Morbidades autorreferidas e estilos de vida em trabalhadores agrícolas e não agrícolas no Brasil: uma análise comparativa entre 2013 e 2019 / Self-reported morbidities and lifestyles of agricultural and non-agricultural workers in Brazil: a comparative analysis between 2013 and 2019

Resumo Investigaram-se diferenças no padrão de adoecimento e estilos de vida entre trabalhadores agrícolas e não agrícolas em 2013 e 2019, com os dados da Pesquisa Nacional de Saúde (PNS). Calcularam-se as prevalências e seus IC de 95% para morbidades autorreferidas, autoavaliação de saúde (AAS) não boa, limitação das atividades habituais por DCNT, número de DCNT, depressão maior ou menor e estilos de vida. Utilizou-se o modelo de Poisson para cálculo das razões de prevalências brutas e ajustadas por sexo e idade. Consideraram-se as ponderações amostrais e o efeito do conglomerado em 2013 e 2019. Avaliaram-se 33.215 trabalhadores não agrícolas e 3.796 agrícolas em 2013. Em 2019, foram 47.849 trabalhadores não agrícolas e 4.751 agrícolas. Os trabalhadores agrícolas estão mais propensos a AAS não boa, problemas crônicos na coluna, excesso de atividade física no trabalho, tabagismo e menor consumo de frutas, legumes e verduras (FLV). Enquanto os trabalhadores não agrícolas apresentaram maiores prevalências de asma/bronquite, depressão, diabetes, e consumo de doces e refrigerantes. Ações diferenciadas de prevenção e manejo de DCNT para os dois grupos de trabalhadores devem ser priorizadas.

Abstract Differences in the profiles of illness and lifestyles among agricultural and non-agricultural workers were investigated using data from the National Health Survey (Brazilian acronym PNS) of 2013 and 2019. The prevalence and 95% CIs were calculated for the following variables: self-reported morbidities, poor self-rated health, limitations of usual activities, number of NCD, major or minor depression and lifestyles. The Poisson model was used to calculate crude and adjusted prevalence ratios, by gender and age. The sample weights and the conglomerate effect in 2013 and 2019 were considered in the analyses. A total of 33,215 non-agricultural workers and 3,797 agricultural workers were evaluated in 2013, whereas 47,849 non-agricultural workers and 4,751 agricultural workers were assessed in 2019. Agricultural workers are more susceptible to poor self-rated health, chronic back problems, excessive physical activity at work, smoking and lower consumption of vegetables and fruit. On the other hand, non-agricultural workers revealed a higher prevalence of asthma/bronchitis, depression and diabetes mellitus and greater consumption of candies and soft drinks. Differentiated NCD prevention and treatment actions for both groups of workers need to be prioritized.

Communicable and non-communicable diseases diagnosis and treatment service availability at primary health care Units during COVID-19 outbreak in Ethiopia

BACKGROUND: Non-communicable diseases (NCDs) pose a substantial global health challenge, resulting in an annual death toll of over 15 million individuals aged 30 to 69. Ethiopia, categorized as COVID-19 vulnerable, grapples with NCD treatment challenges. This study aims to assess disease service availability at primary health units in Ethiopia during the pandemic. METHODS: A facility-based cross-sectional study was conducted from October to December 2021 across regions, encompassing 452 facilities: 92 health centers, 16 primary hospitals, 344 health posts, and 43 districts. Facility selection, based on consultation with regional health bureaus, included high, medium, and low performing establishments. The study employed the WHO tool for COVID-19 capacity assessment and evaluated services for various diseases using descriptive analysis. RESULTS: Results reveal service disruptions in the past year: hospitals (55.6%), health centers (21.7%), districts (30.2%), and health posts (17.4%). Main reasons were equipment shortages (42%), lack of skilled personnel (24%), and insufficient infection prevention supplies (18.8%). While tuberculosis treatment was fully available in 23% of health posts and malaria services in 65.7%, some health centers lacked HIV/AIDS, cardiovascular, mental health, and cervical cancer services. Most communicable and noncommunicable disease diagnoses and treatments were fully accessible at primary hospitals, except for cervical cancer (56.3%) and mental health (62.5%) services. CONCLUSION: Significant gaps exist in expected services at primary health units. Improving disease care accessibility necessitates strengthening the supply chain, resource management, capacity building, and monitoring systems.

