Prevalence of Risk Factors for Cardiovascular Disease and Their Associations with Diet and Physical Activity in Suburban Beijing,China

Background

We calculated new prevalences of risk factors for cardiovascular disease (CVD) and examined their associations with dietary habits and physical activity in a suburban area of Beijing—one of the most urbanized cities in China.

Methods

In 2007, a cross-sectional survey of a representative sample of 19 003 suburban residents aged 18 to 76 years was conducted. Dietary and anthropometric data were collected by questionnaire, and blood pressure, fasting blood glucose, and serum lipids were measured.

Results

The age-standardized prevalences of the CVD risk factors overweight/obesity, diabetes, hypertension, dyslipidemia, and metabolic syndrome (MS) were 31.9%, 6.1%, 33.6%, 30.3%, and 11.6%, respectively. The adjusted odd ratios (95% confidence interval [CI]) of overweight/obesity, diabetes, hypertension, dyslipidemia, and MS for participants who were physically active, as compared with those who were not physically active, were 0.67 (0.47 to 0.85), 0.87 (0.80 to 0.95), 0.92 (0.87 to 0.98), 0.89 (0.82 to 0.96), and 0.74 (0.62 to 0.89), respectively. The adjusted odds ratios (95% CI) of hypertension and MS for participants with a high intake of salt, as compared with those without a high intake of salt, were 1.72 (1.29 to 2.03) and 1.48 (1.16 to 1.77), respectively. In addition, participants who consumed a high-fat diet were more likely to be overweight/obese and dyslipidemic, whereas vegetarians had less risk of overweight/obesity, diabetes, hypertension, dyslipidemia, and MS.

Conclusions

In this population of adults living in suburban Beijing, there were relatively high prevalences of the CVD risk factors overweight/obesity, diabetes, hypertension, dyslipidemia, and MS. Healthy dietary habits and physical activity may reduce the risks of these conditions.Key words: cardiovascular disease, risk factors, associations, dietary habits, physical activity     

Prehypertension and clustering of cardiovascular risk factors among adults in suburban Beijing, China

Background

Prehypertension is common in China and is associated with an increased risk of cardiovascular disease. The present study estimated the current prevalence of prehypertension and its association with clustering of other modifiable cardiovascular risk factors (CRFs) among adults in suburban Beijing.

Methods

A cross-sectional survey of a representative sample of 19 003 suburban adults aged 18 to 76 years was carried out in 2007. Questionnaire data and information on blood pressure, anthropometric characteristics, and laboratory measurements were collected.

Results

The age-standardized prevalence of prehypertension was 35.7% (38.2% in men and 31.8% in women) among adults in suburban Beijing. The prevalence of overweight/obesity, diabetes, dyslipidemia, and physical inactivity was higher in participants with prehypertension (26.7%, 4.8%, 34.3%, and 60.4%, respectively) as compared with normotensive participants (15.9%, 2.7%, 20.5%, and 29.1%, respectively), and in participants with hypertension as compared with those with prehypertension. Overall, 85.3%, 49.8%, and 17.8% of prehypertensive men had 1 or more, 2 or more, and 3 or more CRFs (overweight/obesity, diabetes, dyslipidemia, current smoking, and physical inactivity). These proportions were higher than those in normotensive men (81.5%, 45.1%, and 13.4%) and lower than those in men with hypertension (91.7%, 56.4%, 19.2%). Similar results were found when women with prehypertension were compared with women who were normotensive or hypertensive.

Conclusions

A high prevalence of prehypertension and clustering of other modifiable CRFs are common among prehypertensive adults in suburban Beijing. More-effective population-based lifestyle modifications are required to prevent progression to hypertension and reduce the increasing burden of cardiovascular disease in China.Key words: prehypertension, cardiovascular, risk factor, clustering, suburban     

Smoking Is Associated With Abdominal Obesity,Not Overall Obesity,in Men With Type 2 Diabetes

Objectives

Abdominal obesity increases mortality and morbidity from cardiovascular disease and there is a possibility that smoking effects obesity. However, previous studies concerning the effects of smoking on obesity are inconsistent. The objective of this study was to examine whether smoking is positively related to abdominal obesity in men with type 2 diabetes.

