Pre-existing Non-communicable Diseases Research Articles

Effectiveness of holistic mobile health interventions on diet, and physical, and mental health outcomes: a systematic review and meta-analysis

Good physical and mental health are essential for healthy ageing. Holistic mobile health (mHealth) interventions-including at least three components: physical activity, diet, and mental health-could support both physical and mental health and be scaled to the population level. This review aims to describe the characteristics of holistic mHealth interventions and their effects on related behavioural and health outcomes among adults from the general population. In this systematic review and meta-analysis, we searched MEDLINE, Embase, Cochrane Central Register of Controlled Trials, PsycINFO, Scopus, China National Knowledge Infrastructure, and Google Scholar (first 200 records). The initial search covered January 1, 2011, to April 13, 2022, and an updated search extended from April 13, 2022 to August 30, 2023. Randomised controlled trials (RCTs) and non-randomised studies of interventions (NRSIs) were included if they (i) were delivered via mHealth technologies, (ii) included content on physical activity, diet, and mental health, and (iii) targeted adults (≥18 years old) from the general population or those at risk of non-communicable diseases (NCDs) or mental disorders. Studies were excluded if they targeted pregnant women (due to distinct physiological responses), individuals with pre-existing NCDs or mental disorders (to emphasise prevention), or primarily utilised web, email, or structured phone support (to focus on mobile technologies without exclusive human support). Data (summary data from published reports) extraction and risk-of-bias assessment were completed by two reviewers using a standard template and Cochrane risk-of-bias tools, respectively. Narrative syntheses were conducted for all studies, and random-effects models were used in the meta-analyses to estimate the pooled effect of interventions for outcomes with comparable data in the RCTs. The study was registered in PROSPERO, CRD42022315166. After screening 5488 identified records, 34 studies (25 RCTs and 9 pre-post NRSIs) reported in 43 articles with 5691 participants (mean age 39 years, SD 12.5) were included. Most (91.2%, n = 31/34) were conducted in high-income countries. The median intervention duration was 3 months, and only 23.5% (n=8/34) of studies reported follow-up data. Mobile applications, short-message services, and mobile device-compatible websites were the most common mHealth delivery modes; 47.1% (n=16/34) studies used multiple mHealth delivery modes. Of 15 studies reporting on weight change, 9 showed significant reductions (6 targeted on individuals with overweight or obesity), and in 10 studies reporting perceived stress levels, 4 found significant reductions (all targeted on general adults). In the meta-analysis, holistic mHealth interventions were associated with significant weight loss (9 RCTs; mean difference-1.70kg, 95% CI-2.45 to-0.95; I2=89.00%) and a significant reduction in perceived stress levels (6 RCTs; standardised mean difference [SMD]-0.32; 95% CI-0.52 to-0.12; I2=14.52%). There were no significant intervention effects on self-reported moderate-to-vigorous physical activity (5 RCTs; SMD 0.21; 95%CI-0.25 to 0.67; I2=74.28%) or diet quality scores (5 RCTs; SMD 0.21; 95%CI-0.47 to 0.65; I2=62.27%). All NRSIs were labelled as having a serious risk of bias overall; 56% (n=14/25) of RCTs were classified as having some concerns, and the others as having a high risk of bias. Findings from identified studies suggest that holistic mHealth interventions may aid reductions in weight and in perceived stress levels, with small to medium effect sizes. The observed effects on diet quality scores and self-reported moderate-to-vigorous physical activity were less clear and require more research. High-quality RCTs with longer follow-up durations are needed to provide more robust evidence. To promote population health, future research should focus on vulnerable populations and those in middle- and low-income countries. Optimal combinations of delivery modes and components to improve efficacy and sustain long-term effects should also be explored. National Research Foundation, Prime Minister's Office, Singapore, under its Campus for Research Excellence and Technological Enterprise (CREATE) Programme and Physical Activity and Nutrition Determinants in Asia (PANDA) Research Programme.

