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Soo CC, Farrell MT, Tollman S, Berkman L, Nebel A, Ramsay M. Apolipoprotein E Genetic Variation and Its Association With Cognitive Function in Rural-Dwelling Older South Africans. Front Genet 2021; 12:689756. [PMID: 34721516 PMCID: PMC8551631 DOI: 10.3389/fgene.2021.689756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 08/18/2021] [Indexed: 12/01/2022] Open
Abstract
Apolipoprotein E (APOE) 𝜀4 allele carrier status is well known for its association with an increased likelihood of developing Alzheimer’s disease, but its independent role in cognitive function is unclear. APOE genetic variation is understudied in African populations; hence, this cross-sectional study in a rural South African community examined allele and genotype frequencies, and their associations with cognitive function. Cognitive function was assessed using two different screening methods to produce a total cognition score and four domain-specific cognition scores for verbal episodic memory, executive function, language, and visuospatial ability. Cognitive phenotype and APOE genotype data were used to determine whether APOE variation was significantly associated with cognitive function in this population. Observed allele frequencies for 1776 participants from the HAALSI study [age 40–80years (mean=56.19); 58.2% female] were 58.1% (𝜀3), 25.4% (𝜀4) and 16.5% (𝜀2). Allele distributions were similar to the African super population, but different from all non-African super populations from the 1,000 Genomes Project. The 𝜀3 homozygous genotype was most common (34.9%) and used as the base genotype for comparison in regression models. Four models were tested for each of the five cognitive phenotypes to explore association of APOE variation with cognitive function. In the first model assessing association with all genotypes for all individuals, marginally significant associations were observed for 𝜀2 homozygotes where executive function scored higher by ~0.5 standard deviations (p=0.037, SE=0.23), and for 𝜀3/𝜀4 heterozygotes where visuospatial ability scores were lower (p=0.046, SE=0.14). These did not survive correction for multiple testing. Regional African population differences were observed at the APOE locus. Marginally, significant associations between APOE genotype, and executive function and visuospatial ability indicate the need for larger studies to better examine these associations in African populations. Furthermore, longitudinal data could shed light on APOE genetic association with rate of change, or decline, in cognitive function.
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Affiliation(s)
- Cassandra C Soo
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.,Division of Human Genetics, National Health Laboratory Service and School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Meagan T Farrell
- Harvard Center for Population and Development Studies, Harvard University, Cambridge, MA, United States
| | - Stephen Tollman
- MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Lisa Berkman
- Harvard Center for Population and Development Studies, Harvard University, Cambridge, MA, United States.,Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Almut Nebel
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.,Institute of Clinical Molecular Biology, Kiel University, Kiel, Germany
| | - Michèle Ramsay
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Herbst K, Juvekar S, Jasseh M, Berhane Y, Chuc NTK, Seeley J, Sankoh O, Clark SJ, Collinson MA. Health and demographic surveillance systems in low- and middle-income countries: history, state of the art and future prospects. Glob Health Action 2021; 14:1974676. [PMID: 35377288 PMCID: PMC8986235 DOI: 10.1080/16549716.2021.1974676] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 08/25/2021] [Indexed: 11/09/2022] Open
Abstract
Health and Demographic Surveillance Systems (HDSS) have been developed in several low- and middle-income countries (LMICs) in Africa and Asia. This paper reviews their history, state of the art and future potential and highlights substantial areas of contribution by the late Professor Peter Byass.Historically, HDSS appeared in the second half of the twentieth century, responding to a dearth of accurate population data in poorly resourced settings to contextualise the study of interventions to improve health and well-being. The progress of the development of this network is described starting with Pholela, and progressing through Gwembe, Balabgarh, Niakhar, Matlab, Navrongo, Agincourt, Farafenni, and Butajira, and the emergence of the INDEPTH Network in the early 1990'sThe paper describes the HDSS methodology, data, strengths, and limitations. The strengths are particularly their temporal coverage, detail, dense linkage, and the fact that they exist in chronically under-documented populations in LMICs where HDSS sites operate. The main limitations are generalisability to a national population and a potential Hawthorne effect, whereby the project itself may have changed characteristics of the population.The future will include advances in HDSS data harmonisation, accessibility, and protection. Key applications of the data are to validate and assess bias in other datasets. A strong collaboration between a national HDSS network and the national statistics office is modelled in South Africa and Sierra Leone, and it is possible that other low- to middle-income countries will see the benefit and take this approach.
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Affiliation(s)
- Kobus Herbst
- DSI-MRC South African Population Infrastructure Network, Durban, South Africa
- Population Science, Africa Health Research Institute, Durban, KwaZulu-Natal, South Africa
| | - Sanjay Juvekar
- KEM Hospital Research Centre, Vadu Rural Health Program, Pune, India
| | - Momodou Jasseh
- Medical Research Council Unit, The Gambia at London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Yemane Berhane
- Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | | | - Janet Seeley
- Population Science, Africa Health Research Institute, Durban, KwaZulu-Natal, South Africa
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
| | - Osman Sankoh
- Statistics Sierra Leone, Tower Hill, Freetown, Sierra Leone
- Njala University, University Secretariat, Njala, Sierra Leone
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Heidelberg Institute of Global Health, University of Heidelberg Medical School, Heidelberg, Germany
| | - Samuel J. Clark
- Department of Sociology, The Ohio State University, Columbus, Ohio, USA
| | - Mark A. Collinson
- DSI-MRC South African Population Infrastructure Network, Durban, South Africa
- SAMRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, South Africa
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53
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Dlamini SN, Choudhury A, Ramsay M, Micklesfield LK, Norris SA, Crowther NJ, Crawford AA, Walker BR, Lombard Z, Goedecke JH. Associations Between CYP17A1 and SERPINA6/A1 Polymorphisms, and Cardiometabolic Risk Factors in Black South Africans. Front Genet 2021; 12:687335. [PMID: 34484290 PMCID: PMC8414563 DOI: 10.3389/fgene.2021.687335] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 07/20/2021] [Indexed: 01/11/2023] Open
Abstract
Research in European and Asian populations has reported associations between single nucleotide polymorphisms (SNPs) in CYP17A1 and SERPINA6/A1 and circulating glucocorticoid concentrations, and some key cardiometabolic risk factors. This study aimed to investigate these associations in black South African adults, who are disproportionally affected by the metabolic syndrome and its related cardiometabolic risk factors. The dataset included black South African adults (n = 4,431; 56.7% women) from the AWI-Gen study, genotyped on the H3A genotyping array and imputed using the African reference panel at the Sanger imputation service. From the imputed data, 31 CYP17A1 SNPs and 550 SERPINA6/A1 SNPs were extracted. The metabolic syndrome and its components were defined using the 2009 harmonized guidelines. Serum glucocorticoid concentrations were measured in a subset of 304 men and 573 women, using a liquid chromatography-mass spectrometry method. Genetic associations were detected using PLINK. Bonferroni correction was used to control for multiple testing. A SNP at SERPINA6/A1, rs17090691 (effect allele G), was associated with higher diastolic blood pressure (BP) in all adults combined (p = 9.47 × 10-6). Sex-stratified analyses demonstrated an association between rs1051052 (effect allele G), another SERPINA6/A1 SNP, and higher high-density lipoprotein (HDL) cholesterol concentrations in women (p = 1.23 × 10-5). No association was observed between these variants and glucocorticoids or between any of the CYP17A1 SNPs and metabolic outcomes after adjusting for multiple testing. Furthermore, there were no associations between any of the SNPs tested and the metabolic syndrome. This study reports novel genetic associations between two SNPs at SERPINA6/A1 and key cardiometabolic risk factors in black South Africans. Future replication and functional studies in larger populations are required to confirm the role of the identified SNPs in the metabolic syndrome and assess if these associations are mediated by circulating glucocorticoids.
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Affiliation(s)
- Siphiwe N. Dlamini
- South African Medical Research Council/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Non-communicable Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Ananyo Choudhury
- Faculty of Health Sciences, Sydney Brenner Institute for Molecular Bioscience, University of the Witwatersrand, Johannesburg, South Africa
| | - Michèle Ramsay
- Faculty of Health Sciences, Sydney Brenner Institute for Molecular Bioscience, University of the Witwatersrand, Johannesburg, South Africa
| | - Lisa K. Micklesfield
- South African Medical Research Council/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Shane A. Norris
- South African Medical Research Council/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Nigel J. Crowther
- Department of Chemical Pathology, National Health Laboratory Service, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Andrew A. Crawford
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom
| | - Brian R. Walker
- BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Zané Lombard
- Division of Human Genetics, National Health Laboratory Service, Faculty of Health Sciences, School of Pathology, University of the Witwatersrand, Johannesburg, South Africa
| | - Julia H. Goedecke
- South African Medical Research Council/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Non-communicable Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa
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54
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Dlamini SN, Lombard Z, Micklesfield LK, Crowther N, Norris SA, Snyman T, Crawford AA, Walker BR, Goedecke JH. Glucocorticoids associate with cardiometabolic risk factors in black South Africans. Endocr Connect 2021; 10:873-884. [PMID: 34261039 PMCID: PMC8346194 DOI: 10.1530/ec-21-0195] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 07/14/2021] [Indexed: 01/10/2023]
Abstract
Circulating glucocorticoids are associated with metabolic syndrome and related cardiometabolic risk factors in non-Africans. This study investigated these associations in Africans, whose metabolic phenotype reportedly differs from Europeans. Adiposity, blood pressure, glycaemia, insulin resistance, and lipid profile, were measured in 316 African men and 788 African women living in Soweto, Johannesburg. The 2009 harmonized criteria were used to define metabolic syndrome. Serum glucocorticoids were measured using liquid chromatography-mass spectrometry. Cortisol was associated with greater odds presenting with metabolic syndrome (odds ratio (95% CI) =1.50 (1.04, 2.17) and higher systolic (beta coefficient, β (95% CI) =0.04 (0.01, 0.08)) and diastolic (0.05 (0.02, 0.09)) blood pressure, but higher HDL (0.10 (0.02, 0.19)) and lower LDL (-0.14 (-0.24, -0.03)) cholesterol concentrations, in the combined sample of men and women. In contrast, corticosterone was only associated with higher insulin sensitivity (Matsuda index; 0.22 (0.03, 0.41)), but this was not independent of BMI. Sex-specific associations were observed, such that both cortisol and corticosterone were associated with higher fasting glucose (standardized β (95% CI): 0.24 (0.12, 0.36) for cortisol and 0.12 (0.01, 0.23) for corticosterone) and HbA1c (0.13 (0.01, 0.25) for cortisol and 0.12 (0.01, 0.24) for corticosterone) in men only, but lower HbA1c (0.10 (-0.20, -0.01) for cortisol and -0.09 (-0.18, -0.03) for corticosterone) in women only. Our study reports for the first time that associations between circulating glucocorticoid concentrations and key cardiometabolic risk factors exhibit both glucocorticoid- and sex-specificity in Africans.
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Affiliation(s)
- Siphiwe N Dlamini
- SAMRC/Wits Developmental Pathways for Health Research Unit (DPHRU), School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Non-communicable Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Zané Lombard
- Division of Human Genetics, National Health Laboratory Service, and School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Lisa K Micklesfield
- SAMRC/Wits Developmental Pathways for Health Research Unit (DPHRU), School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Nigel Crowther
- Department of Chemical Pathology, National Health Laboratory Service and Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Shane A Norris
- SAMRC/Wits Developmental Pathways for Health Research Unit (DPHRU), School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Tracy Snyman
- Department of Chemical Pathology, National Health Laboratory Service and Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Andrew A Crawford
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - Brian R Walker
- BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
- Institute of Genetic Medicine to Translational & Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Julia H Goedecke
- SAMRC/Wits Developmental Pathways for Health Research Unit (DPHRU), School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Non-communicable Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa
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55
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Wong EB, Olivier S, Gunda R, Koole O, Surujdeen A, Gareta D, Munatsi D, Modise TH, Dreyer J, Nxumalo S, Smit TK, Ording-Jespersen G, Mpofana IB, Khan K, Sikhosana ZEL, Moodley S, Shen YJ, Khoza T, Mhlongo N, Bucibo S, Nyamande K, Baisley KJ, Cuadros D, Tanser F, Grant AD, Herbst K, Seeley J, Hanekom WA, Ndung'u T, Siedner MJ, Pillay D. Convergence of infectious and non-communicable disease epidemics in rural South Africa: a cross-sectional, population-based multimorbidity study. Lancet Glob Health 2021; 9:e967-e976. [PMID: 34143995 PMCID: PMC8220132 DOI: 10.1016/s2214-109x(21)00176-5] [Citation(s) in RCA: 69] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 03/22/2021] [Accepted: 03/23/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND There has been remarkable progress in the treatment of HIV throughout sub-Saharan Africa, but there are few data on the prevalence and overlap of other significant causes of disease in HIV endemic populations. Our aim was to identify the prevalence and overlap of infectious and non-communicable diseases in such a population in rural South Africa. METHODS We did a cross-sectional study of eligible adolescents and adults from the Africa Health Research Institute demographic surveillance area in the uMkhanyakude district of KwaZulu-Natal, South Africa. The participants, who were 15 years or older, were invited to participate at a mobile health camp. Medical history for HIV, tuberculosis, hypertension, and diabetes was established through a questionnaire. Blood pressure measurements, chest x-rays, and tests of blood and sputum were taken to estimate the population prevalence and geospatial distribution of HIV, active and lifetime tuberculosis, elevated blood glucose, elevated blood pressure, and combinations of these. FINDINGS 17 118 adolescents and adults were recruited from May 25, 2018, to Nov 28, 2019, and assessed. Overall, 52·1% (95% CI 51·3-52·9) had at least one active disease. 34·2% (33·5-34·9) had HIV, 1·4% (1·2-1·6) had active tuberculosis, 21·8% (21·2-22·4) had lifetime tuberculosis, 8·5% (8·1-8·9) had elevated blood glucose, and 23·0% (22·4-23·6) had elevated blood pressure. Appropriate treatment and optimal disease control was highest for HIV (78·1%), and lower for elevated blood pressure (42·5%), active tuberculosis (29·6%), and elevated blood glucose (7·1%). Disease prevalence differed notably by sex, across age groups, and geospatially: men had a higher prevalence of active and lifetime tuberculosis, whereas women had a substantially high prevalence of HIV at 30-49 years and an increasing prevalence of multiple and poorly controlled non-communicable diseases when older than 50 years. INTERPRETATION We found a convergence of infectious and non-communicable disease epidemics in a rural South African population, with HIV well treated relative to all other diseases, but tuberculosis, elevated blood glucose, and elevated blood pressure poorly diagnosed and treated. A public health response that expands the successes of the HIV testing and treatment programme to provide multidisease care targeted to specific populations is required to optimise health in such settings in sub-Saharan Africa. FUNDING Wellcome Trust, Bill & Melinda Gates Foundation, the South African Department of Science and Innovation, South African Medical Research Council, and South African Population Research Infrastructure Network. TRANSLATION For the isiZulu translation of the abstract see Supplementary Materials section.
