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6. Promotion of Cardiovascular Health in Africa: The Alliance for Medical Research in Africa (AMedRA) Expert Panel

Author

KA, Mame Madjiguene, Gaye, Ngone Diaba, Ahadzi, Dzifa, Baker-Smith, Carissa M., Ndao, Serigne Cheikh Tidiane, Wambugu, Vivien, Singh, Gurbinder, Gueye, Khadidiatou, Seck, Daouda, Dia, Khadidiatou, Allen, Norrina Bai, Ba, Awa, Mboup, Waly Niang, Yassine, Rabab, Guissé, Pape Momar, Anne, Malick, Aw, Fatou, Bèye, Serigne Mor, Diouf, Marguerite Tening, Diaw, Mor, Belkhadir, Jamal, Wone, Issa, Kohen, Jamal Eddine, Mbaye, Maïmouna Ndour, Ngaide, Aliou Alassane, Liyong, Elisabeth Alice, Sougou, Ndeye Marième, Lalika, Mathias, Ale, Boni Maxime, Jaiteh, Lamin, Mekonnen, Demeke, Bukachi, Fred, Lorenz, Thiess, Ntabadde, Kauthrah, Mampuya, Warner, Houinato, Dismand, Kitara, David Lagoro, Kane, Abdoul, Seck, Sidy Mouhamed, Fall, Ibrahima Socé, Tshilolo, Léon, Samb, Abdoulaye, Owolabi, Mayowa, Diouf, Massamba, Lamptey, Roberta, Kengne, André Pascal, Maffia, Pasquale, Clifford, Gari D., Sattler, Elisabeth Lilian Pia, Mboup, Mouhamed Chérif, Jobe, Modou, and Gaye, Bamba

Published
2024
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10. Diabetes risk and provision of diabetes prevention activities in 44 low-income and middle-income countries: a cross-sectional analysis of nationally representative, individual-level survey data

Author

Rahim, Nicholas Errol, Flood, David, Marcus, Maja E, Theilmann, Michaela, Aung, Taing N, Agoudavi, Kokou, Aryal, Krishna Kumar, Bahendeka, Silver, Bicaba, Brice, Bovet, Pascal, Diallo, Alpha Oumar, Farzadfar, Farshad, Guwatudde, David, Houehanou, Corine, Houinato, Dismand, Hwalla, Nahla, Jorgensen, Jutta, Kagaruki, Gibson Bernard, Mayige, Mary, Wong-McClure, Roy, Larijani, Bagher, Saeedi Moghaddam, Sahar, Mwalim, Omar, Mwangi, Kibachio Joseph, Sarkar, Sudipa, Sibai, Abla M, Sturua, Lela, Wesseh, Chea, Geldsetzer, Pascal, Atun, Rifat, Vollmer, Sebastian, Bärnighausen, Till, Davies, Justine, Ali, Mohammed K, Seiglie, Jacqueline A, and Manne-Goehler, Jennifer

Published
2023
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11. Diagnostic testing for hypertension, diabetes, and hypercholesterolaemia in low-income and middle-income countries: a cross-sectional study of data for 994 185 individuals from 57 nationally representative surveys

Author

Ochmann, Sophie, von Polenz, Isabelle, Marcus, Maja-Emilia, Theilmann, Michaela, Flood, David, Agoudavi, Kokou, Aryal, Krishna Kumar, Bahendeka, Silver, Bicaba, Brice, Bovet, Pascal, Campos Caldeira Brant, Luisa, Carvalho Malta, Deborah, Damasceno, Albertino, Farzadfar, Farshad, Gathecha, Gladwell, Ghanbari, Ali, Gurung, Mongal, Guwatudde, David, Houehanou, Corine, Houinato, Dismand, Hwalla, Nahla, Jorgensen, Jutta Adelin, Karki, Khem B, Lunet, Nuno, Martins, Joao, Mayige, Mary, Moghaddam, Sahar Saeedi, Mwalim, Omar, Mwangi, Kibachio Joseph, Norov, Bolormaa, Quesnel-Crooks, Sarah, Rezaei, Negar, Sibai, Abla M, Sturua, Lela, Tsabedze, Lindiwe, Wong-McClure, Roy, Davies, Justine, Geldsetzer, Pascal, Bärnighausen, Till, Atun, Rifat, Manne-Goehler, Jennifer, and Vollmer, Sebastian

Published
2023
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12. Improving health outcomes of people with diabetes: target setting for the WHO Global Diabetes Compact

Author

Agoudavi, Kokou, Aryal, Krishna K., Atun, Rifat, Bahendeka, Silver, Bicaba, Brice Wilfried, Bovet, Pascal, Brian, Garry, Damasceno, Albertino, Davies, Justine I., Dorobantu, Maria, Farzadfar, Farshad, Flood, David, Geldsetzer, Pascal, Gurung, Mongal Singh, Guwatudde, David, Houehanou, Corine, Houinato, Dismand, Hwalla, Nahla, Jaacks, Lindsay, Karki, Bahadur Khem, Labadarios, Demetre, Lunet, Nuno, Manne-Goehler, Jennifer, Marcus, Maja E., Martins, Joao, Mayige, Theodory Mary, Norov, Bolormaa, Saeedi Moghaddam, Sahar, Quesnel-Crooks, Sarah, Sibai, Abla M., Sturua, Lela, Theilmann, Michaela, Tsabedze, Lindiwe, Vollmer, Sebastian, Zhumadilov, Zhaxybay, Gregg, Edward W, Buckley, James, Ali, Mohammed K, Davies, Justine, Mehta, Roopa, Griffiths, Ben, Lim, Lee-Ling, Pearson-Stuttard, Jonathan, Tandon, Nikhil, Roglic, Gojka, Slama, Slim, and Shaw, Jonathan E

Published
2023
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16. Dynamics of submicroscopic and microscopic asymptomatic malaria infection and associated factors: A longitudinal study in South Benin.

