Rural Adult Population Research Articles

A Study on Risk Factors for Hypertension among Rural Adult Population of Kancheepuram, Tamil Nadu

A Study on Risk Factors for Hypertension among Rural Adult Population of Kancheepuram, Tamil Nadu

Comparison of the Correlates Between Body Mass Index, Waist Circumference, Waist-to-Height Ratio, and Chronic Kidney Disease in a Rural Chinese Adult Population

The aim of the article was to evaluate and compare the correlates of body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR) with chronic kidney disease (CKD) among a rural Chinese adult population. This was a case-control study. A total of 4,221 adults, aged 27 to 95years, were divided into different groups based on the standard of CKD stages. A receiver operating characteristic curve was performed to evaluate and compare the predictive values of BMI, WC, and WHtR for CKD. Multiple logistic regression model and ordinal logistic regression model were used to estimate the association between BMI, WC, WHtR, and CKD. The main outcome variable was stage of CKD. The abnormality in BMI, WC, and WHtR was associated with the cumulative risk of CKD after adjusting for age, gender, smoking, and drinking, and corresponding odds ratios (ORs) (95% confidence intervals [CIs]) were 1.154 (1.009-1.319), 1.240 (1.077-1.428), and 1.191 (1.030-1.378). After further adjustment for blood lipid, hypertension, type 2 diabetes mellitus, and use of antihypertensive and antidiabetic agents, the association of WC and CKD remained statistically significant (adjusted OR=1.220, 95% CI: 1.052-1.415). Both WC and WHtR were significantly associated with the risk of CKD in females, crude ORs (95% CIs) of cumulative effect of WC and WHtR with CKD were 1.534 (1.296-1.816) and 1.981 (1.683-2.331), respectively. The area under the curves of BMI, WC ,and WHtR for CKD Stage 3 were 0.531, 0.579, and 0.614, and pairwise comparisons showed the area under the curve of WHtR was significantly higher than BMI and WC (P<.001 and P=.002). Our findings suggested that abnormality in BMI, WC, and WHtR was associated with CKD in rural population, and WHtR was better in CKD prediction, especially in female.

Health-related stigma of noncommunicable neurological disease in rural adult populations: A scoping review.

Stigma is a widely recognised public health issue. Many people with neurological disease and their families experience stigmatisation, adding to their burden of illness. Rural populations are typically small, lack anonymity, and often have a higher proportion of older adults with inadequate access to specialised services and resources. Although generally isolated, rural areas can offer benefits such as a sense of familiarity and interconnectedness. The purpose of this scoping review was to map the existing evidence on stigma associated with non‐communicable neurological disease in rural adult populations and identify key findings and gaps in the literature. Our literature search of peer‐reviewed English language articles published from 1 January 1992 to 22 June 2017 was conducted across five databases yielding 8,209 results. After duplicate removal, pairs of reviewers independently screened 6,436 studies according to inclusion criteria developed a priori; 36 articles were identified for inclusion in this review. Study characteristics were described and illustrated by frequency distribution, findings were grouped thematically, and each of the five types of stigma were identified (social, self, health professional, associative, structural). Four factors influencing stigma (knowledge, familiarity, beliefs, and rurality) and four overarching stigma‐related themes (concealment; exclusion; disempowerment, discrimination, and unequal opportunities; and issues related to healthcare systems and providers) emerged. In urban‐rural comparison studies, rural residents were generally less knowledgeable about the neurological disease and more stigmatised. The impact of other factors (i.e., gender, age, and education) on stigma varied and are stated where associations were reported. Three main gaps were identified including: low attention to stigma related to neurological diseases other than epilepsy, limited cross‐cultural comparisons of stigma related to neurological disease, and inclusion of gender as a variable in the analysis of stigma‐related outcomes in only half of the reviewed studies. Further research is recommended.

