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The last frontier for global non-communicable disease action: The emergency department—A cross-sectional study from East Africa
INTRODUCTION: Deaths due to non-communicable diseases (NCDs) have surpassed those due to communicable diseases globally and are projected to do so in Africa by 2030. Despite demonstrated effectiveness in high-income country (HIC) settings, the ED is a primary source of NCD care that has been under-p...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8018633/ https://www.ncbi.nlm.nih.gov/pubmed/33798234 http://dx.doi.org/10.1371/journal.pone.0248709 |
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author | Ngaruiya, Christine Wambua, Mbatha Mutua, Thomas Kedera Owambo, Daniel Muchemi, Morgan Rop, Kipkoech Maciejewski, Kaitlin R. Leff, Rebecca Mutua, Mugane Wachira, Benjamin |
author_facet | Ngaruiya, Christine Wambua, Mbatha Mutua, Thomas Kedera Owambo, Daniel Muchemi, Morgan Rop, Kipkoech Maciejewski, Kaitlin R. Leff, Rebecca Mutua, Mugane Wachira, Benjamin |
author_sort | Ngaruiya, Christine |
collection | PubMed |
description | INTRODUCTION: Deaths due to non-communicable diseases (NCDs) have surpassed those due to communicable diseases globally and are projected to do so in Africa by 2030. Despite demonstrated effectiveness in high-income country (HIC) settings, the ED is a primary source of NCD care that has been under-prioritized in Africa. In this study, we assess the burden of leading NCDs and NCD risk factors in Kenyan Casualty Department patients to inform interventions targeting patients with NCDs in emergency care settings. MATERIALS AND METHODS: Using the WHO STEPwise approach to surveillance (STEPS) tool and the Personal Health Questionnaire (PHQ-9), we conducted a survey of 923 adults aged 18 and over at Kenyatta National Hospital Emergency Department (KNH ED) between May-October 2018. Age, income, household size(t-test), sex, education, marital status, work status, and poverty status (chi-squared test or fisher’s exact test) were assessed using descriptive statistics and analyzed using covariate-adjusted logistic analysis. RESULTS: Over a third of respondents had hypertension (35.8%, n = 225/628), 18.3% had raised blood sugar or diabetes (18.3%, n = 61/333), and 11.7% reported having cardiovascular disease (11.7%, n = 90/769). Having lower levels of education was associated with tobacco use (OR 6.0, 95% CI 2.808–12.618, p < 0.0001), while those with higher levels of education reported increased alcohol use (OR 0.620 (95% CI 0.386–0.994, p = 0. 0472). While a predominant proportion of respondents had had some form of screening for either hypertension (80.3%, n = 630/772), blood sugar (42.6%, n = 334/767) or cholesterol (13.9%, n = 109/766), the proportion of those on treatment was low, with the highest proportion being half of those diagnosed with hypertension reporting taking medication (51.6%, n = 116/225). CONCLUSIONS: This study establishes the ED as a high-risk population with potential for high impact in East Africa, should targeted interventions be implemented. Comprehension of the unique epidemiology and characteristics of patients presenting to the ED is key to guide care in African populations. |
format | Online Article Text |
id | pubmed-8018633 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-80186332021-04-13 The last frontier for global non-communicable disease action: The emergency department—A cross-sectional study from East Africa Ngaruiya, Christine Wambua, Mbatha Mutua, Thomas Kedera Owambo, Daniel Muchemi, Morgan Rop, Kipkoech Maciejewski, Kaitlin R. Leff, Rebecca Mutua, Mugane Wachira, Benjamin PLoS One Research Article INTRODUCTION: Deaths due to non-communicable diseases (NCDs) have surpassed those due to communicable diseases globally and are projected to do so in Africa by 2030. Despite demonstrated effectiveness in high-income country (HIC) settings, the ED is a primary source of NCD care that has been under-prioritized in Africa. In this study, we assess the burden of leading NCDs and NCD risk factors in Kenyan Casualty Department patients to inform interventions targeting patients with NCDs in emergency care settings. MATERIALS AND METHODS: Using the WHO STEPwise approach to surveillance (STEPS) tool and the Personal Health Questionnaire (PHQ-9), we conducted a survey of 923 adults aged 18 and over at Kenyatta National Hospital Emergency Department (KNH ED) between May-October 2018. Age, income, household size(t-test), sex, education, marital status, work status, and poverty status (chi-squared test or fisher’s exact test) were assessed using descriptive statistics and analyzed using covariate-adjusted logistic analysis. RESULTS: Over a third of respondents had hypertension (35.8%, n = 225/628), 18.3% had raised blood sugar or diabetes (18.3%, n = 61/333), and 11.7% reported having cardiovascular disease (11.7%, n = 90/769). Having lower levels of education was associated with tobacco use (OR 6.0, 95% CI 2.808–12.618, p < 0.0001), while those with higher levels of education reported increased alcohol use (OR 0.620 (95% CI 0.386–0.994, p = 0. 0472). While a predominant proportion of respondents had had some form of screening for either hypertension (80.3%, n = 630/772), blood sugar (42.6%, n = 334/767) or cholesterol (13.9%, n = 109/766), the proportion of those on treatment was low, with the highest proportion being half of those diagnosed with hypertension reporting taking medication (51.6%, n = 116/225). CONCLUSIONS: This study establishes the ED as a high-risk population with potential for high impact in East Africa, should targeted interventions be implemented. Comprehension of the unique epidemiology and characteristics of patients presenting to the ED is key to guide care in African populations. Public Library of Science 2021-04-02 /pmc/articles/PMC8018633/ /pubmed/33798234 http://dx.doi.org/10.1371/journal.pone.0248709 Text en © 2021 Ngaruiya et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Ngaruiya, Christine Wambua, Mbatha Mutua, Thomas Kedera Owambo, Daniel Muchemi, Morgan Rop, Kipkoech Maciejewski, Kaitlin R. Leff, Rebecca Mutua, Mugane Wachira, Benjamin The last frontier for global non-communicable disease action: The emergency department—A cross-sectional study from East Africa |
title | The last frontier for global non-communicable disease action: The emergency department—A cross-sectional study from East Africa |
title_full | The last frontier for global non-communicable disease action: The emergency department—A cross-sectional study from East Africa |
title_fullStr | The last frontier for global non-communicable disease action: The emergency department—A cross-sectional study from East Africa |
title_full_unstemmed | The last frontier for global non-communicable disease action: The emergency department—A cross-sectional study from East Africa |
title_short | The last frontier for global non-communicable disease action: The emergency department—A cross-sectional study from East Africa |
title_sort | last frontier for global non-communicable disease action: the emergency department—a cross-sectional study from east africa |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8018633/ https://www.ncbi.nlm.nih.gov/pubmed/33798234 http://dx.doi.org/10.1371/journal.pone.0248709 |
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