Conicity index: an anthropometric indicator of abdominal obesity / Índice de conicidade: um indicador antropométrico de obesidade abdominal

The Brazil, as well as the world, is in a transition process, with changes in the nutritional, epidemiological and lifestyle profiles. At the same time, a progressive increase in life expectancy and the growth of chronic non-communicable diseases (NCDs) have been observed in recent decades. Among them are cardiovascular diseases whose main risk factor is obesity. In this scenario, anthropometric indicators are essential for the early identification of obesity, especially obesity accumulated in the abdominal region. The conicity index is one of the recommended tools for identifying the distribution of body fat, as it is associated with cardiovascular and metabolic complications in the population, especially in individuals with NCDs. Therefore, the use of the anthropometric indicator as a screening tool both in primary care and in epidemiological studies is recommended for the early identification of abdominal obesity. Keywords: abdominal obesity; noncommunicable diseases; anthropometry

O Brasil, bem como o mundo, está em processo de transição, com alterações no perfil nutricional, epidemiológico e de estilo de vida. Paralelamente, observa-se nas últimas décadas o aumento pro-gressivo da expectativa de vida e crescimento das doenças crônicas não transmissíveis (DCNT). En-tre elas, estão as doenças cardiovasculares que possuem como principal fator de risco a obesida-de. Nesse cenário, os indicadores antropométricos são essenciais para a identificação precoce da obesidade, principalmente daquela acumulada na região abdominal. O índice de conicidade é uma das ferramentas recomendadas para a identifica-ção da distribuição da gordura corporal, pois está associado as complicações cardiovasculares e metabólicas da população, principalmente dos in-divíduos com DCNT. Portanto, a utilização do indi-cador antropométrico como ferramenta de rastreio tanto na atenção primária quanto nos estudos epi-demiológicos é aconselhada para a identificação precoce da obesidade abdominal. Palavras-chave: obesidade abdominal, doenças crônicas não transmissíveis, antropometria

Is the Rule of Halves in Hypertension Valid Uniformly across India? A Cross-sectional Analysis of National Family Health Survey-4 Data

Background: Hypertension is widely prevalent across India. The rule of halves is commonly used to describe the attrition and gaps in the care cascade of hypertension management across detection, availing treatment, and having controlled blood pressure (BP) on treatment. Objectives: Using nationally representative data, we aimed to assess the rule of halves in hypertension management in different states of India and across sociodemographic, health system, and personal factors. Methods: A descriptive analysis of secondary data from the National Family Health Survey?4 was conducted. We included 770,662 individuals(112,122 men and 658,540 nonpregnant women) of 15–49 years of age. The proportion of individuals not aware of hypertension status among those with high BP, known hypertensives not availing of treatment, and uncontrolled BP among those on treatment were expressed as percentage with a 95% confidence interval (CI). Results: Of those with high BP, 48.5% (95% CI: 47.8%–49.3%) were not aware of their hypertensive status. Among known hypertensives, 72% (95% CI: 71.2%–72.8%) had not availed treatment for hypertension. Among those on treatment, 39.8% (95% CI: 38.7%–40.9%) had uncontrolled hypertension. Conclusion: The rule of halves of India shows that the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases, and Stroke has made relatively good progress with the detection of hypertension and achieving BP control among those on treatment. However, with three?fourth of known hypertensives not availing treatment, more dividends from the detection of hypertension efforts could be realized. The program needs to especially focus on ensuring the treatment for those detected with hypertension.

Hypertension in Men - An Emerging Public Health Challenge for India: Evidence from National Family Health Survey-4

Background: Men in the 25–54 year age group form the major workforce in developing countries like India. The rising trend of hypertension in this age group is a growing matter of concern. Objectives: This study analyzed secondary data analysis from the National Family Health Survey‑4. Methods: Men in the 25–54 age group (n = 76,410) from 640 districts of the country were included in the study. State and district‑wise trends in hypertension in men along with selected individual lifestyle characteristics were displayed using a geographic information system. Results: The prevalence of hypertension among men in the age group of 25–54 was found to be 35.6% for the entire country. In urban India, the prevalence of hypertension was 38.4% (uncorrected ‑ 40.2%) compared with 33.8% (uncorrected ‑ 34.9%) in rural India. Among the 27,973 hypertensives, 6984 (25%) were the known hypertensives prior to the survey. Out of these only 2403 (34.4%) were taking medicines. The prevalence of tobacco use in any form among the men in this age group was 45.7% (uncorrected ‑ 49%). Conclusion: In conclusion, the study highlights the burden of hypertension in men in the prime age group along with the alarming burden of tobacco consumption and recommends public health and policy interventions targeting both hypertension and tobacco control. It requires urgent attention and specialized strategies in tiding over this epidemic brewing in the workforce of the country

Prevalence of chronic noncommunicable diseases and their associated factors in adults over 39 years in riverside population in the western brazilian amazon region