Impact of COVID-19 pandemic on non-communicable chronic lifestyle diseases in population of India: A systematic review

Background: Diabetes, chronic respiratory diseases, heart diseases, and cancers are diseases of public health importance in India. People with pre-existing non communicable diseases (NCDs) are vulnerable to COVID and associated complications. Risk factors for NCDs were found to have increased due to pandemic. Aims and Objectives: The aim of the study was to study the impact of the COVID 19 on chronic NCDs and life style diseases. Materials and Methods: Articles from India published between March 2019 and May 2022 were searched from database such as PubMed, Scopus, Google scholar using MeSH and keywords such as “COVID 19” OR “Coronavirus” OR “SARS-2 CoVirus” AND Lifestyle diseases,” “COVID-19” OR “Coronavirus” OR “SARS-2 CoVirus” AND “Diabetes” OR “HYPERTENSION.” Summary of 18 articles was presented after inclusion and exclusion criterion and removing of duplicates. Results: Risk of COVID 19 in people with pre-existing non-communicable diseases is high, prognosis is poor, and complications are higher. COVID 19 and lockdown measures resulted in restrictions of movements, dietary and sleep pattern changes, psycho social impacts, non-availability or difficulty in procuring medicines, accessibility to health-care facilities, burden on health-care facilities, difficulties in (using or lack of awareness) about tele-consultations facilities, and thus burden of NCDs is expected to rise in future. Conclusions: COVID 19 pandemic had direct and indirect impact on screening, diagnosis and management of patients with NCDs. Burden of NCDs may rise thereby putting extra burden on health-care facilities which warrants preparedness.

THE ROLE OF ASSESSMENT AND CORRECTION OF NUTRITIONAL STATUS IN A COMPREHENSIVE APPROACH TO COVID-19 PATIENT WITH METABOLIC DISORDERS: Review

The article is devoted to the problem of coronavirus disease COVID-19 with emphasis on the nutritional status of patients. An analytical review of recent publications related to aspects of nutritional support for people in outpatient and inpatient treatment for COVID-19 is presented. The article highlights the pathogenetic justification of the relationship between the immune response and metabolic balance of the body, the optimal content of trace elements, vitamins, components of lipid metabolism. The importance of nutrition as a strategy to support human immune function is considered. Methods for determining the adequate energy balance of patients with severe COVID-19 are presented. Groups of foods and key nutrients that may affect the consequences and clinical course of respiratory infections are described. The importance of assessing and optimizing nutritional status to improve the clinical course and consequences of COVID-19 in patients with comorbid pre-existing non-communicable diseases, such as diabetes, cardiovascular disease, obesity with systemic inflammation, is emphasized.

A Population-Based Cohort Study on Chronic Comorbidity Risk Factors for Adverse Dengue Outcomes.

ABSTRACT.The global burden of dengue is increasing against a background of rising global prevalence of chronic noncommunicable diseases (NCDs) and an epidemiological shift of dengue toward older age groups. The contribution of NCDs toward risk for adverse clinical and healthcare utilization outcomes was assessed in a national linked-database study. About 51,433 adult dengue cases between 2014 and 2015 were assessed for outpatient and inpatient claims data in Taiwan’s National Health Insurance Research Database for the 30 days after their dengue diagnosis. A multivariable logistic regression with generalized estimating equations was used to estimate the probability of adverse dengue outcomes in patients with NCDs compared with dengue patients without underlying diseases. Rheumatoid arthritis and related disease were associated with the highest risk of hospitalization after dengue diagnosis (odds ratio: 1.78; 95% CI: 1.37–2.30), followed by stroke, chronic kidney disease (CKD), liver cirrhosis, asthma, coronary artery disease, chronic obstructive pulmonary disease, diabetes, congestive heart failure, hypertension, and malignancy. Chronic kidney disease and diabetes were associated with higher risks of hospitalization, intensive care unit (ICU) use, and all-cause mortality. After adjusting for socioeconomic status and other variables, the number of coexisting chronic diseases was associated with increasing risk of adverse dengue outcomes. Specific NCDs were associated with longer hospitalizations, ICU admission, and higher healthcare costs. Quantifying the risks of adverse dengue outcomes and health expenditures among dengue patients with preexisting NCDs provides insights for improved clinical management and essential inputs for health economic analyses on the cost-benefit of risk-based routine or catch-up immunization programs.

