Mapping national, regional and local prevalence of hypertension and diabetes in Ethiopia using geospatial analysis

Association between illness perception and medication adherence in patients with diabetes mellitus in North Shoa, Zone: cross-sectional study

Background

Although the impact of illness perception on medication adherence is well-established, its specific influence on medication adherence in Ethiopia remains unclear. Consequently, the objective of this study was to examine the association between illness perception and medication adherence among patients with diabetes mellitus in the North Shoa Zone.

Methods

An institution-based cross-sectional study was conducted from 24 May to 25 June 2022 in the North Shoa zone. The study included a random sample of 552 individuals with diabetes from four public hospitals. Data was collected and entered into Epi Data V.3.1, and analysis was performed using SPSS version 22. Descriptive statistics were used to summarize continuous variables as means with standard deviations, while categorical variables were presented as percentages. The study variables were analyzed using binary logistic regression models to assess the associations between illness perception and medication adherence. In the bivariable analysis, variables with p-values less than 0.20 were entered into a multivariable logistic regression model. Associations with a p-value ≤0.05 and an odds ratio with a 95% confidence interval were considered statistically significant.

Results

The study results revealed that medication adherence was 64.4% (95% CI: 60.1, 67.9), while illness perception was 54.7% (95% CI, 41.2, 49.4). There was a significant and strong association between illness perception and medication adherence (p < 0.0001). In the adjusted model, the illness perception components of consequence showed a significant association with medication adherence (AOR = 3.10, 95% CI: 2.11, 4.55). Similarly, personal control (AOR = 1.77, 95% CI: 1.20, 2.61) and emotional representation of diabetes (AOR = 2.26, 95% CI: 1.54, 3.32) were also significantly associated with medication adherence in patients with diabetes.

Conclusion

The findings of this study indicate a positive association between higher illness perception and increased medication adherence and practice. Therefore, when engaging in discussions about diabetic self-management, diabetes educators should employ psychoeducational approaches that take into account the illness perceptions of patients.

Geo-climatic risk factors for chronic rhinosinusitis in southwest Iran

Chronic rhinosinusitis (CRS) is a prevalent and disabling paranasal sinus disease associated with some environmental factors. In this study, we evaluated the effect of geo-climatic factors on CRS in a region of southwest Iran. The study mapped the residency addresses of 232 patients with CRS who lived in Kohgiluyeh and Boyer-Ahmad province and had undergone sinus surgery from 2014 to 2019. The effects of Mean Annual Humidity (MAH), Mean Annual Rainfall (MAR), Mean Annual Temperature (MAT), maximum MAT (maxMAT), minimum MAT (minMAT), Mean Annual Evaporation (MAE), wind, elevation, slope, and land cover were assessed on the occurrence of CRS using Geographical Information System (GIS). Statistical analysis was performed using univariate and multivariate binary logistic regression. Patients came from 55 points including villages, towns, and cities. In univariate analysis, climatic factors including MAT (OR = 0.537), minMAT (OR = 0.764), maxMAT (OR = 0.63), MAR (OR = 0.994), and MAH (OR = 0.626) were significantly related to CRS occurrence. Elevation (OR = 0.999), slope (OR = 0.9), and urban setting (OR = 24.667) were the significant determinants among geographical factors when analyzed independently. The multivariate analysis found maxMAT (OR = 0.5), MAR (OR = 0.994), elevation (OR = 0.998), and urban (OR = 16.8) as significant factors affecting CRS occurrence. The urban setting is the most critical factor affecting CRS disease. Cold and dry areas and low attitude are the other risk factors for CRS in Kohgiluyeh and Boyer-Ahmad province, southwest Iran.

[Spatial analysis of hypertension in Peruvian adults, 2022]

Objectives

To perform a spatial analysis of arterial hypertension in the Peruvian adult population to identify geographic patterns with a higher concentration of cases.

Materials and methods

A spatial analysis was conducted using data from the Demographic and Family Health Survey (ENDES) 2022. A sample of 29,422 adults was included, and the global Moran's index and Getis-Ord Gi* analysis were used to evaluate spatial autocorrelation and cluster concentration.

Results

The age-standardized prevalence of arterial hypertension was 19.2%. Clusters with a high concentration of arterial hypertension were observed in departments along the Peruvian coast such as Tumbes, Piura, Lambayeque, La Libertad, Ancash, and Lima, as well as in the northern regions of the Highlands. Clusters were also found in the regions of Loreto and Madre de Dios in the Peruvian jungle.

Conclusions

This study revealed geographic patterns of arterial hypertension in Peru, with a higher concentration of cases along the Peruvian coast and in certain regions of the Highlands and Jungle. These findings highlight the need to develop strategies for the prevention and control of the disease, especially in the areas identified as high-prevalence clusters.