Javascript yakadzimwa mubrowser yako parizvino.Kana javascript yakadzimwa, mamwe mabasa ewebhusaiti ino haazovepo.
Nyoresa yako chaiyo ruzivo uye chaiyo mishonga yekufarira, isu tinofananidza ruzivo rwaunopa nezvinyorwa mune yedu yakakura dhatabhesi, uye nekukasira email kopi yePDF kwauri.
Anemia pakati pevakuru vane chirwere cheshuga vanoenda kuchipatara chikuru kumabvazuva kweEthiopia: chidzidzo chemuchinjika
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 inoreva kudzikira kwenhamba yekutenderera kwemasero matsvuku eropa (RBC) uye/kana kudzikiswa kwesimba rekutakura okisijeni semhedzisiro, iyo isingakwani kuzadzisa zvinodiwa zvenyama zvemuviri wemunhu.1,2 Inobata nyika dzichiri kusimukira uye dzakabudirira, kune hutano hwevanhu, hupfumi hwevanhu uye hupfumi.3 Kune vanhu vanosvika bhiriyoni 1.62 vane anemia munyika, inoverengera 24.8% yehuwandu hwepasi rose.4
Diabetes mellitus (DM) chirwere chemetabolism, chinenge chakakamurwa kuva mhando I_juvenile kana insulin-inotsamira chirwere cheshuga uye mhando II_isina-insulin-inomirira chirwere cheshuga.5 Muvarwere vane chirwere cheshuga, kupererwa neropa kunonyanya kukonzerwa nekuzvimba, zvinodhaka, kushomeka kwekudya, chirwere cheitsvo, kufambidzana nezvirwere zve autoimmune, 6,7 kuderera mukugadzirwa kwe erythropoietin, kushaikwa kwesimbi zvachose kana kushanda, uye kurarama kwemasero matsvuku eropa kunopfupika.8,9 Naizvozvo, kupererwa neropa kunowanikwa muvarwere vane chirwere cheshuga.10,11 Muvanhu vakuru, kupararira kweanemia ndeye 24% pakati pevakadzi vezera rekubereka (makore 15-49) uye 15% pakati pevarume vane makore 15-49.12
Muvarwere vane DM, kunyanya avo vane chirwere cheitsvo chiri pachena kana kuti renal insufficiency, kuwanda kweanemia kunenge 2 kusvika ku3 nguva yakakwirira kupfuura yevarwere vasina DM.13,14 Anemia uye chirwere cheshuga, zvakadai senephropathy, retinopathy, neuropathy, kuporesa kweronda rakashata, uye chirwere che macrovascular [15,16], chine kukanganisa kwehupenyu hwevarwere.17-19 Pasinei nechokwadi ichi, mishumo yekutsvakurudza inoratidza kuti vakawanda se25% yevarwere vane chirwere cheshuga havagoni kuziva anemia.20,21
Kuzivikanwa kwekutanga uye kurapwa kweanemia muvarwere veDM kunogona kubatsira kuderedza kurwara uye kufa, nekuvandudza hupenyu hwavo.22 Zvisinei, zvakazara, kuongororwa kweanemia muvarwere vane chirwere cheshuga muEthiopia kwakaderera zvikuru, uye kusvika ikozvino, hapana tsvakurudzo yakakodzera.Izvi ndezvechokwadi kunyanya munzvimbo yekudzidza.Naizvozvo, chidzidzo ichi chine chinangwa chekufungidzira huwandu hweanemia muvarwere vane chirwere cheshuga paGramsoe General Hospital kumabvazuva kweEthiopia uye kuona zvikonzero zvine chekuita nazvo.
Chidzidzo ichi chakaitwa paGlymso General Hospital (GGH) iri muGlymso Town, Habro District, Oromiya State, Eastern Ethiopia.Chipatara ichi chiri makiromita 390 kumabvazuva kweAddis Ababa, guta guru reEthiopia.23 Sekureva kwemushumo weHabro Woreda Health Hofisi, GGH inzvimbo yekutumira vanhu vanosvika miriyoni 1.4 munzvimbo dzakapoteredza.Inopa hutano hwehutano kune vanopfuura 90,000 varwere mumadhipatimendi akasiyana uye makiriniki gore rega rega.Chirwere cheDiabetes Clinic ndechimwe chezvikamu zvehunyanzvi zvinopa masevhisi kuvarwere vanosvika mazana matanhatu nemakumi matanhatu vane chirwere cheshuga.Habro District iri panzvimbo yakakwirira ye1800-2000 mamita.
Chidzidzo chechipatara-based cross-sectional chakaitwa kubva munaChikumi 9, 2020 kusvika Nyamavhuvhu 10, 2020. Vanokodzera vanokodzera vanhu vakuru (≥18 makore) varwere vane chirwere cheshuga vanoteverwa kuGGH.Varwere vakura vane chirwere cheshuga vakawedzerwa ropa mumwedzi mitatu yapfuura, varwere vane pamuviri kana kuti vachangoberekwa kana kuti vanorwara nepfungwa, varwere vakavhiyiwa kana kubuda ropa chero chikonzero, uye varwere vakagamuchira intestinal parasite kurapwa havabatanidzwi. .Dzidza.
Saizi yemuenzaniso yakagadziriswa nekushandisa imwe chete yehuwandu hwehuwandu hwehuwandu uye zvichienderana nemafungiro anotevera: 95% nguva yekuvimba, 5% kukanganisa kukanganisa, uye kupararira kweanemia yevarwere vane chirwere cheshuga kubva kuDessie Referral Hospital muNortheast Ethiopia (p = 26.7) %).24 Mushure mekuwedzera gumi muzana kune vasina-vapindura, saizi yekupedzisira yemuenzaniso ndeye 331.
660 varwere vane chirwere cheshuga vakanyatsoteverwa mukiriniki yechirwere cheshuga muGGH.Govanisa huwandu hwese hwevarwere vane chirwere cheshuga (660) neiyo yekupedzisira saizi saizi (331) kuti uwane mbiri dzesampling nguva.Nekushandisa rejista yevarwere vane chirwere cheshuga vanowana masevhisi ekutevera echirwere cheshuga muchipatara sesampling furemu, takashandisa nzira yakarongeka yekuenzanisira yekubatanidza vamwe varwere vese muchidzidzo.Ipa mumwe nemumwe anotora chidzidzo nhamba yekuzvizivisa kuti asadzokororwe, kana murwere mumwecheteyo akaonekwa zvakare panguva yechidzidzo kune imwezve inotevera.