New Strategies to Improve Patient Adherence to Medications for Noncommunicable Diseases During and After the COVID-19 Era Identified via a Literature Review.

Noncommunicable diseases (NCDs) place a huge burden on healthcare systems and society as a whole. Relatively early in the coronavirus disease 2019 (COVID-19) pandemic, clinicians became aware that in individuals infected with COVID-19, those with preexisting NCDs such as diabetes mellitus and cardiovascular disease (CVD) were at a greater risk of poor outcomes and mortality than those without. The importance of adherence to medications and lifestyle changes to control and prevent NCDs has been a major focus for many years, but with limited success – the proportion of patients adherent and persistent to their medications remains very low. There are many facets to adherence and persistence. Recent evidence suggests that a patient-centric approach is important, and ensuring that a patient is both motivated and empowered is critical to improving adherence/persistence. The COVID-19 pandemic has brought many changes to the way in which patients with NCDs are managed, with telemedicine and ehealth becoming more common. Changes have also occurred in the way in which patients can gain access to medications during the pandemic. The potential for these changes forms the basis of improving the management of patients with NCDs both during and after the pandemic. Over the coming months, a huge amount of work will be put into initiatives to promote adherence to COVID-19 vaccination programs. Those at highest risk of severe COVID-19, such as people aged 80 years and older, are likely to receive the vaccine first in some parts of world. Finally, social determinants of health are critical elements that can impact not just the likelihood of having an NCD or becoming infected with COVID-19, but also access to healthcare, and a patient’s adherence and persistence with their treatments.

Scoring Lifestyle Medicine Goals With FIFA 2022-An Opportunity to Strike Big!

Qatar is one of the few countries in the world with a dedicated national sports day. Qatar believes that sport is one of the best tools to promote a healthy lifestyle to help curb the growing burden of non-communicable diseases (NCDs). With the well-established positive health effects of soccer on cardiovascular, metabolic, and musculoskeletal conditions, the vision of the FIFA World Cup 2022™ hosted by Qatar to use the power of soccer to “open the door of an amazing world experience” is praiseworthy. With NCDs accounting for 70% of deaths in Qatar, there exists a perfect opportunity to promote healthy lifestyles to prevent, treat, and reverse NCDs. We believe that the FIFA World Cup 2022™ presents an opportunity that could contribute to generating valuable evidence on the lifestyle benefits of such large-scale events. This event comes at an opportune moment for countries in the region to make their health systems lifestyle-sensitive. FIFA World Cup 2022™ could just be the tipping point in the region that establishes the role of sports in mitigating the burden of NCDs. With the impact of COVID-19 on persons with pre-existing NCDs, the urgency for addressing the “syndemic” cannot be overemphasized and sport can be the lifestyle medicine.

Addressing the double burden of the COVID-19 and noncommunicable disease pandemics: a new global governance challenge

PurposeAs the coronavirus disease 2019 (COVID-19) continues to spread across countries, it is becoming increasingly clear that the presence of pre-existing noncommunicable diseases (NCDs) dramatically increases the risk of aggravation in persons who contract the virus. The neglect in managing NCDs during emergencies may result in fatal consequences for individuals living with comorbidities. This paper aims to highlight the need for a paradigm shift in the governance of public health emergencies to simultaneously address NCD and noncommunicable disease (CD) pandemics while taking into account the needs of high-risk populations, underlying etiological factors, and the social, economic, and environmental determinants that are relevant for both CDs and NCDs.Design/methodology/approachThe paper reviews the available global frameworks for pandemic preparedness to highlight the governance challenges of addressing the dual agenda of NCDs and CDs during a public health emergency. It proposes key strategies to strengthen multilevel governance in support of countries to better prepare for public health emergencies through the engagement of a wide range of stakeholders across sectors.FindingsAddressing both CD and NCD pandemics during public health emergencies requires (1) a new framework that unites the narratives and overcomes service and system fragmentations; (2) a multisectoral and multistakeholder governance mechanism empowered and resourced to include stakeholders across sectors and (3) a prioritized research agenda to understand the political economy of pandemics, the role played by different political systems and actors and implementation challenges, and to identify combined strategies to address the converging agendas of CDs and NCDs.Research limitations/implicationsThe article is based on the review of available published evidence.Practical implicationsThe uptake of the strategies proposed will better prepare countries to respond to NCD and CD pandemics during public health emergencies.Originality/valueThe article is the first of its kind addressing the governance challenges of the dual pandemic of NCDs and CDs in emergencies.

