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Author(s): Daya, Michelle; Rafaels, Nicholas; Brunetti, Tonya M; Chavan, Sameer; Levin, Albert M; Shetty, Aniket; Gignoux, Christopher R; Boorgula, Meher Preethi; Wojcik, Genevieve; Campbell, Monica; Vergara, Candelaria; Torgerson, Dara G; Ortega, Victor E; Doumatey, Ayo; Johnston, Henry Richard; Acevedo, Nathalie; Araujo, Maria Ilma; Avila, Pedro C; Belbin, Gillian; Bleecker, Eugene; Bustamante, Carlos; Caraballo, Luis; Cruz, Alvaro; Dunston, Georgia M; Eng, Celeste; Faruque, Mezbah U; Ferguson, Trevor S; Figueiredo, Camila; Ford, Jean G; Gan, Weiniu; Gourraud, Pierre-Antoine; Hansel, Nadia N; Hernandez, Ryan D; Herrera-Paz, Edwin Francisco; Jimenez, Silvia; Kenny, Eimear E; Knight-Madden, Jennifer; Kumar, Rajesh; Lange, Leslie A; Lange, Ethan M; Lizee, Antoine; Maul, Pissamai; Maul, Trevor; Mayorga, Alvaro; Meyers, Deborah; Nicolae, Dan L; O'Connor, Timothy D; Oliveira, Ricardo Riccio; Olopade, Christopher O; Olopade, Olufunmilayo; Qin, Zhaohui S; Rotimi, Charles; Vince, Nicolas; Watson, Harold; Wilks, Rainford J; Wilson, James G; Salzberg, Steven; Ober, Carole; Burchard, Esteban G; Williams, L Keoki; Beaty, Terri H; Taub, Margaret A; Ruczinski, Ingo; Mathias, Rasika A; Barnes, Kathleen C; CAAPA | Abstract: An amendment to this paper has been published and can be accessed via a link at the top of the paper.

Self-monitoring of blood glucose (SMBG) is recommended as an integral part of diabetes management. This study aimed to estimate the frequency of SMBG among patients attending a specialist diabetes clinic in Jamaica and to evaluate whether SMBG was associated with better glycaemic control. This cross-sectional study analyzed data from 188 patients, randomly selected from the University Hospital of the West Indies (UHWI) Diabetes Clinic. Self-reported data on blood glucose testing was obtained by a structured interviewer-administered questionnaire. Haemoglobin A1c (HbA1c) was measured from a capillary blood sample. Linear and logistic regression analyses were used to determine the relationship between SMBG and glycaemic control. Among 188 participants (145 females, 43 males, mean age 56 ± 15 years), 60 % (95%CI 52–67 %) performed SMBG. Thirty-one percent of participants monitored their blood glucose at least once daily. Participants less than 40 years old, persons with post-secondary education and those taking insulin were more likely to perform SMBG. Multivariable linear regression showed that performing SMBG was associated with a lower HbA1c after adjusting for age, sex and insulin use (β = −0.102), p = 0.004). In multivariable logistic regression models adjusted for the same variables, SMBG was also associated with lower odds of having poor glycemic control [HbA1c >9 %], OR 0.20, p

Objectives: To determine the relationships between body mass index (BMI) and diet, social and behavioural factors among adult Jamaicans of African origin. Design: Cross-sectional. Setting: Urban communities in Jamaica, West Indies. Subjects: Three-hundred and sixty-three males and 561 females of African origin, aged 25–74 y. Results: Women had higher mean BMIs (27.5±6.4 kg/m2) than men (23.4±4.3 kg/m2); 30.7% of women compared with 6.7% of men were obese. There was a tendency for obese men to have higher percentage of intakes from fat and less from carbohydrate, and women reported diets in which the percentage contribution of protein increased significantly with increasing BMI. In multivariate analyses, BMI was not explained by energy but was associated with protein intakes in females only. Predictors of relative weight were inversely related. Social (marital status) and behavioural (cigarette smoking) factors predicted BMI in both genders; older age in men and increased fibre intakes in women were associated with lower BMI. Conclusions: Social and behavioural factors are important determinants of body weight. Further investigations are needed which consider factors such as physical activity, genetic and other environmental variables as predictors of relative weight.

