Presence Of Non-communicable Diseases Research Articles

Evidence supporting correlation between aging and dengue severity: A retrospective analysis on the 2010 dengue outbreak in Brazil

Objective: The aim of this study is to explore the role of aging and non-communicable diseases (NCDs) as potential risk factors for severe clinical manifestations of dengue. This investigation was conducted within a cohort of patients from the 2010 epidemic in Belo Horizonte, Brazil. Methods: A total of 144 subjects diagnosed with dengue were categorized into two groups, representing the early and late (critical) stages of the disease. Further stratification was performed based on age, distinguishing between young and aged subjects. NCD subjects were also divided into young and aged groups. The symptomatology, previous clinical history, age, and presence of NCDs were inquired. Blood samples were collected for the analysis of platelet, soluble tumor necrosis factor receptor 1 (sTNFR1), and aspartate aminotransferase (AST) levels. The Mann-Whitney test was explored for the comparison of two groups, whereas the Kruskal-Wallis test was used for the analysis of differences among the multiple groups. Categorical variables were examined by Chi-square test. Correlation assessments were conducted using binary logic regression analysis with a 95% confidence interval. P<0.05 was considered statistically significant. Results: Compared to the younger subjects with NCDs, aged subjects exhibited a more severe form of dengue during the critical phase. The presence of NCDs was not associated with a worse dengue outcome in younger individuals, suggesting that aging itself maybe an important contributor to the severity of dengue. Conclusions: In the studied cohort, we emphasize that aging is a significant factor associated with severe manifestations of dengue. While we do not discard the potential role of NCDs in exacerbating disease progression, it may be more prominently impact the aged groups.

PREVALENCE AND RISK FACTORS ASSOCIATED WITH HYPERTENSION IN A RURAL MUNICIPALITY, NEPAL

Background: Hypertension is a significant public health concern globally, as it is a major risk factor for cardiovascular diseases and contributes to high mortality rates. This study aimed to assess the prevalence of hypertension and associated risk factors in Gandaki Rural Municipality. Methods: A cross-sectional study was conducted from May 1 to 13, 2022, involving 315 respondents aged 40 years and above. Hypertension and associated factors were assessed using a self-constructed questionnaire, a doctor’s aneroid sphygmomanometer, and a stethoscope. Logistic regression analysis was performed to identify predictors of hypertension. Results: The majority of respondents (27.3%) were aged between 50 and 59 years, with a mean age of 60.65 years (±12.85). The prevalence of hypertension was 41%. Alcohol consumption was reported by 43.2% of respondents, while 28.3% had a smoking habit, 24.1% used smokeless tobacco, 87.6% consumed red meat, and the majority (60.3%) engaged in moderate-intensity activities. Older age (AOR = 5.4; 95% CI = 2.60–11.06), smoking (AOR = 1.8; 95% CI = 1.06-3.19), presence of non-communicable diseases (AOR = 2.0; 95% CI = 1.03-3.70), and overweight (AOR = 2.4; 95%CI = 1.32-4.22) or obesity (AOR = 5.8; 95%CI = 2.50–13.68) were identified as significant risk factors for hypertension. Conclusions: The prevalence of hypertension was found to be almost two-fifths in Gandaki Rural Municipality, emphasizing the need for preventive strategies focusing on modifiable risk factors. These strategies should focus on major risk factors such as promoting physical activity, discouraging tobacco use, increasing fruit consumption, and reducing red meat intake.

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 < .001) and those without (AOR = 5.797; 95% CI [2.63, 12.78]; p < .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.

