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Background: The vulnerabilities and risks of women injecting drug users (WIDUs) are different compared to their male counterparts. In light of scant literature in this area, we carried out this qualitative study with the aim to explore the lived experiences of WIDUs in the North of Mauritius. Its objectives were (1) To get an insight into the risks taken during the injection practices of WIDUs and (2) To obtain an in-depth understanding of the gender-specific vulnerability of the sexual behaviours of WIDUs. Methods: A qualitative phenomenological approach was used for the research work. Study participants were recruited from a specific needle exchange site, by purposive sampling until saturation of data was reached. In-depth interviews conducted were transcribed for thematic analysis. Ethical clearance was obtained from the relevant authorities. Findings: The principal theme which emerged from the data collected was “Drug Injection Scenario”, with the following sub-themes: settings for drug injection; pre-injection rituals; third party assistance; sharing and recycling of injecting materials. The second theme which came out was “Sex Work and Drug Use Interplay” with either sex work preceding drug injection or drug injection preceding sex work. Finally, the third theme was “Sexual Behaviours Screenplay” with casual encounters and unprotected sex. Conclusions: This study filled the gap with respect to the absence of qualitative studies among WIDUs in Mauritius. It revealed their risky drug injecting practices and sexual behaviours. Their psychological and physical dependence on drug injection contributed to their stay within this vulnerable circle. Their inability to access adequate support hinders them from coming out of the clutches of their risky drug injection and sexual practices. For resilience of the society, there is need to address the needs of this vulnerable group of women.

The World Heart Federation highlights that cardiovascular disease (CVD) is the leading cause of death in women worldwide. Indeed, women have unique female-specific risk factors for stroke, which include pregnancy, history of preeclampsia/eclampsia or gestational diabetes, duration of reproductive life, oral contraceptive use, and postmenopausal hormone therapy. In light of the female-specific risk factors and/or predisposing conditions, there is need to sensitize health professionals and the public in general on CVD in women. This clinical case is being shared with the written consent of the patient so as to avoid misdiagnosis or underdiagnosis of CVD among women.

Background To understand the impact of the COVID-19 pandemic on mortality, this study investigates overall, sex- and age-specific excess all-cause mortality in 20 countries, during 2020. Methods Total, sex- and age-specific weekly all-cause mortality for 2015–2020 was collected from national vital statistics databases. Excess mortality for 2020 was calculated by comparing weekly 2020 observed mortality against expected mortality, estimated from historical data (2015–2019) accounting for seasonality, long- and short-term trends. Crude and age-standardized rates were analysed for total and sex-specific mortality. Results Austria, Brazil, Cyprus, England and Wales, France, Georgia, Israel, Italy, Northern Ireland, Peru, Scotland, Slovenia, Sweden, and the USA displayed substantial excess age-standardized mortality of varying duration during 2020, while Australia, Denmark, Estonia, Mauritius, Norway, and Ukraine did not. In sex-specific analyses, excess mortality was higher in males than females, except for Slovenia (higher in females) and Cyprus (similar in both sexes). Lastly, for most countries substantial excess mortality was only detectable (Austria, Cyprus, Israel, and Slovenia) or was higher (Brazil, England and Wales, France, Georgia, Italy, Northern Ireland, Sweden, Peru and the USA) in the oldest age group investigated. Peru demonstrated substantial excess mortality even in the Conclusions This study highlights that excess all-cause mortality during 2020 is context dependent, with specific countries, sex- and age-groups being most affected. As the pandemic continues, tracking excess mortality is important to accurately estimate the true toll of COVID-19, while at the same time investigating the effects of changing contexts, different variants, testing, quarantine, and vaccination strategies.