Methods

Subjects consisted of 2197 type 2 diabetic patients who visited Huh''s Diabetes Center from 2003 to 2009. Indices of abdominal obesity were defined as visceral fat thickness (VFT) measured by ultrasonography and waist circumference (WC). Overall obesity was defined as body mass index (BMI).

Results

Statistically significant differences in WC and VFT by smoking status were identified. However, there was no statistical difference in BMI according to smoking status. Means of WC and VFT were not significantly higher in heavy smokers and lower in mild smokers. Compared to nonsmokers, the BMI confounder adjusted odds ratio and 95% confidence interval for VFT in ex-smokers and current-smokers were 1.70 (1.21 to 2.39) and 1.86 (1.27 to 2.73), respectively.

Conclusions

Smoking status was positively associated with abdominal obesity in type 2 diabetic patients.     

Peer Reviewed: Obesity and Obesity-Related Comorbidities in a Canadian First Nation Population

Introduction

Rates of obesity are higher among Canada''s Aboriginal First Nations populations than among non-First Nations populations. We studied obesity and obesity-related illness in a Manitoba First Nation community.

Methods

We conducted a screening study of diabetes and diabetes complications in 2003, from which we drew a representative sample of Manitoba First Nations adults (N = 483). We assessed chronic disease and chronic disease risk factors.

Results

Prevalence of obesity and associated comorbidities was higher among women than men. By using multivariate analysis, we found that factors significantly associated with obesity among women were diastolic blood pressure, insulin resistance, and employment status. Among men, factors were age, apolipoprotein A1 level, apolipoprotein B level, and insulin resistance. Seventy-five percent of study participants had at least 1 of the following conditions: obesity, dyslipidemia, hypertension, or diabetes. Comorbidity was high even among the youngest age groups; 22% of men and 43% of women aged 18 to 29 had 2 or more chronic conditions. Twenty-two percent of participants had undiagnosed hypertension. Participants with undiagnosed hypertension had significantly more chronic conditions and were more likely to have microalbuminuria than were those without hypertension. The number of chronic conditions was not significantly different for participants with newly diagnosed hypertension than for those with previously diagnosed hypertension.

Conclusions

The prevalence of obesity and other chronic conditions in the study community is high, especially considering the number of young people. Community-based interventions are being undertaken to reduce the excessive rate of illness.     

Peer Reviewed: Lifestyle Interventions for Hypertension and Dyslipidemia Among Women of Reproductive Age

Introduction

Hypertension and dyslipidemia often precede cardiovascular disease. Lifestyle modifications help prevent these conditions, and referrals for women may be possible during reproductive health care visits. However, screening recommendations vary, which may affect screening rates. The objectives of this systematic review were to 1) assess the available literature on the effectiveness of lifestyle interventions, 2) review hypertension and dyslipidemia screening recommendations for consistency, and 3) report prevalence data for hypertension and dyslipidemia screening among women of reproductive age.

Methods

We conducted a systematic literature search (January 1990-November 2010) for 1) randomized controlled trials on the impact of lifestyle interventions on cardiovascular disease risk factors in women of reproductive age, 2) evidence-based guidelines on hypertension and dyslipidemia screening, and 3) population-based prevalence studies on hypertension or dyslipidemia screening or both.

Results

Twenty-one of 555 retrieved studies (4%) met our inclusion criteria. Lifestyle interventions improved lipid levels in 10 of 18 studies and blood pressure in 4 of 9 studies. Most guidelines recommended hypertension screening at least every 2 years and dyslipidemia screening every 5 years, but recommendations for who should receive dyslipidemia screening varied. One study indicated that 82% of women of reproductive age received hypertension screening during the preceding year. In another study, only 49% of women aged 20 to 45 years received recommended dyslipidemia screening.

