[Full Text] Anemia i Tagata Matutua Ma'i suka Asiasi E Falema'i Tele

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Anemia i tagata matutua e maua i le maʻisuka o loʻo auai i se falemaʻi lautele i Etiopia i sasaʻe: o se suʻesuʻega faʻasolosolo
Teshome Tujuba, 1 Behailu Hawulte Ayele, 2 Sagni Girma Fage, 3 Fitsum Weldegebreal41, Medical Laboratory, Guelmsau General Hospital, Guelmsau City, Ethiopia 2 School of Public Health, Faculty of Health and Medicine, Haramaya University, Harala State, Ethiopia; 3 School of Nursing and Midwifery, Faculty of Health and Medicine, Haramaya University, Ethiopia; 4 Faculty of Health and Medicine, Haramaya University, Harar City, Ethiopia News Agency: Sagni Girma Fage, Faculty of Health and Medical Sciences, Haral University, Ethiopia, Harar, Ethiopia POBox 235 Email giruu06@gmail.com Background: Although anemia is a common disease among diabetic patients, there is very little evidence of anemia in this part of the population in Ethiopia, especially in the research environment. Therefore, the purpose of this study was to evaluate the degree of anemia and related factors in adult diabetic patients treated in a general hospital in eastern Ethiopia. Methods: A cross-sectional study of health basics was conducted on 325 randomly selected adult diabetic patients. Follow-up clinic at the Gramsoe General Hospital in eastern Ethiopia. Use pre-tested structured questionnaires to collect data through interviews and then perform physical and laboratory measurements. Then enter the data into EpiData version 3.1, and use STATA version 16.0 for analysis. Fit a binary logistic regression model to identify factors related to anemia. When p-value<0.05, all statistical tests are declared significant. Results: The degree of anemia in adult diabetic patients was 30.2% (95% confidence interval (CI): 25.4%-35.4%). Men (36%) have higher anemia than women (20.5%). Male (adjusted odds ratio (AOR) = 2.1, 95% CI: 1.2, 3.8), DM ≥ 5 years (AOR = 1.9, 95% CI: 1.0, 3.7), comorbidities (AOR = 1.9, 95) %CI : 1.0, 3.7) and suffering from diabetic complications (AOR = 2.3, 95% CI: 1.3, 4.2) were significantly associated with anemia. Conclusion: Anemia is a moderate to moderate public health problem among adult DM patients in the study subjects. Male gender, the duration of DM, the presence of DM complications, and DM comorbidities are factors related to anemia. Therefore, routine screening and appropriate management should be designed for men, DM patients with long DM duration, and anemia patients with complications and comorbidities, so as to improve the quality of life of patients. Early diagnosis and regular monitoring of diabetes may also help minimize complications. Keywords: Anemia, Diabetes, General Hospital, Eastern Ethiopia
Anemia e fa'atatau i le fa'aitiitia o le aofa'i o sela mumu toto (RBC) fe'avea'i ma/po'o le fa'aitiitia o le gafatia e ave ai le okesene ona o se taunuuga, lea e le lava e fa'amalieina mana'oga fa'aletino o le tino o le tagata.1,2 E aʻafia ai atunuʻu atinaʻe ma atinaʻe, mo le soifua maloloina o tagata, agafesootai ma le tamaoaiga.3 E tusa ma le 1.62 piliona tagata e maua i le anemia i le lalolagi, e tusa ma le 24.8% o le faitau aofaʻi o le lalolagi.4
O le ma'i suka ma'isuka (DM) ose ma'i fa'atosina, e vaevaeina i le ituaiga I_tamaiti po'o le inisalini-faalagolago i le ma'isuka ma le ituaiga II_le-fa'alagolago i le inisalini.5 I tagata maʻi suka, anemia e mafua ona o le fulafula, vailaʻau, le atoatoa o meaʻai, faʻamaʻi fatugaʻo, faʻamaʻi faʻamaʻi autoimmune, 6,7 faʻaitiitiga faʻaitiitiga i le gaosiga o le erythropoietin, le atoatoa poʻo le faʻaogaina o le uʻamea, ma faʻapuupuu le ola toto mumu.8,9 O le mea lea, o le anemia e taatele i tagata mamaʻi.10,11 I tagata matutua, o le faʻateleina o le anemia e 24% i fafine o le fanauina o tausaga (15-49 tausaga) ma le 15% i alii 15-49 tausaga.12