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Affiliation(s)
- Emily B Wong
- Africa Health Research Institute, KwaZulu-Natal, Durban, South Africa; Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA, USA; Division of Infectious Diseases, University of Alabama Birmingham, Birmingham, AL, USA; Division of Infection and Immunity, University College London, London, UK.
| | - Stephen Olivier
- Africa Health Research Institute, KwaZulu-Natal, Durban, South Africa
| | - Resign Gunda
- Africa Health Research Institute, KwaZulu-Natal, Durban, South Africa; School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Olivier Koole
- Africa Health Research Institute, KwaZulu-Natal, Durban, South Africa; London School of Hygiene & Tropical Medicine, London, UK
| | - Ashmika Surujdeen
- Africa Health Research Institute, KwaZulu-Natal, Durban, South Africa
| | - Dickman Gareta
- Africa Health Research Institute, KwaZulu-Natal, Durban, South Africa
| | - Day Munatsi
- Africa Health Research Institute, KwaZulu-Natal, Durban, South Africa
| | | | - Jaco Dreyer
- Africa Health Research Institute, KwaZulu-Natal, Durban, South Africa
| | - Siyabonga Nxumalo
- Africa Health Research Institute, KwaZulu-Natal, Durban, South Africa
| | - Theresa K Smit
- Africa Health Research Institute, KwaZulu-Natal, Durban, South Africa
| | | | | | - Khadija Khan
- Africa Health Research Institute, KwaZulu-Natal, Durban, South Africa
| | | | - Sashen Moodley
- Africa Health Research Institute, KwaZulu-Natal, Durban, South Africa
| | - Yen-Ju Shen
- Africa Health Research Institute, KwaZulu-Natal, Durban, South Africa
| | - Thandeka Khoza
- Africa Health Research Institute, KwaZulu-Natal, Durban, South Africa
| | - Ngcebo Mhlongo
- Africa Health Research Institute, KwaZulu-Natal, Durban, South Africa
| | - Sanah Bucibo
- Africa Health Research Institute, KwaZulu-Natal, Durban, South Africa
| | - Kennedy Nyamande
- Department of Pulmonology and Critical Care, Inkosi Albert Luthuli Hospital, Durban, South Africa; Department of Respiratory Medicine, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Kathy J Baisley
- Africa Health Research Institute, KwaZulu-Natal, Durban, South Africa; London School of Hygiene & Tropical Medicine, London, UK
| | - Diego Cuadros
- Department of Geography, University of Cincinnati, USA
| | - Frank Tanser
- Africa Health Research Institute, KwaZulu-Natal, Durban, South Africa; School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa; Lincoln International Institute for Rural Health, University of Lincoln, UK; Centre for the AIDS Programme of Research in South Africa, University of KwaZulu-Natal, Durban, South Africa
| | - Alison D Grant
- Africa Health Research Institute, KwaZulu-Natal, Durban, South Africa; School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa; London School of Hygiene & Tropical Medicine, London, UK; School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Kobus Herbst
- Africa Health Research Institute, KwaZulu-Natal, Durban, South Africa; Department of Science and Innovation, Medical Research Council, South African Population Research Infrastructure, Durban, South Africa
| | - Janet Seeley
- Africa Health Research Institute, KwaZulu-Natal, Durban, South Africa; London School of Hygiene & Tropical Medicine, London, UK
| | - Willem A Hanekom
- Africa Health Research Institute, KwaZulu-Natal, Durban, South Africa; Division of Infection and Immunity, University College London, London, UK
| | - Thumbi Ndung'u
- Africa Health Research Institute, KwaZulu-Natal, Durban, South Africa; Division of Infection and Immunity, University College London, London, UK; HIV Pathogenesis Programme, Doris Duke Medical Research Institute, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa; The Ragon Institute of Massachusetts General Hospital, Massachusetts Institute of Technology and Harvard Medical School, Cambridge, MA, USA; Max Planck Institute for Infection Biology, Berlin, Germany
| | - Mark J Siedner
- Africa Health Research Institute, KwaZulu-Natal, Durban, South Africa; Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA, USA; School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Deenan Pillay
- Africa Health Research Institute, KwaZulu-Natal, Durban, South Africa; Division of Infection and Immunity, University College London, London, UK
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Tindana P, Ramsay M, Klipstein-Grobusch K, Amoakoh-Coleman M. Advancing non-communicable diseases research in Ghana: key stakeholders' recommendations from a symposium. Ghana Med J 2021; 54:121-125. [PMID: 33536683 PMCID: PMC7829050 DOI: 10.4314/gmj.v54i2.11] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
There has been a growing increase in the prevalence of non-communicable diseases (NCDs) globally with reports suggesting that the fastest increase in NCD deaths in the world will occur in sub-Saharan Africa (SSA) over the next 5 to 15 years. Despite the projected increase in NCD-related deaths, there is little coordinated research in many West African nations, including Ghana, to quantify and study this burden and to translate the research findings into policy and practice. To address these challenges, the Noguchi Memorial Institute for Medical Research and the Navrongo Health Research Centre, both in Ghana, with support from the Wits NCD Research Leadership Training Program organized a two-day symposium to discuss the advancement of NCD research in the West African sub-region. The aim was to propose the way forward for strengthening applied research that can inform the development of health policies and programs focused on NCDs. Participants were drawn from academia, research and health institutions, early career researchers and postdoctoral fellows. We present the key themes that emerged from the symposium and some strategies for advancing NCD research in West Africa. These include interdisciplinary collaboration between NCD researchers in the region, generation of accurate data on disease burden and strengthening stakeholder and public engagement on NCDs.
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Affiliation(s)
- Paulina Tindana
- Department of Health Policy, Planning and Management, School of Public Health, University of Ghana
| | - Michèle Ramsay
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Kerstin Klipstein-Grobusch
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, The Netherlands.,Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Mary Amoakoh-Coleman
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, The Netherlands.,Department of Epidemiology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
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57
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Wade AN, Crowther NJ, Abrahams-Gessel S, Berkman L, George JA, Gómez-Olivé FX, Manne-Goehler J, Salomon JA, Wagner RG, Gaziano TA, Tollman SM, Cappola AR. Concordance between fasting plasma glucose and HbA 1c in the diagnosis of diabetes in black South African adults: a cross-sectional study. BMJ Open 2021; 11:e046060. [PMID: 34140342 PMCID: PMC8212405 DOI: 10.1136/bmjopen-2020-046060] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES We investigated concordance between haemoglobin A1c (HbA1c)-defined diabetes and fasting plasma glucose (FPG)-defined diabetes in a black South African population with a high prevalence of obesity. DESIGN Cross-sectional study. SETTING Rural South African population-based cohort. PARTICIPANTS 765 black individuals aged 40-70 years and with no history of diabetes. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome measure was concordance between HbA1c-defined diabetes and FPG-defined diabetes. Secondary outcome measures were differences in anthropometric characteristics, fat distribution and insulin resistance (measured using Homoeostatic Model Assessment of Insulin Resistance (HOMA-IR)) between those with concordant and discordant HbA1c/FPG classifications and predictors of HbA1c variance. RESULTS The prevalence of HbA1c-defined diabetes was four times the prevalence of FPG-defined diabetes (17.5% vs 4.2%). Classification was discordant in 15.7% of participants, with 111 individuals (14.5%) having HbA1c-only diabetes (kappa 0.23; 95% CI 0.14 to 0.31). Median body mass index, waist and hip circumference, waist-to-hip ratio, subcutaneous adipose tissue and HOMA-IR in participants with HbA1c-only diabetes were similar to those in participants who were normoglycaemic by both biomarkers and significantly lower than in participants with diabetes by both biomarkers (p<0.05). HOMA-IR and fat distribution explained additional HbA1c variance beyond glucose and age only in women. CONCLUSIONS Concordance was poor between HbA1c and FPG in diagnosis of diabetes in black South Africans, and participants with HbA1c-only diabetes phenotypically resembled normoglycaemic participants. Further work is necessary to determine which of these parameters better predicts diabetes-related morbidities in this population and whether a population-specific HbA1c threshold is necessary.
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Affiliation(s)
- Alisha N Wade
- MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Nigel J Crowther
- Department of Chemical Pathology, University of the Witwatersrand, Johannesburg, South Africa
- Department of Chemical Pathology, National Health Laboratory Service, Johannesburg, South Africa
| | - Shafika Abrahams-Gessel
- Centre for Health Decision Science, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
| | - Lisa Berkman
- Harvard Centre for Population and Development Studies, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
| | - Jaya A George
- Department of Chemical Pathology, University of the Witwatersrand, Johannesburg, South Africa
- Department of Chemical Pathology, National Health Laboratory Service, Johannesburg, South Africa
| | - F Xavier Gómez-Olivé
- MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Jennifer Manne-Goehler
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Joshua A Salomon
- Centre for Health Policy, Stanford University, Stanford, California, USA
| | - Ryan G Wagner
- MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Thomas A Gaziano
- Centre for Health Decision Science, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
- Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Stephen M Tollman
- MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
- INDEPTH Network, Accra, Ghana
- Umeå Centre for Global Health Research, Division of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Anne R Cappola
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
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Boua PR, Soo CC, Debpuur C, Maposa I, Nkoana S, Mohamed SF, Choma S, Oduro A, Asiki G, Micklesfield LK, Gómez-Olivé FX, Sorgho H, Mall S, Ramsay M. Prevalence and socio-demographic correlates of tobacco and alcohol use in four sub-Saharan African countries: a cross-sectional study of middle-aged adults. BMC Public Health 2021; 21:1126. [PMID: 34118914 PMCID: PMC8196437 DOI: 10.1186/s12889-021-11084-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 05/18/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Substance misuse is a global public health problem. In addition to social and economic concerns, consumption of tobacco and alcohol is associated with susceptibility to cardiovascular, respiratory, and infectious diseases, cancers, and risk of transition to substance use disorders. African data suggest regional differences in the prevalence and patterns of substance use, but a number of key questions remain. This cross-sectional population-based study of middle-aged adults aims to examine prevalence and socio-demographic correlates of substance use in four sub-Saharan African countries, in rural and urban settings. METHODS Participants aged between 40 and 60 years were recruited from six research centres as part of the Africa Wits-INDEPTH partnership for Genomic Research study. Data on patterns of tobacco and alcohol consumption was captured, and the latter further assessed using the CAGE (cut-annoyed-guilty-eye) questionnaire. RESULTS Data from 10,703 participants suggested that more men (68.4%) than women (33.3%) were current substance users. The prevalence of current smoking was significantly higher in men than in women (34.5% vs 2.1%, p < 0.001). Smokeless tobacco was used more by women than men (14.4% vs 5.3%, p < 0.001). Current smoking was associated with alcohol consumption in men, and smoking cessation in men was associated with being a former drinker, having higher socio-economic status, and if married or cohabiting. Current alcohol consumption was higher in men, compared to women (60.3% vs 29.3%), and highest in men from Soweto (70.8%) and women from Nanoro (59.8%). The overall prevalence of problematic alcohol consumption among men was 18.9%, and women 7.3%. Men were significantly more likely to develop problematic drinking patterns, and this was more common in those who were divorced or widowed, and in current smokers. CONCLUSIONS Regional variation in the patterns and prevalence of substance use was observed across study sites, and in rural and urban settings. The high levels of substance use recorded in this study are of concern due to the increased risk of associated morbidities. Further longitudinal data will be valuable in determining trends in substance misuse in Africa.
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Affiliation(s)
- Palwende Romuald Boua
- Institut de Recherche en Sciences de la Santé, Clinical Research Unit of Nanoro, Nanoro, Burkina Faso.
- Sydney Brenner Institute for Molecular Bioscience and Division of Human Genetics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
| | - Cassandra Claire Soo
- Sydney Brenner Institute for Molecular Bioscience and Division of Human Genetics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Cornelius Debpuur
- Navrongo Health Research Centre, Biomedical Sciences Department, Navrongo, Ghana
| | - Innocent Maposa
- Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Shai Nkoana
- DIMAMO, Department of Pathology and Medical Sciences, School of Health Care Sciences, Faculty of Health Sciences, University of Limpopo, Polokwane, South Africa
| | - Shukri F Mohamed
- Health and Systems for Health Unit, African Population and Health Research Center (APHRC), Nairobi, Kenya
| | - Solomon Choma
- DIMAMO, Department of Pathology and Medical Sciences, School of Health Care Sciences, Faculty of Health Sciences, University of Limpopo, Polokwane, South Africa
| | - Abraham Oduro
- Navrongo Health Research Centre, Biomedical Sciences Department, Navrongo, Ghana
| | - Gershim Asiki
- Health and Systems for Health Unit, African Population and Health Research Center (APHRC), Nairobi, Kenya
| | - Lisa K Micklesfield
- MRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Francesc Xavier Gómez-Olivé
- MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Hermann Sorgho
- Institut de Recherche en Sciences de la Santé, Clinical Research Unit of Nanoro, Nanoro, Burkina Faso
| | - Sumaya Mall
- Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Michèle Ramsay
- Sydney Brenner Institute for Molecular Bioscience and Division of Human Genetics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Nyirenda M. Assessment of cardiovascular disease risks using Framingham risk scores (FRS) in HIV-positive and HIV-negative older adults in South Africa. Prev Med Rep 2021; 22:101352. [PMID: 33816089 PMCID: PMC8010471 DOI: 10.1016/j.pmedr.2021.101352] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 02/23/2021] [Accepted: 02/26/2021] [Indexed: 01/28/2023] Open
Abstract
The relationship between HIV and cardiovascular diseases (CVDs) remains complex. The aim of this study was to estimate the 10-year CVD risk among HIV-positive and HIV-negative people. The validated Framingham Risk Score (FRS) based on the Framingham Heart study was used to predict the CVD risk. Data for this analysis came from a 2016 cross-sectional study of South African community-dwelling older adults (≥50 years). Logistic regression models were constructed to assess the association between CVD risk and HIV. 403 respondents with a mean age 60 (SD = 6.7) years were enrolled, of whom 70% were female, 75% black African, 21.9% smokers, 77.2% never did any vigorous physical activity, and 17% were HIV-positive. The average 10-year CVD risk was 17%; significantly higher in men than women (23.2 vs 14.3%, p < 0.001). Overall, 33% had low CVD risk (FRS < 10%), 39% intermediate (FRS 10-19%) and 28% high risk (FRS ≥ 20%). Furthermore, participants who were HIV-positive were less likely than HIV-negative participants to have high CVD risk (aOR 0.27, 95% CI 0.11-0.66, p = 0.004). These findings of HIV-positive respondents having lower CVD risk than HIV-negative respondents could be due to three issues i) HIV-positive people having lesser cardio-metabolic disease risk factors; ii) possibly higher health care utilization by HIV-positive people; and/or iii) the neglect of HIV-negative people in HIV focused health systems. Periodic cardiovascular disease monitoring using tools like the Framingham Risk Scores is needed. Furthermore, studies with more robust designs are needed to further elucidate the relationship between HIV and CVD risks in HIV endemic sub-Saharan Africa.
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Affiliation(s)
- Makandwe Nyirenda
- South African Medical Research Council, Burden of Disease Research Unit, Francie Van Zijl Drive, Cape Town, South Africa
- University of KwaZulu-Natal, School of Public Health and Nursing, Howard Campus, Durban, South Africa
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60
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Sengupta D, Choudhury A, Fortes-Lima C, Aron S, Whitelaw G, Bostoen K, Gunnink H, Chousou-Polydouri N, Delius P, Tollman S, Gómez-Olivé FX, Norris S, Mashinya F, Alberts M, Hazelhurst S, Schlebusch CM, Ramsay M. Genetic substructure and complex demographic history of South African Bantu speakers. Nat Commun 2021; 12:2080. [PMID: 33828095 PMCID: PMC8027885 DOI: 10.1038/s41467-021-22207-y] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 02/10/2021] [Indexed: 02/01/2023] Open
Abstract
South Eastern Bantu-speaking (SEB) groups constitute more than 80% of the population in South Africa. Despite clear linguistic and geographic diversity, the genetic differences between these groups have not been systematically investigated. Based on genome-wide data of over 5000 individuals, representing eight major SEB groups, we provide strong evidence for fine-scale population structure that broadly aligns with geographic distribution and is also congruent with linguistic phylogeny (separation of Nguni, Sotho-Tswana and Tsonga speakers). Although differential Khoe-San admixture plays a key role, the structure persists after Khoe-San ancestry-masking. The timing of admixture, levels of sex-biased gene flow and population size dynamics also highlight differences in the demographic histories of individual groups. The comparisons with five Iron Age farmer genomes further support genetic continuity over ~400 years in certain regions of the country. Simulated trait genome-wide association studies further show that the observed population structure could have major implications for biomedical genomics research in South Africa.