HIV-Hypertension Comorbidity, Associated Factors and Treatment Option Among HIV Patients Attending Katsina General Hospital, Katsina State Nigeria

People living with human immunodeficiency virus (HIV) are facing an increased burden of non-communicable diseases (NCDs) comorbidity. There is however, paucity of information on the magnitude of HIV-hypertension comorbidity, its associated factors, and how the health system responds to the burden in Nigeria. This study aimed to determine the magnitude of comorbidity HIV and hypertension and associated factors among HIV-positive adults receiving antiretroviral therapy (ART) in Katsina General Hospital, Katsina. Two hundred (200) HIV infected adults (aged ≥ 18) who had been on antiretroviral therapy for at least six months Katsina General Hospital, Katsina were recruited. Participants’ demographics, HIV characteristics, the presence of non-communicable diseases via self-report, from clinic folders and from measurement of their blood pressure on the day of interview and serum lipid profile, were evaluated. The magnitude of HIV and hypertension comorbidity was 28.5%. Old age, higher BMI, higher viral load, alcohol and duration on antiretroviral therapy were found to be factors associated with development of hypertension among HIV-positive adults. The prevalence of hypertension measured on the day of interview was greater than that found on self-report or reported in the clinic folder. Regular screening for the incidences of hypertension, addressing modifiable risk factors, and providing integrated care in the center would help improve the quality of life of comorbid patients.

RISK FACTOR ASSESSMENT OF NON-COMMUNICABLE DISEASES USING COMMUNITY BASED ASSESSMENT CHECKLIST AMONG KASHMIRI ADULT POPULATION

Objective: The Objective of the study was to assess the risk factors of non-communicable diseases (NCDs) using community based assessment checklist (CBAC) form among Kashmiri adults. Methods: This was a community based cross sectional study conducted in the field practice area of department of community medicine, Government medical college Srinagar over a period of 3 months. Results: Among the total of 601, 212 (34.7%) were found to have high risk and 398 (65.2%) were found to have low risk. Majority (38.6%) of the high-risk patients were in the age group of 41–50 years. Age, gender and educational level was significantly associated with high-risk participants with a p<0.001. Tobacco consumption, physical inactivity and presence of NCD were significantly higher among high-risk participants. Conclusion: 34.7% of the study participants were found to have high risk on CBAC assessment. CBAC is a very simple tool that can be used to screen the risk of NCDs in communities by ASHA workers.

Prevalence and sociodemographic determinants of selected noncommunicable diseases among the general population of Cyprus: A large population-based cross-sectional study.

Noncommunicable diseases (NCDs) are the leading cause of morbidity and mortality worldwide. The aim of this study was to determine the prevalence of NCDs among the population of Cyprus and to identify the distribution of the socioeconomic and demographic determinants among individuals with the most frequent NCDs. A cross-sectional study was conducted using stratified sampling. Socioeconomic and demographic characteristics and the presence of NCDs were collected through a standardized questionnaire. The diseases were classified using the 10th revision of the International Classification of Diseases (ICD-10). In total, 1140 individuals participated in the study, among whom 590 (51.7%) had at least one chronic disease. The most prevalent NCDs were hyperlipidemia (17.4%), hypertension (12.9%), and thyroid diseases (8.4%). We identified more males than females with hyperlipidemia aged 25-44 years old and >65 years old (p = 0.024), more males compared to females with hypertension (p = 0.001) and more females compared to males with thyroid diseases (p < 0.001). Individuals with hypertension and hyperlipidemia were more likely to be married, to have completed a higher education, and to have a high annual income. In Cyprus, the majority of the general population had at least one NCD. Hyperlipidemia, hypertension, and thyroid disease are relatively common, even at younger ages, highlighting the need for the development of public health programs aimed at addressing and preventing NCDs.

Work Ability, Work-Related Health, and Effort–Reward Imbalance: A Cross-Sectional Study among University Staff during the COVID-19 Pandemic in Thailand

