The rising burden of type 2 diabetes is a major concern in healthcare worldwide. This research aimed to analyze the global epidemiology of type 2 diabetes. We analyzed the incidence, prevalence, and burden of suffering of diabetes mellitus based on epidemiological data from the Global Burden of Disease (GBD) current dataset from the Institute of Health Metrics, Seattle. Global and regional trends from 1990 to 2017 of type 2 diabetes for all ages were compiled. Forecast estimates were obtained using the SPSS Time Series Modeler. In 2017, approximately 462 million individuals were affected by type 2 diabetes corresponding to 6.28% of the world’s population (4.4% of those aged 15–49 years, 15% of those aged 50–69, and 22% of those aged 70+), or a prevalence rate of 6059 cases per 100,000. Over 1 million deaths per year can be attributed to diabetes alone, making it the ninth leading cause of mortality. The burden of diabetes mellitus is rising globally, and at a much faster rate in developed regions, such as Western Europe. The gender distribution is equal, and the incidence peaks at around 55 years of age. Global prevalence of type 2 diabetes is projected to increase to 7079 individuals per 100,000 by 2030, reflecting a continued rise across all regions of the world. There are concerning trends of rising prevalence in lower-income countries. Urgent public health and clinical preventive measures are warranted.

Pandemics and subsequent lifestyle restrictions such as ‘lockdowns’ may have unintended consequences, including alterations in body weight. This systematic review assesses the impact of pandemic confinement on body weight and identifies contributory factors. A comprehensive literature search was performed in seven electronic databases and in gray sources from their inception until July 1st 2020 with an update in PubMed and Scopus on February 1st 2021. In total, 2,361 unique records were retrieved, of which 41 studies were identified eligible: 1 case control study, 14 cohort and 26 cross-sectional studies (469, 362 total participants). The participants ranged in age from 6–86 years. The proportion of female participants ranged from 37% to 100%. Pandemic confinements were associated with weight gain in 7.2%–72.4% of participants and weight loss in 11.1%–32.0% of participants. Weight gain ranged from 0.6 (±1.3) to 3.0 (±2.4) kg, and weight loss ranged from 2.0 (±1.4) to 2.9 (±1.5) kg. Weight gain occurred predominantly in participants who were already overweight or obese. Associated factors included increased consumption of unhealthy food with changes in physical activity and altered sleep patterns. Weight loss during the pandemic was observed in individuals with previous low weight, and those who ate less and were more physically active before lock down. Maintaining a stable weight was more difficult in populations with reduced income, particularly in individuals with lower educational attainment. The findings of this systematic review highlight the short-term effects of pandemic confinements.

Globally, suicide and HIV/AIDS remain two of the greatest healthcare issues, particularly in low- and middle-income countries. Several studies have observed a relationship between suicidal behaviour and HIV/AIDS. Materials and Methods. The main objective of this research was to determine the prevalence of elevated risk of suicidal ideation in HIV-positive persons immediately following voluntary HIV counselling and testing (VCT). The study sample consisted of adult volunteers attending the VCT clinic at a university-affiliated, general state hospital. Participants completed a sociodemographic questionnaire, Beck's Hopeless Scale, and Beck's Depression Inventory. Results. A significantly elevated risk of suicidal ideation was found in 83.1% of the patients who tested seropositive. Despite a wide age range in the cohort studied, the majority of patients with suicidal ideation were males in the younger age group (age < 30 years), consistent with the age-related spread of the disease and an increase in suicidal behaviour in younger people. Relevant associated variables are discussed. Conclusion. The results serve as important markers that could alert healthcare professionals to underlying suicide risks in HIV-positive patients. It is recommended that screening for elevated risk of suicidal ideation and prevention of suicidal behaviour should form a routine aspect of comprehensive patient care at VCT clinics.

