Non-communicable Diseases In People Research Articles

Ageing and non-communicable disease in people living with HIV - sleep apnea as a neglected non-communicable disease

Ageing and non-communicable disease in people living with HIV - sleep apnea as a neglected non-communicable disease

Non-communicable disease mortality in young people with a history of contact with the youth justice system in Queensland, Australia: a retrospective, population-based cohort study

Young people who have had contact with the criminal justice system are at increased risk of early death, especially from injuries. However, deaths due to non-communicable diseases (NCDs) in this population remain poorly described. We aimed to estimate mortality due to NCDs in people with a history of involvement with the youth justice system, compare NCD mortality rates in this population with those in the general population, and characterise demographic and justice-related factors associated with deaths caused by NCDs in people with a history of contact with the youth justice system. In this retrospective, population-based cohort study (the Youth Justice Mortality [YJ-Mort] study), we included all people aged 10-18 years (at baseline) charged with a criminal offence in Queensland, Australia, between June 30, 1993, and July 1, 2014. We probabilistically linked youth justice records with adult correctional records and national death records up to Jan 31, 2017. Indigenous status was ascertained from youth justice and adult correctional records, with individuals identified as Indigenous in either source classified as Indigenous in the final dataset. We estimated crude mortality rates and standardised mortality ratios (SMRs) for comparisons with data from the Australian general population. We identified risk factors for NCD deaths using competing-risks regression. Of 48 670 individuals aged 10-18 years (at baseline) charged with a criminal offence in Queensland, Australia, between June 30, 1993, and July 1, 2014, 11 897 (24·4%) individuals were female, 36 773 (75·6%) were male, and 13 250 (27·2%) were identified as identified as Indigenous. The median age at first contact with the youth justice system was 15 years (IQR 14-16), the median follow-up time was 13·4 years (8·4-18·4), and the median age at the end of the study was 28·6 years (23·6-33·6). Of 1431 deaths, 932 (65·1%) had a known and attributed cause, and 121 (13·0%) of these were caused by an NCD. The crude mortality rate from NCDs was 18·5 (95% CI 15·5-22·1) per 100 000 person-years among individuals with a history of involvement with the youth justice system, which was higher than among the age-matched and sex-matched Australian general population (SMR 1·67 [1·39-1·99]). Two or more admissions to adult custody (compared with none; adjusted sub-distribution hazard ratio 2·09 [1·36-3·22]), and up to 52 weeks in adult custody (compared with none; 1·98 [1·18-3·32]) was associated with NCD death. Young people with a history of contact with the justice system are at increased risk of death from NCDs compared with age-matched and sex-matched peers in the general Australian population. Reducing youth incarceration and providing young people's rights to access clinical, preventive, and restorative services should be a priority. National Health and Medical Research Council.

Study of Selected Noncommunicable Disease Risk Factors Among Adolescents in A Rural Area of Karnataka

Background and Aim Non-communicable diseases NCD in recent times have attained a magnitude of epidemic proportions with an increasing number of adolescents being reported as obese. Noncommunicable diseases can cause mortality due to excessive smoking absence of physical activity habituation to alcohol and diet which is unhealthy. The earlier knowledge of the occurrence of these diseases among well-to-do urban groups is now changed with the increasing evidence of the occurrence of these non-communicable diseases in people living in rural areas. Hence this study aims at determining the prevalence of certain selected non-communicable risk factors which are lifestyle related such as undernutrition and overnutrition unhealthy eating habits consumption of alcohol and tobacco use and inadequate physical activity among adolescents in the rural area of Karnataka.Methods This community-based cross-sectional study collected information from 516 adolescents aged 10-19 years in the school or house-to-house survey. Anthropometric measurements were done. Validated questionnaires i.e. nutrition questionnaire for adolescents Source Bright Future nutrition and a Global school-based student health survey were used to collect the data. Results Among the 516 adolescents 339 66 were in schooling and 175 33.6 were attending college. Physical inactivity among 139 27 was observed which is alarming in rural areas. About 139 29.1 adolescents were underweight which is also a risk factor for some non-communicable diseases. The proportion of underweight adolescents consuming alcohol and not consuming adequate vegetablesfruits is significant.Conclusion The risk factors identified will help policymakers develop health promotion policies and programs directed toward adolescents to address the growing tide of non-communicable diseases.nbsp

A matched cohort study investigating premature, accentuated, and accelerated aging in people living with HIV.