Assessment of metabolic syndrome risk factors among rural-dwelling older adults requires innovation: partnerships and a mobile unit can help

Purpose Older adults are at risk for developing metabolic syndrome (MSX). Given the growing rural older adult population and the unknown prevalence rate of MSX in rural communities, the purpose of this paper is to assess the risk factors for MSX among rural elders. Design/methodology/approach Individuals aged 55+ from four West Alabama rural communities were assessed by an interdisciplinary healthcare team via a mobile unit (n=216). Descriptive analyses and analysis of variances (ANOVA) were conducted to assess the effect of gender, race and community on the number of risk factors of MSX among rural elders. Findings Results of a three-way ANOVA revealed a significant interaction between gender, age and community on the number of MSX risk factors [F (16,193)= 2.41, p &lt;0.01]. Rural communities with lower social economic status (SES) and predominantly African American residents were at higher risk for developing MSX compared to communities with higher SES [F(3, 68) = 7.42, p&lt;0.05]. Practical implications Findings suggest low SES rural communities are at risk of developing MSX. Innovative approaches such as mobile healthcare delivery are crucial to providing quality healthcare and preventive health screens to underserved rural older adult communities. Originality/value Limited research is available on assessing rural midlife and older adults at risk for metabolic syndrome largely due to lack of communication or transportation infrastructure and their history of negative experiences with public institutions. This research demonstrates that these barriers can be addressed.

Vitamin D status in Kancheepuram District, Tamil Nadu, India

BackgroundVitamin D has multifarious roles in maintenance of health and prevention of disease. The present study was undertaken to assess the vitamin D status of a rural adult south Indian population and to identify its associations with socioeconomic status and cultural practices.MethodsBetween June 2015 and July 2016, 424 healthy adults residing in Kattankulathur block in Tamil Nadu, India, provided venous blood samples and answered questions by personal interview. 25-hydroxy vitamin D was estimated by ELISA.ResultsFifty nine (13.9%) of the 424 participants had 25OHD levels below 12 ng/mL (vitamin D deficient) and 175 (41.3%) had 25OHD levels between 12 to 20 ng/mL (vitamin D insufficiency). In univariate analysis, demographic factors associated with vitamin D status included education, occupation, socioeconomic class, and birthplace; lifestyle factors included sun exposure time, skin surface exposed to sunlight, use of sunscreen, awareness of vitamin D, and consumption of fish; and hygiene related factors included source of drinking water, availability of tap water at home, and closed toilet at home. In ordinal logistic regression, the following variables were found to be independently associated with vitamin D sufficiency: Duration of daily sun exposure below 30 min (Odds ratio 0.31, 95% confidence intervals 0.14–0.71, P = 0.006), sun exposure 30–60 min (OR 0.49, 95% CI 0.30–0.80, P = 0.004), male gender (OR 2.00, 95% CI 1.30–3.09, P = 0.002), higher level of education (OR 0.80, 95% CI 0.69–0.94, P = 0.005), non-consumption of fatty fish (OR 0.48, 95% CI 0.24–0.85, P = 0.035) and presence of closed toilet system at home (OR 0.59, 95% CI 0.37–0.93).ConclusionVDD and VDI are highly prevalent in this rural Indian community. The study identifies socioeconomic and behavior patterns that negatively impact vitamin D sufficiency, thus providing a basis for targeted intervention.

A study on validity of Indian Diabetes Risk Score for screening of diabetes mellitus among rural adult population at Rural Health Training Centre, Bhouri, under Department of Community Medicine

Background: Diabetes mellitus is a major public health problem in India and many of them remain undetected throughout years. This scenario becomes worse in rural setup where limited heath care facilities are available. So, to detect risk of diabetes earlier, Indian diabetes risk score (IDRS) is to be used. There is also various socio demographic and anthropometric factors associated with the risk of occurring diabetes. The aims and objectives of the study were to study the validity of IDRS method as a screening tool in community as well as to determine the association of IDRS with socio demographic factors and body mass index (BMI).Methods: A cross sectional study was conducted on 270 study participants at rural health training centre (RHTC) for a period of around 7 months. All of them were being measured weight, height, waist circumference and calculated BMI. Along with it, they were categorized by applying IDRS method and measured blood sugar by glucometer also.Results: Out of 270 study subjects, 29% found to have high score. By applying IDRS, at score &gt; 60, we found 32% sensitivity and 97% specificity. A statistically significant association of IDRS with age, gender, religion, socioeconomic status (SES), education, occupation and BMI was seen.Conclusions: In present study, IDRS method proved to be a good screening tool for detecting diabetes mellitus at rural set up with minimum cost.