Objective: Suicidal behaviour and HIV/AIDS are significant public health concerns. The aim of this study was to investigate suicidal ideation in patients who were referred to a voluntary HIV counselling and testing (VCT) clinic and who were found to be seropositive. This in order to improve suicide prevention and intervention strategies amongst such patients. Method: The sample studied consisted of volunteer adult patients referred over a three-month period to a HIV VCT clinic based at a university-affiliated general state hospital. Patients completed a questionnaire on sociodemographic data. Suicidal ideation was measured using the Beck Hopelessness Scale and the Beck Depression Inventory (BDI), at two time points (within 72 hours after notification and again at a 6 week follow-up). All patients received extensive pre-and post-test counselling. Results: HIV-test results were available for 189 (99.5%) of the original sample of 190 patients studied, with 157 (83.1%) testing positive. More females tested positive as did unemployed and single/divorced patients. The mean age for HIV-positive patients was 33.49 (SD = 9.449), and for HIV-negative patients it was 37.94 (SD = 15.238). Age was a significant factor in that for each year increase in age, the risk of testing HIV-positive decreased by 4.1%. Lower education and traditional beliefs were also significantly associated with testing HIV-positive. At 72 hours suicidal ideation was present in 17.1% (95% confidence interval 12.16% to 23.45%), and at 6 weeks in 24.1% (95% confidence interval 17.26% to 32.39%) of the seropositive patients. Their average BDI scores were 15.20 and 14.23 respectively at the two time points. Conclusion: Suicidal ideation was present in a significant number of the seropositive cohort studied and increased over a six week period among these patients. The average BDI scores at both time points imply a clinical depression. The findings also suggest an association between positive HIV-test results and certain socio-demographic variables that can act as indicators for suicidal ideation in HIV-infected persons, although this requires further research. Although the relationship between suicidal ideation and HIV-infection is complex, it is an important consideration when assessing patient suicide vulnerability at HIV VCT clinics and when implementing suicide prevention and management strategies.

We aimed to assess global trends in Human Immunodeficiency Virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS) and evaluate progress toward eradication since the inception of the pandemic. Data were extracted from the Global Burden of Disease 2019 update and the UNAIDS Data 2019. The datasets included annual figures from 1990 to 2019 for HIV/AIDS in 204 countries and all world regions. We analyzed rates and trends for prevalence, incidence, mortality and disability adjusted life years. Analysis of age and gender distribution in different regions was used to assess demographic changes. Forecasting was used to estimate disease burden up to 2040. Although many countries have witnessed a decrease in the incidence, for Russia, Ukraine, Portugal, Brazil, Spain and the United States, the rates of new cases are rising since 2010. This trend is present even in age-standardized analysis, indicating a rise in excess of population growth. Over 0.5% of the world's population is infected. About 5000 new infections occur daily, of which 500 are children. Mortality rates are falling globally; currently at 11 deaths per 100,000 population, forecasted to decrease to 8.5 deaths by 2040. Prevalence continues to increase, with South Africa, Nigeria, Mozambique, India, Kenya and the United States having the highest burden. The total number as well as the rates of new HIV infections are rising every year in Europe, South America, North America and other regions over the last decade. Maternal-tochild transmission continues at high rates despite effective preventive regimens. There is an urgent need to develop programs to curb the rising incidence of HIV.