The impact of HIV infection on the aging process is disputed and largely unknown. We aimed to identify whether people living with HIV experience premature, accelerated, and/or accentuated aging by investigating the development of four age-related non-communicable diseases in people living with versus without HIV. This population-based matched cohort study design used UK-based primary care electronic health records from the IQVIA Medical Research Database. Between January 2000 and January 2020, all people living with and without HIV aged ≥18 years were eligible. Outcomes included cardiovascular disease (CVD), hypertension, type 2 diabetes mellitus (T2DM), and chronic kidney disease (CKD), which were identified by Read codes. We used age at diagnosis to investigate premature aging and age at exit date to investigate accentuation and acceleration. For each outcome, people with and without HIV were excluded if they had the outcome of interest at baseline. Participants were matched based on propensity scores (1:1 ratio). Linear regression was used to report any difference in age at diagnosis between the two groups and to report the prevalence trends for age at exit date. In total, 8880 people living with HIV were matched with 8880 people without HIV and were found to have an earlier onset of CVD (54.5 vs. 56.8; p = 0.002). Similarly, people living with HIV had an earlier onset of hypertension (49.7 vs. 51.4; p = 0.002). No difference was found for T2DM or CKD (53.4 vs. 52.6; p = 0.368 and 57.6 vs. 58.1; p = 0.483, respectively). The burden of CKD increased over time, whereas no difference in the burden was found for the other conditions. The earlier development of CVD and hypertension in people living with HIV than in those without HIV indicates premature aging, whereas the increased burden of CKD indicates accelerated aging.

Experience of chronic noncommunicable disease in people living with HIV: a systematic review and meta-aggregation of qualitative studies

BackgroundAn increasing number of people living with HIV (PLWH) have had chronic noncommunicable diseases (NCDs) over the last 5 years. However, robust evidence regarding the perception and challenges of having NCDs among PLWH is limited. Therefore, this study aimed to synthesize qualitative evidence regarding the experiences of PLWH with NCDs.MethodsWe used a meta-aggregation approach to synthesize qualitative studies. Peer-reviewed and gray literature published in English and Chinese from 1996 to November 2020 was searched using electronic databases. Two reviewers independently appraised the methodological quality and extracted data from the included studies. The Joanna Briggs Institute (JBI) meta-aggregation approach was used to synthesize the findings.ResultsIn total, 10,594 studies were identified in the initial database search. Fourteen eligible studies were included in the meta-synthesis. Among these studies, nine synthesized findings regarding the following topics were identified: fragmented healthcare systems, care continuity, manifestations of multiple conditions, financial hardship, stigma and discrimination, polypharmacy burden and adherence, reciprocal relationships between HIV and NCDs, and coping strategies.ConclusionsIn recent years, attempts have been made to institutionalize NCD preventive and control services in HIV long-term care. However, considering the growing problem of HIV and NCD comorbidity globally, integrated primary health care systems are needed to address the problems of PLWH with NCDs. Healthcare professionals should help PLWH develop strategies to better monitor their polypharmacy burden and adherence, stigma and discrimination, financial hardship, and manifestations of multiple conditions to achieve high levels of care continuity.

Trends of age-related non-communicable diseases in people living with HIV and comparison with uninfected controls: A nationwide population-based study in South Korea.