During the COVID-19 pandemic, university policies and public health measures resulted in university staff facing hazardous work environments and psychological health problems. This cross-sectional study aimed to analyze the association between sociodemographic characteristics, health conditions, work-related health, effort and reward imbalance (ERI), and work ability among university staff in southern Thailand. Data were collected using stratified random sampling of 381 participants between April and September 2022. Descriptive statistics and binary logistic regression analyses were used to examine the associations between the variables. The majority of the participants were female (63.5%) and aged below 45 years old (52%). Nearly 70% of the participants reported the absence of non-communicable diseases (NCDs), while half of them were overweight, and 54.9% had an effort–reward ratio (ERR) greater than one. Most participants reported good-to-excellent work ability (82.4%). The probability of having poor-to-moderate work ability was higher among staff working from home (adj. OR = 2.4; 95% CI: 1.3, 4.6), those with NCDs (adj. OR = 3.5; 95% CI: 2.0, 6.4), those who followed poor health behaviors (adj. OR = 2.6; 95% CI: 1.4, 4.9), and those who had an ERR greater than one (adj. OR = 2.8; 95% CI: 1.5, 5.6). In conclusion, the majority of university staff in southern Thailand had good-to-excellent work ability. Work ability was associated with the presence of NCDs, poor health behavior, working from home, and ERI. Therefore, universities should create suitable occupational health programs and resources to mitigate the negative effects of work conditions, including ERI, and promote healthy behaviors for their staff during the COVID-19 pandemic and future disasters.

Periodontitis Patients’ Oral Health Experience and Quality of Life during the Malaysian Movement Control Order-2020

The coronavirus disease 2019 (COVID-19) has sparked concerns among dental patients due to its high infectivity. The implementation of the Movement Control Order in 2020 by the Malaysian government (MMCO-2020) has added constraints to access to dental clinics and may affect the patients’ status of oral disease. This study aims to investigate the impact of MMCO-2020 on the periodontal health and oral health-related quality of life (OHRQoL) of periodontitis patients with/out non-communicable diseases (NCDs). A cross-sectional study involving 139 patients with periodontitis was conducted to assess patients’ OHRQoL, oral health problems, and their perceived barriers to access dental treatment during MMCO-2020 using the Oral Health Impact Profile (OHIP-14) and questionnaire on oral health-related problems. The overall mean OHIP-14 score was relatively low (10.08 ± 8.861), suggesting that the OHRQoL is generally good during MMCO-2020. However, 44 (31.7%) periodontitis patients score ADD =14, indicating poorer oral health status and greater dental treatment needed. There was statistically significant association between periodontitis patients with comorbidities (i.e., presence of NCDs) with poorer OHIP-14 scores and mean plaque score changes at pre- and post-MMCO, suggesting that special care is required by this group, even during the national lockdown. Of the 45 (32.4%) patients who reported having problems, most (30, 36.1%) decided to “visit the dentist for treatment’. Meanwhile, the most frequent barriers were “could not get an appointment” (14, 34%), “problem is not serious” (13, 39.4%) and “fear of COVID” (9, 27.3%). The MMCO-2020 restrictions on the population had a minimal negative impact on the OHRQoL of patients with periodontal disease, but provisions can be arranged to address the basic and urgent needs of selected periodontitis patients, especially those presented with medical comorbidities. Keywords: COVID-19, Dental Health Services, pandemic, Oral Health, barriers

Prevalence, Patterns, and Predictors of Physical Inactivity in an Urban Population of India.

Physical inactivity (PI) is a risk factor for mortality and morbidity. PI and its predictors among the urban population in Bhubaneswar, India, were unknown. Finding out the contribution of PI as a cause of existing noncommunicable diseases (NCD) is difficult without following up with a cohort. The study was hence done to find out the prevalence, patterns, and predictors of physical inactivity in an urban population, and simultaneously investigate its causal relationship with NCD from this cross-sectional study. Cluster random sampling was used with a sample size of 1203 with a design effect of three. Socio-demographic, health profile, physical activity levels, and stage of change for physical activity behavior were collected. Logistic regression and marginal structural model analysis (by inverse probability of treatment weighting {IPTW} using a generalized estimating equation {GEE} to investigate the relationship between physical activity and prevalence of NCDs) were done using IBM SPSS v20 software (Armonk, NY: IBM Corp.). Statistical significance was tested at p=0.05. A total of 1221 subjects participated. The mean age was 35.25 years and 71.9% were physically inactive. General caste, presence of NCD, and being in a static stage of change influenced physical activity positively. PI was found to be a risk factor for NCD with 1.54 times higher odds in this population. The study concluded that the prevalence of physical activity was low and PI was a causative factor for NCD.