Unganidza dhiyabhorosi pane sociodemographic variables, kunwa doro, kusvuta, uye hunhu hwekudya nekushandisa yakarongeka yemibvunzo yakagadziridzwa kubva padanho-nhanho nzira yeWHO chronic disease risk factor monitoring manual.25 Kunwa tii nekofi, kushandisa pombi yemvura, kutsenga mibvunzo yaCarter, kushandiswa kwekudzivirira pamuviri, uye nhoroondo yokuenda kumwedzi zvakawanwa nokuongorora mabhuku akasiyana.Gwaro remibvunzo 26-30 rakanyorwa neChirungu rikaturikirwa mumutauro weko (Afaan Oromoo), rozoshandurirwa kuChirungu nenyanzvi dzemitauro dzakasiyana kuti vatarise kuenderana.Wana data yekiriniki yakadai senguva yechirwere cheshuga, rudzi rwechirwere cheshuga, zvinetso zvechirwere cheshuga, uye kutsanya kweglucose yeropa kubva kune zvinyorwa zvechiremba.Iyo data yakaunganidzwa nevaviri vane hunyanzvi vanamukoti uye nyanzvi yemurabhoritari, uye inotariswa natenzi weakapedza kudzidza nezvehutano hweveruzhinji.
Pima BP (BP) uchishandisa digital blood pressure meter (Heuer) inogara ichiongororwa.Asati ayera BP, munhu anga asina kunwa zvinwiwa zvinopisa, zvakaita setii, kofi kana fodya inoputa, Caterpillar akatsenga, kana kuita maekisesaizi ane simba mumaminetsi makumi matatu apfuura.Mushure mekunge nyaya yacho yazorora kweanenge maminetsi mashanu uye yakanyora avhareji yeBP kuverenga, zviyero zvitatu zvakazvimirira zvakatorwa kuruoko rweruboshwe.Chiyero chechipiri nechechitatu chakatorwa maminitsi mashanu uye gumi mushure mekutanga uye yechipiri kuyerwa, zvichiteerana.Hypertension inotsanangurwa sevarwere vane BP ≥140 yakakwira (SBP≥140 kana DBP≥90mmHg) kana avo vakamboonekwa kuti vari kutora mishonga inorwisa BP.31,32
Kuti titarise chimiro chekudya kuburikidza nebody mass index (BMI), takayera kureba uye huremu hwemurwere.Apo mumwe nomumwe wevatori vechikamu akamira akamira pamadziro, zvitsitsinho zvavo zvakagunzva madziro pamwe chete, hazvina kupfeka shangu, zvakachengeta misoro yavo zvakati twasu, uye zvakayera kureba kwavo nerura ndokurekodha iri pedyo 0.1 cm.Shandisa sikero yedhijitari yakanyorwa 0-130 kg kuyera huremu hwako.Pamberi pechiyero chega chega, gadzirisa sikero kusvika zero level.Edza uremu hwemutori wechikamu akapfeka mbatya dzakareruka uye asina shangu, uye rekodha iri pedyo 0.1 kg.33,34 Body mass index (BMI) inotarwa nekupatsanura huremu hwemuviri (kg) nehupamhi (m).Zvadaro chimiro chekudya chinotsanangurwa se: kana BMI <18.5, underweight;kana BMI = 18.5–24.9, underweight;kana BMI = 25–29.9, kuwandisa;kana BMI ≥30.35,36, kufutisa
Pedyo nechepakati pakati pemucheto wezasi wembabvu dzinonzwisisika uye nechepamusoro pekupedzisira, shandisa kwete-elastic tepi chiyero kuyera chiuno chechiuno uye nyora kune iri pedyo 0.1 cm.Kufuta kwepakati kunotsanangurwa sechikumbaridzo chechiuno chevarume ≥ 94 cm, uye chiuno chechiuno chevakadzi ≥ 80 cm.30,36 Munguva yekudzidziswa, 10 vanhu vakuru vane chirwere cheshuga vakaiswa pasi pechikanganiso chekuyera hunyanzvi (% TEM) kuderedza zvikanganiso zveanthropometric zviyero.Izvo zvinozivikanwa zvikanganiso zvekuyera tekinoroji mukati uye pakati pevacherechedzi ari pasi pe1.5% uye asingasviki 2%, zvichiteerana.
Vanamazvikokota vemurabhoritari vakaunganidza zvingangoita mamililita maviri (2 mL) eropa kubva kune vese vatori vechikamu ndokuaisa muchubhu yekuyedza ine tripotassium ethylenediaminetetraacetic acid (EDTA K3) anticoagulant yekutarisisa hemoglobin.Nyatsosanganisa ropa rakaunganidzwa uye shandisa Sysmex XN-550 hematology analyzer yekuongorora.Kuyera kwehemoglobin kwakagadziriswa nekuderedza kureba kwevose vatori vechikamu nekubvisa 0.8 g / dl uye chimiro chekusvuta nekubvisa 0.03 g / dl.Zvadaro tsanangura kupererwa neropa sechikadzi hemoglobin level <12g/dl uye murume <13g/dl.Kuoma kweanemia kunokamurwa kuva: uwandu hwe hemoglobin yevarume nevakadzi i11–12.9 g/dl uye 11–11.9 g/dl, zvichiteerana, iyo iri minyoro anemia, nepo hemoglobin ine mwero uye yakakomba anemia iri 8–10.9 g/dl, zvichiteerana dl uye <8 mg/dl.Murume nemukadzi
Unganidza mamililita mashanu (5 mL) eropa re venous muchubhu yekuyedza isina anticoagulant kuona creatinine uye urea.Ropa rose risina anticoagulant rakavharwa kwemaminitsi makumi maviri-30 uye centrifuged pa 3000 rpm kwemaminitsi mashanu kuparadzanisa serum.Zvadaro, Mindray BS-200E (China Mindray Biomedical Electronics Co., Ltd.) kiriniki chemistry analyzer yakashandiswa kuona serum creatinine uye urea content ne acid picrine uye enzymatic nzira.37 Shandisa creatinine clearance rate kufungidzira glomerular filtration rate.Shandisa Chronic Kidney Disease (CKD) Ratio (GFR), inoratidzwa seCKD-EPI Cockroft-Gault formula inoratidzwa pa1.73 square metres.
