Diagnosis Of Non-communicable Diseases Research Articles

A retrospective analysis of e-prescriptions for non-communicable diseases on a telehealth platform in Malaysia

BackgroundThe management of non-communicable diseases (NCDs) has benefited from telehealth services. As these services which include teleconsultation services and e-prescriptions are relatively new in Malaysia, the data generated provide an unprecedented opportunity to study medication use patterns for the management of NCDs in the country. We analyze e-prescriptions from a local telehealth service to identify medication use patterns and potential areas to optimize medication use in relation to clinical practice guidelines.MethodsA cross sectional observational study was conducted by retrieving e-prescription records retrospectively from a telehealth service. 739,482 records from January 2019 to December 2021 were extracted using a designated data collection form. Data cleaning, standardization and data analysis were performed using Python version 3.11. The diagnoses were classified according to the International Classification of Disease 10 (ICD-10), while medications were classified using the Anatomical Therapeutic Chemical (ATC) system. Diagnoses, frequency of use for medication classes and individual medications were analyzed and compared to clinical practice guidelines.ResultsThe top five NCD diagnoses utilized by the service were hypertension (37.7%), diabetes mellitus (25.1%), ischemic heart disease (24.3%), asthma (14.4%), and dyslipidemia (11.7%). Medications were prescribed mostly in accordance with guideline recommendations. However, angiotensin receptor blockers (ARBs) were significantly more frequently prescribed compared to angiotensin converting enzyme inhibitors (ACEIs). Several medication classes appeared underutilized, including ACEIs in hypertensive patients with diabetes or ischemic heart disease, sodium glucose cotransporter 2 inhibitors in diabetic patients with ischemic heart disease, and metformin in patients with diabetes.ConclusionsTelehealth services are currently being utilized for the management of NCDs. Medication use for the management of NCDs through these services are mostly in accordance with guideline recommendations, but there exist areas that would warrant further investigation to ensure optimal clinical and economic outcomes are achieved.

Presence of Intestinal Parasites in Patients with Chronic Non-Communicable Diseases in Masaya (Nicaragua).

A cross-sectional study was conducted in Masaya (Nicaragua) to estimate the prevalence of intestinal parasite (IP) infections in patients with non-communicable diseases (NCDs) and to determine the associations between the types of NCDs and patients' epidemiological characteristics of infection. A total of 157 preserved faecal samples were examined (direct wet mount, formalin/ethyl acetate concentration and modified Ziehl-Neelsen technique). Microscopically positive faecal sample identification was completed by conducting a molecular study. The total prevalence of IP was 52% in NCD patients. Diabetic patients presented an IP prevalence of 42%. Blastocystis presented the highest prevalence (42%). A molecular analysis of Giardia intestinalis (prevalence of 1.3%) revealed 100% of sub-assemblage BIII and the Entamoeba complex (5%) was identified as E. dispar. Blastocystis ST1 appeared in 44% of those suffering from diabetes and ST3 in 66% of those suffering from hypertension, while ST2 only appeared in those suffering with several NCDs simultaneously. In diabetic patients, the risk of infection is associated with having pets (p = 0.021) and land-floor houses. The risk of infection appears to be statistically related (p = 0.019) in those with several NCDs having received a previous helminthic deworming treatment. Coordinated public health activities for IP and NCD screening and diagnosis are crucial to their successful control programmes.

Scaling up noncommunicable disease care in a resource-limited context: lessons learned and implications for policy