Perspective: Role of Micronutrients and Omega-3 Long-Chain Polyunsaturated Fatty Acids for Immune Outcomes of Relevance to Infections in Older Adults-A Narrative Review and Call for Action.

ABSTRACTThe immune system is weakened by advancing age, often referred to as immunosenescence, increasing the vulnerability to, and frequently the severity of, infectious diseases in older people. This has become very apparent in the current coronavirus disease 2019 (COVID-19) pandemic for which older people are at higher risk of severe outcomes, even those who are fully vaccinated. Aging affects both the innate and adaptive immune systems and is characterized by an imbalanced inflammatory response. Increasing evidence shows that optimal status of nutrients such as vitamins C, D, and E and selenium and zinc as well as the omega-3 (n–3) fatty acids DHA and EPA can help compensate for these age-related changes. While inadequate intakes of these nutrients are widespread in the general population, this is often more pronounced in older people. Maintaining adequate intakes is a challenge for them due to a range of factors such as physical, physiological, and cognitive changes; altered absorption; and the presence of noncommunicable diseases. While nutritional requirements are ideally covered by a balanced diet, this can be difficult to achieve, particularly for older people. Fortified foods and nutritional complements are effective in achieving adequate micronutrient intakes and should be considered as a safe and cost-effective means for older people to improve their nutritional status and hence support their defense against infections. Complementing the diet with a combination of micronutrients, particularly those playing a key role in the immune system such as vitamins C, D, and E and selenium and zinc as well as DHA and EPA, is recommended for older people. Optimal nutrition to support the immune system in older people will remain essential, particularly in the face of the current COVID-19 pandemic and, thus, developing strategies to ensure adequate nutrition for the growing number of older adults will be an important and cost-effective investment in the future.

Association of parental characteristics with offspring anthropometric failure, anaemia and mortality in India

This study used a wide range of information on parental sociodemographic, physical and behavioural characteristics as well as on the presence of non-communicable diseases among parents and examined the association of these attributes with anthropometric failure, anaemia and mortality of their children aged 0–59 months. Findings revealed that children of fathers aged 30–39 years were less likely to experience anthropometric failure and anaemia; however, survival of children of fathers below 18 years at marriage could be threatened. Parental education had protective association with children’s anthropometric failure, anaemia and under-five mortality. With increasing maternal height, children had lower odds of anthropometric failure and under-five mortality. Tobacco use by mothers was associated with increase in under-five mortality, and children with diabetic fathers had higher odds of under-five mortality.

Distribution of triglycerides and glucose (TyG) index and homeostasis model assessment insulin resistance for the evaluation of insulin sensitivity on late adolescence in Mexicans

Introduction: when peripheral tissues don't respond well to insulin action, it is defined as insulin resistance (IR). Many methods and indices are available for the estimation of IR, among them the homeostasis model assessment of insulin resistance (HOMA-IR) involves fasting plasma glucose and insulin. Nevertheless, the TyG index has a methodological advantage over the HOMA-IR because it requires only measurements provided by routine laboratory tests. Aim: distribution asessment of the HOMA-IR and TyG indexes in the sample. Also, to determine the predictive capacity of HOMA-IR, using TyG cutoff point as IR-positive diagnostic test. Materials and methods: a cross-sectional analytical study with 1686 participants aged 18 to 21 years from the state of San Luis Potosí, Mexico. Anthropometric assessment involves variables of weight and height. Fasting glucose, insulin and triglyceride concentrations were quantified. In addition, a questionnaire was carried out to know the hereditary family history and the presence of noncommunicable diseases (NCDs). Student's t-test was used to assess the differences in mean statistics between males and females. A receiver operating characteristic (ROC) curve was applied to examine the potential of HOMA-IR to identify IR. Results: 56 % of the study adolescents were females and 44 % were males; mean BMI was 22.62 ± 3.21 kg/m2. In the total sample mean serum glucose, insulin, and triglyceride concentrations were 89.48 ± 9.84 mg/dL, 6.26 ± 5.04 µU/mL, and 95.64 ± 55.78 mg/dL, respectively. A prevalence of 28.2 % of IR was determined, evaluated with the cut-off points for the TyG index. Subsequently, Receiver Operator Curves (ROC) were performed to evaluate the predictive capacity of HOMA-IR. The most outstanding cut-off value was 1.08 for the HOMA-IR index, reaching a sensitivity of 66 % and a specificity of 53 %. The prevalence of HOMA-IR greater than or equal to 1.18 was 47 % in the total population, 19.3 % in males and 28.5 % in females Conclusions: HOMA-IR and TyG can be useful diagnostic parameters for the assessment of IR in late adolescence. To provide a health guide for IR, we propose that a HOMA-IR target value ≤ 1.08 should be considered.