I tagata mama'i e maua i le DM, ae maise lava i latou o lo'o maua i le ma'i fatuga'o po'o le le lava o le fatu, o le fa'atupuina o le anemia e tusa ma le 2 i le 3 taimi e maualuga atu ai nai lo tagata mama'i e leai se DM.13,14 Anemia ma le maʻisuka, e pei o le nephropathy, retinopathy, neuropathy, faʻamaʻi le lelei o manuʻa, ma faʻamaʻi macrovascular [15,16], e iai se aʻafiaga leaga i le lelei o le olaga o tagata gasegase.17-19 E ui lava i nei mea moni, o lipoti o suʻesuʻega o loʻo faʻaalia ai e tusa ma le 25% o tagata mamaʻi maʻisuka e le mafai lava ona iloa le anemia.20,21
O le vave iloa ma le togafitia o le anemia i gasegase o le DM e mafai ona fesoasoani e faʻaitiitia le faʻamaʻi ma le oti, ma faʻaleleia atili ai o latou olaga.22 Ae ui i lea, i le aotelega, o le iloiloga o le anemia i tagata mamaʻi mamaʻi i Etiopia e matua maualalo, ma e oʻo mai i le taimi nei, e leai se suʻesuʻega talafeagai.E moni lava lenei mea i le vaega o suʻesuʻega.O le mea lea, o lenei suʻesuʻega e faʻatatau i le faʻatusatusaina o le maualuga o le anemia i tagata maʻi suka i le Gramsoe General Hospital i sasaʻe o Etiopia ma fuafua ai mea e fesoʻotaʻi ma ia.
O le suʻesuʻega na faia i le Glymso General Hospital (GGH) o loʻo i le Glymso Town, Habro District, Oromiya State, Eastern Ethiopia.O le falemaʻi e tu ile 390 kilomita i sasaʻe o Addis Ababa, le laumua o Etiopia.23 E tusa ai ma se lipoti a le Ofisa o le Soifua Maloloina a Habro Woreda, o le GGH o se nofoaga autu e tuʻuina atu mo le tusa ma le 1.4 miliona tagata i le nofoaga lata ane.E tu'uina atu auaunaga fa'alesoifua maloloina i le silia ma le 90,000 gasegase i ona matagaluega ma falema'i eseese i tausaga ta'itasi.O le Falema'i Ma'i Suka o se tasi lea o vaega fa'apolofesa e tu'uina atu auaunaga i le tusa ma le 660 tagata mama'i ma'i suka.O le Itumalo o Habro o loʻo i le maualuga o le 1800-2000 mita.
Sa faia se su'esu'ega fa'asaga i le falema'i mai ia Iuni 9, 2020 e o'o ia Aukuso 10, 2020. O tagata agavaa e auai o tagata matutua (≥18 tausaga) ma'i suka o lo'o tulitatao i le GGH.O tagata matutua e maua i le ma'isuka na tuiina toto i le 3 masina ua tuana'i, o ma'i ma'itaga pe faatoa fananau mai pe mafatia i gasegase o le mafaufau, o tagata mama'i na faia taotoga po'o le tafe toto mo so'o se mafua'aga, ma tagata mama'i na maua togafitiga fa'ama'i intestinal e le o aofia ai. .Aoao.
O le faʻataʻitaʻiga tele na faʻamoemoeina e ala i le faʻaaogaina o se fua faʻatatau o le faitau aofaʻi ma faʻavae i luga o manatu nei: 95% taimi faʻamaonia, 5% faʻasologa o mea sese, ma le anemia faʻateleina o tagata maʻi suka mai Dessie Referral Hospital i Northeast Etiopia (p = 26.7) %).24 A maeʻa ona faʻaopoopo le 10% i tagata e le o tali mai, o le faʻataʻitaʻiga mulimuli e 331.
660 tagata mama'i ma'i suka na tulitatao lelei i se falema'i ma'i suka i le GGH.Vaevae le aofa'i o tagata mama'i ma'i suka (660) i le lapo'a fa'ata'ita'i mulimuli (331) e maua ai ni vaeluaga e lua.I le fa'aogaina o le resitala o tagata ma'i suka o lo'o maua auaunaga tulitatao i le falema'i e fai ma fa'ata'ita'iga fa'ata'ita'iga, na matou fa'aogaina ai se faiga fa'ata'ita'i fa'apitoa e fa'aaofia uma isi gasegase i le su'esu'ega.Tuʻu atu i tagata suʻesuʻe taʻitoʻatasi se numera faʻamaonia tulaga ese e aloese ai mai le toe faʻaluaina, ina neʻi toe sau le maʻi lava e tasi i le taimi o suʻesuʻega mo se isi tulitatao.