We aim to compare the trends of non-communicable diseases (NCDs) and death among people living with HIV (PLWH) and uninfected controls in South Korea. We identified PLWH from a nationwide database of all Korean citizens enrolled from 1 January 2004 to 31 December 2016. A control cohort was randomly selected for PLWH by frequency matching for age and sex in a 20:1 ratio. To compare NCD trends between the groups, adjusted incidence rate ratios for outcomes across ages, calendar years and times after HIV diagnosis were calculated. We included 14134 PLWH and 282039 controls in this study; 58.5% of PLWH and 36.4% of the controls were diagnosed with at least one NCD. The incidence rates of cancers, chronic kidney disease, depression, osteoporosis, diabetes and dyslipidaemia were higher in PLWH than in the controls, whereas those of cardiovascular disease, heart failure, ischaemic stroke and hypertension were lower in PLWH. Relative risks (RRs) for NCDs in PLWH were higher than controls in younger age groups. Trends in the RRs of NCDs tended to increase with the calendar year for PLWH vs. controls and either stabilized or decreased with time after HIV diagnosis. The RR of death from PLWH has decreased with the calendar year, but showed a tendency to rise again after 2014 and was significant at the early stage of HIV diagnosis. Although the RR of each NCD in PLWH showed variable trends compared with that in controls, NCDs in PLWH have been increasingly prevalent.

Incidence of non-communicable diseases (NCDs) in HIV patients on ART in a developing country: Case of Zimbabwe's Chitungwiza Central Hospital-A retrospective cohort study (2010-2019).

IntroductionThe incidence of non-communicable diseases (NCDs) has been reported to be rising over the years leading up to 2010. In Zimbabwe, there are few studies done to examine the incidence of NCDs in people living with HIV (PLHIV) on anti-retroviral treatment (ART).ObjectiveTo determine the incidence of NCDs in HIV patients on ART at the Chitungwiza Central Hospital over ten years and the associated risk factors.MethodsThis was a retrospective cohort study using data from 203 patients enrolled on ART at the Chitungwiza Central Hospital between 2010 and 2019. All 500 records were considered and the selection was based on participants’ consenting to the study and their strict adherence to ART without absconding. The incidence of NCDs was determined and generalized estimating equations (GEE) were used to estimate the association between NCDs and the selected risk factors.FindingsData collected at the study’s baseline (2010) showed that the most prevalent NCD was hypertension, found in (18/203) 8.9% of the study participants, followed by diabetes (6.9%), then followed by cardiovascular diseases (CVD) (3.9%), and the least common NCD was cancer (1.9%). Incidences of all of these NCDs showed an increasing trend as the time of follow-up progressed. The factors found to be significantly associated with the development of NCDs were gender (p = 0.002) and follow-up time (p<0.001). Geographical location was a significant risk factor as urban patients were more likely to develop hypertension as compared to the peri-urban patients (p = 0.001).ConclusionsNCDs and HIV comorbidity is common with women more likely than males to develop NCDs as they advance in age. There is need to devise targeted intervention approach to the respective NCDs and risk factors since they affect differently in relation to the demographic details of the participants.RecommendationsThis paper recommends a multi-stakeholder approach to the management of NCDs, with researchers, clinicians and the government and its various arms taking a leading role.

Tuberculosis and Non-Communicable Disease Multimorbidity: An Analysis of the World Health Survey in 48 Low- and Middle-Income Countries.

Tuberculosis (TB) is a leading cause of mortality in low- and middle-income countries (LMICs). TB multimorbidity [TB and ≥1 non-communicable diseases (NCDs)] is common, but studies are sparse. Cross-sectional, community-based data including adults from 21 low-income countries and 27 middle-income countries were utilized from the World Health Survey. Associations between 9 NCDs and TB were assessed with multivariable logistic regression analysis. Years lived with disability (YLDs) were calculated using disability weights provided by the 2017 Global Burden of Disease Study. Eight out of 9 NCDs (all except visual impairment) were associated with TB (odds ratio (OR) ranging from 1.38–4.0). Prevalence of self-reported TB increased linearly with increasing numbers of NCDs. Compared to those with no NCDs, those who had 1, 2, 3, 4, and ≥5 NCDs had 2.61 (95% confidence interval (CI) = 2.14–3.22), 4.71 (95%CI = 3.67–6.11), 6.96 (95%CI = 4.95–9.87), 10.59 (95%CI = 7.10–15.80), and 19.89 (95%CI = 11.13–35.52) times higher odds for TB. Among those with TB, the most prevalent combinations of NCDs were angina and depression, followed by angina and arthritis. For people with TB, the YLDs were three times higher than in people without multimorbidity or TB, and a third of the YLDs were attributable to NCDs. Urgent research to understand, prevent and manage NCDs in people with TB in LMICs is needed.

