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Mutowo MP, Lorgelly PK, Laxy M, Renzaho AMN, Mangwiro JC, Owen AJ. The Hospitalization Costs of Diabetes and Hypertension Complications in Zimbabwe: Estimations and Correlations. J Diabetes Res 2016; 2016:9754230. [PMID: 27403444 PMCID: PMC4925986 DOI: 10.1155/2016/9754230] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Revised: 05/24/2016] [Accepted: 05/24/2016] [Indexed: 01/23/2023] Open
Abstract
Objective. Treating complications associated with diabetes and hypertension imposes significant costs on health care systems. This study estimated the hospitalization costs for inpatients in a public hospital in Zimbabwe. Methods. The study was retrospective and utilized secondary data from medical records. Total hospitalization costs were estimated using generalized linear models. Results. The median cost and interquartile range (IQR) for patients with diabetes, $994 (385-1553) mean $1319 (95% CI: 981-1657), was higher than patients with hypertension, $759 (494-1147) mean $914 (95% CI: 825-1003). Female patients aged below 65 years with diabetes had the highest estimated mean costs ($1467 (95% CI: 1177-1828)). Wound care had the highest estimated mean cost of all procedures, $2884 (95% CI: 2004-4149) for patients with diabetes and $2239 (95% CI: 1589-3156) for patients with hypertension. Age below 65 years, medical procedures (amputation, wound care, dialysis, and physiotherapy), the presence of two or more comorbidities, and being prescribed two or more drugs were associated with significantly higher hospitalization costs. Conclusion. Our estimated costs could be used to evaluate and improve current inpatient treatment and management of patients with diabetes and hypertension and determine the most cost-effective interventions to prevent complications and comorbidities.
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Affiliation(s)
- Mutsa P. Mutowo
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Paula K. Lorgelly
- Centre for Health Economics, Monash University, Melbourne, VIC 3800, Australia
| | - Michael Laxy
- Helmholtz Zentrum München (GmbH), German Research Center for Environmental Health, Institute of Health Economics and Health Care Management (IGM), Ingolstädter Landstraße 1, 85764 Neuherberg, Germany
| | - Andre M. N. Renzaho
- School of Social Science and Psychology, University of Western Sydney, Sydney, NSW 2751, Australia
| | | | - Alice J. Owen
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
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Abstract
BACKGROUND In the absence of a systematic collection of data pertaining to heart failure, summarizing the data available from individual studies provides an opportunity to estimate the burden of heart failure. The present study systematically reviewed the literature to estimate the incidence and prevalence rates of heart failure in Australia. METHODS Studies reporting on prevalence or incidence of heart failure published between 1990 and 2015 were identified through a systematic search of Embase, PubMed, Ovid Medline, MeSH, Scopus and websites of the Australian Institute of Health, and Welfare and Australian Bureau of Statistics. RESULTS The search yielded a total of 4978 records, of which thirteen met the inclusion criteria. There were no studies reporting on the incidence of heart failure. The prevalence of heart failure in the Australian population ranged between 1.0% and 2.0%, with a significant proportion of cases being previously undiagnosed. The burden of heart failure was higher among Indigenous than non-Indigenous Australians (age-standardized prevalence rate ratio of 1.7). Heart failure was prevalent in women than men, and in rural and remote regions than in the metropolitan and capital territories. CONCLUSION This systematic review highlights the limited available data on the epidemiology of heart failure in Australia. Population level studies, using standardized approaches, are needed in order to precisely describe the burden of HF in the population.
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Affiliation(s)
- Berhe W Sahle
- Centre of Cardiovascular Research and Education in Therapeutics, Department of Epidemiology and Preventive Medicine, Monash University, 99 Commercial Road, Melbourne, Vic, 3004, Australia.
- School of Public Health, Mekelle University, Mekelle, Ethiopia.
| | - Alice J Owen
- Centre of Cardiovascular Research and Education in Therapeutics, Department of Epidemiology and Preventive Medicine, Monash University, 99 Commercial Road, Melbourne, Vic, 3004, Australia.
| | - Mutsa P Mutowo
- School of Public Health, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.
| | - Henry Krum
- Centre of Cardiovascular Research and Education in Therapeutics, Department of Epidemiology and Preventive Medicine, Monash University, 99 Commercial Road, Melbourne, Vic, 3004, Australia.
| | - Christopher M Reid
- Centre of Cardiovascular Research and Education in Therapeutics, Department of Epidemiology and Preventive Medicine, Monash University, 99 Commercial Road, Melbourne, Vic, 3004, Australia.
- School of Public Health, Curtin University, Perth, Australia.