Sociodemographic, socioeconomic, clinical and behavioural predictors of body mass index vary by sex in rural South African adults-findings from the AWI-Gen study

ABSTRACTBackground: Despite increasing obesity in South African adults, data on the prevalence and determinants of body mass index (BMI) from rural communities, home to a significant proportion of the population, are scarce.Objectives: To investigate overall and sex-specific determinants of BMI in a rural adult South African population undergoing rapid social and epidemiological transitions.Methods: Baseline cross-sectional demographic, socioeconomic, anthropometric, clinical and behavioural data were collected between 2015 and 2016 from 1388 individuals aged 40–60 years and resident in the Agincourt sub-district of Mpumalanga province, a setting typical of rural northeast South Africa. A Health and Socio-Demographic Surveillance System (HDSS) underpins the sub-district and contributes to the Africa Wits-INDEPTH partnership for Genomic Studies (AWI-Gen). Linear regression was used to investigate univariate associations between log-transformed BMI and individual variables and multiple linear regression was used to investigate independent predictors of BMI overall and in sex-stratified analyses.Results: Median BMI was significantly higher in females (28.7 kg/m2[95% CI 24.2–33.2] vs 23.0 kg/m2[95% CI 20.3–26.8];p < 0.001) with male sex associated with 17% lower BMI. In sex-stratified multiple linear regression models, compared to those never married, BMI was 7% higher in currently married males and 6% in currently married females. Current smoking in men and former smoking in women were associated with reductions in BMI of 13% and 26% respectively, compared with non-smokers. Higher educational attainment in women and higher socioeconomic status in men were both associated with higher BMI, while being HIV-positive and alcohol consumption in women were associated lower BMI.Conclusions: Female sex strongly predicts higher BMI in this rural African population. While some predictors of higher BMI differ by sex, married individuals in both sexes had a higher BMI, suggesting that, in addition to developing sex-specific interventions to combat overweight and obesity, targeting married couples may result in reduction in population BMI.

Physical Frailty and Cognitive Functioning in Korea Rural Community-Dwelling Older Adults.

Cognitive frailty is a heterogeneous clinical manifestation characterized by the simultaneous presence of physical frailty and cognitive impairment. The objective of this study was to investigate the association between physical frailty and cognitive function in rural community-dwelling older Korean adults, taking four cognitive domains into account. We carried out a cross-sectional population-based study which enrolled 104 community-dwelling elderly. Physical frailty phenotype, as well as its individual criteria, were used. Cognitive functioning was examined in the four domains of memory, processing speed, cognitive flexibility, and working memory. Demographic data, lipid profile, muscle strength, physical function, and 25-hydroxyvitamin D (25[OH]D) concentration collected from questionnaire interviews and assessments were included. Of the 104 older adults (77% female), 24.3% were classified as robust, 49.6% as prefrail, and 16.5% as frail. Linear regression analyses showed that the severity of frailty index was associated with four cognitive domains Muscle strength (i.e., Grip strength, Knee extensor and flexor), physical function (i.e., SPPB and Gait speed), and 25[OH]D were associated with poorer cognitive function. Within our population of Korean rural community-dwelling older adults, physical frailty status, muscle strength, physical functions, and biochemical measurements were associated with poorer cognitive function. Synchronicity of physical frailty and cognitive dysfunction may contribute to the negative health-related effects associated with aging.