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Affiliation(s)
- Dhriti Sengupta
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Ananyo Choudhury
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Cesar Fortes-Lima
- Human Evolution, Department of Organismal Biology, Evolutionary Biology Centre, Uppsala University, Uppsala, Sweden
| | - Shaun Aron
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Gavin Whitelaw
- KwaZulu-Natal Museum, Pietermaritzburg, South Africa
- School of Geography, Archaeology & Environmental Studies, University of the Witwatersrand, Johannesburg, South Africa
| | - Koen Bostoen
- UGent Centre for Bantu Studies, Department of Languages and Cultures, Ghent University, Ghent, Belgium
| | - Hilde Gunnink
- UGent Centre for Bantu Studies, Department of Languages and Cultures, Ghent University, Ghent, Belgium
| | - Natalia Chousou-Polydouri
- Department of Comparative Linguistic Science and Center for the Interdisciplinary Study of Language Evolution, University of Zürich, Zürich, Switzerland
| | - Peter Delius
- Department of History, University of the Witwatersrand, Johannesburg, South Africa
| | - Stephen Tollman
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - F Xavier Gómez-Olivé
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Shane Norris
- MRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Felistas Mashinya
- Department of Pathology and Medical Sciences; School of Health Care Sciences, Faculty of Health Sciences, University of Limpopo, Polokwane, South Africa
| | - Marianne Alberts
- Department of Pathology and Medical Sciences; School of Health Care Sciences, Faculty of Health Sciences, University of Limpopo, Polokwane, South Africa
| | - Scott Hazelhurst
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- School of Electrical and Information Engineering, University of the Witwatersrand, Johannesburg, South Africa
| | - Carina M Schlebusch
- Human Evolution, Department of Organismal Biology, Evolutionary Biology Centre, Uppsala University, Uppsala, Sweden
- SciLifeLab, Uppsala, Sweden
- Palaeo-Research Institute, University of Johannesburg, Johannesburg, South Africa
| | - Michèle Ramsay
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
- Division of Human Genetics, National Health Laboratory Service and School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
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Paximadis M, Picton ACP, Sengupta D, Ramsay M, Puren A, Tiemessen CT. Interleukin-8 genetic diversity, haplotype structure and production differ in two ethnically distinct South African populations. Cytokine 2021; 143:155489. [PMID: 33814271 DOI: 10.1016/j.cyto.2021.155489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 10/14/2020] [Accepted: 02/28/2021] [Indexed: 11/16/2022]
Abstract
A single nucleotide polymorphism (SNP), 251 bases upstream from the IL-8 transcription start (-251A>T, rs4073), has been extensively investigated in cancers and inflammatory and infectious diseases in predominantly European and Asian populations. We sequenced the IL-8 gene of 109 black and 32 white South African (SA) individuals and conducted detailed characterization of gene variation and haplotype structure. IL-8 production in phytohaemagglutinin (PHA)-stimulated peripheral blood mononuclear cells (PBMCs) of a subset (black: N = 22; white: N = 32) of these individuals was measured using ELISA. Select variants were genotyped for additional black individuals (N = 141), and data from the 1000 Genomes Project were used for haplotype analysis and comparative purposes. In white individuals, the -251A>T SNP formed part of a prevalent six-variant haplotype [haplotype frequency (HF): 61%], Hap-1C, involving the following variants: -251A>T; +394T>G (rs2227307); +780C>T (rs2227306); +1240->A (rs2227541); +1635C>T (rs2227543) and +2770A>T (rs2227543). Hap-1C (-251T+394T+780C+1240+A+1635C+2770A) was composed of two three-variant sub-haplotypes [Hap-1Ca: -251T+394T+1240+A; Hap-1Cb: +780C+1635C+2770A) sharing similarities with haplotypes identified in the black population. Hap-1C was found to be present in European, East and South Asian populations. Four haplotypes were identified in the black population with the two prevalent haplotypes each comprised of two variants: Hap-1B [-251A>T and +1240->A; -251T+1240+A; HF: 14%] and Hap-2B [-743T>C (rs2227532) and +2452A>C (rs2227545); -743C+2452C; HF: 13%]. Populations did not differ in unstimulated PBMC IL-8 production. Upon PHA stimulation, PBMCs from white individuals produced more IL-8 (P = 0.04), suggesting the -251T allele is responsible for higher production, however further analysis revealed that Hap-1C (and constituent sub-haplotypes), did not associate with IL-8 production. Populations did however differ in monocyte number with the white population having significantly more monocytes compared to the black population (P = 0.025), and furthermore monocyte number strongly correlated with IL-8 production in both population groups (black: p = 0.0002, r = 0.71; white: P = 0.0005, r = 0.59). Hap-1B, Hap-2B, and a SNP located one base pair upstream of the IL-8 ATG start codon, +100C>T SNP (rs2227538), all associated with higher IL-8 production in the black population - individuals harbouring at least one of these haplotypes/variant associated with higher IL-8 production (P = 0.003) compared to individuals without. The black population was enriched for individuals harbouring Hap-1B and/or Hap-2B compared to the 1000 Genomes project sub-Saharan African population (P = 0.006), suggesting that SA black individuals may be high IL-8 producers. Given the paucity of IL-8-related studies that have been conducted in populations from sub-Saharan Africa, this study has significantly increased our understanding of this important chemokine in the South African population.
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Affiliation(s)
- Maria Paximadis
- Centre for HIV and STIs, National Institute for Communicable Diseases, Johannesburg, South Africa; Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
| | - Anabela C P Picton
- Centre for HIV and STIs, National Institute for Communicable Diseases, Johannesburg, South Africa; Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Dhriti Sengupta
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Michele Ramsay
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Adrian Puren
- Centre for HIV and STIs, National Institute for Communicable Diseases, Johannesburg, South Africa; Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Caroline T Tiemessen
- Centre for HIV and STIs, National Institute for Communicable Diseases, Johannesburg, South Africa; Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Adiposity Phenotypes and Subclinical Atherosclerosis in Adults from Sub-Saharan Africa: An H3Africa AWI-Gen Study. Glob Heart 2021; 16:19. [PMID: 33833943 PMCID: PMC7977036 DOI: 10.5334/gh.863] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background: Obesity and adipose tissue distribution contribute to an increased risk of cardiovascular disease (CVD) by promoting atherosclerosis. This association has been poorly studied in sub–Saharan Africa (SSA) despite the rising prevalence of cardiovascular disease. Objectives: We determined the association between various adiposity phenotypes and carotid intima–media thickness (CIMT), a proxy of subclinical atherosclerosis, in a large SSA population. Methods: A population–based cross–sectional study was performed from 2013–2016 in Burkina Faso, Ghana, Kenya and South Africa. Body mass index (BMI), waist (WC), hip circumferences (HC), visceral (VAT) and subcutaneous adipose tissue (SCAT) using B-mode ultrasound were measured. Ultrasonography of left and right far wall CIMT of the common carotid artery was used as an indicator of subclinical atherosclerosis. Individual participant data meta–analyses were used to determine the associations between adiposity phenotypes and CIMT in the pooled sample while adjusted multivariable linear regression analyses were used for site specific analyses. Results: Data were obtained from 9,010 adults (50.3% women and a mean age of 50± 6years). Men had higher levels of visceral fat than women while women had higher BMI, waist and hip circumference and subcutaneous fat than men at all sites except Burkina Faso. In the pooled analyses, BMI (β–value [95% CIs]: 19.5 [16.8, 22.3] μm) showed the strongest relationship with CIMT followed by VAT (5.86 [4.65, 7.07] μm), SCAT (5.00 [2.85, 7.15] μm), WC (1.27 [1.09, 1.44] μm) and HC (1.23 [1.04, 1.42] μm). Stronger associations were observed in men than in women. Conclusion: Obesity within SSA will likely result in higher levels of atherosclerosis and promote the occurrence of cardio- and cerebrovascular events, especially in males, unless addressed through primary prevention of obesity in both rural and urban communities across Africa. The inverse association of VAT with CIMT in Burkina Faso and Ghana requires further investigation. Highlights
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63
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Agongo G, Debpuur C, Amenga-Etego L, Nonterah EA, Kaburise MB, Oduro A, Ramsay M, Tindana P. Community engagement and feedback of results in the H3Africa AWI-Gen project: Experiences from the Navrongo Demographic and Health Surveillance site in Northern Ghana. AAS Open Res 2021; 4:15. [PMID: 33959702 PMCID: PMC8063542 DOI: 10.12688/aasopenres.13081.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2020] [Indexed: 11/20/2022] Open
Abstract
Community and Public engagement (CE) have gained traction as an ethical best practice for the conduct of genomics research, particularly in the context of Africa. In the past 10 years, there has been growing scholarship on the value and practice of engaging key stakeholders including communities involved in genomics research. However, not much has been documented on how research teams, particularly in international collaborative research projects, are navigating the complex process of engagement including the return of key research findings. This paper is part of a series of papers describing the CE processes used in the AWI-Gen study sites. We describe the key processes of engagement, challenges encountered and the major lessons learned. We pay particular attention to the experiences in returning research results to participants and communities within the Demographic and Health Surveillance site in northern Ghana.
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Affiliation(s)
| | | | - Lucas Amenga-Etego
- West African Centre for Cell Biology and Infectious Pathogens, Department of Biochemistry, University of Ghana, Accra, Ghana
| | - Engelbert A Nonterah
- Navrongo Health Research Centre, Navrongo, Ghana.,Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | | | | | - Michele Ramsay
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of Witswatersrand, Johannesburg, South Africa
| | - Paulina Tindana
- Health Policy, Plannng and Management, School of Public Health, College of Health Sciences, University of Ghana, Legon/Accra, Ghana
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64
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Nonterah EA, Crowther NJ, Oduro A, Agongo G, Micklesfield LK, Boua PR, Choma SSR, Mohamed SF, Sorgho H, Tollman SM, Norris SA, Raal FJ, Grobbee DE, Ramsay M, Bots ML, Klipstein-Grobusch K. Poor cardiovascular health is associated with subclinical atherosclerosis in apparently healthy sub-Saharan African populations: an H3Africa AWI-Gen study. BMC Med 2021; 19:30. [PMID: 33563289 PMCID: PMC7874493 DOI: 10.1186/s12916-021-01909-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 01/13/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The cardiovascular health index (CVHI) introduced by the American Heart Association is a valid, accessible, simple, and translatable metric for monitoring cardiovascular health in a population. Components of the CVHI include the following seven cardiovascular risk factors (often captured as life's simple 7): smoking, dietary intake, physical activity, body mass index, blood pressure, glucose, and total cholesterol. We sought to expand the evidence for its utility to under-studied populations in sub-Saharan Africa, by determining its association with common carotid intima-media thickness (CIMT). METHODS We conducted a cross-sectional study involving 9011 participants drawn from Burkina Faso, Ghana, Kenya, and South Africa. We assessed established classical cardiovascular risk factors and measured carotid intima-media thickness of the left and right common carotid arteries using B-mode ultrasonography. Adjusted multilevel mixed-effect linear regression was used to determine the association of CVHI with common CIMT. In the combined population, an individual participant data meta-analyses random-effects was used to conduct pooled comparative sub-group analyses for differences between countries, sex, and socio-economic status. RESULTS The mean age of the study population was 51 ± 7 years and 51% were women, with a mean common CIMT of 637 ± 117 μm and CVHI score of 10.3 ± 2.0. Inverse associations were found between CVHI and common CIMT (β-coefficients [95% confidence interval]: Burkina Faso, - 6.51 [- 9.83, - 3.20] μm; Ghana, - 5.42 [- 8.90, - 1.95]; Kenya, - 6.58 [- 9.05, - 4.10]; and South Africa, - 7.85 [- 9.65, - 6.05]). Inverse relations were observed for women (- 4.44 [- 6.23, - 2.65]) and men (- 6.27 [- 7.91, - 4.64]) in the pooled sample. Smoking (p < 0.001), physical activity (p < 0.001), and hyperglycemia (p < 0.001) were related to CIMT in women only, while blood pressure and obesity were related to CIMT in both women and men (p < 0.001). CONCLUSION This large pan-African population study demonstrates that CVHI is a strong marker of subclinical atherosclerosis, measured by common CIMT and importantly demonstrates that primary prevention of atherosclerotic cardiovascular disease in this understudied population should target physical activity, smoking, obesity, hypertension, and hyperglycemia.
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Affiliation(s)
- Engelbert A Nonterah
- Clinical Sciences Department, Navrongo Health Research Centre, Ghana Health Service, Navrongo, Ghana. .,Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
| | - Nigel J Crowther
- Department of Chemical Pathology, National Health Laboratory Service, Faculty of Health Services, University of the Witwatersrand, Johannesburg, South Africa
| | - Abraham Oduro
- Clinical Sciences Department, Navrongo Health Research Centre, Ghana Health Service, Navrongo, Ghana
| | - Godfred Agongo
- Clinical Sciences Department, Navrongo Health Research Centre, Ghana Health Service, Navrongo, Ghana
| | - Lisa K Micklesfield
- MRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Palwendé R Boua
- Institut de Recherché en Sciences de la Santé, Clinical Research Unit of Nanoro, Nanoro, Burkina Faso
| | - Solomon S R Choma
- DIMAMO Health Demographic Surveillance Site, Department of Pathology and Medical Sciences, School of Health Care Sciences, Faculty of Health Sciences, University of Limpopo, Polokwane, South Africa
| | | | - Herman Sorgho
- Institut de Recherché en Sciences de la Santé, Clinical Research Unit of Nanoro, Nanoro, Burkina Faso
| | - Stephen M Tollman
- MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Shane A Norris
- MRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Frederick J Raal
- Carbohydrate and Lipid Metabolism Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Diederick E Grobbee
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Michelé Ramsay
- Sydney Brenner Institute of Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Michiel L Bots
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Kerstin Klipstein-Grobusch
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.,Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Multimorbidity from Chronic Conditions among Adults in Urban Slums: The AWI-Gen Nairobi Site Study Findings. Glob Heart 2021; 16:6. [PMID: 33598386 PMCID: PMC7824985 DOI: 10.5334/gh.771] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Background: In the era of double burden of infectious and non-communicable diseases in sub-Saharan Africa, the burden of multimorbidity is likely to be common. However, there is limited evidence on the burden and its associated factors in the sub-Saharan African context. Objective: The aim of this study was to determine the levels and identify determinants of multimorbidity from chronic conditions in two urban slums in Nairobi. Methods: Data collected from 2003 study participants aged 40–60 years in two urban slums of the Nairobi Urban Health and Demographic Surveillance System in 2015 were used. Using self-report, anthropometry and key biomarkers, data on 16 conditions including chronic diseases, behavioral disorders and metabolic abnormalities were gathered. Lifetime multimorbidity defined by the occurrence of at least two chronic conditions in an individual at any time during their life course was computed. Factors associated with lifetime multimorbidity were identified using multiple logistic regression. Findings: A total of 2,081 chronic conditions were identified among 1,302 individuals. While 701 (35.0%) had no chronic condition, single morbidity was reported in 726 (36.2%) of the study population. The overall prevalence of lifetime multimorbidity was 28.7%. The prevalence of dyads and triads of simultaneous occurrences of conditions (episodic multimorbidity) was 20.8% and 6.1%, respectively. Single morbidity was positively associated with gender and alcohol consumption; and negatively associated with employment. Women, older people, the unemployed, current smokers and current alcohol consumers had higher levels of lifetime multimorbidity in the study population. Interpretation: The findings of this study indicate that a considerable proportion of adults living in urban slums experience multimorbidity from chronic conditions. Further studies with a better rigor to establish temporal associations between socio-demographic factors and the occurrence of chronic conditions are needed to explore the impacts and implications on health status and health system.
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Taiwo RO, Ipadeola J, Yusuf T, Fagbohunlu F, Jenfa G, Adebamowo SN, Adebamowo CA. Qualitative study of comprehension of heritability in genomics studies among the Yoruba in Nigeria. BMC Med Ethics 2020; 21:124. [PMID: 33298068 PMCID: PMC7726892 DOI: 10.1186/s12910-020-00567-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 12/03/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND With growth of genomics research in Africa, concern has arisen about comprehension and adequacy of informed consent given the highly technical terms used in this field. We therefore decided to study whether there are linguistic and cultural concepts used to communicate heritability of characters, traits and diseases in an indigenous African population. METHODS We conducted Focus Group Discussions among 115 participants stratified by sex, age and socio-economic status and Key Informant Interviews among 25 stakeholders and Key Opinion Leaders among Yoruba living in Ibadan, Nigeria. We used Atlas-ti v.8.3.17 software to analyze the data, using thematic approach. RESULTS The study participants identified several linguistic and cultural concepts including words, proverbs, and aphorisms that are used to describe heritable characters, traits and diseases in their local dialect. These included words that can be appropriated to describe dominant and recessive traits, variations in penetrance and dilution of strength of heritable characteristics by time and inter-marriage. They also suggested that these traits are transmitted by "blood", and specific partner's blood may be stronger than the other regardless of sex. CONCLUSIONS Indigenous Yoruba populations have words and linguistic concepts that describe the heritability of characters, traits and diseases which can be appropriated to improve comprehension and adequacy of informed consent in genomics research. Our methods are openly available and can be used by genomic researchers in other African communities.
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Affiliation(s)
- Rasheed O Taiwo
- Division of Research Ethics, Center for Bioethics and Research, Ibadan, Nigeria
| | - John Ipadeola
- Division of Research Ethics, Center for Bioethics and Research, Ibadan, Nigeria
| | - Temilola Yusuf
- Division of Research Ethics, Center for Bioethics and Research, Ibadan, Nigeria
| | - Faith Fagbohunlu
- Division of Research Ethics, Center for Bioethics and Research, Ibadan, Nigeria
| | - Gbemisola Jenfa
- Division of Research Ethics, Center for Bioethics and Research, Ibadan, Nigeria
| | - Sally N Adebamowo
- Division of Research Ethics, Center for Bioethics and Research, Ibadan, Nigeria.,Department of Epidemiology and Public Health, Greenebaum Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Clement A Adebamowo
- Division of Research Ethics, Center for Bioethics and Research, Ibadan, Nigeria. .,Department of Epidemiology and Public Health, Greenebaum Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, MD, USA. .,Institute of Human Virology, Abuja, Nigeria. .,Institute of Human Virology Building, School of Medicine, University of Maryland, 725 West Lombard Street, Baltimore, MD, 21201, USA.
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67
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Ceballos FC, Hazelhurst S, Clark DW, Agongo G, Asiki G, Boua PR, Xavier Gómez-Olivé F, Mashinya F, Norris S, Wilson JF, Ramsay M. Autozygosity influences cardiometabolic disease-associated traits in the AWI-Gen sub-Saharan African study. Nat Commun 2020; 11:5754. [PMID: 33188201 PMCID: PMC7666169 DOI: 10.1038/s41467-020-19595-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 10/12/2020] [Indexed: 11/10/2022] Open
Abstract
The analysis of the effects of autozygosity, measured as the change of the mean value of a trait among offspring of genetic relatives, reveals the existence of directional dominance or overdominance. In this study we detect evidence of the effect of autozygosity in 4 out of 13 cardiometabolic disease-associated traits using data from more than 10,000 sub-Saharan African individuals recruited from Ghana, Burkina Faso, Kenya and South Africa. The effect of autozygosity on these phenotypes is found to be sex-related, with inbreeding having a significant decreasing effect in men but a significant increasing effect in women for several traits (body mass index, subcutaneous adipose tissue, low-density lipoproteins and total cholesterol levels). Overall, the effect of inbreeding depression is more intense in men. Differential effects of inbreeding depression are also observed between study sites with different night-light intensity used as proxy for urban development. These results suggest a directional dominant genetic component mediated by environmental interactions and sex-specific differences in genetic architecture for these traits in the Africa Wits-INDEPTH partnership for Genomic Studies (AWI-Gen) cohort.
