Knowledge Of Non-communicable Diseases Research Articles

Knowledge of Non-communicable Disease Risk Factors among Community Health Workers in South Africa

Introduction: Community Health Workers play an important role in supporting patients with chronic non-communicable diseases (NCDs), therefore they need to be constantly updated with current knowledge to enable them to perform their activities effectively. The purpose of this study was to assess the knowledge of NCDs risk factors among Community Health Workers (CHWs) in South Africa. Methodology: A triple “A” approach (assessment, analysis, and action) was used among 40 CHWs working with patients with chronic non-communicable diseases. All CHWs gave voluntary, informed consent in writing and verbally before they were allowed to participate in the study. For the initial assessment, CHWs completed a questionnaire to assess knowledge about the knowledge of NCDs. The questionnaire was analysed to determine their baseline performance. The findings of the assessment identified shortcomings in the knowledge of CHWs, specifically on diabetes and hypertension knowledge. Feedback was given to the CHWs followed by a short training on healthy living, focusing on the risk factors associated with NCDs (diabetes and hypertension). Training of CHWs was conducted using an adapted national training programme together with CHW prevention of healthy lifestyle modules designed by experts from the School of Public Health, University of the Western Cape. All statistical tests were two-tailed, and p<.05 was considered statistically significant. Results: The majority (97.5%) of the CHWs who had their knowledge assessed were women. Fifty-five percent (55%) were within age 30-45 years, while 45% were between the ages 46-60 years. The majority of the participants had secondary school education (92.5%) and 1-15 years of experience (97.5%) as CHWs. The results of the post-training assessment revealed that 48.5%, 63.6%, 42.4%, 72.7%, 42.5%, 57.6%, and 18.2% had poor knowledge of diabetes, hypertension, diabetes complications, hypertension complications, advice for diabetic patient, advice for hypertension, and nutrition advice of NCDs, respectively. Regression analysis showed that those with higher education levels were significantly highly likely to be knowledgeable about hypertension complications (OR=19.6, CI=1.14, 336.0). Conclusion: There was poor knowledge of risk factors for NCDs among CHWs. An association exists between the knowledge of risk factors for NCDs and education levels among the participants. There is a need for regular refresher training programs for CHWs to upscale their knowledge about NCDs, coupled with frequent review of CHWs program and curriculum.

Adapting and implementing training, guidelines and treatment cards to improve primary care-based hypertension and diabetes management in a fragile context: results of a feasibility study in Sierra Leone

BackgroundSierra Leone, a fragile country, is facing an increasingly significant burden of non-communicable diseases (NCDs). Facilitated by an international partnership, a project was developed to adapt and pilot desktop guidelines and other clinical support tools to strengthen primary care-based hypertension and diabetes diagnosis and management in Bombali district, Sierra Leone between 2018 and 2019. This study assesses the feasibility of the project through analysis of the processes of intervention adaptation and development, delivery of training and implementation of a care improvement package and preliminary outcomes of the intervention.MethodsA mixed-method approach was used for the assessment, including 51 semi-structured interviews, review of routine treatment cards (retrieved for newly registered hypertensive and diabetic patients from June 2018 to March 2019 followed up for three months) and mentoring data, and observation of training. Thematic analysis was used for qualitative data and descriptive trend analysis and t-test was used for quantitative data, wherever appropriate.ResultsA Technical Working Group, established at district and national level, helped to adapt and develop the context-specific desktop guidelines for clinical management and lifestyle interventions and associated training curriculum and modules for community health officers (CHOs). Following a four-day training of CHOs, focusing on communication skills, diagnosis and management of hypertension and diabetes, and thanks to a CHO-based mentorship strategy, there was observed improvement of NCD knowledge and care processes regarding diagnosis, treatment, lifestyle education and follow up. The intervention significantly improved the average diastolic blood pressure of hypertensive patients (n = 50) three months into treatment (98 mmHg at baseline vs. 86 mmHg in Month 3, P = 0.001). However, health systems barriers typical of fragile settings, such as cost of transport and medication for patients and lack of supply of medications and treatment equipment in facilities, hindered the optimal delivery of care for hypertensive and diabetic patients.ConclusionOur study suggests the potential feasibility of this approach to strengthening primary care delivery of NCDs in fragile contexts. However, the approach needs to be built into routine supervision and pre-service training to be sustained. Key barriers in the health system and at community level also need to be addressed.