Coping strategies for obese individuals with obstructive sleep apnea during COVID-19 pandemic: A narrative review.

BackgroundPatients infected with SARS-CoV-2- having pre-existing non-communicable diseases (NCDs)- are at a higher risk of complications. Obesity is one of the proven risk factors causing NCDs and can influence outcomes of COVID-19 patients. It is closely related to obstructive sleep apnea (OSA). The increased risk of COVID-19 and reduced access to treatment of non-COVID conditions during the pandemic may increase the stress in obese patients with OSA. This situation makes it necessary for them to cope with their condition by themselves. This review aimed at the effect of this pandemic on these patients and coping strategies for them.MethodsDatabases like PubMed and Scopus were searched using a combination of key words. Full-text articles meeting the inclusion criteria were selected.ResultsThe search yielded eight studies, discussing about the potential interactions between the COVID-19, obesity and OSA, the impact of COVID-19 on them, and management of these patients.ConclusionsIncreased prevalence of COVID-19 was found among obese patients with OSA. The fear of COVID-19 and shift of health care workers to manage COVID-19 patients has affected their regular visits to the hospital. However, there is lack of coping strategies for them, which should soon be established for these patients.

COVID-19 outbreak, social distancing and mass testing in Kenya-insights from a mathematical model

As reported by the World Health Organization (WHO), the world is currently facing a devastating pandemic of a novel coronavirus (COVID-19), which started as an outbreak of pneumonia of unknown cause in the Wuhan city of China in December 2019. Since then, the respiratory disease has exponentially spread to over 210 countries. By the end of April, COVID-19 had caused over three million confirmed cases of infections and over 200,000 fatalities globally. The trend poses a huge threat to global public health. Understanding the early transmission dynamics of the infection and evaluating the effectiveness of control measures is crucial for assessing the potential for sustained transmission to occur in new areas. We employed a SEIHQRD delay differential mathematical transmission model with reported Kenyan data on cases of COVID-19 to estimate how transmission varies over time and which population to target for mass testing. The model is concise in structure, and successfully captures the course of the COVID-19 outbreak, and thus sheds light on understanding the trends of the outbreak and the vulnerable populations. The results show that, the government should target population in the informal settlement for mass testing and provide affordable sanitizers and clean water to this population. The model results also indicate that people with pre-existing non-communicable diseases (NCDs) should be identified and given special medical care. Given the absence of vaccine at the moment, non-pharmaceutical intervention is needed to effectively reduce the final epidemic size.

Coronavirus disease-2019 infection among people living with noncommunicable diseases: Improving the prognosis

The ongoing Corona Virus Disease-2019 (COVID-19) infection tends to affect all age-groups, while the development of the serious complications, including mortality has been reported among elderly people and those with pre-existing chronic illnesses. The available evidence suggests that any age group person living with any of the non-communicable diseases (NCDs) can get infected by COVID-19. Keeping the prognosis of the patients with pre-existing NCDs, it is important that the practice of smoking should be discouraged by them. In conclusion, the people living with non-communicable diseases tends to develop serious pulmonary complications secondary to the acquisition of COVID-19 infection. Thus, it is the responsibility of these people to strictly adhere to the prevention measures, while the health professionals should understand their vulnerability and provide additional care while managing them to save their lives.