Background Cardiovascular disease (CVD) is the leading cause of mortality worldwide; however, the epidemiology of CVD among nationals from the United Arab Emirates (UAE) remains unknown. This study aimed to estimate the 9-year incidence rate of CVD and determine the risk factors associated with CVD among UAE nationals at high cardiovascular risk. In addition, we investigated whether sex was an important modifier of the risk factors associated with incident CVD in this population. Methods A retrospective cohort study was conducted on 977 subjects, including 492 women, aged ≥18 years, who did not have histories of CVD, and who had ≥1 CVD risk factors. Multivariable Cox proportional hazards regression analyses stratified by sex were used to examine the predictors of major CVD events, namely, myocardial infarction (MI), stroke, and acute peripheral arterial occlusion. Results During a median follow-up period of 8.9 years, the incidence rate of major CVD was 12.7 per 1000 person-years (95% confidence interval [CI] 10.4–15.4), and among men and women were 16.8 (95% CI 12.9–21.4) and 9.0 (95% CI 6.4–12.4) per 1000 person-years, respectively. Major CVD and MI were significantly more frequent among men than women, and the stroke and acute peripheral arterial occlusion rates were similar for both sexes. Multivariable Cox analyses showed that the systolic blood pressure, estimated glomerular filtration rate, and serum glycosylated hemoglobin A1c level were strong predictors of major CVD in both sexes. Among women, the total cholesterol (TC)-to-high-density lipoprotein-cholesterol (HDL-C) ratio (hazard ratio [HR] 1.44, 95% CI 1.02–2.04) was an additional independent predictor of major CVD. Age (HR 1.50, 95% CI 1.19–1.89) and a history of smoking (HR 1.80, 95% CI 1.07–3.02) were significant risk factors associated with major CVD in men. Conclusions Among high-risk UAE nationals who did not have histories of CVD, the risk of major CVD was associated with high systolic blood pressure, a low estimated glomerular filtration rate, and poorly controlled diabetes. The high TC-to-HDL-C ratios, especially among women, and smoking among men, are modifiable risk factors that should be managed aggressively. Electronic supplementary material The online version of this article (10.1186/s12872-019-1131-2) contains supplementary material, which is available to authorized users.

<p><strong>Background and objectives.</strong> HIV/AIDS and suicidal behaviour are major public health concerns. The aim of this study was to examine the relationship between hopelessness, depression and suicidal ideation in HIV-infected persons.</p><p><strong>Methods.</strong> The sample consisted of all adult volunteers attending a voluntary counselling and testing (VCT) HIV clinic at a university affiliated state hospital. Suicidal ideation and depression were measured using the Beck Hopelessness Scale (BHS) and the Beck Depression Inventory (BDI), respectively, at two intervals, viz. 72 hours and 6 weeks after HIV diagnosis.</p><p><strong>Results.</strong> Of the 156 patients who tested positive for HIV, 32 (20.5%) had a hopelessness score of 9 or above on the BHS and 130 patients (82.8%) were depressed according to the BDI at 72 hours after diagnosis. Of the 109 patients assessed 6 weeks after diagnosis, 32 (28.8%) had a hopelessness score of &gt;9 on the BHS and 86 (78.2%) were depressed according to the BDI. A moderately positive correlation at both time periods was found between hopelessness and depression. A ROC analysis showed optimal sensitivity, indicating that the HIV-positive depressed patients were at risk for suicidal behaviour.</p><p><strong>Conclusion.</strong> The significant correlations between hopelessness, depression and suicidal ideation are important markers that should alert healthcare professionals to underlying suicide risks in HIV-positive patients. Early recognition of this and suicide prevention strategies should be incorporated into the treatment offered at VCT HIV clinics.</p>

BackgroundOverweight and obesity is an emerging health problem, particularly amongst urban Black women living in areas of high HIV prevalence. Understanding factors affecting this pandemic is essential to enable effective weight loss programmes to be implemented. This study explored urban Black women's perception of their body image against a backdrop of pre-existing non-communicable diseases (NCDs).MethodIn this cross-sectional exploratory study 328 urban Black women were sampled systematically. Anthropometric measurements were conducted and women were interviewed using the Stunkard body image silhouettes as a tool to determine perception.ResultsMost of the subjects (61%) were in the 40–59 years age group. Mean body mass index (BMI) was 37 (± 9.41 kg/m2) with over 90% being overweight or obese. Diabetes mellitus was the most common NCD, with a prevalence of 72%. Amongst the diabetic patients 7% were overweight and 64% obese. Perceived body image compared to derived BMI showed that women underestimated their body image across all weight categories. Over 40% indicated a normal to overweight preferred body image, with 99% of respondents associating the underweight silhouettes with disease and HIV infection.ConclusionUrban Black women with underlying NCDs and living in an area of high HIV prevalence perceive themselves to be thinner than their actual BMI, which may be a barrier to weight loss management. This misperception may be used as a proxy risk marker for weight gain in urban Black women.