Author

Telfils, Rodeline, Dossou, Akpéyédjé Yannelle, Djènontin, Armel, Adimi, Elisée, Akoho, Romuald, Bailly, Justine, Bouraïma, Aziz, Matondo, Déborah, Sissinto-Savi de Tove, Yolande, Houinato, Dismand, Massougbodji, Achille, Dechavanne, Célia, and Cottrell, Gilles

Subjects
MARKOV processes, MALARIA prevention, REGRESSION analysis, LONGITUDINAL method, INFECTION
Abstract

Introduction: Asymptomatic malaria infection is now recognized as a potential threat to malaria control. However, its prevalence and its dynamics are poorly documented especially in a perennial context of high seasonal transmission. A longitudinal study was conducted in southern Benin to investigate the dynamics of asymptomatic malaria infection and to identify factors influencing it. Methods: A cohort of 377 participants was recruited, stratified into three age groups (under 5 years, between 5 and 15 years, over 15 years). After inclusion, two visits were made one-month apart between August and November 2021. Malaria infection was diagnosed by microscopy and PCR and questionnaires were administered to the participants. The dynamics of malaria infection, both submicroscopic (positive PCR / negative blood smear) and microscopic (positive blood smear), and related factors were determined using a mixed ordinal polytomous regression model and a multistate Markov model. Results: The human infectious reservoir consisted primarily of asymptomatic submicroscopic infections (289/512 (56.4%)), followed by asymptomatic microscopic infections (182/512 (35.5%)) and symptomatic infections (41/512 (8%)). The prevalence of asymptomatic infection was highly related to age-group (5–15 years: OR: 4.12 [2.55–6.67] and > 15 years OR: 2.80 [1.73–4.54] compared to the under 5 years old group). The children under 15 years with asymptomatic infection had the highest risk of becoming symptomatic. The mean duration of asymptomatic infections in 5–15-year-olds was the longest (76.7 days (53.8–109.1)). Conclusion: This study revealed a persistent asymptomatic malaria reservoir over the follow-up period, with substantial variations between age-groups. These findings are important elements to consider for an optimal deployment of malaria control interventions. [ABSTRACT FROM AUTHOR]

Published
2024
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17. High prevalence of cardiovascular risk factors in pregnant women in Benin.

Author

Tchibozo, Eyram Maria Concheta, Houehanou Sonou, Yessito Corine, Ariyoh Amidou, Salmane, Hountondji, Fabrice, Zantou, Femi, Lacroix, Philippe, Houinato, Dismand Stephan, and Bezanahary, Holy

Subjects
CHILDBEARING age, CARDIOVASCULAR diseases risk factors, PREGNANT women, HYPERTENSION, GESTATIONAL age
Abstract

Introduction: Modifiable cardiovascular risk factors (CVRF) are highly prevalent in SubSaharan African communities. In these countries the burden of CVRF during early pregnancy has been poorly documented. Aim: The objective of this study was to describe the frequency of CVRF in pregnant women before the 20th week of gestation in Benin Methods: Consecutive pregnant women with a gestational age < 20th week were included in 30 maternity clinics in Benin. Univariate and multivariate analyses were used to determine characteristics associated with CVRF. Results: 1244 pregnant women were included (680 (54.7%) in urban areas and 584 (45.3%) in rural areas). The median age was 26 years. The frequencies of high blood pressure (HBP), obesity and diabetes were 18.9%, 15.0% and 3.1% respectively. Very few women (25.3%) were aware of the HBP disorder. HBP was associated with an age ≥ 35 years (OR = 1.7, 95%CI:1.1–2.7), a rural setting (OR = 2.6; 95%CI:1.9–3.5), an insufficient consumption of fruits and vegetables (OR = 3.2; 95%CI:2.0–5.3) and a history of at least 2 fetal losses (OR = 1.9; 95% CI [1.4–2.7]). The risk of being overweight was associated with an age >24 years old (OR = 1.6; 95%CI:1.1–2.2) conversely a rural setting was protective (OR = 0.7; 95%CI:0.5–0.9). Obesity was associated with an age > 35 years old (OR = 4.1; 95%CI:2.5–6.8) and a rural setting (OR = 0.3; 95%CI: 0.2–0.5). Conclusion: The frequency of CVRF in women before 20th week of gestation was high. Most of the women were unaware of the disorder. Thus the screening of CVRF among women of reproductive age might be relevant. [ABSTRACT FROM AUTHOR]

Published
2024
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20. Body-mass index and diabetes risk in 57 low-income and middle-income countries: a cross-sectional study of nationally representative, individual-level data in 685 616 adults