Aoina faʻamatalaga i luga ole sociodemographic fesuiaiga, inu ava malosi, ulaula, ma uiga o meaʻai e ala i le faʻaaogaina o se fesili faʻatulagaina e faʻafetaui mai le laasaga taʻitasi o le WHO faʻamaʻi faʻamaʻi faʻalavelave mataʻituina tusi lesona.25 O le taumafaina o lauti ma kofe, fa'aogaina o le paipa vai, fesili lamu a Carter, fa'aogaina o le fa'ama'itaga, ma le tala fa'asolopito o le ma'i masina na maua e ala i le iloiloina o tusi eseese.O le 26-30 fesili na tusia i le Igilisi ma fa'aliliu i le gagana fa'apitonu'u (Afaan Oromoo), ona toe fa'aliliu lea i le Igilisi e tagata tomai fa'apitoa i gagana eseese e siaki ai le fa'atasi.Maua mai fa'amatalaga fa'apitoa e pei o le umi o le ma'i suka, ituaiga o le ma'i suka, fa'alavelave o le ma'i suka, ma le maualuga o le kulukose toto anapogi mai fa'amaumauga a le ma'i.O faʻamaumauga na aoina e ni tausimai faʻapolofesa e toʻalua ma se tekinisia falesuesue, ma vaʻavaʻaia e se matai o le soifua maloloina lautele faauu.
Fua le toto maualuga (BP) e fa'aaoga ai se mita fa'afuainumera toto (Heuer) e fa'amaonia i taimi uma.A'o le'i fuaina le toto maualuga, e le'i inuina e le tagata ni meainu vevela, e pei o lauti, kofe po'o tapaa ulaula, lamu le Caterpillar, pe faia ni fa'amalositino malosi i le 30 minute mulimuli.A maeʻa ona malolo le mataupu mo le itiiti ifo i le lima minute ma faʻamaumau le faitau aofaʻi o le BP, e tolu fua tutoʻatasi na faia i le lima agavale.O le fua lona lua ma le lona tolu na faia i le lima ma le sefulu minute pe a uma le fua muamua ma le lua, i le faasologa.O le maualuga o le toto e faauigaina o tagata mamaʻi e maualuga le BP (SBP≥140 poʻo DBP≥90mmHg) poʻo i latou na maua muamua o loʻo inu vailaʻau faʻamalosi.31,32
Ina ia iloa le tulaga o meaʻai e ala i le faʻasologa o le tino (BMI), matou te fuaina le maualuga ma le mamafa o le maʻi.Pe a tutu saʻo tagata taʻitoʻatasi i luga o le puipui, o latou mulivae e paʻi faʻatasi i le puipui, e leʻi faia ni seevae, faʻasaʻo o latou ulu, ma fua lo latou maualuga i se pule ma faʻamaumau le 0.1 cm lata ane.Fa'aaogā le fua fa'afuainumera fa'ailoga 0-130 kg e fua ai lou mamafa.A'o le'i fuaina ta'itasi, fa'avasega le fua i se tulaga e leai.Fua le mamafa o le tagata auai a'o ofuina ni lavalava mama ma leai ni seevae, ma fa'amaumau le 0.1 kg sili ona latalata.33,34 Fa'ailoga o le tino (BMI) e fa'atatau i le vaevaeina o le mamafa o le tino (kg) i le maualuga (m).Ona faʻamatalaina lea o le tulaga o meaʻai: afai BMI <18.5, laʻititi;afai BMI = 18.5–24.9, la'ititi le mamafa;afai BMI = 25–29.9, mamafa mamafa;afai BMI ≥30.35,36, oona
I tafatafa o le ogatotonu i le va o le pito i lalo ole ivi 'aso'aso ma le pito i luga ole pito, fa'aoga se fua fa'amau e le fa'amauina e fua ai le li'o o le puimanava ma fa'amau i le 0.1 cm lata ane.Obesity tutotonu o loʻo faʻamatalaina o le sulugatiti circumference threshold mo alii ≥ 94 cm, ma le sulugatiti circumference threshold mo tamaitai ≥ 80 cm.30,36 I le taimi o aʻoaʻoga, 10 tagata matutua maʻi suka maʻisuka na aʻafia i faʻalavelave faʻapitoa fua faʻapitoa (%TEM) e faʻaitiitia ai faʻalavelave faʻafuaseʻi fua o mea sese.O fa'amatalaga fa'apitoa fa'atekinisi fa'atatau i totonu ma le va o tagata matau e itiiti ifo i le 1.5% ma le itiiti ifo i le 2%, fa'asologa.
