Hypertension Prevalence,Awareness,Treatment,and Control and Their Associated Socioeconomic Factors in China:A Spatial Analysis of A National Representative Survey

Objective We aimed to investigate and interpret the associations between socioeconomic factors and the prevalence, awareness, treatment, and control of hypertension at the provincial level in China.Methods A nationally and provincially representative sample of 179,059 adults from the China Chronic Disease and Nutrition Surveillance study in 2015–2016 was used to estimate hypertension burden. The spatial Durbin error model was fitted to investigate socioeconomic factors associated with hypertension indicators.Results Overall, it was estimated that 29.20% of the participants were hypertensive nationwide,among whom, 34.32% were aware of their condition, 27.69% had received antihypertensive treatment,and 7.81% had controlled their condition. Per capita gross domestic product(GDP) was associated with hypertension prevalence(coefficient:-2.95, 95% CI:-5.46,-0.45) and control(coefficient: 6.35, 95% CI:1.36, 11.34) among adjacent provinces and was also associated with awareness(coefficient: 2.93, 95%CI: 1.12, 4.74) and treatment(coefficient: 2.67, 95% CI: 1.21, 4.14) in local province. Beds of internal medicine(coefficient: 2.66, 95% CI: 1.08, 4.23) was associated with control in local province. Old dependency ratio(coefficient:-3.58, 95% CI:-5.35,-1.81) was associated with treatment among adjacent provinces and with control(coefficient:-1.69, 95% CI:-2.42,-0.96) in local province.Conclusion Hypertension indicators were not only directly influenced by socioeconomic factors of local area but also indirectly affected by characteristics of geographical neighbors. Population-level strategies should involve optimizing supportive socioeconomic environment by integrating clinical care and public health services to decrease hypertension burden.

Prevalence of diarrhoea and risk factors among children under five years old in Mbour,Senegal:a cross-sectional study

Background:Diarrhoeal diseases remain an important cause of mortality and morbidity among children,particularly in low-and middle-income countries.In Senegal,diarrhoea is responsible for 15%of all deaths in children under the age of five and is the third leading cause of childhood deaths.For targeted planning and implementation of prevention strategies,a context-specific understanding of the determinants of diarrhoeal diseases is needed.The aim of this study was to identify risk factors of diarrhoeal diseases in children under the age of five in Mbour,Senegal.Methods:Between February and March 2014,a cross-sectional survey was conducted in four zones of Mbour to estimate the burden of diarrhoeal diseases(i.e.diarrhoea episodes in the 2 weeks preceding the survey)and associated risk factors.The zones covered urban central,peri-central,north peripheral and south peripheral areas.Overall,596 households were surveyed by a questionnaire,yielding information on sociodemographic,environmental and hygiene behavioural factors.Univariable and multivariable logistic regression analyses were used to identify risk factors associated with the occurrence of diarrhoea.Results:The reported prevalence of diarrhoea among children under the age of five during the 2 weeks preceding the survey was 26%.Without adjustment,the highest diarrhoea prevalence rates were observed in the peri-central(44.8%)and urban central zones(36.3%).Multivariable regression revealed significant associations between diarrhoeal diseases and unemployment of mothers(adjusted odds ratio[aOR]=1.62,95%confidence interval[CI]:1.18-2.23),use of open bags for storing household waste(aOR=1.75,95%CI:1.00-3.02),evacuation of household waste in public streets(aOR=2.07,95%CI:1.20-3.55),no treatment of stored drinking water(aOR=1.69,95%CI:1.11-2.56)and use of shared toilets(aOR=1.69,95%CI:1.11-2.56).Conclusion:We found a high prevalence of diarrhoea in children under the age of five in Mbour,with the highest prevalence occurring in the central and peri-central areas.These findings underscore the need for public health interventions to alleviate the burden of diarrhoea among vulnerable groups.Promotion of solid waste disposal and reduction of wastewater exposure should be implemented without delay.

Patient Enablement in Chronic Diseases in Primary Health Care, Riyadh City, KSA

Background: Chronic diseases continue to cause high morbidity and mortality in Saudi Arabia. Patients severing from diabetes mellitus, hypertension and associated complications have recently increased and most of these patients find it extremely difficult to understand or cope with their illness. The objective of this study is to determine the level of patients’ enablement in chronic disease and its predictors. Methods: A community based cross-sectional study was conducted between December 2014 and January 2015. Six hundred and four (604) Patients attending the Chronic Disease Clinic in Alwazarat Health center were randomly selected to participate in the study. Patients aged 18 years and above, who willingly agreed to participate, were included in the study. Self-reported questionnaire was used to determine patient level of enablement. Descriptive statistics such as mean and median were calculated and binary logistic regression was employed to determine the predictors of patient’s enablement to chronic disease. Results: Our results show that five hundred and sixty five (565) out of (604) patients participated in the study with 86.6% response rate. Type 2 diabetes mellitus affecting 40.65% while hypertension affecting 37.79% of the patients in Al wazarat health center. Patient’s enablement to chronic disease was very low and ranged between 2.41 and 1.53 out of 5.0. Binary logistic regression shows that age (male: OR;0.84, 95% CI, 0.72 - 1.04, female. OR;1.04, 95% CI 0.88 - 1.39), marital status (male: OR;0.72, 95% CI 0.54 - 1.11, female: OR 1.01;95% CI 0.82 - 1.29), patient educational level and number of problems discussed with physician and consultation length between male patients and their physician were statistically significant and correlated with patients enablement to chronic disease (P < 0.05). Conclusion: This study shows that patient’s enablement in chronic disease is very low but constitutes an important arm in patients care management. It should be considered as a measurable patient outcome from healthcare services. More prospective studies on this important topic are highly recommended.

Do natural resources impact economic growth:An investigation of P5+1 countries under sustainable management

Natural resources represent the base of our living and the entire economic activity.Their depletion is a major challenge for the economic development of both developed and developing economies.Their effi-cient use is an indispensable requirement and must be the aim of the public policies designed by the authorities worldwide.In this research,we have investigated the impact of the natural resources rent on the economic growth in some major wealthy economies of the world(P5+1 countries namely:US,UK,France,China,Russia,and Germany).We have applied a quantile-on-quantile regression to analyse this impact on different quantiles and a cross-sectional autoregressive distributed lag(CS-ARDL)approach for the panel of these six countries.The Dumitrescu-Hurlin panel causality test was also used to check the causality between natural resource rents and economic growth in these countries.Results show a negative relationship between natural resources rent and economic growth for the panel but a different impact on quantiles in each country.Only for China and the US,a positive effect can be noticed for both lower and higher quantiles of natural resources and economic growth.The Dumitrescu-Hurlin causality test shows that natural resources can predict economic growth only in China,the U.S.,and the panel.In contrast,no causality was found for the other four countries included in the panel.We suggest that nations invest in wind and solar projects,use biofuels and nuclear energy,introduce a temporary profit tax to protect consumers from escalating energy prices,and increase energy efficiency in buildings and industry.Businesses would benefit from a regulatory framework that is uniform and exhaustive,as well as easier to traverse and more receptive to innovation and creativity.Public-private partnership investments in innovation,innovation incentives,and environmental sector opportunities may foster long-term economic growth。