Author

Teufel, Felix, Seiglie, Jacqueline A, Geldsetzer, Pascal, Theilmann, Michaela, Marcus, Maja E, Ebert, Cara, Arboleda, William Andres Lopez, Agoudavi, Kokou, Andall-Brereton, Glennis, Aryal, Krishna K, Bicaba, Brice Wilfried, Brian, Garry, Bovet, Pascal, Dorobantu, Maria, Gurung, Mongal Singh, Guwatudde, David, Houehanou, Corine, Houinato, Dismand, Jorgensen, Jutta M Adelin, Kagaruki, Gibson B, Karki, Khem B, Labadarios, Demetre, Martins, Joao S, Mayige, Mary T, McClure, Roy Wong, Mwangi, Joseph Kibachio, Mwalim, Omar, Norov, Bolormaa, Crooks, Sarah, Farzadfar, Farshad, Moghaddam, Sahar Saeedi, Silver, Bahendeka K, Sturua, Lela, Wesseh, Chea Stanford, Stokes, Andrew C, Essien, Utibe R, De Neve, Jan-Walter, Atun, Rifat, Davies, Justine I, Vollmer, Sebastian, Bärnighausen, Till W, Ali, Mohammed K, Meigs, James B, Wexler, Deborah J, and Manne-Goehler, Jennifer

Published
2021
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23. Multiple cardiovascular risk factor care in 55 low- and middle-income countries: A cross-sectional analysis of nationally-representative, individual-level data from 280,783 adults

Author

Diallo, Alpha Oumar, primary, Marcus, Maja E., additional, Flood, David, additional, Theilmann, Michaela, additional, Rahim, Nicholas E., additional, Kinlaw, Alan, additional, Franceschini, Nora, additional, Stürmer, Til, additional, Tien, Dessie V., additional, Abbasi-Kangevari, Mohsen, additional, Agoudavi, Kokou, additional, Andall-Brereton, Glennis, additional, Aryal, Krishna, additional, Bahendeka, Silver, additional, Bicaba, Brice, additional, Bovet, Pascal, additional, Dorobantu, Maria, additional, Farzadfar, Farshad, additional, Ghamari, Seyyed-Hadi, additional, Gathecha, Gladwell, additional, Guwatudde, David, additional, Gurung, Mongal, additional, Houehanou, Corine, additional, Houinato, Dismand, additional, Hwalla, Nahla, additional, Jorgensen, Jutta, additional, Kagaruki, Gibson, additional, Karki, Khem, additional, Martins, Joao, additional, Mayige, Mary, additional, McClure, Roy Wong, additional, Moghaddam, Sahar Saeedi, additional, Mwalim, Omar, additional, Mwangi, Kibachio Joseph, additional, Norov, Bolormaa, additional, Quesnel-Crooks, Sarah, additional, Sibai, Abla, additional, Sturua, Lela, additional, Tsabedze, Lindiwe, additional, Wesseh, Chea, additional, Geldsetzer, Pascal, additional, Atun, Rifat, additional, Vollmer, Sebastian, additional, Bärnighausen, Till, additional, Davies, Justine, additional, Ali, Mohammed K., additional, Seiglie, Jacqueline A., additional, Gower, Emily W., additional, and Manne-Goehler, Jennifer, additional

Published
2024
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24. Work environment and hypertension in industrial settings in Benin in 2019: a cross-sectional study

Author

Adjobimey, Menonli, primary, Houehanou, Corine Yessito, additional, Cisse, Ibrahim Mama, additional, Mikponhoue, Rose, additional, Hountohotegbe, Esdras, additional, Tchibozo, Concheta, additional, Adjogou, Amelée, additional, Dossougbété, Véronique, additional, Gounongbe, Fabien, additional, Ayelo, Paul Ahoumenou, additional, Hinson, Vikkey, additional, and Houinato, Dismand Stephan, additional

Published
2024
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25. The prevalence and demographic associations of headache in the adult population of Benin:a cross-sectional population-based study

Author

Adoukonou, Thierry, Agbetou, Mendinatou, Dettin, Eric, Kossi, Oyene, Husøy, Andreas, Thomas, Hallie, Houinato, Dismand, Steiner, Timothy J., Adoukonou, Thierry, Agbetou, Mendinatou, Dettin, Eric, Kossi, Oyene, Husøy, Andreas, Thomas, Hallie, Houinato, Dismand, and Steiner, Timothy J.

Abstract

Background: The Global Burden of Disease (GBD) study is increasingly well informed with regard to headache disorders, but sub-Saharan Africa (SSA) remains one of the large regions of the world with limited data directly derived from population-based studies. The Global Campaign against Headache has conducted three studies in this region: Ethiopia in the east, Zambia in the south and Cameroon in Central SSA. Here we report a similar study in Benin, the first from West SSA. Methods: We used the same methods and questionnaire, applying cluster-randomized sampling in three regions of the country, randomly selecting households in each region, visiting these unannounced and randomly selecting one adult member (aged 18–65 years) of each household. The HARDSHIP structured questionnaire, translated into Central African French, was administered face-to-face by trained interviewers. Demographic enquiry was followed by diagnostic questions based on ICHD-3 criteria. Results: From 2,550 households with eligible members, we recruited 2,400 participants (participating proportion 94.1%). Headache ever was reported by almost all (95.2%), this being the lifetime prevalence. Headache in the last year was reported by 74.9%. Age-, gender- and habitation-adjusted estimates of 1-year prevalence were 72.9% for all headache, 21.2% for migraine (including definite and probable), 43.1% for TTH (also including definite and probable), 4.5% for probable medication-overuse (pMOH) and 3.1% for other headache on ≥ 15 days/month. One-day (point) prevalence of headache was 14.8% according to reported headache on the day preceding interview. Conclusions: Overall, these findings are evidence that headache disorders are very common in Benin, a low-income country. The prevalence of pMOH, well above the estimated global mean of 1–2%, is evidence that poverty is not a bar to medication overuse. The findings are very much the same as those in a similar study in its near neighbour, Cameroon. With regard to

