Screening for dysglycaemia using anthropometric indices in an adult population in Oman

Background: A previous community-based cross-sectional survey conducted in a semi-urban community revealed that 44% of people aged 18+ years manifest dysglycaemia, which appears to echo the national trend. There is lack of studies examining the role of anthropometric indices in people with dysglycaemia.

Aim: We explored the screening ability of anthropometric indices, body mass index [BMI], waist circumference [WC], waist-to-hip ratio [WHR], and waist-to-height ratio [WHtR] to detect dysglycaemia in the adult Omani population based on a community-based survey conducted in 2005. The potential of anthropometric indices to detect the presence of glycaemic disorder could aid in detection, prevention and health education.

Methods: A total of 480 male and 795 female subjects aged 18+ years were included in this study. The prevalence of dysglycaemia was analysed using the American Diabetic Association criteria. Logistic regression approach and Receiver-Operating Characteristic [ROC] curve analysis was performed.

Results: The analysis revealed that mean values of age, BMI, WC, WHR and WHtR increased significantly from normoglycemic to pre-diabetic and further to diabetic in both sexes [P<0.0001]. Dysglycemia showed an increasing prevalence with age. WHtR showed the highest sensitivity for detecting dysglycemia in all age groups compared to other anthropometric indices with sensitivity rate of 94.4% in .45 years, 88.6% in [25- 44] years and 45.6% in age group <25 years

Conclusion: Among the anthropometric indices we investigated, WHtR was the best predictor of dysglycaemia among Omani adults aged > 25 years

Oncogenic human papillomavirus and cervical pre-cancerous lesions in brothel-based sex workers in India

A community-based cross-sectional study was conducted in brothel-based sex workers of West Bengal, Eastern India, to determine their oncogenic human papillomavirus [HPV] status and the presence of pre-cancerous lesions. A total of 229 sex workers from three districts of West Bengal participated in the study. All the study participants were interviewed with the aid of a pre-tested questionnaire to determine their sociodemographics, risk behaviour and risk perceptions after obtaining informed verbal consent. The interview was followed by collection of cervical cells from all participants using a disposable vaginal speculum and cervical cytobrush. Oncogenic HPV DNA was detected by real-time polymerase chain reaction [PCR]. A simultaneous Papanicolaou test ['Pap smear'] was performed to detect cervical cytological abnormalities. Overall, the prevalence of oncogenic HPV was found to be 25% [58/229] among the studied population. A subset [n = 112] of the sample was tested separately to determine the existence and magnitude of HPV genotypes 16 and 18. The results showed that genotype 16 was prevalent in 10% [11/112], genotype 18 in 7% [8/112] and both genotype 16 and 18 in 7% [8/112]. The HPV prevalence rate showed a decreasing trend with age, being 71.4% in the 10-19 years age group, 32.3% in the 20-29 years age group, 18.3% in the 30-39 years age group and 2.5% in the 1 year and >1 year, respectively. This difference was found to be statistically significant both by univariate and multivariate analysis. In this study, it was observed that sex workers with an average number of daily clients of six or more had an HPV prevalence of 67% [n = 6], those with four to five clients had a prevalence of 45% [n = 9], those with two to three clients had a prevalence of 30% [n = 34] and those with one or less clients had a prevalence of 10% [n = 9] [statistically significant differences, P = 0.00003]. Multivariate analysis showed a statistical association only with a duration of sex work of /= 101 [OR = 2.5; 95% CI 1.3-5]. Regarding pre-cancerous lesions, 2 of 229 sex workers showed the presence of a low-grade squamous intraepithelial lesion along with high-risk HPV. Thus, 1% of the studied population suffer from a pre-cancerous lesion caused by high-risk HPV. This study concludes that young sex workers are particularly vulnerable to high-risk HPV, similar to human immunodeficiency virus [HIV]. The observation of older sex workers relatively free from HPV supports the view of acquired immunity against HPV, which needs to be studied in-depth further. There is a need for a suitable community-based intervention programme targeted towards sex workers, with special reference to younger sex workers, for control and prevention of HPV and cervical cancer. Vaccination against HPV for newly entrant sex workers may be an important component for a successful intervention programme