Strategies to Enhance Retention in a Cohort Study Among Adults of Turkish Descent Living in Berlin

Retention is important for statistical power and external validity in long-term cohort studies. The aims of our study were to evaluate different retention strategies within a cohort study of adults of Turkish descent in Berlin, Germany, and to compare participants and non-participants. In 2011-2012, a population-based study was conducted among adults of Turkish descent to primarily examine recruitment strategies. 6 years later, the participants were re-contacted and invited to complete a self-report questionnaire regarding their health status, health care utilization, and satisfaction with medical services. The retention strategy comprised letters in both German and Turkish, phone calls, and home visits (by bilingual staff). We calculated the response rate and retention rate, using definitions of the American Association for Public Opinion Research, as well as the relative retention rate for each level of contact. Associations of baseline recruitment strategy, sociodemographic, migration-related and health-related factors with retention were investigated by logistic regression analysis. Of 557 persons contacted, 249 (44.7%) completed the questionnaire. This was 50.1% of those whose contact information was available. The relative retention rate was lowest for phone calls (8.9%) and highest for home visits (18.4%). Participants were more often non-smokers and German citizens than non-participants. For all remaining factors, no association with retention was found. In this study, among adults of Turkish descent, the retention rate increased considerably with every additional level of contact. Implementation of comprehensive retention strategies provided by culturally matched study personnel may lead to higher validity and statistical power in studies on migrant health issues

Body perception and anthropometric measures of obesity as risk factors for cardiometabolic disease in Turkish population in Berlin and Essen

Hintergrund: In Deutschland lebende Erwachsene türkischer Abstammung weisen eine höhere Prävalenz von Fettleibigkeit und kardiometabolischen Risikofaktoren auf als die Gastbevölkerung. Für die Entwicklung kulturell angepasster Strategien zur Krankheitsprävention benötigen wir Erkenntnisse über ihre Gewichtswahrnehmung. Ziel dieser Arbeit war es, Zusammenhänge zwischen Gewichtsstatus und Diabetes mellitus Typ 2, Hypertonie und Dyslipidämie zu identifizieren und die Beziehungen zwischen objektiv gemessenem und selbstberichtetem Gewichtsstatus sowie Gewichtswahrnehmung bei Erwachsenen türkischer Abstammung, in Deutschland zu ermitteln. Methoden: Daten von 624 Erwachsenen in Essen und 597 Erwachsenen in Berlin wurden analysiert. Sie wurden zwischen Februar 2011 und September 2012 über registerbasierte Informationen und soziale Netzwerke rekrutiert. Für die Erhebung folgender Faktoren wurden zweisprachige, Fragebogen gestützte Interviews geführt: Demographie, Sozioökonomie, Lebensstil, Gewichtsangabe, Gewichtswahrnehmung und Gesundheitszustand. Zusätzlich wurden Körpergewicht, Körpergröße, Taillenumfang und Hüftumfang gemessen. Mittels logistischer Regressionen wurden Odds Ratios und 95% Konfidenzintervalle (KI) für die Assoziationen zwischen anthropometrischen Maßen und Diabetes mellitus Typ 2, Hypertonie und Dyslipidämie berechnet. Die Übereinstimmungen zwischen Gewichtsangabe und gemessenem Gewichtsstatus sowie zwischen Gewichtswahrnehmung und Gewichtsstatus wurden durch Kreuztabellen ermittelt. Ergebnisse: Die Teilnehmenden waren überwiegend weiblich und mittleren Alters. Ein Drittel der Bevölkerung hatte eine niedrige formale Schulbildung und eine ungesunde Lebensweise. 76% der Studienbevölkerung hatten einen BMI ≥25,0 kg/m2, 65% abdominelle Adipositas und 53% erhöhtes WHR. BMI und Taillenumfang zeigten einen direkten Zusammenhang mit Diabetes mellitus Typ 2, nach Adjustierung für Alter, Geschlecht, Geburtsland, Sprache, formale Bildung, Raucherstatus, körperliche Aktivität und andere chronische Erkrankungen. Ein erhöhtes WHR war signifikant mit einer höheren Chance für Diabetes mellitus Typ 2 verbunden. Ein erhöhter BMI war signifikant mit einer höheren Chance für Hypertonie assoziiert. Die Übereinstimmung von Gewichtsangabe und gemessenem Gewichtsstatus bei Männern und Frauen lag in Berlin bei 76% und in Essen bei 77%. Es gab 50% Übereinstimmung zwischen Gewichtswahrnehmung und gemessenem Gewichtsstatus, während Unterwahrnehmung in Berlin 42% und in Essen 44% betrug. Schlussfolgerungen: Adipositas ist in dieser Studienpopulation verbreitet und hängt stark mit Diabetes mellitus Typ 2 und Hypertonie zusammen. Während die Gewichtsangaben mit dem gemessenen Gewicht gut übereinstimmen, unterbewerten mehr als 40% ihren Gewichtsstatus. Weitere Untersuchungen sind notwendig, um die Gründe für diese Gewichtswahrnehmung bei in Deutschland lebenden Erwachsenen türkischer Abstammung aufzudecken.Background: Adults of Turkish descent living in Germany show higher prevalence rates of obesity and cardiometabolic risk factors than the host population. For the design of culturally adapted prevention programs, we need insights into their weight perceptions. Therefore, we aimed at determining the associations between weight status and self-reported chronic diseases and the relationships between objectively measured weight status, self-reported weight status, and weight perception among 1221 adults of Turkish descent living in two German cities. Methods: This study analyzed data of 624 adults from Essen and 597 adults from Berlin. Recruitment took place between February 2011 and September 2012, and used register-based information and social networks. Questionnaire-guided interviews were conducted on demographic, socio-economic, and lifestyle factors as well as body weight, weight perception and health status. Additionally, body weight, height, waist circumference and hip circumference were measured. We calculated odds ratios and 95% confidence intervals for the associations between anthropometric measures and self-reported diabetes mellitus type 2, hypertension and dyslipidemia, using conventional cut-offs for body mass index, waist circumference, and waist-to-hip ratio. The proportions of agreement between self-reported weight and actual weight status as well as between weight perception and weight status were identified by cross-tabulations. Results: In this middle-aged, predominately female Turkish population, one-third had low formal education and unhealthy lifestyle. 76% of the Turkish population had a BMI ≥25.0 kg/m2, 65% had abdominal overweight or obesity and 53% had increased WHR. BMI and waist circumference tended to be directly associated with diabetes mellitus type 2 after accounting for age, sex, country of birth, language, formal education, smoking status, physical activity and chronic diseases. Increased WHR was significantly associated with higher odds of self-reported diabetes mellitus type 2. Increased BMI was significantly associated with a higher probability of self-reported hypertension. The agreement between self-reported and measured weight status was 76% in Berlin and 77% in Essen, and this was similar for men and women. In contrast, weight perception and measured weight status were in agreement in 50% of the participants, while the proportions of under-perception were 42% in Berlin and 44% in Essen. Conclusions: Adiposity is common in this study population and it is strongly associated with diabetes mellitus type 2 and hypertension. While self-reported weight agrees well with measured weight, more than 40% under-perceive their weight status. Further investigations into the reasons for weight under-perception among adults of Turkish descent living in Germany are warranted