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Mutowo MP, Owen AJ, Billah B, Lorgelly PK, Gumbie KE, Mangwiro JC, Renzaho AMN. Burden attributable to Cardiometabolic Diseases in Zimbabwe: a retrospective cross-sectional study of national mortality data. BMC Public Health 2015; 15:1213. [PMID: 26644134 PMCID: PMC4672515 DOI: 10.1186/s12889-015-2554-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 12/01/2015] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Cardiometabolic diseases (CMDs) are an important cause of mortality worldwide and the burden associated with them is increasing in Sub-Saharan Africa. The tracking of mortality helps support evidence based health policy and priority setting. Given the growing prevalence of non-communicable diseases in Zimbabwe, a study was designed to determine the mortality attributable to CMDs in Zimbabwe. METHODS The study design was a retrospective cross-sectional analysis of national mortality from 1996 to 2007, collated by the Ministry of Health and Child Welfare in Zimbabwe. We employed generalized additive models to flexibly estimate the trend of the CMD mortality and a logistic regression model was used to find significant factors (cause of death according to the death certificate) of the CMD mortality and predict CMD mortality to 2040. RESULTS CMDs accounted for 8.13% (95% CI: 8.08% - 8.18%) of all deaths during 1996 to 2007 (p = 0.005). During the study period CMD mortality rate increased by 29.4% (95% CI: 19.9% - 41.1%). The association between gender and CMD mortality indicated female mortality was higher for diabetes (p < 0.001), hypertensive disease (p < 0.001), CVD (p < 0.001) and pulmonary disease (p < 0.001), while male mortality was higher for ischaemic (p = 0.010) and urinary diseases (p < 0.001). There was no gender difference for endocrine disease (p = 0.893). Overall, females have 1.65% higher mortality than males (p < 0.001). CMD mortality is predicted to increase from 9.6 (95% CI: 8.0% - 11.1%) in 2015 to 13.7% (95% CI: 10.2% - 17.2%) in 2040 for males, and from 11.6% (95% CI: 10.2% - 12.9%) in 2015 to 16.2% (95% CI: 13.1% - 19.3%) in 2040 in females. CONCLUSION The findings of this study indicate a growing prevalence of CMDs and related mortality in Zimbabwe. Health policy decisions and cost-effective preventive strategies to reduce the burden of CMDs are urgently required.
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Affiliation(s)
- Mutsa P Mutowo
- School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004, Australia.
| | - Alice J Owen
- School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004, Australia.
| | - Baki Billah
- School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004, Australia.
| | - Paula K Lorgelly
- Centre for Health Economics, Monash University, Melbourne, 3004, Australia.
| | - Kudzai E Gumbie
- Fellow of the Institute of Actuaries (FIA) , Harare, Zimbabwe.
| | - John C Mangwiro
- Zimbabwe Diabetes Association, PO Box 1797, Harare, Zimbabwe.
| | - Andre M N Renzaho
- School of Social Science and Psychology, University of Western Sydney, Sydney, 2751, , New South Wales, Australia.
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Gowda U, Mutowo MP, Smith BJ, Wluka AE, Renzaho AMN. Vitamin D supplementation to reduce depression in adults: meta-analysis of randomized controlled trials. Nutrition 2014; 31:421-9. [PMID: 25701329 DOI: 10.1016/j.nut.2014.06.017] [Citation(s) in RCA: 137] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Revised: 05/28/2014] [Accepted: 06/11/2014] [Indexed: 01/16/2023]
Abstract
OBJECTIVES The aim of this study was to estimate the weighted mean effect of vitamin D supplementation in reducing depressive symptoms among individuals aged ≥18 y diagnosed with depression or depressive symptoms. METHODS A meta-analysis of randomized controlled trials (RCTs) in which vitamin D supplementation was used to reduce depression or depressive symptoms was conducted. Databases MEDLINE, EMBASE, psych INFO, CINAHL plus, and the Cochrane library were searched from inception to August 2013 for all publications on vitamin D and depression regardless of language. The search was further updated to May 2014 to include newer studies being published. Studies involving individuals aged ≥18 y who were diagnosed with depressive disorder based on both the Diagnostic and Statistical Manual of Mental Disorders or other symptom checklist for depression were included. Meta-analysis was performed using random effects model due to differences between the individual RCTs. RESULTS The analysis included nine trials with a total of 4923 participants. No significant reduction in depression was seen after vitamin D supplementation (standardized mean difference = 0.28; 95% confidence interval, -0.14 to 0.69; P = 0.19); however, most of the studies focused on individuals with low levels of depression and sufficient serum vitamin D at baseline. The studies included used different vitamin D doses with a varying degree of intervention duration. CONCLUSIONS Future RCTs examining the effect of vitamin D supplementation among individuals who are both depressed and vitamin D deficient are needed.
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Affiliation(s)
- Usha Gowda
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Mutsa P Mutowo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Ben J Smith
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Anita E Wluka
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Melbourne, Victoria, Australia
| | - Andre M N Renzaho
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Centre for International Health, Burnet Institute, Melbourne, Victoria, Australia; School of Social Sciences and Psychology, University of Western Sydney, Sydney, New South Wales, Australia.
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Halliday JA, Green J, Mellor D, Mutowo MP, de Courten M, Renzaho AMN. Developing programs for African families, by African families: engaging African migrant families in Melbourne in health promotion interventions. Fam Community Health 2014; 37:60-73. [PMID: 24297008 DOI: 10.1097/fch.0000000000000011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Obesity is an emerging problem for African migrants in Australia, but few prevention programs incorporate their cultural beliefs and values. This study reports on the application of community capacity-building and empowerment principles in 4 workshops with Sudanese families in Australia. Workshop participants prioritized health behaviors, skill and knowledge gaps, and environments for change to identify culturally centered approaches to health promotion. The workshops highlighted a need for culturally and age-appropriate interventions that build whole-of-family skills and knowledge around the positive effects of physical activity and nutrition to improve health within communities while reducing intergenerational and gender role family conflicts.
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Affiliation(s)
- Jennifer A Halliday
- Global Health and Society Unit, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia (Mss Halliday and Mutowo and A/Prof Renzaho); Murdoch Children's Research Institute, Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia, and Parenting Research Centre, East Melbourne, Victoria, Australia (Dr Green); School of Psychology, Faculty of Health, Deakin University, Burwood, Victoria, Australia (Prof Mellor); School of Global Health, University of Copenhagen, Copenhagen, Denmark (Prof de Courten); and Centre for International Health, Burnet Institute, Melbourne, Victoria, Australia (Prof Renzaho)
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