Assessment of knowledge on non-communicable diseases and their screening tests among elderly population in an urban area of Bengaluru

Background: Non-communicable diseases (NCDs) are the leading cause of morbidity and premature mortality in most low and middle income countries (LMIC) around the world. Recent estimates shown that about 80% of NCDs deaths occur in LMIC and nearly three fourth of global NCDs related deaths take place after the age of 60. The knowledge of NCDs and their related screening tests among elderly is essential for early detection which reduces further development of the disease and its complications, thereby reducing the burden of health care cost. Hence, the present study was undertaken.Methods: A descriptive study was conducted among 245 study subject after obtaining informed consent. Using pre-tested structured questionnaire, information was collected regarding knowledge on NCDs and their screening tests. Results were entered in Microsoft excel and analyzed using descriptive statistics.Results: 81.6% of study subjects were aware of common NCDs. Off which only 02% were aware of 6 NCDs (out of 12 NCDs considered in this study). Regarding individual diseases, about 61.6% subjects were aware of Hypertension and 52.7% about DM. About knowledge of screening test, 69% were aware about any screening test and 58.8% were aware of screening test for hypertension and 41.6% for diabetes mellitus.Conclusions: The overall knowledge regarding NCDs and their screening tests is poor among elderly population.

Exploring health literacy in relation to noncommunicable diseases in Samoa: a qualitative study

BackgroundSamoa is suffering from alarming rates of noncommunicable diseases (NCDs). To address this epidemic, tackling health literacy is important. A qualitative study was conducted with the aim to explore health literacy in Samoa in relation to NCDs.MethodsSix focus groups were conducted, with a total sample size of 73 participants aged over 18 years. The semi-structured interview guide was based on the conceptual model of the European Health Literacy project (HLS-EU). Data was translated, transcribed, coded, and categorized as part of the qualitative analysis.ResultsThe analysis resulted in one overarching category and seven sub-categories based on 19 themes. It revealed that health literacy in Samoa is strongly influenced by the culture. Personal responsibility is lacking. The family circle is central to health in a community where support is provided through the church and local groupings. Basic knowledge of NCDs was present in the population, but a deeper understanding of chronic disease implications was lacking. Difficulties with regards to medication adherence for chronic diseases arose as a topic, and traditional healers are still strongly embedded in the local society. Finally, the health system’s performance, especially primary care services at the local level, is suffering from the high burden of NCDs and has been challenged to respond to the needs of the community it serves.ConclusionThe findings of this study show how health literacy in Samoa is influenced by culture and suggest employing participatory, culture-sensitive, public health interventions which address the family as a whole, building on health literacy to address major public health problems like NCDs and remove barriers in the health system.

Lipid and Diabetic Profiles of School Teachers in Afghanistan Facing Food Insecurity and Their Association with Knowledge Relating to Healthy Lifestyle