Conclusions

Lifestyle interventions may offer modest benefits for reducing blood pressure and lipids in this population. Inconsistency among recommendations for dyslipidemia screening may contribute to low screening rates. Future studies should clarify predictors of and barriers to cholesterol screening in this population.     

Relationship Between Decayed Teeth and Metabolic Syndrome: Data From 4716 Middle-Aged Male Japanese Employees

Background

Epidemiological findings regarding the relationship between decayed teeth (DT) and metabolic syndrome (MetS) are scarce. We evaluated the relationship of DT with MetS, obesity, and MetS components in early middle-aged male Japanese employees.

Methods

We cross-sectionally analyzed dental and medical health checkup results from a total of 4716 participants aged 42 or 46 years. Logistic regression models were employed to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) after adjustment for age, breakfast consumption frequency, drinking habits, smoking status, and physical activity.

Results

Significant differences in the prevalence of MetS, obesity determined by body mass index, and the components of MetS between participating men with and without DT were detected (all P < 0.01). The adjusted OR of MetS was 1.41 (95% CI, 1.14–1.74) for those with 1 or 2 DT, and 1.66 (95% CI, 1.28–2.16) for those with ≥3 DT (P for trend = 0.01), and this significant relationship was observed even in those without periodontal pocket formation (P for trend = 0.03) or missing teeth (P for trend = 0.02). DT was significantly related to overweight/obesity and the MetS components of hypertension, dyslipidemia, and hyperglycemia, with adjusted ORs of 1.35 (95% CI, 1.19–1.53), 1.22 (95% CI, 1.07–1.39), 1.18 (95% CI, 1.03–1.34), and 1.33 (95% CI, 1.13–1.56), respectively. In addition, even in non-overweight/non-obese men, DT was found to be related to dyslipidemia and hyperglycemia, though with marginal significance (P < 0.05).

Conclusions

Our findings suggest that having DT is related to MetS in early middle-aged Japanese men directly and through obesity and is independent of health behaviors, periodontal condition, and tooth loss.Key words: dental caries, dyslipidemia, hyperglycemia, hypertension, obesity     

Substance Use and Sexually Transmitted Infections Among Anti-Retroviral Treatment Attendees in Jimma University Specialized Hospital,Jimma, Ethiopia

Background

Substance use increases both the risk of Human Immunodeficiency Virus and other Sexually Transmitted Infections, either directly or indirectly. The association of substance use and Sexually Transmitted Infections has not yet studied in Southwestern Ethiopia. The main aim of this study is to determine the associations between substance use and Sexually Transmitted Infections on clients under follow up in Anti-Retroviral Treatment clinic at Jimma University Specialized Hospital.

Methods

A cross-sectional study was conducted on clients under follow up at Anti-Retroviral Treatment clinic from June 10 to July 10, 2011 at Jimma University Specialized Hospital. Data collection was done using a pre-coded and pre-tested questionnaire. Trained Anti-Retroviral Treatment adherence counselors collected the data. Data were entered and analyzed using SPSS for Windows version 16.0. Chi-square test was used to measure the levels of significance. P-value < 0.05 was considered as significant.

Results

Three hundred thirty eight Anti-Retroviral Treatment attendees participated in the study. Two hundred twenty (65.1%) of the study participants were females and their mean (±SD) age was 33.6 ± 8.04 years while 156 (46.2%) of them lied in the age group of 25–34 years. Clients who reported that they had Sexually Transmitted Infections were 120 (35.5%). Those who consumed alcohol were more likely to have contracted in Sexually Transmitted Infections: AOR (95% CI) =0.46 (0.26–0.80).

Conclusion

Prevalence of Sexually Transmitted Infections was comparable among females and males. Substance use, particularly alcohol consumption, found to be a potential risk factor for Sexually Transmitted Infections.     

Peer Reviewed: Depression, Diabetes, and Chronic Disease Risk Factors Among US Women of Reproductive Age

Introduction

Depression and chronic disease have implications for women''s overall health and future pregnancies. The objective of this study was to estimate the prevalence and predictors of diabetes and chronic disease risk factors among reproductive-age women with depression.

