The future health and economic burden of obesity-attributable type 2 diabetes and liver disease among the working-age population in Saudi Arabia.

BACKGROUND: Obesity and type 2 diabetes (T2DM) are increasing in Saudi Arabia (SA). Among other conditions, these risk factors increase the likelihood of non-alcoholic fatty liver disease (NAFLD), which in turn increases risks for advanced liver diseases, such as non-alcoholic steatohepatitis (NASH), cirrhosis and cancer. The goal of this study was to quantify the health and economic burden of obesity-attributable T2DM and liver disease in SA. METHODS: We developed a microsimulation of the SA population to quantify the future incidence and direct health care costs of obesity-attributable T2DM and liver disease, including liver cancer. Model inputs included population demographics, body mass index, incidence, mortality and direct health care costs of T2DM and liver disease and relative risks of each condition as a function of BMI category. Model outputs included age- and sex-disaggregated incidence of obesity-attributable T2DM and liver disease and their direct health care costs for SA's working-age population (20-59 years) between 2020 and 2040. RESULTS: Between 2020 and 2040, the available data predicts 1,976,593 [± 1834] new cases of T2DM, 285,346 [±874] new cases of chronic liver diseases, and 2,101 [± 150] new cases of liver cancer attributable to obesity, amongst working-age people. By 2040, the direct health care costs of these obesity-attributable diseases are predicted to be 127,956,508,540 [± 51,882,446] USD. CONCLUSIONS: The increase in obesity-associated T2DM and liver disease emphasises the urgent need for obesity interventions and strategies to meaningfully reduce the future health and economic burden of T2DM, chronic liver diseases and liver cancer in SA.

Peak months of pandemic's first-wave in India: a cross-sectional assessment of knowledge, attitudes and practice towards COVID-19 among internet-savvy individuals.

Background: A successful pandemic response in populated geographies and resource-limited settings like India relies on informed decision making. Knowledge, attitudes, and practices (KAP) studies performed during these times are crucial to illustrate how well a community adopts prevention strategies. Objective: The present study, conducted during the peak months of the first wave of the COVID-19 pandemic, aimed at assessing the KAP levels of internet-savvy Indians. Methods: This observational cross-sectional study was conducted between 20 May and 10 October 2020. We employed a self-reported questionnaire using Google Forms, containing two parts-demographics and KAP evaluation-with the latter having three subsections of 10, 5, and 5 questions each. Data from completed questionnaires were extracted and exported from Google Forms and coded. Descriptive statistics and first-order analysis were conducted. Binary logistic regression was performed with a 95% confidence interval to determine significant associations between categorical dependent and independent variables. Results: We received responses from 1154 participants (58.84% male). Most respondents had good knowledge of the disease transmission course (92.55%), showed seriousness towards the emerging illness (91.07%), had a good attitude towards personal hygiene and physical distancing (93.76%), and had followed good safety/hygienic practices (93.76%). Good attitudes differed significantly between Karnataka and Tamil Nadu provinces (OR 1.053; 95% CI 0.588-1.886; p = 0.0439). The survey participants did not show any significant gender differences in any question types (p > 0.05). Conclusions: The results obtained add significant value to the existing KAP literature on COVID-19 in India and may help policymakers achieve public compliance with preventive measures.