BackgroundAlthough primary care models for the care of common non-communicable diseases (NCD) have been developed in sub-Saharan Africa, few have described an integrated, decentralized approach at the community level. We report the results of a four-year, Ethiopian project to expand this model of NCD care to 15 primary hospitals and 45 health centres encompassing a wide geographical spread and serving a population of approximately 7.5 million people.MethodsFollowing baseline assessment of the 60 sites, 30 master trainers were used to cascade train a total of 621 health workers in the diagnosis, management and health education of the major common NCDs identified in a scoping review (hypertension, diabetes, chronic respiratory disease and epilepsy). Pre- and post-training assessments and regular mentoring visits were carried out to assess progress and remedy supply or equipment and medicines shortages and establish reporting systems. The project was accompanied by a series of community engagement activities to raise awareness and improve health seeking behaviour.ResultsA total of 643,296 people were screened for hypertension and diabetes leading to a new diagnosis in 24,313 who were started on treatment. Significant numbers of new cases of respiratory disease (3,986) and epilepsy (1,925) were also started on treatment. Mortality rates were low except among patients with hypertension in the rural health centres where 311 (10.2%) died during the project. Loss to follow up (LTFU), defined as failure to attend clinic for > 6 months despite reminders, was low in the hospitals but represented a significant problem in the urban and rural health centres with up to 20 to 30% of patients with hypertension or diabetes absenting from treatment by the end of the project. Estimates of the population disease burden enrolled within the project, however, were disappointing; asthma (0.49%), hypertension (1.7%), epilepsy (3.3%) and diabetes (3.4%).ConclusionThis project demonstrates the feasibility of scaling up integrated NCD services in a variety of locations, with fairly modest costs and a methodology that is replicable and sustainable. However, the relatively small gain in the detection and treatment of common NCDs highlights the huge challenge in making NCD services available to all.

Primary health care response to noncommunicable diseases: an assessment of Wellness Clinics in Ghana

BackgroundGlobally, there is a significant unmet need for the rapidly growing burden of Non-Communicable Diseases (NCDs). Ghana has adopted and implemented Wellness Clinics (WC) nationwide to respond to the rising burden of NCDs. Regrettably, very little is known about WCs, including their structure and the services they offer. This study explores the concept of WC, their structure, position within the hospital environment, and services from the perspectives of healthcare providers and clients.MethodsAn exploratory qualitative study was conducted with health professionals (n = 12) and clients (n = 26) of Wellness Clinics in two district hospitals and one regional hospital in a deprived region of Ghana where NCDs are rising. Using the WHO-PEN approach, an interview guide was purposely designed for this study. The data were analysed thematically using Atlas.ti.ResultsAll three Wellness Clinics were sub-units under the outpatient department. The WC was created by the facilities to respond to the increase in NCDs and to meet annual performance review requirements. The Wellness Clinics provided NCD diagnosis, counselling, and treatment services to approximately 300 clients per week at the facility level. Only one of the WCs provided NCD prevention services at the community level. Integrated NCD care was also provided at the WC, despite the health system and individual-level challenges reported by the health workers and clients.ConclusionThe implementation of the Wellness Clinic demonstrates the government’s commitment to addressing the increasing burden of NCDs in Ghana through the primary health system. To maximise the impact of the wellness clinics, we recommend developing best practices, providing logistics, and addressing health insurance challenges.

Insights into Factors Impacting On Non-Communicable Diseases in the Prisons of Pakistan- A Scoping Review

Non-Communicable Diseases (NCDs) continue to increase globally, including where recorded among prison populations. Pakistan, like many low- and middle-income countries is facing significant health system challenges. Little is known about NCDs in its prison population. A scoping review mapped and described what is known about factors impacting on NCDs in the prison population of Pakistan. Objective: To describe factors impacting Non-Communicable Diseases (NCDs) in the prison population of Pakistan and to inform policy and improve prison conditions, nutrition, and healthcare for effective NCD management and care. Methods: A comprehensive search was conducted on Web of Science, PubMed and EMBASE, restricted to publications from 2000 to 2023. Eight studies fulfilled the eligibility criteria. Records were independently screened, charted and content analysis was undertaken. Results: Six themes were generated; Nutritional and dietary provisions, Physical activity and body mass index; Substance use and dependence; Hypertension and diabetes; Access to medical care and Mental health. Prior and detention related risk and lifestyle factors underpin the chronic ill health of people living in prison. These include prior history of smoking and alcohol use, and situational aspects of prison conditions causing environmental stress, malnutrition and sedentarism. Where reported, hypertension, obesity and depression were high among people in prison. Conclusions: Prisons are fundamental to the domestic NCD response. Prisons in Pakistan require dedicated resourcing to improve basic conditions, nutrition and healthcare allocations for all people living in prisons. The review highlights the need for prison-based NCD screening, diagnosis, treatment and care in Pakistan, in close alliance with specialist care in hospitals. Further health research is warranted to examine the effectiveness of NCD policies and practices in place in contemporary prison systems in Pakistan.