© The Author(s) 2022. Published by Oxford University Press on behalf of the European Society of Cardiology. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com, The ongoing obesity epidemic represents a global public health crisis that contributes to poor health outcomes, reduced quality of life, and >2.8 million deaths each year. Obesity is relapsing, progressive, and heterogeneous. It is considered a chronic disease by the World Obesity Federation (WOF) and a chronic condition by the World Heart Federation (WHF). People living with overweight/obesity are at greater risk for cardiovascular (CV) morbidity and mortality. Increased adiposity (body fat), particularly visceral/abdominal fat, is linked to CV risk and CV disease (CVD) via multiple direct and indirect pathophysiological mechanisms. The development of CVD is driven, in part, by obesity-related metabolic, endocrinologic, immunologic, structural, humoral, haemodynamic, and functional alterations. The complex multifaceted nature of these mechanisms can be challenging to understand and address in clinical practice. People living with obesity and CVD often have concurrent chronic physical or psychological disorders (multimorbidity) requiring multidisciplinary care pathways and polypharmacy. Evidence indicates that intentional weight loss (particularly when substantial) lowers CVD risk among people with overweight/obesity. Long-term weight loss and maintenance require ongoing commitment from both the individual and those responsible for their care. This position paper, developed by the WOF and the WHF, aims to improve understanding of the direct and indirect links between overweight/obesity and CVD, the key controversies in this area and evidence relating to cardiometabolic outcomes with available weight management options. Finally, an action plan for clinicians provides recommendations to help in identifying and addressing the risks of obesity-related CVD (recognizing resource and support variances between countries).

Objectives: The main objective of this study was to investigate the COVID-19 beliefs of a random sample of Mauritian social media users. Study design: Cross-sectional study. Methods: This quantitative research was undertaken by means of an online survey instrument, with questions on participants' behaviour towards COVID-19 and their belief with respect to susceptibility, barriers, benefits, cues to actions and self-efficacy. Results: In total, 405 participants completed the survey. Participants had a low mean COVID-19 perceived susceptibility and perceived severity. Significant differences in susceptibility were observed among different age groups, places of residence and educational levels. A significant difference in self-efficacy was found between people living in urban and rural areas. Participants aged

Objective: This clinical study monitored the effect of eating cooked Moringa oleifera leaves on the blood pressure (BP) of healthy participants in view of the perception that consumption of Moringa...

Purpose Since there is no existing qualitative study on Type 1 Diabetes (T1D) in Mauritius, this study was undertaken to explore the lived experience of mothers having a child with T1D in Mauritius. Design and methods This research work used a phenomenological approach with the interview of a purposeful sample of eleven mothers having a child diagnosed with T1D. Data collected was analyzed by two independent investigators. Ethical clearance was obtained from the Department of Medicine Ethics Committee of the University of Mauritius. Results The emerging themes were ‘Facing disruption in life’, ‘Experiencing mixed feelings’, ‘Taking matters in hands’ and ‘Coping with life’. They put forward the four major components of the lived experience of being the mother of a child diagnosed with T1D. 3 to 4 minor themes. Conclusions The study shows that diagnosis of Type 1 Diabetes in a child has a profound psychosocial impact on mother's personal, family and professional lives. There is need to support parents in the delivery of optimal care to their child to avoid unpredictable complications and unnecessary loss of lives. Practice implications Both nurses and doctors should be aware of their crucial role in demonstrating empathy towards parents/children affected by T1D. There is a need for training programs to develop a culture where empathy enhances nursing and medical practice.

Introduction Designated smoking areas (DSAs) have become a common feature of public places in various developed and developing countries that have ratified the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC). However, this situation is not in line with the WHO FCTC. In this context, this study was designed to explore the perception of stakeholders on the DSA prevailing in workplaces in Mauritius and to explore the feasibility of smoking cessation interventions in the workplace. Methods A qualitative study using semi-structured, face-to-face interviews was conducted among the various stakeholders in tobacco control in Mauritius. Data collected were transcribed verbatim for analysis. Results Three main themes emerged from this study: 1) a need for comprehensive smoke-free law, 2) a need for smoking cessation services, and 3) a need for stakeholders’ involvement (local government, employers, and health professionals) in the promotion of tobacco cessation programs. Conclusions We make a call for a workplace Designated Stop Smoking Area (DSSA) in order to phase out existing DSAs. DSSAs will be a therapeutic means to divert smokers away from DSAs, in order to change their behaviour with respect to tobacco use. Group therapy, individual counselling, and tobacco treatment will be made accessible in these DSSAs, which with a touch of innovation can become a VIP lounge for stop-smoking services. This innovative call for DSSAs is meant to sensitize policy makers of developing countries on how to proceed for the elimination of DSAs.

