Prevalence and Correlates of Cardiovascular Autonomic Neuropathy Among
                        Patients with Diabetes in Uganda: A Hospital-Based Cross-sectional
                        Study

Migisha, Richard; Agaba, David Collins; Katamba, Godfrey; Kwaga, Teddy; Tumwesigye, Raymond; Miranda, Silvia Lopez; Muyingo, Anthony; Siedner, Mark J.

doi:10.5334/gh.765

Cited by 11 publications

(3 citation statements)

References 49 publications

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“…Our study participants were patients who consented to participate in the Cardiovascular autonomic neuropathy (CAN) study. The methods for this study have been described in detail elsewhere [ 12 ]. Briefly, the CAN study recruited 303 participants aged 18-65 years, through consecutive sampling.…”

Section: Methodsmentioning

confidence: 99%

High prevalence of uncontrolled hypertension among patients with type 2 diabetes mellitus: a hospital-based cross-sectional study in southwestern Uganda

Saasita¹,

Senoga²,

Muhongya³

et al. 2021

Pan Afr Med J

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Introduction most patients with diabetes mellitus are prone to uncontrolled blood pressures despite effective medical therapies; only about 30% of hypertensive patients have their blood pressures controlled. Poor control of hypertension is associated with increased risk for cardiovascular mortality and morbidity. We aimed to determine the prevalence and associated factors of uncontrolled hypertension among patients with type 2 diabetes mellitus (T2DM) attending ambulatory care at Mbarara Regional Referral Hospital, Southwestern Uganda. Methods we conducted a cross-sectional study from January to April 2019, among hypertensive T2DM patients. We used a structured questionnaire to obtain data on socio-demographic and clinical characteristics. We defined uncontrolled hypertension in participants with blood pressure ≥140/90mmHg and performed binary logistic regression to determine factors associated with uncontrolled hypertension. Results we analyzed data of 206 hypertensive participants with concomitant T2DM, with a median age of 54 (IQR, 49-60) years, and median duration of diabetes of 4 (IQR, 3-8) years; 71% were female. The prevalence of uncontrolled hypertension was 82.5% (170/206). Isolated systolic hypertension (aOR=7.58; 95%CI: 2.18-26.36, P=0.001) and left ventricular hypertrophy (LVH) (aOR=5.38; 95%CI: 1.11-26.10, P=0.037) were significantly associated with uncontrolled hypertension. Conclusion this study revealed a high prevalence of uncontrolled hypertension among T2DM patients in Southwestern Uganda. Isolated systolic hypertension and LVH were the key factors associated with uncontrolled hypertension. We recommend optimization therapy to reduce the burden of uncontrolled hypertension among patients with T2DM especially in those with isolated systolic hypertension, and left ventricular hypertrophy, who are at higher cardiovascular risk.

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Section: Methodsmentioning

confidence: 99%

High prevalence of uncontrolled hypertension among patients with type 2 diabetes mellitus: a hospital-based cross-sectional study in southwestern Uganda

Saasita¹,

Senoga²,

Muhongya³

et al. 2021

Pan Afr Med J

Self Cite

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“…In addition, each Ewing’s test can be scored as 0 for a normal result, 0.5 for a borderline result, and 1 for an abnormal result. Therefore, a total score of 0-5 can be attributed to the standard battery performance, as previously described[ 60 , 64 ]. The progression of CAN stages is associated with a worse prognosis, emphasizing the need for tests for early diagnosis[ 8 ].…”

Section: Ewing’s Batterymentioning

confidence: 99%

Cardiovascular autonomic neuropathy in diabetes: Pathophysiology, clinical assessment and implications