E-Diagnostic system for diabetes disease prediction on an IoMT environment-based hyper AdaBoost machine learning model

One of the most fatal and serious diseases that humans have encountered is diabetes, an illness affecting thousands of individuals yearly. In this era of digital systems, diabetes prediction based on machine learning (ML) is gaining high momentum. One of the benefits of treating patients early in the course of their noncommunicable diseases (NCDs) is that they can avoid costly therapies when the illness worsens later in life. Incidentally, diabetes is complicated by the dearth of medical professionals in underserved areas, such as distant rural communities. In these situations, the Internet of Medical Things and machine learning (ML) models can be used to offer healthcare practitioners the necessary prediction tools to more effectively and timely make decisions, thus assisting the early identification and diagnosis of NCDs. In this study, four conventional and hyper-AdaBoost ML models were trained and tested on the PIMA Indian Diabetes dataset. Patients with diabetes were classified on the basis of laboratory findings. Pre-processing tasks, such as the handling of imbalanced data and missing values, were performed prior to feature importance and normalisation activities. The algorithm with the best performance was examined using precision, accuracy, F1, recall and area under the curve metrics. Then, all ML models were hyper parametrically tuned via grid search to optimise their performance and reduce their error times. The decision process was also evaluated to further enhance the models. The AdaBoost-ET model performed even when features were not selected for binary classification. The model proposed in this study can predict diabetes with unprecedented high accuracy compared with the models in previous studies.

IJCM_181A: Health behavioral change and Associated factors among patients diagnosed with non-communicable diseases in the Rural areas of Southern India

Background: Non-communicable diseases (NCDs) contributed to 71% of the global mortality and affect the ageing population with variable proportions. NCD diagnosis gives an opportunity for patients to change their health behaviors. Secondary prevention strategies like diet modification, physical activity and smoking cessation after NCD diagnosis are important and should be emphasized particularly for middle-aged and older adults. Objectives: 1. To assess the level of health behavioral change adopted by the patients diagnosed with NCDs registered under Rural field practice area. 2. To evaluate the factors influencing the health behavioral change in NCD patients. Methodology: This is a Cross-sectional study design conducted at Rural Health & Training Centre, Government Medical College, Ananthapuramu, from August 2023 to October 2023. Simple random sampling was used to select 150 registered NCD cases from the RHTC data-base. We included participants who were diagnosed with either diabetes, cardiovascular disease, chronic lung disease, or cancer after recruitment. Data were collected by using pre-designed semi-structured questionnaire. Data was analyzed using IBM SPSS version 25.0. Associations were tested using chi-squares and for all comparisons p-value <0.05 was considered significant. Results: In total 48 (32%) NCD cases have adopted suggested behavioral change instructed by the physician. Factors such as females, graduates, Class III & above SES, diagnosed between 5 to 10 years, not having any other co-morbidities were significantly associated with good health behavioral change. Conclusion: Around two third of the diagnosed NCD cases were not compliant to health behavioral change. Hence, health care providers need to provide behavioral change communication related to health behaviors in addition to standard medical care.

Equity and unmet need of non-communicable diseases services in Saudi Arabia using a National Household Survey (2019).