Na aoina e tekinisia o fale su'esu'e pe tusa ma le lua mililita (2 mL) o fa'ata'ita'iga toto mai tagata uma na auai ma tu'u i totonu o se paipa su'esu'e o lo'o iai le tripotassium ethylenediaminetetraacetic acid (EDTA K3) anticoagulant mo le su'esu'eina o le hemoglobin.Fa'afefiloi lelei le toto atoa na aoina ma fa'aoga le Sysmex XN-550 hematology analyzer mo au'ili'iliga.O le fuaina o le hemoglobin na fetuunai e ala i le faʻaitiitia o le maualuga o tagata auai uma e ala i le toesea o le 0.8 g / dl ma le ulaula tulaga e ala i le toesea o le 0.03 g / dl.Ona faauigaina lea o le anemia o le maualuga o le hemoglobin fafine <12g/dl ma le tane <13g/dl.O le ogaoga o le anemia ua vaevaeina i: o le hemoglobin maualuga o alii ma tamaitai o le 11-12.9 g / dl ma le 11-11.9 g / dl, i le faasologa, o le anemia vaivai, ae o le hemoglobin maualuga o le anemia feololo ma ogaoga e 8-10.9 g/dl, fa'asologa dl ma <8 mg/dl.Le tane ma le fafine
Ao mai le lima mililita (5 mL) o le toto vena i totonu o se paipa su'esu'e e aunoa ma se vailaau fa'ama'i e iloa ai le creatinine ma le urea.O le toto atoa e aunoa ma le anticoagulant e faʻapipiʻiina mo le 20-30 minute ma faʻamalo i le 3000 rpm mo le 5 minute e vavae ese ai le sua.Ona, o le Mindray BS-200E (China Mindray Biomedical Electronics Co., Ltd.) su'esu'e kemisi fa'afoma'i na fa'aaogaina e fa'amautu ai le creatinine serum ma le urea e ala ile picrine acid ma metotia enzymatic.37 Fa'aaogā le fua ole kilia ole creatinine e fa'atatau ile fua ole fa'amama ole glomerular.Fa'aaoga le Fa'ama'i Fa'ama'i Fa'ama'i (CKD) Fa'atatau (GFR), fa'aalia e pei o le CKD-EPI Cockroft-Gault fua fa'atatau i le 1.73 sikuea mita.
O le maualuga o le kulukose o le toto anapogi (a itiiti ifo i le 8 itula) e fuaina i tui tamatamailima e fa'aaoga ai le mita o le kulukose toto ua fa'avasega mo le kulukose toto.38 Afai ole maualuga ole kulukose ole toto ole anapogi e i lalo ole 80 pe> 130mg/dl, o lona uiga ole tulafono ole pulea ole kulukose toto.Pulea pe a o'o ile 80-130mg/dl le maualuga ole kulukose ile toto anapogi
O tagata su'esu'e na auai na tu'uina atu i ai se la'au fa'apipi'i laupapa mama ma se ipu palasitika mama, mago, fa'amago ma le numera fa'asologa o le mataupu mo su'esu'ega fecal parasite.Fa'atonu i latou e aumai se fa'ata'ita'i o le nofoa fou e lua kalama (pe tusa ma le lapo'a o le lima matua).Ina ua mae'a ona su'esu'eina anufe (fuamoa ma/po'o larvae) fa'aogaina auala fa'apipi'i sa'o susu, sa siaki fa'ata'ita'iga i totonu ole 30 minute o le aoina mai o fa'ata'ita'iga.O faʻataʻitaʻiga na totoe na teuina i totonu o se faʻamau suʻega o loʻo i ai le 10 mL o le 10% formalin e faʻaleleia ai le fua o le suʻesuʻeina o parasites, ma a maeʻa togafitiga faʻatasi ma le formalin-ether precipitation concentration technology, na faʻaaogaina le Olympus Microscope mo le asiasiga.