Methods

We used population-based data from the 2006, 2008, and 2010 Behavioral Risk Factor Surveillance System to examine prevalence of diabetes and prediabetes, binge and heavy drinking, smoking, overweight and obesity, and physical inactivity among 69,043 women aged 18 to 44 years with current major or minor depression, a past depression diagnosis, or no depression. In a multivariable logistic regression model, we calculated adjusted odds ratios (AORs) and 95% confidence intervals (CIs) of 1, 2, and 3 or more chronic disease risk factors by depression status.

Results

We found that 12.8% of reproductive-aged women experienced both current depression and 1 or more chronic disease risk factors. Compared to women with no depression, currently depressed women and those with a past diagnosis had higher prevalence of diabetes, smoking, binge or heavy drinking, obesity, and physical inactivity (P < .001 for all). Odds of 3 or more chronic conditions and risk factors were elevated among women with major (AOR, 5.7; 95% CI, 4.3-7.7), minor (AOR, 4.7; 95% CI, 3.7-6.1), and past diagnosis of depression (AOR, 2.8; 95% CI, 2.4-3.4).

Conclusion

Depressed women of reproductive age have high rates of chronic disease risk factors, which may affect their overall health and future pregnancies.     

Presence of an interaction between smoking and being overweight increases risks of hypertension, diabetes, and cardiovascular disease in outpatients with mood disorders

Objective

We aimed to evaluate the hypothesis that the presence of an interaction between smoking and being overweight increases the risks of lifestyle-related diseases (hypertension, diabetes mellitus, dyslipidemia, and cardiovascular disease) in outpatients with mood disorders.

Methods

In this cross-sectional survey, using data from 213 outpatients with mood disorders (95 men, 118 women), we calculated the adjusted odds ratios (ORs) with 95% confidence intervals (CIs) for each of hypertension, diabetes, dyslipedemia, and cardiovascular disease, using a binary logistic regression model; we then calculated the adjusted OR values for smokers and non-smokers with body mass indexes (BMIs) of <25 or ≥25 kg/m². Next, we examined the data for the presence of an interaction between smoking and being overweight, using three measures of additive interaction: relative excess risk due to the interaction (RERI), attributable proportion due to the interaction (AP), and the synergy index (S).

Results

Smokers with BMI <25 kg/m² had a significantly lower risk of hypertension (OR 0.27, 95% CI 0.09–0.81) than non-smokers with BMI <25 kg/m² (reference group). Compared with the reference group, overweight non-smokers had a significantly higher risk (2.82, 1.34–6.19) of hypertension, and overweight smokers had a higher risk (4.43, 1.28–15.26) of hypertension and very high risks of diabetes (8.24, 2.47–27.42) and cardiovascular disease (13.12, 1.95–88.41). The highest RERI was derived from the relation with cardiovascular disease. The highest AP and S were derived from the relation with type 2 diabetes. There was no interaction of smoking and being overweight with dyslipidemia.

Conclusion

The presence of an interaction between smoking and being overweight exacerbates the risks of hypertension, diabetes, and cardiovascular disease in outpatients with mood disorders.     

Risk and Protective Factors for Arthritis Status and Severity

Objective

To examine how cigarette smoking, alcohol consumption, obesity, and physical activity are associated with the risk and severity of arthritis among adults living in Delaware.

Introduction

Research has indicated several risk and protective factors for arthritis, including cigarette smoking, alcohol consumption, obesity, and physical activity (1–4). However, it is not well understood how all these factors interact to increase/decrease the risk of arthritis.

Methods

Data from the 2009 Delaware Behavioral Risk Factor Surveillance System (BRFSS) were analyzed in the current study. Potential risk and protective factors for arthritis status and severity examined in this study included: smoking status, alcohol consumption, weight status, and physical activity level. Weighted percentages were calculated for the risk and protective factors by arthritis status and activity limitation due to arthritis/joint symptoms, and were analyzed using a Rao-Scott χ2 test. A logistic regression analysis was performed to determine an odds ratio (OR) while adjusting for gender, age, race/ethnicity, and education.