Kutsanya mazinga eglucose muropa (angangoita maawa masere) anoyerwa nezvigunwe zvemunwe uchishandisa mita yeglucose yeropa yakarongedzerwa yeglucose yeropa.38 Kana iyo yekutsanya yeropa glucose level iri <80 or> 130mg/dl, saka iyo code haina kudzorwa yekudzora glucose yeropa.Kudzora kana kukosha kweglucose yeropa kutsanya kuri pakati pe80-130mg/dl 39
Vatori vechidzidzo ichi vakapihwa danda rakachena rekushandisa uye kapu yepurasitiki yakachena, yakaoma, isingabude iine serial nhamba yemukuru pairi kuti iongororwe utachiona hwetsvina.Varaire kuti vauye nemuenzaniso mutsva wechigaro wemagiramu maviri (anenge saizi yechigunwe chikuru).Mushure mekuona makonye (mazai uye / kana mhunga) uchishandisa nzira dzakanyorova dzekumisa, sampuli dzakatariswa mukati memaminitsi makumi matatu ekuunganidzwa kwemuenzaniso.Mienzaniso yakasara yakachengetwa muchubhu yekuedza ine 10 mL ye10% formalin kuti ivandudze chiyero chekuonekwa kwezvipembenene, uye mushure mekurapa nefomalin-ether precipitation concentration teknolojia, Olympus Microscope yakashandiswa pakuongorora.
Shandisa lancet sterile kuunganidza ropa recapillary kubva paminwe kuti uone marariya.Gadzirira firimu reropa rakatetepa pagirazi rakachena risina mafuta, uye ipapo mhepo yakaoma.Iwo masiraidhi akasvibiswa ne10% Giemsa kweanenge maminetsi gumi, uye mhando dzemarariya parasite dzakaongororwa.Apo 100 nzvimbo dzesimba repamusoro dzakaongororwa pasi pechinangwa chekunyudza oiri, siraidhi yakanzi haina kunaka.40
Dzidzo yemazuva maviri pamusoro pematurusi ekuunganidza dhata uye nzira dzakapihwa kune vanotora data nevatariri.Pamberi peChiro General Hospital yakaunganidza data chaiyo yevane 30 vane chirwere cheshuga, mubvunzo wemibvunzo wakagara waongororwa uye kuchinjwa kwakakodzera kwakaitwa maererano.Chiyero chemuviri chinomisikidzwa neicho chikanganiso chehunyanzvi chechiyero (%TEM).Uye zvakare, akajairwa maitiro ekushanda anoteverwa mune ese marabhoritari sampu yekuunganidza, kuchengetedza, kuongorora uye kurekodha maitiro.
Mvumo yetsika yakawanikwa kubva kuInstitutional Health Research Ethics Review Committee (IHRERC) yeyaimbova Chikoro cheHutano neMushonga cheAm Valley University (IHRERC 115/2020).Kojiji yakapa tsamba yekutsigira GGH uye yakawana mvumo kubva kumukuru wechipatara.Usati watora data, wana mvumo yeruzivo, yekuzvidira, yakanyorwa uye yakasainwa kubva kune mumwe nemumwe anotora chidzidzo.Vatori vechikamu vakaudzwa kuti data yese inounganidzwa kubva kwavari yaizochengetwa yakavanzika kuburikidza nekushandiswa kwekodhi, uye hapana zviziviso zvemunhu zvaizoshandiswa, uye zvaizoshandiswa chete pakutsvaga zvinangwa.Tsvakurudzo iyi yakaitwa maererano ne "Declaration of Helsinki".
Tarisa kutendeseka kweiyo data yakaunganidzwa, encode uye isa EpiData vhezheni 3.1, uye wozotumira kune STATA vhezheni 16.0 yekutarisira data uye kuongororwa.Shandisa zvikamu, zviyero, maavhareji, uye zvakajairwa kutsauka kutsanangura data.Mushure mekugadzirisa chiyero che hemoglobin maererano nehuwandu hwekusvuta kwevatori vechikamu uye kukwirira kwenzvimbo yacho, mamiriro ekushaya ropa akagadziriswa maererano nehurongwa hutsva hwe WHO.Gadzirisa maviri-variable logistic regression modhi kuti uone zvinosiyana zvekupedzisira multivariate logistic regression analysis.Mu bivariate logistic regression, mabhii ane p-value ≤ 0.25 anoonekwa sevanoda kudzoreredza zvinhu zvakawanda.Gadzira multivariate logistic regression model kuti uone zvinhu zvisingaenderani neanemia.Shandisa odds ratio uye 95% nguva yekuvimba kuyera simba rekubatana.Chiyero chekukosha kwenhamba chakaziviswa se p-value <0.05.
Muchidzidzo ichi, vanosvika mazana matatu nemakumi maviri nevashanu vevarwere veDM vakapinda mumusangano, uye mhinduro yaive 98.2%.Ruzhinji rwevatori vechikamu;vanhurume vanobva kumaruwa 203 (62.5%), 247 (76%), 204 (62.8%) ne279 (85.5%) varume vakaroora, uye rudzi rwavo iOromo.Nguva yepakati yevatori vechikamu yaive makore makumi mana, uye iyo interquartile range (IQR) yaive makore makumi maviri.Inenge 62% yevatori vechikamu havana kumbobvira vawana dzidzo yepamutemo, uye 52.6% yevatori vechikamu varimi vane hunyanzvi (Tafura 1).
Tafura 1 Yemagariro-demographic maitiro evakuru veDM varwere vanorapwa muchipatara chese kumabvazuva kweEthiopia muna 2020 (N = 325)
Pakati pevatori vechikamu chekudzidza, 74 (22.8%) vakashuma kuti vakanga vasvuta kamwe chete muupenyu hwavo, zvichienzaniswa ne13 vanosvuta ikozvino (4%).Pamusoro pezvo, vanhu gumi nevaviri (3.7%) ndivo vari kunwa izvozvi, uye 64.3% yevakapinda chidzidzo tii nhema.Vanopfuura chikamu chimwe muzvitatu (68.3%) chevatori vechikamu vakashuma kuti vanogara vachinwa kofi mushure mekudya.zana nemakumi matatu nevatatu (96.3%) uye 310 (95.4%) vatori vechikamu vakadya michero nemiriwo zvisingasviki kashanu pasvondo.Nezvehutano hwavo hwekudya, 92 (28.3%) uye 164 (50.5%) vatori vechikamu vakanga vakanyanya kuwandisa uye nechepakati (Tafura 2).