Objectives: To investigate lipid and diabetic profiles of school teachers in Kabul, Afghanistan, who face food insecurity, and examine the association of those with the teachers’ knowledge of non-communicable diseases (NCDs). Methods: A survey to examine biochemical indicators of NCDs (triglycerides (TG), total cholesterol (TC), high-density lipoprotein (HDL), hemoglobin A1c (HbA1c), blood pressure, height, weight, waist circumference), food insecurity, lifestyle and knowledge of NCDs was conducted among 600 school teachers. Analyses were made of biochemical indicators of NCDs, blood pressure, metabolic syndrome, obesity, and subject’s lifestyle in relation to food security and the subject’s knowledge of NCDs. Results: Thirty-nine percent of school teachers experienced food insecurity. The percentage of TC ≥ 200 mg/dL; HbA1c ≥ 5.5%; hypertension and metabolic syndrome were 20.2%, 29.7%, 32.2% and 33.7%, respectively. Food insecurity was associated with lower fruit and vegetable consumption and higher potato consumption. Food insecurity was associated with increased TC (AOR 2.03; 95%CI: 1.23 - 3.34), decreased HDL (AOR 1.70; 95%CI: 1.12 - 2.58), increased HbA1c (AOR 1.73; 95%CI: 1.14 - 2.64), hypertension (AOR 1.68; 95%CI: 1.01 - 2.80) and diagnosis of metabolic syndrome (AOR 1.78; 95%CI: 1.18 - 2.68), after adjustment by demographic, socioeconomic and lifestyle variables. Among people living under condition of food insecurity, greater NCD knowledge was associated with smaller prevalence of TG ≥ 150 mg/dL, HDL < 40 mg/dL, and diagnosis of metabolic syndrome. Conclusions: Under conditions of food insecurity, diets have less variety and individuals are more likely to exhibit biomedical risk factors of NCDs. Even under conditions of food insecurity, people with knowledge of NCDs may have better coping strategies for their choice of lifestyles and exhibited a lower percentage of risk factors of NCDs.

The perceptions and experiences of North Korean refugee doctors concerning the burden of non-communicable diseases in North Korea.

Non-communicable diseases (NCDs) are a major challenge to health and social development in the 21st century, and North Korea is no exception. However, there is a lack of information concerning NCDs in North Korea, and a different approach is needed to understand the NCDs burden there. This study examines the perceptions and experiences of refugee doctors from North Korea concerning the NCDs burden in North Korea. Focus group discussions were conducted with 10 refugee doctors from North Korea who had been recruited through snowball sampling. North Korean refugee doctors participating in this study indicated that NCDs are the highest priority diseases, that North Koreans did not appear to have a high level of understanding and knowledge of NCDs, that economic breakdown was the primary cause of the NCDs burden, and that a high priority should be assigned to targeting NCDs in North Korea. Although the North Korean refugee doctors were medical professionals, they faced serious challenges accessing and managing patients with NCDs. South Korea needs to prepare for a potentially large number of people with NCDs should a freer movement of peoples occur between the two countries.

Interventions for improving management of chronic non-communicable diseases in Dikgale, a rural area in Limpopo Province, South Africa

BackgroundChronic disease management (CDM) is an approach to health care that keeps people as healthy as possible through the prevention, early detection and management of chronic diseases. The aim of this study was to develop interventions to improve management of chronic diseases in the form of an integrated, evidence-based chronic disease management model in Dikgale, a rural area of Limpopo Province in South Africa.MethodsA multifaceted intervention, called ‘quality circles’ (QCs) was developed to improve the quality and the management of chronic diseases in the Dikgale Health and Demographic Surveillance System (HDSS). These QCs used the findings from previous studies which formed part of the larger project in the study area, namely, the quantitative study using STEPwise survey and qualitative studies using focus group discussions and semi-structured interviews.ResultsThe findings from previous studies in Dikgale HDSS revealed that an epidemiological transition is occurring. Again, the most widely reported barriers from previous studies in this rural area were: lack of knowledge of NCDs; shortages of medication and shortages of nurses in the clinics, which results in patients having long waiting-time at clinics. Lack of training of health care providers on the management of chronic diseases and the lack of supervision by the district and provincial health managers, together with poor dissemination of guidelines, were contributing factors to the lack of knowledge of non-communicable diseases (NCDs) management among nurses and community health care workers (CHWs). Consideration of all of these findings led to the development of model which focuses on integrating nursing services, CHWs and traditional health practitioners (THPs), including a well-established clinical information system for health care providers. A novel aspect of the model is the inclusion of community ambassadors who are on treatment for NCDs and are, thus, repositories of knowledge who can serve as a bridge between health care workers and community members.ConclusionThe model developed highlights the need for health interventions that aim to control risk factors at the population level, the need for availability of NCD-trained nurses, functional equipment and medication and a need to improve the link with traditional healers.