Preexisting morbidity profile of women newly diagnosed with breast cancer in sub-Saharan Africa: African Breast Cancer-Disparities in Outcomes study.

The presence of preexisting morbidities poses a challenge to cancer patient care. There is little information on the profile and prevalence of multi‐morbidities in breast cancer patients across middle income countries (MIC) to lower income countries (LIC) in sub‐Saharan Africa (SSA). The African Breast Cancer–Disparities in Outcomes (ABC‐DO) breast cancer cohort spans upper MICs South Africa and Namibia, lower MICs Zambia and Nigeria and LIC Uganda. At cancer diagnosis, seven morbidities were assessed: obesity, hypertension, diabetes, asthma/chronic obstructive pulmonary disease, heart disease, tuberculosis and HIV. Logistic regression models were used to assess determinants of morbidities and the influence of morbidities on advanced stage (stage III/IV) breast cancer diagnosis. Among 2189 women, morbidity prevalence was the highest for obesity (35%, country‐specific range 15‐57%), hypertension (32%, 15‐51%) and HIV (16%, 2‐26%) then for diabetes (7%, 4%‐10%), asthma (4%, 2%‐10%), tuberculosis (4%, 0%‐8%) and heart disease (3%, 1%‐7%). Obesity and hypertension were more common in upper MICs and in higher socioeconomic groups. Overall, 27% of women had at least two preexisting morbidities. Older women were more likely to have obesity (odds ratio: 1.09 per 10 years, 95% CI 1.01‐1.18), hypertension (1.98, 1.81‐2.17), diabetes (1.51, 1.32‐1.74) and heart disease (1.69, 1.37‐2.09) and were less likely to be HIV positive (0.64, 0.58‐0.71). Multi‐morbidity was not associated with stage at diagnosis, with the exception of earlier stage in obese and hypertensive women. Breast cancer patients in higher income countries and higher social groups in SSA face the additional burden of preexisting non‐communicable diseases, particularly obesity and hypertension, exacerbated by HIV in Southern/Eastern Africa.

The impact of novel coronavirus COVID-19 on noncommunicable disease patients and health systems: a review.

Coronavirus disease 2019 (COVID‐19) is an ongoing global pandemic affecting all levels of health systems. This includes the care of patients with noncommunicable diseases (NCDs) who bear a disproportionate burden of both COVID‐19 itself and the public health measures enacted to combat it. In this review, we summarize major COVID‐19‐related considerations for NCD patients and their care providers, focusing on cardiovascular, pulmonary, renal, haematologic, oncologic, traumatic, obstetric/gynaecologic, operative, psychiatric, rheumatologic/immunologic, neurologic, gastrointestinal, ophthalmologic and endocrine disorders. Additionally, we offer a general framework for categorizing the pandemic’s disruptions by disease‐specific factors, direct health system factors and indirect health system factors. We also provide references to major NCD medical specialty professional society statements and guidelines on COVID‐19. COVID‐19 and its control policies have already resulted in major disruptions to the screening, treatment and surveillance of NCD patients. In addition, it differentially impacts those with pre‐existing NCDs and may lead to de novo NCD sequelae. Likely, there will be long‐term effects from this pandemic that will continue to affect practitioners and patients in this field for years to come.

Non-communicable diseases and inequalities increase risk of death among COVID-19 patients in Mexico.

The SARS-CoV-2 pandemic compounds Mexico's pre-existing challenges: very high levels of both non-communicable diseases (NCD) and social inequity. Using data from national reporting of SARS-CoV-2 tested individuals, we estimated odds of hospitalization, intubation, and death based on pre-existing non-communicable diseases and socioeconomic indicators. We found that obesity, diabetes, and hypertension are positively associated with the three outcomes in a synergistic manner. The municipal poverty level is also positively associated with hospitalization and death. Mexico's response to COVID-19 is complicated by a synergistic double challenge: raging NCDs and extreme social inequity. The response to the current pandemic must take both into account both to be effective and to ensure that the burden of COVID-19 not falls disproportionately on those who are already disadvantaged.

