ArticleThe Lancet regional health. Western Pacific2022
Cascades of diabetes and hypertension care in Samoa: Identifying gaps in the diagnosis, treatment, and control continuum - a cross-sectional study.
Article in The Lancet regional health. Western Pacific, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 24 citations in OpenAlex.
- Care Cascades for Hypertension in Low-Income Settings: A Systematic Review and Meta-Analysis.International journal of public health · 2023Pooled it
- Inequality in prevalence of unmedicated hypertension or diabetes among older Filipinos: analysis of nationally representative survey data.International journal of cardiology. Cardiovascular risk and prevention · 2026Article
- Reorienting health promotion in remote Pacific Island communities: building family and child-centered agent-of-change models for sustainable behavior change.The Lancet regional health. Western Pacific · 2026Article
- HIV Pre-Exposure Prophylaxis Cascade Stages Among Men Who Have Sex With Men With Sexually Transmitted Infections in China: Multicenter Cross-Sectional Survey Study.JMIR public health and surveillance · 2024Article
- Identify unmet needs in diabetes care in Shandong, China: a secondary analysis of a cross-sectional study using cascade of care framework.BMC endocrine disorders · 2024Article
- Missed opportunities for hypertension screening of older people in the Philippines: cross-sectional analysis of nationally representative individual-level data.The Lancet regional health. Western Pacific · 2024Article
- Capacity for the management of kidney failure in the International Society of Nephrology Oceania and South East Asia (OSEA) region: report from the 2023 ISN Global Kidney Health Atlas (ISN-GKHA).Kidney international supplements · 2024Review
- Indication of mixed glucose and fatty acid use by inferred brown adipose tissue activity in Samoans.American journal of human biology : the official journal of the Human Biology Council · 2024Article
- Understanding Gaps in the Hypertension and Diabetes Care Cascade: Systematic Scoping Review.JMIR public health and surveillance · 2024Article
- When the cold gets under your skin: Evidence for brown adipose tissue activity in Samoan adults.American journal of biological anthropology · 2024Article
- Association between age at menarche and cardiometabolic risk among Samoan adults.American journal of human biology : the official journal of the Human Biology Council · 2024Article
- Cascade of diabetes care in Bangladesh, Bhutan and Nepal: identifying gaps in the screening, diagnosis, treatment and control continuum.Scientific reports · 2023Article
- Arterial hypertension and its covariates among nomadic Raute hunter-gatherers of Western Nepal: a mixed-method study.BMJ open · 2023Article
- Multivariate analysis of a missense variant in CREBRF reveals associations with measures of adiposity in people of Polynesian ancestries.Genetic epidemiology · 2023Article
- The tide of dietary risks for noncommunicable diseases in Pacific Islands: an analysis of population NCD surveys.BMC public health · 2022Article
- Regional Research-Practice-Policy Partnerships in Response to Climate-Related Disparities: Promoting Health Equity in the Pacific.International journal of environmental research and public health · 2022Article
- Undiagnosed hypertension and type 2 diabetes mellitus among Marshallese adults in the Republic of the Marshall Islands.The journal of medicine accessArticle
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Authors and funding
11 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundSamoa is a Pacific Island country facing one of the highest burdens of non-communicable disease globally.
methodsIn this study, we apply a cascade-of-care approach to understand gaps in the awareness, treatment, and control cascade of diabetes and hypertension in a cross-sectional, convenience sample of 703 young, high-risk Samoan adults (29.5-50.9 years).
findingsNon-communicable diseases were prevalent in the study sample: 19.5% (95% CI: 16.6%-22.7%) of participants had diabetes; 47.6% (95% CI: 43.7%-51.4%) presented with pre-diabetes or diabetes; 31.0% (95% CI: 27.5%-34.6%) had hypertension; and nearly 90% (95% CI: 86.7%-91.5%) had overweight or obesity. Among those with diabetes and hypertension, only 20.5% (95% CI: 13.9%-28.4%) and 11.8% (95% CI: 7.8%-16.9%) of participants were aware of their condition, respectively. Only 0.8% (95% CI: 0.0%-4.2%) of all participants with diabetes had achieved glycemic control; only 2.8% (95% CI: 1.1%-6.1%) of those with hypertension achieved control.
interpretationWe found a significant burden of diabetes and hypertension in Samoa, exceeding the recent prevalence estimates of other low- to middle-income countries by nearly two-fold. A severe unmet need in both detection and subsequent control and monitoring of these chronic conditions exists. Our results suggest that the initial diagnosis and surveillance stage in the cascade of care for chronic conditions should be a major focus of primary care efforts; national screening campaigns and programs that leverage village and district nurses to deliver community-based primary care may significantly impact gap closure in the NCD cascade.
fundingThis study was supported by the U.S. National Institutes of Health R01HL140570 (PIs: McGarvey and DeLany); AR was supported by NIH FIC D43TW010540; HK and AR-C were supported by the Minority Health and Health Disparities International Research Training (MHIRT) Program at Brown University, NIH Grant # 5T37MD008655.
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