Saudi Arabia is implementing a comprehensive health system transformation in health services provision, governance, and financing. Given the high burden of non-communicable diseases (NCD), a key objective of the transformation is to integrate NCD prevention and treatment into primary care. The study objectives were to assess primary care service use for treatment of NCDs, to quantify existing inequities in preventive services utilization, and to identify regional and sociodemographic factors associated with these inequities. Using the 2019 Kingdom of Saudi Arabia World Health Survey, multivariable logistic regression models were conducted to identify predictors of utilization of primary care services for NCD prevention and treatment, unmet need among those with a diagnosis of diabetes, hypertension, or dyslipidemia, and unmet need in breast and cervical cancer screening. Among those with an NCD diagnosis, living in a high-income household was associated with a lower probability of having an unmet need compared to those in low-income households. Furthermore, rural residents were less likely to have an unmet need compared to urban residents (OR 0.58, p=0.029). Individuals without a perceived need for healthcare within the last 12 months had three times the probability of unmet need in comparison to those with such a perceived need (p<0.001). Women in all regions had a lower probability of ever having a mammogram compared to women in the central regions around Riyadh. Women with an education above a secondary level had five times the odds of undergoing cervical cancer screening and three times the likelihood of ever having a mammogram (P=0.012, p=0.02) than other women. Compared to women in low-income households, those in middle (OR 1.99, P=0.026), upper middle (OR 3.47, p<0.001), or high-income households (OR 2.59, p<0.001) had a higher probability of having had cervical cancer screening. Inequities in NCD treatment and prevention services' utilization in Saudi Arabia are strongly associated with region of living, population density, wealth, income, education and perceived need for health care. More research is needed to better understand the extent of unmet primary care needs for NCD and how to address the underlying contributing factors to access inequities.

Non-communicable diseases and their risk factors in Ukraine: analysis of the global burden of disease 2019 study.

Aim: To analyse the burden and risk factors of Non-Communicable diseases (NCDs) in Ukraine to determine the ways to prevent them. Materials and Methods: Using a statistical method, NCDs DALYs (Disability-Adjusted Life Years) in Ukraine were analyzed in dynamics for 1990-2019 and in comparison, with European and EU countries based on the data from "Global Burden of Disease, 2019" research. Results: The burden of NCDs in Ukraine is 1.5 time higher than in European and EU countries. The most negative dynamic trends and significant differences between indicators in Ukraine and EU countries (with an excess of 2 or more times) were identified for DALYs due to cardiovascular diseases, digestive diseases and substance use disorders. In Ukraine the burden of NCDs can be reduced on 25.9% by normalization of systolic blood pressure, on 21.2% by optimizing diet, on18.5% by quitting smoking, on 17.6% by lowering LDL cholesterol, on 16.5% by normalizing body weight and on 9.2% by quitting alcohol abuse. Conclusions: Ukraine should develop and implement a modern system for monitoring and assessing the NCDs burden and their risk factors; strengthen the capacity of public health institutions and their ability to attract communities to implement interventions to control NCDs modified risk factors, increase awarnes and the population's responsible attitude towards their health; strengthen the ability and motivate primary health care to provide quality primary prevention, screening and timely diagnosis and treatment of chronic NCDs.

Mapping evidence on barriers to and facilitators of diagnosing noncommunicable diseases among people living with human immunodeficiency virus in low- and middle-income countries in Africa: A scoping review.

To map the evidence on the barriers to and facilitators of diagnosing noncommunicable diseases among people living with HIV in low- and middle-income countries in Africa. Noncommunicable diseases are increasing among people living with HIV. Thus, strengthened and sustained diagnosis of noncommunicable diseases through integrated noncommunicable diseases and HIV care is needed to improve patient outcomes. However, there is paucity of evidence on the barriers and facilitators diagnosing noncommunicable diseases among people living with HIV in low- and middle-income countries. The Arksey and O'Malley methodological framework was used. A comprehensive systematic search of academic databases (MEDLINE, Academic Search Complete, APA PsycInfo, CAB, and Health Source/Nursing) was performed via EBSCO search and PubMed. The articles were reviewed independently by three reviewers. The results were structured using Capability-Opportunity-Motivation-Behavior model and Theoretical Domains Framework. A total of 152 articles were retrieved for full-text review. Forty-one articles met the inclusion criteria. The identified barriers were relevant to all the Capability-Opportunity-Motivation-Behavior constructs and 14 Theoretical Domains Framework domains. A lack of knowledge and awareness of noncommunicable diseases, fear of stigma, financial problems and out-of-pocket payments were the most cited patient-level barriers. Healthcare providers (knowledge and awareness gaps, skill and competence deficiencies, unwillingness, burnout, low motivation, and apathy) were frequently cited. Lack of equipment, noncommunicable disease medications and supply chain challenges, lack of integrated noncommunicable disease and HIV care, and shortage of trained healthcare providers were identified as health-system-level barriers. This scoping review is the first to identify barriers and facilitators using a theoretical framework. The most cited barriers include a lack of integrated HIV and noncommunicable disease care, equipment and logistics chain challenges for noncommunicable diseases, patients' and healthcare providers' lack of knowledge and awareness of noncommunicable diseases, and healthcare provider's skill and competency deficiencies. Addressing these issues is crucial for improving patient outcomes and reducing the burden on healthcare providers and health systems.