Results

Adults living in Delaware self-reporting arthritis were more likely to be former and current smokers than those without self-reported arthritis (p < 0.001, OR = 1.64–1.70). Moderate and heavy alcohol drinking was associated with lower prevalence and severity of arthritis (p < 0.001, OR = 0.45–0.74). There was a significant relationship between obesity and arthritis status or activity limitation due to arthritis/joint symptoms (p < 0.01, OR = 1.62–2.14). Furthermore, people with arthritis having activity limitation due to arthritis/joint symptoms were more likely to not meet the current physical activity recommendations (5) (p = 0.013, OR = 1.49).

Conclusions

Cigarette smoking, alcohol consumption, obesity, and physical activity are all associated with the prevalence and severity of arthritis. It is possible that smoking and obesity have a negative impact on the risk and severity of arthritis, whereas alcohol consumption and physical activity may reduce its risk and severity. Further research, including prospective cohort studies, is necessary to determine the true absolute risk of developing arthritis, so that we can design the effective prevention strategies.     

Peer Reviewed: Trends in Selected Chronic Conditions and Behavioral Risk Factors Among Women of Reproductive Age, Behavioral Risk Factor Surveillance System, 2001-2009

Introduction

Some potentially modifiable risk factors and chronic conditions cause significant disease and death during pregnancy and promote the development of chronic disease. This study describes recent trends of modifiable risk factors and controllable chronic conditions among reproductive-aged women.

Methods

Data from the 2001 to 2009 Behavioral Risk Factor Surveillance System, a representative state-based telephone survey of health behavior in US adults, was analyzed for 327,917 women of reproductive age, 18 to 44 years. We calculated prevalence ratios over time to assess trends for 4 selected risk factors and 4 chronic conditions, accounting for age, race/ethnicity, education, health care coverage, and individual states.

Results

From 2001 to 2009, estimates of 2 risk factors improved: smoking declined from 25.9% to 18.8%, and physical inactivity declined from 25.0% to 23.0%. One risk factor, heavy drinking, did not change. From 2003 to 2009, the estimates for 1 risk factor and 4 chronic conditions worsened: obesity increased from 18.3% to 24.7%, diabetes increased from 2.1% to 2.9%, high cholesterol increased from 10.3% to 13.6%, asthma increased from 13.5% to 16.2%, and high blood pressure increased from 9.0% to 10.1%. All trends were significant after adjustment, except that for heavy drinking.

Conclusion

Among women of reproductive age, prevalence of smoking and physical inactivity improved, but prevalence of obesity and all 4 chronic conditions worsened. Understanding reasons for the improvements in smoking and physical activity may support the development of targeted interventions to reverse the trends and help prevent chronic disease and adverse reproductive outcomes among women in this age group.     

Incidence, causes and outcome of obstructed labor in jimma university specialized hospital

Background

Obstructed labor is one of the common preventable causes of maternal and perinatal morbidity and mortality in developing countries. Africa has the highest maternal mortality in the world, estimated at an average of about 1,000 deaths per 100,000 live births. This study was conducted to assess the incidence, causes and outcome of obstructed labor in Jimma University Specialized Hospital.

Methods

Hospital-based, cross-sectional study was conducted on all mothers who were admitted and delivered in the labor ward of Jimma University Specialized Hospital from November 1, 2008 to April 30, 2009. Data was collected using structured questionnaire and checklist, and then analyzed using SPSS for windows version 16.0.

Results

The incidence of obstructed labor was 12.2%. Out of these 61.5% did not have antenatal care follow-up. Most of the cases, accounting for 145(81.0%), 160 (89.4%) and 170 (93.9%) were referred from health centers, visited the hospital after at least 12 hours of labor and came from a distance of more than 10 kilometers, respectively. The causes of obstructed labor were cephalo-pelvic disproportion in 121(67.6%) and malpresentation in 50 (27.9%) of the cases. The commonest maternal complications observed were uterine rupture in 55 (45.1%) and sepsis in 48 (39.3%) of the cases with complications. Forty-five point eight percent of fetuses were born alive and all had low first minute APGAR score.