Tafura 2 Maitiro uye hutano hunhu hwevakuru veDM varwere vanorapwa kuEastern Ethiopia General Hospital muna 2020 (N = 325)
Vanopfuura 170 (52.3%) varwere vane Type II DM vaive neavhareji yeDM yenguva ye4.5 (SD±4.0) makore.Vanenge 50% yevarwere veDM vari kutora oral hypoglycemic zvinodhaka (glibenclamide uye / kana metformin), uye inenge zvikamu zvitatu kubva muzvina zvevadzidzi vekudzidza vane shuga isingadzoreki yeropa (Tafura 3).Nezve comorbidities, 2% yevatori vechikamu vaive necomorbidities.80 (24.6%) uye 173 (53.2%) varwere vane DM vasina hypertension vaiva anemia uye vasina anemia maererano.Kune rumwe rutivi, pakati pevarwere veDM vakaonekwa kuti vane hypertension, 189 (5.5%) uye 54 (16.6%) vaiva anemia maererano.
Tafura 3 Makiriniki maitiro evakuru veDM varwere vanorapwa muchipatara chese kumabvazuva kweEthiopia muna 2020 (N = 325)
Dhigirii yeanemia muvarwere vane chirwere cheshuga ndeye 30.2% (95% CI: 25.4-35.4%), uye avhareji hemoglobin level 13.2±2.3g/dl (varume: 13.4±2.3g/dl, vakadzi: 12.9±1.7g/ dl).Nezvekuoma kweanemia muDM varwere vane chirwere chekushaya ropa, pakanga pane 64 zviitiko zvekushaya ropa (65.3%), 26 zviitiko zvepakati peanemia (26.5%), uye 8 zviitiko zvekushaya ropa (8.2%).Anemia muvarume (36.0%) yakanga yakakwirira kudarika vakadzi (20.5%) (p = 0.003) (Mufananidzo 1).Takawana kuwirirana kwakanaka pakati pekuoma kweanemia uye nguva yechirwere cheshuga (r = 0.1556, p = 0.0049).Izvi zvinoreva kuti sezvo nguva yeDM inowedzera, kuoma kweanemia kunowedzera kuwedzera.
Mufananidzo 1 Anemia level nehukadzi muvarwere vakuru veDM vanorapwa muchipatara chikuru kumabvazuva kweEthiopia muna 2020 (N = 325)
Pakati pevarwere veDM, 64% yevarume ne79.5% yevakadzi havana anemia, ukuwo 28.7% ne71.3% yevanotsenga Khat parizvino vane ropa.67% yevarwere vakuru veDM vakashandisa kofi mushure mekudya vakanga vasina anemia, uye 32.9% yavo vakawanikwa vane anemia.Nezve kuvapo kwehutano, 72.2% yevarwere vane DM vasina comorbidities vaiva anemia, uye 36.3% yevarwere vane DM comorbidities vaiva anemia.Varwere vane chirwere cheshuga vane matambudziko eDM vaiva nepamusoro anemia (47.4%) pane avo vasina DM complications (24.9%) (Tafura 4).
Tafura 4 Zvinhu zvine chekuita neanemia pakati pevarwere vakuru veDM vakarapwa muchipatara chese kumabvazuva kweEthiopia muna 2020 (N = 325)
Fit bivariate uye multivariate logistic regression models kuti uongorore kushamwaridzana pakati peanemia uye zvinotsanangurwa zvakasiyana.In a bivariate analysis;zera, murume kana mukadzi, mamiriro ewanano, Khat kutsenga, kofi mushure mekudya, comorbidities, diabetesic complications, DM nguva uye chikafu chekudya (BMI) zvine hukama zvakanyanya neanemia ine p kukosha <0.25, uye vari Multivariate candidate logistic regression.
Mune multivariate logistic regression analysis, varume vane DM ≥ 5 makore ekureba, kuvapo kwehutano uye zvinetso zveDM zvakabatanidzwa zvakanyanya neanemia.Varume vakuru veDM varwere vane 2.1 nguva yakawanda yekutambura neanemia kupfuura vakadzi (AOR = 2.1, 95% CI: 1.2, 3.8).Kuenzaniswa nevarwere veDM vasina comorbidities, varwere veDM vane comorbidities vane 1.9 nguva inowanzova anemia (AOR = 1.9, 95% CI: 1.0, 3.7).Zvichienzaniswa nevarwere vane DM nguva yemakore 1-5, varwere veDM vane DM nguva ≥ makore 5 vane 1.8 nguva yakawanda yekuvandudza anemia (AOR = 1.8, 95% CI: 1.1, 3.3).Ngozi yekushaya ropa kune varwere vane matambudziko eDM ndeye 2.3 nguva yevamwe vashandi (AOR = 2.3, 95% CI: 1.3, 4.2) (Tafura 4).
Ichi chidzidzo chakaongorora kuoma kweanemia uye zvinhu zvine chekuita neDM varwere vakateverwa nechirwere cheshuga paGelemso General Hospital.Dhigirii reanemia muchidzidzo chazvino i30.2%.Zvinoenderana neiyo WHO kupatsanurwa kwekukosha kwehutano hweveruzhinji, munharaunda yekutsvagisa, anemia idambudziko rehutano hweveruzhinji pakati pevarwere vakuru vane DM.Gender, nguva yeDM, kuvapo kweDM complications, uye varume vane DM comorbidities vakaonekwa sezvikonzero zvine chokuita neanemia.
Dhigirii yeanemia muchidzidzo ichi inofananidzwa neyeEthiopian Dessie Referral Hospital [24], asi yakakwirira kudarika yeEthiopian Fenote Selam Hospital [41] mune imwe nzvimbo yekudzidza yakaitwa muChina, 42 Australia, 43 neIndia [44]. ]., Izvo zvakaderera pane zvidzidzo zvakaitwa muThailand [45], Saudi Arabia [46] uye Cameroon [47].Musiyano uyu unogona kunge uri nekuda kwekusiyana kwezera rehuwandu hwechidzidzo.Semuyenzaniso, kusiyana nekudzidza kwazvino kwanga kusingasanganisire vanhu vakuru vanopfuura makore gumi nemasere, chidzidzo muThailand chaisanganisira vanhu vakuru vanopfuura makore makumi matanhatu, nepo chidzidzo muCameroon chaisanganisira vakuru vanopfuura makore makumi mashanu.Misiyano inogonawo kunge yakakonzerwa nekuderera kwetsvo kushanda, kuzvimba, kudzvinyirirwa kwemafupa emapfupa, uye kushaya zvokudya zvinovaka muviri (kuwedzera nezera)17.