Improving the management of patients with chronic cardiac and respiratory diseases by extending pulse-oximeter uses: the dynamic pulse-oximetry.

Respiratory and cardio-vascular chronic diseases are among the most common noncommunicable diseases (NCDs) worldwide, accounting for a large portion of health-care costs in terms of mortality and disability. Their prevalence is expected to rise further in the coming years as the population ages. The current model of care for diagnosing and monitoring NCDs is out of date because it results in late medical interventions and/or an unfavourable cost-effectiveness balance based on reported symptoms and subsequent inpatient tests and treatments. Health projects and programs are being implemented in an attempt to move the time of an NCD's diagnosis, as well as its monitoring and follow up, out of hospital settings and as close to real life as possible, with the goal of benefiting both patients' quality of life and health system budgets. Following the SARS-CoV-2 pandemic, this implementation received additional impetus. Pulseoximeters (POs) are currently used in a variety of clinical settings, but they can also aid in the telemonitoring of certain patients. POs that can measure activities as well as pulse rate and oxygen saturation as proxies of cardio-vascular and respiratory function are now being introduced to the market. To obtain these data, the devices must be absolutely reliable, that is, accurate and precise, and capable of recording for a long enough period of time to allow for diagnosis. This paper is a review of current pulse-oximetry (POy) use, with the goal of investigating how its current use can be expanded to manage not only cardio-respiratory NCDs, but also acute emergencies with telemonitoring when hospitalization is not required but the patients' situation is debatable. Newly designed devices, both "consumer" and "professional," will be scrutinized, particularly those capable of continuously recording vital parameters on a 24-hour basis and coupling them with daily activities, a practice known as dynamic pulse-oximetry.

Mapping evidence on barriers to and facilitators of diagnosing noncommunicable diseases (NCDs) among people living with human immunodeficiency virus (PLWH) in low- and middle-income countries (LMICs) in Africa: A scoping review protocol

Background Noncommunicable diseases (NCDs) represent a global public health challenge in all population groups, but the prevalence of major NCDs, such as depression, hypercholesterolemia, hypertension, obesity and diabetes, is increasing at a rapid rate among people living with human immunodeficiency virus (PLWH). Studies show that integrated NCDs and human immunodeficiency virus (HIV) services have improved the patient outcome of PLWH with comorbidities with NCDs. It requires a strengthened and sustainable way of diagnosing major NCDs early among PLWH. However, there is limited evidence regarding the barriers to and facilitators of early diagnosis of NCDs (depression, hypercholesterolemia, hypertension, obesity and diabetes) among PLWH in low- and middle-income countries (LMICs). This review will systematically map the literature and describe the barriers and facilitators of diagnosing NCDs (depression, hypercholesterolemia, hypertension, obesity and diabetes) among PLWH in LMICs in Africa. Methods The methodology presented by Arksey and O’Malley and the recommendation set out by Levac and colleagues will be used. PubMed, MEDLINE with full text via the EBSCO host, Google Scholar, Science Direct and Scopus will be used for a comprehensive search for data extraction. The search will be conducted using keywords, Boolean terms, and Medical Subject Headings (MeSH). All studies with eligible titles will be exported to the EndNote citation manager for deduplication and imported to Rayyan software for screening. Two reviewers will independently screen abstracts, and the preferred reporting items for systematic review and meta-analysis extension to scoping review (PRISMA-Sc) guidelines will be used to guide the search in conducting the scoping review. We will perform descriptive data analysis for quantitative studies, NVivo software version 12 will be used for qualitative studies, and thematic content analysis will be carried out. This scoping review will include studies that included PLWH with those diagnosed with major NCDs (depression, hypercholesterolemia, hypertension, obesity, and diabetes) in LMICs in Africa. Discussion This scoping review will highlight evidence mapping on barriers and facilitators of diagnosing NCDs (depression, hypercholesterolemia, hypertension, obesity, and diabetes) among PLWH LMICs in Africa. Scoping Review Registration: registered on Open Science Framework (https://osf.io/xvtwd/).