Driving a greater understanding of non-communicable diseases in Africa through collaborative research: the experience of the GSK Africa NCD Open Lab

# Background The majority of premature deaths from non-communicable diseases (NCDs) occur in low-income countries. However, clinical research in these patient populations is generally lacking. Thus, many treatment paradigms for NCDs are either absent or extrapolated from populations with different genetics, health needs, and socio-economic circumstances. # Methods To evaluate the outcomes from the first call for proposals from the GSK Africa NCD Open Lab. Funding was offered to research projects aiming to improve understanding and generate new knowledge of NCDs in African populations. Proposals were sought for projects relating to cancer, cardiovascular disease, diabetes, chronic respiratory disease or chronic kidney diseases. The proposal had to be led by African scientists from Cameroon, The Gambia, Ghana, Kenya, Cote d'Ivoire, Malawi, Nigeria or Uganda and include a capacity building component. # Results The 155 eligible proposals covered oncology (31.0%), cardiovascular disease (27.1%), metabolic disorders such as diabetes (20.6%), chronic respiratory disease (9.7%) and chronic kidney disease (6.5%). Most applications were from Nigeria (37.8%), Kenya (17.3%) and Uganda (13.5%). Following initial review, 23 proposals were considered by a Scientific Advisory Board, and ten were invited to submit full applications. Five projects were funded in cardiovascular disease, the interaction between cardiovascular disease and HIV infection, breast cancer, asthma and chronic kidney disease/diabetes. Principal investigators were from Nigeria, Uganda and Malawi with collaborators from Cameroon, Ethiopia, Kenya, Mozambique, South Africa, the UK, USA and the Netherlands. All of the projects involved research capacity strengthening elements. # Conclusions These projects have the potential to improve the understanding of the aetiology and natural history of specific NCDs, while also informing the development of clinical guidelines for the effective management of disease. However, far more needs to be done to address capacity building and funding for NCD research in Africa.

Exploring knowledge and attitudes toward non-communicable diseases among village health teams in Eastern Uganda: a cross-sectional study

BackgroundCommunity health workers are essential personnel in resource-limited settings. In Uganda, they are organized into Village Health Teams (VHTs) and are focused on infectious diseases and maternal-child health; however, their skills could potentially be utilized in national efforts to reduce the growing burden of non-communicable diseases (NCDs). We sought to assess the knowledge of, and attitudes toward NCDs and NCD care among VHTs in Uganda as a step toward identifying their potential role in community NCD prevention and management.MethodsWe administered a knowledge, attitudes and practices questionnaire to 68 VHT members from Iganga and Mayuge districts in Eastern Uganda. In addition, we conducted four focus group discussions with 33 VHT members. Discussions focused on NCD knowledge and facilitators of and barriers to incorporating NCD prevention and care into their role. A thematic qualitative analysis was conducted to identify salient themes in the data.ResultsVHT members possessed some knowledge and awareness of NCDs but identified a lack of knowledge about NCDs in the communities they served. They were enthusiastic about incorporating NCD care into their role and thought that they could serve as effective conduits of knowledge about NCDs to their communities if empowered through NCD education, the availability of proper reporting and referral tools, and visible collaborations with medical personnel. The lack of financial remuneration for their role did not emerge as a major barrier to providing NCD services.ConclusionsUgandan VHTs saw themselves as having the potential to play an important role in improving community awareness of NCDs as well as monitoring and referral of community members for NCD-related health issues. In order to accomplish this, they anticipated requiring context-specific and culturally adapted training as well as strong partnerships with facility-based medical personnel. A lack of financial incentivization was not identified to be a major barrier to such role expansion. Developing a role for VHTs in NCD prevention and management should be a key consideration as local and national NCD initiatives are developed.