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Affiliation(s)
- Francisco C Ceballos
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Scott Hazelhurst
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- School of Electrical & Information Engineering, University of the Witwatersrand, Johannesburg, South Africa
| | - David W Clark
- Centre for Global Health Research, Usher Institute, University of Edinburgh, Teviot Place, Edinburgh, EH8 9AG, UK
| | - Godfred Agongo
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Navrongo Health Research Centre, Navrongo, Ghana
| | - Gershim Asiki
- African Population and Health Research Center, Nairobi, Kenya
| | - Palwende R Boua
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Faculty of Health Sciences University of the Witwatersrand, Division of Human Genetics, National Health Laboratory Service and School of Pathology, Johannesburg, South Africa
- Clinical Research Unit of Nanoro, Institut de Recherche en Sciences de la Santé, Nanoro, Burkina Faso
| | - F Xavier Gómez-Olivé
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Felistas Mashinya
- Department of Pathology and Medical Science, School of Health Care Sciences, Faculty of Health Sciences, University of Limpopo, Polokwane, South Africa
| | - Shane Norris
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Faculty of Health Sciences University of the Witwatersrand, Division of Human Genetics, National Health Laboratory Service and School of Pathology, Johannesburg, South Africa
| | - James F Wilson
- Centre for Global Health Research, Usher Institute, University of Edinburgh, Teviot Place, Edinburgh, EH8 9AG, UK
- Medical Research Council Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Western General Hospital, Edinburgh, EH4 2XU, UK
| | - Michèle Ramsay
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
- Faculty of Health Sciences University of the Witwatersrand, Division of Human Genetics, National Health Laboratory Service and School of Pathology, Johannesburg, South Africa.
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68
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Oduaran OH, Tamburini FB, Sahibdeen V, Brewster R, Gómez-Olivé FX, Kahn K, Norris SA, Tollman SM, Twine R, Wade AN, Wagner RG, Lombard Z, Bhatt AS, Hazelhurst S. Gut microbiome profiling of a rural and urban South African cohort reveals biomarkers of a population in lifestyle transition. BMC Microbiol 2020; 20:330. [PMID: 33129264 PMCID: PMC7603784 DOI: 10.1186/s12866-020-02017-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 10/19/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Comparisons of traditional hunter-gatherers and pre-agricultural communities in Africa with urban and suburban Western North American and European cohorts have clearly shown that diet, lifestyle and environment are associated with gut microbiome composition. Yet, little is known about the gut microbiome composition of most communities in the very diverse African continent. South Africa comprises a richly diverse ethnolinguistic population that is experiencing an ongoing epidemiological transition and concurrent spike in the prevalence of obesity, largely attributed to a shift towards more Westernized diets and increasingly inactive lifestyle practices. To characterize the microbiome of African adults living in more mainstream lifestyle settings and investigate associations between the microbiome and obesity, we conducted a pilot study, designed collaboratively with community leaders, in two South African cohorts representative of urban and transitioning rural populations. As the rate of overweight and obesity is particularly high in women, we collected single time-point stool samples from 170 HIV-negative women (51 at Soweto; 119 at Bushbuckridge), performed 16S rRNA gene sequencing on these samples and compared the data to concurrently collected anthropometric data. RESULTS We found the overall gut microbiome of our cohorts to be reflective of their ongoing epidemiological transition. Specifically, we find that geographical location was more important for sample clustering than lean/obese status and observed a relatively higher abundance of the Melainabacteria, Vampirovibrio, a predatory bacterium, in Bushbuckridge. Also, Prevotella, despite its generally high prevalence in the cohorts, showed an association with obesity. In comparisons with benchmarked datasets representative of non-Western populations, relatively higher abundance values were observed in our dataset for Barnesiella (log2fold change (FC) = 4.5), Alistipes (log2FC = 3.9), Bacteroides (log2FC = 4.2), Parabacteroides (log2FC = 3.1) and Treponema (log2FC = 1.6), with the exception of Prevotella (log2FC = - 4.7). CONCLUSIONS Altogether, this work identifies putative microbial features associated with host health in a historically understudied community undergoing an epidemiological transition. Furthermore, we note the crucial role of community engagement to the success of a study in an African setting, the importance of more population-specific studies to inform targeted interventions as well as present a basic foundation for future research.
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Affiliation(s)
- O. H. Oduaran
- Sydney Brenner Institute for Molecular Bioscience, University of the Witwatersrand, Johannesburg, South Africa
- Division of Human Genetics, National Health Laboratory Service, and School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - F. B. Tamburini
- Department of Genetics, Stanford University, Stanford, CA USA
| | - V. Sahibdeen
- Division of Human Genetics, National Health Laboratory Service, and School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - R. Brewster
- School of Medicine, Stanford University, Stanford, CA USA
| | - F. X. Gómez-Olivé
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- INDEPTH Network, East Legon, Accra, Ghana
| | - K. Kahn
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- INDEPTH Network, East Legon, Accra, Ghana
| | - S. A. Norris
- SAMRC Developmental Pathways for Health Research Unit, Department of Paediatrics, University of the Witwatersrand, Johannesburg, South Africa
- School of Human Development and Health, University of Southampton, Southampton, UK
| | - S. M. Tollman
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- INDEPTH Network, East Legon, Accra, Ghana
| | - R. Twine
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - A. N. Wade
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - R. G. Wagner
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- INDEPTH Network, East Legon, Accra, Ghana
| | - Z. Lombard
- Division of Human Genetics, National Health Laboratory Service, and School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - A. S. Bhatt
- Department of Genetics, Stanford University, Stanford, CA USA
- School of Medicine, Stanford University, Stanford, CA USA
- Department of Medicine (Hematology), Stanford University, Stanford, CA USA
| | - S. Hazelhurst
- Sydney Brenner Institute for Molecular Bioscience, University of the Witwatersrand, Johannesburg, South Africa
- School of Electrical and Information Engineering, University of the Witwatersrand, Johannesburg, South Africa
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69
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Agongo G, Amenga-Etego L, Nonterah EA, Debpuur C, Choudhury A, Bentley AR, Oduro AR, Rotimi CN, Crowther NJ, Ramsay M, H Africa. Candidate Gene Analysis Reveals Strong Association of CETP Variants With High Density Lipoprotein Cholesterol and PCSK9 Variants With Low Density Lipoprotein Cholesterol in Ghanaian Adults: An AWI-Gen Sub-Study. Front Genet 2020; 11:456661. [PMID: 33193594 PMCID: PMC7661969 DOI: 10.3389/fgene.2020.456661] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 09/30/2020] [Indexed: 02/06/2023] Open
Abstract
Variations in lipid levels are attributed partly to genetic factors. Genome-wide association studies (GWASs) mainly performed in European, African American and Asian cohorts have identified variants associated with LDL-C, HDL-C, total cholesterol (TC) and triglycerides (TG), but few studies have been performed in sub-Saharan Africans. This study evaluated the effect of single nucleotide variants (SNVs) in eight candidate loci (ABCA1, LCAT, LPL, PON1, CETP, PCSK9, MVK, and MMAB) on lipid levels among 1855 Ghanaian adults. All lipid levels were measured directly using an automated analyser. DNA was extracted and genotyped using the H3Africa SNV array. Linear regression models were used to test the association between SNVs and log-transformed lipid levels, adjusting for sex, age and waist circumference. In addition Bonferroni correction was performed to account for multiple testing. Several variants of CETP, LCAT, PCSK9, and PON1 (MAF > 0.05) were associated with HDL-C, LDL-C and TC levels at p < 0.05. The lead variants for association with HDL-C were rs17231520 in CETP (β = 0.139, p < 0.0001) and rs1109166 in LCAT (β = −0.044, p = 0.028). Lower LDL-C levels were associated with an intronic variant in PCSK9 (rs11806638 [β = −0.055, p = 0.027]) and increased TC was associated with a variant in PON1 (rs854558 [β = 0.040, p = 0.020]). In silico functional analyses indicated that these variants likely influence gene function through their effect on gene transcription. We replicated a strong association between CETP variants and HDL-C and between PCSK9 variant and LDL-C in West Africans, with two potentially functional variants and identified three novel variants in linkage disequilibrium in PON1 which were associated with increasing TC levels in Ghanaians.
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Affiliation(s)
- Godfred Agongo
- Navrongo Health Research Centre, Navrongo, Ghana.,Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.,Division of Human Genetics, National Health Laboratory Service and School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Lucas Amenga-Etego
- Navrongo Health Research Centre, Navrongo, Ghana.,West African Centre for Cell Biology of Infectious Pathogens, Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Legon, Ghana
| | - Engelbert A Nonterah
- Navrongo Health Research Centre, Navrongo, Ghana.,Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, Netherlands
| | | | - Ananyo Choudhury
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Amy R Bentley
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, United States
| | | | - Charles N Rotimi
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, United States
| | - Nigel J Crowther
- Department of Chemical Pathology, National Health Laboratory Service and School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Michèle Ramsay
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.,Division of Human Genetics, National Health Laboratory Service and School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | | | - H Africa
- Navrongo Health Research Centre, Navrongo, Ghana.,Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.,Division of Human Genetics, National Health Laboratory Service and School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.,West African Centre for Cell Biology of Infectious Pathogens, Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Legon, Ghana.,Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, Netherlands.,Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, United States.,Department of Chemical Pathology, National Health Laboratory Service and School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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70
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Mashinya F, Alberts M, Mashaba RG, Tindana PO. Community engagement in Genomics research; Challenges and lessons learnt in the AWI-Gen study at Dikgale Health and Demographic Surveillance System (HDSS) Site, South Africa. AAS Open Res 2020. [DOI: 10.12688/aasopenres.13076.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
As health research often requires consent from participants and permission from community gate keepers, community engagement is considered an integral process of health research. Community engagement is also important in building trust between the research team and participants, gathering information on the needs and expectations of the community with respect to the project and present the community with an opportunity to gain more information on the goals of the research. Although there are published guidelines on how to conduct community engagement activities, the concept itself and the way in which it is put into practice is highly contextual. In this paper we reflect on the community engagement strategy used in the AWI-Gen Phase 1 study at the Dikgale Health and Demographic Surveillance System (Dikgale HDSS) site, the challenges encountered throughout the research process and the lessons learnt. Lastly, we highlight possible improvements to the CE strategic framework for AWI-Gen Phase 2 in Dikgale HDSS that may enhance the participation of the community.
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71
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da Rocha J, Othman H, Tiemessen CT, Botha G, Ramsay M, Masimirembwa C, Adebamowo C, Choudhury A, Brandenburg JT, Matshaba M, Simo G, Gamo FJ, Hazelhurst S. G6PD variant distribution in sub-Saharan Africa and potential risks of using chloroquine/hydroxychloroquine based treatments for COVID-19. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2020:2020.05.27.20114066. [PMID: 32577690 PMCID: PMC7302299 DOI: 10.1101/2020.05.27.20114066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Chloroquine/hydroxychloroquine have been proposed as potential treatments for COVID-19. These drugs have warning labels for use in individuals with glucose-6-phosphate dehydrogenase (G6PD) deficiency. Analysis of whole-genome sequence data of 458 individuals from sub-Saharan Africa showed significant G6PD variation across the continent. We identified nine variants, of which four are potentially deleterious to G6PD function, and one (rs1050828) that is known to cause G6PD deficiency. We supplemented data for the rs1050828 variant with genotype array data from over 11,000 Africans. Although this variant is common in Africans overall, large allele frequency differences exist between sub-populations. African sub-populations in the same country can show significant differences in allele frequency (e.g. 16.0% in Tsonga vs 0.8% in Xhosa, both in South Africa, ρ=2.4×10 -3 ). The high prevalence of variants in the G6PD gene found in this analysis suggests that it may be a significant interaction factor in clinical trials of chloroquine and hydrochloroquine for treatment of COVID-19 in Africans.
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Affiliation(s)
- Jorge da Rocha
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Division of Human Genetics, National Health Laboratory Service, and School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Houcemeddine Othman
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Caroline T. Tiemessen
- Centre for HIV and STIs, National Institute for Communicable Diseases, National Health Laboratory Services and Faculty of Health Sciences, University of the Witwatersrand, Johannesburg South Africa
| | - Gerrit Botha
- Computational Biology Division and H3ABioNet, Department of Integrative Biomedical Sciences, University of Cape Town, South Africa
| | - Michèle Ramsay
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Division of Human Genetics, National Health Laboratory Service, and School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Collen Masimirembwa
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Clement Adebamowo
- Institute for Human Virology, Abuja, Nigeria
- Institute of Human Virology and Greenebaum Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, MD
| | - Ananyo Choudhury
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Jean-Tristan Brandenburg
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Mogomotsi Matshaba
- Botswana-Baylor Children’s Clinical Center of Excellence, Gaborone, Botswana
- Baylor College of Medicine, Houston, United States
| | - Gustave Simo
- Molecular Parasitology and Entomology Unit, Department of Biochemistry, Faculty of Science, University of Dschang, Dschang, Cameroon
| | | | - Scott Hazelhurst
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- School of Electrical & Information Engineering, University of the Witwatersrand, Johannesburg, South Africa
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72
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Akpa OM, Made F, Ojo A, Ovbiagele B, Adu D, Motala AA, Mayosi BM, Adebamowo SN, Engel ME, Tayo B, Rotimi C, Salako B, Akinyemi R, Gebregziabher M, Sarfo F, Wahab K, Agongo G, Alberts M, Ali SA, Asiki G, Boua RP, Gómez-Olivé FX, Mashinya F, Micklesfield L, Mohamed SF, Nonterah EA, Norris SA, Sorgho H, Tollman S, Parekh RS, Chishala C, Ekoru K, Waddy SP, Peprah E, Mensah GA, Wiley K, Troyer J, Ramsay M, Owolabi MO. Regional Patterns and Association Between Obesity and Hypertension in Africa: Evidence From the H3Africa CHAIR Study. Hypertension 2020; 75:1167-1178. [PMID: 32172619 PMCID: PMC7176339 DOI: 10.1161/hypertensionaha.119.14147] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 01/12/2020] [Accepted: 02/12/2020] [Indexed: 12/12/2022]
Abstract
Hypertension and obesity are the most important modifiable risk factors for cardiovascular diseases, but their association is not well characterized in Africa. We investigated regional patterns and association of obesity with hypertension among 30 044 continental Africans. We harmonized data on hypertension (defined as previous diagnosis/use of antihypertensive drugs or blood pressure [BP]≥140/90 mmHg/BP≥130/80 mmHg) and obesity from 30 044 individuals in the Cardiovascular H3Africa Innovation Resource across 13 African countries. We analyzed data from population-based controls and the Entire Harmonized Dataset. Age-adjusted and crude proportions of hypertension were compared regionally, across sex, and between hypertension definitions. Logit generalized estimating equation was used to determine the independent association of obesity with hypertension (P value <5%). Participants were 56% women; with mean age 48.5±12.0 years. Crude proportions of hypertension (at BP≥140/90 mmHg) were 47.9% (95% CI, 47.4-48.5) for Entire Harmonized Dataset and 42.0% (41.1-42.7) for population-based controls and were significantly higher for the 130/80 mm Hg threshold at 59.3% (58.7-59.9) in population-based controls. The age-adjusted proportion of hypertension at BP≥140/90 mmHg was the highest among men (33.8% [32.1-35.6]), in western Africa (34.7% [33.3-36.2]), and in obese individuals (43.6%; 40.3-47.2). Obesity was independently associated with hypertension in population-based controls (adjusted odds ratio, 2.5 [2.3-2.7]) and odds of hypertension in obesity increased with increasing age from 2.0 (1.7-2.3) in younger age to 8.8 (7.4-10.3) in older age. Hypertension is common across multiple countries in Africa with 11.9% to 51.7% having BP≥140/90 mmHg and 39.5% to 69.4% with BP≥130/80 mmHg. Obese Africans were more than twice as likely to be hypertensive and the odds increased with increasing age.