Backgroung: The prevalence of Chronic Noncommunicable Disease (CND) are rocketting over the world, including in young adults. The WHO estimates that more than half of the deaths in the world are caused by CND.A cross-sectional study was carried out from june to november 2016. The researchers visited 16 communities, with a sample size of 183 adult individuals performed for convenience. The patients went through screening and verified: weight, height, abdominal circumference, blood pressure, clinical-epidemiological history and performed physical and laboratory examination. Prevalence ratios were calculated with confidence intervals of 95% and with statistical significance with p<0.05.This study aims to estimate the prevalence of CND and its associated factors in the adult riverside population of the Rio Madeira in Humaitá, Amazonas State, Western Brazilian Amazon.The prevalence of systemic arterial hypertension (SAH) was 44.7%, 52.6% in female. Of the individuals with SAH, 77.5% did not use medication. About 51.5% of them had Grade I SAH. The prevalence of type 2 diabetes mellitus was 16.4%, where no patient used medication and about 40.4% of the studied population fits in the glucose intolerance range. Metabolic syndrome presented a prevalence of 24.0%, with a higher frequency in females (33.8%) (p=0.007). Concerning chronic kidney disease, a prevalence of 12.1% was observed in both sexes. The associated factors found were alcoholism, smoking, sedentary lifestyle and obesity, and more than 45% of the patients had at least two associated factors. The population had a high prevalence of CND and associated factors, low frequency of medication use, revealing inefficiency of the local health system. Increased coverage of the Governmental Family Health Strategy (GFHS) and the increase in number of trained Community Health Assistants , together with health education actions can increase the population's health standard.

A prevalência de Doença Crônica Não Transmissível (DCNT) está elevada em todo o mundo, incluindo em adultos jovens. A OMS estima que mais da metade das mortes no mundo são causadas por DCNT.Um estudo transversal foi realizado de junho a novembro de 2016. Os pesquisadores visitaram 16 comunidades, com um tamanho de amostra de 183 indivíduos adultos, realizada por conveniência. Os pacientes passaram por triagem e verificados: peso, altura, circunferência abdominal, pressão arterial, história clínico-epidemiológica, sendo realizado exame físico e laboratorial. Razões de prevalência foram calculadas com intervalos de confiança de 95% e com significância estatística com p<0,05. Este estudo tem como objetivo estimar a prevalência de DCNT e seus fatores associados na população ribeirinha do Rio Madeira em Humaitá, Estado do Amazonas, Amazônia Ocidental, em adultos com mais de 39 anos. A prevalência de hipertensão arterial sistêmica (HAS) foi de 44,7%, 52,6% no sexo feminino. Dos indivíduos com HAS, 77,5% não faziam uso de medicamentos. Cerca de 51,5% deles tinham HAS grau I. A prevalência de diabetes mellitus tipo 2 foi de 16,4%, nenhum paciente fazia uso de medicamentos e cerca de 40,4% da população estudada se enquadra na faixa de intolerância à glicose. A síndrome metabólica apresentou prevalência de 24,0%, com maior frequência no sexo feminino (33,8%) (p = 0,007). Em relação à doença renal crônica, foi observada prevalência de 12,1% em ambos os sexos. Os fatores de risco associados encontrados foram etilismo, tabagismo, sedentarismo e obesidade, sendo que mais de 45% dos pacientes apresentavam pelo menos dois fatores associados. A população apresentou alta prevalência de DCNT e fatores associados, baixa frequência de uso de medicamentos, revelando ineficiência do sistema de saúde local. O aumento da cobertura da Estratégia Saúde da Família (ESF) e o aumento do número de Agentes Comunitários de Saúde capacitados, aliados a ações de educação em saúde, podem elevar o padrão de saúde da população.

Effectiveness of an integrated-Weight Management Programme (i-WMP) in Reducing Body Weight among Noncommunicable Disease Patients in Malaysian Government Primary Care Clinics: A Randomised Controlled Trial

@#Introduction: Obesity is a global issue called as “globesity”. Overweight and obesity may lead to many noncommunicable diseases (NCDs). Primary care is the first centre to monitor and follow-up the progress of NCD patients. Therefore, the objective of this study was to determine the effectiveness of an integrated-Weight Management Programme (i-WMP) to reduce body weight among NCD patients from two Government primary care clinics from Hulu Langat District. Methods: This study was single-blinded randomised controlled trial by design. There were 244 eligible patients were randomised into intervention (n = 122) or wait-list control group (n = 122). The i-WMP was developed based on the behaviour change wheel through the operationalization of behaviour change techniques. The duration of this intervention programme was four weeks. Data collected at week 0, week 4, and week 12. The software IBM SPSS was used to analyse the data. Generalized linear mixed model analysis with intention-to-treat principle was applied. Results: The retention rate was 74.2%. Findings showed that the i-WMP was significantly effective in reducing not only body weight as primary outcome but also secondary outcomes such as waist-to-height ratio, waist circumference, body mass index, and total sitting time. It also improved effectively other secondary outcomes such as participants’ knowledge, attitude, and practice towards dietary and towards physical activity. However, no significant changes were reported for body fat percentage and total physical activity metabolic equivalent of task-minutes/week. Conclusion: Implications surrounding the implementation of i-WMP in the primary care clinics are recommended.

