum of chronic NCDs in a child. The choice of a product for optimizing the nutrition of vulnerable groups of the population, taking into account their physiological characteristics, seems to be an urgent task. The purpose of this study was to study the feasibility and relevance of using in the diet of vulnerable groups of the population (the elderly, pregnant and lactating women) an fortified product based on goat’s milk. Compared to cow’s milk, goat’s milk has a greater nutritional and biological value, is easier to digest, its fatty acid composition has an anti-inflammatory effect, helps reduce the risk of atherosclerosis and prevent cardiovascular diseases, and also helps strengthen the immune system, improves calcium absorption, and does not violate absorption of iron. Additional enrichment of goat milk products with vitamins and microelements increases their nutritional value. An actual way to correct the nutrition of vulnerable groups of the population is the introduction of fortified products made on the basis of goat’s milk into the diet.

The prevalence of anxiety syndrome in people with chronic non-communicable diseases in real clinical practice

Objective: to study of the features of the spread of anxiety syndrome in patients with chronic non-communicable diseases (CNCD) in outpatient practice. Materials and methods: the study included persons of both sexes over 18 years of age who visited outpatient facilities in a large industrial center of Eastern Siberia in the summer of 2022. Diagnosis of chronic NCDs was established according to modern clinical guidelines. The examined were divided into two groups. The first group included persons without NCDs, the second group included patients with concomitant NCDs. The psycho-emotional state was assessed using the Spielberger-Khanin test with separate determination of the levels of personal and situational anxiety. Statistical data analysis was carried out using the Statistica 12.0 software package (StatSoft Inc., USA). Results: the level of situational anxiety in patients with chronic NCDs was statistically significantly higher compared to individuals without concomitant somatic pathology. In patients with chronic NCD, compared with individuals without them, a significant increase in the median scores for the level of low and moderately expressed personal anxiety and for the level of moderate and high situational anxiety was revealed. In the group of patients with CND, a high level of personal and situational anxiety was significantly more often observed in comparison with persons without CND. Conclusion: the prevalence of anxiety syndrome, especially situational anxiety in patients with chronic NCD in the outpatient network is quite high and reaches 93%, which requires a solution to the issue of practical psychiatric care for these patients.

Scientific background for programs to combat chronic non-communicable diseases on the basis of benchmarking of administrative-territorial units of Turkmenistan

Introduction . Template approaches to the formation of strategies and action plans to combat chronic noncommunicable diseases (CNCDs) are fraught with low efficiency, a mismatch between the resources spent and the results obtained. There is a need for "individualization" of strategies, taking into account local characteristics, capabilities and needs of individual administrative-territorial units. Objective . Scientifically substantiate a set of programs and activities to combat chronic NCDs, taking into account the characteristics and needs of each administrative-territorial unit of Turkmenistan. Material and methods . A general benchmarking of the administrative-territorial units of Turkmenistan was carried out. The rating parameters are determined by the logical and methodological deduction procedure. The included parameters reflect in a balanced way the socio-economic and demographic status of the region, the readiness of the healthcare system, the development of prevention, treatment and diagnostic work in relation to chronic NCDs. Results and discussion . For the first time, a rating was compiled and benchmarking of the administrative-territorial units of Turkmenistan was carried out in the aspect of combating NCDs; for the first time, the corresponding needs, opportunities and characteristics of each region were objectively characterized, which is the basis for planning and management decisions. Based on the rating and benchmarking, an original tool for strategic planning has been developed - a matrix of the prevailing influence of typical barriers to combat NCDs in the administrative-territorial units of Turkmenistan. Conclusions . A matrix of the prevailing influence of typical barriers to combat NCDs in the administrative-territorial units of Turkmenistan has been developed, which serves as the basis for strategic planning of a set of measures.