National health registries – a ‘goldmine’ for studying non-communicable disease occurrence in Norway – the NCDNOR project

To estimate occurrence of non-communicable diseases (NCDs) over the life-course in the Norwegian population, national health registries are a vital source of information since they fully represent the entire non-institutionalised population. However, as they are mainly established for administrative purposes, more knowledge about how NCDs are recorded in the registries is needed. To establish this, we begin by counting the number of individuals registered annually with one or more NCDs in any of the registries. The study population includes all inhabitants who lived in Norway from 2004 to 2020 ( N~6.4m). The NCD outcomes are diabetes, cardiovascular diseases, chronic obstructive lung diseases, cancer and mental disorders/substance use disorders. Further, we included hip fractures in our NCD concept. The data sources used to identify individuals with NCDs, including detailed information on diagnoses in primary and secondary health care and dispensings of prescription drugs, are the Cancer Registry of Norway, The Norwegian Patient Registry, The Norwegian Control and Payment of Health Reimbursement database, and The Norwegian Prescription Database. The number of individuals registered annually with an NCD diagnosis and/or a dispensed NCD drug increased over the study period. Changes over time may reflect changes in disease incidence and prevalence, but also changes in disease-specific guidelines, reimbursement schemes and access to and use of health services. Data from more than one health registry to identify individuals with NCDs are needed since the registries reflect different levels of health care services and therefore may reflect disease severity.

Six month incidence of major adverse cardiovascular events among adults with HIV in northern Tanzania: a prospective observational study

ObjectivesWe aimed to prospectively describe incident cardiovascular events among people living with HIV (PLWH) in northern Tanzania. Secondary aims of this study were to understand non-communicable disease care-seeking behaviour and...

Transitions in and out of work across the life course of patient with a NCD diagnosis

Abstract Background Coupled with its impact on quality of life, non-communicable Diseases (NCD) may degrade both the quality and quantity of the workforce, and stunt economic growth and productive employment. However, there is limited information about the social costs of NCDs to identify priorities in resource allocation, particularly in regard to retirement policies. In this paper, we investigate if NCDs affect them employment status, i.e., the patients’ ability to work beyond middle age, using longitudinal data. Methods We used longitudinal data from employed men and women who responded to the sixth and seventh waves of the SHARE project from several European countries and Israel. We restricted the sample to all people working up to 3 years before the expected retirement age for each country. To achieve a representative sample of employed people from each country we calculated calibrated longitudinal individual weights for participants in these two waves. It was to adjust for non-response, sample selection bias, and attrition (N = 9645). We modelled the probability to change employment status on Wave 7 as function of having a NCD, adjusting for age, gender, marital status, job satisfaction, education level, and country, using multinominal logistic regressions. Results Overall, 30.3% of the study population self-reported one NCD and 28.3% mentioned at least two chronic health conditions (multimorbidity). Among multimorbid individuals the risk of unemployment is 1.27 times more (OR = 1.271, 95% CI (1.266-1.276).), while the risk of retirement is multiplied by 1.26 (OR = 1.259, 95%CI (1.255-1.262)). Conclusions Having one NCD or multimorbidity is a common phenomenon in the working middle-aged European population. It is associated with unemployment and retirement, controlling for educational level, age, marital status, gender, job satisfaction, and country. This result highlights that early retirement will persist unless health policies are implemented to decrease the burden of NCDs. Key messages • This study shows that there is a strong association between having one or more NCD with unemployment and retirement, controlling for educational, age, and occupational type. • Results reinforce that we need health policies focused on alerting society about real impact of NCD on employment.