Conclusion

The incidence of obstructed labor was high with high rate of complications. The antenatal care follow-up practice was also found to be low. Improved antenatal care coverage, good referral system, and availing comprehensive obstetric care in nearby health institution are recommended to prevent obstructed labor and its complications.     

The quality of care provided to patients with chronic non-communicable diseases: a retrospective multi-setup study in jimma zone, southwest ethiopia

Background

Chronic Non-Communicable Diseases are among the major causes of morbidity and mortality worldwide. However, access to and quality of health care for patients is very low in developing countries including Ethiopia. Hospitals and Health Centers are the main sources of health care for such patients in Ethiopia. In this study we assessed the quality of care patients with Chronic Non-Communicable Diseases received in hospital and health center setups.

Methods

A retrospective multi-setup study was conducted in Jimma University Specialized Hospital and four Health Centers in Jimma Zone from February to March 2010. A total of 52 process indicators of quality covering three disease conditions: Diabetes, Hypertension and Epilepsy were measured by reviewing randomly selected medical records. Quality of care was measured as a proportion of recommended components of care actually provided to patients. And also outcome and structural measures were assessed to supplement process measures of quality.

Results

Six hundred seventy four medical records were reviewed. Recommended care components were actually provided to patients in 35.1% (95% CI:34.1%, 36.0%), 38.5% (95% CI:37.5%, 39.5%) and 60.1% (95% CI:59.3%, 61.0%) of times on which patients were eligible, among patients with Diabetes, Hypertension and Epilepsy, respectively. After case mix adjustment, it was found that 45.9% (95% CI:45.4%, 46.5%) of recommended components of care was actually provided to patients. This was 45.1% (95% CI:44.4%, 45.8%) in the hospital and 30.5% (95% CI:29.7%, 31.3%) in the health centers. Among patients for whom outcome data was available, optimal level of disease control was achieved only for 47 (30.5%), 40 (38.5%) and 193 (52.9%) of patients with Diabetes, Hypertension and Epilepsy, respectively.

Conclusion

The quality of care provided to patients with Chronic Non-Communicable Diseases is very low in both settings though it is relatively better in Jimma University Specialized Hospital. Therefore, a continuous process of quality improvement is recommended in both settings.     

Risk factors for noncommunicable chronic diseases in women in China: surveillance efforts

Objective

To investigate risk factors for chronic noncommunicable diseases (NCDs) and their determinants in Chinese women.

Methods

Data from the 2010 China Chronic Disease and Risk Factor Surveillance survey, comprising a nationally representative sample of women, were obtained to determine the prevalence of eight risk factors for chronic NCDs: current smoking, harmful use of alcohol, insufficient intake of fruit and vegetables, physical inactivity, overweight and obesity, raised blood pressure, raised fasting blood glucose and raised total serum cholesterol. The mean number of risk factors per woman was estimated. Their independent demographic and socioeconomic covariates were also examined with ordinal logistic regression.

Findings

The following prevalences were found: insufficient intake of fruit and vegetables, 51.7%; overweight and obesity, 32.3%; raised blood pressure, 29.7%; physical inactivity, 18.3%; raised total serum cholesterol, 18.1%; raised blood glucose, 7.0%; current smoking, 2.4%; and harmful use of alcohol, 1.3%. The mean number of risk factors per woman was 1.61; 48.0% of the women had at least two risk factors. Women who were older, poorer, from rural areas or from eastern or central China had more risk factors, but only being more than 35 years old, poorly educated and a resident of eastern or central China independently increased the likelihood of having multiple risk factors.

Conclusion

Risk factors for chronic NCDs are common among Chinese women aged 18 or older. Interventions to reduce these factors are needed and should target women who are older, who live in eastern or central China or who are poorly educated.     