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Affiliation(s)
- Onoja M. Akpa
- From the Center for Genomic and Precision Medicine, College of Medicine, (O.M.A., B.S., R.A., M.O.O.), University of Ibadan, Ibadan, Nigeria
- Department of Epidemiology and Medical Statistics, College of Medicine (O.M.A.), University of Ibadan, Ibadan, Nigeria
- Institute of Cardiovascular Diseases, College of Medicine (O.M.A.), University of Ibadan, Ibadan, Nigeria
- Sydney Brenner Institute for Molecular Bioscience and Division of Human Genetics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa (O.M.A., F. Made, S.A.A., M.R.)
| | - Felix Made
- The Epidemiology and Surveillance Section, National Institute for Occupational Health, National Health Laboratory Services, Gauteng Region, South Africa (F. Made)
- Sydney Brenner Institute for Molecular Bioscience and Division of Human Genetics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa (O.M.A., F. Made, S.A.A., M.R.)
| | - Akinlolu Ojo
- Clinical research and global health initiatives, University of Arizona Health Sciences (A.O.)
| | - Bruce Ovbiagele
- Department of Neurology, University of California, San Francisco CA, USA (B.O.)
| | - Dwomoa Adu
- School of Medicine and Dentistry, University of Ghana, Accra, Ghana (D.A.)
| | - Ayesha A. Motala
- Department of Diabetes and Endocrinology, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa (A.A.M.)
| | - Bongani M. Mayosi
- Department of Medicine, Groote Schuur Hospital (B.M.M.), University of Cape Town, South Africa
| | - Sally N. Adebamowo
- Department of Epidemiology and Public Health, Greenebaum Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, MD, USA (S.N.A.)
| | - Mark E. Engel
- Division of Cardiology, Department of Medicine (M.E.E., C.C.), University of Cape Town, South Africa
| | - Bamidele Tayo
- Department of Preventive Medicine and Epidemiology, Loyola University Chicago Stritch School of Medicine, Maywood, IL (B.T.)
| | - Charles Rotimi
- Center for Research on Genomics and Global Health, NHGRI, NIH, Bethesda, MD, USA (C.R.)
| | - Babatunde Salako
- From the Center for Genomic and Precision Medicine, College of Medicine, (O.M.A., B.S., R.A., M.O.O.), University of Ibadan, Ibadan, Nigeria
| | - Rufus Akinyemi
- From the Center for Genomic and Precision Medicine, College of Medicine, (O.M.A., B.S., R.A., M.O.O.), University of Ibadan, Ibadan, Nigeria
| | - Mulugeta Gebregziabher
- Department of Public Health Sciences, Medical University of South Carolina, Charleston SC, USA (M.G.)
| | - Fred Sarfo
- Kwame Nkrumah University of Science and Technology, Kumasi, Ghana (F.S.)
| | - Kolawole Wahab
- Department of Medicine, University of Ilorin, Nigeria (K. Wahab)
| | - Godfred Agongo
- Navrongo Health Research Centre, Ghana (G. Agongo, E.A.N.)
| | - Marianne Alberts
- Department of Pathology and Medical Science, School of Health Care Sciences, Faculty of Health Sciences, University of Limpopo, Polokwane, South Africa (M.A., F. Mashinya)
| | - Stuart A. Ali
- Sydney Brenner Institute for Molecular Bioscience and Division of Human Genetics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa (O.M.A., F. Made, S.A.A., M.R.)
| | - Gershim Asiki
- African Population and Health Research Center, Nairobi, Kenya (G. Asiki, S.F.M.)
| | - Romuald P. Boua
- Institut de Recherche en Sciences de la Sante, Clinical Research Unit of Nanoro, Burkina Faso (R.P.B., H.S.)
| | - F. Xavier Gómez-Olivé
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa (F.X.G.-O., S.T.)
| | - Felistas Mashinya
- Department of Pathology and Medical Science, School of Health Care Sciences, Faculty of Health Sciences, University of Limpopo, Polokwane, South Africa (M.A., F. Mashinya)
| | - Lisa Micklesfield
- MRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa (L.M., S.A.N.)
| | - Shukri F. Mohamed
- African Population and Health Research Center, Nairobi, Kenya (G. Asiki, S.F.M.)
| | | | - Shane A. Norris
- MRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa (L.M., S.A.N.)
| | - Hermann Sorgho
- Institut de Recherche en Sciences de la Sante, Clinical Research Unit of Nanoro, Burkina Faso (R.P.B., H.S.)
| | - Stephen Tollman
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa (F.X.G.-O., S.T.)
| | - Rulan S. Parekh
- Departments of Pediatrics, Medicine and Epidemiology, Hospital for Sick Children, University Health Network and University of Toronto, Canada (R.S.P.)
| | - Chishala Chishala
- Division of Cardiology, Department of Medicine (M.E.E., C.C.), University of Cape Town, South Africa
| | - Kenneth Ekoru
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD (K.E.)
| | - Salina P. Waddy
- Department of Neurology, Atlanta Veterans Affairs Medical Center, Decatur, GA (S.P.W.)
| | - Emmanuel Peprah
- College of Global Public Health, New York University, New York, NY (E.P.)
| | - George A. Mensah
- Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute, NIH, Bethesda, MD (G.A.M.)
| | - Ken Wiley
- Division of Genomic Medicine, National Human Genome Research Institute, Bethesda, MD (K. Wiley)
| | - Jennifer Troyer
- Human Heredity and Health in Africa, Division of Genome Sciences (J.T.), National Institutes of Health, Bethesda, MD
| | - Michèle Ramsay
- Sydney Brenner Institute for Molecular Bioscience and Division of Human Genetics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa (O.M.A., F. Made, S.A.A., M.R.)
| | - Mayowa O. Owolabi
- From the Center for Genomic and Precision Medicine, College of Medicine, (O.M.A., B.S., R.A., M.O.O.), University of Ibadan, Ibadan, Nigeria
| | - as members of the CVD Working Group of the H3Africa Consortium
- From the Center for Genomic and Precision Medicine, College of Medicine, (O.M.A., B.S., R.A., M.O.O.), University of Ibadan, Ibadan, Nigeria
- Department of Epidemiology and Medical Statistics, College of Medicine (O.M.A.), University of Ibadan, Ibadan, Nigeria
- Institute of Cardiovascular Diseases, College of Medicine (O.M.A.), University of Ibadan, Ibadan, Nigeria
- The Epidemiology and Surveillance Section, National Institute for Occupational Health, National Health Laboratory Services, Gauteng Region, South Africa (F. Made)
- Sydney Brenner Institute for Molecular Bioscience and Division of Human Genetics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa (O.M.A., F. Made, S.A.A., M.R.)
- Clinical research and global health initiatives, University of Arizona Health Sciences (A.O.)
- Department of Neurology, University of California, San Francisco CA, USA (B.O.)
- School of Medicine and Dentistry, University of Ghana, Accra, Ghana (D.A.)
- Department of Diabetes and Endocrinology, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa (A.A.M.)
- Department of Medicine, Groote Schuur Hospital (B.M.M.), University of Cape Town, South Africa
- Division of Cardiology, Department of Medicine (M.E.E., C.C.), University of Cape Town, South Africa
- Department of Epidemiology and Public Health, Greenebaum Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, MD, USA (S.N.A.)
- Department of Preventive Medicine and Epidemiology, Loyola University Chicago Stritch School of Medicine, Maywood, IL (B.T.)
- Center for Research on Genomics and Global Health, NHGRI, NIH, Bethesda, MD, USA (C.R.)
- Department of Public Health Sciences, Medical University of South Carolina, Charleston SC, USA (M.G.)
- Kwame Nkrumah University of Science and Technology, Kumasi, Ghana (F.S.)
- Department of Medicine, University of Ilorin, Nigeria (K. Wahab)
- Navrongo Health Research Centre, Ghana (G. Agongo, E.A.N.)
- Department of Pathology and Medical Science, School of Health Care Sciences, Faculty of Health Sciences, University of Limpopo, Polokwane, South Africa (M.A., F. Mashinya)
- African Population and Health Research Center, Nairobi, Kenya (G. Asiki, S.F.M.)
- Institut de Recherche en Sciences de la Sante, Clinical Research Unit of Nanoro, Burkina Faso (R.P.B., H.S.)
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa (F.X.G.-O., S.T.)
- MRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa (L.M., S.A.N.)
- Departments of Pediatrics, Medicine and Epidemiology, Hospital for Sick Children, University Health Network and University of Toronto, Canada (R.S.P.)
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD (K.E.)
- Department of Neurology, Atlanta Veterans Affairs Medical Center, Decatur, GA (S.P.W.)
- College of Global Public Health, New York University, New York, NY (E.P.)
- Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute, NIH, Bethesda, MD (G.A.M.)
- Division of Genomic Medicine, National Human Genome Research Institute, Bethesda, MD (K. Wiley)
- Human Heredity and Health in Africa, Division of Genome Sciences (J.T.), National Institutes of Health, Bethesda, MD
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73
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Blood Pressure Indices and Associated Risk Factors in a Rural West African Adult Population: Insights from an AWI-Gen Substudy in Ghana. Int J Hypertens 2020; 2020:4549031. [PMID: 32395338 PMCID: PMC7201512 DOI: 10.1155/2020/4549031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Accepted: 03/17/2020] [Indexed: 11/17/2022] Open
Abstract
Systolic (SBP) and diastolic blood pressure (DBP) are commonly used for cardiovascular disease (CVD) risk prediction, and pulse pressure (PP) and mean arterial blood pressure (MAP) can provide additional information. It is therefore important to understand the factors associated with these cardiovascular risk markers. This cross-sectional study involved 1839 men and women aged 40-60 years. Data on SBP, DBP, MAP, PP, sociodemography, lifestyle, anthropometry, and lipids were collected. Gender-stratified linear regression analyses were performed to determine the association between log-transformed blood pressure indices and the study variables. Age was associated with all measured blood pressure indices (p < 0.001) among men and women. Men had higher SBP (p=0.007) and PP (p < 0.001) than women. Nankana ethnicity was associated with higher PP levels (p < 0.005) in the total population. Vendor meal consumption among women was associated with higher PP levels (p < 0.05). Fruit intake among men was associated with lower PP levels (p < 0.05). Currently unmarried women had higher SBP (p < 0.005), DBP (p < 0.05), MAP (p < 0.005), and PP (p < 0.005) than currently married women. Pesticide exposure was negatively associated with SBP (p < 0.005), DBP (p < 0.005), MAP (p < 0.005), and PP (p < 0.05) among women. Increased subcutaneous fat was associated with DBP (p < 0.005) and MAP (p < 0.05) among women. Among men, hip circumference was associated with higher DBP and MAP (p < 0.05 for both associations), subcutaneous fat associated with higher SBP (p < 0.005), DBP (p < 0.001), and MAP (p < 0.001) and visceral fat was associated with higher PP (p < 0.05). In the total population, visceral fat was associated with higher DBP (p < 0.05) and MAP (p < 0.001). High-density lipoprotein cholesterol was positively associated with SBP (p < 0.005), DBP (p < 0.005), and MAP (p < 0.001) for women and positively associated with SBP, DBP, and MAP (p < 0.001 for all three) and PP (p < 0.05) for men. The association of blood pressure indices with modifiable risk factors suggests that targeted health interventions may reduce CVD risk in this population.
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74
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Owolabi MO, Akpa OM, Made F, Adebamowo SN, Ojo A, Adu D, Motala AA, Mayosi BM, Ovbiagele B, Adebamowo C, Tayo B, Rotimi C, Akinyemi R, Gebregziabher M, Sarfo F, Wahab KW, Parekh RS, Engel ME, Chisala C, Peprah E, Mensah G, Wiley K, Troyer J, Ramsay M. Data Resource Profile: Cardiovascular H3Africa Innovation Resource (CHAIR). Int J Epidemiol 2020; 48:366-367g. [PMID: 30535409 DOI: 10.1093/ije/dyy261] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2018] [Indexed: 12/13/2022] Open
Affiliation(s)
| | - Onoja M Akpa
- Center for Genomic and Precision Medicine.,Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Felix Made
- Epidemiology and Surveillance Section, National Health Laboratory Services, Braamfontein, Gauteng Region, South Africa.,Sydney Brenner Institute for Molecular Bioscience and Division of Human Genetics, University of the Witwatersrand, Johannesburg, South Africa
| | - Sally N Adebamowo
- Department of Epidemiology and Public Health, and Greenebaum Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Akinlolu Ojo
- Clinical Research and Global Health Initiatives, University of Arizona Health Sciences, Tucson, AZ, USA
| | - Dwomoa Adu
- School of Medicine and Dentistry, University of Ghana, Accra, Ghana
| | - Ayesha A Motala
- Department of Diabetes and Endocrinology, University of KwaZulu-Natal, Durban, South Africa
| | - Bongani M Mayosi
- Department of Medicine, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa
| | - Bruce Ovbiagele
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA
| | - Clement Adebamowo
- Department of Epidemiology and Public Health, and Greenebaum Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, MD, USA.,Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, and Institute of Human Virology, Abuja, Nigeria.,Center for Bioethics and Research, Department of Medicine, Ibadan, Nigeria
| | - Bamidele Tayo
- Department of Preventive Medicine and Epidemiology, Loyola University Chicago Stritch School of Medicine, Maywood, IL, USA
| | - Charles Rotimi
- Center for Research on Genomics and Global Health, NHGRI, NIH, Bethesda, MD, USA
| | | | - Mulugeta Gebregziabher
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Fred Sarfo
- Department of Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - Rulan S Parekh
- Department of Pediatrics, Medicine and Epidemiology, Hospital for Sick Children, Research Institute, University Health Network and University of Toronto, Toronto, ON, Canada
| | - Mark E Engel
- Division of Cardiology, Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Chisala Chisala
- Division of Cardiology, Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Emmanuel Peprah
- Global Health Program, Department of Social and Behavioral Sciences, New York University, NY, USA
| | | | | | - Jennifer Troyer
- Division of Genome Sciences, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - Michèle Ramsay
- Sydney Brenner Institute for Molecular Bioscience and Division of Human Genetics, University of the Witwatersrand, Johannesburg, South Africa
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75
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Bentley AR, Callier SL, Rotimi CN. Evaluating the promise of inclusion of African ancestry populations in genomics. NPJ Genom Med 2020; 5:5. [PMID: 32140257 PMCID: PMC7042246 DOI: 10.1038/s41525-019-0111-x] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 12/16/2019] [Indexed: 12/24/2022] Open
Abstract
The lack of representation of diverse ancestral backgrounds in genomic research is well-known, and the resultant scientific and ethical limitations are becoming increasingly appreciated. The paucity of data on individuals with African ancestry is especially noteworthy as Africa is the birthplace of modern humans and harbors the greatest genetic diversity. It is expected that greater representation of those with African ancestry in genomic research will bring novel insights into human biology, and lead to improvements in clinical care and improved understanding of health disparities. Now that major efforts have been undertaken to address this failing, is there evidence of these anticipated advances? Here, we evaluate the promise of including diverse individuals in genomic research in the context of recent literature on individuals of African ancestry. In addition, we discuss progress and achievements on related technological challenges and diversity among scientists conducting genomic research.
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Affiliation(s)
- Amy R. Bentley
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD USA
| | - Shawneequa L. Callier
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD USA
- Department of Clinical Research and Leadership, The George Washington University School of Medicine and Health Sciences, Washington, DC USA
| | - Charles N. Rotimi
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD USA
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76
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Tindana P, Depuur C, de Vries J, Seeley J, Parker M. Informed consent in genomic research and biobanking: taking feedback of findings seriously. Glob Bioeth 2020; 31:200-215. [PMID: 33343193 PMCID: PMC7734033 DOI: 10.1080/11287462.2020.1717896] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Genomic research and biobanking present several ethical, social and cultural challenges, particularly when conducted in settings with limited scientific research capacity. One of these challenges is determining the model of consent that should support the sharing of human biological samples and data in the context of international collaborative research. In this paper, we report on the views of key research stakeholders in Ghana on what should count as good ethical practice when seeking consent for genomic research and biobanking in Africa. This study was part of a multi-country qualitative case study conducted in three African countries: Ghana, Uganda and Zambia under the auspices of the Human Heredity and Health in Africa initiative (H3Africa). Our study suggests that while participants are willing to give consent for their samples and associated data to be used for future research purposes, they expect to receive feedback about the progress of the research and about the kinds of research being undertaken on their samples and data. These expectations need to be anticipated and discussed during the consent process which should be seen as part of an ongoing communication process throughout the research process.