AROGYA Intelligent Health Care Application

People of today pay less attention to their daily diet due to their busy lifestyles. Therefore, there is a great tendency to contract chronic non-communicable diseases. Furthermore, the lack of nutritious meals and daily exercise causes chronic non-communicable diseases in people with no age difference. In our first part, we developed to predict specialization in cardiology using symptoms. However, when we refer to a doctor, we must at least know what specialist should know based on their symptoms. In addition, there is a problem with the recipe. If the pharmacist has misread the prescription given by the doctor, patients can receive bad medications, leading to terrible side effects and even death due to careless writing by the doctor. As a solution, an application function can be proposed that will be developed in the project and the function should be able to improve the readability and intelligibility of the patient with prescription drugs. Therefore, the patient always knows the prescribed medications through the application to avoid the problem mentioned above. According to the 2016 pharmaceutical magazine, there are cholesterol and diabetic patients suffering mainly from chronic non-communicable diseases in Sri Lanka.

New approaches to the prevention of chronic non-communicable diseases in people of working age

Introduction. Chronic non-communicable diseases (CND) are a global health problem. In Russia, there is still a high mortality rate from CND, especially among the working-age population. A promising method of dealing with the chronic noninfectious diseases are school of health. For the working-age population, health schools can be one of the most effective and affordable methods of preventing CND. The aim of study is to analyze the attendance of the school of health for arterial hypertension. Consider alternatives to combat CND in the working-age population, similar to health schools. Materials and methods. During the work, we used data from the school of health on arterial hypertension, conducted on the basis of the GBUZ "City polyclinic No. 8" DZM. The study included all male and female patients who attended school in 2018. at the age of 18 and older. The assessment of school attendance, age and gender characteristics of students, test results, and analysis of systolic and diastolic blood pressure indicators at the control reception was carried out. Results. 140 people were trained, including 116 women (83%) and 24 men (17%). The average age of patients ranged from 43 to 90 (72.3±9) years. Among the students there were only 18 (12.9%) people of working age:14 women and 4 men. The age of women ranged from 43 to 90 years, men - from 60 to 89 years. During the training, the level of knowledge of patients increased from 6.3±1.7 (out of 10 possible) to 9.0±0.9 points (p&lt;0.001). According to the results of the control measurement, the average SAP was 131.1±11.8 mm Hg, and the DAP was 78.6±9.0 mm Hg. For patients of working age, the average SAP was 130.4±15.1 mm Hg, and the DAP was 76.5±8.3 mm Hg. Conclusions. Training in the school of health significantly increases the level of medical awareness of patients about their disease. There is a need for greater promotion of health schools among the working-age population. Student and trade Union platforms for organizing preventive actions can serve as an alternative to health schools for able-bodied citizens. Remote methods of prevention and raising medical awareness can become a new stage in the development of CND prevention.

Prevalence, healthcare costs and management of non-communicable diseases in people living with human immunodeficiency virus: A scoping review.

BackgroundCoexistence of human immunodeficiency virus (HIV) and non-communicable diseases (NCDs) is an important public health issue of increasing concern. However, the prevalence, healthcare costs and management protocols for NCDs in people living with HIV (PLHIV) remain unclear in most settings.AimTo scope evidence on prevalence, healthcare costs and disease management protocols associated with NCDs in PLHIV from studies published before July 2019.MethodsElectronic databases were searched for published articles, and reference lists were checked for relevant studies. Key terms included were HIV/AIDS, co-morbidity or multi-morbidity, NCDs, healthcare costs, treatment protocols, diabetes mellitus, hypertension in various combinations.ResultsA total of 152 records were assessed, and thereafter 25 studies were included in the final review after all the elimination. Twelve of the 25 studies mostly reported prevalence of NCDs in PLHIV, 4 reported impact of HIV–NCD co-morbidity on healthcare costs and 1 reported management protocols and capacity of antiretroviral therapy (ART) sites to manage HIV–NCD co-morbidity.ConclusionsResults showed higher prevalence rates of diabetes mellitus and hypertension in PLHIV compared with HIV-negative people. However, there was inconsistency in NCD prevalence data from studies conducted in sub-Saharan African (SSA) countries, and limited research evidence on capacity of ART sites to manage NCDs in PLHIV. Low prevalence rates of NCDs reported in SSA countries could be an indication of limited capacity to screen for NCDs because of the influence of health system and/or patient-level factors. Most studies were generally limited to cross-sectional studies, with very few interventional, longitudinal studies.

