Objectives: Our aim in this study was to identify how to improve diabetic retinopathy screening from the perspectives of people with type 2 diabetes and health-care professionals and to elicit their thoughts on initiatives to increase attendance.
Methods: A total of 38 semistructured interviews were conducted with people with type 2 diabetes (n=20), general practitioners (n=10), and ophthalmic staff (n=8). The interviews examined ideas for improving screening and elicited feedback on 3 initiatives: getting a fixed appointment; same-day screening; and outsourcing screening to general practice, including the use of artificial intelligence (AI).
Rapid development in deep learning for image analysis inspired studies to focus on predicting cardiovascular risk using retinal fundus images. This scoping review aimed to identify and describe studies using retinal fundus images and deep learning to predict cardiovascular risk markers and diseases. We searched MEDLINE and Embase on 17 November 2023.
View Article and Find Full Text PDFBackground: Electronic medical record (EMR) systems have the potential to improve the quality of care and clinical outcomes for individuals with chronic and complex diseases. However, studies on the development and use of EMR systems for type 1 (T1) diabetes management in sub-Saharan Africa are few.
Objective: The aim of this study is to analyze the need for improvements in the care processes that can be facilitated by an EMR system and to develop an EMR system for increasing quality of care and clinical outcomes for individuals with T1 diabetes in Rwanda.
Objectives: Between 2003 and 2019, three trials (randomised controlled trials [RCTs]) in Guinea-Bissau randomised infants to an early 2-dose measles vaccine (MV) schedule at 4 and 9 months vs standard MV at 9 months. The RCTs produced contradictory mortality results; the effect being beneficial in the 2-dose group in the first but tending to have higher mortality in the last two RCTs. We hypothesised that increased frequency of campaigns with oral polio vaccine (C-OPV) explained the pattern.
View Article and Find Full Text PDFRetina fundus images conducted in Greenland are telemedically assessed for diabetic retinopathy by ophthalmological nurses in Denmark. Applying an AI grading solution, in a Greenlandic setting, could potentially improve the efficiency and cost-effectiveness of DR screening. We developed an AI model using retina fundus photos, performed on persons registered with diabetes in Greenland and Denmark, using Optos® ultra wide-field scanning laser ophthalmoscope, graded according to ICDR.
View Article and Find Full Text PDFObjective: In the 2020 UNAIDS HIV treatment goals, 90% of people living with HIV (PLHIV) should be diagnosed, 90% of these should receive antiretroviral treatment (ART) and 90% of these should be virally suppressed. We aimed to evaluate whether Guinea-Bissau fulfills the 2020 treatment goals for both for HIV-1 and HIV-2.
Design: By combining data from a general population survey, treatment records from HIV clinics across Guinea-Bissau and a biobank from patients attending the largest HIV clinics in Bissau, we estimated each column of the 90-90-90 cascade.
Background: Early 2-dose measles vaccine (MV) at 4 and 9 months of age vs. the WHO strategy of MV at 9 months of age reduced all-cause child mortality in a previous trial. We aimed to test two hypotheses: 1) a 2-dose strategy reduces child mortality between 4 and 60 months of age by 30%; 2) receiving early MV at 4 months in the presence versus absence of maternal measles antibodies (MatAb) reduces child mortality by 35%.
View Article and Find Full Text PDFInt J Circumpolar Health
December 2022
Since 1993, regular population health surveys in Greenland have supported and monitored the public health strategy of Greenland and have monitored cardiometabolic and lung diseases. The most recent of these surveys included 2539 persons aged 15+ from 20 communities spread over the whole country. The survey instruments included personal interviews, self-administered questionnaires, blood sampling, anthropometric measurements, blood pressure, ECG, oral glucose test, pulmonary function, hand grip strength and chair stand test.
View Article and Find Full Text PDFThe 'thrifty phenotype' hypothesis proposed that fetal undernutrition increases risk of diabetes in later life. Undernourished low birthweight Indian babies are paradoxically more adipose compared to well-nourished European babies, and are at higher risk of diabetes in later life. Twin pregnancies are an example of growth restrictive environment due to shared maternal nutrition.
View Article and Find Full Text PDFObjective: The aim of the study was to identify factors associated with nonattendance in a Danish nationwide screening program for diabetic retinopathy among people with type 2 diabetes.
Research Design And Methods: A retrospective observational study linking individual-level register data was performed. First, we compared characteristics of 156,878 people with type 2 diabetes divided into attenders and never-attenders on the basis of their screening history over a 6-year period.
