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Prevalence and factors associated with pre-diabetes and undiagnosed diabetes in Cambodia: cross-sectional study based on the World Health Survey Plus 2023

Por: Chhim · S. · Ku · G. V. · Kowal · P. · Te · V. · Sorithisey · M. · Ngor · C. · Walton · P. · Maung · K. T. · Ng · N. · Naidoo · N. · Por · I. · Klipstein-Grobusch · K. · Chhea · C. · Sopheab · H.
Objective

This study aimed to determine the prevalence and factors associated with pre-diabetes and undiagnosed type 2 diabetes (UDD) in Cambodia.

Design

This analysis used data from the WHO World Health Survey Plus, which was collected using a cross-sectional design with a GIS-based, three-stage sampling approach. Multiple logistic regression was used to identify key associated factors, based on a significance level of p

Setting

Data were collected from all 25 provinces in Cambodia between 12 March 2023 and 31 May 2023.

Participants

4427 individuals aged 18 years or older, residing in the selected household for at least 6 months in the past year.

Primary outcome measures

Pre-diabetes (Haemoglobin A1c (HbA1c) 5.7%–6.4%) and UDD (HbA1c≥6.5%), without prior knowledge of having type 2 diabetes (T2D).

Results

The weighted prevalences of pre-diabetes and UDD were 26.4% (95% CI 24.0% to 29.0%) and 9.3% (95% CI 7.9% to 11.0%). Pre-diabetes prevalence was higher in urban areas compared with rural areas (adjusted OR, aOR=1.2, 95% CI 1.0 to 1.4), males (aOR=1.7, 95% CI 1.3 to 2.3), individuals aged 40–49 (aOR=1.8, 95% CI 1.4 to 2.4), individuals aged 50+ years group (aOR=2.9, 95% CI 2.3 to 3.6) compared with the 18–39 years group, overweight individuals (aOR=1.7, 95% CI 1.4 to 2.0), obese (aOR=2.1, 95% CI 1.5 to 3.0) and those with elevated total triglycerides (aOR=1.3, 95% CI 1.1 to 1.5). Similar risk factors were identified for UDD, with the addition of hypertension (aOR=1.6, 95% CI 1.3 to 2.0) and high waist circumference (aOR=2.0, 95% CI 1.5 to 2.7).

Conclusions

The high prevalence of pre-diabetes and UDD in Cambodia is a pressing public health concern. Urgent and intensive interventions are needed to effectively prevent and manage T2D, particularly among urban residents, older persons and individuals with metabolic risk factors.

Self-reported sexually transmitted infections among adults in South and Southeast Asian countries: a multilevel analysis of recent DHS data (2015-2023)

Por: Sabo · K. G. · Mare · K. U. · Lahole · B. K. · Wengoro · B. F. · Demeke · H. S. · Mohamed · A. A. · Bilal · M. A. · Moloro · A. H.
Objective

To assess the pooled prevalence of self-reported sexually transmitted infections (STIs) and their associated factors among adults in South and Southeast Asia, using the Demographic and Health Survey data collected between 2015 and 2023.

Design

A community-based cross-sectional study design was conducted using a multistage cluster sampling approach. Multilevel multivariable logistic regression analysis was employed to identify predictors of self-reported sexually transmitted infections (STIs). Model selection was guided by Akaike’s information criterion, and adjusted odds ratios (AORs) with 95% CIs were estimated to determine statistically significant associations.

Setting

South and Southeast Asia.

Participants

This analysis included a weighted sample of 791 019 adults aged 15–49 who reported ever having had sexual intercourse. The majority of the participants were female (n=6 87 880; 87%), and most were from Southeast Asia (n=7 00 539; 89%).