Association of self-reported sleep problems with morbidities and multimorbidities according to sex: National Health Survey 2019.

To evaluate the association between self-reported sleep problems and the presence of non-communicable diseases (NCDs) and multimorbidity, and whether these associations differ by sex. This is a cross sectional study performed with data from the Brazilian National Health Survey, 2019. Prevalence ratios between morbidities, the number of NCDs, and the self-report of sleep problems were estimated by Poisson regression with robust variance, according to sex. This study analysed data from 85,531 Brazilians age ≥ 18 years. The self-reported sleep problems were associated with all the herein studied morbidities and multimorbidities. The prevalence of sleep problems was higher in those who stated one or two (PR = 2.37; 95%CI 2.22;2.54) and three or more NCDs (PR = 4.73; 95%CI 4.37;5.11). Prevalence ratios of the association with diabetes, lung disease, mental disease, renal disease and multimorbidities were higher among males. NCDs significantly impacted sleep quality, with a particularly stronger association in both, males and females.

Association of maternal age and presence of non-communicable diseases in consanguineous marriage with congenital abnormalities in infants

Consanguineous marriages are most common among communities where most families are of traditional and extended types. It has been seen that females who conceive at a very young age or have any non-communicable disease have higher chances to have off springs with congenital abnormalities. Objective: To find out the association between maternal age and non-communicable diseases with congenital abnormalities in children. Methods: It is a cross-sectional study performed at District Head Quarter Hospital, Okara, including 100 married participants in the age range of 19-55 years after obtaining their informed consent Results: It was observed that 57% of mothers were below 20 at marriage, 42% were above 20 at marriage and 1% of mothers were above 30 at marriage, were having children with congenital abnormalities. 22 out of 100 mothers had obesity, 15 had diabetes and 21 had CVD when pregnant. The infants born to these mothers suffered from brain anomalies, cleft lip and cleft palate, CVD and diabetes. The results were obtained with p less than 0.05. Conclusion: Congenital abnormalities were more common among children with mothers aged below 20 or 25 and suffering from any metabolic or genetic disorder.

Noncommunicable disease, clinical course and COVID-19 prognosis: results based on I-CORE Registry.

There are no data on the association between clinical course and comorbidity in Iranian patients with COVID-19. To determine noncommunicable disease (NCD), clinical characteristics and prognosis of patients hospitalized with COVID-19 in Isfahan, Islamic Republic of Iran. This multicentric retrospective observational study was performed on all patients hospitalized with COVID-19 in Isfahan from 17 February to 6 April 2020. We recruited 5055 patients. Data on clinical course and comorbid NCDs such as hypertension, coronary heart disease (CHD), diabetes mellitus (DM), cancer, chronic kidney disease (CKD) and chronic respiratory disease (CRD) were collected. Statistical analyses were done by Mann-Whitney U, χ2 and logistic regression tests using Stata version 14. DM and hypertension were the most prevalent comorbidities in patients with positive and negative reverse transcription polymerase chain reaction (RT-PCR). Odds ratio (95% confidence interval) of mortality-associated factors was significant for DM [1.35 (1.07-1.70)], CHD [1.58 (1.26-1.96)], CRD [2.18 (1.58-3.0)], and cancer [3.55 (2.42-5.21)]. These results remained significant for cancer after adjustment for age, sex and clinical factors. Among patients with positive RT-PCR, death was significantly associated with CRD and cancer, while this association disappeared after adjustment for all potential confounders. There was a significant association between NCDs and higher occurrence of low oxygen saturation, mechanical ventilation requirement and intensive care unit admission after adjustment for age and sex. The presence of NCDs alone did not increase mortality in patients with COVID-19, after adjustment for all potential confounders including clinical factors.