An epidemiological study on alcohol consumption and knowledge of its harmful effects on human health among rural adult population of adopted villages covered under field practice area of a private medical college in Udaipur, Rajasthan

Background: Consumption of alcohol among adults is a serious public health issue worldwide. However the knowledge of adverse effects of alcohol consumption on human health is very negligibly less in small towns and villages of India. Present study was conducted to determine the extent of alcohol intake and the knowledge of its adverse effects on human health among adult population.Methods: A cross-sectional study was carried out on randomly selected 400 rural adults from a field practice area of private medical college, Udaipur.Results: Prevalence of alcohol consumption was found to be (47.25%) with (49.36%) males and (39%) females. More than half of drinkers (55.9%) were belonging to 30-39 age group. Country liquor was preferred by (68.88%) and only (17.77%) consume English (IMFL). (56%) of alcohol consumers were drinking alcohol for more than a year. Most of the drinkers (49%) were induced by their friends, (24%) were induced/influenced by their parents. (42.25%) drinkers had knowledge of harmfulness of alcohol drinking; however the awareness per se did not have statistically significant effect for alcohol consumption. Results showed that the knowledge of excessive intake of alcohol can cause harmful effects on human health like Infertility to woman, irregular menstrual cycle, cancer were statistically significant (p&lt;0.05) gender wise, while effects like depression, sleep disturbances, alcoholic hepatises, liver disease, malnutrition were statistically not significant (p&gt;0.05).Conclusions: There is a need to enhance awareness on adverse effects of alcohol and at least bring down consumption level among heavy drinkers through peer group/family/community involvement.

Risk factors for HTLV-1 infection in Central Africa: A rural population-based survey in Gabon.

BackgroundHuman T-Lymphotropic Virus type 1 (HTLV-1) is a human oncoretrovirus that infects at least 5 to 10 million people worldwide and is associated with severe diseases. Africa appears as the largest HTLV-1 endemic area. However, the risk factors for the acquisition of HTLV-1 remain poorly understood in Central Africa.MethodsWe conducted an epidemiological survey between 2013 and 2017, in rural areas of 6 provinces of Gabon, in a rainforest environment. Epidemiological data were obtained and blood samples were collected after informed consent. Plasma were screened for HTLV-1 antibodies by ELISA and the positive samples were then tested by Western blot (WB). Genomic DNA derived from buffy-coat was subjected to two semi-nested PCRs amplifying either HTLV-1 env gene or LTR region fragments.ResultsWe recruited 2,060 individuals over 15 years old, including 1,205 men and 855 women (mean age: 49 years). Of these, 299 were found to be ELISA HTLV-1/2 seropositive. According to WB criteria, 136 were HTLV-1 (6.6%), 25 HTLV-1/2 (1.2%) and 9 HTLV seroreactive (0.4%). PCR results showed that 146 individuals were positive for at least one PCR: 104 for the env gene and 131 for the LTR region. Based on both serological and molecular results, 179 individuals were considered infected with HTLV-1, leading to an overall prevalence of 8.7%. The distribution of HTLV-1 infection was heterogeneous across the country. Based on multivariable analyses, female gender, increasing age, ethnicity (Pygmy) and multiple hospitalizations (more than 5 times) were found to be independent risk factors for HTLV-1 infection. Furthermore, a non-human primate bite appeared to be marginally associated with a higher risk of HTLV-1 infection.ConclusionBased on state-of-the-art serological and molecular methods, we have demonstrated that rural adult populations in Gabon are highly endemic for HTLV-1. Our results regarding risk factors should lead to public health actions aiming to reduce HTLV-1 transmission.

Multidrug-Resistant Enterobacteriaceae Colonising the Gut of Adult Rural Population in South India