Published
2024

28. The state of hypertension care in 44 low-income and middle-income countries: a cross-sectional study of nationally representative individual-level data from 1·1 million adults

Author

Geldsetzer, Pascal, Manne-Goehler, Jennifer, Marcus, Maja-Emilia, Ebert, Cara, Zhumadilov, Zhaxybay, Wesseh, Chea S, Tsabedze, Lindiwe, Supiyev, Adil, Sturua, Lela, Bahendeka, Silver K, Sibai, Abla M, Quesnel-Crooks, Sarah, Norov, Bolormaa, Mwangi, Kibachio J, Mwalim, Omar, Wong-McClure, Roy, Mayige, Mary T, Martins, Joao S, Lunet, Nuno, Labadarios, Demetre, Karki, Khem B, Kagaruki, Gibson B, Jorgensen, Jutta M A, Hwalla, Nahla C, Houinato, Dismand, Houehanou, Corine, Msaidié, Mohamed, Guwatudde, David, Gurung, Mongal S, Gathecha, Gladwell, Dorobantu, Maria, Damasceno, Albertino, Bovet, Pascal, Bicaba, Brice W, Aryal, Krishna K, Andall-Brereton, Glennis, Agoudavi, Kokou, Stokes, Andrew, Davies, Justine I, Bärnighausen, Till, Atun, Rifat, Vollmer, Sebastian, and Jaacks, Lindsay M

Published
2019
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29. Consumption of Fruits and Vegetables Among Individuals 15 Years and Older in 28 Low- and Middle-Income Countries

Author

Frank, Sarah M, Webster, Jacqui, McKenzie, Briar, Geldsetzer, Pascal, Manne-Goehler, Jennifer, Andall-Brereton, Glennis, Houehanou, Corine, Houinato, Dismand, Gurung, Mongal Singh, Bicaba, Brice Wilfried, McClure, Roy Wong, Supiyev, Adil, Zhumadilov, Zhaxybay, Stokes, Andrew, Labadarios, Demetre, Sibai, Abla Mehio, Norov, Bolormaa, Aryal, Krishna K, Karki, Khem Bahadur, Kagaruki, Gibson B, Mayige, Mary T, Martins, Joao S, Atun, Rifat, Bärnighausen, Till, Vollmer, Sebastian, and Jaacks, Lindsay M

Published
2019
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35. Association between urban–rural location and prevalence of type 2 diabetes and impaired fasting glucose in West Africa: a cross–sectional population–based epidemiological study

Author

Issaka, Ayuba, primary, Stevenson, Christopher, additional, Paradies, Yin, additional, Houehanou, Yessito Corine N, additional, Bosu, William K, additional, Kiwallo, Jean Baptiste, additional, Wesseh, Chea Sanford, additional, Houinato, Dismand Stephan, additional, Nazoum, Diarra J P, additional, and Cameron, Adrian J, additional

Published
2023
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36. Prognostic factors and overall survival of breast cancer in Benin: a hospital-based study

Author

GNANGNON, Freddy Houéhanou Rodrigue, primary, PARENTE, Alexis, additional, ABOUBAKAR, Moufalilou, additional, KIKI-MIGAN, Yannick, additional, TOTAH, Terence, additional, GBESSI, Dansou Gaspard, additional, BAGNAN, Josiane Angéline TONATO, additional, LALEYE, Anatole Adébowalé, additional, PREUX, Pierre-Marie, additional, DENAKPO, Justin Lewis, additional, BLANQUET, Véronique, additional, and HOUINATO, Dismand Stephan, additional

Published
2023
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39. Incidence de l'epilepsie après un accident vasculaire cerebral à Parakou en 2014

Author

Adoukonou Thierry, Accrombessi Donald, Agbétou Mendinatou, and Houinato Dismand

Subjects
incidence, épilepsie, accident vasculaire cérébrale, Medicine
Abstract

INTRODUCTION: les accidents vasculaires cérébraux (AVC) constituent une des principales causes acquises de l'épilepsie de l'adulte mais peu de données sont disponibles sur l'incidence de l'épilepsie après un AVC en Afrique. L'objectif de cette étude était d'estimer l'incidence de l'épilepsie chez les patients victimes d'AVC à Parakou. METHODES: il s'est agi d'une étude de type cohorte dynamique ayant inclus 203 patients victimes d'AVC et hospitalisés dans le service de neurologie du CHU de Parakou. Les patients aux antécédents d'épilepsie étaient exclus du suivi. Les patients étaient suivis sur une période de 21mois allant du 1er Janvier 2013 au 30 Septembre 2014. L'épilepsie était définie selon les critères de la Ligue Internationale contre l'Epilepsie. RESULTATS: ils étaient âgés de 18 à 99 ans avec une moyenne de 58,4 ans , 14,2 ans. Le délai moyen de consultation après l'installation des symptômes était de 54,3h (+/-112,9h). Les AVC ischémiques représentaient 45,8%, les hémorragiques 31% et 23,2% d'indéterminés. L'incidence cumulée de l'épilepsie était de 17. La densité d'incidence de l'épilepsie était de 9,8 pour 100 personnes-années. Les facteurs associés à la survenue de l'épilepsie étaient le niveau d'instruction, la durée d'hospitalisation et le score de BARTHEL. CONCLUSION: l'incidence de l'épilepsie reste très élevée et la prise en compte des facteurs associés dans les stratégies de prise en charge pourrait permettre de réduire sa charge globale.