Tinoshamiswa kuti muchidzidzo chedu, kupererwa neropa kwechirume kunowanikwa zvakanyanya kupfuura vanhukadzi.Kuwana uku kunopesana nemamwe mishumo yekutsvakurudza [42,48], umo vakadzi vanowanzotambura neanemia kupfuura varume vane chirwere cheshuga.Chikonzero chinogona kukonzera musiyano uyu chingave chekuti varume vari muchidzidzo chedu vaive nepamusoro Khat kutsenga tsika, izvo zvinogona kukonzera kurasikirwa kwechido49, uye Khat ine tannins-chinhu chinoderedza bioavailability yeisina-heme iron mukudya.50 Chimwe chikonzero chingangove chekuti kudyiwa kwekofi netii zvakanyanya muvarume muchidzidzo ichi kwakatadzisa kutorwa kwesimbi kubva muura.51-54
Takaona kuti varwere vane DM ≥ 5 makore vane mukana wekuita anemia kupfuura varwere vane DM vane makore 1-5.Izvi zvinoenderana nezvidzidzo zvakaitwa paFenote Selam Hospital muEthiopia, 41 Iraq 55 neUnited Kingdom.17 Izvi zvinogona kunge zvakakonzerwa nekugara kwenguva refu kune hyperglycemia, zvichiita kuti kuwedzera kwe cytokines inoputika ine anti-erythropoietin madhara, zvichiita kuti nhamba iderere.Kuderedza kutenderera kwemasero matsvuku eropa kunotungamirira kukuderedza kutenderera kwehemoglobin.35
Zvinoenderana nezvidzidzo zvakaitwa muChina, 13 anemia muchidzidzo ichi yaive yakawanda kune varwere veDM vane matambudziko.Biologically, matambudziko eshuga anogona kukuvadza zvakanyanya sero uye tsinga yeropa yeitsvo, systemic kuzvimba, uye kuiswa kwe erythropoietin release inhibitors kunogona kutungamirira kuchirwere cheshuga anemia.56 Hypoxia inogona kukanganisa gene expression, metabolism, capillary permeability uye cell survival 57. Kuderedzwa kwemasero matsvuku eropa uye maitiro ayo e-antioxidant anosangana neanemia anogonawo kukonzera mamwe matambudziko muvarwere vane chirwere cheshuga58.
Mukuwedzera, varwere veDM vane comorbidities vanowanzoita anemia kupfuura varwere veDM vasina comorbidities.Izvi zvinofananidzwa nezvidzidzo zvekare zvakafanana [35,59], izvo zvingave zvichikonzerwa nemigumisiro yehutano (yakadai sehypertension) inotungamirira kumatambudziko emwoyo, nokudaro kuwedzera ngozi yekushaya ropa.60
Seimwe yezvidzidzo zvishoma zvemurabhoritari zvakaitwa muEthiopiya, zvirwere zvisingaperi seDM zvawedzera kuwanda, izvo zvinoumba simba retsvagiridzo iyi.Kune rumwe rutivi, chidzidzo ichi chidzidzo chimwe chete chinobva kuchipatara uye chingave chisingamiriri varwere vose vane DM kana varwere vanoteverwa mune mamwe masangano ezvokurapa.Muchinjikwa-chikamu chimiro chechimiro chekudzidza chatakashandisa hachibvumire kugadzwa kwehukama hwenguva pakati peanemia uye zvinhu.Zvidzidzo zvenguva yemberi zvingada kushandisa macake controls, cohort studies kana mamwe madhizaini ekutsvagisa kuti atarise zviratidzo nezviratidzo zveanemia, RBC morphology, serum iron, vhitamini B12, uye folic acid mazinga.
Munzvimbo yekutsvagisa, anemia idambudziko rehutano hweveruzhinji pakati pevarwere veDM vakuru.Gender, nguva yeDM, kuvapo kweDM complications, uye comorbidities vaiva varume uye vakaonekwa sezvikonzero zvine chokuita neanemia.Nokudaro, nguva dzose kuongororwa kweanemia uye hutungamiri hwakakodzera kune varwere veDM vane nguva yakareba yeDM, comorbidities uye zvinetso zvinofanira kugadzirirwa kuvandudza hupenyu hwevarwere.Kukurumidza kuongororwa uye kugara uchitarisa DM kunogona kubatsirawo kuderedza matambudziko.
Dhata inotsigira mhedzisiro yakashumwa muzvinyorwa inogona kuwanikwa kubva kumunyori anowirirana zvinoenderana nezvinodiwa.
Tinoda kutenda mukuru weGelemso General Hospital, vashandi veDiabetes Clinic, vatori vechikamu chekudzidza, vanotora data uye vabatsiri vekutsvakurudza.
Vese vanyori vakapa zvakakosha kumabasa emushumo, ingave maererano nemafungiro, dhizaini yekutsvagisa, kuuraya, kutora data, kuongorora uye kududzira, kana mune zvese izvi zvikamu;akatora chikamu mukunyora, kudzokorora kana kuongorora kwakasimba kwechikamu ichi;pakupedzisira Yakabvumira shanduro kuti ibudiswe;yakawana chibvumirano pajenari iyo chinyorwa chakatumirwa;uye vakabvuma kuva nomutoro wezvinhu zvose zvebasa racho.
1. WHO.Iyo hemoglobin concentration inoshandiswa kuongororwa uye kuomarara kuongororwa kweanemia.Vitamin uye mineral nutrition information system.Geneva, Switzerland.2011. NMH / NHD / MNM / 11.1.Inowanikwa kubva kune inotevera webhusaiti: http://www.who.int/entity/vmnis/indicators/haemoglobin.Yakashanyirwa muna Ndira 22, 2021.
2. Viteri F. Mafungiro matsva ekugadzirisa kushayikwa kwesimbi: kudyiwa kwevhiki nevhiki kwesimbi yekuwedzera, nharaunda yekudzivirira kuwedzera kune mapoka makuru ane ngozi.Biomedical Environmental Science.1998;11(1): 46-60.
3. Mehdi U, Toto RD.Anemia, chirwere cheshuga uye chirwere cheitsvo chisingaperi.Chirwere cheshuga.2009;32(7):1320-1326.doi: 10.2337/dc08-0779
5. Johnson LJ, Gregory LC, Christenson RH, Harmening DM.Appleton uye Lange akatevedzana anotsanangura ongororo yekiriniki chemistry.New York: McGraw-Hill;2001.
