A glimpse into the future: modelling global prevalence of hypertension.

BACKGROUND: Hypertension is a major risk factor for cardiovascular diseases. Insights and foresights on trends of hypertension prevalence are crucial to informing health policymaking. We examined and projected the patterns of hypertension prevalence among sexes. METHODS: Using annual hypertension prevalence (18 + years) data sourced from WHO Global Health Observatory data repository from 1975 to 2015, Prophet models were developed to forecast the 2040 prevalence of hypertension in males, females, and both sexes. We used k-means clustering and self-organising maps to determine the clusters of hypertension prevalence concerning both sexes among 176 countries. RESULTS: Worldwide, Croatia is estimated to have the highest prevalence of hypertension in males by 2040, while that of females is in Niger. Among the world's most populated countries, Pakistan and India are likely to increase by 7.7% and 4.0% respectively in both sexes. South-East Asia is projected to experience the largest hypertension prevalence in males, whereas Africa is estimated to have the highest prevalence of hypertension in females. Low-income countries are projected to have the highest prevalence of hypertension in both sexes. By 2040, the prevalence of hypertension worldwide is expected to be higher in the male population than in female. Globally, the prevalence of hypertension is projected to decrease from 22.1% in 2015 to 20.3% (20.2 - 20.4%) in 2040. We also identified three patterns of hypertension prevalence in 2040, cluster one countries are estimated to have the highest prevalence of hypertension in males (29.6%, 22.2 - 41.1%) and females (29.6%, 19.4 - 38.7%). CONCLUSION: These findings emphasise the need for new and effective approaches toward the prevention and control of hypertension in Africa, South-East Asia, and Low-income countries.

Trends in cervical cancer screening research in sub-Saharan Africa: A bibliometric analysis of publications from 2001 to 2020.

Sub-Saharan Africa has the highest incidence of cervical cancer globally. However, compared to developed countries, the region has lower uptake of cervical cancer screening. Research contribution and progress in the field of cervical cancer in the region has not been well investigated. This bibliometric review aimed to address this information gap by examining changes in research volume and type over a 20 year time frame. Medline, Embase, PsycINFO, CINAHL, and Cochrane Library were searched to identify peer-reviewed publications about cervical cancer screening in sub-Saharan Africa. Changes (from 2001 to 2020) in the (i) total publications, (ii) number and proportion of data-based publications relative to non-data-based publications, and descriptive relative to intervention publications, and (iii) the number and proportion of publications meeting the EPOC design criteria relative to those not meeting the EPOC design criteria were assessed using a generalised linear Poisson model, a generalised binomial model and the Pearson Chi-squared test respectively. A two-year increase in time was associated with an estimated 32 % increase in the total number of publications. While no measurement studies were recorded, the bulk of data-based publications (89 %) were descriptive studies. Relative to descriptive publications, a 1 % increase in the proportion of intervention publications was observed over time. Only a small proportion (28 %) of intervention studies met the EPOC design criteria. Our findings suggest that researchers and funders in the region should invest more effort and money in measurement and rigorous intervention research to inform outcome measures and cervical cancer screening policy and practice, respectively.

Knowledge about epilepsy and factors associated with attitudes toward marrying, employing, and driving people with epilepsy: A cross-sectional survey of Asokore Mampong community dwellers in Ghana.

BACKGROUND: Due to lack of information and illiteracy, epilepsy remains a stigmatized disease in sub-Saharan Africa. OBJECTIVES: The main aim of the study was to determine, among community dwellers in Asokore Mampong Municipality (Ghana): (i) the knowledge on risk factors, signs and symptoms, management of epilepsy, and (ii) factors associated with attitudes toward marrying, employing, or driving people with epilepsy (PWE). METHODS: A cross-sectional study of 100 randomly selected individuals aged 18 years and older in Asokore Mampong Municipality was conducted in February 2019. A self-administered questionnaire was used to assess the knowledge about epilepsy and attitudes toward marrying, employing, and driving people with epilepsy. Frequencies and corresponding percentages were used to describe the study participants, their knowledge regarding epilepsy and attitudes toward marrying, employing, or driving people with epilepsy. Univariate and multivariate logistic regression analyses were used to determine the factors associated with attitudes toward marrying, employing, or driving people with epilepsy. RESULTS: Majority (33%) of the respondents indicated that epilepsy is caused by possession of evil spirits or witchcraft. More than 60% of the respondents correctly identified all signs and symptoms presented in the survey. Almost half (45%) of the respondents selected orthodox/medical treatment as the treatment for epilepsy. The odds of marrying PWE among Akans and Ewe/Ga Adangbe were 90% [adjusted Odds ratio (aOR) = 0.10, 95% CI: 0.01-0.67] and 84% lower [aOR = 0.16, 95% CI: 0.04-0.62] compared to odds of marrying PWE among Northerners, respectively. Compared to respondents with no formal education, the odds of employing PWE were 88% lower [aOR = 0.12, 95% CI: 0.03-0.40] among those with tertiary education. In addition, the odds of driving a person with an epileptic attack among Muslims/Traditionalists were 81% lower [aOR = 0.19, 95% CI: 0.05-0.68] than Christians. Respondents between 18 and 30 years old had more than 5 times higher odds of driving a person with an epileptic attack [aOR 5.28, 95% CI: 1.15-24.84] compared to respondents above 30 years. CONCLUSIONS: Individuals in Asokore Mampong have less knowledge about the risk factors and treatment of epilepsy. Generally, they have negative attitudes toward marrying, employing, and driving PWE. Findings from this study highlight the need to increase education to reduce the stigma associated with epilepsy. We recommend that a massive educational campaign should be organized by the Ghana Health Service to address deficiencies in knowledge as well as the negative attitudes toward PWE.