Some results of the study on knowledge, attitudes and practices of risk factors for non-communicable diseases among graduate students of secondary school / Монголын Анагаах Ухаан

Introduction@#Globally, deaths from NCDs increased by 15% between 2010 and 2020 (44 million deaths), with an estimated 10.4 million deaths in Southeast Asia (WHO, 2020). </br> In this regard, a research was conducted to assess the knowledge, attitudes and practices of graduate students of secondary school about risk factors for non-communicable diseases. @*Purpose@#To assess the knowledge, attitude and practice of secondary school graduate students of the about the risk factors for non-communicable diseases.@*Material and Method@#In the research, one school from the rural and four school from the urban settings were selected in the Ulaanbaatar city using a purposive deliberate sampling method. A total of 350 students were involved. The information was examined using questionnaires with 4 chapters and 65 questions, which were specifically designed to knowledge, attitudes and practice regarding risk factors for non-communicable diseases. </br>The research was discussed and approved at the meeting of the Ethics Subcommittee of the “Ach” University on April 13, 2021. After providing detailed information about the research through the “Introductory Permit Form”, we contacted with the social worker in charge of the high school students to obtain permission to include students in the research and received formal confirmation via Gmail. @*Result@#30.3 percent of the respondents said that they allow smoking in the ger, but 18.9 percent do not. 42% of the respondents said that the reason for not eating fruits and vegetables is that they are expensive and do not believe in the quality of imported fruits and vegetables, while 77.8 % have a negative habit of adding salt to their food. 29.4% do not know how to be active, 29.4% do not like to be active, when asking how many hours a day do you exercise, 46.6 percent answered 15 minutes, 37.4 percent 30 minutes, 8.9 percent 45 minutes and 6.4 percent 60 minutes. When answering a question to clarify knowledge about the use of the Internet, 50.9% percent said it was 1-2 hours, 6.4 percent - 30-45 minutes and when asking to find out how much time they use the Internet per day, 35.4% said 3-4 hours, 30% answered 5-6 hours, which have a negative habit.@*Conclusion@#</br>1. 80% of students involved in the research have sufficient knowledge about the risk factors for NCDs. </br>2. 70% have a positive attitude towards risk factors for NCDs. </br>3. 60% lead a healthy behavior, but the remaining 40% need to be developed and habituate healthy behaviors and practice.

Prevalence of hypertension and obesity in patients with type 2 Diabetes Mellitus

Abstract Faced with the increase of type 2 Diabetes mellitus (DM2) and the failure in treatment, questions have been raised about the clinical situation of these patients. The present study analyzes the prevalence of hypertension and obesity in DM2 patients. Data were collected through interviews and anamnesis of 16 participants. After the meetings, in which capillary glycemia and blood pressure were measured, the participants received guidance about glycemic monitoring, blood pressure control and changes in lifestyle. Approximately 75% of the participants were women with average age of 65 years, 87.5% were sedentary, 18.75% smoked and/or used alcoholic beverages and none performed regular blood glucose monitoring. The initial blood glucose average was 148 mg/ dL and finally decreased to 133 mg/dL. There was no significant difference in blood pressure levels. Regarding the body mass index, 89.4% of the patients were above normal standards and 100% had altered waist circumference values. There is a need for studies like this in order to promote educational practices for health and disease control, highlighting the importance of multidisciplinary teams and the pharmaceutical professional, since non-adherence to blood glucose monitoring, also associated with hypertension and obesity, can interfere with the individual's clinical condition.

Mortalidad prematura según causas seleccionadas en el Policlínico 5 de septiembre / Premature Mortality due to Selected Causes in 5 de Septiembre Municipality

Introducción: El conocimiento de las tendencias de mortalidad prematura en una población puede contribuir a realizar acciones que disminuyan los años de vida potencial perdidos por distintas causas. Objetivo: determinar la tendencia de mortalidad prematura por enfermedad de arterias, arteriolas y vasos, enfermedad cerebrovascular, infarto agudo del miocardio, diabetes mellitus, enfermedad pulmonar obstructiva crónica y cáncer de mama, próstata, bucal, colon y cérvix en el policlínico 5 de septiembre de Consolación del Sur. Métodos: Se realizó un estudio descriptivo retrospectivo del total de fallecidos prematuramente n = 313 por las causas seleccionadas, para ello se analizaron, a través de estadística descriptiva, los datos del Registro de Mortalidad de la Dirección Provincial de Salud Pública de Pinar del Río. Resultados: Existió correspondencia entre el incremento de la edad y el aumento de los fallecidos, los más afectados fueron el grupo etario 60-69 años, el sexo masculino y el color blanco de piel. Solo las enfermedades de arterias, arteriolas y vasos, la EPOC y la diabetes mellitus mostraron tendencia al ascenso. El mayor riesgo de morir prematuramente correspondió a los Grupos Básicos de Trabajo 2 y 4, y las causas de mayor tasa fueron la enfermedad cerebrovascular, infarto agudo de miocardio y EPOC. La población estudiada perdió 9,86 años de vida como promedio y el cáncer de cérvix fue la enfermedad que más aportó años de vida potencial perdidos. Conclusiones: Se apreció tendencia a la disminución de mortalidad prematura general por las enfermedades estudiadas(AU)

