The Interventional Capacity of Community Health Volunteers for Screening and Linkages of Non-Communicable Diseases in Nyeri County, Kenya

Non-communicable diseases (NCDs) account for 63% of mortalities. Approximately 80% of these NCD-related deaths occur in LMICs. A quasi-experimental study utilizing a non-equivalent pre-and post-test was conducted from May 2022 to March 2023 with 370 study participants. Multistage cluster and random sampling were used to select ten community units, and therefore, 150 CHVs were chosen for the control unit, and 150 were used to form the interventional group. Data was collected from the KOBO app. Six (6) homogenous FGDs comprised ten members, and 10 KII were conducted across study sites. Quantitative data was analyzed using SPSS version 28.0, and qualitative data was audio-recorded, transcribed, and analyzed via N-Vivo 12. The study shows that 59.3% of respondents have minimal information, and 92.7% (n = 139) have no clear understanding of NCDs, with a pre-intervention capacity of 48.8%. Independent sample t-test showed a significant difference in capacity from a pre-intervention average of 48.75 (SD ± 5.7)%, which increased to 68.28 (SD ± 7.6)%, p < 0.001. A well-designed community interventional model plays a pivotal role in grassroots healthcare delivery but requires optimization for NCD management.

Assessment of Barriers and Challenges to the Screening and Linkages of Non-Communicable Diseases by Community Health Volunteers in Nyeri County, Kenya

Non-communicable diseases (NCDs) are a significant global health challenge, contributing to 50% of worldwide morbidity and 63% of mortality. The burden is particularly substantial in low—and middle-income countries (LMICs), where 80% of NCD-related deaths occur. A quasi-experimental study addressed this challenge from May 2022 to March 2023. This study utilized a non-equivalent pre-and post-test design, with 300 participants in the quantitative and 70 in the qualitative. The study employed multistage cluster and random sampling to select ten community units, resulting in 150 community health volunteers (CHVs) in the control unit and 150 in the intervention group. Data collection was facilitated through the KOBO app. Qualitative data analysis involved six homogeneous focus group discussions (FGDs) and ten key informant interviews (KIIs), audio-recorded, transcribed, and analyzed using N-Vivo 12. Despite efforts to implement screening programs and improve linkages to care, significant barriers persist. This article reviews these barriers, drawing on current literature and empirical evidence. Key obstacles identified include limited awareness, inadequate healthcare infrastructure, cultural beliefs, financial constraints, fragmented healthcare systems, and challenges linking individuals to appropriate care services. The article explores strategies to overcome these barriers, emphasizing the importance of collaborative approaches involving stakeholders at various levels. Addressing these challenges aims to strengthen NCD screening and linkages to care, ultimately improving health outcomes for populations globally. Several recommendations emerge from the study’s findings and literature review. Raising awareness about NCDs and preventive measures is crucial and can be achieved through targeted health education campaigns and community outreach programs. Addressing healthcare infrastructure deficiencies, such as inadequate facilities and workforce shortages, is essential to ensure access to quality care. Cultural beliefs and practices also play a significant role in shaping health-seeking behavior. Engaging with local communities and incorporating cultural sensitivity into healthcare delivery can help bridge the gap between traditional beliefs and modern healthcare practices. Financial constraints pose a significant barrier to healthcare services, particularly in LMICs. Innovative financing mechanisms, such as health insurance schemes or subsidies, can help alleviate this burden and improve access to care. Furthermore, the fragmented nature of healthcare systems can hinder effective NCD management. Enhancing coordination and integration between primary care providers, specialists, and community health workers is essential to ensure seamless care delivery and patient follow-up. Finally, strengthening linkages between screening programs and care services is critical for the timely diagnosis and management of NCDs. This requires establishing robust referral systems and ensuring continuity of care for patients throughout their healthcare journey. In conclusion, addressing the multifaceted barriers to NCD screening and care linkage is essential for improving health outcomes globally. By implementing targeted interventions and fostering collaboration among stakeholders, progress can be made towards reducing the burden of NCDs and promoting population health.