Background: Multidrug-resistant (MDR) colonisers act as a reservoir for transmission of antibiotic resistance and are a source of infection. Exposure to antibiotics by the commensal flora renders them resistant. Antibiotic consumption and hospitalisation are two major factors influencing this. We studied, antibiotic-resistant bacteria colonising rural adult population who had restricted access to health care and presumably had low consumption of antibiotics. Aim: Detection of multidrug resistance genes of extended spectrum β-lactamase (ESBL-CTX-M), AmpC β-Lactamase (CIT), Klebsiella pneumoniae carbapenemase (KPC) and New Delhi Metallo β-lactamase (NDM) in Enterobacteriaceae colonising the gut of adult population in a South Indian rural community. Methodology: Faecal samples of 154 healthy volunteers were screened for Enterobacteriaceae resistant to commonly used antibiotics by standard methods, followed by phenotypic detection of ESBL by double disk synergy method, AmpC by spot inoculation and carbapenemases by imipenem and ethylenediaminetetraacetic acid + imipenem combined E-test strips and modified Hodge test. Polymerase chain reaction was done to detect blaCTX-M, blaCIT, blaKPC-1 and blaNDM-1 genes coding for ESBL, AmpC, KPC and NDM, respectively. Results: Colonisation rate of enteric bacteria with MDR genes in the community was 30.1%. However, phenotypically, only ESBL (3.2%) and NDM (0.65%) were detected. While the genes coding for ESBL, AmpC and NDM were detected in 35.6%, 17.8% and 4.4% of the MDR isolates, respectively. Conclusions: Carriage of MDR strains with a potential to express multidrug resistance poses a threat of dissemination in the community. Awareness for restricted use of antibiotics and proper sanitation can contain the spread of resistant bacteria.

Predictors of Reproductive Autonomy among a Rural University Population.

Reproductive autonomy is necessary for one's overall well-being and is defined as the ability to decide and control issues of contraceptive use, pregnancy, and birth. Barriers to consistent contraceptive use persist, limiting an individual's ability to exercise reproductive autonomy. The present study investigated the prevalence of reproductive autonomy and gender beliefs among 468 university students (311 women and 157 men) in a rural setting. Participants completed surveys measuring reproductive autonomy, attitudes around gender beliefs, and demographic questions. Correlations revealed a positive association between decision making, communication, and freedom from coercion. Multiple regressions found significant predictors to achieving reproductive autonomy, including holding healthy gender beliefs, being a woman, using birth control, engaging in less religious activity, and being a non-Christian. Social work efforts should support young adults to effectively communicate about the use of contraception within relationships and to promote healthy gender beliefs. Assessment tools should include screening for coercive behaviors such as intimidation, isolation, and threats within intimate partnerships. Social work advocacy efforts should focus on decreasing the continuing barriers to both comprehensive reproductive health care and access to highly effective contraceptives. The specific reproductive health needs of rural young adult populations should also be further examined.

Prevalence of Type 2 Diabetes Mellitus in Rural Adults (&gt;_31years) in Bangladesh

Diabetes is one of the most prevalent and serious non- communicable diseases all over the world. It is the leading cause of death, disability, and economic loss, and it is identified as a major threat to global development. Among the adults (age 20-79 years) with diabetes in the top five South East Asian countries, Bangladesh is in the second position. The number of people with diabetes in Bangladesh was 5.10 million in 2013, which is expected to increase to 8.20 million by 2035. Therefore, this study aimed to estimate the prevalence of type 2 diabetes in a rural population aged &gt;_ 31 years living at a village in the district of Bagerhat, Bangladesh, and to aware the people of the area about diabetes and to detect diabetes early for early care to prevent its complications. In this study we used 'Prodigy Preferred blood Glucose Meter' for testing fasting blood glucose to diagnose diabetes. The study was conducted from 2012 to 2015. Random sampling method was used to select participants. Fasting plasma glucose of the 400 participants of &gt;_ 31 years of age was done at a 'Free Friday Clinic' of the study area. Out of 400 participants 38 (09.50%) were diabetic. Among the participants (n=400), 45.50% were male and 54.50% were female. We found a high prevalence of DM in the rural Bangladeshi adult population (9.5%). The present study found that about one in ten Bangladeshi adults has diabetes (9.5%). This finding is consistent with many other studies from low-and middleincome countries including India (8.6%), Sri Lanka (8.0%), China (9.6%), Nauru (13.7%), and Panama (9.5%). Our study together with previous study confirms that prevalence of diabetes is increasing in Bangladesh.Faridpur Med. Coll. J. Jan 2018;13(1): 20-23