Introduction A literature review has revealed an absence of studies investigating the knowledge and behaviour of teachers towards secondhand smoke (SHS). This study was thus designed with the following objectives: 1) Assess the knowledge of SHS among primary school teachers, 2) Determine their behaviour towards SHS, and 3) Identify any relationship between knowledge and behaviour of participants. Methods A national cross-sectional study was conducted among a representative sample from 28 primary schools in all four educational zones of Mauritius in 2017. A self-administered questionnaire was used to collect data from primary school teachers. Data analysis was performed on 389 questionnaires. Results The mean knowledge score was found to be 28.9 (SD=4.8), which is just above the threshold score (>27) for good knowledge. Less than two-thirds of the participants (63.2%) were in the 'good knowledge' category. The mean behaviour score was found to be 26.6 (SD=6.8), which is situated in the range for 'satisfactory behaviour' in terms of avoiding SHS. Pearson correlation testing revealed a significant association between knowledge of SHS and behaviour towards exposure to SHS. Conclusions This study showed that nearly two-thirds of teachers had good knowledge of the health dangers of SHS and applied this knowledge in their behaviour by keeping away from cigarette smoke.

Background: In the context of the COVID-19 pandemic, the Government of Mauritius announced the first three COVID-19 cases in the island on 18 March 2020. Following the outbreak, measures for national lockdown which were implemented as from 20 March 2020 were subsequently upgraded to national curfew as from 23 March. The need thus arose to observe the natural behaviour of Mauritians in the social environment resulting from the COVID-19 confinement measures. Methods: A qualitative study with ethnographic approach was undertaken in Mauritius, during the period 18 March to 1 May 2020, by Mauritian investigators who were immersed in the social context. As ethnographers in the digital era, we travelled through the internet in order to be on the field site. Following participant observation, data analysis and interpretation, we followed the Standards for Reporting Qualitative Research (SRQR). We also undertook the ethnography-related reflexivity process for quality assurance of this qualitative study. Findings: This study revealed four main themes with respect to the behaviour of Mauritians in the social context of the COVID-19 outbreak as follows: Adapting to confinement measures, panic buying, sustaining media communication and facing the dangers of COVID-19. Interpretation: The interpretation of our findings led us to draw the lessons learnt during the course of this study which provides insights potentially applicable to middle-income countries for their respective public health response to COVID-19.

BackgroundIn response to high smoking rates, especially among men, Mauritius launched a National Action Plan on Tobacco Control in 2008. It changed its tax system from a mixed system to a uniform specific system. Despite these interventions, cigarette consumption and smoking prevalence in Mauritius decreased only marginally in the subsequent decade.MethodUsing publicly available data, we decompose the retail price of cigarettes into tax and net-of-tax components, between 2011 and 2017. We cover premium, popular and economy cigarettes.ResultsSince its introduction in 2008, the nominal excise tax was increased six times. Between 2011 and 2017, the real value of the excise tax increased by 47%. Meanwhile, British American Tobacco (BAT) increased the real net-of-tax price of premium cigarettes by 61.8% and of popular cigarettes by 47.2%, thus overshifting the tax increase. On economy cigarettes, BAT decreased the real net-of-tax price by 14.7%, thus undershifting the excise tax increase.ConclusionThrough its pricing strategy, BAT has greatly undermined Mauritius’s tobacco control policy. However, BAT cannot continue undershifting the excise tax on economy brands, since the net-of-tax proportion of the retail price is very low already. BAT would have little choice but to increase the retail price on economy brands in response to future excise tax increases. The government of Mauritius is encouraged to keep the specific excise tax structure but to increase the rate at which it is levied.