Prevalence of Dyslipidemia and Hypertension in Indian Type 2 Diabetic Patients with Metabolic Syndrome and its Clinical Significance

Objectives

The present study was designed to estimate the prevalence of dyslipidemia and hypertension based on the National Cholesterol Educational Programme Adult Treatment Panel III definition of metabolic syndrome (MetS). The study also focuses on prevalence for MetS with respect to the duration of disease in Gwalior–Chambal region of Madhya Pradesh, India.

Methods

Type 2 diabetic patients (n = 700) were selected from a cross-sectional study that is regularly being conducted in the School of Studies in Biochemistry, Jiwaji University Gwalior, India. The period of our study was from January 2007 to October 2009. Dyslipidemia and hypertension were determined in type 2 diabetic patients with MetS as per National Cholesterol Educational Programme Adult Treatment Panel III criteria.

Results

The mean age of the study population was 54 ± 9.3 years with 504 (72%) males and 196 (28%) females. The prevalence of MetS increased with increased duration of diabetes in females; however, almost constant prevalence was seen in the males. Notable increase in the dyslipidemia (64.1%) and hypertension (49%) in type 2 diabetic patients were seen. The steep increase in dyslipidemia and hypertension could be the reason for the growing prevalence of diabetes worldwide. The study also noted a close association between age and occurrence of MetS.

Conclusion

Individual variable of MetS appears to be highly rampant in diabetic population. Despite treatment, almost half of patients still met the criteria for MetS. Effective treatment of MetS components is required to reduce cardiovascular risk in diabetes mellitus hence accurate and early diagnosis to induce effective treatment of MetS in Indian population will be pivotal in the prevention of cardiovascular disease and type 2 diabetes.     

Bacteraemia among severely malnourished children in jimma university hospital, ethiopia

Background

Sever acute malnutrition severely suppresses every component of the immune system leading to increased susceptibility and severity to infection. However, symptoms and signs of infections are often unapparent making prompt clinical diagnosis and early treatment very difficult. The aim of the study was to determine the magnitude of bacteraemia and antimicrobial sensitivity among severely malnourished children.

Methods

Severely malnourished children admitted in Jimma University Specialized Hospital were enrolled between October, 2009 to May, 2010. Blood samples were collected, processed and bacterial isolates were identified using standard bacteriological procedures. Then, antibiotic susceptibility pattern of the isolates was determined by using Kirby-Bauer technique.

Results

Bacteraemia was seen in 35 (20.6%) of the 170 study subjects. There were a total of 35 bacterial isolates, Gram positive bacteria constitute 24(68.6%) of the isolates, where Staphylococcus aureus was the leading Gram positive isolate while Klebsiella species were the dominant Gram negative isolates. Twelve (7.1%) children died and 4 (33.3%) of them had bacteraemia. While susceptibility was more than 80% to Gentamicin, Ciprofloxacin and Ceftriaxone, increased level of resistance was documented to commonly used antibiotics, such as Amoxycillin, Co-trimoxazole and Chloramphenicol.

Conclusion

High prevalence of bacteraemia with predominating Gram positive isolates and increased level of resistance to commonly used antibiotics was shown among severely malnourished children in Jimma. Further studies are required to revise the current guideline for antibiotic choice.     

Reasons and outcomes of admissions to the medical wards of jimma university specialized hospital, southwest ethiopia

Background

Non-communicable diseases are the main reasons for admission to the medical wards in high-income countries. While in low and middle income countries communicable diseases are the main reasons for admission to the medical wards. However, in some low and middle income countries the reasons for admission are changing from communicable diseases to non-communicable diseases. But, data on reasons for admission to the medical wards of low income countries is scarce. Therefore, this study takes one year data from a low income country referral hospital aiming at describing the recent reasons and outcomes of medical admissions to see whether there is a change in reasons for admission and the outcome.

Methods

A retrospective study examined patient case notes and ward registration books of medical admissions at Jimma University Specialized Hospital from January 1, 2008 to December 31, 2008. Socio-demographic variables, reasons and outcomes of admission were some of the variables recorded during the data collection. The International Statistical Classification of Disease was used for sorting and categorizing the diagnosis. The data was then analyzed using SPSS windows version 13.0.