Comprehensive analysis of the trend in main indicators of the health of the adult population suffered from chronic non-communicable diseases with the preventive activity of medical institutions

Purpose. The relevance of the study is determined by the high incidence of chronic non-communicable diseases (CNCD) and the mortality of the working population. Materials and methods. As part of an observational study, morbidity and mortality due to CNCDs in the adult population of the Saratov region, the trend in the medical examination index and medical prevention activity over 2011-2020 were analyzed. Results. Analysis of trends in morbidity and mortality due to chronic NCDs for 2011-2020 showed the gain. Respiratory diseases are leading in their structure (chronic bronchitis, emphysema - an increase by 200 cases (+200%), obstructive pulmonary disease - 200 (+50%), asthma - 0 (0%)), obesity - 100 (+62,5%), diseases of the circulatory system (DCS) - 1330 (+35,5%), diseases characterized by high blood pressure - 460 (+39,3%), coronary heart disease - 750 (+98,7%) cerebrovascular diseases - 190 (+19,6%); type II diabetes - 50 (+17,8%), malignant neoplasms - 50 (+12,2%). In the structure of total mortality the share of CNSD in 2011 was 51%, neoplasms - 12,6%, and in 2020, CNSD of tumor formations amounted to 49,4% and 12,6%, respectively. Increase in deaths due to neoplasms (15,8%), CNSD (12,2%) in 2020 compared to 2011, and compared to 2019 due to diabetes mellitus (+90.8%), diseases of the respiratory system (+44,4%), CSD (+17,2%), in particular, coronary heart disease (+27,7%), cerebrovascular diseases (+2,7%), malignant neoplasms (-1,6%). Limitations. The study has regional (Saratov region) limitations. Conclusion. Primary morbidity and mortality rates reflect an unfavourable prognosis for CNCDs in the adult population of the Saratov region. This justifies the analysis of health care and the development of highly effective methods of prevention and treatment and rehabilitation measures aimed at maintaining health and extending the working longevity of the population.

Clustering of lifestyle risk factors among adult population in India: A cross-sectional analysis from 2005 to 2016.

IntroductionIndividual’s early life style and health behaviors are directly linked to chronic non-communicable diseases. Considering the increased burden of NCDs during the last two decades, the aim of this study is to assess co-occurrence/clustering of lifestyle risk factors and its association with different socio-demographic and economic characteristics among adult men and women in India from 2005–2016.MethodsThis study utilized the data from the National Family Health Survey 2005–06 and 2015–16 survey rounds. Multinomial logistic regression is employed to evaluate co-occurrence of multiple risk factors among adult men and women of different socio-economic and demographic characteristics to identify the subgroups with elevated risk of clustering of multiple unhealthy lifestyle risk factors.ResultsMore adult men in India tend to exhibit clustering of multiple non-communicable disease risk factors than females. Individuals between 30–49 years of age, residing in urban areas, the population with no education, separated couples and those from poor economic strata are the specific population subgroups show higher prevalence of co-occurrence of multiple risk factors. The regional pattern of clustering of risk factors shows that the prevalence of co-occurrence of multiple risk factors is higher among men and women from the North-Eastern part of India compared to the other regions of the country.ConclusionThe prevalence of clustering of multiple risk factors associated with chronic NCDs is substantially high and has increased between 2005–06 to 2015–16. India may therefore experience a significant increase in the burden of chronic non-communicable diseases in the coming years. We therefore conclude that appropriate strategies should be implemented by policy makers and the government to reduce the overall health burden of NCDs due to lifestyle habits.

Surveillance of Cardiovascular Risk Factors in the Fifth Military Sector Health Center, Ngaoundéré, Cameroon: Observational Study.

