Objective: The aim of this work was to determine the prevalence, associated factors and quality of high blood pressure (HBP) management in three regions of Benin in 2015. Methodology: This was a cross-sectional study,...Objective: The aim of this work was to determine the prevalence, associated factors and quality of high blood pressure (HBP) management in three regions of Benin in 2015. Methodology: This was a cross-sectional study, with two components. The first component included adults aged from 18 to 69 years, selected using a three-stage random sampling within the households. Data were collected thanks to the French version of the WHO STEPS instrument. Anthropometric data, including blood pressure, capillary fasting glucose and total cholesterol were measured according to standard procedures. The second component included Public Health Centers (PHC) selected by a random stratified multi-stage sampling. Data were collected on the structures and the processes of HBP management using the standardized tool for assessing the capacities of management of non-communicable diseases in peripheral health centers provided by the World Health Organization. Results: A total of 4816 participants were included in the first component. The mean age was 35.8 ± 12.7 years. The weighted prevalence of HBP was 27.9% (95% Confidence Interval (CI) [25.6 - 30.2]). It was higher in the 60 - 69 years compared to the lower age groups (Adjusted Odd-ratio (ORa) = 5;95% CI [3.9 - 6.5)]). HBP was positively associated with urban residence (ORa = 1.26;95% CI [1.24 - 1.28]), obesity (ORa = 1.46;95% CI [1.43 - 1.50]), hyperglycemia (ORa = 1.13;95% CI [1.10 - 1.15)]) and hypercholesterolemia (ORa = 1.64;95% CI [1.59 - 1.70)]). A total of 27 PHC were included in the second component. Taking blood pressure and other anthropometric measurements was not routine in PHC. Several essential medicines were not available in the PHC. A low level of community involvement in the management of HBP was noted. Conclusion: This study confirms the high prevalence of HBP and shows inadequacies in its management in the targeted PHC. More appropriate prevention and control measures for HBP should be implemented.展开更多
Aims: Diabetes is a major public health problem in low and middle-income countries. This study 1) estimated prevalence and factors associated with hyperglycemia in Benin, and 2) assessed the treatment quality of diabe...Aims: Diabetes is a major public health problem in low and middle-income countries. This study 1) estimated prevalence and factors associated with hyperglycemia in Benin, and 2) assessed the treatment quality of diabetes. Methodology: A cross-sectional research was conducted with two components. The First component has included 4954 subjects aged (18 - 69) randomly selected in Mono/Couffo and Donga regions. Data were collected according to WHO’s STEPS approach. Capillary blood glucose was measured using the automat Cardiocheck®PA. The Second component considered Public Health Centers (PHCs) within the study regions. Health system established for diabetes control, healthcare practices and the level of involvement of the Public Healthcare Providers and community actors in the management of diabetes have been explored. Findings: A total of 4775 subjects participated in the first component with a predominance of women (56.8%), rural residence and aged (Conclusion: Diabetes prevalence goes increasingly in Benin when its management is inadequate in PHCs. Prevention and control actions should be strengthened.展开更多
Background: Cardiovascular rehabilitation in Germany traditionally is offered as inpatient service often located far from patient’s residence, and ambulatory rehabilitation still represents a minority. The German Reg...Background: Cardiovascular rehabilitation in Germany traditionally is offered as inpatient service often located far from patient’s residence, and ambulatory rehabilitation still represents a minority. The German Registry of Ambulatory Cardiac Rehabilitation (KARREE) was designed to contribute to rehabilitation quality assurance and to evaluate clinical characteristics of patients participating in ambulatory rehabilitation centers. Methods: In four ambulatory rehabilitation centers 2989 patients were consecutively registered from 2008 to 2011 and evaluated with respect to social status, cardiovascular diagnoses and risk factors, psychological status, medication and short term clinical and social outcome. Results: Most patients referred to the ambulatory cardiac rehabilitation had an acute cardiovascular event, with patients after acute coronary syndrome representing the majority (59.9%). Female were strongly underrepresented (16.7%). Patient’s clinical characteristics varied with the age groups evaluated ( 70 years). Whereas the reported physical inactivity, overweight and cigarette smoking was declining with age, diabetes and hypertension significantly increased. Furthermore the reported and evaluated psychosocial stress was declining with age. Regarding the group of patients still employed, 43.5 % were estimated as fit for work directly at the end of the rehabilitation program, whereas a stepwise reintegration into employment was performed in 16.7%. The majority of patients were transferred to ambulatory heart groups or other forms of after care for stabilizing regular physical activity. Conclusions: The large variation of the characteristics of patients participating cardiac rehabilitation underscore the need of an individualized approach for a successful implementation of secondary prevention and reintegration of these patients into their social life.展开更多