Increased Risk of Hospitalization and Death in Patients with COVID-19 and Pre-existing Noncommunicable Diseases and Modifiable Risk Factors in Mexico

BackgroundThe population in Mexico has high prevalence rates of noncommunicable diseases (NCDs). Hospitalization and death of COVID-19 patients in the countries most affected by the pandemic has been associated to chronic comorbidities.ObjectiveTo describe the prevalence of NCDs in patients with COVID-19 in Mexico and analyze the increased risk due to comorbidities and risk factors on hospitalization, utilization of intensive care units and death.MethodsA cross-sectional study was performed from 212,802 confirmed COVID-19 cases reported by the Ministry of Health up to June 27, 2020. Odds ratios were performed using logistic regression model.ResultsUp to 47.40% of patients with COVID-19 diagnosis were also reported with a comorbidity, with hypertension being the most frequent (20.12%). The report of at least one NCD significantly increased the risk of death with respect to patients without such diagnoses. Chronic kidney disease increased the risk of death the most (OR 2.31), followed by diabetes (OR 1.69), immunosuppression (OR 1.62), obesity (OR 1.42), hypertension (OR 1.24), chronic obstructive pulmonary disease (OR 1.20). The comorbidities that most increased the risk of ICU and of intubation were diabetes, immunosuppression and obesity.ConclusionNCD comorbidities increase the severity of COVID-19 infection. Given high NCD prevalence rates among the Mexican population, the pandemic poses a special threat to the health system and to society. Special prevention measures need to be strengthened for persons with NCD diagnoses in the short-term. In the mid-term, disease control strategies need to be improved to protect these patients against COVID-19 severity.

COVID-19: The Inflammation Link and the Role of Nutrition in Potential Mitigation.

The novel coronavirus disease (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has engulfed the world, affecting more than 180 countries. As a result, there has been considerable economic distress globally and a significant loss of life. Sadly, the vulnerable and immunocompromised in our societies seem to be more susceptible to severe COVID-19 complications. Global public health bodies and governments have ignited strategies and issued advisories on various handwashing and hygiene guidelines, social distancing strategies, and, in the most extreme cases, some countries have adopted “stay in place” or lockdown protocols to prevent COVID-19 spread. Notably, there are several significant risk factors for severe COVID-19 infection. These include the presence of poor nutritional status and pre-existing noncommunicable diseases (NCDs) such as diabetes mellitus, chronic lung diseases, cardiovascular diseases (CVD), obesity, and various other diseases that render the patient immunocompromised. These diseases are characterized by systemic inflammation, which may be a common feature of these NCDs, affecting patient outcomes against COVID-19. In this review, we discuss some of the anti-inflammatory therapies that are currently under investigation intended to dampen the cytokine storm of severe COVID-19 infections. Furthermore, nutritional status and the role of diet and lifestyle is considered, as it is known to affect patient outcomes in other severe infections and may play a role in COVID-19 infection. This review speculates the importance of nutrition as a mitigation strategy to support immune function amid the COVID-19 pandemic, identifying food groups and key nutrients of importance that may affect the outcomes of respiratory infections.

COVID-19 and noncommunicable diseases: Identifying research priorities to strengthen public health response

Coronavirus disease 2019 (COVID-19) pandemic is the most important global public health event of this century, and India is among the first 15 countries with affected persons. Persons with male gender, older age, and preexisting noncommunicable diseases (NCDs) are found to be associated with severe and fatal disease. Specific treatment modalities for COVID-19 are still elusive. NCDs are reported as presenting symptoms in COVID-19 patients, and preexisting NCD can worsen COVID-19 prognosis. The management of NCDs in the context of COVID-19 infection is challenging. India poses a huge burden of NCDs and their risk factors which could synergize with COVID-19 for serious illness and outcome. This article reviews and proposes a research agenda for COVID-19 and NCDs in the ambit of strategic approach: review of adequacy of existing mechanisms to tackle NCDs and their risk factors, strengthen the evidence base, enable remote access health-care service delivery, strategically revamp health systems to become more responsive, integrated, and universal, encourage all-round innovation through collaborations and partnerships, and empower community actions for home-based care. The key research domains are burden and epidemiology, health-care delivery, use of technology, sectoral approach, surveillance-monitoring-evaluation, behavioral and communication research, and governance and policy. Within each domain, key research priorities are identified which would be cross-cutting across more domains.