Published
2019
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40. Diabetes diagnosis and care in sub-Saharan Africa: pooled analysis of individual data from 12 countries

Author

Manne-Goehler, Jennifer, Atun, Rifat, Stokes, Andrew, Goehler, Alexander, Houinato, Dismand, Houehanou, Corine, Hambou, Mohamed Msaidie Salimani, Mbenza, Benjamin Longo, Sobngwi, Eugène, Balde, Naby, Mwangi, Joseph Kibachio, Gathecha, Gladwell, Ngugi, Paul Waweru, Wesseh, C Stanford, Damasceno, Albertino, Lunet, Nuno, Bovet, Pascal, Labadarios, Demetre, Zuma, Khangelani, Mayige, Mary, Kagaruki, Gibson, Ramaiya, Kaushik, Agoudavi, Kokou, Guwatudde, David, Bahendeka, Silver K, Mutungi, Gerald, Geldsetzer, Pascal, Levitt, Naomi S, Salomon, Joshua A, Yudkin, John S, Vollmer, Sebastian, and Bärnighausen, Till

Published
2016
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43. Diabetes risk and provision of diabetes prevention activities in 44 low-income and middle-income countries:a cross-sectional analysis of nationally representative, individual-level survey data

Author

Rahim, Nicholas Errol, Flood, David, Marcus, Maja E., Theilmann, Michaela, Aung, Taing N., Agoudavi, Kokou, Aryal, Krishna Kumar, Bahendeka, Silver, Bicaba, Brice, Bovet, Pascal, Diallo, Alpha Oumar, Farzadfar, Farshad, Guwatudde, David, Houehanou, Corine, Houinato, Dismand, Hwalla, Nahla, Jorgensen, Jutta, Kagaruki, Gibson Bernard, Mayige, Mary, Wong-McClure, Roy, Larijani, Bagher, Saeedi Moghaddam, Sahar, Mwalim, Omar, Mwangi, Kibachio Joseph, Sarkar, Sudipa, Sibai, Abla M., Sturua, Lela, Wesseh, Chea, Geldsetzer, Pascal, Atun, Rifat, Vollmer, Sebastian, Bärnighausen, Till, Davies, Justine, Ali, Mohammed K., Seiglie, Jacqueline A., Manne-Goehler, Jennifer, Rahim, Nicholas Errol, Flood, David, Marcus, Maja E., Theilmann, Michaela, Aung, Taing N., Agoudavi, Kokou, Aryal, Krishna Kumar, Bahendeka, Silver, Bicaba, Brice, Bovet, Pascal, Diallo, Alpha Oumar, Farzadfar, Farshad, Guwatudde, David, Houehanou, Corine, Houinato, Dismand, Hwalla, Nahla, Jorgensen, Jutta, Kagaruki, Gibson Bernard, Mayige, Mary, Wong-McClure, Roy, Larijani, Bagher, Saeedi Moghaddam, Sahar, Mwalim, Omar, Mwangi, Kibachio Joseph, Sarkar, Sudipa, Sibai, Abla M., Sturua, Lela, Wesseh, Chea, Geldsetzer, Pascal, Atun, Rifat, Vollmer, Sebastian, Bärnighausen, Till, Davies, Justine, Ali, Mohammed K., Seiglie, Jacqueline A., and Manne-Goehler, Jennifer

Abstract

Background: The global burden of diabetes is rising rapidly, yet there is little evidence on individual-level diabetes prevention activities undertaken by health systems in low-income and middle-income countries (LMICs). Here we describe the population at high risk of developing diabetes, estimate diabetes prevention activities, and explore sociodemographic variation in these activities across LMICs. Methods: We performed a pooled, cross-sectional analysis of individual-level data from nationally representative, population-based surveys conducted in 44 LMICs between October, 2009, and May, 2019. Our sample included all participants older than 25 years who did not have diabetes and were not pregnant. We defined the population at high risk of diabetes on the basis of either the presence of impaired fasting glucose (or prediabetes in countries with a haemoglobin A1c available) or overweight or obesity, consistent with the WHO Package of Essential Noncommunicable Disease Guidelines for type 2 diabetes management. We estimated the proportion of survey participants that were at high risk of developing diabetes based on this definition. We also estimated the proportion of the population at high risk that reported each of four fundamental diabetes prevention activities: physical activity counselling, weight loss counselling, dietary counselling, and blood glucose screening, overall and stratified by World Bank income group. Finally, we used multivariable Poisson regression models to evaluate associations between sociodemographic characteristics and these activities. Findings: The final pooled sample included 145 739 adults (86 269 [59·2%] of whom were female and 59 468 [40·4%] of whom were male) across 44 LMICs, of whom 59 308 (40·6% [95% CI 38·5–42·8]) were considered at high risk of diabetes (20·6% [19·8–21·5] in low-income countries, 38·0% [37·2–38·9] in lower-middle-income countries, and 57·5% [54·3–60·6] in upper-middle-income countries). Overall, the rea