Introduction: Knowledge about tendencies of premature mortality in a population can contribute to carrying out actions that reduce the number of years of potential life lost due to different causes. Objective: To determine the tendency of premature mortality due to disease of the arteries, arterioles and vessels, cerebrovascular disease, acute myocardial infarction, diabetes mellitus, chronic obstructive pulmonary disease (COPD), as well as breast, prostate, oral, colon and cervical cancer in 5 de Septiembre Polyclinic of Consolación del Sur Municipality. Methods: A retrospective and descriptive study was carried out with the total number of prematurely deceased (n=313) for the selected causes. For this purpose, the data from the Mortality Registry of the Provincial Directorate of Public Health of Pinar del Río were analyzed through descriptive statistics. Results: There was a correspondence between increase in age and increase in deaths; the most affected were those in age group 60-69 years, as well as the male sex and white skin color. Only diseases of the arteries, arterioles and vessels, COPD and diabetes mellitus showed an upward tendency. The highest risk for dying prematurely corresponded to the basic work groups 2 and 4, while the causes with the highest rate were cerebrovascular disease, acute myocardial infarction and COPD. The study population lost 9.86 years of life on average and cervical cancer was the disease that accounted for the highest amount of lost years of potential life. Conclusions: There was a tendency towards a decrease in general premature mortality due to the diseases studied(AU)

Avaliação da qualidade dos vídeos sobre câncer de mama mais visualizados no YouTube: relevância para promoção da saúde da mulher / Quality assessment of the most watched breast cancer videos on YouTube: relevance to improve women's health / Evaluación de la calidad de los videos sobre el cáncer de mama más vizualizados en YouTube: relevancia para promover la salud de la mujer

O câncer de mama é uma das principais enfermidades que acomete a saúde das mulheres no mundo e as estratégias destinadas à melhoria do acesso das mulheres às informações sobre prevenção são fundamentais. O objetivo do estudo apresentado neste artigo foi avaliar a qualidade de vídeos relacionados ao tema do câncer de mama. A busca dos vídeos ocorreu a partir da palavra-chave 'câncer de mama' na plataforma YouTube. Os dados referentes às informações de cunho técnico foram obtidos por meio da análise das informações contidas na descrição dos vídeos e, posteriormente, foi realizada sua análise de conteúdo. Para serem analisados, foram extraídos os 200 primeiros vídeos mais vistos. A maioria (72%) e aqueles com intuito de divulgar conteúdo informativo ao leigo (73%) e com foco na prevenção secundária (71,5%) são considerados ruins ou péssimos (53%). Conclui-se, que o YouTube se apresenta como uma ferramenta limitada a ser utilizada no processo de educação de mulheres visando ao controle do câncer de mama.

Breast cancer is one of the main diseases that affect the health of women in the world and strategies aimed at improving women's access to information on prevention are fundamental. The objective of the study presented in this article was to assess the quality of some videos related to breast cancer. The videos were searched using the keyword 'breast cancer' on the YouTube platform. The data referring to the technical information was obtained through the analysis of the information contained in the description of the videos and subsequently their content analysis was carried out. The first 200 most viewed videos were extracted for analysis. The majority (72%) and those aiming to disseminate informative content to laypeople (73%) and focusing on secondary prevention (71.5%) are considered bad or very bad (53%). It was concluded that YouTube is a limited tool to be used in the process of educating women about the control of breast cancer.

El cáncer de mama es una de las principales enfermedades que afectan la salud de las mujeres en el mundo y las estrategias destinadas a mejorar el acceso de las mujeres a la información sobre prevención son fundamentales. El objetivo del estudio presentado en este artículo fue evaluar la calidad de videos relacionados con el tema del cáncer de mama. Los videos fueran buscados utilizando la palabra clave 'cáncer de mama' en la plataforma de YouTube. Los datos referentes a la información técnica se obtuvieron mediante el análisis de la información contenida en la descripción de los videos y posteriormente se realizó su análisis de contenido. Fueron extraídos los primeros 200 videos más vistos para hacer su análisis. La mayoría (72%) y aquellos que tienen la finalidad de difundir contenidos informativos al lego en la materia (73%) y enfocon la prevención secundaria (71,5%) son considerados de poca calidade o pésimos (53%). Se concluye que YouTube se revela una herramienta limitada para ser utilizada en el proceso de educación de las mujeres destinada al control del cáncer de mama.

Prevalence of obesity, high blood pressure, dyslipidemia and their associated factors in children and adolescents in a municipality in the Brazilian Amazon region / Prevalência de obesidade, pressão arterial elevada e dislipidemia e seus fatores associados em crianças e adolescentes de um município amazônico, Brasil

