Cascades of diabetes and hypertension care in Samoa: Identifying gaps in the diagnosis, treatment, and control continuum - a cross-sectional study.
Cascades of diabetes and hypertension care in Samoa: Identifying gaps in the diagnosis, treatment, and control continuum - a cross-sectional study.
复制标题
DOI：
10.1016/j.lanwpc.2021.100313
复制
发表时间：
2022-01
期刊：
影响因子：
--
通讯作者：
Hawley NL
中科院分区：
文献类型：
--
作者：
LaMonica LC;McGarvey ST;Rivara AC;Sweetman CA;Naseri T;Reupena MS;Kadiamada H;Kocher E;Rojas-Carroll A;DeLany JP;Hawley NL
萨摩亚是一个太平洋岛国，面临着全球非传染性疾病负担最重的国家之一。在这项研究中，我们采用级联护理方法，以了解糖尿病和高血压的认知，治疗和控制级联的差距，在一个横截面，方便的样本703年轻，高风险的萨摩亚成年人（29.5-50.9岁）。非传染性疾病在研究样本中普遍存在：19.5%（95% CI：16.6%-22.7%）参与者患有糖尿病; 47.6%（95% CI：43.7%-51.4%）表现为糖尿病前期或糖尿病; 31.0%（95%CI：27.5%-34.6%）有高血压;近90%（95%CI：86.7%-91.5%）有超重或肥胖。在糖尿病和高血压患者中，分别只有20.5%（95%CI：13.9%-28.4%）和11.8%（95%CI：7.8%-16.9%）的参与者知道自己的病情。只有0.8%（95% CI：0.0%-4.2%）的糖尿病患者血糖得到控制;只有2.8%（95% CI：1.1%-6.1%）的高血压患者血糖得到控制。我们发现，萨摩亚的糖尿病和高血压负担很重，比其他中低收入国家最近估计的患病率高出近两倍。在这些慢性病的检测和随后的控制和监测方面存在着严重的未满足的需要。我们的研究结果表明，慢性病级联护理的初始诊断和监测阶段应该是初级保健工作的主要重点;利用村和地区护士提供社区初级保健的国家筛查活动和计划可能会显着影响NCD级联中的差距缩小。本研究得到了美国国立卫生研究院R 01 HL 140570（PI：McGarvey和DeLany）的支持; AR得到了NIH FIC D43 TW 010540的支持; HK和AR-C得到了布朗大学少数民族健康和健康差异国际研究培训（MHIRT）项目的支持，NIH资助号：5 T37 MD 008655。
Samoa is a Pacific Island country facing one of the highest burdens of non-communicable disease globally. In this study, we apply a cascade-of-care approach to understand gaps in the awareness, treatment, and control cascade of diabetes and hypertension in a cross-sectional, convenience sample of 703 young, high-risk Samoan adults (29.5-50.9 years). Non-communicable diseases were prevalent in the study sample: 19.5% (95% CI: 16.6%-22.7%) of participants had diabetes; 47.6% (95% CI: 43.7%-51.4%) presented with pre-diabetes or diabetes; 31.0% (95% CI: 27.5%-34.6%) had hypertension; and nearly 90% (95% CI: 86.7%-91.5%) had overweight or obesity. Among those with diabetes and hypertension, only 20.5% (95% CI: 13.9%-28.4%) and 11.8% (95% CI: 7.8%-16.9%) of participants were aware of their condition, respectively. Only 0.8% (95% CI: 0.0%-4.2%) of all participants with diabetes had achieved glycemic control; only 2.8% (95% CI: 1.1%-6.1%) of those with hypertension achieved control. We found a significant burden of diabetes and hypertension in Samoa, exceeding the recent prevalence estimates of other low- to middle-income countries by nearly two-fold. A severe unmet need in both detection and subsequent control and monitoring of these chronic conditions exists. Our results suggest that the initial diagnosis and surveillance stage in the cascade of care for chronic conditions should be a major focus of primary care efforts; national screening campaigns and programs that leverage village and district nurses to deliver community-based primary care may significantly impact gap closure in the NCD cascade. This study was supported by the U.S. National Institutes of Health R01HL140570 (PIs: McGarvey and DeLany); AR was supported by NIH FIC D43TW010540; HK and AR-C were supported by the Minority Health and Health Disparities International Research Training (MHIRT) Program at Brown University, NIH Grant # 5T37MD008655.
登录
查看更多内容
影响因子：
37.8
作者：
Fuster, Valentin;Kelly, Bridget B.;Vedanthan, Rajesh
通讯作者：
Vedanthan, Rajesh
DOI：
10.1377/hlthaff.2018.05287
发表时间：
2019-07
期刊：
Health affairs (Project Hope)
影响因子：
--
作者：
Osetinsky B;Hontelez JAC;Lurie MN;McGarvey ST;Bloomfield GS;Pastakia SD;Wamai R;Bärnighausen T;de Vlas SJ;Galárraga O
通讯作者：
Galárraga O
影响因子：
2.9
作者：
Keighley, ED;McGarvey, ST;Vial, S
通讯作者：
Vial, S
影响因子：
16.2
作者：
DePue, Judith D.;Dunsiger, Shira;McGarvey, Stephen T.
通讯作者：
McGarvey, Stephen T.
DOI：
10.1111/1753-6405.13113
发表时间：
2021-07-26
影响因子：
3.5
作者：
Fraser-Hurt, Nicole;Naseri, Leausa Take;Zhang, Shuo
通讯作者：
Zhang, Shuo