Published
2023

44. Diagnostic testing for hypertension, diabetes, and hypercholesterolaemia in low-income and middle-income countries:a cross-sectional study of data for 994 185 individuals from 57 nationally representative surveys

Author

Ochmann, Sophie, von Polenz, Isabelle, Marcus, Maja Emilia, Theilmann, Michaela, Flood, David, Agoudavi, Kokou, Aryal, Krishna Kumar, Bahendeka, Silver, Bicaba, Brice, Bovet, Pascal, Campos Caldeira Brant, Luisa, Carvalho Malta, Deborah, Damasceno, Albertino, Farzadfar, Farshad, Gathecha, Gladwell, Ghanbari, Ali, Gurung, Mongal, Guwatudde, David, Houehanou, Corine, Houinato, Dismand, Hwalla, Nahla, Jorgensen, Jutta Adelin, Karki, Khem B., Lunet, Nuno, Martins, Joao, Mayige, Mary, Moghaddam, Sahar Saeedi, Mwalim, Omar, Mwangi, Kibachio Joseph, Norov, Bolormaa, Quesnel-Crooks, Sarah, Rezaei, Negar, Sibai, Abla M., Sturua, Lela, Tsabedze, Lindiwe, Wong-McClure, Roy, Davies, Justine, Geldsetzer, Pascal, Bärnighausen, Till, Atun, Rifat, Manne-Goehler, Jennifer, Vollmer, Sebastian, Ochmann, Sophie, von Polenz, Isabelle, Marcus, Maja Emilia, Theilmann, Michaela, Flood, David, Agoudavi, Kokou, Aryal, Krishna Kumar, Bahendeka, Silver, Bicaba, Brice, Bovet, Pascal, Campos Caldeira Brant, Luisa, Carvalho Malta, Deborah, Damasceno, Albertino, Farzadfar, Farshad, Gathecha, Gladwell, Ghanbari, Ali, Gurung, Mongal, Guwatudde, David, Houehanou, Corine, Houinato, Dismand, Hwalla, Nahla, Jorgensen, Jutta Adelin, Karki, Khem B., Lunet, Nuno, Martins, Joao, Mayige, Mary, Moghaddam, Sahar Saeedi, Mwalim, Omar, Mwangi, Kibachio Joseph, Norov, Bolormaa, Quesnel-Crooks, Sarah, Rezaei, Negar, Sibai, Abla M., Sturua, Lela, Tsabedze, Lindiwe, Wong-McClure, Roy, Davies, Justine, Geldsetzer, Pascal, Bärnighausen, Till, Atun, Rifat, Manne-Goehler, Jennifer, and Vollmer, Sebastian

Abstract

Background Testing for the risk factors of cardiovascular disease, which include hypertension, diabetes, and hypercholesterolaemia, is important for timely and effective risk management. Yet few studies have quantified and analysed testing of cardiovascular risk factors in low-income and middle-income countries (LMICs) with respect to sociodemographic inequalities. We aimed to address this knowledge gap. Methods In this cross-sectional analysis, we pooled individual-level data for non-pregnant adults aged 18 years or older from nationally representative surveys done between Jan 1, 2010, and Dec 31, 2019 in LMICs that included a question about whether respondents had ever had their blood pressure, glucose, or cholesterol measured. We analysed diagnostic testing performance by quantifying the overall proportion of people who had ever been tested for these cardiovascular risk factors and the proportion of individuals who met the diagnostic testing criteria in the WHO package of essential noncommunicable disease interventions for primary care (PEN) guidelines (ie, a BMI >30 kg/m 2 or a BMI >25 kg/m 2 among people aged 40 years or older). We disaggregated and compared diagnostic testing performance by sex, wealth quintile, and education using two-sided t tests and multivariable logistic regression models. Findings Our sample included data for 994 185 people from 57 surveys. 19·1% (95% CI 18·5–19·8) of the 943 259 people in the hypertension sample met the WHO PEN criteria for diagnostic testing, of whom 78·6% (77·8–79·2) were tested. 23·8% (23·4–24·3) of the 225 707 people in the diabetes sample met the WHO PEN criteria for diagnostic testing, of whom 44·9% (43·7–46·2) were tested. Finally, 27·4% (26·3–28·6) of the 250 573 people in the hypercholesterolaemia sample met the WHO PEN criteria for diagnostic testing, of whom 39·7% (37·1–2·4) were tested. Women were more likely than men to be tested for hypertension and diabetes, and people, BACKGROUND: Testing for the risk factors of cardiovascular disease, which include hypertension, diabetes, and hypercholesterolaemia, is important for timely and effective risk management. Yet few studies have quantified and analysed testing of cardiovascular risk factors in low-income and middle-income countries (LMICs) with respect to sociodemographic inequalities. We aimed to address this knowledge gap. METHODS: In this cross-sectional analysis, we pooled individual-level data for non-pregnant adults aged 18 years or older from nationally representative surveys done between Jan 1, 2010, and Dec 31, 2019 in LMICs that included a question about whether respondents had ever had their blood pressure, glucose, or cholesterol measured. We analysed diagnostic testing performance by quantifying the overall proportion of people who had ever been tested for these cardiovascular risk factors and the proportion of individuals who met the diagnostic testing criteria in the WHO package of essential noncommunicable disease interventions for primary care (PEN) guidelines (ie, a BMI >30 kg/m2 or a BMI >25 kg/m2 among people aged 40 years or older). We disaggregated and compared diagnostic testing performance by sex, wealth quintile, and education using two-sided t tests and multivariable logistic regression models. FINDINGS: Our sample included data for 994 185 people from 57 surveys. 19·1% (95% CI 18·5-19·8) of the 943 259 people in the hypertension sample met the WHO PEN criteria for diagnostic testing, of whom 78·6% (77·8-79·2) were tested. 23·8% (23·4-24·3) of the 225 707 people in the diabetes sample met the WHO PEN criteria for diagnostic testing, of whom 44·9% (43·7-46·2) were tested. Finally, 27·4% (26·3-28·6) of the 250 573 people in the hypercholesterolaemia sample met the WHO PEN criteria for diagnostic testing, of whom 39·7% (37·1-2·4) were tested. Women were more likely than men to be tested for hypertension and diabetes, and people in higher wealth quintiles