Retinal image quality in northern rural Chinese adult population

Objective: To assess the retinal image quality of the normal northern rural Chinese adult population. Methods: A normal population-based, cross-sectional study. From Oct, 2012 to Jan 2013, a clustered, random sampling procedure was used to select normal population who visual acuity≤ 0(LogMAR) and 30-69 years old from 2 villages. All eligible subjects were invited to undergo a comprehensive eye examination, and the retinal image quality related index were examined with pupil 4 mm using objective optical quality analysis systemⅡ(OQAS Ⅱ, Visiometrics, Spain), including MTFcutoff, VA20, VA9, PSF50, PSF10, OSI, SR. And describe the retinal image quality of different age group, including 30-39y, 40-49y, 50-59y, 60-69y. Results: Among 1 108 participants (61.9%) that completed examinations in our center, 681 participants (1 362 eyes) were recruited. There were 146, 586, 440 and 190 eyes in each group. The spherical equivalent refraction of each group was (-0.35±0.84), (-0.19±0.50), (-0.03±0.54) and (0.20±0.71) D. The best corrected vision acuity of each group was -0.02±0.04, -0.01±0.03, -0.01±0.02 and -0.00±0.01. The MTFcutoff of each group was (37.06±9.31), (36.69±8.93), (36.52±9.05) and (32.61±10.08) c/deg. Retinal imaging parameters were significantly different(MTFcutoff: MD=4.45, SR:MD=0.03, PSF50: MD=-0.45, PSF10: MD=-2.87, VA20:MD=0.13, A9:MD=0.09, OSI:MD=-0.41, P<0.001)between aged 30-39 group and aged 60-69 group. Objective scattering index (OSI) were significantly different(MD=-0.13, P=0.004)between aged 30-39 group and aged 50-59 group. Retinal imaging parameters were significantly different(MTFcutoff:MD=4.45, SR:MD=0.03, PSF50:MD=-0.45, PSF10:MD=-2.87, VA20:MD=0.13, VA9: MD=0.09, OSI: MD=-0.41, P<0.001)between aged 40-49 group and aged 60-69 group. Retinal imageing parameters were significantly different(MTFcutoff: MD=4.45, SR: MD=0.03, PSF50: MD=-0.45, PSF10: MD=-2.87, VA20:MD=0.13, VA9:MD=0.09, OSI:MD=-0.41,P<0.001)between aged 50-59 group and aged 60-69 group. Conclusion: Retinal image quality was gradually worse over time in the northern rural Chinese adult population. (Chin J Ophthalmol, 2018, 54:593-598).

A community based study on awareness of organ donation among young adults in rural areas of Puducherry

Background: The objective of the study was to determine the knowledge, attitudes and practices regarding organ donation in a selected rural adult population in Pondicherry.Methods: Simple random sampling was used to generate a sample of 100 in rural service areas of IGMC&amp;RI. Face to face interview was conducted based on a pre-tested questionnaire in selected rural areas of Pondicherry. Data was analysed using SPSS v.22 and associations were tested using the Pearson's Chi square test.Results: 66% of the participants in this survey had adequate knowledge score for organ donation. Knowledge about organ donation was significantly associated with employment status (p=0.025). Television emerged as the major source of information. Only 19% had donated an organ. All (19%) were volunteers who have donated blood.Conclusions: Better knowledge may ultimately translate into the act of donation. Effective measures should be taken to educate people with relevant information with the involvement of media and doctors.