INTRODUCTION: The incidence of chronic noncommunicable disease (CND) are rocketting over the world, including in young adults. The WHO estimates that more than half of the deaths in the world, even in underdeveloped countries, are caused by CND. OBJECTIVES: The study aimed to estimate the prevalence of obesity, high blood pressure (HBP) and dyslipidemia and its associated factors. METHODS: The authors carried out a cross-sectional study of 1,431 schools in the public-school system of Monte, Brazilian Western Amazon, with children and adolescents aged 6 to 15 years. A random sampling of 496 individuals was carried out. The OpenEpi platform was used to calculate the sample size, considering p<0.05 and a presumed prevalence of CND of 50%. The authors applied a clinical-epidemiological questionnaire, made anthropometric measurements and laboratory tests. Diagnostic parameters recommended by the recent guidelines of the Ministry of Health in Brazil were used. RESULTS: Prevalence of CND was: Obesity 11.8%, HBP of 6.7% and dyslipidemia of 25.4%. After multivariate log-binomial analysis of the dependent variables, the statistically significant risk factors were overweight 18.4%, sedentary lifestyle 32.2%, family history of cardiovascular disease 23.4%, family history of HBP 84.2%, family dyslipidemia 55.8%, family obesity 38.7% and family chronic renal disease 40.6%. CONCLUSION: The findings pointed out to a context with a relatively high prevalence of CND, as well as their associated factors. Intervention measures such as health education, food education, stimulation of physical exercise, better school feeding and an improvement of the public health system are needed to mitigate the occurrence of CND.

INTRODUÇÃO: A incidência de Doenças Crônicas Não Transmissíveis (DCNT) está aumentando em todo o mundo, inclusive em adultos jovens. A OMS estima que mais da metade das mortes no mundo, mesmo em países subdesenvolvidos, são causadas por DCNT. OBJETIVO: O estudo teve como objetivo estimar a prevalência de obesidade, pressão arterial elevada (PAE) e dislipidemia e seus fatores associados. MÉTODO: Os autores realizaram um estudo transversal com uma amostra randomizada de 496 de 1.431 alunos das escolas da rede pública de ensino de Monte Negro, Amazônia Ocidental, com crianças e adolescentes de 6 a 15 anos. Foi realizada uma amostragem aleatória de 496 indivíduos. Para o cálculo do tamanho da amostra foi utilizada a plataforma OpenEpi, considerando p <0,05 e prevalência presumida de DCNT de 50%. Os autores aplicaram um questionário clínico-epidemiológico, realizaram medidas antropométricas e exames laboratoriais. Foram utilizados parâmetros diagnósticos recomendados pelas diretrizes recentes do Ministério da Saúde do Brasil. Os dados foram analisados por por tetes estatísticos univariados e depois, multivariados, para se detectar associação entre causas e desfechos. RESULTADOS: A prevalência de DCNT foi: Obesidade 11,8%, Pressão Arterial Elevada de 6,7% e dislipidemia de 25,4%. Após análise log-binomial multivariada das variáveis dependentes, os fatores associados estatisticamente significativos foram sobrepeso 18,4%, sedentarismo 32,2%, história familiar de doença cardiovascular 23,4%, história familiar de hipertensão arterial sistêmica 84,2%, dislipidemia familiar 55,8%, obesidade familiar 38,7% e doença renal crônica familiar 40,6%. CONCLUSÃO: Os achados apontam para um contexto com prevalência relativamente elevada de DCNT, bem como seus fatores associados em crianças/adolescentes. Medidas de intervenção como educação em saúde, educação alimentar, estímulo à prática de exercícios físicos, melhor alimentação escolar e melhoria do sistema público de saúde são necessárias para mitigar a ocorrência de DCNT.

Awareness, knowledge and acceptance of community on a noncommunicable disease intervention – Findings from the “Healthy Community, Developed Nation” (KOSPEN) in the Southern Zone of Peninsular Malaysia

@#Community-based health promotion programme has been recognised to reduce modifiable lifestyle risk behaviours for non-communicable diseases. The aim of this study was to evaluate the proportion of the awareness, knowledge and acceptance of a community-based intervention programme, “Komuniti Sihat, Pembina Negara“ (KOSPEN) (Healthy Community, Developed Nation). Methods This cross-sectional study employed a two-stage proportionate sampling method to select a representative sample of communities in the Southern states of Peninsular Malaysia, Negeri Sembilan, Malacca, and Johor. Face-to-face interviews by trained research assistants using pre-validated questionnaires was the study tool applied. Results The study revealed that approximately two thirds of respondents were aware of the KOSPEN programme (65.5%) and almost half (45.4%) of them were involved in the health promotion activities, namely health screenings (84.8%), health talks (66.4%), and providing plain water in formal occasion (52.9%). About two thirds and one-quarter of them have a very good (73.4%) and good (24.1%) general view on this programme. Four out of ten respondents faced difficulties joining the activities. Lack of time (83.0%) was reported as the main barrier. Conclusions The KOSPEN programme in overall was moderately accepted by the community. However, the need for future improvement has to be highlighted in order to enhance the involvement and participation of the communities.