Factors Associated With Common Mental Disorders and the Presence of Noncommunicable Diseases During the COVID-19 Pandemic in Indonesia: A Study in Bogor, West Java

The coronavirus disease (COVID-19) pandemic has significantly impacted the mental health of Indonesians, including those with noncommunicable diseases (NCDs) and those without. However, it is known that COVID-19 has a higher fatality rate in people with NCDs. This study aimed to determine the difference in the prevalence of common mental disorders (CMD) among respondents with and without NCDs and identify the associated factors of CMD from each sub-sample. This cross-sectional study used respondents from the Bogor Cohort Study of noncommunicable disease risk factors. The NCDs in the current study included hypertension, coronary heart disease (CHD), stroke, and diabetes mellitus (DM). The diagnosis of NCD was determined by trained medical professionals following research protocols. A total of 2,936 participants were involved in this study, including 1,734 with NCDs and 1,202 without. Multiple logistic regression was used to analyze factors associated with CMD in respondents with and without NCDs. The prevalence of CMD was slightly higher in respondents with NCDs (5.1%) than in those without NCDs (3.6%). Experiencing COVID-19 symptoms in the last six months was a factor associated with CMD in both groups; those with NCDs (AOR = 4.156; 95% CI [2.37, 7.30]; p &lt; .001) and those without (AOR = 5.797; 95% CI [2.63, 12.78]; p &lt; .001). Not having health insurance was a factor associated with CMD, only in respondents with NCDs (AOR = 2.582; 95% CI [1.35, 4.93]; p = .004). Female gender and low education were factors associated with CMD only in respondents without NCDs. During the COVID-19 pandemic, newly diagnosed subjects with NCDs and non-adherence to treatment were identified as factors associated with CMD in respondents with NCDs who had undergone PCR and/or rapid testing. During the pandemic, the knowledge of COVID-19 symptoms and health insurance ownership significantly impacted the community’s wellbeing, not only for physical but also for psychological health.

Smoking cessation behavior in patients with a diagnosis of a non-communicable disease: The impact of perceived disease severity of and susceptibility to the disease.

The Health Belief Model comprises two constructs influencing changed behaviors impacting on health, namely perceived severity and susceptibility. The aim of this study was to identify the impact of the combination of, or interactions between, these two constructs on quitting smoking in smokers with a diagnosis of a non-communicable disease (NCD). From the large insurance claims database maintained by JMDC database (JMDC, Tokyo), we extracted data on 13284 participants who smoked. All participants were stratified according to their NCD diagnosis based on perceived severity and susceptibility as follows: Category I (high severity and high susceptibility) - acute myocardial infarction, and lung cancer; Category II (high severity and low susceptibility) - colorectal cancer, and stomach cancer; Category III (low severity and high susceptibility) - asthma, and transient ischemic attack; Category IV (low severity and low susceptibility) - appendicitis, and glaucoma. We performed multi-variable logistic regression analysis and calculated the proportion of those who were smoking at the first health check-up after the diagnosis and every three years thereafter. Using glaucoma as the reference, the adjusted odds ratios for smoking cessation were 14.2 (95% CI: 11.4-17.8) to 14.8 (95% CI: 12.5-17.4) in Category I; 4.5 (95% CI: 3.8-5.4) to 6.6 (95% CI: 5.4-8.0) in Category II; and 1.9 (95% CI: 1.7-2.1) to 2.8 (95% CI: 2.2-3.7) in Category III. In Categories I and II, the proportion of smokers rapidly decreased after diagnosis and mostly remained low thereafter. Smoking cessation rates for Categories I and II were not associated with readiness to improve lifestyles prior to NCD diagnosis. Our study confirms the significant impact of perceived severity of and susceptibility to the diagnosed disease on smoking cessation. The multiplicative effect of these two constructs at NCD diagnosis represents a 'teachable moment', a window of opportunity, for encouraging successful long-term smoking cessation.