Knowledge of non-communicable diseases and practices related to healthy lifestyles among adolescents, in state schools of a selected educational division in Sri Lanka

BackgroundBehaviors established during the adolescence have life-long consequences to the onset of non-communicable diseases (NCDs) in later life. Therefore, it is essential to understand adolescents’ knowledge and practices with the intention of developing preventive programs focusing on this age group. The objective of the study was to assess knowledge about selected NCDs, and lifestyle choices among school students aged 17–19 years in state schools of the Maharagama Educational Division, Sri Lanka.MethodsA descriptive, cross-sectional study was conducted among students aged 17–19 years attending state schools in Maharagama Education Division. A total of 634 students were selected from 9 schools conducting Advance Level classes. Stratified sampling was done based on stream of study and the number needed from each stratum was decided according to probability proportionate to size which was followed by cluster sampling within the strata to select the classes included.Data were collected using a self-administered-questionnaire on socio-demographic characteristics and economic status; lifestyle-related practices; knowledge on Non-Communicable -Diseases. Logistic regression was used to assess the associations.ResultsProportion students with good overall knowledge was 43%(n = 272). Forty-three percent (n = 275) consumed a healthy diet, and 20%(n = 129) engaged in adequate physical activity 3%(n = 18) of students were current smokers and 12%(n = 73) current alcohol users 12%(n = 73).Overall “good” knowledge about NCDs was associated with being a science stream student(OR = 3.3; 95%CI:2.1–5.2). Healthy diet was associated with female sex (OR = 2.1; 95%CI: 1.5–3.0), and adequate physical activity with male sex (OR = 2.1; 95% CI:1.4–3.2), non-science-stream (OR = 2.1; 95%CI:1.2–3.7) and upper socio economic status (OR = 2.0; 95%CI:1.3–3.0). Non-smoking was associated with overall good knowledge (OR = 4.1; 95%CI:1.2–13.7) and female sex (OR = 0;95%CI:1.5-infinity). Abstinence from alcohol was associated with being a female (OR = 6.9; 95%CI:3.4–13.9), and with mother and fathers’ education level of > General-Certificate of Examinations Ordinary Level (GCE O/L) (OR = 2.9; 95%CI:1.1–8.4 and OR = 3.5; 95%CI:1.1–11.2 respectively).ConclusionKnowledge about NCDs and healthy lifestyle-practices were poor among school students aged 17–19 years. Lack of knowledge about healthy and unhealthy behaviors highlights the importance of carrying out regular surveillance for NCD risk factors, and initiating programs for the prevention of NCDs amongst adolescents.

Knowledge and Risk Factors Prevalence of Non Communicable Diseases (NCDs) in Nigeria: a case study of Adult population in Delta State

Non Communicable Diseases (NCDs) are the major causes of mortality and morbidity globally. Knowledge about NCDs and their risk factors are not only considered critical in NCDs prevention and management, but hold the potential to reduce the burden.. Objective: This cross-sectional descriptive study was aimed at determining NCDs knowledge level and risk factors prevalence among adult population in Delta State. Data collection: A semi-structured, interviewer-administered questionnaire was used to collect quantitative data from the participants and was then subjected to data analysis using of SPSS version 20. Results: Findings shows low knowledge of NCDs and its risk factors with only 16.66% having good knowledge of NCDs and 12.17% good knowledge level of its risk factors. Prevalence profile of the risk factors among the participants revealed varied responses, with four risks factors showing high prevalence value of above 20%: sedentarism (23.96%); high fast foods consumption (39.79%); inadequate fruit and vegetable (37.70%); excess soft drinks consumption (62.71%) . Hypertension was the most self –reported NCDs among the studied population (43.75%), followed by 23.13%, chronic respiratory diseases 20.42% and diabetes 6.04%. Conclusion: These findings revealed clustering of NCDs risk factors among the studied population, thus an expected increase in NCDs burden consequently. Since most of these risk factors can be reduced by behavioral modifications, population wide education on NCDs and its risks factors as well as strengthening of the Primary health care centres for early detection is hereby recommended