BackgroundNoncommunicable diseases (NCDs) are the leading causes of death worldwide. They were responsible for 40 million of the 57 million deaths recorded worldwide in 2016. In Cameroon, epidemiological studies have been devoted to NCDs and their risk factors. However, none provides specific information on their extent or the distribution of their risk factors within the Cameroonian defense forces.ObjectiveThe objective of our study was to assess the cardiovascular risk of a Cameroonian military population compared with that of its neighboring civilian population.MethodsWe conducted a cross-sectional study that involved subjects aged 18 to 58 years, recruited from October 2017 to November 2018 at the Fifth Military Sector Health Center in Ngaoundéré, Cameroon. Data collection and assessment were done according to the World Health Organization (WHO)’s STEPS manual for surveillance of risk factors for chronic NCDs and the Alcohol Use Disorders Identification Test. Five cardiovascular risk factors were assessed: smoking, harmful alcohol consumption, obesity/overweight, hypertension, and diabetes. The risk was considered high in subjects with 3 or more of the factors. Univariate analysis and multivariate logistic regression were carried out according to their indications.ResultsOur study sample of 566 participants included 295 soldiers and 271 civilians of the same age group (median age 32 years versus 33 years, respectively; P=.57). The military sample consisted of 31 officers and 264 noncommissioned officers (NCOs). Soldiers were more exposed to behavioral risk factors than civilians, with a prevalence of smoking of 13.9% versus 4.4% (P<.001) and excessive alcohol consumption of 61.7% versus 14.8% (P<.001). They also presented with a higher cardiovascular risk than civilians (odds ratio 2.7, 95% CI 1.50-4.81; P<.001), and among the military participants, the cardiovascular risk was higher for officers than for NCOs (51.6% versus 14.0%, respectively; P<.001).ConclusionsCameroonian soldiers are particularly exposed to cardiovascular behavioral risk factors and consequently are at higher risk of NCDs.Trial RegistrationClinicalTrials.gov NCT04315441; https://clinicaltrials.gov/ct2/show/NCT04315441

Prevalence and associated factors of chronic non-communicable diseases among cross-country truck drivers in Ethiopia

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

PREVALENCE OF NON-COMMUNICABLE DISEASES AMONG GERIATRIC POPULATION IN AL- NASIRIYAH CITY 2015..

Objectives: To assess the extent of NCDs among geriatric people in Al- Nasiriyah city together with an assessment of general health status and the health care services provided to this segment of the population. Methodology: Analytical, cross-sectional study in form of household survey had been conducted in Al- Nasiriyah City, from 1 October 2015 to the end of August 2016. A multistage sampling involving 423 individuals aged ≥ 60 years as a representative sample. Results: The overall prevalence of chronic NCDs was 89%. The top five chronic diseases were hypertension (67%), diabetes (31.2%), musculoskeletal diseases (15.4%), heart diseases (11.1%), and cataract (12.8%). Prevalence of mutimorbidity (patient with two or more chronic diseases) was 59%. The main geriatric symptoms were vision problems (77.8%), feeling sad or depressed (36.4%), hearing problems (31.7%), falls (30%), memory problems (22.9%), and urinary symptoms (11.1%). Conclusion: The overall prevalence of chronic NCDs, mutimorbidity and geriatric problems among geriatric people of Al- Nasiriyah city was high, particularly cardiovascular diseases and diabetes alarming the need for actual and focused efforts in the field of prevention and improvement as well as strengthen the health care system particularly geriatric health care to reduce morbidity and to improve the healthy life years for elderly people.

Expanding access to non-communicable disease care in rural Malawi: outcomes from a retrospective cohort in an integrated NCD–HIV model

ObjectivesNon-communicable diseases (NCDs) account for one-third of disability-adjusted life years in Malawi, and access to care is exceptionally limited. Integrated services with HIV are widely recommended, but few examples exist...

Types, Characters and Trend of Congenital Anomalies in Thi-Qar / 2 years assessment

Objectives: To assess the extent of NCDs among geriatric people in Al- Nasiriyah city together with an assessment of general health status and the health care services provided to this segment of the population. Methodology: Analytical, cross-sectional study in form of household survey had been conducted in Al- Nasiriyah City, from 1 October 2015 to the end of August 2016. A multistage sampling involving 423 individuals aged ≥ 60 years as a representative sample. Results: The overall prevalence of chronic NCDs was 89%. The top five chronic diseases were hypertension (67%), diabetes (31.2%), musculoskeletal diseases (15.4%), heart diseases (11.1%), and cataract (12.8%). Prevalence of mutimorbidity (patient with two or more chronic diseases) was 59%. The main geriatric symptoms were vision problems (77.8%), feeling sad or depressed (36.4%), hearing problems (31.7%), falls (30%), memory problems (22.9%), and urinary symptoms (11.1%). Conclusion: The overall prevalence of chronic NCDs, mutimorbidity and geriatric problems among geriatric people of Al- Nasiriyah city was high, particularly cardiovascular diseases and diabetes alarming the need for actual and focused efforts in the field of prevention and improvement as well as strengthen the health care system particularly geriatric health care to reduce morbidity and to improve the healthy life years for elderly people.