Fa'aaogā se tui fa'amama e aoina mai ai toto toto mai tamatamai lima e iloa ai le malaria.Saunia se ata manifinifi o le toto i luga o le tioata mama e tasi e aunoa ma le gaʻo, ona faʻagogo lea o le ea.O fa'ase'e na pisia i le 10% Giemsa mo le tusa ma le 10 minute, ma fa'ata'ita'iina ituaiga o malaria.Ina ua su'esu'eina le 100 fanua maualuga i lalo o le fa'atofuina o le suau'u, na manatu le fa'ase'e e le lelei.40
E lua aso a'oa'oga i le aoina o fa'amaumauga ma metotia na tu'uina atu i tagata aoina fa'amaumauga ma supavaisa.Aʻo leʻi aoina e le Falemaʻi Lautele a Chiro le faʻamatalaga moni o le 30 maʻi maʻisuka, o le fesili na faʻataʻitaʻiina muamua ma na faia ni suiga talafeagai.O le fua fa'aletino e fa'avasegaina e le fa'alavelave fa'apitoa fa'apitoa o le fua (%TEM).E le gata i lea, e mulimulita'ia faiga masani i le aoina o fa'ata'ita'iga, teuina, au'ili'ili ma le fa'amauina.
O le fa'atagaga tau amio na maua mai i le Institutional Health Research Ethics Review Committee (IHRERC) o le a'oga muamua o le Soifua Maloloina ma Fa'afomai a le Iunivesite o Am Valley (IHRERC 115/2020).Ua tuuina atu e le kolisi se tusi aloaia o le lagolago i le GGH ma maua mai le faatagaga mai le ulu o le falemai.A'o le'i aoina fa'amaumauga, ia maua mai le fa'amatalaga, ofo fua, tusitusia ma saini fa'atagaga mai tagata su'esu'e ta'ito'atasi.Na taʻu atu i tagata auai o faʻamaumauga uma e aoina mai ia i latou o le a faʻamausaliina e ala i le faʻaogaina o tulafono laiti, ma e leai se faʻamatalaga patino o le a faʻaaogaina, ma o le a faʻaaogaina mo na o suʻesuʻega.O lenei suʻesuʻega sa faia e tusa ai ma le "Taʻutinoga a Helsinki".
Siaki le fa'amaoni o fa'amaumauga na aoina, fa'aigoa ma ulufale i le EpiData version 3.1, ona fa'atau atu lea i le STATA version 16.0 mo le fa'atonutonuina o fa'amaumauga ma au'ili'iliga.Fa'aoga pasene, fa'atatau, averesi, ma fa'asologa masani e fa'amatala ai fa'amaumauga.Ina ua uma ona fetuunai le maualuga o le hemoglobin e tusa ai ma le tulaga ulaula o tagata auai ma le maualuga o le eria, na fuafuaina le tulaga o le anemia e tusa ai ma le tulaga fou o le faʻavasegaina o WHO.Fa'apipi'i se fa'ata'ita'iga fa'asologa fa'asologa e lua-suia e fa'ailoa ai fe'au mo le su'esu'ega mulimuli o le fa'asologa o fa'asologa fa'asologa.I le bivariate logistic regression, o fesuiaiga ma le p-value ≤ 0.25 ua manatu o ni sui tauva mo multivariate logistic regression.Fa'atuina se fa'ata'ita'iga fa'asologa fa'asologa fa'asologa e fa'ailoa ai mea e le feso'ota'i ma le anemia.Fa'aoga le fua fa'atatau ma le 95% taimi fa'alagolago e fua ai le malosi o le mafutaga.O le tulaga taua o fuainumera na faʻaalia o le p-value <0.05.
I lenei suʻesuʻega, o le aofaʻi o 325 tagata matutua DM maʻi na auai i le fonotaga, ma o le tali e 98.2%.Le tele o tagata auai;O alii mai nuu i tua e 203 (62.5%), 247 (76%), 204 (62.8%) ma le 279 (85.5%) o alii faaipoipo, ma o lo latou ituaiga o Oromo.O le vaeluagalemu o tausaga o tagata na auai e 40 tausaga, ma o le interquartile range (IQR) e 20 tausaga.E tusa ma le 62% o i latou na auai e le'i maua ni a'oa'oga aloa'ia, ma e 52.6% o i latou na auai o faifa'ato'aga fa'apolofesa (Siata 1).
Laulau 1 Socio-demographic uiga o tagata matutua DM maʻi togafitia i se falemaʻi lautele i Etiopia i sasaʻe i le 2020 (N = 325)
I totonu o tagata suʻesuʻe na auai, 74 (22.8%) na lipotia mai na latou ulaula a itiiti ifo ma le tasi i o latou olaga, faʻatusatusa i le 13 tagata ulaula (4%).E le gata i lea, 12 tagata (3.7%) o loʻo inu i le taimi nei, ma 64.3% o tagata suʻesuʻe o loʻo auai i le lauti uliuli.E sili atu ma le tasi vaetolu (68.3%) o tagata suʻesuʻe na lipotia mai latou te inu kofe i taimi uma pe a uma 'aiga.E selau tolu sefulu tolu (96.3%) ma le 310 (95.4%) tagata auai na 'ai fualaau aina ma fualaau faisua i lalo ifo o le lima taimi i le vaiaso.E tusa ai ma o latou tulaga taumafa, 92 (28.3%) ma le 164 (50.5%) na auai na ova le mamafa ma le ogatotonu (Laulau 2).