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Affiliation(s)
- Paulina Tindana
- Department of Health Policy, Planning and Management, University of Ghana School of Public Health, Accra, Ghana
| | | | | | - Janet Seeley
- MRC/UVRI Uganda Research Unit on Aids, Kampala, Uganda
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77
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Genetic associations between serum low LDL-cholesterol levels and variants in LDLR, APOB, PCSK9 and LDLRAP1 in African populations. PLoS One 2020; 15:e0229098. [PMID: 32084179 PMCID: PMC7034850 DOI: 10.1371/journal.pone.0229098] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 01/29/2020] [Indexed: 01/08/2023] Open
Abstract
Non-communicable diseases, including cardiovascular diseases (CVDs), are increasing in African populations. High serum low density lipoprotein cholesterol (LDL-cholesterol) levels are a known risk factor for CVDs in European populations, but the link remains poorly understood among Africans. This study investigated the associations between serum LDL-cholesterol levels and selected variants in the low density lipoprotein receptor (LDLR), apolipoprotein B (APOB), proprotein convertase subtilisin/kexin type 9 (PCSK9) and low density lipoprotein receptor adaptor protein 1 (LDLRAP1) genes in some selected African populations. Nineteen SNPs were selected from publicly available African whole genome sequence data based on functional prediction and allele frequency. SNPs were genotyped in 1000 participants from the AWI-Gen, study selected from the extremes of LDL-cholesterol level distribution (500 with LDL-cholesterol>3.5 mmol/L and 500 with LDL-cholesterol<1.1 mmol/L). The minor alleles at five of the six associated SNPs were significantly associated (P<0.05) with lower LDL-cholesterol levels: LDLRAP1 rs12071264 (OR 0.56, 95% CI: 0.39-0.75, P = 2.73x10-4) and rs35910270 (OR 0.78, 95% CI: 0.64-0.94, P = 0.008); APOB rs6752026 (OR 0. 55, 95% CI: 0.41-0.72, P = 2.82x10-5); LDLR: rs72568855 (OR 0.47, 95% CI: 0.27-0.82, P = 0.008); and PCSK9 rs45613943 (OR = 0.72, 95% CI: 0.58-0.88, P = 0.001). The minor allele of the sixth variant was associated with higher LDL-cholesterol levels: APOB rs679899 (OR 1.41, 95% CI: 1.06-1.86, P = 0.016). A replication analysis in the Africa America Diabetes Mellitus (AADM) study found the PCSK9 variant to be significantly associated with low LDL-cholesterol levels (Beta = -0.10). Since Africans generally have lower LDL-cholesterol levels, these LDL-cholesterol associated variants may be involved in adaptation due to unique gene-environment interactions. In conclusion, using a limited number of potentially functional variants in four genes, we identified significant associations with lower LDL-cholesterol levels in sub-Saharan Africans.
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78
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Boua PR, Brandenburg JT, Choudhury A, Hazelhurst S, Sengupta D, Agongo G, Nonterah EA, Oduro AR, Tinto H, Mathew CG, Sorgho H, Ramsay M. Novel and Known Gene-Smoking Interactions With cIMT Identified as Potential Drivers for Atherosclerosis Risk in West-African Populations of the AWI-Gen Study. Front Genet 2020; 10:1354. [PMID: 32117412 PMCID: PMC7025492 DOI: 10.3389/fgene.2019.01354] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 12/10/2019] [Indexed: 12/22/2022] Open
Abstract
Introduction Atherosclerosis is a key contributor to the burden of cardiovascular diseases (CVDs) and many epidemiological studies have reported on the effect of smoking on carotid intima-media thickness (cIMT) and its subsequent effect on CVD risk. Gene-environment interaction studies have contributed towards understanding some of the missing heritability of genome-wide association studies. Gene-smoking interactions on cIMT have been studied in non-African populations (European, Latino-American, and African American) but no comparable African research has been reported. Our aim was to investigate smoking-SNP interactions on cIMT in two West African populations by genome-wide analysis. Materials and methods Only male participants from Burkina Faso (Nanoro = 993) and Ghana (Navrongo = 783) were included, as smoking was extremely rare among women. Phenotype and genotype data underwent stringent QC and genotype imputation was performed using the Sanger African Imputation Panel. Smoking prevalence among men was 13.3% in Nanoro and 42.5% in Navrongo. We analyzed gene-smoking interactions with PLINK after adjusting for covariates: age and 6 PCs (Model 1); age, BMI, blood pressure, fasting glucose, cholesterol levels, MVPA, and 6 PCs (Model 2). All analyses were performed at site level and for the combined data set. Results In Nanoro, we identified new gene-smoking interaction variants for cIMT within the previously described RCBTB1 region (rs112017404, rs144170770, and rs4941649) (Model 1: p = 1.35E-07; Model 2: p = 3.08E-08). In the combined sample, two novel intergenic interacting variants were identified, rs1192824 in the regulatory region of TBC1D8 (p = 5.90E-09) and rs77461169 (p = 4.48E-06) located in an upstream region of open chromatin. In silico functional analysis suggests the involvement of genes implicated in biological processes related to cell or biological adhesion and regulatory processes in gene-smoking interactions with cIMT (as evidenced by chromatin interactions and eQTLs). Discussion This is the first gene-smoking interaction study for cIMT, as a risk factor for atherosclerosis, in sub-Saharan African populations. In addition to replicating previously known signals for RCBTB1, we identified two novel genomic regions (TBC1D8, near BCHE) involved in this gene-environment interaction.
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Affiliation(s)
- Palwende Romuald Boua
- Clinical Research Unit of Nanoro, Institut de Recherche en Sciences de la Santé, Nanoro, Burkina Faso.,Faculty of Health Sciences, Sydney Brenner Institute for Molecular Bioscience (SBIMB), University of the Witwatersrand, Johannesburg, South Africa.,Division of Human Genetics, National Health Laboratory Service and School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Jean-Tristan Brandenburg
- Faculty of Health Sciences, Sydney Brenner Institute for Molecular Bioscience (SBIMB), University of the Witwatersrand, Johannesburg, South Africa
| | - Ananyo Choudhury
- Faculty of Health Sciences, Sydney Brenner Institute for Molecular Bioscience (SBIMB), University of the Witwatersrand, Johannesburg, South Africa
| | - Scott Hazelhurst
- Faculty of Health Sciences, Sydney Brenner Institute for Molecular Bioscience (SBIMB), University of the Witwatersrand, Johannesburg, South Africa.,School of Electrical and Information Engineering, University of the Witwatersrand, Johannesburg, South Africa
| | - Dhriti Sengupta
- Faculty of Health Sciences, Sydney Brenner Institute for Molecular Bioscience (SBIMB), University of the Witwatersrand, Johannesburg, South Africa
| | - Godfred Agongo
- Faculty of Health Sciences, Sydney Brenner Institute for Molecular Bioscience (SBIMB), University of the Witwatersrand, Johannesburg, South Africa.,Division of Human Genetics, National Health Laboratory Service and School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.,Navrongo Health Research Centre, Ghana Health Service, Navrongo, Ghana
| | - Engelbert A Nonterah
- Navrongo Health Research Centre, Ghana Health Service, Navrongo, Ghana.,Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Abraham R Oduro
- Navrongo Health Research Centre, Ghana Health Service, Navrongo, Ghana
| | - Halidou Tinto
- Clinical Research Unit of Nanoro, Institut de Recherche en Sciences de la Santé, Nanoro, Burkina Faso
| | - Christopher G Mathew
- Faculty of Health Sciences, Sydney Brenner Institute for Molecular Bioscience (SBIMB), University of the Witwatersrand, Johannesburg, South Africa.,Department of Medical and Molecular Genetics, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
| | - Hermann Sorgho
- Clinical Research Unit of Nanoro, Institut de Recherche en Sciences de la Santé, Nanoro, Burkina Faso
| | - Michèle Ramsay
- Faculty of Health Sciences, Sydney Brenner Institute for Molecular Bioscience (SBIMB), University of the Witwatersrand, Johannesburg, South Africa.,Division of Human Genetics, National Health Laboratory Service and School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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79
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Doumatey AP, Ekoru K, Adeyemo A, Rotimi CN. Genetic Basis of Obesity and Type 2 Diabetes in Africans: Impact on Precision Medicine. Curr Diab Rep 2019; 19:105. [PMID: 31520154 DOI: 10.1007/s11892-019-1215-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
PURPOSE OF REVIEW Recent advances in genomics provide opportunities for novel understanding of the biology of human traits with the goal of improving human health. Here, we review recent obesity and type 2 diabetes (T2D)-related genomic studies in African populations and discuss the implications of limited genomics studies on health disparity and precision medicine. RECENT FINDINGS Genome-wide association studies in Africans have yielded genetic discovery that would otherwise not be possible; these include identification of novel loci associated with obesity (SEMA-4D, PRKCA, WARS2), metabolic syndrome (CA-10, CTNNA3), and T2D (AGMO, ZRANB3). ZRANB3 was recently demonstrated to influence beta cell mass and insulin response. Despite these promising results, genomic studies in African populations are still limited and thus genomics tools and approaches such as polygenic risk scores and precision medicine are likely to have limited utility in Africans with the unacceptable possibility of exacerbating prevailing health disparities. African populations provide unique opportunities for increasing our understanding of the genetic basis of cardiometabolic disorders. We highlight the need for more coordinated and sustained efforts to increase the representation of Africans in genomic studies both as participants and scientists.
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Affiliation(s)
- Ayo P Doumatey
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, 12 South Drive, Building 12A, Room 4047, Bethesda, MD, 20862, USA
| | - Kenneth Ekoru
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, 12 South Drive, Building 12A, Room 4047, Bethesda, MD, 20862, USA
| | - Adebowale Adeyemo
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, 12 South Drive, Building 12A, Room 4047, Bethesda, MD, 20862, USA
| | - Charles N Rotimi
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, 12 South Drive, Building 12A, Room 4047, Bethesda, MD, 20862, USA.
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80
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Ahmed AE, Mpangase PT, Panji S, Baichoo S, Souilmi Y, Fadlelmola FM, Alghali M, Aron S, Bendou H, De Beste E, Mbiyavanga M, Souiai O, Yi L, Zermeno J, Armstrong D, O'Connor BD, Mainzer LS, Crusoe MR, Meintjes A, Van Heusden P, Botha G, Joubert F, Jongeneel CV, Hazelhurst S, Mulder N. Organizing and running bioinformatics hackathons within Africa: The H3ABioNet cloud computing experience. AAS Open Res 2019; 1:9. [PMID: 32382696 PMCID: PMC7194140 DOI: 10.12688/aasopenres.12847.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2019] [Indexed: 08/20/2023] Open
Abstract
The need for portable and reproducible genomics analysis pipelines is growing globally as well as in Africa, especially with the growth of collaborative projects like the Human Health and Heredity in Africa Consortium (H3Africa). The Pan-African H3Africa Bioinformatics Network (H3ABioNet) recognized the need for portable, reproducible pipelines adapted to heterogeneous computing environments, and for the nurturing of technical expertise in workflow languages and containerization technologies. Building on the network's Standard Operating Procedures (SOPs) for common genomic analyses, H3ABioNet arranged its first Cloud Computing and Reproducible Workflows Hackathon in 2016, with the purpose of translating those SOPs into analysis pipelines able to run on heterogeneous computing environments and meeting the needs of H3Africa research projects. This paper describes the preparations for this hackathon and reflects upon the lessons learned about its impact on building the technical and scientific expertise of African researchers. The workflows developed were made publicly available in GitHub repositories and deposited as container images on Quay.io.
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Affiliation(s)
- Azza E. Ahmed
- Centre for Bioinformatics and Systems Biology, Faculty of Science, University of Khartoum, Khartoum, Sudan
- Department of Electrical and Electronic Engineering, Faculty of Engineering, University of Khartoum, Khartoum, Sudan
| | - Phelelani T. Mpangase
- Sydney Brenner Institute for Molecular Bioscience, University of the Witwatersrand, Johannesburg, South Africa
| | - Sumir Panji
- Computational Biology Division, Integrative Medical Biosciences, University of Cape Town, Cape Town, South Africa
| | - Shakuntala Baichoo
- Department of Digital Technologies, University of Mauritius, Reduit, Mauritius
| | - Yassine Souilmi
- Australian Centre for Ancient DNA, University of Adelaide, Adelaide, Australia
| | - Faisal M. Fadlelmola
- Centre for Bioinformatics and Systems Biology, Faculty of Science, University of Khartoum, Khartoum, Sudan
| | - Mustafa Alghali
- Centre for Bioinformatics and Systems Biology, Faculty of Science, University of Khartoum, Khartoum, Sudan
| | - Shaun Aron
- Sydney Brenner Institute for Molecular Bioscience, University of the Witwatersrand, Johannesburg, South Africa
| | - Hocine Bendou
- South African National Bioinformatics Institute, University of the Western Cape, Cape Town, South Africa
| | - Eugene De Beste
- South African National Bioinformatics Institute, University of the Western Cape, Cape Town, South Africa
| | - Mamana Mbiyavanga
- Computational Biology Division, Integrative Medical Biosciences, University of Cape Town, Cape Town, South Africa
| | - Oussema Souiai
- Institut Pasteur De Tunis and Institut Superieur des Technologies Médicales de Tunis, University Tunis Al Manar, Tunis, Tunisia
| | - Long Yi
- South African National Bioinformatics Institute, University of the Western Cape, Cape Town, South Africa
| | - Jennie Zermeno
- Institute for Genomic Biology, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Don Armstrong
- Institute for Genomic Biology, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Brian D. O'Connor
- Genomics Institute, University of California, Santa Cruz, Santa Cruz, CA, USA
| | - Liudmila Sergeevna Mainzer
- Institute for Genomic Biology, University of Illinois at Urbana-Champaign, Urbana, IL, USA
- National Center for Supercomputing Applications, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | | | - Ayton Meintjes
- Computational Biology Division, Integrative Medical Biosciences, University of Cape Town, Cape Town, South Africa
| | - Peter Van Heusden
- South African National Bioinformatics Institute, University of the Western Cape, Cape Town, South Africa
| | - Gerrit Botha
- Computational Biology Division, Integrative Medical Biosciences, University of Cape Town, Cape Town, South Africa
| | - Fourie Joubert
- Centre for Bioinformatics and Computational Biology, Department of Biochemistry, Genetics and Microbiology, University of Pretoria, Pretoria, South Africa
| | - C. Victor Jongeneel
- Institute for Genomic Biology, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Scott Hazelhurst
- Sydney Brenner Institute for Molecular Bioscience, University of the Witwatersrand, Johannesburg, South Africa
- School of Electrical & Information Engineering, University of the Witwatersrand, Johannesburg, South Africa
| | - Nicola Mulder
- Computational Biology Division, Integrative Medical Biosciences, University of Cape Town, Cape Town, South Africa
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81
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Ahmed AE, Mpangase PT, Panji S, Baichoo S, Souilmi Y, Fadlelmola FM, Alghali M, Aron S, Bendou H, De Beste E, Mbiyavanga M, Souiai O, Yi L, Zermeno J, Armstrong D, O'Connor BD, Mainzer LS, Crusoe MR, Meintjes A, Van Heusden P, Botha G, Joubert F, Jongeneel CV, Hazelhurst S, Mulder N. Organizing and running bioinformatics hackathons within Africa: The H3ABioNet cloud computing experience. AAS Open Res 2019; 1:9. [PMID: 32382696 PMCID: PMC7194140 DOI: 10.12688/aasopenres.12847.2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2019] [Indexed: 11/20/2022] Open
Abstract
The need for portable and reproducible genomics analysis pipelines is growing globally as well as in Africa, especially with the growth of collaborative projects like the Human Health and Heredity in Africa Consortium (H3Africa). The Pan-African H3Africa Bioinformatics Network (H3ABioNet) recognized the need for portable, reproducible pipelines adapted to heterogeneous computing environments, and for the nurturing of technical expertise in workflow languages and containerization technologies. Building on the network’s Standard Operating Procedures (SOPs) for common genomic analyses, H3ABioNet arranged its first Cloud Computing and Reproducible Workflows Hackathon in 2016, with the purpose of translating those SOPs into analysis pipelines able to run on heterogeneous computing environments and meeting the needs of H3Africa research projects. This paper describes the preparations for this hackathon and reflects upon the lessons learned about its impact on building the technical and scientific expertise of African researchers. The workflows developed were made publicly available in GitHub repositories and deposited as container images on Quay.io.
