Prevalence, Associated Factors and Awareness of Hypertensive Retinopathy Among an Elderly Population with Hypertension in Nepal: The Bhaktapur Retina Study

Author(s):  
Raba Thapa ◽  
Shankar Khanal ◽  
Hendra Tan ◽  
Suman Thapa ◽  
Gerardus Hermanus Maria Bartholomeus van Rens van Rens

Abstract Background: This study aimed to assess the prevalence, associated factors and awareness of hypertensive retinopathy among an elderly population with hypertension in Nepal Methods: A population-based, cross-sectional study was conducted from 2013 to 2015 in Bhaktapur district, Nepal. The sample size was 2100 subjects age 60 years and above. From this sample, all diagnosed patients with hypertension were analyzed. A detailed history was obtained, and an ocular examination was performed. Blood sugar and blood pressure were measured. Result: Information was complete for 1860 (88.57%) subjects. The age ranged from 60 to 95 years with the mean ± SD age of 69.64±7.31 years. Hypertension was found in 643 subjects (34.61%), of which 224 (12.04%) were newly diagnosed cases. Hypertensive retinopathy was found in 81 cases (12.6%). Grade 1, grade 2, and grade 3 hypertensive retinopathy comprised 53 (65.43%), 19 (23.46%), and 9 (11.11%) cases, respectively. Hypertensive retinopathy was more frequent in the age group 70-79 years (15.23%) compared to other age groups, among males (13.25%), illiterates (13.56%), diabetics (16.49%), and those with body mass index (BMI) ≥25 kg/m2 (14%). However, none of the factors was found to be statistically significant. Among the subjects with hypertension, awareness of hypertension’s effects on the eyes, retina and vision was found in 13.84%, 8.4%, and 11.98% respectively. Conclusion: Prevalence of hypertension, hypertensive retinopathy and associated factors among an elderly population were similar to other countries. Awareness of hypertensive retinopathy was found in only 8.4%. Increased emphasis should be directed toward improving awareness campaigns. Key words: Hypertension, hypertensive retinopathy, elderly, awareness, Nepal

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e041755
Author(s):  
Srinivas Marmamula ◽  
Satya Brahmanandam Modepalli ◽  
Thirupathi Reddy Kumbham ◽  
Rajesh Challa ◽  
Jill E Keeffe

ObjectivesTo assess the prevalence of disabilities (vision, hearing, mobility, cognitive, self-care and communication) and non-communicable diseases (NCDs) among the elderly population in two districts in Telangana, India.DesignPopulation-based cross-sectional study using a cluster random sampling method to select the study clusters.SettingElderly population in Khammam and Warangal districts were recruited. Detailed interviews were conducted by trained community health workers. Personal and demographic information such as age, gender, level of education and a self-report of NCDs was collected. The Washington Disability Questionnaire was administered to assess the presence of disabilities.Participants1821 participants aged ≥60 years, 54.5% were women, and 73.3% had no education.Primary outcome measurePrevalence of disabilities and NCDs.ResultsOverall, the prevalence of at least disability was 20.3% (95% CI 16.3 to 24.9). The prevalence of self- reported disabilities were: seeing (5.9%; 95% CI 4.4 to 7.8), mobility (12.8%; 95% CI 9.7 to 16.8), hearing (3.6%; 95% CI 2.7 to 4.8), cognition (4.8%; 95% CI 3.5 to 6.7), self-care (3.3%; 95% CI 2.3 to 4.7) and communication (1.8%; 95% CI 1.2 to 2.6). Overall, the prevalence of at least one NCD was 34.2% (95% CI 30.9 to 37.7). Hypertension was the most common systemic condition (25.4%; 95% CI 22.4 to 28.7), followed by diabetes (9.0%; 95% CI 7.3 to 11.0), and body pains (muscle-skeletal) (9.9%; 95% CI 8.1 to 12.2).ConclusionEvery fifth elderly person in the districts of Khammam and Warangal in Telangana had at least one self-reported disability. Besides, a third of the elderly had at least one NCD. There is a definite need to develop comprehensive public health strategies to address disabilities and NCDs in Telangana.