Clustering of Non-communicable Diseases Risk Factors in Healthy Adults Aged 35 Years and Older in Shenzhen,China

We assessed the prevalence of non‐ communicable diseases（NCDs） risk factors with a focus on their clustering among healthy adults in Shenzhen, China. Data from the 2011 China Health and Nutrition Survey, comprising a regionally representative sample of 806 healthy adults aged 35 years or older, were obtained to determine the prevalence of five risk factors for NCDs. The prevalence of current smoking, central obesity, impaired fasting glucose, borderline hypertension, and borderline high total cholesterol was 19.97%, 28.29%, 4.47%, 10.55%, and 36.10%, respectively. A total 63.77% of participants had at least one risk factor. Upon examination of risk factor clustering, we observed that 7.57% of participants had at least three risk factors. Using this threshold as a cutoff, clustering of risk factors was associated with sex [odds ratio（OR） = 3.336, 95% confidence interval（CI）： 1.782 to 6.246], physical activity（OR = 1.913, 95% CI： 1.009 to 3.628）, and BMI（OR = 7.376, 95% CI： 3.812 to 14.270）. The prevalence of risk factors for NCDs is fairly high among healthy adults in Shenzhen, with a clustering tendency.

Impact of sepsis and non-communicable diseases on prognostic models to predict the outcome of hospitalized chronic liver disease patients

AIM To evaluate the impact of sepsis and non-communicable diseases(NCDs) on the outcome of decompensated chronic liver disease(CLD) patients.METHODSIn this cross-sectional study, medical records of patients with CLD admitted to the Gastroenterology unit at the Aga Khan University Hospital were reviewed.Patients older than 18 years with decompensation of CLD(i.e., jaundice, ascites,encephalopathy, and/or upper gastrointestinal bleed) as the primary reason for admission were included, while those who were admitted for reasons other than decompensation of CLD were excluded. Each patient was followed for 6 wk after index admission to assess mortality, prolonged hospital stay(> 5 d), and early readmission(within 7 d).RESULTS A total of 399 patients were enrolled. The mean age was 54.3 ± 11.7 years and64.6%(n = 258) were male. Six-week mortality was 13%(n = 52). Prolonged hospital stay and readmission were present in 18%(n = 72) and 7%(n = 28) of patients, respectively. NCDs were found in 47.4%(n = 189) of patients. Acute kidney injury, sepsis, and non-ST elevation myocardial infarction were found in41%(n = 165), 17.5%(n = 70), and 1.75%(n = 7) of patients, respectively. Upon multivariate analysis, acute kidney injury, non-ST elevation myocardial infarction, sepsis, and coagulopathy were found to be statistically significant predictors of mortality. While chronic kidney disease(CKD), low albumin, and high Model for End-Stage Liver Disease(MELD)-Na score were found to be statistically significant predictors of morbidity. Addition of sepsis in conventionalMELD score predicted mortality even better than MELD-Na(area under receiver operating characteristic: 0.735 vs 0.686; P < 0.001). Among NCDs, CKD was found to increase morbidity independently.CONCLUSION Addition of sepsis improved the predictability of MELD score as a prognostic marker for mortality in patients with CLD. Presence of CKD increases the morbidity of patients with CLD.

Prevalence of Tobacco Use and Associated Factors among Adults in Benin in 2015: Results of the National Survey of Non-Communicable Disease Risk Factors

