Introduction: Arab populations have many similarities and dissimilarities. They share culture, language and religion but they are also subject to economic, political and social differences. The purpose of this study i...Introduction: Arab populations have many similarities and dissimilarities. They share culture, language and religion but they are also subject to economic, political and social differences. The purpose of this study is to understand the causes of the rising trend of diabetes prevalence in order to suggest efficient actions susceptible to reduce the burden of diabetes in the Arab world. Method: We use principal component analysis to illustrate similarities and differences between Arab countries according to four variables: 1) the prevalence of diabetes, 2) impaired glucose tolerance (IGT), 3) diabetes related deaths and 4) diabetes related expenditure per person. A linear regression is also used to study the correlation between human development index and diabetes prevalence. Results: Arab countries are mainly classified into three groups according to the diabetes comparative prevalence (high, medium and low) but other differences are seen in terms of diabetes-related mortality and diabetes related expenditure per person. We also investigate the correlation between the human development index (HDI) and diabetes comparative prevalence (R = 0.81). Conclusion: The alarming rising trend of diabetes prevalence in the Arab region constitutes a real challenge for heath decision makers. In order to alleviate the burden of diabetes, preventive strategies are needed, based essentially on sensitization for a more healthy diet with regular exercise but health authorities are also asked to provide populations with heath- care and early diagnosis to avoid the high burden caused by complications of diabetes.展开更多
Background: The last Moroccan population and family health survey (EPSF 2011) was carried out between November 2010 and March 2011. The final report and the whole database are not yet accessible while a preliminary re...Background: The last Moroccan population and family health survey (EPSF 2011) was carried out between November 2010 and March 2011. The final report and the whole database are not yet accessible while a preliminary report was released early March 2012. The information given so far does not allow for a complete evaluation of the present health situation in Morocco. However, a partial equity analysis can be devoted to the comparison of health indicators in terms of gender and urban-rural gaps. Method: 1) Questionnaires: a household questionnaire dealt with household characteristics, general health, housing condition and anthropometric data for children less than six years of age. A second questionnaire was devoted specifically to ever married women and dealt with their resources, marriage, reproductive health, family planning, AIDS/SIDA, healthcare and nutrition. 2) Data collection: data were collected through the national survey using a three-stage stratified sampling design to select 640 clusters covering the 16 Moroccan regions. A total of 15,577 households were randomly drawn, providing a sample of 75,061 individuals (51.1% females and 48.9% males) for investigation. 3) Analysis: in this short report, we relied only on partial data released by the Ministry of Health in a preliminary report. We used absolute differences and relative ratios to study the evolution of gender and urban-rural gaps on the basis of socioeconomic indicators. Results and Discussion: The Moroccan population seems to be in the last phase of its demographic transition. The total fertility rate decreased from 5.6 children per woman in 1980 to 2.5 in 2011. The mean age of first marriage went from 24 years for men and 17.5 years for women in 1960 to 31.5 years and 26.3 in 2011 for men and women respectively. The age structure is showing a trend of ageing population. Generally, health indicators related to reproductive and women’s health improved noticeably and consequently, maternal and infant mortality also decreased. However, while these achievements are praiseworthy as national averages, they remain insufficient in terms of equitable healthcare and access to health services since there is still a long way to go in order to reduce the huge gender gaps and rural-urban disparities. Conclusion: In this short report, we showed that, as averages, health indicators improved noticeably during the last decade but gender inequality and urban-rural disparities are still challenging health decision makers. Moroccan health decision makers are urged to adopt an equitable health strategy, starting by giving access to data for analysis, monitoring and evaluation.展开更多