English

INTRODUCTION: Tobacco is a major risk factor of numerous adult chronic noncommunicable diseases. In India, the GATS Survey revealed that the prevalence of smoking is more than one-third in the adults (35%), the overall prevalence in males being 48% and among females it is 20%. AIM: The aim of our study was to determine the socio-demography of tobacco use in rural setting and to assess the knowledge, attitude & practices of tobacco use in the rural area. METHODS: All patients aged 18 years or above attending subcentre at village Panzinara of Block Sumbal. The data was collected on a semi-structured questionnaire. RESULTS: 71 patients attending the sub center for various health states were taken up for the study. Majority of the patients were in the age group of 58-68 years (23.9%). Males comprised 56.3%. 63.4% gave positive response to ever any tobacco use & amongst the tobacco users 80% were daily users. Tobacco use was significantly associated with male sex. 51.1% of the patients had started tobacco use in adolescent age of 10-19 years. 62.2% were Hookah smokers, 24.4% cigarette smokers. Tobacco being injurious to health was known by 39.4% patients, 21.1% knew it lead to some cancers, 4.2% were aware that it can cause hypertension, diabetes & cancers. 35.3% were aware that it is to be avoided. CONCLUSION: In spite of awareness about hazards of tobacco use & knowledge of non-communicable diseases, this high prevalence calls for more active psychological, social & medical interventions for tobacco users. Targeting the adolescent population for raising awareness would be additionally beneficial.

Tobacco smoking in Mongolia: findings of a national knowledge, attitudes and practices study

BackgroundIn 2009, 48% of males aged 15 or over in Mongolia consumed tobacco, placing Mongolia among the countries with the highest prevalence of male smokers in the world. Importantly, tobacco use is one of the four major risk factors contributing to the global burden of non-communicable diseases (NCDs) – the leading cause of mortality in Mongolia. However, the knowledge, attitudes and practices of the Mongolian population with regards to smoking are largely unmeasured. In this context, a national NCDs knowledge, attitudes and practices survey focusing, among other things, on NCD risk factors was implemented in Mongolia in late 2010 to complement the previous WHO STEPwise approach to Surveillance Survey (STEPS) findings from 2009. This publication explores the smoking-related findings of the Knowledge, Attitudes and Practices Survey (KAPS).MethodsA nationally representative sample size was calculated using methodologies aligned with the WHO STEPS surveys. As a result, 3450 people from across Mongolia were selected using a multi-stage, random cluster sampling method from permanent residents aged between 15 and 64 years. The KAP survey questionnaire was interviewer-administered on a door-to-door basis.ResultsIn Mongolia at 2010, 46.3% of males and 6.8% of females were smokers. This practice was especially dominant among males and urban dwellers (MOR 2.2), and more so among the middle-aged (45–54) (MOR 2.1) while still displaying a high prevalence among Mongolian youth (15.5%). The probability of smoking was independent of the level of education. Although the level of awareness of the health hazards related to tobacco smoking was generally very high in the population, this was influenced by the level of education as more people with a primary and secondary level of education believed that smoking at least one pack of cigarette per day was required to harm one’s health (MOR 5.8 for primary education and 2.5 for secondary). Finally, this knowledge did not necessarily translate into a behavioural outcome as 15.5% of the population did not object to people smoking in their house, and especially so among males (MOR 4.1).ConclusionThe findings of this KAP survey corroborate the 2009 WHO STEPS Survey findings with regards to the prevalence of tobacco smoking in Mongolia. It identifies males, urban dwellers and Mongolian youth as groups that should be targeted by public health measures on tobacco consumption, while keeping in mind that higher levels of awareness of the harms caused by tobacco smoking do not necessarily translate into behavioural changes.