Published
2023

45. Improving health outcomes of people with diabetes: target setting for the WHO Global Diabetes Compact

Author

Gregg, Edward W, primary, Buckley, James, additional, Ali, Mohammed K, additional, Davies, Justine, additional, Flood, David, additional, Mehta, Roopa, additional, Griffiths, Ben, additional, Lim, Lee-Ling, additional, Manne-Goehler, Jennifer, additional, Pearson-Stuttard, Jonathan, additional, Tandon, Nikhil, additional, Roglic, Gojka, additional, Slama, Slim, additional, Shaw, Jonathan E, additional, Agoudavi, Kokou, additional, Aryal, Krishna K., additional, Atun, Rifat, additional, Bahendeka, Silver, additional, Bicaba, Brice Wilfried, additional, Bovet, Pascal, additional, Brian, Garry, additional, Damasceno, Albertino, additional, Davies, Justine I., additional, Dorobantu, Maria, additional, Farzadfar, Farshad, additional, Geldsetzer, Pascal, additional, Gurung, Mongal Singh, additional, Guwatudde, David, additional, Houehanou, Corine, additional, Houinato, Dismand, additional, Hwalla, Nahla, additional, Jaacks, Lindsay, additional, Karki, Bahadur Khem, additional, Labadarios, Demetre, additional, Lunet, Nuno, additional, Marcus, Maja E., additional, Martins, Joao, additional, Mayige, Theodory Mary, additional, Norov, Bolormaa, additional, Saeedi Moghaddam, Sahar, additional, Quesnel-Crooks, Sarah, additional, Sibai, Abla M., additional, Sturua, Lela, additional, Theilmann, Michaela, additional, Tsabedze, Lindiwe, additional, Vollmer, Sebastian, additional, and Zhumadilov, Zhaxybay, additional

Published
2023
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47. Association between country preparedness indicators and quality clinical care for cardiovascular disease risk factors in 44 lower- and middle-income countries: A multicountry analysis of survey data

Author

Davies, Justine I., Reddiar, Sumithra Krishnamurthy, Hirschhorn, Lisa R., Ebert, Cara, Marcus, Maja-Emilia, Seiglie, Jacqueline A., Zhumadilov, Zhaxybay, Supiyev, Adil, Sturua, Lela, Silver, Bahendeka K., Sibai, Abla M., Quesnel-Crooks, Sarah, Norov, Bolormaa, Mwangi, Joseph K., Omar, Omar Mwalim, Wong-McClure, Roy, Mayige, Mary T., Martins, Joao S., Lunet, Nuno, Labadarios, Demetre, Karki, Khem B., Kagaruki, Gibson B., Jorgensen, Jutta M. A., Hwalla, Nahla C., Houinato, Dismand, Houehanou, Corine, Guwatudde, David, Gurung, Mongal S., Bovet, Pascal, Bicaba, Brice W., Aryal, Krishna K., Msaidié, Mohamed, Andall-Brereton, Glennis, Brian, Garry, Stokes, Andrew, Vollmer, Sebastian, Bärnighausen, Till, Atun, Rifat, Geldsetzer, Pascal, Manne-Goehler, Jennifer, and Jaacks, Lindsay M.