Background Tobacco tax increase reduces tobacco use, but smokers especially socioeconomically disadvantaged who do not quit smoking may experience financial stress (Lantz et al. 2005; Siahpush et al. 2007; Krueger et al. 2008; Pampel et al . 2010). This study was carried out to explore the lived experience of socioeconomically disadvantaged smokers with respect to tobacco tax increase. The study objectives were to look into their spending mechanism, to examine their smoking behaviour and to capture their cognition to quit smoking. Methods This qualitative study with phenomenological approach took place in a smoking cessation clinic of a regional hospital in Mauritius. A purposive sample of socioeconomically disadvantaged smokers was constituted until theoretical saturation was reached. A semi-structured guide was used to collect data through face-to-face interviews which were recorded and transcribed verbatim. Data was analysed using Thematic Framework Analysis in order to establish the emerging themes. Ethical clearance was obtained from the relevant research ethics committee. Results The main themes which emerged included the following: Tobacco-related expenses as priority, Large amount of monthly income for tobacco-related expenses, Need to satisfy cravings, Exacerbation of financial stress, Scepticism about tobacco tax effectiveness, Strategies to maintain smoking, Need for complete ban of cigarettes in the country and Need for government to provide assistance for smoking cessation. The findings from this study constitute new qualitative data pertaining to the lived experience of a group of socioeconomically disadvantaged smokers. Conclusions This study shows that tobacco taxation contributes to the socioeconomic burden of smokers who maintain smoking. In order to address tobacco-related poverty and inequality, there is need for targeted intervention by health authorities to provide assistance for smoking cessation among socioeconomically disadvantaged smokers, especially during the aftermath of tobacco tax increase policy of the country.

Introduction Mauritius has one of the highest rates of smoking in Africa. Smoking cessation is a priority for preventing tobacco-related morbidity and mortality. The purpose of this study is to identify the predictors of quit intentions among smokers in Mauritius in order to strengthen tobacco control policies and inform the development and delivery of services that may increase the likelihood of successful quitting. Methods Data were drawn from one wave (2009) of the International Tobacco Control (ITC) Mauritius Survey, a face-to-face cohort survey of a nationally representative sample of 598 adult smokers who were randomly selected from nine geographic districts in Mauritius using a multistage sampling procedure. Results The vast majority of smokers (77.8%) had plans to quit smoking. Longer duration of past quit attempts (6 months or less), perceiving benefits of quitting, worrying about smoking damaging health in the future, and enjoyment of smoking were significantly associated with quit intentions. However, socio-demographic characteristics, past quit attempts, overall attitude about smoking, and Heaviness of Smoking Index (HSI) were not associated with quit intentions. Conclusions The predictors of quit intentions among Mauritian smokers were generally similar to those found among smokers in other high- and middle-income countries. However, in contrast to findings in those other countries, nicotine dependence as measured by the HSI was not a significant predictor of quit intentions among Mauritian smokers. These findings highlight the need to consider the predictors of quit intentions when developing and delivering smoking cessation support services in Mauritius.

Tobacco is a silent killer, with more than 400 poisonous chemical substances. The use of tobacco is driven by dependence on nicotine, the primary addictive substance in tobacco. Smoking in the workplace has adverse effects on both the employee health and productivity. Hence, it is important to raise awareness on the need to quit smoking. The objectives of the study were to determine the intention to quit smoking and cessation attempts among employees of an educational institution, to assess the association between level of dependence and the Trans-Theoretical Model of Change and to identify the smoking cessation facilities available in Mauritius. This study had a mixed approach. In the quantitative part, smokers were recruited using a convenience sampling. The inclusion criteria were employees who were current smokers. A validated questionnaire adapted from the Global Adult Tobacco Survey questionnaire was used. The qualitative part evaluated the facilities available at the Smoking Cessation Clinics set up in Mauritius. The findings showed that 81 % of the participants intended to quit smoking and most of them planned to quit within the next month. Three major obstacles to relapse were identified. Awareness of smoking cessation techniques was low but willingness to use nicotine replacement therapy and other support therapy was high. This study highlighted the need to implement free smoking cessation programs on work premises to cater for the needs of employees so that they stop inhaling poisonous chemical substances which jeopardize the health and future of employees.