Introduction: Tobacco use and exposure to tobacco smoke are one of the most preventable causes of death and disability worldwide. The risk is even higher among daily tobacco consumers. The World Health Organization (WHO) recommended that surveillance of major risk factors for non- communicable diseases (NCDs), such as smoking, be imperative to predicting the future burden of NCDs, identifying adequate interventions to decrease future burden and monitor trends. In 2015, a survey on NCD risk factors was conducted in Benin to estimate the prevalence of major NCD risk factors. We analyzed the data from this survey to estimate the prevalence and risk factors associated with daily tobacco consumption in Benin. Methods: A nationwide representative sample of the population was constituted in the 12 departments of Benin. The WHO STEPS wise tool was used to collect data on behavioral and demographic characteristics, including daily tobacco consumption. Tobacco consumption was subdivided into three categories: The daily consumption of tobacco, the daily consumption of smoked tobacco and non-smoked tobacco. Multivariate analysis through the weighted logistic regression was used to identify potential factors associated with daily consumption of tobacco. Results: Over the 5.126 surveyed subjects, 7.49% were daily tobacco consumers, with 3.85% being daily users of smoked tobacco and 4.36% being daily consumers of non-smoked tobacco. Men were more likely to be daily consumers of tobacco compared to women (OR = 7.42;95%CI = [4.98;11.06]). Compared to respondents aged 18 to 24, those aged 45 to 54 were five times more likely to consume tobacco (OR = 5.58;95%IC = [2.71;11.47]). Respondents residing in the departments of Atacora, Couffo and Borgou were respectively 4.28 times, 3.93 times and 2.63 times more likely to consume tobacco compared to those residing in the department of Alibori. Respondents with no education were more likely to consume tobacco daily compared to respondents who had finished high school or were in university (OR = 3.73;95%CI = [1.36;10.23]. Respondents who were overweight were less likely to be daily users of tobacco compared to people with normal weight status (OR = 0.57;95%CI = [0.34;0.96]). Conclusion: There is a relatively high prevalence of smoking in Benin, where one out of 8 people, consumes tobacco products daily. Being elderly, male, having no formal education, residing in Atacora, Borgou or Couffo were significantly associated with daily smoking. Prevention actions should thus target those sub-groups of the population.

Underwater Optical Wireless Communications （UOWC） Based on Visible Light

In this paper, we investigate the effect of water attenuation on an underwater optical wireless communication based on LOS model. We take into account parameters including the chlorophyll concentration and also discuss the choice of suitable wavelength for underwater optical wireless communication. Using analytical expressions and calculating the Jerlov water type attenuation, the received signal power is studied. The characteristics of bit error rate for four kinds of optical modulation techniques （OOK, 2FSK, 2DPSK, and L-PPM） are analyzed. The results show that the performance of OOK and 2DPSK are more suitable for underwater optical wireless communication. On the other hand, the wavelength 450 nm is better compared with the wavelength 600 nm.

The challenge of combatting non-communicable diseases in Trinidad: Access to hospital care

Chronic illnesses, or non-communicable diseases (NCDs), account for a growing number of deaths worldwide. The English-speaking Caribbean has the highest per capita burden of NCDs in the region of the Americas [1]. This paper presents an overview of hospital availability on the island of Trinidad in the West Indies and examines rates of NCDs as reported in hospital discharge summaries. The project integrates a Geographic Information System (GIS) with epidemiologic and bio-statistical data to provide essential spatial analysis not otherwise possible. It examines the island’s ability to effectively deliver treatment to residents with NCDs by providing a geographic perspective to public data published on the internet by the Trinidad-Tobago Ministry of Health and the Central Statistical Office. The study reveals a significant variability in several dimensions of access to health care.

Prevalence of Non-Communicable Diseases and Number of Comorbidities According to Differences in Household Income Levels in Japan: Analysis from National Health and Nutrition Survey

Though it has been reported that in Western developed countries socioeconomic status is associated with non-communicable diseases (NCD), there are sparse evidence from Japan, midst an income gap that has been pointed out in recent years. Therefore, we examined the presence or absence of NCD and the number of comorbidities according to household income in Japanese, using data from the National Health and Nutrition Survey of 2010. 1287 men and 1659 women aged 20 - 79 years from households at 3 income levels (<2, 2 - 5.9, ≥6 million yen) were analyzed. Participants completed questionnaires regarding whether they had been diagnosed with NCD, as well as undergoing clinical laboratory tests. Logistic regression analyses were used for statistical analysis with adjustment for age, gender, household size, and population of municipalities. The prevalences of participants with high, medium, and low income were 22.3%, 57.6%, and 20.2%, respectively. Participants with the lowest income had the highest odds of hypertension (OR [95% confidence interval (CI)] = 1.71 [1.29 - 2.26], p p = 0.041), and stroke (5.07 [2.04 - 12.60] p < 0.001). Additionally, prevalences of participants with 2 or 3 NCD (hypertension, diabetes, and hypercholesterolemia) were 15.0% and 33.0% in high and low income levels, respectively. A low income could contribute to a high prevalence of NCD and large number of comorbidities among Japanese. Establishing a health policy in Japan is needed to enable an optimal health condition and lifestyle regardless of socioeconomic disparities.