Results

The pooled prevalence of self-reported STIs among adults in South and Southeast Asia was 12.94% (95% CI 7.73% to 18.14%). At the individual level, higher odds of reporting STIs were associated with being female (AOR 1.84; 95% CI1.68 to 2.02), having middle (AOR 1.11; 95% CI 1.04 to 1.19) or high wealth status (AOR 1.15; 95% CI 1.07 to 1.24]), being employed (AOR 1.14; 95% CI 1.07 to 1.22), having multiple sexual partners (AOR 2.79; 95% CI 2.22 to 3.52) and having undergone HIV testing (AOR 1.10; 95% CI: 1.02 to 1.20). Conversely, lower odds of self-reported STIs were observed among individuals aged 35–39 years (AOR 0.78; 95% CI 0.66 to 0.92), 40–44 years (AOR 0.68; 95% CI 0.58 to 0.82) and 45–49 years (AOR 0.61; 95% CI 0.52 to 0.73); those who had ever been in a union (AOR 0.71; 95% CI 0.62 to 0.83); individuals with higher education (AOR 0.84; 95% CI 0.76 to 0.93); and those with comprehensive HIV knowledge (AOR 0.82; 95% CI 0.77 to 0.87). At the community level, high illiteracy rates (AOR 1.25; 95% CI 1.15 to 1.35) and high media non-exposure (AOR 1.11; 95% CI 1.02 to 1.20) were positively associated with STIs, while rural residence (AOR 0.81; 95% CI 0.74 to 0.89) and living in Southeast Asia (AOR: 0.47; 95% CI 0.42 to 0.53) were linked to lower odds of self-reported STIs.

Conclusions

A substantial prevalence of self-reported STIs was observed among adults in South and Southeast Asia. Both individual- and community-level factors influence STI risk. The individual-level determinants include socio-demographic characteristics, sexual behaviours, HIV-related knowledge and testing history, while community-level factors reflect disparities in geographic location, educational attainment and media exposure.

Burden of abnormal nutritional indices among women aged 15-24 years in 40 low-income and middle-income countries: a multilevel multinomial logistic regression analysis

Por: Lahole · B. K. · Wengoro · B. F. · Mare · K. U.
Background

Despite global efforts to improve nutrition, young women aged 15–24 years in low-income and middle-income countries (LMICs) face persistent dual burdens of malnutrition, marked by high rates of underweight and emerging issues of overnutrition, such as overweight and obesity. Current research often emphasises individual-level factors, potentially overlooking broader regional influences.

Objective

To examine the burden of abnormal nutritional indices among women aged 15–24 years in 40 LMICs using the most recent Demographic and Health Survey conducted between 2015 and 2023.

Design

Cross-sectional study design.

Setting

40 LMICs.

Participants

357 587 young women aged 15–24 years.

Primary and secondary outcome measures

A multilevel mixed-effect multinomial analysis was conducted to identify determinants of underweight, overweight and obesity. The adjusted relative risk ratio with 95% CI was used to declare the statistical significance of the association.

Results

Our analysis found that among young women aged 15–24 years in LMICs, the pooled prevalence of underweight was 25.7% (95% CI 25.6% to 25.8%), with substantial country-level variation. The highest prevalence was in Timor-Leste (35.4%) and India (31.6%), while Jordan (2.9%) and Zambia (5.5%) had the lowest rates. Overweight and obesity prevalence was 17.7% (95% CI 15.7% to 19.7%), with the highest rates in Jordan (48.9%) and Zambia (40.9%) and the lowest in Timor-Leste (3.9%) and Ethiopia (4.5%). Furthermore, factors such as household wealth, age at marriage, age, education status, access to media, employment status, parity, contraceptive use, toilet facility, region and place of residence were statistically associated with being underweight, overweight and obese.

Conclusions

Our study highlights significant variations in nutritional status among young women aged 15–24 years in LMICs, with a notable prevalence of underweight and emerging challenges of overweight and obesity. Country-specific strategies addressing socioeconomic disparities and regional differences are crucial for effective public health interventions to improve nutritional outcomes among this vulnerable population.

El niño del sol y de la luna: la experiencia en la atención del parto respetado

Objetivo principal: Comprender la experiencia en la atención del parto respetado de una mujer atendida en una unidad de partería profesional. Metodología: Estudio cualitativo fenomenológico llevado a cabo en una usuaria con control de embarazo casi exclusivo en la Unidad de Partería seleccionada a conveniencia. Se realizaron entrevistas en profundidad y análisis de contenido. Resultados principales: Surgieron las siguientes categorías que dan sentido a la experiencia de parir: 1) parir con amor, 2) la partera como vía del empoderamiento de la mujer y su familia e 3) Interculturalidad-respeto a las tradiciones. Conclusión principal: El análisis de las categorías muestra que el parto respetado es una vivencia única, personalizada, con resultados positivos tanto para la madre y el recién nacido como para los familiares.

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