Non-communicable diseases, sociodemographic vulnerability and the risk of mortality in hospitalised children and adolescents with COVID-19 in Brazil: a cross-sectional observational study

ObjectivesTo analyse how previous comorbidities, ethnicity, regionality and socioeconomic development are associated with COVID-19 mortality in hospitalised children and adolescents.DesignCross-sectional observational study using publicly available data from the Brazilian Ministry...

The influence of geriatric status on labor activity in women aged 55–64 years old

Aim: to estimate the associations between employment status, functional and cognitive status, physical health, and geriatric syndromes in women aged 55–64. Materials and methods. A cross-sectional study included 250 women aged 55 to 64 years. Sociodemographic factors, functional and cognitive status, health status, risk factors for chronic noncommunicable diseases (NCD), and presence of NCD were analyzed. The prevalence of changes indicative of geriatric syndromes was estimated. Results. The study included 250 women aged 55–64 years (mean age 59.3 ± 2.9 years). Risk factors (RF) for NCD were identified in all subjects. Abdominal obesity and lipid metabolism disorders (increased blood cholesterol levels and LDL cholesterol levels) were the most common RFs for NCD. The incidence of dyslipidemia as RF NCD was 94%. CVD, diseases of the musculoskeletal system, gastrointestinal tract (GIT), varicose veins of the lower extremities, and endocrine pathology prevailed in NCD. In women aged 55–64 years, aging increases the likelihood that a woman will not work by 2.5 times, using ≥two assistive devices — 2 times, the presence of urinary incontinence/ leakage — 2.3 times, probable depression — 2.7 times. Conclusion: geriatric syndromes are primarily associated with a decrease in functional activity in women aged 55-64 years; this association is associated with socio-demographic, economic factors, and health status (the presence of FRs for NCD and NCD themselves).

The influence of gender differences on functional and cognitive status, physical health and the prevalence of changes indicating geriatric syndromes in people aged 60–64 years old

Aim . To investigate gender differences and evaluate their impact on functional and cognitive status, level of physical health and the prevalence of changes indicating geriatric syndromes in people aged 60-64 years old. Material and methods . 250 men and 118 women aged 60-64 were examined. Sociodemographic factors, functional and cognitive status, health status, risk factors for noncommunicable diseases (NCDs), the presence of NCDs and the prevalence of changes indicating geriatric syndromes were assessed. Results . Among women there were more widows, single (without a partner) and single living, they were less likely to continue to work after retirement and more often had a low financial status. The prevalence of risk factors for NCDs and NCDs was high in both groups. The women were characterized by higher quantity of NCDs and polymorbidity index; they also took more drugs. Quality of live, nutrition status were lower in the group of women than men. More often depression was in the group of women. The prevalence of changes indicating geriatric syndromes was higher in women; they often used auxiliary means (glasses, a hearing aid, a cane, etc.). Conclusion . In the group of women aged 60-64 years old changes in health status, physical and functional status, indicating geriatric syndromes are more common. Women are more vulnerable socially; their health is worse. Identified differences between women and men aged 60-64 years old should be taken into account when planning treatment and rehabilitation measures in people of this age category for better results.

Economic and humanistic burden associated with noncommunicable diseases among adults with depression and anxiety in the United States