Burden of Non-Communicable Diseases at a Tertiary Care Hospital of Central Uttar-Pradesh: A Retrospective Study

Introduction: Non Communicable Diseases (NCD) has emerged as leading threat to mankind. It approximates to around 70% mortality burden worldwide. Its mortality burden is more in low & middle income countries. Most of the premature deaths from NCDs are attributed to modifiable risk factors. In Uttar Pradesh there has been a raise in prevalence of non-communicable diseases in the last two decades. Methodology: Mortality and morbidity data from 1st Jan 2014 to Dec 2016 was obtained from Medical Records Department, UPUMS, Saifai Etawah. The data, thus collected was analyzed by using SPSS 24. Results: Morbidity pattern in UPUMS Saifai reported Blindness and cardiovascular disease (CVD) was leading cause of admission and was increasing year after year. Road traffic acid (RTA), Stroke and CVD were the leading causes of mortality in last 3 years among the patients admitted in tertiary care hospital UPUMS, Saifai, Etawah, U.P., India. Conclusion: Even in rural area prevalence of NCD is at raising trend. RTA, CVD and Stroke were leading causes of death even in rural area.

Investigating College Students’ Diet and Physical Activity Behaviors Regarding Non-Communicable Diseases Prevention in China

We aimed to investigate if college students’ dietary and physical activity adhered to the Chinese Dietary Guidelines, the Composing Editorial Board of Physical Activity Guidelines, and WHO recommendation for NCDs prevention. Methods: A 3-day (2 weekdays and 1 weekend day) 24-hour (24-HRs) dietary recall was conducted to record details of participants’ food consumption. One-way analysis of variance (ANOVA) was applied to examine the influence of the identified demographic variables (including BMI, gender, major, family monthly income, and place of household registration) on the 8 food groups’ consumption. We analyzed the effect of the various demographic variables on sodium intake by the student’s t-test. The questionnaire, International Physical Activity Questionnaire (IPAQ)-Short Form, was utilized to assess participants’ physical activity (PA) level. The Wilcoxon-Mann-Whitney was applied to analyze participants’ physical activity. Results: Our research indicated participants consumed much fewer fruits and vegetables and excessive meats on average for both males and females regarding NCDs prevention. Conclusion: Participants’ dietary intake did not comply with the Chinese Dietary Guide-lines recommendation for chronic diseases prevention. Nutrition knowledge and health education are needed for college students. .

Associated Risk Factors of Non-Communicable Disease in Three Sites across Ivory Coast: An Urban (Cocody), Peri-Urban (Abobo) and Rural (Yocoboué) Area

Introduction: The prevalence of Non-communicable diseases (NCDs) has increased so it’s becoming a global public health problem. This problem is also threatening in Sub-Sahara Africa (SSA) country including Ivory Coast. Ivory Coast is a country of 22.6 million people experiencing rapid economic development and social change. All development is typically associated with an increase in non-communicable disease (NCD) risk factors. Our study aimed to determine the prevalence and associated factors of the major risk factors of NCDs among the population of Cocody, Abobo and Yocoboué in the Ivory Coast. Methods: A descriptive and analytical cross-sectional study was conducted and involved 1146 adults of 19 to 60 years from general population in Cocody (urban), Abob (peri-urban) and Yocoboué (rural). The WHO STEPS risk factor survey has been changed a bit and was administered. it contains anthropometric and biochemical measures. Results: The prevalence of NCD risk factors was markedly different across the three sites particularly between urban (Cocody) and rural (Yocoboué) areas. The overall prevalence estimates of the risk factors were 15.2% for current smoking, 57.71% for harmful use of alcohol, 58.84% for low physical activity, 24.71% for sedentariness (sitting at least 7 h), 69.45% for skipping breakfast, 61% for having late dinner and 36% for snacking. Concerning biological risk factor we noticed 40.95% for Overweight/obesity, 52.96% for abdominal obesity, 14.61% for raised blood pressure, 23.37% for raised blood sugar and 18.51 low HDL-C. Being female has an important associated with an increased risk for having abdominal obesity (OR: 25.7) and being overweight or obese (OR: 11.3), suffering from hypertension increased with age, 30 - 39 years (OR 8.45), 40 - 49 years (OR 13.4) and 50 years and above (OR 24.6). Conclusion: Adult residents in the two (Urban and peri-urban) of three different areas are developing high-risk NCDs, particularly Cocody’s population. At the end, we observed among participants that the female gender, living in urban areas and clustering are the most concerned by non-communicable disease risk factors. To reach the goal, preventive and therapeutic interventions are needed among the targeted population.