Management of Lung Abscess : Review of 50 cases in Al-Hussein Teaching Hospital / Thi-Qar ( 2013-2018 )

Objectives: To assess the extent of NCDs among geriatric people in Al- Nasiriyah city together with an assessment of general health status and the health care services provided to this segment of the population. Methodology: Analytical, cross-sectional study in form of household survey had been conducted in Al- Nasiriyah City, from 1 October 2015 to the end of August 2016. A multistage sampling involving 423 individuals aged ≥ 60 years as a representative sample. Results: The overall prevalence of chronic NCDs was 89%. The top five chronic diseases were hypertension (67%), diabetes (31.2%), musculoskeletal diseases (15.4%), heart diseases (11.1%), and cataract (12.8%). Prevalence of mutimorbidity (patient with two or more chronic diseases) was 59%. The main geriatric symptoms were vision problems (77.8%), feeling sad or depressed (36.4%), hearing problems (31.7%), falls (30%), memory problems (22.9%), and urinary symptoms (11.1%). Conclusion: The overall prevalence of chronic NCDs, mutimorbidity and geriatric problems among geriatric people of Al- Nasiriyah city was high, particularly cardiovascular diseases and diabetes alarming the need for actual and focused efforts in the field of prevention and improvement as well as strengthen the health care system particularly geriatric health care to reduce morbidity and to improve the healthy life years for elderly people.

Congenital Anomalies in Thi-Qar: A Recent Observational Study during 2019

Objectives: To assess the extent of NCDs among geriatric people in Al- Nasiriyah city together with an assessment of general health status and the health care services provided to this segment of the population. Methodology: Analytical, cross-sectional study in form of household survey had been conducted in Al- Nasiriyah City, from 1 October 2015 to the end of August 2016. A multistage sampling involving 423 individuals aged ≥ 60 years as a representative sample. Results: The overall prevalence of chronic NCDs was 89%. The top five chronic diseases were hypertension (67%), diabetes (31.2%), musculoskeletal diseases (15.4%), heart diseases (11.1%), and cataract (12.8%). Prevalence of mutimorbidity (patient with two or more chronic diseases) was 59%. The main geriatric symptoms were vision problems (77.8%), feeling sad or depressed (36.4%), hearing problems (31.7%), falls (30%), memory problems (22.9%), and urinary symptoms (11.1%). Conclusion: The overall prevalence of chronic NCDs, mutimorbidity and geriatric problems among geriatric people of Al- Nasiriyah city was high, particularly cardiovascular diseases and diabetes alarming the need for actual and focused efforts in the field of prevention and improvement as well as strengthen the health care system particularly geriatric health care to reduce morbidity and to improve the healthy life years for elderly people.

Self-Reported Prevalence of Chronic Non-Communicable Diseases in Relation to Socioeconomic and Educational Factors in Colombia: A Community-Based Study in 11 Departments.

Background:Chronic non-communicable diseases are prevalent conditions in developing countries, such as Colombia. Several socioeconomic and educational factors have been associated with these pathologies. However, there is little country-specific information regarding the self-reported prevalence of chronic diseases and their association with the aforementioned factors in Colombia.Objectives:To evaluate the current situation of chronic non-transmissible diseases in Colombia by self-report and to analyze its potential relationship with sociodemographic, economic and educational factors.Methods:This is a cross-sectional baseline sub-analysis from the prospective, standardized collaborative PURE study in Colombia. Participants were recruited between 2005 to 2009, in 11 departments of the country, and included 7,485 subjects of 35 to 70 years old. Questionnaires of self-reported chronic non-communicable diseases, and demographic, socioeconomic and educational variables were applied.Results:Hypertension was the most prevalent chronic condition reported with a prevalence of 22.2% (21.2%–23.1%, 95% CI), followed by diabetes with a prevalence of 5.7% (5.1%–6.2%, 95% CI), asthma 2.7% (2.2%–3.0%, 95% CI), coronary heart disease 2.4% (2.0%–2.7%, 95% CI), stroke and heart failure 1.5% (1.2%–1.8%, 95% CI) each, chronic obstructive pulmonary disease 1.2% (0.6%–1.5%, 95% CI), and cancer 1.2% (1.0%–1.5%, 95% CI). Among the study sample, 23.3% (22.4%–24.3%, 95% CI) reported having one chronic NCDs, and 6.4% (5.9%–7.0%, 95% CI) reported having multiple chronic NCDs. The prevalence of multiple NCDs increased significantly with age, was more common in those from households with higher income, whereas it was significantly lower in persons with high education.The central and central-east regions of the country are those with the higher prevalence of self-reported NCDs.Conclusion:The results of the current study indicate the presence of socioeconomic and educational inequalities in the distribution of chronic NCDs in the Colombian population.