Prevalence and risk factors of pulmonary hypertension among adult patients with HIV infection in Ethiopia.

Globally, non-communicable diseases are increasing in people living with HIV. Pulmonary hypertension is a rare non-communicable disease in people living with HIV with a reported prevalence of <1%. However, data on pulmonary hypertension in people living with HIV from Africa are scarce and are non-existent from Ethiopia. This study aimed to examine the prevalence and severity of echocardiographic pulmonary hypertension and risk factors associated with pulmonary hypertension in people living with HIV in Ethiopia. A total of 315 consecutive adult people living with HIV followed at the Tikur Anbessa Specialized Hospital HIV Referral Clinic were enrolled from June 2018 to February 2019. Those with established pulmonary hypertension of known causes were excluded. A structured questionnaire was used to collect data on demographics, respiratory symptoms, physical findings, physician-diagnosed lung disease, and possible risk factors. Pulmonary hypertension was defined by a tricuspid regurgitant velocity of ≥2.9 m/sec on transthoracic echocardiography. A tricuspid regurgitant velocity ≥3.5, which translates into a pulmonary arterial pressure/right ventricular systolic pressure of ≥50 mmHg, was considered moderate-to-severe pulmonary hypertension. The mean age of the participants was 44.5 ± 9.8 years and 229 (72.7%) were females. Pulmonary hypertension was diagnosed in 44 (14.0%) of participants, of whom 9 (20.5%) had moderate-to-severe disease. In those with pulmonary hypertension, 17 (38.6%) were symptomatic: exertional dyspnea, cough, and leg swelling were seen in 12 (27.3%), 9 (20.5%), and 4 (9.1%), respectively. There was no significant difference in those with pulmonary hypertension compared to those without the disease by gender, cigarette smoking, previous history of pulmonary tuberculosis treatment, physician-diagnosed chronic obstructive pulmonary disease or bronchial asthma, duration of anti-retroviral therapy therapy or anti-retroviral regimen type. Pulmonary hypertension looks to be a frequent complication in people living with HIV in Ethiopia and is often associated with significant cardiopulmonary symptoms. Further studies using right heart catheterization are needed to better determine the etiology and prevalence of pulmonary hypertension in people living with HIV in Ethiopia compared to other countries.

Frequency of non-communicable diseases in people 50 years of age and older receiving HIV care in Latin America.

A growing population of older adults with HIV will increase demands on HIV-related healthcare. Nearly a quarter of people receiving care for HIV in Latin America are currently 50 years or older, yet little is known about the frequency of comorbidities in this population. We estimated the prevalence and incidence of non-communicable diseases (NCDs) among people 50 years of age or older (≥50yo) receiving HIV care during 2000-2015 in six centers affiliated with the Caribbean, Central and South American network for HIV epidemiology (CCASAnet). We estimated the annual prevalence, and overall prevalence and incidence of cardiovascular diseases, diabetes, hypertension, dyslipidemia, psychiatric disorders, chronic liver and renal diseases, and non-AIDS-defining cancers, and multimorbidity (more than one NCD) of people ≥50yo receiving care for HIV. Analyses were performed according to age at enrollment into HIV care (<50yo and ≥50yo). We included 3,415 patients ≥50yo, of whom 1,487(43%) were enrolled at age ≥50 years. The annual prevalence of NCDs increased from 32% to 68% and multimorbidity from 30% to 40% during 2000-2015. At the last registered visit, 53% of patients enrolled <50yo and 50% of those enrolled ≥50yo had at least one NCD. Most common NCDs at the last visit in each age-group at enrollment were dyslipidemia (36% in <50yo and 28% in ≥50yo), hypertension (17% and 18%), psychiatric disorders (15% and 10%), and diabetes (11% and 12%). The prevalence of NCDs and multimorbidity in people ≥50 years receiving care for HIV in CCASAnet centers in Latin America increased substantially in the last 15 years. Our results make evident the need of planning for provision of complex, primary care for aging adults living with HIV.