Subjects
Developing countries -- Health aspects, Cardiovascular diseases -- Risk factors -- Care and treatment, Biological sciences
Abstract

Background Cardiovascular diseases are leading causes of death, globally, and health systems that deliver quality clinical care are needed to manage an increasing number of people with risk factors for these diseases. Indicators of preparedness of countries to manage cardiovascular disease risk factors (CVDRFs) are regularly collected by ministries of health and global health agencies. We aimed to assess whether these indicators are associated with patient receipt of quality clinical care. Methods and findings We did a secondary analysis of cross-sectional, nationally representative, individual-patient data from 187,552 people with hypertension (mean age 48.1 years, 53.5% female) living in 43 low- and middle-income countries (LMICs) and 40,795 people with diabetes (mean age 52.2 years, 57.7% female) living in 28 LMICs on progress through cascades of care (condition diagnosed, treated, or controlled) for diabetes or hypertension, to indicate outcomes of provision of quality clinical care. Data were extracted from national-level World Health Organization (WHO) Stepwise Approach to Surveillance (STEPS), or other similar household surveys, conducted between July 2005 and November 2016. We used mixed-effects logistic regression to estimate associations between each quality clinical care outcome and indicators of country development (gross domestic product [GDP] per capita or Human Development Index [HDI]); national capacity for the prevention and control of noncommunicable diseases ('NCD readiness indicators' from surveys done by WHO); health system finance (domestic government expenditure on health [as percentage of GDP], private, and out-of-pocket expenditure on health [both as percentage of current]); and health service readiness (number of physicians, nurses, or hospital beds per 1,000 people) and performance (neonatal mortality rate). All models were adjusted for individual-level predictors including age, sex, and education. In an exploratory analysis, we tested whether national-level data on facility preparedness for diabetes were positively associated with outcomes. Associations were inconsistent between indicators and quality clinical care outcomes. For hypertension, GDP and HDI were both positively associated with each outcome. Of the 33 relationships tested between NCD readiness indicators and outcomes, only two showed a significant positive association: presence of guidelines with being diagnosed (odds ratio [OR], 1.86 [95% CI 1.08-3.21], p = 0.03) and availability of funding with being controlled (OR, 2.26 [95% CI 1.09-4.69], p = 0.03). Hospital beds (OR, 1.14 [95% CI 1.02-1.27], p = 0.02), nurses/midwives (OR, 1.24 [95% CI 1.06-1.44], p = 0.006), and physicians (OR, 1.21 [95% CI 1.11-1.32], p < 0.001) per 1,000 people were positively associated with being diagnosed and, similarly, with being treated; and the number of physicians was additionally associated with being controlled (OR, 1.12 [95% CI 1.01-1.23], p = 0.03). For diabetes, no positive associations were seen between NCD readiness indicators and outcomes. There was no association between country development, health service finance, or health service performance and readiness indicators and any outcome, apart from GDP (OR, 1.70 [95% CI 1.12-2.59], p = 0.01), HDI (OR, 1.21 [95% CI 1.01-1.44], p = 0.04), and number of physicians per 1,000 people (OR, 1.28 [95% CI 1.09-1.51], p = 0.003), which were associated with being diagnosed. Six countries had data on cascades of care and nationwide-level data on facility preparedness. Of the 27 associations tested between facility preparedness indicators and outcomes, the only association that was significant was having metformin available, which was positively associated with treatment (OR, 1.35 [95% CI 1.01-1.81], p = 0.04). The main limitation was use of blood pressure measurement on a single occasion to diagnose hypertension and a single blood glucose measurement to diagnose diabetes. Conclusion In this study, we observed that indicators of country preparedness to deal with CVDRFs are poor proxies for quality clinical care received by patients for hypertension and diabetes. The major implication is that assessments of countries' preparedness to manage CVDRFs should not rely on proxies; rather, it should involve direct assessment of quality clinical care., Author(s): Justine I. Davies 1,2,3,4,*, Sumithra Krishnamurthy Reddiar 5, Lisa R. Hirschhorn 6, Cara Ebert 7, Maja-Emilia Marcus 8, Jacqueline A. Seiglie 9, Zhaxybay Zhumadilov 10, Adil Supiyev 11, Lela [...]

Published
2020
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49. List of Contributors

Author

Adoukonou, Thierry, primary, Ajzenberg, Daniel, additional, Barnett, Craig, additional, Boumediene, Farid, additional, Carod-Artal, Francisco J., additional, Clément, Jean-Pierre, additional, Couratier, Philippe, additional, Denis, François, additional, Desport, Jean-Claude, additional, Dessein, Alain, additional, Dessein, Hélia, additional, Diagana, Mouhamadou, additional, Dubreuil, Catherine-Marie, additional, Dumas, Michel, additional, Faucher, Jean-François, additional, Fayemendy, Philippe, additional, Fleury, Agnès, additional, Garcia, Hector H., additional, Guerchet, Maëlenn, additional, Hackembruch, Heber J., additional, Handschumacher, Pascal, additional, Hantz, Sébastien, additional, Houinato, Dismand, additional, Idris, Mohamad I., additional, Jésus, Pierre, additional, Joubert, Jacques, additional, Ketzoian, Carlos N., additional, Kibru, Dawit, additional, Lacroix, Philippe, additional, Lannuzel, Annie, additional, Logroscino, Giancarlo, additional, Magy, Laurent, additional, Marin, Benoît, additional, Marquet, Sandrine, additional, Mathis, Stéphane, additional, Millogo, Athanase, additional, Newton, Charles R., additional, Ngoungou, Edgard B., additional, Nubukpo, Philippe, additional, Palmer, Valerie S., additional, Perna, Abayubá, additional, Ploy, Marie-Cécile, additional, Preux, Pierre-Marie, additional, Prince, Martin, additional, Reis, Jacques, additional, Spencer, Peter S., additional, Tan, Chong T., additional, Tchalla, Achille, additional, Tekle-Haimanot, Redda, additional, Vallat, Jean-Michel, additional, and Winkler, Andrea S., additional

Published
2018
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