Duque

Mediano

Lorenzo

et al. 2021

WJD

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Cardiovascular autonomic neuropathy (CAN) is a debilitating condition that mainly occurs in long-standing type 2 diabetes patients but can manifest earlier, even before diabetes is diagnosed. CAN is a microvascular complication that results from lesions of the sympathetic and parasympathetic nerve fibers, which innervate the heart and blood vessels and promote alterations in cardiovascular autonomic control. The entire mechanism is still not elucidated, but several aspects of the pathophysiology of CAN have already been described, such as the production of advanced glycation end products, reactive oxygen species, nuclear factor kappa B, and pro-inflammatory cytokines. This microvascular complication is an important risk factor for silent myocardial ischemia, chronic kidney disease, myocardial dysfunction, major cardiovascular events, cardiac arrhythmias, and sudden death. It has also been suggested that, compared to other traditional cardiovascular risk factors, CAN progression may have a greater impact on cardiovascular disease development. However, CAN might be subclinical for several years, and a late diagnosis increases the mortality risk. The duration of the transition period from the subclinical to clinical stage remains unknown, but the progression of CAN is associated with a poor prognosis. Several tests can be used for CAN diagnosis, such as heart rate variability (HRV), cardiovascular autonomic reflex tests, and myocardial scintigraphy. Currently, it has already been described that CAN could be detected even during the subclinical stage through a reduction in HRV, which is a non-invasive test with a lower operating cost. Therefore, considering that diabetes mellitus is a global epidemic and that diabetic neuropathy is the most common chronic complication of diabetes, the early identification and treatment of CAN could be a key point to mitigate the morbidity and mortality associated with this long-lasting condition.

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“… 20 Cardiovascular diseases research area. We realized 13 publications from the MURTI trainees in this area: (i) PMC5766276 21 (ii) https://doi.org/10.29392/001c.19464 ; 22 (iii) PMC7470164; 23 (iv) PMC7218768; 24 (v) PMC8077796; 25 (vi) https://doi.org/10.1007/s13410-021-00944-6 ; 26 (vii) https://doi.org/10.11604/pamj.2021.39.142.28620 (viii) PMC7367467; 28 (ix) PMC6877961; 29 (x) PMC7396089; 30 (xi) PMC7004860; 31 (xii) PMC6641537; 32 (xiii) PMC7592727. 33 Neurological disorders and stroke research area.…”

Section: Resultsmentioning

confidence: 99%

Mbarara University Research Training Initiative: Experiences and Accomplishments of the MEPI Junior D43 TW010128 Award in Uganda

Wakida¹,

Atuhaire²,

Karungi³

et al. 2021

AMEP

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Objective In 2015, Mbarara University of Science and Technology was awarded the Mbarara University Research Training Initiative (MURTI) under grant number D43 TW010128 to build capacity of junior faculty to become the next generation of researchers in Africa. In this paper, we document the experiences and achievements of the research capacity building efforts at MUST. Methods We conducted a descriptive evaluation study which involved document review and in-depth interviews. We used “Reach” and ‘Effectiveness’ from the RE-AIM framework to guide the document review, and the organizational theory of implementation effectiveness to guide the in-depth interviews. Results In the MURTI program, we conducted 17 short courses between August 2015 and July 2021, a total of 6597 attendances were recorded. The most attended courses were responsible conduct of research (n = 826), qualitative research methods (n = 744), and data management (n = 613). Thirty-three fellows were recruited and funded to conduct mentored research leading to 48 publications and 14 extramural grant applications were yielded. From the in-depth interviews, the participants appreciated the research training program, the enhanced research skills attained, and the institutional capacity built. They attributed the success of the program to the training approach of using short courses, readiness of the junior faculty to change, and the supportive environment by the mentors and trainers in the program. Conclusion The D43 TW010128 research training grant-built capacity for the junior faculty at MUST, enhanced their research skills, promoted research capacity institutionally and provided career development for the junior faculty. This was possible due to the positive attitude of the junior faculty (organizational readiness) to change and the supportive environment (mentors and trainers) during implementation of the grant. These two factors provided a favorable institutional climate that guaranteed success of the funding goals.

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Prevalence and Correlates of Cardiovascular Autonomic Neuropathy Among Patients with Diabetes in Uganda: A Hospital-Based Cross-sectional Study

Cited by 11 publications

References 49 publications

High prevalence of uncontrolled hypertension among patients with type 2 diabetes mellitus: a hospital-based cross-sectional study in southwestern Uganda

High prevalence of uncontrolled hypertension among patients with type 2 diabetes mellitus: a hospital-based cross-sectional study in southwestern Uganda

Cardiovascular autonomic neuropathy in diabetes: Pathophysiology, clinical assessment and implications

Mbarara University Research Training Initiative: Experiences and Accomplishments of the MEPI Junior D43 TW010128 Award in Uganda

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