Sustaining Increase in Life Expectancy in Africa Requires Active Preventive Measures against Non-Communicable Diseases

It is projected that aged population (≥60 years) will continue to increase globally, including in Africa. This is due to reduced population growth, decreased fecundity and improved medical interventions;factors which increase life expectancy. While this is typical for developed countries, it is not the same for Africa and similar developing regions. In these regions, a significant proportion of death is due to non-communicable diseases (NCD’s) such as hypertension, cerebrovascular accident, coronary heart disease, diabetes mellitus, chronic renal disease and cancer, among others. Rising prevalence of NCD’s due mainly to western style diets and sedentary living is made worse by inadequate nutrition education, high prevalence of low birth weight, poor health services, lack of efficient tobacco control and deficient planning of built environment. In order to halt the possible reduction in life expectancy occasioned by NCD’s, efforts by the community, health planners and governments in Africa to address relevant NCD’s, must be put in place. Suggested measures are: nutrition education, regular community directed physical exercise, improved environmental planning and development. Others are review of present health service model, early detection, prevention and treatment of NCD’s, including improved antenatal care to reduce low birth weights, and establishment of policies and measures that decreased access to tobacco especially by women of childbearing age. Africa and similar developing regions cannot fund the health bill due to NCD’s and their complications;hence it is important that this scourge is attended to with all seriousness.

国内慢性非传染性疾病管理模式现状分析

随着疾病谱的逐渐转变和人口老龄化不断加快,慢性非传染性疾病(以下称慢性病)患病率、致残率、致死率呈上升趋势,我国居民整体健康已受到严重威胁,国家卫生资源和社会经济面临沉重负担。我国一直在探索有效的慢性病管理模式,希望利用正确且符合我国国情的慢性病管理模式缓解慢性病导致的各种压力。文章对国内慢性病管理模式进行综述,介绍在慢性病管理体系各个阶段提出的模式类型,分析各类型慢性病管理模式的内容、特点及需要改进的方面,以期为各地区的慢性病管理模式提供参考。

生命全程路径与慢性非传染性疾病防治

本文通过从慢性非传染性疾病(NCDs)胎源学说和现有探讨生命全程对慢性病影响的因果机制模型,展开对生命全程理论在NCDs防治策略中的作用进行综述。从生命全程的角度总结了慢性病发生和发展过程,强调能够通过早期识别高风险表型和风险标记,在生命早期提供及时的干预措施,支持当前NCDs第一级预防的努力。最后提出WHO倡导的生命全程路径与可持续发展目标协同作用的政策建议。

老年慢性病病人电子健康素养干预的研究进展

阐述老年慢性病病人电子健康素养的概念与发展、评估工具以及基于理论的干预现状和干预策略这3个主要方面。旨在明确构建电子健康素养干预方案时可借鉴的相关理论模型和干预策略,为我国老年慢性病病人构建基于理论的干预方案提供有力的参考。