Author(s):  
Houda Ben Ayed ◽  
Sourour Yaich ◽  
Mariem Ben Hmida ◽  
Maissa Ben Jemaa ◽  
Maroua Trigui ◽  
...  

AbstractObjectivesThis study aimed to estimate the extent of smoking experience among high and middle school adolescents in Southern Tunisia and to delineate its potential associated factors.MethodsWe conducted a cross-sectional study among middle and high school-adolescents in the governorate of Sfax, South of Tunisia in the 2017–2018 school-years. A questionnaire was anonymously administered to a representative sample of 1,210 school-adolescents randomly drawn.ResultsThe mean age of the school-adolescents was 15.6 ± 4.2 years. The prevalence of lifetime smoking was 16.7% (95% CI=[14.7–18.8%]) (boys 32.6%; girls 5.9%;p<0.001). Among the respondents, 13.9% (95% CI=[11.9–15.8%]) were current smokers. In multivariate logistic regression analysis, independent associated factors of current smoking were male gender (Adjusted (AOR)=10.2; p<0.001), 16–17 and 18–19-year age-groups (AOR=2; p=0.005 and AOR=2.6; p=0.001, respectively), below average academic performance (AOR=5.2; p=0.012), divorced parents (AOR=3.9; p=0.007), family monthly income ≥800 dollars (AOR=2.1; p=0.001), having a part time job (AOR=3.9; p<0.001) and a perceived high stress level (AOR=1.98; p=0.008). Secondhand smoke (AOR=1.8; p=0.011) and concomitant alcohol drink (AOR=14.56; p<0.001) were independent predictors of current smoking, while high education level of the father was independently associated with lower prevalence of current smoking (AOR=0.17; p<0.001).ConclusionThe prevalence of lifetime and current smoking were relatively high in Southern Tunisian middle and high schools. Multilevel influences on youth smoking behavior had been identified, which reflected the need to conceive appropriate school interventions and effective antismoking education program.


BMJ Open ◽  
2017 ◽  
Vol 7 (11) ◽  
pp. e017966 ◽  
Author(s):  
Maria Elizete A Araujo ◽  
Marcus T Silva ◽  
Tais F Galvao ◽  
Mauricio G Pereira

ObjectivesTo estimate the prevalence of healthcare use and associated factors in the Manaus metropolitan region and to describe the reasons for lack of access.DesignCross-sectional population-based study.SettingA survey conducted between May and August of 2015 in eight cities from Manaus metropolitan region, Amazonas, Brazil.Participants4001 adults ≥18 years of age.Primary outcomes measuresPhysician visits, dentist visits and hospitalisations in the last 12 months were the primary outcomes. Associated factors were investigated through the calculation of prevalence ratio (PR) obtained by hierarchical Poisson regression modelling.Results4001 adults were included in the study, 53% of whom were women. The self-reported prevalence of medical visits was 77% (95% CI 75% to 77%); dentist visits, 36% (95% CI 34% to 37%) and hospital admission, 7% (95% CI 6% to 7%). Physician visits were higher in women PR=1.18 (95% CI 1.14 to 1.23), the elderly PR=1.18 (95% CI 1.10 to 1.26) and people with health insurance PR=1.14 (95% CI 1.10 to 1.19). Dentist visits declined with older age PR=0.38 (95% CI 0.30 to 0.49), lower education level PR=0.62 (95% CI 0.51 to 0.74) and lower economic class PR=0.65 (95% CI 0.57 to 0.75). Hospitalisations were found to be twice as frequent for women than for men and three times as frequent among those who reported very poor health status. Among the individuals who did not receive medical attention in the previous 2 weeks, 58% reported lack of facilities or appointment unavailable and 14% reported lack of doctors.ConclusionWhile more than half visited the doctor in the last year, a lower proportion of people with socioeconomic inequities visited the dentist. Organisational and service policies are needed to increase equity in health services in the region.


2017 ◽  
Vol 6 (4) ◽  
pp. 7-13 ◽  
Author(s):  
V K Khanal ◽  
R Upreti ◽  
U Oli ◽  
A K Sunny ◽  
A Ghimire ◽  
...  