Laulau 2 Amio ma mea taumafa o tagata matutua DM maʻi togafitia ile Falemaʻi Tele a Etiopia i Sasaʻe ile 2020 (N = 325)
E sili atu i le 170 (52.3%) tagata mamaʻi ma le ituaiga II DM sa i ai le umi ole DM ole 4.5 (SD±4.0) tausaga.Toeitiiti atoa le 50% o tagata gasegase o le DM o lo'o inuina vaila'au o le hypoglycemic oral (glibenclamide ma/po'o le metformin), ma toeitiiti atoa le tolu-kuata o tagata su'esu'e o lo'o i ai le kulukose toto le pulea (Laulau 3).E tusa ai ma comorbidities, 2% o tagata auai sa comorbidities.O le 80 (24.6%) ma le 173 (53.2%) o tagata mama'i e maua i le DM e aunoa ma le toto maualuga o le anemia ma le le anemia.I le isi itu, o tagata gasegase o le DM na maua i le toto maualuga, 189 (5.5%) ma le 54 (16.6%) na maua i le anemia.
Fuafuaga 3 Faʻamatalaga faʻapitoa o tagata matutua o le DM na togafitia i se falemaʻi lautele i Etiopia i sasaʻe i le 2020 (N = 325)
Ole maualuga ole anemia ile ma'i suka ole 30.2% (95% CI: 25.4-35.4%), ma le averesi o le hemoglobin e 13.2±2.3g/dl (alii: 13.4±2.3g/dl, fafine: 12.9±1.7g/dl. dl).E tusa ai ma le ogaoga o le anemia i tagata gasegase o le DM e maua i le anemia, e 64 mataupu o le anemia (65.3%), 26 mataupu o le anemia (26.5%), ma le 8 mataupu o le anemia ogaoga (8.2%).Anemia i alii (36.0%) na matua maualuga atu nai lo tamaitai (20.5%) (p = 0.003) (Ata 1).Na matou maua se fa'amaopoopo lelei tele i le va o le ogaoga o le anemia ma le umi o le ma'isuka (r = 0.1556, p = 0.0049).O lona uiga a o'o ina fa'atuputeleina le umi ole DM, e fa'atuputeleina fo'i le tuga o le anemia.
Ata 1 Ole maualuga ole Anemia ile itupa ile tagata matutua ole DM na togafitia ile falema'i tele ile itu i sasae o Etiopia ile 2020 (N = 325)
I totonu o tagata maʻi DM, 64% o tane ma 79.5% o fafine e le maua le anemia, ae 28.7% ma le 71.3% o loʻo iai nei Khat chewers e anemia.67% o tagata matutua ma'i DM na fa'aogaina le kofe pe a uma 'ai e le'i maua i le anemia, ma le 32.9% oi latou na maua e maua i le anemia.E tusa ai ma le i ai o faʻamaʻi pipisi, 72.2% o tagata mamaʻi e leai ni faʻamaʻi pipisi o le anemia, ma le 36.3% o tagata mamaʻi na maua i le DM comorbidities o le anemia.O tagata mama'i e maua i le ma'isuka e maua i le ma'isuka e maualuga atu le anemia (47.4%) nai lo i latou e leai ni fa'afitauli o le DM (24.9%) (Laulau 4).
Fuafuaga 4 Fa'ailoga e feso'ota'i ma le anemia i tagata matutua o le DM o lo'o togafitia i le falema'i i sasa'e o Etiopia i le 2020 (N = 325)
Fa'afetaui fa'ata'ita'iga fa'ata'ita'iga fa'asolo fa'atasi ma multivariate e su'esu'e ai le feso'ota'iga i le va o le anemia ma suiga fa'amalamalamaga.I se su'esu'ega lua;tausaga, itupa, tulaga faaipoipo, lamu Khat, kofe pe a uma 'ai, comorbidities, maʻisuka faʻalavelave, DM umi ma le tulaga o meaʻai (BMI) e matua fesoʻotaʻi ma le anemia ma le p tau <0.25, ma o le Multivariate candidate logistic regression.