BMJ Open Diabetes Res Care
September 2021
Introduction: Diabetes is increasing among Greenlandic Inuit; however, the prevalence of cardiovascular autonomic neuropathy (CAN) is yet unknown. The assessment of CAN requires an ability to differentiate between normal and abnormal. The aim was to establish normative reference data of cardiovascular autonomic function in Greenlandic Inuit.
View Article and Find Full Text PDFObjective: BCG vaccination is frequently delayed in low-income countries. Restrictive vial-opening policies, where a vial of BCG vaccine is not opened for few children, are a major reason for delay. During delays, children are unprotected against tuberculosis (TB) and deprived of non-specific effects of BCG.
View Article and Find Full Text PDFAim: To estimate the incidence and prevalence of nephropathy and investigate whether high and fluctuating HbA levels were associated with development of nephropathy among T1 diabetes individuals in Rwanda.
Methods: From 2009 to 2018, 471 T1 diabetes individuals from Rwanda were assessed for nephropathy (albumin-creatinine ratio (ACR) ≥ 30 mg/g). We calculated the mean HbA (HbA-MEAN) and two measures of HbA variability, i.
Int J Circumpolar Health
December 2021
To assess the prevalence of diabetic retinopathy (DR) among persons with diabetes and prediabetes participating in the 2018 Population Health Survey in Greenland (B2018), a follow-up survey of three previous health surveys. Participants were invited to a diabetes complication screening. We assessed the prevalence of DR using Optos Daytona Ultra-wide field fundus camera and assessed differences in prevalence according to demographic and clinical characteristics using chi square test and a t-test and assessed DR based on ethnicity.
View Article and Find Full Text PDFIntroduction: Measles vaccine (MV) may improve health beyond measles protection. To avoid wastage from multi-dose vials, children in Guinea-Bissau are only measles vaccinated when aged 9-11 months and when six or more children are present. We assessed health impacts of providing MV to all measles-unvaccinated children 9-35 months.
View Article and Find Full Text PDFBackground: Previous studies have indicated an association between childhood adversities and type 1 diabetes but have been underpowered and limited by selection. We aim to quantify the effect of accumulation of childhood adversities on type 1 diabetes risk, and to assess whether the effect differs between males and females in a large and unselected population sample.
Methods: We used register-based data covering all children born in Denmark between 1980 and 2015, totalling >2 million children.
Background: The burden of diabetes mellitus in Sub-Saharan Africa is growing rapidly, and yet the prevalence and patient characteristics are still largely unknown.
Objectives: We analyzed clinical and demographic characteristics of Type 2 diabetes (T2DM) patients attending a diabetes clinic in Guinea-Bissau from February 2008 to April 2014, and estimated the prevalence and risk factors of unknown-impaired fasting plasma glucose (FPG) and diabetes, as well as excess mortality associated with T2DM.
Methods: We characterized T2DM patients attending the national diabetes clinic in Bissau.
In Guinea-Bissau, a vial of BCG vaccine is often not opened unless 10 infants are present for vaccination, with the aim of reducing vaccine wastage. This causes delays in vaccination, as previously demonstrated in Guinea-Bissau and other low-income countries. Reducing wastage of BCG vaccine to save money may deprive infants of important health benefits and transfer costs from the vaccination programme to mothers.
View Article and Find Full Text PDFPurpose: Diabetic retinopathy (DR) screening methods are costly, requiring specialized personnel and patient mydriasis. The Optos apparatus can be operated by nonspecialists and provides ultra-wide-field imaging, with 200° views of the retina in a single image. We compared DR grading obtained from Optos imaging with DR grading from conventional Topcon imaging.
View Article and Find Full Text PDFThe Danish Heart Foundation and the non-governmental organization Neighborhood Mothers have co-developed a culturally adapted intervention seeking to promote healthy dietary behaviour among ethnic minority women. This feasibility study explores the potential of the intervention to reach ethnic minority women using health promotion initiatives. Participants attended instructor courses or cooking events, where culturally adapted, healthy recipes were introduced and meals prepared.
View Article and Find Full Text PDFBackground: The HIV-2 and HTLV-1 prevalences in Bissau have followed similar trends in surveys from 1996 and 2006 with HTLV-1 prevalences of 3.6% and 2.3%, respectively.
View Article and Find Full Text PDFBackground: The authors assessed the risk of admission and mortality at the main neonatal intensive care unit (NICU) at the National Hospital Simão Mendes (NHSM) in Guinea-Bissau.
Methods: The Bandim Health Project (BHP) maintains a health and demographic surveillance system (HDSS) in the capital Bissau, including at the NHSM. Data from January 2008 to August 2013 was used to assess NICU incubator admissions and mortality.