Type 2 diabetes in Tirana City, Albania: a rapid increase in a country in transition.

AIMS: To determine how the prevalence of Type 2 diabetes mellitus has changed in Tirana, the capital of Albania, over 20 years. METHODS: Cluster sampling was used to select 700 households including 1540 adults 25 years of age and over in Tirana City, Albania in 2001. RESULTS: Of 1540 potential subjects, 1120 participated (response rate 72.7%). Using the 1985 WHO criteria to provide comparability with earlier data, the overall prevalence of Type 2 diabetes mellitus in the age group 25+ was 6.3% (95% confidence interval 4.8-7.7); 6.9% (4.8-9.1%) male; 5.6% (3.8-7.5%) female. The age-adjusted prevalence in those aged 25+ was 5.4%. Of respondents, 3.4% were known to have diabetes, and 2.9% were newly identified through the survey. The prevalence of diabetes increased with age, although among men there was a slight decline after age 65. Impaired glucose tolerance was found in a further 2.9% of respondents, again increasing with age. The prevalence of diabetes has increased significantly since 1980, doubling in the age group 50+. Use of the 1999 WHO diagnostic criteria produces a higher unadjusted prevalence, at 9.7% (8-11.4%). In a logistic regression model, obesity and family history were independent determinants of the probability of having diabetes. Among those known to have diabetes, control was poor. CONCLUSIONS: The prevalence of diabetes in Albania has increased rapidly, consistent with what has been seen in other countries undergoing rapid modernization. It is likely to increase further in the future, with important implications for health policy

The prevalence and correlates of physical inactivity among adults in Ho Chi Minh City

<p>Abstract</p> <p>Background</p> <p>Socioeconomic changes have led to profound changes in individuals' lifestyles, including the adoption of unhealthy food consumption patterns, prevalent tobacco use, alcohol abuse and physical inactivity, especially in large cities like Ho Chi Minh City (HCMC). The Stepwise Approach to Surveillance of Non-communicable Disease Risk Factors survey was conducted to identify physical activity patterns and factors associated with 'insufficient' levels of physical activity for health in adults in HCMC.</p> <p>Methods</p> <p>A cross-sectional survey was conducted in 2005 among 1906 adults aged 25–64 years using a probability proportional to size cluster sampling method to estimate the prevalence of non-communicable disease risk factors including physical inactivity. Data on socioeconomic status, health behaviours, and time spent in physical activity during work, commuting and leisure time were collected. Physical activity was measured using the validated Global Physical Activity Questionnaire (GPAQ). Responders were classified as 'sufficiently active' or 'insufficiently active' using the GPAQ protocol. Correlates of insufficient physical activity were identified using multivariable logistic regression.</p> <p>Results</p> <p>A high proportion of adults were physically inactive, with only 56.2% (95% CI = 52.1–60.4) aged 25–64 years in HCMC achieving the minimum recommendation of 'doing 30 minutes moderate-intensity physical activity for at least 5 days per week'. The main contributors to total physical activity among adults were from working and active commuting. Leisure-time physical activity represented a very small proportion (9.4%) of individuals' total activity level. Some differences in the pattern of physical activity between men and women were noted, with insufficient activity levels decreasing with age among women, but not among men. Physical inactivity was positively associated with high income (OR = 1.77, 95% CI = 1.05–2.97) and high household wealth index (OR = 1.86, 95% CI = 1.29–2.66) amongst men.</p> <p>Conclusion</p> <p>Public health policies and programs to preserve active commuting in HCMC and to promote time spent in recreational physical activity in both genders and across all age groups, but especially among young adults, will be critical in any comprehensive national plan to tackle inactivity. Clear and consistent national recommendations about how much physical activity Vietnamese people need for preventing and managing non-communicable diseases should also be part of this population-wide promotional effort.</p

Obesity prevalence from a European perspective: a systematic review

<p>Abstract</p> <p>Background</p> <p>Obesity has been recognised as an important contributing factor in the development of various diseases, but comparative data on this condition are limited. We therefore aimed to identify and discuss current epidemiological data on the prevalence of obesity in European countries.</p> <p>Methods</p> <p>We identified relevant published studies by means of a MEDLINE search (1990–2008) supplemented by information obtained from regulatory agencies. We only included surveys that used direct measures of weight and height and were representative of each country's overall population.</p> <p>Results</p> <p>In Europe, the prevalence of obesity (body mass index ≥ 30 kg/m²) in men ranged from 4.0% to 28.3% and in women from 6.2% to 36.5%. We observed considerable geographic variation, with prevalence rates in Central, Eastern, and Southern Europe being higher than those in Western and Northern Europe.</p> <p>Conclusion</p> <p>In Europe, obesity has reached epidemic proportions. The data presented in our review emphasise the need for effective therapeutic and preventive strategies.</p

Epidemiology of hypertension and associated cardiovascular risk factors in a country in transition: a population based survey in Tirana City, Albania.

STUDY OBJECTIVE: To describe the prevalence of hypertension and other cardiovascular risk factors on the adult population of Tirana City (Albania). DESIGN: Cross sectional survey. SETTING: Tirana City in mid-2001. PARTICIPANTS: 1120 adults aged 25 years and over (response rate=72.7%). MAIN RESULTS: Overall, hypertension prevalence (blood pressure =140 and/or 90 mm Hg, or known hypertensive receiving anti-hypertensive treatment) was 31.8% (36.6% and 27.4% in men and women respectively). Age standardised prevalence of hypertension (adjusted to the adult population of Tirana) was 30.2% (99% confidence intervals 29.8% to 30.6%) in men and 22.7% (22.3% to 23.1%) in women. Men were significantly more likely to be hypertensive than women (p value=0.001). Of those who had been diagnosed with hypertension, 87% were receiving anti-hypertensive therapy and more than half of them (52%) were adequately controlled. The prevalence of hypertension increased with increasing age and was more common in the obese in both sexes. While the prevalence of hypertension matched that in other industrialised and transition countries, the combination of hypertension with other cardiovascular risk factors was rather less common. CONCLUSION: These findings provide important new evidence on the prevalence of hypertension and its association with other cardiovascular risk factors in Albania. Albania is in a state of rapid transition, with evidence that risk factors for non-communicable diseases have already increased considerably over the past two decades. These finding provide a unique baseline against which future change can be compared