Health disparity toward noncommunicable diseases among residents in rural Cambodia: a descriptive study / Journal of Rural Medicine

Objective: Regional disparities in health services is a crucial problem in Cambodia. Particularly, a number of NCD risk factors are more common among the rural poor. Fortunately, 80% of NCDs are preventable and cost-effective interventions exist. Therefore, health care needs assessments regarding NCDs in poor rural areas are vital. The object of this pilot study was to identify health care needs regarding NCDs among residents in poor rural areas in Cambodia.Materials and Methods: A medical health check-up and questionnaire survey were conducted with 208 rural residents who participated in a free health check-up and doctor consultation in Kaoh Peam Reang.Results: One hundred sixteen (55.8%) females were included in the total sample size of 208 participants; the majority (52.9%) were between 35 and 65 years of age. Twenty-five participants (12%) were current smokers, and 44 (21%) were current alcohol drinkers. Eighty (38.5%) participants had hypertension and 44 participants (21.2%) had a body mass index over 25. Alcohol drinking and smoking habits were more common among men. The five most frequent medical complaints were headache (18.3%), lower back pain (14.4%), foot and hand pain (13.9%), joint pain (10.1%), and difficulty breathing (10.1%).Conclusions: The medical need for doctor consultations regarding chronic disease and chronic pain might be higher in poor rural areas in Cambodia.

Prevalence of Risk Factors of Noncommunicable Diseases in 12 Barangays of the AMIGA Municipalities of Cavite

Objective@#This study aims to determine the prevalence of risk factors of non-communicable diseases (NCDs) in 16 barangays of the AMIGA municipalities of Cavite. @*Methods@#The research is a cross-sectional study. Randomly chosen participants were interviewed using a translated version of the WHO Steps questionnaire. Interviewees were then invited to participate in another session where their anthropometric measurements were taken and their fasting blood sugar and cholesterol levels were determined.@*Results@#The research was done in 12 out of the 16 targeted barangays. A total of 1,527 participants were interviewed and 1,123 of them completed the study. The most significant findings in all 12 barangays were a very high rate of passive smoking (range of 60-80%); a relatively high proportion of respondents with obesity by all 3 parameters (BMI 29-52%; waist circumference 42-78%; and waist-to-hip ratio 41-78%) despite sufficient intake of fruits and vegetables and more than adequate physical activity; and a high proportion of participants with hypertension (more than 30% in 8 out of 12 barangays) and diabetes mellitus (more than 8% in 7 out of 12 barangays). @* Conclusion@#A high prevalence of risk factors of NCDs, particularly obesity, hypertension, and diabetes was found in the 12 barangays of AMIGA that participated in the study. Results of this study should provide the baseline data against which the success of an ongoing program in the area can be measured.

Two innovative Brazilian programs relating to road safety prevention. A case study

ABSTRACT BACKGROUND: The World Health Organization (WHO) 2017 Global Conference in Montevideo, Uruguay, was dedicated to promoting successful cases and best practices in fighting and preventing noncommunicable disease (NCDs). The global effort undertaken by WHO aims to reduce road traffic deaths in order to meet goal number 3.4 of the sustainable development goals. OBJECTIVES: To describe two Brazilian road safety prevention programs, presented at the WHO 2017 Global Conference: São Paulo Traffic Safety Movement (Movimento Paulista de Segurança no Trânsito) and Safe Life Program of Brasília (Programa Brasília Vida Segura), along with their governance structures, models and results. DESIGN AND SETTING: This was a descriptive case study conducted in São Paulo and Brasilia from 2015 to 2018. These programs aimed to reduce the number of deaths caused by road accidents to 8.3 deaths per 100,000 inhabitants in São Paulo by 2020 and in Brasília by 2016; and to reduce harmful use of alcohol by 10% by 2020. METHODS: These two initiatives were designed, managed and operated to bring together government and civil society, i.e. industry, academia, non-governmental organizations (NGOs), etc., around the common goal of saving lives. They were collaborative and guided by sharing of best practices, learning and information, thereby making it possible to attain more and better results. Their format enables reproduction in cities across all Brazilian regions. RESULTS: The results attest to the efficacy of the programs implemented in these two cities. In Brasília, the initiative helped reduce the number of traffic-related deaths by 35% (2017). In the same year in the state of São Paulo, 7,600 deaths were avoided. CONCLUSION: Both programs are innovative public policies that deal with health issues caused by the external agents that ultimately account for the rapid increase in days lost to disability. Prevention of external causes of deaths and injuries, such as traffic violence, strongly correlates with changes in habits and actions, especially excessive consumption of alcohol, and with NCDs in Brazil.

Metabolic syndrome among elderly care-home residents in southern India: a cross-sectional study.