Dietary determinants of obesity among Mexican women

Introduction Lifestyle and dietary habits in the Mexican population have dramatically changed in the last 20 years, reflected in an increased prevalence of overweight and obesity in both urban and rural adult populations. The prevalence of overweight and obesity in Mexican adults is 38.8% and 32.4%, respectively. In adults, abdominal obesity is more prevalent among women than men (82.8% versus 64.5%, respectively). In women over 60 years of age, overweight and obesity rates are even greater—nearly 40% are overweight and 35.5% obese. A healthy diet has been shown to prevent weight gain. It is therefore important to investigate dietary factors that are most strongly associated with obesity in this highly obese population group. Dietary patterns are used to assess the overall diet. One approach to evaluate dietary patterns is to use a priori patterns which are based on dietary recommendations. The objective of this study was to evaluate the associations between the consumption of food groups and a priori defined dietary patterns and anthropometric measures in women from the CAMA study. Methods Our study population is based on 1062 women (35 to 69-years-old) from the control group of the CAMA study, which is a multi-centre population-based case-control study on breast cancer conducted in Mexico. Each woman was interviewed via personal interview during which dietary intakes were assessed using a semi-quantitative Food Frequency Questionnaire. The indices used in the study are the Dietary Approaches to Stop Hypertension (DASH) score, the Healthy Eating Index (HEI) score, the Mediterranean Diet Score (MDS) and the Diet Quality Index (DQI) score. To estimate associations of food groups and dietary patterns with anthropometric measures, generalized linear regression models were used and adjusted for potential confounders, such as age, centre and educational level. Results Mean age, body mass index (BMI), waist circumference (WC), hip circumference (HC) and waist-to-hip ratio (WHR) among the participants were 51.1 (years), 30.5 (kg/m2), 99.4 (cm), 109.3 (cm) and 0.91, respectively. When individual food groups were examined, a higher consumption of legumes was associated with lower body mass index (BMI), waist circumference (WC) and hip circumference (HC). Regarding dietary patterns, a higher adherence to MDS was associated with lower WC. We did not observe any significant association between other food groups or a priori dietary patterns and anthropometric measurements in models adjusted for confounders. Conclusions In this population of Mexican women, most of the a priori dietary scores appeared to be of limited value in predicting the association between diet and anthropometric measures. However, higher adherence to the Mediterranean diet was associated with lower WC.

Associations between untreated depression and secondary health care utilization in patients with hypertension and/or diabetes

We determined the prevalence of untreated depression in patients with hypertension (HT) and/or diabetes (DM) and estimated the extra health care use and expenditures associated with this comorbidity in a rural Hungarian adult population. We also assessed the potential workload of systematic screening for depression in this patient group. General health check database from a primary care programme containing survey data of 2027 patients with HT and/or DM was linked to the outpatient secondary care use database of National Institute of Health Insurance Fund Management. Depression was ascertained by Beck Depression Inventory score and antidepressant drug use. The association between untreated depression and secondary healthcare utilization indicated by number of visits and expenses was evaluated by multiple logistic regression analysis controlled for socioeconomic/lifestyle factors and comorbidity. The age-, sex- and education-specific observations were used to estimate the screening workload for an average general medical practice. The frequency of untreated depression was 27.08%. The untreated severe depression (7.45%) was associated with increased number of visits (OR 1.60, 95% CI 1.11-2.31) and related expenses (OR 2.20, 95% CI 1.50-3.22) in a socioeconomic status-independent manner. To identify untreated depression cases among patients with HT and/or DM, an average GP has to screen 42 subjects a month. It seems to be reasonable and feasible to screen for depression in patients with HT and/or DM in the primary care, in orderto detect cases without treatment (which may be associated with increase of secondary care visits and expenditures) and to initiate the adequate treatment of them.

Five-year incidence and progression of myopic maculopathy in a rural Chinese adult population: the Handan Eye Study.

To determine the cumulative five-year incidence and progression of myopic maculopathy in a rural Chinese adult population. The Handan Eye Study was a population-based longitudinal study. In 2006, 6830 subjects aged 30+ years participated in this study (baseline). Five years later, 5394 subjects (follow-up rate: 85.3%) took part in the follow-up study. Participants had a detailed eye examination, including visual acuity, standardized refraction and fundus photography according to a similar protocol at both baseline and follow-up. Myopic maculopathy was defined as any of the following signs: diffuse chorioretinal atrophy, patchy chorioretinal atrophy, macular atrophy, lacquer cracks and myopic choroidal neovascularization at the posterior pole. Parapapillary atrophy was assessed separately. Of 5394 participants, 5078 (10021 eyes) had gradable fundus photographs. Over the five years, four participants (five eyes) developed new myopic maculopathy, with an eye-specific incidence of 0.05% (95% CI, 0.02-0.10%). Among the 51 eyes with myopic maculopathy at baseline, the progression occurred in 18 eyes (35.3%), with new signs of patchy chorioretinal atrophy in 11 eyes (21.6%), diffuse chorioretinal atrophy in seven eyes (13.7%), lacquer cracks in three eyes (6.9%), macular atrophy in three eyes (6.9%) and myopic choroidal neovascularization in two eyes (3.9%). By multivariable analysis, female gender (OR, 9.14; p=0.004) and higher educational level (OR, 8.24; p=0.004) were associated with a higher risk of progression of myopic maculopathy, whereas lower myopia at baseline (OR, 0.79; p<0.0001) and hypertension (OR, 0.21; p=0.017) were associated with a reduced risk. The five-year incidence of myopic maculopathy was 0.05% in rural Chinese adults aged 30+years. The progression rate in participants with myopic maculopathy was 35.3%, indicating the importance of regular follow-up for these patients.