上海市奉贤区慢性病高风险人群饮酒情况及影响因素分析

目的了解上海市奉贤区慢性病高风险人群的饮酒情况及影响因素,为开展慢性病高风险人群的饮酒干预及健康管理提供理论依据。方法以“2018年奉贤区慢性病及其危险因素监测”项目中符合慢性病高风险人群标准的3682人作为研究对象进行问卷调查。结果奉贤区慢性病高风险人群的现在饮酒率和过量饮酒率分别为28.30%和26.10%;男性的现在饮酒率和过量饮酒率分别为53.33%和31.74%,高于女性的10.50%和5.15%。现在饮酒者的日均酒精摄入量为5.98g;男性和女性日均酒精摄入量分别为10.26g和0.85g,差异有统计学意义(P<0.01)。饮用率最高的3种酒分别为黄酒(58.73%)、啤酒(37.81%)和葡萄酒(26.58%);男性中以黄酒的饮用率最高(65.69%),女性中以葡萄酒的饮用率最高(33.68%)。多因素logistic回归分析结果显示:女性、≥65岁人群的现在饮酒风险较低;男性、高年龄组人群的过量饮酒风险较高。结论奉贤区慢性病高风险人群的饮酒率较高,应针对不同人群的饮酒特点开展有针对性的健康干预措施,减少与饮酒相关的慢性病发病风险。

慢性病患者中医传统功法康复训练促进与阻碍因素的Meta整合

目的系统评价并整合慢性病患者中医传统功法康复训练的促进与阻碍因素的质性研究,为制订干预策略提供理论依据。方法系统检索中国知网、万方数据知识服务平台、维普网、中国生物医学文献数据库、Cochrane Library、Web of Science、PubMed、Embase中有关慢性病患者中医传统功法康复训练的促进与阻碍因素的质性研究,检索时限均为建库至2024年5月,采用JBI循证卫生中心的质性研究真实性评价工具(2016版)对文献质量进行评价,采用汇集性整合方法对结果进行分析。结果共纳入8篇文献,提炼出56个结果,归纳为10个新类别,综合成2个整合结果:促进因素包括对中医传统功法康复训练的好奇心、感知的身心益处、感知的健康威胁、良好的社会支持、干预因素(中医传统功法康复训练的优势及教学方式);阻碍因素包括缺乏意志力、疾病和治疗因素的影响、对运动风险的担忧、缺乏练习的条件、干预因素(动作的挑战性及线上/小组教学的弊端)。结论慢性病患者中医传统功法康复训练受多种因素影响,医务人员应根据相关因素,结合患者对中医传统功法康复训练的态度及观点,制订符合患者的中医传统功法康复训练的干预措施。

浅述国内外慢病风险评估工具研究进展

随着我国经济的发展和生活水平的提高,慢性非传染性疾病(简称慢病)的发病率逐步上升,成为重大公共健康问题。本文综述了国内外慢病风险评估工具的研究进展,重点分析了心血管疾病(CVD)、糖尿病和脑卒中的风险评估工具,并探讨了生物标记物在CVD风险评估中的应用,以及人工智能技术在风险评估中的潜力与挑战。研究表明,多种风险评估工具能有效预测个体的慢病发病风险,但同时也存在数据依赖性、透明度和可解释性问题、技术局限性与误判风险等挑战。未来研究应注重工具的个性化和精准化,加强跨学科合作和技术创新,提高公众对慢病风险评估工具的认知和使用率。

生活方式医学教育在美国的发展

生活方式干预作为慢性病防治首选,已被医学界认可。生活方式医学在美国发展20余年,多家医学院校创新医学课程改革,开展本科与研究生阶段课程、明确专业核心能力培养目标、成立专业性学术组织和认证考核制度。文章旨在介绍生活方式医学教育在美国的发展情况,供同行借鉴。

Treating Hypertension in the Workplace: Can the Numbers Be Controlled in 3 Months?

Hypertension is a public health problem that affects both developed and developing countries. Senegal is making significant progress in the fight against this and other chronic, non-communicable diseases. Achieving blood pressure control within three months of treatment is an important pillar of Senegal’s strategy. The objective of this study was to evaluate the achievement of blood pressure control within three months of treatment at SCL. Our results show the need to strengthen blood pressure management skills of healthcare staff.