Aims: This study estimated the economic and humanistic burden associated with chronic non-communicable diseases (NCCDs) among adults with comorbid major depressive and/or any anxiety disorders (MDD and/or AAD).Materials and methods: A retrospective analysis was conducted using the Medical Expenditure Panel Survey data (2010–2015). The analytic cohort included adults (≥18 years) with MDD only (C1), AAD only (C2), or both (C3). The presence of either of 6 NCCDs (cardiovascular diseases [CVD], pulmonary disorders [PD], pain, high cholesterol, diabetes, and obesity) were assessed. Study outcomes included healthcare costs, activity limitations, and quality of life. Multivariate regressions were conducted in each of the 3 cohorts to evaluate the association between the presence of NCCDs and outcomes.Results: The analytic sample included 9,160,465 patients: C1 (4,391,738), C2 (3,648,436), C3 (1,120,292). Pain (59%) was the most common condition, followed by CVD (55%), high cholesterol (50%), obesity (42%), PD (17%), and diabetes (14%). Mean annual healthcare costs were the greatest for C3 ($14,317), followed by C1 ($10,490) and C2 ($7,906). For C1, CVD was associated with the highest increment in annual costs ($3,966) followed by pain ($3,617). For C2, diabetes was associated with the highest incremental annual costs ($4,281) followed by PD ($2,997). For C3, cost trends were similar to those seen in C2. NCCDs resulted in a significant decrease in physical quality of life across all cohorts. Pain was associated with a significantly higher likelihood of self-reported physical, social, cognitive, and activity limitations compared to those without pain.Conclusions: 60% of patients with MDD and/or AAD had at least one additional NCCD, which significantly increased the economic and humanistic burden. These findings are important for payers and clinicians in making treatment decisions. These results underscore the need for development of multi-pronged interventions which aim to improve quality of life and reduce activity limitations among patients with mental health disorders and NCCDs.

Respiratory and other illnesses among the jute-mill workers in an industrial unit of Bangladesh

Background and aims: Bangladesh produces 33% of the world’s jute and about 40 million people in Bangladesh are directly or indirectly involved in the jute sector. The jute (organic) dust inhalation causes byssinosis and other respiratory illnesses. However, no study has yet addressed the health status of the jute handlers/workers in Bangladesh. This study aimed to determine the prevalence of respiratory illnesses among the Jute Mill Workers (JMWs). Additionally, this study tried to find out the overall health status of the JMWs which included presence of non-communicable diseases (NCD) and its related risk, which are usually ignored.&#x0D; Study design: A cross-sectional study conducted in a purposively selected jute mill - 40km off from Dhaka City. Of the 5500 workers, a list of 600 workers was provided by the mill authority for enrollment in the study. The investigations included – a) interviewing on socio-demography and clinical history; b) anthropometry (height, weight, waist- and hip-circumference); c) blood pressure measurement; d) estimation of fasting blood glucose and lipids; e) peak flow meter test; f) spirometry; g) high resolution computerized tomography (HRCT) and electrocardiography.&#x0D; Results: Of the enlisted 600 jute mill workers, 514 (men / women = 478 / 36) took part in the study. The response rate was 85%. For overall estimate of bio-physical characteristics (n = 514), the means (95% confidence interval) of age, body mass index (BMI), waist-hip ratio (WHR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were 44.19 (43.34 – 45.04) years, 24.44 (24.16 – 24.73), 0.90 (0.90 – 0.91), 118.9 (117.4 – 120.4), 79.69 (78.81 – 8/0.54), respectively. Regarding social class and education, 84.4% were from non-affluent (poor) class and 50% were illiterate. About 88% of the JMWs had been working for ≥42 hours a week and 91.6% were exposed to moderate or heavy work (equivalent to ≥60 min walk). The prevalence of breathlessness, tightness of chest and chronic cough were 16.5%, 25.7% and 16.3%, respectively. The restrictive and obstructive pulmonary functions were detected in 7.0% and 0.8% of study population respectively. The prevalence of systolic hypertension was 16.5%, diastolic hypertension was 7.2% and diabetes (IFG+DM) was 13.3%. They had increased cardiovascular risks – hypertriglyceridemia (23.9%) and hypercholesterolemia (24.3%).&#x0D; Conclusions: JMWs have been suffering mostly from respiratory illnesses and a substantial number of them suffer from undiagnosed hypertension, diabetes and other non-communicable diseases. Dyslipidemia was also prevalent as a potential risk factor. The study could not assess ocular, auditory, musculoskeletal and mental health and it suggests that a well designed study should address these health related problems of JMWs.&#x0D; IMC J Med Sci 2019; 13(1): 007