I le multivariate logistic regression analysis, o tane e iai le DM ≥ 5 tausaga le umi, o le i ai o faʻamaʻi ma faʻalavelave o le DM na matua fesoʻotaʻi ma le anemia.O tamaʻitaʻi maʻi matutua DM e 2.1 taimi e sili atu ona maua i le anemia nai lo tamaitai (AOR = 2.1, 95% CI: 1.2, 3.8).Pe a faʻatusatusa i tagata maʻi DM e aunoa ma ni faʻalavelave faʻapitoa, o tagata maʻi DM ma faʻamaʻi pipisi e 1.9 taimi e sili atu ona maua i le anemia (AOR = 1.9, 95% CI: 1.0, 3.7).Pe a faʻatusatusa i tagata mamaʻi ma le DM umi o le 1-5 tausaga, o le DM maʻi ma le DM umi ≥ 5 tausaga e 1.8 taimi e sili atu ona tupu ai le anemia (AOR = 1.8, 95% CI: 1.1, 3.3).O le aʻafiaga o le anemia i tagata mamaʻi e iai faʻafitauli DM e 2.3 taimi nai lo a latou paaga (AOR = 2.3, 95% CI: 1.3, 4.2) (Table 4).
O lenei suʻesuʻega na iloilo ai le ogaoga o le anemia ma mea e fesoʻotaʻi i tagata mamaʻi DM na tulitatao mo le maʻisuka i Gelemso General Hospital.Ole maualuga ole anemia ile su'esu'ega o iai nei e 30.2%.E tusa ai ma le faʻavasegaga a le WHO o le taua o le soifua maloloina lautele, i le siosiomaga suʻesuʻe, o le anemia o se faʻafitauli faʻalesoifua maloloina lautele i le va o tagata matutua maʻi ma le DM.Itupa, umi o le DM, o le i ai o faʻafitauli o le DM, ma tamaloloa e maua i le DM comorbidities na faʻamaonia o ni mea e fesoʻotaʻi ma le anemia.
O le maualuga o le anemia i lenei suʻesuʻega e faʻatusatusa i le Ethiopian Dessie Referral Hospital [24], ae maualuga atu nai lo le Ethiopian Fenote Selam Hospital [41] i se suʻesuʻega faʻapitonuʻu na faia i Saina, 42 Ausetalia, 43 ma Initia [44]. ]., Le mea e maualalo ifo nai lo suʻesuʻega na faia i Taialani [45], Saudi Arabia [46] ma Cameroon [47].O lenei eseesega atonu e mafua mai i le eseesega o tausaga o le faitau aofaʻi o suʻesuʻega.Mo se faʻataʻitaʻiga, e le pei o le suʻesuʻega o loʻo iai nei e leʻi aofia ai tagata matutua i luga atu o le 18 tausaga, o se suʻesuʻega i Taialani na aofia ai tagata matutua i luga atu o le 60 tausaga, ae o se suʻesuʻega i Cameroon na aofia ai tagata matutua i luga atu o le 50 tausaga.O le eseesega e mafai foi ona mafua ona o le faaitiitia o le gaioiga o fatuga'o, mumu, taofiofia o ga'o ponaivi, ma le le lelei o meaai (faateleina i le matua)17.
Matou te ofo i la matou suʻesuʻega, o le anemia o le tane e sili atu ona taatele nai lo le fafine.O lea su'esu'ega e fa'afeagai ma isi lipoti o su'esu'ega [42,48], lea e sili atu ona maua ai fafine i le anemia nai lo ali'i e maua i le ma'i suka.O le mafuaʻaga e ono mafua ai lenei eseesega atonu ona o tamaloloa i la matou suʻesuʻega e maualuga atu le masani o le lamu o le Khat, e ono mafua ai le leiloa o le manaʻo49, ma o le Khat o loʻo i ai tannins-o se mea e faʻaitiitia ai le bioavailability o le non-heme iron i le taumafataga.50 O le isi mafuaaga e mafai ona o le maualuga o le taumafa o le kofe ma le lauti i alii i lenei suʻesuʻega e taofia ai le mitiia o le uʻamea mai le manava.51-54
Na matou iloa o tagata mama'i e maua i le DM ≥ 5 tausaga e sili atu ona maua le anemia nai lo tagata mama'i e maua i le DM e 1-5 tausaga.O loʻo ogatasi lea ma suʻesuʻega na faia i le Falemai o Fenote Selam i Etiopia, 41 Iraq 55 ma le United Kingdom.17 Atonu e mafua ona o le umi o le aafia i le hyperglycemia, e oʻo atu ai i le faʻateleina o cytokines faʻamaʻi ma aʻafiaga anti-erythropoietin, e mafua ai le faʻaitiitia o le numera.O le faʻaitiitia o sela mumu toto e taʻavale e taʻitaʻia ai le faʻaitiitia o le hemoglobin feʻaveaʻi.35
E tusa ai ma suʻesuʻega na faia i Saina, 13 anemia i lenei suʻesuʻega na sili atu ona taatele i tagata maʻi DM ma faʻalavelave.I le biologically, o fa'afitauli o le ma'i suka e mafai ona matua fa'aleagaina ai le sela ma le fa'atoto o le toto o le fatuga'o, fa'amumu fa'alavelave, ma le fa'aosoina o le erythropoietin fa'asa'oloto inhibitors e ono o'o atu ai i le ma'i suka anemia.56 Hypoxia e mafai ona a'afia ai le fa'aaliga o le kenera, metabolism, fa'aogaina o le capillary ma le ola sela 57. Fa'aitiitia le toto mumu ma ana mea fa'aantiantioxidant e feso'ota'i ma le anemia e ono fa'atupuina atili fa'alavelave i tagata mama'i suka58.