Injury is a serious public health threat as it is one of the leading cause of death globally. This study aims to assess the prevalence of injury, pattern of injury and its associated factors among people residing in a rural area of Aurabani VDC of Eastern Nepal. A population based cross sectional study was carried out among 552 people residing in selected wards with door to door visit. The prevalence of minor injury was 3.1% and major was 0.4% per year in the study.Most common mode of injury was fall and most common type was incised wound. Injuries mostly occurred in extremities, in morning time, autumn season and in roads while most of the injuries were accidental in nature. 


2021 ◽  
Vol 12 ◽  
Author(s):  
Dandan Guo ◽  
Xin Zhang ◽  
Changqing Zhan ◽  
Qiuxing Lin ◽  
Jie Liu ◽  
...  

Background: Obesity is a potentially modifiable risk factor for cognitive impairment. However, sex-specific relationships between obesity and cognitive impairment in late life remain unclear.Objective: We aimed to assess sex differences in the association between various obesity parameters and cognitive impairment in a low-income elderly population in rural China.Methods: A population-based cross-sectional study was conducted to collect basic information from elderly residents aged 60 years and older from April 2014 to August 2014 in rural areas of Tianjin, China. Obesity parameters, including body mass index (BMI) and waist circumference (WC), and Mini Mental State Examination scores were measured, and the relationships between these variables were assessed.Results: A total of 1,081 residents with a mean age of 67.70 years were enrolled in this study. After adjusting for age, educational attainment, smoking status, drinking status, physical exercise participation, and the presence of diabetes and hyperlipidemia, blood pressure group; a high BMI was found to be associated with an increased prevalence of cognitive impairment in elderly women. Each 1-unit increase in BMI was associated with a 5.9% increase in the prevalence of cognitive impairment. WC was related to the prevalence of cognitive impairment in elderly men, and each 1-cm increase in WC was associated with a 4.0% decrease in the prevalence of cognitive impairment. However, there were no significant associations between WC and cognitive function in women or between BMI and cognitive impairment in men.Conclusion: A greater WC was positively associated with better cognitive function in low-income elderly men in rural China, whereas a higher BMI was associated with an increased risk of cognitive impairment in elderly women, independent of sociodemographic, lifestyle, and health-related comorbid factors. Our results suggest weight management of elderly women in rural China may have cognitive benefits. However, randomized controlled trials would be needed to confirm causality.


2020 ◽  
Vol 6 (1) ◽  
pp. 32-37
Author(s):  
Chhimi Wangmo ◽  
Nor Tshering Lepcha

Introduction: The aim of this hospital-based study was to assess the prevalence and associated factors of pterygium among adult patients visiting the Ophthalmology Outpatient Department (OPD) in the Jigme Dorji Wangchuck National Referral Hospital (JDWNRH), Thimphu. Methods: A cross sectional study was carried out in the ophthalmology OPD in the national referral hospital, Thimphu from 1st January, 2018 to 31st December, 2018, during which 1599 adult patients were selected through systematic random sampling. Results: The prevalence of pterygium was 12.8% (95% CI: 11.2 -14.5). Among 271 eyes with pterygium, the distribution of grade 1, grade 2 and grade 3 pterygium was 34.7%, 56.1% and 9.2% respectively. Pterygium wasmost common in the age group of 36-55 years. The significant factors associated with pterygium were age group, occupation and usage of sunglasses. Individuals who were 36-55 years (adjusted OR 2.70, 95% CI 1.82-4.0) and >55 years (adjusted OR 2.17, 95% CI 1.34-3.50) had significantly higher risk than 18-35 years (p< 0.002), and not using sunglasses (adjusted OR 1.97, 95% CI1.17-3.33, p = 0.007) significantly increased the risk of pterygium. Indoor occupation, particularly being a student was protective against pterygium (OR 0.08, 95% CI 10.02-0.33, p< 0.001). Only 14.1% used sunglasses and among them, 27.6% were aware that sunglasses can protect from ultraviolet radiation. Conclusion: This study found a high prevalence of pterygium among adults aged 18 years and above. Those aged 36-55 years and an occupation involving outdoor activities were affected more. Encouraging usage of sunglasses may reduce pterygium


BMJ Open ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. e027152 ◽  
Author(s):  
Dahui Wang ◽  
Huai Zhang ◽  
Haiyan Ma ◽  
Long Zhang ◽  
Lei Yang ◽  
...  