Beyond 2020: Modelling obesity and diabetes prevalence.

AIMS: To examine and forecast the patterns of diabetes prevalence in synergy with obesity. METHODS: Prophet models were employed to forecast the prevalence of diabetes and obesity in 2030 using time-series data from the WHO Global Health Observatory data repository. K-means clustering models and self-organising maps were used to identify the patterns (clusters) of diabetes prevalence in association with obesity among 183 countries. RESULTS: Three patterns of diabetes prevalence were identified, countries in cluster three were estimated to have the highest obesity (44.9%, 26.2-65.8%) and diabetes prevalence (25.3%, 18.3-32.6%) in 2030. By 2030, countries in the Eastern Mediterranean and Upper-middle-income are projected to have the highest prevalence of diabetes. Overall, Niue is likely to have the biggest impact of diabetes. Liberia is projected to experience the largest rise in the prevalence of diabetes, with over 100% growth from 2014 to 2030. Libya, Kuwait, UK, USA, Argentina, and Nauru are estimated to have the peak prevalence of obesity on their respective continents. There is no decline in the influence of obesity in 185 countries by 2030. Globally, the prevalence of diabetes is projected to increase in 2030. CONCLUSION: These estimates of diabetes prevalence in adults confirm continuity in the "diabetes crisis".

A cross-sectional study of barriers to cervical cancer screening uptake in Ghana: An application of the health belief model.

BACKGROUND: The high incidence (32.9, age-standardized per 100,000) and mortality (23.0, age-standardized per 100,000) of cervical cancer (CC) in Ghana have been largely attributed to low screening uptake (0.8%). Although the low cost (Visual inspection with acetic acid) screening services available at various local health facilities screening uptake is meager. OBJECTIVE: The purpose of the study is to determine the barriers influencing CC screening among women in the Ashanti Region of Ghana using the health belief model. METHODS: A analytical cross-sectional study design was conducted between January and March 2019 at Kenyase, the Ashanti Region of Ghana. The study employed self-administered questionnaires were used to collect data from 200 women. Descriptive statistics were used to examine the differences in interest and non-interest in participating in CC screening on barriers affecting CC screening. Multivariable logistic regression was used to determine factors affecting CC screening at a significance level of p<0.05. RESULTS: Unemployed women were less likely to have an interest in CC screening than those who were employed (adjustes odds ratio (aOR) = 0.005, 95%CI:0.001-0.041, p = 0.005). Women who were highly educated were 122 times very likely to be interested in CC screening than those with no or low formal education (aOR = 121.915 95%CI: 14.096-1054.469, p<0.001) and those who were unmarried were less likely to be interested in CC screening than those with those who were married (aOR = 0.124, 95%CI: 0.024-0.647, p = 0.013). Also, perceived threat, perceived benefits, perceived barriers and cues for action showed significant differences with interest in participating in screening with a P-values <0.003. The association was different for long waiting time, prioritizing early morning and late evening screening which showed no significant difference (P-value > 0.003). CONCLUSIONS: Married women, unemployed and those with no formal education are less likely to participate in CC screening. The study details significant barriers to cervical cancer screening uptake in Ghana. It is recommended that the Ghana health services should develop appropriate, culturally tailored educational materials to inform individuals with no formal education through health campaigns in schools, churches and communities to enhance CC screening uptake.

Understanding the role of educational interventions on medication adherence in hypertension: A systematic review and meta-analysis.

BACKGROUND: Medication adherence among patients with hypertension has continued to be a challenge despite various educational interventions utilised in their care. The effect of the different educational methods on medication adherence in hypertension remains uncertain. OBJECTIVES: To examine the effect of educational interventions on improving medication adherence among patients with hypertension. METHODS: A systematic search was conducted using EMBASE, MEDLINE, PsycINFO, CINHAL, PUBMED, HTA and Cochrane controlled trial registry from 1999 to 2019. Subgroup analysis was performed according to the various methods of educational intervention. RESULTS: Twelve studies identified from seven databases were interrogated. There was a low to moderate quality evidence to support the improvement of medication adherence with educational interventions. Verbal education had a small statistically significant effect d = 0.18 (95% CI 0.01-0.34, p < 0.04). No statistically significant difference was found between bimodal (verbal and printed) and multimodal (verbal, printed and electronic) educational interventions. Frequent contacts during patient education showed better outcomes of medication adherence. CONCLUSIONS: Verbal educational interventions can improve health literacy and consequent adherence to medication among individuals with hypertension. Frequent verbal educational interventions can enhance patient engagement, participation as well as promote medication literacy and adherence. Healthcare professionals should adopt innovative ways of ensuring regular follow-ups and making educational sessions more interactive and useful to patients.