Tuberculosis and Non-Communicable Disease Multimorbidity: An Analysis of the World Health Survey in 48 Low- and Middle-Income Countries

Background: Tuberculosis (TB) is a leading cause of mortality in low-and middle-income countries (LMICs). TB multimorbidity (TB & >1 non-communicable diseases (NCDs)) is common, but data is sparse. We investigated the patterns and burden TB multimorbidity in adults across 48 LMICs. Methods: Cross-sectional, community-based data including adults from 21 low-income countries (n=105,286) and 27 middle-income countries (n=137,666) were utilized from the World Health Survey. Nine NCDs (i.e., angina, arthritis, asthma, diabetes, depression, edentulism, hearing problem, schizophrenia and visual impairment) and TB were assessed with multivariable logistic regression analysis. Years lived with disability (YLDs) were calculated using disability weights provided by the 2017 Global Burden of Disease Study. Results: Eight out of 9 NCDs (all except visual impairment) were associated with TB (OR ranging from 1.38-4.0). Prevalence of TB increased linearly with increasing numbers of NCDs. Compared to those with no NCDs, those who had 1, 2, 3, 4, and ≥5 NCDs had 2.61 (95%CI=2.14-3.22), 4.71 (95%CI=3.67-6.11), 6.96 (95%CI=4.95-9.87), 10.59 (7.10-15.80), and 19.89 (95%CI=11.13-35.52) times higher odds for TB. Among those with TB, the most prevalent combinations of NCDs were angina and depression, followed by angina and arthritis. For people with TB, the YLDs with three times higher than controls and a third of the YLDs were attributable to NCDs. Conclusion: People with TB are at substantially greater risk of multimorbid NCDs compared to controls. People with TB and multimorbid NCDs experience considerable increased YLDs. Urgent research to understand, prevent and manage NCDs in people with TB in LMICs is needed. Funding Statement: This research was supported by the Medical Research Council (Grant Reference: MC_PC_MR/T037806/1 and in part by the National Institute of Health Research using Official Development Assistance (ODA) funding (Grant: 17/63/130: NIHR Global Health Research Group: Improving Outcomes in Mental and Physical Multimorbidity and Developing Research Capacity (IMPACT) in South Asia at the University of York). Declaration of Interests: All authors declare no conflict of interest. Ethics Approval Statement: Ethical approval for the survey was provided by ethical boards at each study site. All participants gave their informed consent.

Noncommunicable disease among adults with cerebral palsy: A matched cohort study.

ObjectiveTo compare the incidence of noncommunicable diseases between adults with and without cerebral palsy (CP).MethodsA cohort study was conducted using primary care data from the Clinical Practice Research Datalink. Cox models, stratified by matched set and adjusted for potential confounders, were fitted to compare the risk of any noncommunicable disease, cancer, cardiovascular disease, type 2 diabetes mellitus, and respiratory disease between adults with and without CP.ResultsThe analysis included 1,705 adults with CP and 5,115 age-, sex-, and general practice–matched adults without CP. There was evidence from adjusted analyses that adults with CP had 75% increased risk of developing any noncommunicable disease compared to adults without CP (hazard ratio [HR] 1.75, 95% confidence interval [CI] 1.58–1.94). Specifically, they had increased risk of cardiovascular disease (HR 1.76, 95% CI 1.48–2.11) and respiratory disease (HR 2.61, 95% CI 2.14–3.19). There was no evidence of increased risk of cancer or type 2 diabetes mellitus.ConclusionsAdults with CP had increased risk of noncommunicable disease, specifically cardiovascular and respiratory disease. These findings highlight the need for clinical vigilance regarding identification of noncommunicable disease in people with CP and further research into the etiology and management of noncommunicable disease in this population.