Due to its chronic nature with severe complications, diabetes needs costly prolonged treatment and care. The high economic burden of diabetes is particularly threatening low and middle income countries. World-wide, st...Due to its chronic nature with severe complications, diabetes needs costly prolonged treatment and care. The high economic burden of diabetes is particularly threatening low and middle income countries. World-wide, studies have shown that the cost of diabetes per person is much higher than the per capita health expenditure. This study is the first to estimate the direct and indirect cost of diabetes in Morocco. The direct cost of diabetes was computed by assuming three scenarios of prices (low, medium and high) due to different prices of insulin, oral drugs and other items used in diabetes treatment and care. Indirect costs of diabetes were estimated by the lifetime forgone earnings caused by premature death and disability due to diabetes. The direct cost of diabetes in Morocco was estimated to be between US $0.47 and US $1.5 billion whereas the indirect cost was estimated to be around US $2 billion accounting for 57% of the total cost of diabetes under the high cost scenario, 69% under the medium scenario and 81% under the low cost scenario. The average per capita indirect cost was estimated to be US $1113, relatively higher than the direct cost of diabetes which was seen to vary from US$ 259 to US $830. The results yielded by this study were compared to those obtained by similar studies in different regions and countries of the world. As a conclusion, the findings of this study indicate a high economic burden of diabetes and stress the importance that Moroccan health decision makers should give to sensitisation, early diagnosis and treatment of diabetes especially with the crucial growing trend of diabetes prevalence.展开更多
Worldwide, diabetes is affecting 370 million people, causing nearly five million deaths and absorbing more than 471 billion USD per year. Mathematical models have been developed to simulate, analyse and understand the...Worldwide, diabetes is affecting 370 million people, causing nearly five million deaths and absorbing more than 471 billion USD per year. Mathematical models have been developed to simulate, analyse and understand the dynamics of β-cells, insulin and glucose. In this paper, we consider the effect of genetic predisposition to diabetes on dynamics of β-cells, glucose and insulin. We assume that the β-cell dynamics is governed by the differential equation: . The model indicates different behaviours according to the presence or absence of genetic predisposition. In presence of predisposition (ε = 1), the model shows three equilibrium points: a stable physiological equilibrium point (G = 100, I = 20, β = 600), a stable trivial pathological equilibrium point (G = 600, I = 0, β = 0) and a saddle point (G = 250, I = 9.8, β = 129.36). In absence of predisposition (ε = 0), the model has only two equilibrium points: an unstable pathological equilibrium point (G = 600, I = 0, β = 0) and a stable physiological equilibrium point (G = 82.6, I = 23, β = 900). In order to see how physical activity, obesity and other factors affect insulin sensitivity, simulations are carried out with different values of insulin induced glucose uptake rate (c), β-cell maximum insulin secretory rate (d) and environmental capacity (K).展开更多
文摘Introduction: Arab populations have many similarities and dissimilarities. They share culture, language and religion but they are also subject to economic, political and social differences. The purpose of this study is to understand the causes of the rising trend of diabetes prevalence in order to suggest efficient actions susceptible to reduce the burden of diabetes in the Arab world. Method: We use principal component analysis to illustrate similarities and differences between Arab countries according to four variables: 1) the prevalence of diabetes, 2) impaired glucose tolerance (IGT), 3) diabetes related deaths and 4) diabetes related expenditure per person. A linear regression is also used to study the correlation between human development index and diabetes prevalence. Results: Arab countries are mainly classified into three groups according to the diabetes comparative prevalence (high, medium and low) but other differences are seen in terms of diabetes-related mortality and diabetes related expenditure per person. We also investigate the correlation between the human development index (HDI) and diabetes comparative prevalence (R = 0.81). Conclusion: The alarming rising trend of diabetes prevalence in the Arab region constitutes a real challenge for heath decision makers. In order to alleviate the burden of diabetes, preventive strategies are needed, based essentially on sensitization for a more healthy diet with regular exercise but health authorities are also asked to provide populations with heath- care and early diagnosis to avoid the high burden caused by complications of diabetes.