Aim: To investigate the relationship between anthropometry at birth and glucose/insulin metabolism in childhood using the response to an oral glucose challenge. Method: Four hundred mother/child pairs on whom gestational and birth data were available were studied. After an overnight fast, anthropometric measurements were made on the children and an oral glucose tolerance test performed. The plasma concentrations of insulin, pro-insulin and 32–33 split pro-insulin were also measured. Skinfold thicknesses were used to calculate percentage body fat and fat mass was derived from the percentage fat and absolute weight. Results: The mean age of the children was 8 y (range 7.5–10.5), and six exhibited impaired glucose tolerance based on WHO criteria. Insulin concentration 120 min after the oral glucose load (a measure of insulin resistance) was inversely related to length at birth (P

Background Health surveys provide important information on the burden and secular trends of risk factors and disease. Several factors including survey and item non-response can affect data quality. There are few reports on efficiency, validity and the impact of item non-response, from developing countries. This report examines factors associated with item non-response and study efficiency in a national health survey in a developing Caribbean island. Methods A national sample of participants aged 15–74 years was selected in a multi-stage sampling design accounting for 4 health regions and 14 parishes using enumeration districts as primary sampling units. Means and proportions of the variables of interest were compared between various categories. Non-response was defined as failure to provide an analyzable response. Linear and logistic regression models accounting for sample design and post-stratification weighting were used to identify independent correlates of recruitment efficiency and item non-response. Results We recruited 2012 15–74 year-olds (66.2% females) at a response rate of 87.6% with significant variation between regions (80.9% to 97.6%; p < 0.0001). Females outnumbered males in all parishes. The majority of subjects were recruited in a single visit, 39.1% required multiple visits varying significantly by region (27.0% to 49.8% [p < 0.0001]). Average interview time was 44.3 minutes with no variation between health regions, urban-rural residence, educational level, gender and SES; but increased significantly with older age category from 42.9 minutes in the youngest to 46.0 minutes in the oldest age category. Between 15.8% and 26.8% of persons did not provide responses for the number of sexual partners in the last year. Women and urban residents provided less data than their counterparts. Highest item non-response related to income at 30% with no gender difference but independently related to educational level, employment status, age group and health region. Characteristics of non-responders vary with types of questions. Conclusion Informative health surveys are possible in developing countries. While survey response rates may be satisfactory, item non-response was high in respect of income and sexual practice. In contrast to developed countries, non-response to questions on income is higher and has different correlates. These findings can inform future surveys.

Objective: In this study we examined the effects of birth weight (BWT) and early life socioeconomic circumstances (SEC) on systolic and diastolic blood pressure (SBP, DBP) among Jamaican young adults. Study Design and Setting: Longitudinal study of 364 men and 430 women from the Jamaica 1986 Birth Cohort Study. Information on maternal SEC at birth and BWT were linked to information collected at 18-20 years old. Sex-specific multilevel linear regression models were used to examine whether adult SBP and DBP were associated with BWT and maternal SEC. Results: In unadjusted models, SBP was inversely related to BWT z-score in both men and women (beta = -0.82 and -1.18, respectively) but achieved statistical significance for women only. After adjustments for current age, current BMI, current height, maternal age and mother's occupation at child's birth, a one standard deviation (SD) unit increase in BWT was associated with 1.16 mmHg reduction in SBP among men (95%CI -2.15, -0.17; p=0.021) and a 1.34 mmHg reduction in SBP among women (95%CI -2.21, -0.47; p=0.003). High maternal occupational SEC at birth was consistently associated with lowest SBP across the standardized BWT distribution. SBP was 2-4 mmHg lower among those with high SEC mothers at birth than among those whose mothers were unemployed at birth. Conclusion: SBP at 18-20 years-old was lowest among those whose mothers had high SEC at birth and was inversely related to BWT.