Construct validity and reliability of EQ-5D-3L for stroke survivors in a lower middle income setting

Stroke is a leading disease accounting for burden of chronic NCDs especially in lower and lower-middle income (LMI) settings. Quality of Life (QOL) is considered as an important facet of determination of success of patient management. EQ-5D-3L is a generic QOL tool. It provides an index score amalgamating responses for five descriptive questions and a visual analogue scale (VAS) value. To assess the validity and reliability of EQ-5D-3L for stroke patients in Sri Lanka, which is a LMI setting. A descriptive cross sectional study was done among 100 stroke survivors among whom 50 each were managed at an ambulatory setting and an in-ward setting. A second wave of data collection was done for reliability analysis among one half of participants. The validity of EQ-5D-3L was assesses with five a-priori hypotheses. Reliability was assessed with test-retest method and with internal consistency. Non parametric Mann Whitney U test and Spearman correlation coefficients were used in the analysis. The EQ-5D index scores had significant positive correlation with SF-36 domain scores (p<0.001). The EQ-5D VAS scores had significant positive correlation with SF-36 domain scores (p<0.01). Index and VAS values of the EQ-5D were proved to be valid in known-group comparison (p<0.001). Participants reporting some kind of impairment for EQ-5D-3L dimensions had lower SF-36 domain scores. All the kappa values in the analysis of test-retest method were significant (p<0.001). For the VAS score, the Spearman correlation coefficient in test-reter analysis was 0.993 (p<0.001). Cronbach’s alpha value was 0.928. and Recommendations EQ-5D-3L questionnaire demonstrates construct validity and a is a reliable toolin measuring QOL among stoke survivors in Sri Lanka.

The 2007 Caribbean Community Port-of-Spain Declaration on noncommunicable diseases: an overview of a multidisciplinary evaluation.

ABSTRACTObjectivesNoncommunicable diseases (NCDs) are a threat to social and economic development, including in the Caribbean. In 2007 the Caribbean Community (CARICOM) held the world's first-ever summit of heads of government on NCD prevention and control and issued the landmark Declaration of Port-of-Spain: Uniting to Stop the Epidemic of Chronic NCDs. The objectives of this paper are to provide an overview of a formal evaluation of the Declaration and to highlight key findings that could inform further implementation of the Declaration's 15 mandates.MethodsThe evaluation's six research objectives were decided through stakeholder engagement and assessed by concurrent quantitative and qualitative research methods, using the following four themes: 1) trends in risk factors, morbidity, and mortality; 2) national and Caribbean-wide policy responses, and factors associated with policy successes and difficulties; 3) the international impact of the Declaration; and 4) the potential for raising revenue from tobacco and alcohol taxation in order to support NCD prevention and control.ResultsThere are marked disparities in NCD mortality and trends among the 20 CARICOM member countries and territories. No CARICOM member had fully implemented all of the Declaration's 15 mandates (which were monitored by 26 indicators), with 10 CARICOM members implementing fewer than half of the indicators, and with most members lacking a well-functioning multisectoral NCD Commission. Larger CARICOM members tended to have higher levels of implementation than did smaller members. Mandates that received active support from regional institutions tended to be better implemented by the CARICOM members than did mandates that lacked that kind of support. Feasible national tobacco and alcohol tax increases could more than cover the cost of implementing the World Health Organization NCD “best buy” interventions in the CARICOM member countries and territories.ConclusionsPriorities for further implementation of the mandates from the Port-of-Spain Declaration include establishing throughout the CARICOM member countries and territories fully functioning national bodies to support multisectoral action for NCD prevention; greater regional support in policy development and implementation for smaller countries; and greater targeted use of taxes on tobacco and alcohol to support NCD control and prevention.