Cette étude sur les croyances alimentaires a été faite dans le but de déterminer les perceptions des Mauriciens sur l’effet de dix aliments sur la tension artérielle et de les analyser. Les données ont été obtenues à partir d’un échantillon représentatif de la population de Maurice et de Rodrigues. La taille de l’échantillon était de 800 personnes tirées au hasard. Cette étude qui a obtenu l’accord du Comité d’Ethique du Ministère de la Santé et de la Qualité de la Vie de Maurice a demandé un consentement éclairé et écrit de la part de chaque participant. Ce travail a mis en évidence un certain nombre de perceptions présentes parmi les Mauriciens et a démontré leur degré de mise en pratique. Les résultats de cette étude ont fait ressortir le besoin de faire une éducation de la population sur les valeurs nutritives des aliments associés à des croyances culturelles. This questionnaire survey about folk food beliefs was carried out with the objectives to determine the perceptions of the inhabitants of Mauritius and Rodrigues on the effect of ten food items on blood pressure and to critically analyse these perceptions. Data was obtained from a representative sample of the population of Mauritius and Rodrigues, which comprised 800 randomly selected adults. Ethical clearance was obtained from the local health authority, the Ministry of Health and Quality of Life of Mauritius, and informed written consent was obtained from each participant. The results of ths study expose a number of perceptions prevalent among Mauritians and demonstrate the extent to which they are put into practice. The findings highlight the need to educate Mauritians on the nutritive value of foods items that are associated with strong cultural beliefs.

Coronary heart disease (CHD) is among one of the major causes of deaths in Mauritius. It is important to screen biochemical markers, amongst other clinical and para-clinical tests, in view of the prevention of the disease. The study consisted of screening a random sample of 300 employees for total cholesterol above the desirable range (>5.17 mmol/l). A second fasting blood test was performed in those who had high total cholesterol. The lipid profile was performed using commercially available kits. The Total Cholesterol to High Density Lipoprotein Cholesterol ratio was calculated for identification of those at risk of CHD.

There is increasing concern for the rising incidence of Type 1 Diabetes mellitus worldwide. In Mauritius, there is no official data on the incidence of this disease. On the other hand, the recent creation of a two non-governmental organizations in less than five years to support patients calls for a situational analysis of the disease. Therefore, this research work has been designed with the aim to appraise the epidemiology of Type 1 Diabetes mellitus in Mauritius. Epidemiological data of all Type 1 diabetic patients 14 years of age was collected by means of a questionnaire comprising mainly of closed ended questions. This questionnaire was subject to a prior pilot study. Ethical clearance was obtained from the Ethics Committee of the local health authority. The age-standardized average incidence, for the period under scrutiny, was 4.94/100000/year. In boys and girls, it is 4.59 and 6.63/100000/year respectively. Referring to age of onset, it was observed that in male patients, the highest peak was observed at the age of 7 and 12 years whereas in female cases, the highest peak was observed at the age of 10 years. The median age at diagnosis for male and female patients was 8.02 and 10.0 years respectively. Being given the high incidence of T1D in Mauritius and the global rising trend, the surveillance of this disease needs to be addressed.

Mauritius has Type 2 Diabetes mellitus as public health issue, whereby unhealthy modes of eating and sedentary lifestyles are factors to be addressed in the primary prevention of the disease among the youth. This study was thus designed to investigate the prevalence of Leisure-time physical activity (LTPA) among university students in Mauritius and to explore their motivations and constraints to engage in LTPA, using the ecological model of health promotion. Data were collected from a representative group of university students in Mauritius using a self-administered questionnaire. Qualitative and quantitative data pertaining to LTPA issues were collected. Three-fifths of the participants met the recommended levels of LTPA. The majority of inactive participants were female. Motivations provided by participants to engage in LTPA were predominantly intrapersonal. The three most mentioned motivations were improvement in physical health, improvement in physical appearance and to have fun. Constraints faced by participants to engage in LTPA were mainly of an intrapersonal nature. The three main constraints provided by students were lack of time, having to study and not being motivated. Therefore, interventions to promote LTPA among university students should simultaneously address development of time-management skills and provision of incentives to perform LTPA.