文摘Background: The last Moroccan population and family health survey (EPSF 2011) was carried out between November 2010 and March 2011. The final report and the whole database are not yet accessible while a preliminary report was released early March 2012. The information given so far does not allow for a complete evaluation of the present health situation in Morocco. However, a partial equity analysis can be devoted to the comparison of health indicators in terms of gender and urban-rural gaps. Method: 1) Questionnaires: a household questionnaire dealt with household characteristics, general health, housing condition and anthropometric data for children less than six years of age. A second questionnaire was devoted specifically to ever married women and dealt with their resources, marriage, reproductive health, family planning, AIDS/SIDA, healthcare and nutrition. 2) Data collection: data were collected through the national survey using a three-stage stratified sampling design to select 640 clusters covering the 16 Moroccan regions. A total of 15,577 households were randomly drawn, providing a sample of 75,061 individuals (51.1% females and 48.9% males) for investigation. 3) Analysis: in this short report, we relied only on partial data released by the Ministry of Health in a preliminary report. We used absolute differences and relative ratios to study the evolution of gender and urban-rural gaps on the basis of socioeconomic indicators. Results and Discussion: The Moroccan population seems to be in the last phase of its demographic transition. The total fertility rate decreased from 5.6 children per woman in 1980 to 2.5 in 2011. The mean age of first marriage went from 24 years for men and 17.5 years for women in 1960 to 31.5 years and 26.3 in 2011 for men and women respectively. The age structure is showing a trend of ageing population. Generally, health indicators related to reproductive and women’s health improved noticeably and consequently, maternal and infant mortality also decreased. However, while these achievements are praiseworthy as national averages, they remain insufficient in terms of equitable healthcare and access to health services since there is still a long way to go in order to reduce the huge gender gaps and rural-urban disparities. Conclusion: In this short report, we showed that, as averages, health indicators improved noticeably during the last decade but gender inequality and urban-rural disparities are still challenging health decision makers. Moroccan health decision makers are urged to adopt an equitable health strategy, starting by giving access to data for analysis, monitoring and evaluation.
文摘Due to its chronic nature with severe complications, diabetes needs costly prolonged treatment and care. The high economic burden of diabetes is particularly threatening low and middle income countries. World-wide, studies have shown that the cost of diabetes per person is much higher than the per capita health expenditure. This study is the first to estimate the direct and indirect cost of diabetes in Morocco. The direct cost of diabetes was computed by assuming three scenarios of prices (low, medium and high) due to different prices of insulin, oral drugs and other items used in diabetes treatment and care. Indirect costs of diabetes were estimated by the lifetime forgone earnings caused by premature death and disability due to diabetes. The direct cost of diabetes in Morocco was estimated to be between US $0.47 and US $1.5 billion whereas the indirect cost was estimated to be around US $2 billion accounting for 57% of the total cost of diabetes under the high cost scenario, 69% under the medium scenario and 81% under the low cost scenario. The average per capita indirect cost was estimated to be US $1113, relatively higher than the direct cost of diabetes which was seen to vary from US$ 259 to US $830. The results yielded by this study were compared to those obtained by similar studies in different regions and countries of the world. As a conclusion, the findings of this study indicate a high economic burden of diabetes and stress the importance that Moroccan health decision makers should give to sensitisation, early diagnosis and treatment of diabetes especially with the crucial growing trend of diabetes prevalence.
文摘Worldwide, diabetes is affecting 370 million people, causing nearly five million deaths and absorbing more than 471 billion USD per year. Mathematical models have been developed to simulate, analyse and understand the dynamics of β-cells, insulin and glucose. In this paper, we consider the effect of genetic predisposition to diabetes on dynamics of β-cells, glucose and insulin. We assume that the β-cell dynamics is governed by the differential equation: . The model indicates different behaviours according to the presence or absence of genetic predisposition. In presence of predisposition (ε = 1), the model shows three equilibrium points: a stable physiological equilibrium point (G = 100, I = 20, β = 600), a stable trivial pathological equilibrium point (G = 600, I = 0, β = 0) and a saddle point (G = 250, I = 9.8, β = 129.36). In absence of predisposition (ε = 0), the model has only two equilibrium points: an unstable pathological equilibrium point (G = 600, I = 0, β = 0) and a stable physiological equilibrium point (G = 82.6, I = 23, β = 900). In order to see how physical activity, obesity and other factors affect insulin sensitivity, simulations are carried out with different values of insulin induced glucose uptake rate (c), β-cell maximum insulin secretory rate (d) and environmental capacity (K).