E le gata i lea, o tagata maʻi DM e iai faʻamaʻi pipisi e sili atu ona faigofie ile anemia nai lo tagata maʻi DM e aunoa ma ni faʻamaʻi.E faʻatusatusa lenei mea i suʻesuʻega tutusa talu ai [35,59], atonu e mafua mai i le aʻafiaga o faʻamaʻi (e pei o le toto maualuga) e oʻo atu ai i faʻalavelave cardiovascular, ma faʻateleina ai le lamatiaga o le anemia.60
I le avea ai ma se tasi o nai suʻesuʻega faʻavae suʻesuʻe na faia i Etiopia, o faʻamaʻi faʻamaʻi e pei o le DM ua faʻateleina ma sili atu ona taatele, lea e aofia ai le malosi o lenei suʻesuʻega.I le isi itu, o lenei suʻesuʻega o se suʻesuʻega e tasi e faʻavae i luga o se falemaʻi ma atonu e le faʻatusalia uma tagata mamaʻi i le DM poʻo tagata gasegase o loʻo tulitatao i isi falemaʻi.O le uiga fa'asolosolo o le su'esu'ega su'esu'ega na matou fa'aaogaina e le fa'atagaina ai le fa'atuina o sootaga fa'aletino i le va o le anemia ma mea taua.O suʻesuʻega i le lumanaʻi atonu e manaʻomia le faʻaogaina o faʻataʻitaʻiga, suʻesuʻega kulupu poʻo isi suʻesuʻega suʻesuʻega e iloilo ai faʻailoga ma faʻamaoniga o le anemia, RBC morphology, serum iron, vitamini B12, ma folic acid levels.
I le si'osi'omaga su'esu'e, o le anemia ose fa'afitauli tau le soifua maloloina lautele i le va o tagata matutua ma'i DM.Itupa, umi o le DM, le iai o faʻafitauli o le DM, ma faʻamaʻi pipisi o tane ma na faʻamaonia o ni mea e fesoʻotaʻi ma le anemia.O le mea lea, o su'esu'ega masani o le anemia ma le fa'atonuga talafeagai mo tagata ma'i DM e umi le umi o le DM, fa'alavelave fa'alavelave ma fa'alavelave e tatau ona fuafua e fa'aleleia atili ai le olaga o tagata mama'i.Ole su'esu'ega vave ma le mata'ituina o le DM e mafai fo'i ona fesoasoani e fa'aitiitia fa'alavelave.
O faʻamatalaga e lagolagoina ai faʻaiʻuga o loʻo lipotia i totonu o tusitusiga e mafai ona maua mai le tusitala fetaui e tusa ai ma manaʻoga talafeagai.
Matou te fia faʻafetai i le ulu o Gelemso General Hospital, le aufaigaluega a le Diabetes Clinic, tagata suʻesuʻe suʻesuʻe, aoina faʻamaumauga ma fesoasoani suʻesuʻe.
O tusitala uma na faia sao taua i le galuega o le lipoti, pe i le tulaga o manatu, mamanu suʻesuʻega, faʻatinoina, mauaina o faʻamaumauga, auʻiliʻiliga ma faʻamatalaga, poʻo i nei vaega uma;'auai i le tusiaina, toe teuteu po'o le iloiloga malosi o lenei fuaiupu;Mulimuli ane Faamaonia le lomiga e lomia;na maua se maliliega i luga o le tusi talaaga na tuʻuina atu i ai le tusiga;ma malilie e nafa ma vaega uma o le galuega.
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