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BACKGROUND: Treatment adherence is a primary key in controlling diabetes disease. The study aims to determine the prevalence of treatment adherence in type 2 diabetes mellitus (T2DM) patients, investigate the potential influence of adherence on elevated blood glucose levels, and identify the key factors which play a role in non-adherence to the prescribed drugs. METHOD: A cross-sectional study method was utilized to collect data from all T2DM patients at the Diabetic and Endocrine Centre and Shar Hospital in Sulaymaniyah city in the Kurdistan region of Iraq from February 2022 to April 2022. The data collection was performed through a structured questionnaire. The prevalence of drug adherence was assessed using the Morisky Medication-Taking Adherence Scale (4-item), and the glycated hemoglobin test (A1C) was used to determine the blood glucose level. RESULT: A total of 300 participants were studied, and more than half of them (192; 64%) revealed that they did not adhere to their anti-diabetic medications. Non-adherence was significantly associated with higher A1C. Several barriers to non-adherence were identified as multiple medications, feeling the dose given is high, lack of finance, and side effects by 209 (70%), 116 (39%), 113 (38%), and 103 (34%), respectively. CONCLUSION: The current study's result revealed that most T2DM patients have no adherence to their medication. This non-adherence is significantly linked to higher A1C levels, emphasizing the critical role of medication compliance in managing diabetes effectively. The study also sheds light on the multiple barriers such as taking multiple prescriptions, the perception that the dose is excessive, lack of finances, and experiencing side effects, which contribute to non-adherence among diabetes patients. These findings underscore the need for healthcare providers to address these barriers and develop tailored strategies to enhance medication adherence among individuals with diabetes.
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INTRODUCTION: Although Cysticercus tenuicollis is one of the most economic and veterinary important parasite in Iraq, scanty molecular characterization exists for this helminth. This study aimed to determine the prevalence and molecular description of C. tenuicollis isolates from sheep in Kalar district of Iraq. METHODOLOGY: A total of 2,906 slaughtered sheep were examined post-mortem. Up to 20 samples of C. tenuicollis was extracted and amplified using mitochondrial COX1 gene. RESULTS: The overall prevalence rate was 6.88%, and female sheep recorded higher rate of infection (24.35%) than male (6.16%) with significant difference (p<0.05). The molecular results showed 14 haplotypes for COX1 gene and the pairwise nucleotide variation among them was ranged from 0.2 to 2.6%. Twelve out of fourteen haplotypes of C. tenuicollis involving one to three base mutations were discovered in Kalar, Iraq for the first time and this could be a unique mutation internationally and did not registered previously. Eleven newly recorded haplotypes involved only one single mutation and the remaining one involved three mutations. Phylogenetic interpretation showed that Cysticercus tenuicollis-Kalar isolate were clustered in one clade, and closely related to isolates discovered in Nigeria, China, Turkey, Poland, and Iran. CONCLUSIONS: This study provided a new record data on prevalence and discovered novel strains of C. tenuicollis in the study area for the first time named Cysticercus tenuicollis-Kalar isolate. Novel haplotypes might consider endemic genetic characterization of this metacestode. The present data may be useful to provide a good molecular background for future preventive and control programs.