Hearing loss (≥26 dB threshold in the better ear), as a common chronic condition in humans, is increasingly gaining attention. Relevant research in China is relatively scarce, so we conduct a population-based study to investigate the prevalence of hearing loss among age groups, genders and ears in Zhejiang province, China, from September 2016 to June 2018.Study designPopulation-based cross-sectional studyParticipantsA total of 3754 participants aged 18–98 years and living in Zhejiang province, China.Outcome measuresPure-tone audiometric thresholds were measured at frequencies of 0.125–8 kHz for each subject. All participants were asked to complete a structured questionnaire, in the presence of a healthcare official.ResultsThe prevalence of speech-frequency and high-frequency hearing loss was 27.9% and 42.9%, respectively, in Zhejiang. There were significant differences in auditory thresholds at most frequencies among the age groups, genders (male vs female: 31.6%vs24.1% at speech frequency; 48.9% vs 36.8% at high frequency) and ears. In addition to the common factors affecting both types of hearing loss, a significant correlation was found between personal income and speech-frequency hearing loss (OR=0.69, 95% CI 0.52 to 0.92), and between hyperlipidaemia and high-frequency hearing loss (OR=1.45, 95% CI 1.02 to 2.07).ConclusionThe prevalence of hearing loss was high among people living in Zhejiang, particularly males, and in the left ear. Moreover, hearing thresholds increased with age. Several lifestyle and environment factors, which can be influenced by awareness and education, were significantly associated with hearing loss.


2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Thamil Arasu Saminathan ◽  
Lai Seong Hooi ◽  
Muhammad Fadhli Mohd Yusoff ◽  
Loke Meng Ong ◽  
Sunita Bavanandan ◽  
...  

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Asmita Shrestha ◽  
Chet Kant Bhusal ◽  
Binjwala Shrestha ◽  
Kiran Dev Bhattarai

Background. Malnutrition is a major public health problem and most enveloping cause of morbidity and mortality among children and adolescents throughout the world. This study was aimed at assessing the nutritional status and associated factors among 6-10-year-old children in selected earthquake-affected areas of Gorkha district, Nepal. Methods. A community-based cross-sectional study among 420 mothers having children of age groups 6-10 years (with anthropometric measurement among children) was conducted using a mixed method in selected earthquake-affected areas of Gorkha district, Nepal, from October 2015 to April 2016. Gorkha was selected purposively from 14 earthquake-affected districts. Two village development committees were selected randomly among 6 having severe impact. Randomly, 5 wards were selected from each of the 2 village development committees. As the sample was 420, 42 children were selected randomly from every ward. Result. Among the 420 children, 31.9% were underweight, 51.9% were stunted, and 2.9% were wasted after the earthquake. Children who were more prone to being underweight were the following: male children (RR=1.34 95% CI: 1.01-1.78) and children from illiterate mothers (RR=2.49, 95% CI: 1.85-3.36), illiterate fathers (RR=1.73, 95% CI: 1.32-2.27), and homemaker mothers (RR=0.28, 95% CI: 0.20-0.38); children whose families were using nonimproved sources of water (RR=2.60, 95% CI: 1.07-6.60); and households having food insecurity (RR=12.97, 95% CI: 3.29-51.18). Similarly, children of illiterate fathers (RR=1.67, 95% CI: 1.41-1.97), children of illiterate mothers (RR=2.32, 95% CI: 1.91-2.83), children of homemaker mothers (RR=0.59, 95% CI: 0.49-0.70), children whose family were using treated water (RR=0.32, 95% CI: 0.15-0.67), and children from food insecure households (RR=10.52, CI: 4.05-27.33) were found to be stunted. After adjustment, children from households consuming nonimproved water were 6 times more likely (OR=6.75; 95% CI: 1.59-28.62) to be wasted. Conclusion. Illiterate mothers, illiterate fathers, mothers engaged in occupation other than household work, and food insecure households were found to be independent predictors of underweight and stunting. Nonimproved source of drinking water was found to be independent predictors of wasting.


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