6. Gulati M, AgrawalN.Chidzidzo pamusoro pekupararira kweanemia kune varwere vane Type 2 chirwere cheshuga.Sch J App Med Science.2016;4 (5F): 1826-1829.
7. Cawood TJ, Buckley U, Murray A, etc. Kuwanda kweanemia muvarwere vane chirwere cheshuga.Ir J Med Sayenzi.2006;175(2):25.doi: 10.1007 / BF03167944
8. Kuo IC, Lin-HY-H, Nu SW, etc. Glycated hemoglobin uye kufungidzira kwevarwere vane chirwere chepamusoro chechirwere cheshuga chisingaperi.Scientific Representative.2016;6:20028.doi: 10.1038 / srep20028
9. Loutradis C, Skodra A, Georgianos P, etc. Chirwere cheshuga chinowedzera kupararira kweanemia kune varwere vane chirwere chepfungwa chisingaperi: nested case-control study.Nyika J Nephrol.2016;5(4):358.doi: 10.5527 / wjn.v5.i4.358
10. Rajagopal L, Ganesan V, Abdullah S, Arunachalam S, Kathamuthu K, RamrajB.Kuongorora hukama pakati pe electrolytes, anemia, uye glycosylated hemoglobin (Hba1c) mazinga mune varwere vane Type 2 chirwere cheshuga.Asian J mishonga yekiriniki yekutsvakurudza.2018;11(1): 251–256.doi: 10.22159 / ajpcr.2018.v11i1.22533
11. Angelousi A, Major E. Anemia, njodzi yakajairika asi kazhinji isingazivikanwi muvarwere vane chirwere cheshuga: kuongorora.Chirwere cheshuga Metabolism 2015;41(1): 18-27.doi: 10.1016 / j.diabet.2014.06.001
12. Ethiopian CSA, ICF International Organization.Izvo zvakakosha zvakawanikwa zve2016 Ethiopian Demographic and Health Survey.Ethiopian Central Bureau yeStatistics uye ICF International.Addis Ababa, Ethiopia neRockville, Maryland, USA;2017.
13. Iye BB, Xu M, Wei L, etc. Ukama huri pakati peanemia uye zvinetso zvisingaperi muChina varwere vane chirwere cheshuga chechipiri.Iyo Great Arch yeIranian Medicine.2015;18(5): 277-283.
14. Wright J, Oddy M, RichardsT.Kuvapo uye hunhu hweanemia mune diabetic tsoka maronda.kupererwa neropa.2014;2014: 1–8.doi: 10.1155/2014/104214
15. Thambiah SC, Samsudin IN, George E, etc. Anemia yechirwere cheshuga 2 (T2DM) muPutrajaya Hospital.J Med Health Science, Malaysia.2015;11(1): 49-61.
16. Roman RM, Lobo PI, Taylor RP, etc. Chidzidzo chinotarisirwa chekudzivirira kwemuviri we normalizing hemoglobin concentration muhemodialysis varwere vanowana recombinant human erythropoietin.J Am Soc Nephrol.2004;15(5): 1339-1346.doi: 10.1097 / 01.ASN.0000125618.27422.C7
17. Trevest K, Treadway H, Hawkins-van DCG, Bailey C, Abdelhafiz AH.Kuwanda uye zvinogadziriswa zveanemia muvarwere vakwegura vane chirwere cheshuga vanoenda kukiriniki yekunze: kuongorora-chikamu.Clinical chirwere cheshuga.2014;32(4):158.doi: 10.2337 / diaclin.32.4.158
18. Thomas MC, Cooper ME, Rossing K, Parving HH.Diabetic Anemia: Kurapa kwacho kwakakodzera here?chirwere cheshuga.2006;49(6):1151.doi: 10.1007 / s00125-006-0215-6
19. New JP, Aung T, Baker PG, etc. Kuwanda kwekushaya ropa kusingazivikanwi kune varwere vane chirwere cheshuga uye chirwere chisingaperi chetsvo chakakwirira: chidzidzo chevanhu.Chirwere cheshuga.2008;25(5): 564-569.doi: 10.1111 / j.1464-5491.2008.02424.x
20. Bosman DR, Winkler AS, Marsden JT, Macdougall IC, Watkins PJ.Anemia uye erythropoietin kushomeka kunogona kuitika mumatanho ekutanga echirwere cheshuga nephropathy.Chirwere cheshuga.2001;24(3): 495-499.doi: 10.2337 / diacare.24.3.495
21. McGill JB, Bell DS.Basa reanemia uye erythropoietin muchirwere cheshuga.J Diabetes matambudziko.2006;20(4):262-272.doi: 10.1016 / j.jdiacomp.2005.08.001
22. Baisakhiya S, Garg P, Singh S. Anemia murudzi rwechipiri vane chirwere cheshuga vane uye vasina chirwere cheshuga retinopathy.International Medical Science Public Health.2017;6(2): 303-306.doi: 10.5455/ijmsph.2017.03082016604
23. Wikipedia.Gelemso iri munharaunda yeOromia musi waChikumi 11, 2020. 2020 [reference date ndiGumiguru 20, 2020].Inowanikwa kubva kune inotevera URL: https://en.wikipedia.org/wiki/Gelemso.Yakashanyirwa muna Ndira 22, 2021.
24. Fiseha T, Adamo A, Tesfaye M, Gebreweld A, Hirst JA.Kuwanda kweanemia mumakiriniki evarwere vanorwara nechirwere cheshuga kuchamhembe kwakadziva kumabvazuva kweEthiopia.PLoS imwe.2019;14(9): e0222111.doi: 10.1371/journal.pone.0222111