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Affiliation(s)
- Azza E Ahmed
- Centre for Bioinformatics and Systems Biology, Faculty of Science, University of Khartoum, Khartoum, Sudan.,Department of Electrical and Electronic Engineering, Faculty of Engineering, University of Khartoum, Khartoum, Sudan
| | - Phelelani T Mpangase
- Sydney Brenner Institute for Molecular Bioscience, University of the Witwatersrand, Johannesburg, South Africa
| | - Sumir Panji
- Computational Biology Division, Integrative Medical Biosciences, University of Cape Town, Cape Town, South Africa
| | - Shakuntala Baichoo
- Department of Digital Technologies, University of Mauritius, Reduit, Mauritius
| | - Yassine Souilmi
- Australian Centre for Ancient DNA, University of Adelaide, Adelaide, Australia
| | - Faisal M Fadlelmola
- Centre for Bioinformatics and Systems Biology, Faculty of Science, University of Khartoum, Khartoum, Sudan
| | - Mustafa Alghali
- Centre for Bioinformatics and Systems Biology, Faculty of Science, University of Khartoum, Khartoum, Sudan
| | - Shaun Aron
- Sydney Brenner Institute for Molecular Bioscience, University of the Witwatersrand, Johannesburg, South Africa
| | - Hocine Bendou
- South African National Bioinformatics Institute, University of the Western Cape, Cape Town, South Africa
| | - Eugene De Beste
- South African National Bioinformatics Institute, University of the Western Cape, Cape Town, South Africa
| | - Mamana Mbiyavanga
- Computational Biology Division, Integrative Medical Biosciences, University of Cape Town, Cape Town, South Africa
| | - Oussema Souiai
- Institut Pasteur De Tunis and Institut Superieur des Technologies Médicales de Tunis, University Tunis Al Manar, Tunis, Tunisia
| | - Long Yi
- South African National Bioinformatics Institute, University of the Western Cape, Cape Town, South Africa
| | - Jennie Zermeno
- Institute for Genomic Biology, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Don Armstrong
- Institute for Genomic Biology, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Brian D O'Connor
- Genomics Institute, University of California, Santa Cruz, Santa Cruz, CA, USA
| | - Liudmila Sergeevna Mainzer
- Institute for Genomic Biology, University of Illinois at Urbana-Champaign, Urbana, IL, USA.,National Center for Supercomputing Applications, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | | | - Ayton Meintjes
- Computational Biology Division, Integrative Medical Biosciences, University of Cape Town, Cape Town, South Africa
| | - Peter Van Heusden
- South African National Bioinformatics Institute, University of the Western Cape, Cape Town, South Africa
| | - Gerrit Botha
- Computational Biology Division, Integrative Medical Biosciences, University of Cape Town, Cape Town, South Africa
| | - Fourie Joubert
- Centre for Bioinformatics and Computational Biology, Department of Biochemistry, Genetics and Microbiology, University of Pretoria, Pretoria, South Africa
| | - C Victor Jongeneel
- Institute for Genomic Biology, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Scott Hazelhurst
- Sydney Brenner Institute for Molecular Bioscience, University of the Witwatersrand, Johannesburg, South Africa.,School of Electrical & Information Engineering, University of the Witwatersrand, Johannesburg, South Africa
| | - Nicola Mulder
- Computational Biology Division, Integrative Medical Biosciences, University of Cape Town, Cape Town, South Africa
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82
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Runs of homozygosity in sub-Saharan African populations provide insights into complex demographic histories. Hum Genet 2019; 138:1123-1142. [DOI: 10.1007/s00439-019-02045-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 07/03/2019] [Indexed: 12/20/2022]
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83
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Nonterah EA, Boua PR, Klipstein-Grobusch K, Asiki G, Micklesfield LK, Agongo G, Ali SA, Mashinya F, Sorgho H, Nakanabo-Diallo S, Debpuur C, Kyobutungi C, Alberts M, Norris S, Tollman S, Tinto H, Soo CC, Mukomana F, Hazelhurst S, Wade AN, Kahn K, Oduro AR, Grobbee DE, Sankoh O, Ramsay M, Bots ML, Crowther NJ. Classical Cardiovascular Risk Factors and HIV are Associated With Carotid Intima-Media Thickness in Adults From Sub-Saharan Africa: Findings From H3Africa AWI-Gen Study. J Am Heart Assoc 2019; 8:e011506. [PMID: 31304842 PMCID: PMC6662137 DOI: 10.1161/jaha.118.011506] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background Studies on the determinants of carotid intima-media thickness ( CIMT ), a marker of sub-clinical atherosclerosis, mostly come from white, Asian, and diasporan black populations. We present CIMT data from sub-Saharan Africa, which is experiencing a rising burden of cardiovascular diseases and infectious diseases. Methods and Results The H3 (Human Hereditary and Health) in Africa's AWI-Gen (African-Wits-INDEPTH partnership for Genomic) study is a cross-sectional study conducted in adults aged 40 to 60 years from Burkina Faso, Kenya, Ghana, and South Africa. Cardiovascular disease risk and ultrasonography of the CIMT of right and left common carotids were measured. Multivariable linear and mixed-effect multilevel regression modeling was applied to determine factors related to CIMT. Data included 8872 adults (50.8% men), mean age of 50±6 years with age- and sex-adjusted mean (±SE) CIMT of 640±123μm. Participants from Ghana and Burkina Faso had higher CIMT compared with other sites. Age (β = 6.77, 95%CI [6.34-7.19]), body mass index (17.6[12.5-22.8]), systolic blood pressure (7.52[6.21-8.83]), low-density lipoprotein cholesterol (5.08[2.10-8.06]) and men (10.3[4.75- 15.9]) were associated with higher CIMT. Smoking was associated with higher CIMT in men. High-density lipoprotein cholesterol (-12.2 [-17.9- -6.41]), alcohol consumption (-13.5 [-19.1--7.91]) and HIV (-8.86 [-15.7--2.03]) were inversely associated with CIMT. Conclusions Given the rising prevalence of cardiovascular diseases risk factors in sub-Saharan Africa, atherosclerotic diseases may become a major pan-African epidemic unless preventive measures are taken particularly for prevention of hypertension, obesity, and smoking. HIV -specific studies are needed to fully understand the association between HIV and CIMT in sub-Saharan Africa.
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Affiliation(s)
- Engelbert A Nonterah
- 1 Navrongo Health Research Centre Ghana Health Service Navrongo Ghana.,2 Julius Global Health Julius Center for Health Sciences and Primary Care University Medical Center Utrecht Utrecht University Utrecht the Netherlands
| | - Palwende R Boua
- 3 Clinical Research Unit of Nanoro Institut de Recherche en Sciences de la Santé Nanoro Burkina Faso.,4 Sydney Brenner Institute of Molecular Bioscience Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa.,5 Division of Human Genetics Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa
| | - Kerstin Klipstein-Grobusch
- 2 Julius Global Health Julius Center for Health Sciences and Primary Care University Medical Center Utrecht Utrecht University Utrecht the Netherlands.,6 Division of Epidemiology and Biostatistics School of Public Health Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa
| | - Gershim Asiki
- 10 African Population and Health Research Centre (APHRC) Nairobi Kenya
| | - Lisa K Micklesfield
- 7 MRC/Wits Developmental Pathways for Health Research Unit Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa
| | - Godfred Agongo
- 1 Navrongo Health Research Centre Ghana Health Service Navrongo Ghana
| | - Stuart A Ali
- 4 Sydney Brenner Institute of Molecular Bioscience Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa
| | - Felistas Mashinya
- 11 Dikgale Health Demographic Surveillance Site Department of Pathology and Medical Sciences School of Health Care Sciences Faculty of Health Sciences University of Limpopo Polokwane South Africa
| | - Herman Sorgho
- 3 Clinical Research Unit of Nanoro Institut de Recherche en Sciences de la Santé Nanoro Burkina Faso
| | - Seydou Nakanabo-Diallo
- 3 Clinical Research Unit of Nanoro Institut de Recherche en Sciences de la Santé Nanoro Burkina Faso
| | - Cornelius Debpuur
- 1 Navrongo Health Research Centre Ghana Health Service Navrongo Ghana
| | | | - Marianne Alberts
- 11 Dikgale Health Demographic Surveillance Site Department of Pathology and Medical Sciences School of Health Care Sciences Faculty of Health Sciences University of Limpopo Polokwane South Africa
| | - Shane Norris
- 7 MRC/Wits Developmental Pathways for Health Research Unit Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa
| | - Stephen Tollman
- 6 Division of Epidemiology and Biostatistics School of Public Health Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa.,8 MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt) School of Public Health Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa.,12 INDEPTH-Network Accra Ghana
| | - Halidou Tinto
- 3 Clinical Research Unit of Nanoro Institut de Recherche en Sciences de la Santé Nanoro Burkina Faso
| | - Cassandra C Soo
- 4 Sydney Brenner Institute of Molecular Bioscience Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa.,5 Division of Human Genetics Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa
| | - Freedom Mukomana
- 4 Sydney Brenner Institute of Molecular Bioscience Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa
| | - Scott Hazelhurst
- 4 Sydney Brenner Institute of Molecular Bioscience Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa
| | - Alisha N Wade
- 8 MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt) School of Public Health Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa
| | - Kathleen Kahn
- 6 Division of Epidemiology and Biostatistics School of Public Health Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa.,8 MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt) School of Public Health Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa.,12 INDEPTH-Network Accra Ghana
| | - Abraham R Oduro
- 1 Navrongo Health Research Centre Ghana Health Service Navrongo Ghana
| | - Diederick E Grobbee
- 2 Julius Global Health Julius Center for Health Sciences and Primary Care University Medical Center Utrecht Utrecht University Utrecht the Netherlands
| | - Osman Sankoh
- 6 Division of Epidemiology and Biostatistics School of Public Health Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa.,12 INDEPTH-Network Accra Ghana
| | - Michèle Ramsay
- 4 Sydney Brenner Institute of Molecular Bioscience Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa.,5 Division of Human Genetics Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa
| | - Michiel L Bots
- 2 Julius Global Health Julius Center for Health Sciences and Primary Care University Medical Center Utrecht Utrecht University Utrecht the Netherlands
| | - Nigel J Crowther
- 9 Department of Chemical Pathology National Health Laboratory Services (NHLS) Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa
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84
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Wagner RG, Crowther NJ, Gómez-Olivé FX, Kabudula C, Kahn K, Mhembere M, Myakayaka Z, Tollman S, Wade AN. Sociodemographic, socioeconomic, clinical and behavioural predictors of body mass index vary by sex in rural South African adults-findings from the AWI-Gen study. Glob Health Action 2019; 11:1549436. [PMID: 30499746 PMCID: PMC6282437 DOI: 10.1080/16549716.2018.1549436] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Background: Despite increasing obesity in South African adults, data on the prevalence and determinants of body mass index (BMI) from rural communities, home to a significant proportion of the population, are scarce. Objectives: To investigate overall and sex-specific determinants of BMI in a rural adult South African population undergoing rapid social and epidemiological transitions. Methods: Baseline cross-sectional demographic, socioeconomic, anthropometric, clinical and behavioural data were collected between 2015 and 2016 from 1388 individuals aged 40–60 years and resident in the Agincourt sub-district of Mpumalanga province, a setting typical of rural northeast South Africa. A Health and Socio-Demographic Surveillance System (HDSS) underpins the sub-district and contributes to the Africa Wits-INDEPTH partnership for Genomic Studies (AWI-Gen). Linear regression was used to investigate univariate associations between log-transformed BMI and individual variables and multiple linear regression was used to investigate independent predictors of BMI overall and in sex-stratified analyses. Results: Median BMI was significantly higher in females (28.7 kg/m2[95% CI 24.2–33.2] vs 23.0 kg/m2[95% CI 20.3–26.8];p < 0.001) with male sex associated with 17% lower BMI. In sex-stratified multiple linear regression models, compared to those never married, BMI was 7% higher in currently married males and 6% in currently married females. Current smoking in men and former smoking in women were associated with reductions in BMI of 13% and 26% respectively, compared with non-smokers. Higher educational attainment in women and higher socioeconomic status in men were both associated with higher BMI, while being HIV-positive and alcohol consumption in women were associated lower BMI. Conclusions: Female sex strongly predicts higher BMI in this rural African population. While some predictors of higher BMI differ by sex, married individuals in both sexes had a higher BMI, suggesting that, in addition to developing sex-specific interventions to combat overweight and obesity, targeting married couples may result in reduction in population BMI.
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Affiliation(s)
- Ryan G Wagner
- a MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa.,b Umeå Centre for Global Health Research, Division of Epidemiology and Global Health, Department of Public Health and Clinical Medicine , Umeå University , Umeå , Sweden
| | - Nigel J Crowther
- c Department of Chemical Pathology, National Health Laboratory Service and Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa
| | - F Xavier Gómez-Olivé
- a MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa
| | - Chodziwadziwa Kabudula
- a MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa
| | - Kathleen Kahn
- a MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa.,b Umeå Centre for Global Health Research, Division of Epidemiology and Global Health, Department of Public Health and Clinical Medicine , Umeå University , Umeå , Sweden.,d INDEPTH Network , Accra , Ghana
| | - Memory Mhembere
- a MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa
| | - Zola Myakayaka
- a MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa
| | - Stephen Tollman
- a MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa.,b Umeå Centre for Global Health Research, Division of Epidemiology and Global Health, Department of Public Health and Clinical Medicine , Umeå University , Umeå , Sweden.,d INDEPTH Network , Accra , Ghana
| | - Alisha N Wade
- a MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa
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85
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Ramsay M, Crowther NJ, Agongo G, Ali SA, Asiki G, Boua RP, Gómez-Olivé FX, Kahn K, Khayeka-Wandabwa C, Mashinya F, Micklesfield L, Mukomana F, Nonterah EA, Soo C, Sorgho H, Wade AN, Wagner RG, Alberts M, Hazelhurst S, Kyobutungi C, Norris SA, Oduro AR, Sankoh O, Tinto H, Tollman S. Regional and sex-specific variation in BMI distribution in four sub-Saharan African countries: The H3Africa AWI-Gen study. Glob Health Action 2019; 11:1556561. [PMID: 30845902 PMCID: PMC6407581 DOI: 10.1080/16549716.2018.1556561] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Background: African populations are characterised by diversity at many levels including: demographic history, genetic ancestry, language, wealth, socio-political landscape, culture and behaviour. Several of these have a profound impact on body fat mass. Obesity, a key risk factor for cardiovascular and metabolic diseases, in the wake of the epidemiological and health transitions across the continent, requires detailed analysis together with other major risk factors. Objective: To compare regional and sex-specific body mass index (BMI) distributions, using a cross-sectional study design, in adults aged 40–60 years across six study sites in four sub-Saharan African (SSA) countries and to compare the determinants of BMI at each. Methods: Anthropometric measurements were standardised across sites and BMI calculated. Median BMI and prevalence of underweight, lean, overweight and obesity were compared between the sexes and across sites. Data from multivariable linear regression models for the principal determinants of BMI were summarised from the site-specific studies. Results: BMI was calculated in 10,702 participants (55% female) and was significantly higher in women than men at nearly all sites. The highest prevalence of obesity was observed at the three South African sites (42.3–66.6% in women and 2.81–17.5% in men) and the lowest in West Africa (1.25–4.22% in women and 1.19–2.20% in men). Across sites, higher socio-economic status and educational level were associated with higher BMI. Being married and increased dietary intake were associated with higher BMI in some communities, whilst smoking and alcohol intake were associated with lower BMI, as was HIV infection in the regions where it was prevalent. Conclusion: In SSA there is a marked variation in the prevalence of obesity both regionally and between men and women. Our data suggest that the drive for social upliftment within Africa will be associated with rising levels of obesity, which will require the initiation of targeted sex-specific intervention programmes across specific African communities.
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Affiliation(s)
- Michèle Ramsay
- a Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa.,b Division of Human Genetics , National Health Laboratory Service and School of Pathology, Faculty of Health Sciences, University of the Witwatersrand , Johannesburg , South Africa
| | - Nigel J Crowther
- c Department of Chemical Pathology, National Health Laboratory Service, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa
| | - Godfred Agongo
- a Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa.,d Navrongo Health Research Centre , Navrongo , Ghana
| | - Stuart A Ali
- a Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa
| | - Gershim Asiki
- e African Population and Health Research Center , Nairobi , Kenya
| | - Romuald P Boua
- a Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa.,b Division of Human Genetics , National Health Laboratory Service and School of Pathology, Faculty of Health Sciences, University of the Witwatersrand , Johannesburg , South Africa.,f Clinical Research Unit of Nanoro, Institut de Recherche en Sciences de la Sante , Nanoro , Burkina Faso
| | - F Xavier Gómez-Olivé
- g MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa
| | - Kathleen Kahn
- g MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa.,h School of Public Health, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa.,i INDEPTH Network , Accra , Ghana
| | | | - Felistas Mashinya
- j Department of Pathology and Medical Science, School of Health Care Sciences, Faculty of Health Sciences , University of Limpopo , Polokwane , South Africa
| | - Lisa Micklesfield
- k MRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa
| | - Freedom Mukomana
- a Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa
| | | | - Cassandra Soo
- a Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa.,b Division of Human Genetics , National Health Laboratory Service and School of Pathology, Faculty of Health Sciences, University of the Witwatersrand , Johannesburg , South Africa
| | - Hermann Sorgho
- f Clinical Research Unit of Nanoro, Institut de Recherche en Sciences de la Sante , Nanoro , Burkina Faso
| | - Alisha N Wade
- g MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa
| | - Ryan G Wagner
- g MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa
| | - Marianne Alberts
- j Department of Pathology and Medical Science, School of Health Care Sciences, Faculty of Health Sciences , University of Limpopo , Polokwane , South Africa
| | - Scott Hazelhurst
- a Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa.,l School of Electrical & Information Engineering, University of the Witwatersrand , Johannesburg , South Africa
| | | | - Shane A Norris
- k MRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa
| | | | - Osman Sankoh
- h School of Public Health, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa.,i INDEPTH Network , Accra , Ghana.,m Statistics Sierra Leone , Freetown , Sierra Leone.,n Department of Community Medicine, College of Medicine and Allied Health Sciences , University of Sierra Leone , Freetown , Sierra Leone
| | - Halidou Tinto
- f Clinical Research Unit of Nanoro, Institut de Recherche en Sciences de la Sante , Nanoro , Burkina Faso
| | - Stephen Tollman
- g MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa.,h School of Public Health, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa.,i INDEPTH Network , Accra , Ghana
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86
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Mohamed SF, Haregu TN, Khayeka-Wandabwa C, Muthuri SK, Kyobutungi C. Magnitude and predictors of normal-weight central obesity- the AWI-Gen study findings. Glob Health Action 2019; 12:1685809. [PMID: 31694493 PMCID: PMC6844381 DOI: 10.1080/16549716.2019.1685809] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 10/23/2019] [Indexed: 11/24/2022] Open
Abstract
Background: Normal-weight central obesity is associated with higher mortality than general obesity as defined by body mass index, particularly in the absence of central fat distribution.Objective: The aim of this study was to examine the magnitude and predictors of normal-weight central obesity in an urban informal settlement setting in Kenya.Methods: We used data from the AWI-Gen study, a cross-sectional survey targeting randomly selected consenting adults between the ages of 40-60 in two urban informal settlements of Nairobi between 2014 and 2016. Central obesity was determined using waist circumference, waist to hip ratio, visceral fat thickness, and subcutaneous fat thickness. General obesity was determined using body mass index (BMI).Results: About 20.0% of participants in the study had general obesity. The prevalence of central obesity as measured by waist circumference was 52.0%, by waist-to-hip ratio was 53.5%, by visceral fat thickness was 32.4% and by subcutaneous fat thickness was 49.2%. The prevalence of normal-weight central obesity in the study population was highest when measured by waist to hip ratio (38.1%) and lowest when measured by visceral fat thickness (18.1%). Factors associated with normal-weight central obesity as assesses by waist circumference were being female, of older age, and in full-time employment. Older age was associated with normal-weight central obesity as assessed by waist to hip ratio.Conclusion: The findings highlight a significant prevalence of normal-weight central obesity among adults in a poor urban setting in Kenya, pointing to women as a key target group for focused interventions. Longitudinal studies are needed to establish whether there is a link between normal-weight central obesity and mortality in such settings as has been found in other settings.