Study protocol for development and validation of a single tool to assess risks of stroke, diabetes mellitus, myocardial infarction and dementia: DemNCD-Risk

IntroductionCurrent efforts to reduce dementia focus on prevention and risk reduction by targeting modifiable risk factors. As dementia and cardiometabolic non-communicable diseases (NCDs) share risk factors, a single risk-estimating tool...

Characterizing non-communicable disease trends in undocumented migrants over a period of 10 years in Italy

Undocumented migrants represent a large part of the population in Countries of the European Union (EU) such as Italy. Their health burden is not fully understood and likely to be related mainly to chronic conditions. Information on their health needs and conditions may help to target public health interventions but is not found in national public health databases. We conducted a retrospective observational study of non-communicable disease (NCD) burden and management in undocumented migrants receiving medical care from Opera San Francesco, a non-governmental organization (NGO) in Milan, Italy. We analyzed the health records of 53,683 clients over a period of 10 years and collected data on demographics, diagnosis and pharmacological treatments prescribed. 17,292 (32.2%) of clients had one or more NCD diagnosis. The proportion of clients suffering from at least one NCD increased from 2011 to 2020. The risk of having an NCD was lower in men than women (RR = 0.88, 95% CI 0.86–0.89), increased with age (p for trend < 0.001) and changed with ethnicity. African and Asian migrants had a lower risk than Europeans of cardiovascular diseases (RR 0.62 CI 0.58–0.67, RR 0.85 CI 0.78–0.92 respectively) and mental health disorders (RR 0.66 CI 0.61–0.71, RR 0.60 CI 0.54–0.67 respectively), while the risk was higher in Latin American people (RR 1.07 CI 1.01–1.13, RR 1.18 CI 1.11–1.25). There was a higher risk of diabetes in those from Asia and Latin America (RR 1.68 CI 1.44–1.97, RR 1.39 CI 1.21–1.60). Overall, migrants from Latin America had the greatest risk of chronic disease and this was true for diabetes, cardiovascular diseases and mental health disorders. Undocumented migrants demonstrate a significantly different health burden of NCDs, which varies with ethnicity and background. Data from NGOs providing them with medical assistance should be included in structuring public health interventions aimed at the prevention and treatment of NCDs. This could help to better allocate resources and address their health needs.

Stakeholder perceptions on scaling-up community-led interventions for prevention and control of non-communicable diseases in Bangladesh: a qualitative study

BackgroundEngaging communities is an important component of multisectoral action to address the growing burden of non-communicable diseases (NCDs) in low- and middle-income countries. We conducted research with non-communicable disease stakeholders in Bangladesh to understand how a community-led intervention which was shown to reduce the incidence of type 2 diabetes in rural Bangladesh could be scaled-up.MethodsWe purposively sampled any actor who could have an interest in the intervention, or that could affect or be affected by the intervention. We interviewed central level stakeholders from donor agencies, national health policy levels, public, non-governmental, and research sectors to identify scale-up mechanisms. We interviewed community health workers, policy makers, and non-governmental stakeholders, to explore the feasibility and acceptability of implementing the suggested mechanisms. We discussed scale-up options in focus groups with community members who had attended a community-led intervention. We iteratively developed our data collection tools based on our analysis and re-interviewed some participants. We analysed the data deductively using a stakeholder analysis framework, and inductively from codes identified in the data.ResultsDespite interest in addressing NCDs, there was a lack of a clear community engagement strategy at the government level, and most interventions have been implemented by non-governmental organisations. Many felt the Ministry of Health and Family Welfare should lead on community engagement, and NCD screening and referral has been added to the responsibilities of community health workers and health volunteers. Yet there remains a focus on reproductive health and NCD diagnosis and referral instead of prevention at the community level. There is potential to engage health volunteers in community-led interventions, but their present focus on engaging women for reproductive health does not fit with community needs for NCD prevention.ConclusionsResearch highlighted the need for a preventative community engagement strategy to address NCDs, and the potential to utilise existing cadres to scale-up community-led interventions. It will be important to work with key stakeholders to address gender issues and ensure flexibility and responsiveness to community concerns. We indicate areas for further implementation research to develop scaled-up models of community-led interventions to address NCDs.