25. WHO.WHO's step-by-step maitiro ekuongororwa kwezvirwere zvisingatapukirwe Geneva, Switzerland: WHO;2017.
26. Aynalem SB, Zeleke AJ.Kuwanda kwechirwere cheshuga uye njodzi dzayo muvanhu vane makore gumi nemashanu zvichikwira muMizan-Aman Township, Southwest Ethiopia, 2016: a cross-sectional study.Int J endocrine.2018;2018: 2018. doi: 10.1155 / 2018/9317987
27. Seifu W. Gilgil Gibe Field Research Center, Southwestern Ethiopia, 2013. Kuwanda uye njodzi dzechirwere cheshuga uye kukanganisa kutsanya kweglucose yeropa kune vanhu vakuru vane makore 15-64: nhanho-nhanho nzira.MOJ Hutano Hwevanhu.2015;2(5): 00035. doi: 10.15406 / mojph.2015.02.00035
28. Roba HS, Beyene AS, Mengesha MM, Ayele BH.Kuwanda kwehypertension uye zvinhu zvakabatana muDire Dawa City, Eastern Ethiopia: nharaunda-yakavakirwa muchinjiko-chikamu kudzidza.Int J hypertension.2019;2019: 1-9.doi: 10.1155 / 2019/9878437
29. Tesfaye T, Shikur B, Shimels T, Firdu N. Pakati pemitezo yeFederal Police Commission inogara muAddis Ababa, Ethiopia, kupararira uye zvinhu zvine chokuita nechirwere cheshuga uye kuderera kwekutsanya kweglucose yeropa.BMC Endocr yakavhiringika.2016;16(1): 68. doi: 10.1186 / s12902-016-0150-6
30. Abebe SM, Berhane Y, Worku A, Getachew A, LiY.Kuwanda kwehypertension uye zvinhu zvakabatana: chimiro-chakavakirwa munharaunda chidzidzo kuchamhembe kwakadziva kumadokero kweEthiopia.PLoS imwe.2015;10(4): e0125210.doi: 10.1371/journal.pone.0125210
31. Kearney PM, Whelton M, Reynold K, Muntner P, Whelton PK, HeJ.Mutoro wepasi rose wehypertension: global data analysis.The Lancet 2005;365(9455):217-223.doi: 10.1016 / S0140-6736 (05) 17741-1
32. Singh S, Shankar R, Singh GP.Kuwanda kwehypertension uye zvine chekuita nenjodzi zvinhu: chidzidzo chemukati medhipatimendi muguta reVaranasi.Int J hypertension.2017;2017: 2017. doi: 10.1155 / 2017/5491838
33. De Onis M, Habicht JP.Anthropometric referensi data rekushandiswa kwenyika dzese: kurudziro yeNyanzvi Komiti yeWorld Health Organisation.Iyi ndiyo J Clinical Chikafu.1996;64(4):650-658.doi: 10.1093 / ajcn / 64.4.650
34. WHO.Mamiriro emuviri: kushandiswa uye kududzira anthropometry.WHO technical report series.1995;854(9).
35. Barbieri J, Fontela PC, Winkelmann ER, etc. Anemia mumhando ye2 chirwere cheshuga.kupererwa neropa.2015;2015: 2015. doi: 10.1155/2015/354737
36. Owolabi EO, Ter GD, Adeni OV.Kufutisa kwepakati uye kwakajairwa-huremu hwepakati-kati kufutisa pakati pevakuru mune metropolitan medical institution yeBuffalo, South Africa: a cross-sectional kudzidza.J chikafu chevanhu vane hutano.2017;36(1): 54. doi: 10.1186 / s41043-017-0133-x
37. Adera H, Hailu W, Adane A, Tadesse A. Chiitiko chekushaya ropa uye zvikonzero zvaro zvine chokuita nevarwere vane chirwere chetsvo chisingaperi paGondar University Hospital kuchamhembe kwakadziva kumadokero kweEthiopia: chipatara-based cross-sectional study.Int J Nephrol Renovasc Dis.2019;12: 219. doi: 10.2147 / IJNRD.S216010
38. Chiwanga FS, Njelekela, Massachusetts, Diamond MB, etc. Kuwanda kwechirwere cheshuga uye pre-diabetes uye njodzi dzine chokuita nechirwere cheshuga mumaguta nemaruwa muTanzania neUganda.Global health action.2016;9(1): 31440. doi: 10.3402/gha.v9.31440
39. Kassahun T, Eshetie T, Gesesew H. Zvinhu zvine chokuita nekutonga kweglucose yeropa muvanhu vakuru vane chirwere cheshuga 2: kuongorora kwepamusoro muEthiopia.BMC Res Notes.2016;9(1): 78. doi: 10.1186 / s13104-016-1896-7
40. Fana SA, Bunza MDA, Anka SA, Imam AU, Nataala SU.Kuwanda uye njodzi dzinosangana nehutachiona hwemarariya pakati pevakadzi vane pamuviri munharaunda dzemadhorobha kuchamhembe kwakadziva kumadokero kweNigeria.Kuparira urombo.2015;4(1): 1-5.doi: 10.1186 / s40249-015-0054-0
41. Abate A, Birhan W, Alemu A. Association of anemia uye renal function tests muvarwere vane chirwere cheshuga vanopinda Fenote Selam Hospital muSigoyam, Northwest Ethiopia: chidzidzo chemuchinjikwa.BMC Hematol.2013;13(1): 6. doi: 10.1186 / 2052-1839-13-6
42. Chen CX, Li YC, Chan SL, Chan KH.Anemia uye Type 2 Diabetes: Chidzidzo cheRetrospective cheImpact yePrimary Care Case Series.Hong Kong Med J. 2013;19(3): 214–221.doi: 10.12809 / hkmj133814
43. Wee YH, Anpalahan M. Basa rekuchembera mune yakajairika ropa anemia yerudzi rwe2 chirwere cheshuga.Curr Sayenzi Yekukwegura.2019;12(2): 76-83.doi: 10.2174 / 1874609812666190627154316
44. Panda AK, Ambad County.Kuwanda kweanemia muvarwere vane chirwere cheshuga chechipiri uye kuwirirana kwayo neHBA1c: chidzidzo chekutanga.Natl J Physiol Pharm Pharmacol.2018;8(10): 1409-1413.doi: 10.5455 / njppp.2018.8.0621511072018
45. Sudchada P, Kunmaturos P, Deoisares R. Anemia kuwanda mumhando ye2 chirwere cheshuga muThailand, asi hapana hukama hunoenderana nehutano hwemwoyo kana chirwere chisingaperi chetsvo.Singapore Medical Journal, 2013;28(2): 190-198.
