BackgroundMetabolic syndrome (MS) comprises a set of conditions that are risk factors for cardiovascular diseases and diabetes. Numerous epidemiological studies on MS have been conducted, but there has not been a systematic analysis of the prevalence of MS in the Chinese population. Therefore, the aim of this study was to estimate the pooled prevalence of MS among subjects in Mainland China.MethodsWe performed a systematic review by searching both English and Chinese literature databases. Random or fixed effects models were used to summarize the prevalence of MS according to statistical tests for heterogeneity. Subgroup, sensitivity, and meta-regression analyses were performed to address heterogeneity. Publication bias was evaluated using Egger’s test.ResultsThirty-five papers were included in the meta-analysis, with a total population of 226,653 Chinese subjects. Among subjects aged 15 years and older, the pooled prevalence was 24.5 % (95 % CI: 22.0–26.9 %). By sex, the prevalences were 19.2 % (95 % CI: 16.9–21.6 %) in males and 27.0 % (95 % CI: 23.5–30.5 %) in females. The pooled prevalence of MS increased with age (15–39 years: 13.9 %; 40–59 years: 26.4 %; and ≥60 years: 32.4 %). Individuals living in urban areas (24.9 %, 95 % CI: 18.5–31.3 %) were more likely to suffer from MS than those living in rural areas (19.2 %, 95 % CI: 14.8–23.7 %). Hypertension was the most prevalent component of MS in males (52.8 %), while the most prevalent component of MS for females was central obesity (46.1 %).ConclusionsOur systematic review suggested a high prevalence of MS among subjects in Mainland China, indicating that MS is a serious public health problem. Therefore, more attention should be paid to the prevention and control of MS.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-016-2870-y) contains supplementary material, which is available to authorized users.

BackgroundThe awareness, treatment and control of diabetes mellitus (DM) can effectively reflect on the social status of diabetes conditions. Although several researchers have investigated the awareness, treatment and control rates of diabetes mellitus in China, little is known about their association with risk factors. This study aims to examine the relationship between risk factors and awareness, treatment and control of diabetes mellitus in northeast China.MethodsA cross-sectional survey was conducted in 2012. Multistage stratified random cluster sampling design was used to select participants aged 18 to 79 years old. The analysis was based on a representative sample of 1,854 adult subjects. Multivariable logistic regression analysis was used to examine socio-demographic factors associated with the levels of awareness, treatment and control of diabetes mellitus.ResultsThe awareness, treatment, and control rates of diabetes mellitus were 64.1%, 52.9% and 44.2%, respectively. In the multivariable logistic regression analysis, family history of diabetes was significantly positively associated with awareness (OR, 2.145; 95% CI, 1.600–2.875) and treatment (OR, 2.021; 95% CI, 1.559–2.619) of diabetes mellitus, while negatively associated with control (OR, 0.671; 95% CI, 0.529–0.951). Cigarette smokers and alcohol drinkers were less likely than non-smokers and non-drinkers to be aware of their blood glucose levels (OR, 0.895, 0.614; 95% CI, 0.659–1.216, 0.446–0.844, respectively). Participants who frequently exercise were more likely to be aware of their diabetic conditions than people who never or rarely exercise (OR, 2.003; 95% CI, 1.513–2.651).ConclusionsWe found that the awareness and treatment of diabetes mellitus were positively associated with age and were high in participants with a family history of diabetes and those who exercise frequently, but low for cigarette smokers and alcohol drinkers. Participants with a family history of diabetes had their diabetic condition poorly controlled.

BackgroundIn China, even though the prevalence of dyslipidemia among adults increased yearly and dyslipidemia being an important risk factor for cardiovascular diseases among the Chinese population, however, the awareness, treatment and control of dyslipidemia are at low levels, and only limited studies on the influence factors associated with the awareness, treatment and control dyslipidemia in China have been carried out.MethodsThe analysis was based on a representative sample of 7138 adult subjects aged 18 ~ 79 years recruited from a cross-sectional study of chronic disease and risk factors among adults in the Jilin province in 2012. Chi-square test was used to compare the rates of dyslipidemia awareness, treatment and control between different characteristics of participants. Multiple logistic regression analyses were performed separately for each group to explore the associations between participants’ characteristics and dyslipidemia awareness, treatment and control.ResultsAmong participants with dyslipidemia, 11.6% were aware of the diagnosis, 8.4% were receiving treatment, and 34.8% had dyslipidemia controlled. Increase in age and BMI ≥ 24 kg/m2 were by far the strongest risk factors associated with better awareness and treatment of dyslipidemia. Retirees were more likely to be aware of their dyslipidemia condition (OR = 1.255; 95% CI: 1.046, 1.506) and to be receiving treatment (OR = 1.367; 95% CI: 1.114, 1.676) than manual workers. A family history of dyslipidemia increased the likelihood of awareness (OR = 3.620; 95% CI: 2.816, 4.653) and treatment (OR = 3.298; 95% CI: 2.488, 4.371) of dyslipidemia. Alcohol drinking and physical activity were associated with a lower level of awareness and treatment.Cigarette smokers (OR = 0.501; 95% CI: 0.349, 0.719) and those with BMI ≥ 24 kg/m2 (OR = 0.480; 95% CI: 0.326, 0.706) who received treatment were also associated with poor dyslipidemia control.ConclusionOur study highlights low levels of awareness, poor treatment and control of dyslipidemia among adults aged 18 ~ 79 in the Jilin province. Promotion of healthy lifestyles and establishment of a comprehensive strategy of screening, treatment and control of dyslipidemia is needed to reduce or prevent the risk of cardiovascular disease in the Jilin province.