Long‐Term Electrically‐Induced Muscle Exercise Duration Modulates Distinct Gene Signaling Pathways in People with Spinal Cord Injury

Exercise as a form of medicine attenuates the development of chronic non‐communicable diseases (NCDs) in people with intact nervous systems as they age. However, there is a knowledge gap regarding the influence of electrically induced skeletal muscle exercise on NCDs in people with spinal cord injury (SCI). Gene signaling pathway analysis offers an opportunity to understand the long‐term effects of electrically induced exercise on people with chronic and complete paralysis from SCI; providing a basis for interventions to be studied in future clinical trials.PurposeTo determine if long term electrically induced skeletal muscle exercise regulates complex network signaling pathways associated with improved metabolic health in people with SCI.MethodsWe analyzed 17 paired muscle samples from 11 males with complete SCI who completed at least 3 months of a unilateral exercise training program using electrical stimulation. During their exercise training, participants underwent routine physiological assessments. At the end of their exercise training, muscle samples were obtained from the exercised and non‐exercised limb. Extracted RNA was hybridized to Affymetrix Human Exon microarrays. Probe intensities were normalized using a robust multi‐array average. Gene expression values were analyzed using an a priori list of gene sets defined by the Reactome Pathways Knowledgebase and genes related to metabolic and hypertrophy pathways in skeletal muscle using the gene set enrichment algorithm and a fold‐change signature. Muscle biopsy samples were grouped together as a single cohort, and subdivided into 2 groups based on the training duration and muscle physiologic properties (&lt;6 and &gt;6 months of training). All participants provided written consent approved by the University of Iowa Institutional Review Board in compliance with the Declaration of Helsinki.ResultsWe analyzed over 17,000 genes and 1,900 genesets curated from the Reactome Pathways Knowledgebase. When we subdivided the muscle samples into 2 phenotypes based on training duration, we found 19 pathways associated with metabolism and mitochondrial function to be significantly up regulated (FDR &lt; 0.25) in the trained phenotype compared to the untrained phenotype. A subset of representative genes that were up regulated included the mitochondria protein carrier genes (MPC1 and MPC2), the citric acid cycle genes (SDHA, SDHB), the oxidative phosphorylation genes (NDUFA2 and NDUFB1), and mitochondrial biogenesis genes (PGC1α).ConclusionsOverall health is dependent, in part, on skeletal muscle size and metabolic capacity. 6 months of chronic electrically induced exercise was sufficient to reverse the expression of important metabolic gene pathways needed to recreate an oxidative phenotype in chronically paralyzed skeletal muscles. Future studies are underway to ascertain if electrically induced exercise attenuates the development of NCDs in people with SCI.Support or Funding InformationResearch Support: This study was funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development: R01HD084645, R01HD082109This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Evolution of major non-HIV-related comorbidities in HIV-infected patients in the Italian Cohort of Individuals, Naïve for Antiretrovirals (ICONA) Foundation Study cohort in the period 2004-2014.

The management of HIV disease is complicated by the incidence of a new spectrum of comorbid noncommunicable diseases (NCDs). It is important to document changes in the prevalence of NCDs over time. The aim of the study was to describe the impact of ageing on HIV markers and on the prevalence of NCDs in people living with HIV (PLWHIV) in the Italian Cohort of Individuals, Naïve for Antiretrovirals (ICONA) seen for care in 2004-2014. Analyses were conducted separately for a closed cohort (same people seen at both times) and an open cohort (all people under follow-up). We used the χ2 test for categorical factors and the Wilcoxon test for quantitative factors to compare profiles over time. The closed cohort included 1517 participants and the open cohort 3668 under follow-up in 2004 and 6679 in 2014. The median age of the open cohort was 41 [interquartile range (IQR) 37-46] years in 2004 and 44 (IQR 36-52) years in 2014. Analysis of the closed cohort showed an increase in the prevalence of some NCDs [the prevalence of dyslipidaemia increased from 75% in 2004 to 91% in 2014, that of hypertension from 67 to 84%, and that of cardiovascular disease (CVD) from 18 to 32%] and a decrease in renal function (5% with eGFR < 60 mL/min per 1.73 m2 in 2004 versus 30% in 2014); the percentage of people in the high-risk group for the Framingham CHD score more than tripled (from 13 to 45%). Results in the open cohort were similar. The burden of NCDs in our PLWHIV population markedly worsened over a 10-year time-span, which is likely to be a result of the effects of both ageing and HIV infection as well as their interaction. Special attention must be given to the management and prevention of NCDs.