Five-year refractive changes in a rural Chinese adult population and its related factors: the Handan Eye Study.

Provision of refractive changes is important to predict eye care needs for aging population. To provide 5-year refractive changes in a rural Chinese adult population. Population-based longitudinal study. At baseline, 6830 subjects aged 30+ years took part in the Handan Eye Study. A total of 5394 of the 6323 survivors (85.3%) participated in the 5-year follow-up. Ocular examinations including standardized refraction were performed according to the same protocol at both baseline and follow-up. Change in spherical equivalent (SE; sphere + 1/2 cylinder) and astigmatism. A total of 3970 right eyes were available for refraction analysis. The 5-year change in SE for all subjects was +0.17 diopters (D), and was -0.21D, +0.14D, +0.40D and +0.08D for subjects aged 30-39, 40-49, 50-59, and 60-69 years, respectively. By binary regression analysis, myopic shift was associated with severe nuclear opacity, longer axil length, diabetes and large change of lens power, while hyperopic shift was associated with older age and ocular hypertension at baseline. There was a mean change of 0.18D in the against-the-rule astigmatism. There was a myopic shift for those 30-39 years old and a hyperopic shift from 40 to 69 years old in a rural Chinese adult population. Those with severe nuclear opacity, longer axil length, diabetes and large change of lens power tended to have a myopic shift, while those being older and having ocular hypertension at baseline were prone to have a hyperopic shift. There was also an increase in against-the-rule astigmatism in this population.

Prevalence of Risk Factors of non-communicable Diseases in an Adult Population of Rural Bangladesh

Background:A community based survey was carried out to determine the distribution of major noncommunicable diseases risk factors as well as to explore the detection and treatment rate of diabetes mellitus and hypertension in rural adult population of Bangladesh.Methods: The survey was done in2006 among 545 individualsaged 25 to 64 years randomly drawn from a village (Ekhlaspur under Chandpur district) of Bangladesh. Information on diet, physical activity, alcohol and tobacco, and treatment history for hypertension and diabetes were collected. Height, weight, waist circumference, blood pressure, capillary blood glucose and total cholesterol were measured.Results: There were 269 men and 276 women with the mean age of 43.9 years (standard deviation, 11.6 years). Six in ten (62.4%) of them used tobacco in some form (smoking or smokeless), 93.7% did not consume adequate fruits and vegetables (five servings or more), and 7.4% of them had low physical activity. More than 6% were overweight or obese (BMI ≥25kg/m2) and 10% had hypertension (blood pressure ≥140/ 90 mmHg or medication). Capillary blood measurement and history of medication combined provided a prevalence of 3.1% for diabetes while prevalence of hypercholesterolemia (≥240 mg/dL) was 2.9% based on capillary blood cholesterol level alone. Less than half of hypertensive and less than one-tenth diabetes subjects were receiving treatmentfor their respective conditions.Conclusions: Prevalence of noncommunicable diseases risk factorsis fairly high even in thisruralBangladeshi sample. Treatment rate for hypertension and diabetes is quite low. Interventionsshould address lifestyle changes and treatment of diabetes and hypertension.Cardiovasc. j. 2018; 10(2): 126-134