Middle-term outcomes in renal transplant recipients with COVID-19: a national, multicenter, controlled study

Background In this study, we evaluated 3-month clinical outcomes of kidney transplant recipients (KTR) recovering from COVID-19 and compared them with a control group. Method The primary endpoint was death in the third month. Secondary endpoints were ongoing respiratory symptoms, need for home oxygen therapy, rehospitalization for any reason, lower respiratory tract infection, urinary tract infection, biopsy-proven acute rejection, venous/arterial thromboembolic event, cytomegalovirus (CMV) infection/disease and BK viruria/viremia at 3 months. Results A total of 944 KTR from 29 different centers were included in this study (523 patients in the COVID-19 group; 421 patients in the control group). The mean age was 46 +/- 12 years (interquartile range 37-55) and 532 (56.4%) of them were male. Total number of deaths was 8 [7 (1.3%) in COVID-19 group, 1 (0.2%) in control group; P = 0.082]. The proportion of patients with ongoing respiratory symptoms [43 (8.2%) versus 4 (1.0%); P Conclusion The prevalence of ongoing respiratory symptoms increased in the first 3 months post-COVID in KTRs who have recovered from COVID-19, but mortality was not significantly different

COVID-19 associated multisystemic inflammatory syndrome in 614 children with and without overlap with Kawasaki disease-Turk MIS-C study group.

Multisystemic inflammatory syndrome (MIS-C) diagnosis remains difficult because the clinical features overlap with Kawasaki disease (KD). The study aims to highlight the clinical and laboratory features and outcomes of patients with MISC whose clinical manifestations overlap with or without KD. This study is a retrospective analysis of a case series designed for patients aged 1 month to 18 years in 28 hospitals between November 1, 2020, and June 9, 2021. Patient demographics, complaints, laboratory results, echocardiographic results, system involvement, and outcomes were recorded. A total of 614 patients were enrolled; the median age was 7.4 years (interquartile range (IQR) 3.9-12 years). A total of 277 (45.1%) patients with MIS-C had manifestations that overlapped with KD, including 92 (33.3%) patients with complete KD and 185 (66.7%) with incomplete KD. Lymphocyte and platelet counts were significantly lower in patients with MISC, overlapped with KD (lymphocyte count 1080 vs. 1280 cells x mu L, p = 0.028; platelet count 166 vs. 216 cells x 10(3)/mu L, p 12 years reduced the risk of overlap with KD by 66% (p < 0.001, 95% CI 0.217-0.550), lethargy increased the risk of overlap with KD by 2.6-fold (p = 0.011, 95% CI 1.244-5.439), and each unit more albumin (g/dl) reduced the risk of overlap with KD by 60% (p < 0.001, 95% CI 0.298-0.559)