The occurrence and quality of care of non-communicable diseases in people living with HIV in Maseru, Lesotho: a mixed-methods study

The occurrence and quality of care of non-communicable diseases in people living with HIV in Maseru, Lesotho: a mixed-methods study

Package of essential noncommunicable disease (PEN) interventions in primary health-care settings in the Democratic People's Republic of Korea: A feasibility study.

The prevention and control of noncommunicable diseases (NCDs) is a priority for the Democratic People's Republic of Korea. Mortality due to NCDs in people aged over 30 years was 1239 per 100 000 in 2009 and the 2014-2020 national strategy includes population-level goals for health promotion and disease prevention. This paper reports a pilot study on the feasibility of implementing components of the World Health Organization (WHO) Package of essential noncommunicable disease (PEN) interventions for primary health care in low-resource settings (WHO PEN) to enable early detection and management of cardiovascular disease and diabetes mellitus at the level of primary care. WHO PEN protocols were adapted for local use by household doctors, who provide ambulatory care in polyclinics in the mornings and household visits in the afternoons. The pilot project was implemented in two polyclinics in Pyongyang, covering a population of 32 000. After training, and during routine household visits in June 2014, 70 household doctors screened all adults aged over 35 years (18 340) for cardiovascular disease and diabetes mellitus, and their risk factors. A total of 2319 patients with cardiovascular disease or diabetes, and those with high-risk factors, were referred to the polyclinics for three quarterly visits for testing and management. Final household screening of the population was done in June 2015. This pilot project demonstrated the feasibility of integrating screening and management into the standard primary health-care system in the Democratic People's Republic of Korea. The household doctors were able to detect and manage risks for cardiovascular disease and diabetes by using the protocols based on WHO PEN. Among 18 340 individuals aged over 35 years, implementation of WHO PEN interventions led to a significant reduction in the number of people with a 10-year risk of cardiovascular disease ≥20% (from 1748 [9.5%] to 543 [3.0%]) over a 1-year period. Involvement of household doctors can increase access to services for prevention and control of cardiovascular disease and diabetes in the Democratic People's Republic of Korea.

Prevalence and Knowledge Assessment of HIV and Non-Communicable Disease Risk Factors among Formal Sector Employees in Namibia.

IntroductionThe burden of non-communicable diseases (NCDs) is growing in sub-Saharan Africa combined with an already high prevalence of infectious disease, like HIV. Engaging the formal employment sector may present a viable strategy for addressing both HIV and NCDs in people of working age. This study assesses the presence of three of the most significant threats to health in Namibia among employees in the formal sector: elevated blood pressure, elevated blood glucose, and HIV and assesses the knowledge and self-perceived risk of employees for these conditions.MethodsA health and wellness screening survey of employees working in 13 industries in the formal sector of Namibia was conducted including 11,192 participants in the Bophelo! Project in Namibia, from January 2009 to October 2010. The survey combined a medical screening for HIV, blood glucose and blood pressure with an employee-completed survey on knowledge and risk behaviors for those conditions. We estimated the prevalence of the three conditions and compared to self-reported employee knowledge and risk behaviors and possible determinants.Results25.8% of participants had elevated blood pressure, 8.3% of participants had an elevated random blood glucose measurement, and 8.9% of participants tested positive for HIV. Most participants were not smokers (80%), reported not drinking alcohol regularly (81.2%), and had regular condom use (66%). Most participants could not correctly identify risk factors for hypertension (57.2%), diabetes (57.3%), or high-risk behaviors for HIV infection (59.5%). In multivariate analysis, having insurance (OR:1.15, 95%CI: 1.03 – 1.28) and a managerial position (OR: 1.29, 95%CI: 1.13 – 1.47) were associated with better odds of knowledge of diabetes.ConclusionThe prevalence of elevated blood pressure, elevated blood glucose, and HIV among employees of the Namibian formal sector is high, while risk awareness is low. Attention must be paid to improving the knowledge of health-related risk factors as well as providing care to those with chronic conditions in the formal sector through programs such as workplace wellness.