Background: Healthcare workers (HCWs) are known to spearhead the fight against the COVID-19 pandemic. As such, their knowledge, attitude, and practice (KAP) toward coronavirus disease 2019 (COVID-19) are considered critical to the success of the current COVID-19 response efforts. This study aims to determine HCWs' KAP toward COVID-19 and assesses their perception of their healthcare facilities preparedness to respond appropriately to the ongoing COVID-19 pandemic in Sierra Leone. Methods: We conducted an online cross-sectional study among HCWs (n=516) between 1st May 2020 and 30th June 2020. We collected our data using a self-administered structured questionnaire via email and online social media platforms. We analyzed our data using descriptive statistics and regression analysis (p<0.05). Results: Close to three-fourth of HCWs (n=375, 72.7%) were knowledgeable regarding COVID-19. Doctors were more knowledgeable than community health workers and laboratory technicians (AOR= 2.48, 95% CI: 1.16-5.31, p=0.019) regarding COVID-19. Close to twothirds of HCWs (n=301, 58.3%) HCWs show positive attitudes toward COVID-19. Being male (AOR=2.08, 95% CI: 1.36-3.20, p=0.001) and directly involved in COVID-19 patient care (AOR=3.21, 95% CI: 1.88-5.48, p<0.001) were identified as predictors of positive attitude towards COVID-19. HCWs are generally adhering to COVID-19 safe practices with majority indicating that they regularly wash or sanitize their hands (n=510, 98.8%) and used facemask at point of care (n=499, 96.7%). Majority of HCWs are of the view that their healthcare facilities are ill-prepared to adequately respond to COVID-19 with majority (n= 400, 77.5%) of them stating that their facilities lack enough personal protective equipment. Conclusion: HCWs in Sierra Leone showed good knowledge, positive attitude and practice regarding COVID-19. However, HCWs are of the view that their healthcare facilities are illprepared to respond adequately to the COVID-19 outbreak. Health authorities and policymakers need to provide the necessary resources to allow HCWs to work in a safe environment.

Background There is limited information on surgical site infections (SSI) and the related antibiotic resistance needed to guide their management and prevention in Sierra Leone. In this study, we aimed to establish the incidence and risk factors of SSI and the related antibiotic resistance among adults attending a tertiary hospital, and a secondary health facility in Freetown, Sierra Leone. Methods This is a prospective cohort study designed to collect data from adult (18 years or older) patients who attended elective and emergency surgeries at two hospitals in Freetown between February and July, 2021. Data analysis was done using STATA version 16. Results Of 338 patients, 245 (72.5%) and 93 (27.5%) had their surgeries at the tertiary and secondary hospitals, respectively. Many were males 192 (56.8%), less than 35 years 164 (48.5%), and 39 (11.5%) developed an SSI. Of the 39 patients who acquired an SSI, 7 (17.9%) and 32 (82.1%) had their surgeries at the secondary and tertiary hospitals, respectively. The incidence of SSI is higher in contaminated 17 (43.6%) than in clean-contaminated 12 (30.8%) and clean 10 (25.6%) wounds. Wound swabs were collected in 29 (74.4%) patients, of which 18 (62.1%) had bacterial growth. In total, 49 isolates of 14 different bacteria including gram-negative 41 (83.7%) and gram-positive 8 (16.3%) isolates were identified. Of these, 32 (65.3%) were Enterobacteriaceae, 9 (18.4%) were Non-fermenting gram-negative bacilli and 10 (12.2%) were Enterococci. The most common isolates were Escherichia coli (12, 24.5%), Klebsiella pneumoniae (10, 20.4%), Acinetobacter baumannii (5, 10.2%), Klebsiella oxytoca (4, 8.2%) and Enterococcus faecalis (4, 8.2%). The Enterobacteriaceae were either resistance to carbapenems (4, 8.2%) or were extended-spectrum beta-lactamase (ESBL) producing organisms (29, 59.2%). Male sex [p = 0.031], an ASA score ≥ 2 [p = 0.020), administration of general anaesthesia [p = 0.018] and elevated fasting glucose [p = 0.033] were predictive of SSI. Conclusion The incidence of SSI in this study is comparable to other low- and middle-income countries, but a substantial proportion of these postoperative wounds have an ESBL-producing Enterobacteriaceae. Therefore, routine surveillance of SSI and related antibiotic resistance is required in resource-limited settings.