46. Al-Salman M. Anemia muvarwere vane chirwere cheshuga: kuwanda uye kufambira mberi kwechirwere.Gen Med.2015;1-4.
47. Feteh VF, Choukem SP, Kengne AP, Nebongo DN, Ngowe-Ngowe M. Anemia muvarwere vane chirwere cheshuga chechipiri uye kuwirirana kwayo nerenal function muzvipatara zvepamusoro muAfrica yeSouth Africa: chidzidzo chemuchinjikwa.BMC adrenaline.2016;17(1): 29. doi: 10.1186 / s12882-016-0247-1
48. Idris I, Tohid H, Muhammad NA, etc. Anemia muvarwere vepakutanga vane chirwere cheshuga chechipiri (T2DM) uye chirwere chisingaperi chetsvo (CKD): chidzidzo chezvikamu zvakasiyana-siyana.BMJ yakavhurwa.2018;8(12): 12. doi: 10.1136 / bmjopen-2018-025125
49. Wabe NT, Mohamed, Massachusetts.Vesainzi vanofungei nezve catha edulis forsk?Mhedziso yemakemikari, toxicology uye pharmacology.J Exp Integr Med.2012;2(1): 29. doi: 10.5455 / jeim.221211.rw.005
50. Al-Motarreb A, Al-Habori M, Broadley KJ.Khaki kutsenga, chirwere chemoyo uye mamwe matambudziko emukati ekurapa: mamiriro azvino uye ramangwana rekutsvaga mazano.J Journal yeNational Pharmacology.2010;132(3):540-548.doi: 10.1016 / j.jep.2010.07.001
51. Disler P, Lynch SR, Charlton RW, etc. Mhedzisiro yetii pakutorwa kwesimbi.Intestine.1975;16(3): 193-200.doi: 10.1136 / gut.16.3.193
52. Fan FS.Kunyanya kunwa green tea kunogona kukonzera iron kushomeka anemia.Clinical kesi mumiririri.2016;4(11): 1053. doi: 10.1002 / ccr3.707
53. Kumera G, Haile K, Abebe N, Marie T, Eshete T, Ciccozzi M. Anemia uye kushamwaridzana kwayo nekofi yekudya uye hookworm utachiona pakati pevakadzi vane pamuviri vari kuongorora prenatal check-ups paDebre Markos Referral Hospital muNorthwestern Ethiopia.PLoS imwe.2018;13(11): e0206880.doi: 10.1371/journal.pone.0206880
54. Nelson M, Poulter J. Mhedzisiro yekunwa tii pane chimiro chesimbi muUK: kuongorora.J Hum kudya kunovaka muviri.2004;17(1):43-54.doi: 10.1046 / j.1365-277X.2003.00497.x
55. Abdul Kadir AH.Kuwanda kwezvirwere zvisingaperi uye iron inoshaya anemia pakati pevakuru vane chirwere cheshuga muguta reErbil.Zanco J Med Sci.2014;18(1): 674-679.doi: 10.15218 / zjms.2014.0013
56. Thomas MC, MacIsaac RJ, Tsalamandris C, etc. Anemia kune varwere vane chirwere cheshuga 1.J Clinical endocrine metabolism.2004;89(9):4359-4363.doi: 10.1210 / jc.2004-0678
57. Deicher R, HörlWH.Anemia ndiyo ngozi yekukura kwechirwere cheitsvo chisingaperi.Curr Opin Nephrol hypertension.2003;12(2): 139-143.doi: 10.1097 / 00041552-200303000-00003
58. Klemm A, Voigt C, Friedrich M, etc. Electron paramagnetic resonance inoyera tsvuku tsvuku yeropa antioxidant kukwanisa kwevarwere vehemodialysis.Nephrol dial transplantation.2001;16(11): 2166–2171.doi: 10.1093 / ndt / 16.11.2166
59. Ximenes RMO, Barretto ACP, Silva E. Anemia kune varwere vane mwoyo kukundikana: kukura kwengozi zvinhu.Rev Bras Cardiol.2014;27(3): 189–194.
60. Francisco PMSB, Belon AP, Barros MBDA, etc. Self-reported diabetes kune vakwegura: kupararira, zvinhu zvakabatana uye maitiro ekudzora.Cad Saude Publica.2010;26(1): 175-184.doi: 10.1590 / S0102-311X2010000100018
Iri basa rakatsikiswa uye rakapihwa rezenisi neDove Medical Publishing Co., Ltd. Mamiriro akazara erezinesi iri anogona kuwanikwa pa https://www.dovepress.com/terms.php, akasanganiswa neCreative Commons Attribution-Non-commercial ( unported, v3.0) rezinesi.Kuwana basa kunoreva kuti unogamuchira aya mazwi.Kana basa racho rikasarudzika zvakanaka, haringashandiswe kune zvisiri zvekutengesa pasina imwe mvumo kubva kuDove Medical Press Limited.Kuti uwane mvumo yekushandisa basa nekuda kwezvinangwa zvekutengesa, ndapota tarisa kune ndima 4.2 uye 5 yematemu edu.
Bata Nesu•Privacy Policy•Masangano uye Mapartners•Recommendations•Terms and Conditions•Kurudzira webhusaiti ino•Kudzokera kumusoro
©Copyright 2021•Dove Press Ltd•maffey.com yekuvandudza software•Kunamira kwekugadzira webhu
Maonero anoburitswa muzvinyorwa zvese zvakaburitswa pano ndeaya evanyori chaivo uye haafanire kuratidza maonero eDove Medical Press Ltd kana chero wevashandi vayo.
Dove Medical Press ndeyeTaylor & Francis Group, rinova dhipatimendi rekutsikisa redzidzo reInforma PLC, kodzero yekodzero 2017 Informa PLC.kodzero dzose dzakachengetedzwa.Nzvimbo iyi ndeye uye inoshandiswa neInforma PLC (inozonzi "Informa"), uye hofisi yayo yakanyoreswa i5 Howick Nzvimbo, London SW1P 1WG.Yakanyoreswa muEngland neWales.Nhamba 3099067. UK VAT boka: GB 365 4626 36
Kuti tipe masevhisi akagadzirirwa kune vashanyi vewebhusaiti yedu uye vashandisi vakanyoreswa, tinoshandisa makuki kuongorora traffic yevashanyi uye kugadzirisa zvemukati.Iwe unogona kuverenga yedu yekuvanzika mutemo kuti unzwisise mashandisiro atinoita makuki.Isu tinochengeta zvakare data nezve vashanyi uye vashandisi vakanyoreswa kuti vashandise mukati uye kugovana ruzivo nevanoshanda navo bhizinesi.Unogona kuverenga mutemo wedu wekuvanzika kuti unzwisise kuti tinochengeta data ripi, mabatiro atinoita, watinogovana naye uye kodzero yako yekudzima data.
Nguva yekutumira: Feb-19-2021