Result

A total of 610 patient case notes were reviewed. The mean age of the patients was 36 years (SD ± 15.75). The highest number of admissions 218 (35.7%) was among the age groups 21 to 30 years. Communicable diseases; namely severe community acquired pneumonia 139(22.8%), all infectious and parasitic diseases category 100 (16.4%), and pyogenic as well as chronic meningitis 80(13.1%) were the most common reasons for admission. The death rate among patients admitted to the medical wards was 12.6%.

Conclusions

Communicable diseases were still the common reasons for medical admissions at Jimma University Specialized Hospital. The outcome of medical admissions has not changed over sixteen years.     

Frequency and related factors of masked hypertension at a worksite in Korea

Objectives

Masked hypertension is associated with metabolic risks and increased risk of cardiovascular disease. The purpose of this study was to identify the frequency of and risk factors of masked hypertension in Korean workers.

Methods

The study was conducted among 121 employees at a hotel in Gyeongju, Korea, from December 2008 to February 2009. We measured blood pressure (BP) both in the clinic and using 24-hour ambulatory BP monitors for all subjects. Hypertension was defined independently by both methods, and subjects were classified into four groups: true normotension, masked hypertension, white coat hypertension, and sustained hypertension.

Results

The frequency of masked hypertension in our study group was 25.6%. Compared with true normotension, the factors related to masked hypertension were male gender (odds ratio [OR], 10.7; 95% confidence interval [CI], 1.41 to 81.09), aging one year (OR, 0.88; 95% CI, 0.78 to 0.99), clinic BP 120-129/80-84 mmHg (OR, 8.42; 95% CI, 1.51 to 46.82), clinic BP 130-139 / 85-89 mmHg (OR, 12.14; 95% CI, 1.80 to 81.85), smoking (OR, 5.51; 95% CI, 1.15 to 26.54), and increase of total cholesterol 1 mg / dL (OR, 1.05; 95% CI, 1.02 to 1.08). In males only, these factors were clinic BP 120-129 / 80-84 mmHg (OR, 15.07; 95% CI, 1.55 to 146.19), clinic BP 130-139 / 85-89 mmHg (OR, 17.16; 95% CI, 1.56 to 189.45), smoking (OR, 11.61; 95% CI, 1.52 to 88.62), and increase of total cholesterol 1 mg/dL (OR, 1.05; 95% CI, 1.01 to 1.09).

Conclusions

The frequency of masked hypertension was high in our study sample. Detection and management of masked hypertension, a known strong predictor of cardiovascular risk, could improve prognosis for at-risk populations.     

Microbiological Assessment of Indoor Air of Teaching Hospital Wards: A case of Jimma University Specialized Hospital

Background

Hospital environment represents a congenial situation where microorganisms and susceptible patients are indoors together. Thus, the objective of this study is to provide fundamental data related to the microbial quality of indoor air of Jimma University Specialized Hospital wards, to estimate the health hazard and to create standards for indoor air quality control.

Methods

The microbial quality of indoor air of seven wards of Jimma University Specialized Hospital was determined. Passive air sampling technique, using open Petri-dishes containing different culture media, was employed to collect sample twice daily.

Results

The concentrations of bacteria and fungi aerosols in the indoor environment of the wards ranged between 2123 – 9733 CFU/m³. The statistical analysis showed that the concentrations of bacteria that were measured in all studied wards were significantly different from each other (p-value=0.017), whereas the concentrations of fungi that were measured in all sampled wards were not significantly different from each other (p-value=0.850). Moreover, the concentrations of bacteria that were measured at different sampling time (morning and afternoon) were significantly different (p-value =0.001).

conclusion

All wards that were included in the study were heavily contaminated with bacteria and fungi. Thus, immediate interventions are needed to control those environmental factors which favor the growth and multiplication of microbes, and it is vital to control visitors and students in and out the wards. Moreover, it is advisable that strict measures be put in place to check the increasing microbial load in the hospital environment.