Women\u2019s knowledge on common non-communicable diseases and nutritional need during pregnancy in three townships of Ayeyarwaddy region, Myanmar: a cross-sectional study

BackgroundHealth systems in many countries do not adequately address non-communicable diseases (NCDs) during pregnancy, especially in low- and middle-income countries. In Myanmar, most studies on NCDs have investigated risk factors and prevalence of NCDs in the general population. This study aimed to assess the level of knowledge of common NCDs and nutritional need during pregnancy and to identify the factors associated with such knowledge, in three townships of Ayeyarwaddy region in Myanmar.MethodsA cross-sectional study was conducted among pregnant women aged between 18 and 49 years. We interviewed 630 pregnant women by using a pretested structured questionnaire. Knowledge questionnaire had five categories: general knowledge in NCDs, hypertension, diabetes, anemia, and nutritional need during pregnancy. Knowledge scores ranged from 0 to 56. We used Bloom’s cut-off point to classify the knowledge into three levels: low level as 59% or below (0–33 scores), moderate level as 60–80% (34–49 scores), and high level as 80–100% (50–56 scores). We conducted multiple linear regression analyses to find the association between different exposure variables (behavioral risk factors, pre-existing NCDs in pregnant women, and family history of NCDs) and knowledge on common NCDs and nutritional need during pregnancy adjusted for socioeconomic factors.ResultsAmong pregnant women, 64.8% had moderate level of knowledge, 22.7% had low level, and only 12.5% had high level. The mean knowledge scores were 39.6 (standard deviation 10.2). Pregnant women with the following factors were more likely to have higher knowledge: their belonging to the second, middle, and fourth quintiles of wealth index and their family members’ status of having some kind of NCDs.ConclusionsMajority of pregnant women had low to moderate level of knowledge on common NCDs and nutritional need during pregnancy. Wealth and family history of NCDs were significantly associated with their knowledge. Prevention and promotion of NCDs should be integrated in maternal and child health programs and should emphasize for the pregnant women who are in the poorest or richest wealth quintiles and who do not have family history of NCDs.

Overweight and obesity amongst Black women in Durban, KwaZulu-Natal: A ‘disease’ of perception in an area of high HIV prevalence

BackgroundOverweight and obesity is an emerging health problem, particularly amongst urban Black women living in areas of high HIV prevalence. Understanding factors affecting this pandemic is essential to enable effective weight loss programmes to be implemented. This study explored urban Black women's perception of their body image against a backdrop of pre-existing non-communicable diseases (NCDs).MethodIn this cross-sectional exploratory study 328 urban Black women were sampled systematically. Anthropometric measurements were conducted and women were interviewed using the Stunkard body image silhouettes as a tool to determine perception.ResultsMost of the subjects (61%) were in the 40–59 years age group. Mean body mass index (BMI) was 37 (± 9.41 kg/m2) with over 90% being overweight or obese. Diabetes mellitus was the most common NCD, with a prevalence of 72%. Amongst the diabetic patients 7% were overweight and 64% obese. Perceived body image compared to derived BMI showed that women underestimated their body image across all weight categories. Over 40% indicated a normal to overweight preferred body image, with 99% of respondents associating the underweight silhouettes with disease and HIV infection.ConclusionUrban Black women with underlying NCDs and living in an area of high HIV prevalence perceive themselves to be thinner than their actual BMI, which may be a barrier to weight loss management. This misperception may be used as a proxy risk marker for weight gain in urban Black women.