Background: The health of the elderly population and the emergence of noncommunicable diseases have become major public health issues in recent years. Metabolic syndrome is thought to be the main driving force for the global epidemic of cardiovascular diseases, as well as for type 2 diabetes. This cross-sectional study aimed to determine the prevalence of metabolic syndrome and its correlates among the residents of care homes for the elderly in Hyderabad city, India. Methods: A total 114 elderly persons (aged ≥60 years) were evaluated in a cross-sectional study. Metabolic syndrome was defined by the 2005 criteria of the International Diabetes Federation. Data were collected on selected sociodemographic, behavioural and nutritional variables and cardiometabolic risk factors. Blood pressure and anthropometric measurements were also recorded. Fasting blood samples were collected for measurement of blood glucose and serum lipid levels. Univariable logistic regression was applied to investigate the associations between metabolic syndrome and known risk factors; adjusted analysis was then done by multivariable logistic regression for significant variables. Results: The overall prevalence of metabolic syndrome was 42.1% (48/114) among the study population. A higher prevalence (50.9%; 27/53) was found among women. High blood pressure or taking antihypertensive medication was found to be the most common (95.8%; 46/48) cardiometabolic component. The risk of metabolic syndrome did not differ significantly by age group, sex, caste, religion, type of diet (vegetarian or non-vegetarian), educational status, behavioural factors such as tobacco use and alcohol intake, physical activity (assessed by modified Eastern Cooperative Oncology Group [ECOG] scale), or physical exercise. However, a body mass index ≥23 kg/m2 was associated with metabolic syndrome (unadjusted odds ratio [OR]: 8.97; 95% confidence interval [CI]: 3.78–21.28); adjusted OR: 9.31; 95% CI: 4.12–22.14) Conclusion: The overall prevalence of metabolic syndrome in this study population of elderly care-home residents in India was more than 40%. Further research on the burden of metabolic syndrome in the elderly population is warranted.

Descriptive and predictive time series analysis of premature mortality from noncommunicable disease among Filipinos

INTRODUCTION: The problem of increasing mortality from noncommunicable disease (NCD) in the Philippines warrants an in-depth assessment of premature death rate in the country. This research aims to explore the temporal characteristics of mortality younger than 70 years old from the leading NCD among Filipinos from 2006 to 2012 and forecast premature mortality rates in 2013 to 2016. METHODS: Time series modeling and forecasting using the Box-Jenkins method was performed on secondary ecologic data extracted from the national mortality database maintained by the Philippine Statistics Authority-National Statistics Office.RESULTS: Premature death rate from cardiovascular diseases has been increasing steadily. Diabetes mellitus, which shows initially rising mortality among the 30-69-year-old age group, has been reversed in 2009. Trends of premature mortality from cancers and chronic lung diseases did not appear to change over time. NCD mortality rates in the 30-69-year-old age group are generally expected to plateau from 2013 onwards.CONCLUSION: This novel application of time series analysis on premature NCD mortality data drives both further scientific studies and formal programmatic evaluation by providing a better evidence-based picture of NCD burden in the country. 

International Medical Mission Facing Global Increase of Chronic Disease: 2-Year Experience in Bangladesh

Specialists of developing countries are facing the epidemic growth of noncommunicable diseases (NCDs). From 2011 to 2013, I, as a Korean volunteer doctor, had been working in a local primary healthcare center in Bangladesh, assessing rates of NCDs. Proportion of patients with NCDs was increased from 74.96% in 1999 to 83.05% in 2012, particularly due to the spreading of diabetes mellitus, cardiovascular diseases, and tuberculosis. To succeed in medical mission in developing countries, volunteer doctors have to take measures for preventing chronic diseases along with proper treatment.

Lessons for addressing noncommunicable diseases within a primary health-care system from the Ballabgarh project, India.

Background: Most patients with noncommunicable diseases (NCDs) can be managed appropriately at the primary care level, using a simplified standard protocol supported by low-cost drugs. The primary care response to common NCDs is often unstructured and inadequate in low- and middle-income countries. This study assessed the feasibility of integration of NCD prevention and control within the primary health-care system of India. Methods: This study was done among 12 subcentres, 2 primary health centres (PHCs) and one subdistrict hospital in a block in north India. All 28 multipurpose health workers of these subcentres underwent 3-day training for delivering the package of NCD interventions as a part of their routine functioning. A time–motion study was conducted before and after this, to assess the workload on a sample of the workers with and without the NCD work. Screening for risk assessment was done at domiciliary level as well as at health-facility level (opportunistic screening), and the cost was estimated based on standard costing procedures. Individuals who screened positive were investigated with electrocardiography and fasting blood sugar. PHCs were strengthened with provision of essential medicines and technologies. Results: After training, 6% of the time of workers (n = 7) was spent in the NCDrelated activities, and introduction of NCD activities did not impact the coverage of other major national health programmes. Loss during referral of “at-risk” subjects (37.5% from home to subcentre and 33% from subcentre to PHC) resulted in screening efficiency being lowest at domiciliary level (1.3 cases of NCDs identified per 1000 screened). In comparison to domiciliary screening (`21 830.6; US$ 363.8 per case identified), opportunistic screening at subdistrict level (`794.6; US$ 13.2) was 27.5 times and opportunistic screening at PHC (`1457.5; US$ 24.3) was 15.0 times lower. There was significant utilization of NCD services provided at PHCs, including counselling. Conclusion: Opportunistic screening appears to be feasible and a cost-effective strategy for risk screening. It is possible to integrate NCD prevention and control into primary health care in India.