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To meet the twin challenge of DM and HTN in developing countries, PHCs will have to be strengthened with a concerted and multipronged effort to provide promotive, preventive, curative, and rehabilitative services. Introduction Diabetes mellitus DM and hypertension HTN have emerged as major medical and public health issues worldwide, and both are important risk factors for coronary artery disease CADheart failure, and cerebrovascular disease.
DM is increasing in epidemic proportions globally. The number of people with diabetes increased from — million in to — million in The International Diabetes Federation IDF has come up with much higher figures in a recent report which estimated that inmillion people worldwide had DM and if this trend continues, bymillion people, or one in 10 adults, will have DM [ 3 ].
DM exerts a significant burden resulting in increased morbidity and mortality, decreased life expectancy, and reduced quality of life, as well as individual and national income losses. Additionally, HTN affects about one billion people worldwide [ 4 ] and it is estimated that byup to 1.
Raised blood pressure BP is estimated to cause 7. Globally, between andSBP decreased by 0. The high prevalence of HTN makes it a significant factor for mortality and morbidity. Individuals with HTN are known to have a twofold higher risk of developing CAD, four times higher risk of congestive heart failure, and seven times higher risk of cerebrovascular disease and stroke compared to normotensive subjects.
Extensive epidemiological studies conducted in AFR region show that HTN is one of the commonest cardiovascular ailments and that BP assumes more importance with increasing age, particularly in the Sub-Saharan Africa [ 8 ]. DM and HTN are also known to coexist in patients [ 9 ].
Indeed, there is a strong correlation between changing lifestyle factors and increase in both DM and HTN. Challenges in managing both DM and HTN more effectively include factors at the patient, provider, and system levels.
Epidemiologic studies have an important clinical impact and have led to an increasing appreciation of the value of epidemiology as a scientific basis for clinical and public health practice.
As primary health care is the first level of contact of the individuals, the family, and the community with the national health system, there is an urgent need for an integrated approach at primary health care PHC level for addressing the burden of HTN and DM.
Diabetes creates a huge economic burden not only due to the direct costs of treatment particularly of its complications, but also in terms of man hours lost due to the debilitating effect the disease has on the individual and his or her family and society as a whole.
Epidemiological studies have shown that DM is increasing rapidly in people of South Asian, African, and African Caribbean origins [ 11 ].
The WHO and IDF have utilized methods that combine available country data at regular intervals and extrapolated estimates for remaining countries without data.
The number of individuals with DM in the SEA region in the year and the projected figures for the year are presented in Table 1 [ 3 ]. There are significant differences between and within countries because of the geographical diversity in socioeconomic growth rates, demographic and lifestyle changes, and perhaps differences in ethnic susceptibility to DM.
The overall number of people with DM in India in based on this study was estimated to be Number of people with diabetes in thousands in the 20—79 age group in countries of Southeast Asia and [ 3 ]. Trends in age-standardised diabetes prevalence in the SEA region between and for male and female population [ 2 ].
The recent NFHS 3 data [ 17 ], which studied urban and rural residents all women aged 15—49 and all men aged 15—54 in 29 states of India during the yearreported that more than two percent of men and women had self-reported DM. The number of women who had DM ranged from perwomen in Rajasthan to 2, perwomen in Kerala.
It has also been reported that there is a dramatic increase in the prevalence of type 2 DM in the African regions [ 18 ]. However, currently DM rates are rising in many parts of Africa [ 20 ].
Studies from Sub-Saharan Africa report prevalence rates of 2. In a recent community-based screening for DM conducted simultaneously in four major Cameroonian cities, the sex-specific-age-adjusted prevalence of DM for men and women had dramatically risen to The number of individuals with DM in the AFR region in the year and the projected figures for the year are presented in Table 2 [ 3 ].i An Assessment of Knowledge on Type 2 Diabetes, the Means of Preventing it, and Attitudes towards Preventing Type 2 Diabetes Mellitus in Middle-aged Nigerian Women.
Traditional male circumcision in eastern and southern Africa: a systematic review of prevalence and complications Andrea Wilcken a, Thomas Keil a & Bruce Dick b. a. Institute for Social Medicine, Epidemiology and Health Economics, Charité University Medical Centre, Berlin, Germany.
Review of the Literature. Systematic Review. Kelly et al performed a systematic review to evaluate the association between elevated plasma insulin levels and the traits associated with metabolic. Diabetes is a growing non communicable disease (NCD) epidemic.
Current international guidelines dictate that in pregnancy, universal screening for GDM for early detection is essential to improve.
Medication Adherence With Diabetes Medication Because all of these factors and more continue to affect medication adherence, a systematic review of the literature was conducted to summarize the literature since among adult type 2 diabetic Nigerians attending a primary care clinic in under-resourced environment of eastern Nigeria.
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