文摘Objective: The aim of this work was to determine the prevalence, associated factors and quality of high blood pressure (HBP) management in three regions of Benin in 2015. Methodology: This was a cross-sectional study, with two components. The first component included adults aged from 18 to 69 years, selected using a three-stage random sampling within the households. Data were collected thanks to the French version of the WHO STEPS instrument. Anthropometric data, including blood pressure, capillary fasting glucose and total cholesterol were measured according to standard procedures. The second component included Public Health Centers (PHC) selected by a random stratified multi-stage sampling. Data were collected on the structures and the processes of HBP management using the standardized tool for assessing the capacities of management of non-communicable diseases in peripheral health centers provided by the World Health Organization. Results: A total of 4816 participants were included in the first component. The mean age was 35.8 ± 12.7 years. The weighted prevalence of HBP was 27.9% (95% Confidence Interval (CI) [25.6 - 30.2]). It was higher in the 60 - 69 years compared to the lower age groups (Adjusted Odd-ratio (ORa) = 5;95% CI [3.9 - 6.5)]). HBP was positively associated with urban residence (ORa = 1.26;95% CI [1.24 - 1.28]), obesity (ORa = 1.46;95% CI [1.43 - 1.50]), hyperglycemia (ORa = 1.13;95% CI [1.10 - 1.15)]) and hypercholesterolemia (ORa = 1.64;95% CI [1.59 - 1.70)]). A total of 27 PHC were included in the second component. Taking blood pressure and other anthropometric measurements was not routine in PHC. Several essential medicines were not available in the PHC. A low level of community involvement in the management of HBP was noted. Conclusion: This study confirms the high prevalence of HBP and shows inadequacies in its management in the targeted PHC. More appropriate prevention and control measures for HBP should be implemented.
文摘Aims: Diabetes is a major public health problem in low and middle-income countries. This study 1) estimated prevalence and factors associated with hyperglycemia in Benin, and 2) assessed the treatment quality of diabetes. Methodology: A cross-sectional research was conducted with two components. The First component has included 4954 subjects aged (18 - 69) randomly selected in Mono/Couffo and Donga regions. Data were collected according to WHO’s STEPS approach. Capillary blood glucose was measured using the automat Cardiocheck®PA. The Second component considered Public Health Centers (PHCs) within the study regions. Health system established for diabetes control, healthcare practices and the level of involvement of the Public Healthcare Providers and community actors in the management of diabetes have been explored. Findings: A total of 4775 subjects participated in the first component with a predominance of women (56.8%), rural residence and aged (Conclusion: Diabetes prevalence goes increasingly in Benin when its management is inadequate in PHCs. Prevention and control actions should be strengthened.
文摘Background: Cardiovascular rehabilitation in Germany traditionally is offered as inpatient service often located far from patient’s residence, and ambulatory rehabilitation still represents a minority. The German Registry of Ambulatory Cardiac Rehabilitation (KARREE) was designed to contribute to rehabilitation quality assurance and to evaluate clinical characteristics of patients participating in ambulatory rehabilitation centers. Methods: In four ambulatory rehabilitation centers 2989 patients were consecutively registered from 2008 to 2011 and evaluated with respect to social status, cardiovascular diagnoses and risk factors, psychological status, medication and short term clinical and social outcome. Results: Most patients referred to the ambulatory cardiac rehabilitation had an acute cardiovascular event, with patients after acute coronary syndrome representing the majority (59.9%). Female were strongly underrepresented (16.7%). Patient’s clinical characteristics varied with the age groups evaluated ( 70 years). Whereas the reported physical inactivity, overweight and cigarette smoking was declining with age, diabetes and hypertension significantly increased. Furthermore the reported and evaluated psychosocial stress was declining with age. Regarding the group of patients still employed, 43.5 % were estimated as fit for work directly at the end of the rehabilitation program, whereas a stepwise reintegration into employment was performed in 16.7%. The majority of patients were transferred to ambulatory heart groups or other forms of after care for stabilizing regular physical activity. Conclusions: The large variation of the characteristics of patients participating cardiac rehabilitation underscore the need of an individualized approach for a successful implementation of secondary prevention and reintegration of these patients into their social life.