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Affiliation(s)
- Shukri F. Mohamed
- Health and Systems for Health Unit (HSH), African Population and Health Research Center (APHRC), Nairobi, Kenya
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Tilahun Nigatu Haregu
- Health and Systems for Health Unit (HSH), African Population and Health Research Center (APHRC), Nairobi, Kenya
- Non-Communicable Disease Unit, School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Christopher Khayeka-Wandabwa
- School of Pharmaceutical Science and Technology (SPST), Health Science Platform, Tianjin University, Tianjin, China
| | - Stella Kagwiria Muthuri
- Health and Systems for Health Unit (HSH), African Population and Health Research Center (APHRC), Nairobi, Kenya
| | - Catherine Kyobutungi
- Health and Systems for Health Unit (HSH), African Population and Health Research Center (APHRC), Nairobi, Kenya
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87
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Baichoo S, Souilmi Y, Panji S, Botha G, Meintjes A, Hazelhurst S, Bendou H, Beste ED, Mpangase PT, Souiai O, Alghali M, Yi L, O'Connor BD, Crusoe M, Armstrong D, Aron S, Joubert F, Ahmed AE, Mbiyavanga M, Heusden PV, Magosi LE, Zermeno J, Mainzer LS, Fadlelmola FM, Jongeneel CV, Mulder N. Developing reproducible bioinformatics analysis workflows for heterogeneous computing environments to support African genomics. BMC Bioinformatics 2018; 19:457. [PMID: 30486782 PMCID: PMC6264621 DOI: 10.1186/s12859-018-2446-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 10/23/2018] [Indexed: 12/30/2022] Open
Abstract
Background The Pan-African bioinformatics network, H3ABioNet, comprises 27 research institutions in 17 African countries. H3ABioNet is part of the Human Health and Heredity in Africa program (H3Africa), an African-led research consortium funded by the US National Institutes of Health and the UK Wellcome Trust, aimed at using genomics to study and improve the health of Africans. A key role of H3ABioNet is to support H3Africa projects by building bioinformatics infrastructure such as portable and reproducible bioinformatics workflows for use on heterogeneous African computing environments. Processing and analysis of genomic data is an example of a big data application requiring complex interdependent data analysis workflows. Such bioinformatics workflows take the primary and secondary input data through several computationally-intensive processing steps using different software packages, where some of the outputs form inputs for other steps. Implementing scalable, reproducible, portable and easy-to-use workflows is particularly challenging. Results H3ABioNet has built four workflows to support (1) the calling of variants from high-throughput sequencing data; (2) the analysis of microbial populations from 16S rDNA sequence data; (3) genotyping and genome-wide association studies; and (4) single nucleotide polymorphism imputation. A week-long hackathon was organized in August 2016 with participants from six African bioinformatics groups, and US and European collaborators. Two of the workflows are built using the Common Workflow Language framework (CWL) and two using Nextflow. All the workflows are containerized for improved portability and reproducibility using Docker, and are publicly available for use by members of the H3Africa consortium and the international research community. Conclusion The H3ABioNet workflows have been implemented in view of offering ease of use for the end user and high levels of reproducibility and portability, all while following modern state of the art bioinformatics data processing protocols. The H3ABioNet workflows will service the H3Africa consortium projects and are currently in use. All four workflows are also publicly available for research scientists worldwide to use and adapt for their respective needs. The H3ABioNet workflows will help develop bioinformatics capacity and assist genomics research within Africa and serve to increase the scientific output of H3Africa and its Pan-African Bioinformatics Network.
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Affiliation(s)
- Shakuntala Baichoo
- Department of Digital Technologies, University of Mauritius, Reduit, Mauritius.
| | - Yassine Souilmi
- Australian Centre for Ancient DNA, University of Adelaide, Adelaide, South Australia, Australia
| | - Sumir Panji
- Computational Biology Division, Department of Integrative Medical Biosciences, IDM, University of Cape Town, Cape Town, South Africa
| | - Gerrit Botha
- Computational Biology Division, Department of Integrative Medical Biosciences, IDM, University of Cape Town, Cape Town, South Africa
| | - Ayton Meintjes
- Computational Biology Division, Department of Integrative Medical Biosciences, IDM, University of Cape Town, Cape Town, South Africa
| | - Scott Hazelhurst
- School of Electrical & Information Engineering, University of the Witwatersrand, Johannesburg, South Africa.,Sydney Brenner Institute for Molecular Bioscience, University of the Witwatersrand, Johannesburg, South Africa
| | - Hocine Bendou
- South African National Bioinformatics Institute, University of the Western Cape, Bellville, Cape Town, South Africa.,Natural Sciences, University of the Western Cape, Bellville, Cape Town, South Africa
| | - Eugene de Beste
- South African National Bioinformatics Institute, University of the Western Cape, Bellville, Cape Town, South Africa.,Natural Sciences, University of the Western Cape, Bellville, Cape Town, South Africa
| | - Phelelani T Mpangase
- Sydney Brenner Institute for Molecular Bioscience, University of the Witwatersrand, Johannesburg, South Africa
| | - Oussema Souiai
- Institut Pasteur De Tunis, University Tunis El manar, Tunis, Tunisia.,Institut Superieur des Technologies Medicales de Tunis, University Tunis El manar, Tunis, Tunisia
| | - Mustafa Alghali
- Center for Bioinformatics & Systems Biology, Faculty of Science, University of Khartoum, Khartoum, Sudan.,Department of Electrical & Electronic Engineering, Faculty of Engineering, University of Khartoum, Khartoum, Sudan
| | - Long Yi
- South African National Bioinformatics Institute, University of the Western Cape, Bellville, Cape Town, South Africa.,Natural Sciences, University of the Western Cape, Bellville, Cape Town, South Africa
| | - Brian D O'Connor
- Genomics Institute, University of California, Santa Cruz, California, USA
| | - Michael Crusoe
- Common Workflow Language project, Software Freedom Conservancy, New York City, NY, USA
| | - Don Armstrong
- Institute for Genomic Biology, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - Shaun Aron
- Sydney Brenner Institute for Molecular Bioscience, University of the Witwatersrand, Johannesburg, South Africa
| | - Fourie Joubert
- Centre for Bioinformatics and Computational Biology, Department of Biochemistry, Genetics and Microbiology, University of Pretoria, Pretoria, South Africa
| | - Azza E Ahmed
- Center for Bioinformatics & Systems Biology, Faculty of Science, University of Khartoum, Khartoum, Sudan.,Department of Electrical & Electronic Engineering, Faculty of Engineering, University of Khartoum, Khartoum, Sudan
| | - Mamana Mbiyavanga
- Computational Biology Division, Department of Integrative Medical Biosciences, IDM, University of Cape Town, Cape Town, South Africa
| | - Peter van Heusden
- South African National Bioinformatics Institute, University of the Western Cape, Bellville, Cape Town, South Africa.,Natural Sciences, University of the Western Cape, Bellville, Cape Town, South Africa
| | - Lerato E Magosi
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK.,Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Jennie Zermeno
- National Center for Supercomputing Applications, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - Liudmila Sergeevna Mainzer
- Institute for Genomic Biology, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA.,National Center for Supercomputing Applications, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - Faisal M Fadlelmola
- Center for Bioinformatics & Systems Biology, Faculty of Science, University of Khartoum, Khartoum, Sudan
| | - C Victor Jongeneel
- Institute for Genomic Biology, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - Nicola Mulder
- Computational Biology Division, Department of Integrative Medical Biosciences, IDM, University of Cape Town, Cape Town, South Africa
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88
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Agongo G, Nonterah EA, Debpuur C, Amenga-Etego L, Ali S, Oduro A, Crowther NJ, Ramsay M. The burden of dyslipidaemia and factors associated with lipid levels among adults in rural northern Ghana: An AWI-Gen sub-study. PLoS One 2018; 13:e0206326. [PMID: 30485283 PMCID: PMC6261546 DOI: 10.1371/journal.pone.0206326] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2018] [Accepted: 10/10/2018] [Indexed: 12/15/2022] Open
Abstract
Dyslipidaemia is a primary risk factor for cardiometabolic disease, causing over 17 million deaths globally in 2015. However, the burden of dyslipidaemia and factors associated with lipid levels remain unknown in many rural African populations. Therefore, this study evaluated the association of socio-demographic, anthropometric and behavioural factors with lipid levels in rural Ghana. The prevalence of hypercholesterolaemia, hypertriglyceridaemia and elevated LDL-C in the total population of 1839 (846 men and 993 women) was 4.02%, 2.12%, and 5.55% respectively and did not differ between genders. The prevalence of low HDL-C levels was 60.30% and differed (p = 0.005) between men (56.86%) and women (63.24%). Subcutaneous abdominal fat was associated with TC (β = 0.067, p = 0.015) and TG (β = 0.137, p<0.001) among women and LDL-C (β = 0.139, p = 0.006) and TC (β = 0.071, p = 0.048) among men. Body mass index was associated with TC (β = 0.010, p = 0.043) among men while waist circumference was associated with LDL-C (β = 0.116, p<0.001) and TG (β = 0.094, p<0.001) among women. Hip circumference was negatively associated (β = -0.053, p = 0.043) while visceral fat was positively associated with TG (β = 0.033, p = 0.022) among women. Socioeconomic status, education, being unmarried and employment were associated with HDL-C (β = 0.081, p = 0.004), LDL-C (β = 0.095, p = 0.004) and TG (β = 0.095, p = 0.001) all among women, and TC (β = 0.070, p = 0.010) among men, respectively. Nankana women had lower TC (β = -0.069, p = 0.001), and men lower TG levels (β = -0.084, p = 0.008) than the other ethnic groups. Tobacco smoking (β = 0.066, p = 0.024) and alcohol intake (β = 0.084, p = 0.001) were associated with HDL-C levels among men and women respectively. Further studies are required to investigate whether high prevalence of low HDL-C levels in this population presents with any adverse cardiovascular disease outcomes. Associations of education, employment and adiposity with lipid levels suggest that future societal advances and increases in the prevalence of obesity may lead to associated adverse health consequences. Monitoring and interventions are required to limit these effects.
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Affiliation(s)
- Godfred Agongo
- Navrongo Health Research Centre, Navrongo, Ghana
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Division of Human Genetics, National Health Laboratory Service and School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Engelbert Adamwaba Nonterah
- Navrongo Health Research Centre, Navrongo, Ghana
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
| | | | | | - Stuart Ali
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Nigel J. Crowther
- Department of Chemical Pathology, National Health Laboratory Service and School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, South Africa
| | - Michèle Ramsay
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Division of Human Genetics, National Health Laboratory Service and School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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89
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Asiki G, Mohamed SF, Wambui D, Wainana C, Muthuri S, Ramsay M, Kyobutungi C. Sociodemographic and behavioural factors associated with body mass index among men and women in Nairobi slums: AWI-Gen Project. Glob Health Action 2018; 11:1470738. [PMID: 29966508 PMCID: PMC6032012 DOI: 10.1080/16549716.2018.1470738] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background: Body mass index (BMI) is rising globally with a faster increase in urban areas in low- and middle-income countries. It is critical to identify modifiable risk factors for BMI to prevent the occurrence of associated health consequences. Objective: To investigate socio-demographic, behavioural and biological factors associated with BMI in Nairobi slums. Methods: In 2014-2015, a cross sectional study of men and women aged 40–60 years in Nairobi slums (Korogocho and Viwandani) was conducted. Data were collected on socio-demographic, behavioural and biological characteristics. Mean BMI, overweight and obesity were computed. Hierarchical multiple linear regression analysis was conducted separately for men and women to explore factors associated with BMI. Results: In total, 1942 study participants (54.4%, women) with a mean age (SD) of 48.3 (5.3) years and 48.8(5.6) years for women and men respectively were recruited. Mean BMI was higher among women than men (27.6 versus 22.8; p < 0.001). More women were overweight (30.9% versus 19.6%; p < 0.001) and obese (32.1% versus 5.1%; p < 0.001) than men. Among men, BMI was independently associated with wealth index, bread consumption and self-reported diabetes and was negatively associated with current tobacco smoking, HIV and TB infections. Among women, BMI was independently associated with wealth, current non-problematic drinking, and sedentary time, but was lower among other ethnicities compared to Kikuyu, among current smokers, women with longer sleep, and those with HIV infection and tuberculosis. Wealth index contributed the most variance in BMI among women and men (10.4%, 7.5%, respectively), but behavioural factors (7.4%) among men and biological factors (6.5%) among women accounted for most of the additional BMI variance. Conclusions: Adults aged 40–60 years in the urban slums of Nairobi have a high BMI associated with wealth. Bread consumption by men and sedentary life among women are the main risky behaviours that need urgent targeted interventions.
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Affiliation(s)
- Gershim Asiki
- a Health and Systems for Health Unit , African Population and Health Research Center , Nairobi , Kenya.,b Department of Women's and Children's Health , Karolinska Intitutet , Stockholm , Sweden
| | - Shukri F Mohamed
- a Health and Systems for Health Unit , African Population and Health Research Center , Nairobi , Kenya
| | - David Wambui
- a Health and Systems for Health Unit , African Population and Health Research Center , Nairobi , Kenya
| | - Caroline Wainana
- a Health and Systems for Health Unit , African Population and Health Research Center , Nairobi , Kenya
| | - Stella Muthuri
- a Health and Systems for Health Unit , African Population and Health Research Center , Nairobi , Kenya
| | - Michelle Ramsay
- c Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa.,d Division of Human Genetics, National Health Laboratory Service and School of Pathology, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa
| | - Catherine Kyobutungi
- a Health and Systems for Health Unit , African Population and Health Research Center , Nairobi , Kenya
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90
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Sankoh O. Why population-based data are crucial to achieving the Sustainable Development Goals. Int J Epidemiol 2018; 46:4-7. [PMID: 28204483 DOI: 10.1093/ije/dyx010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2017] [Indexed: 11/12/2022] Open
Affiliation(s)
- Osman Sankoh
- INDEPTH Network, Accra, Ghana.,School of Public Health, University of Witwatersrand, Johannesburg, South Africa.,Department of Mathematics and Statistics, Njala University, Njala, Sierra Leone
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91
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Sahibdeen V, Crowther NJ, Soodyall H, Hendry LM, Munthali RJ, Hazelhurst S, Choudhury A, Norris SA, Ramsay M, Lombard Z. Genetic variants in SEC16B are associated with body composition in black South Africans. Nutr Diabetes 2018; 8:43. [PMID: 30026463 PMCID: PMC6053407 DOI: 10.1038/s41387-018-0050-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 05/14/2018] [Accepted: 05/23/2018] [Indexed: 12/12/2022] Open
Abstract
Objective The latest genome-wide association studies of obesity-related traits have identified several genetic loci contributing to body composition (BC). These findings have not been robustly replicated in African populations, therefore, this study aimed to assess whether European BC-associated gene loci played a similar role in a South African black population. Methods A replication and fine-mapping study was performed in participants from the Birth to Twenty cohort (N = 1,926) using the Metabochip. Measurements included body mass index (BMI), waist and hip circumference, waist-to-hip ratio (WHR), total fat mass, total lean mass and percentage fat mass (PFM). Results SNPs in several gene loci, including SEC16B (Padj < 9.48 × 10−7), NEGR1 (Padj < 1.64 × 10−6), FTO (Padj < 2.91 × 10−5), TMEM18 (Padj < 2.27 × 10−5), and WARS2(Padj < 3.25 × 10−5) were similarly associated (albeit not at array-wide signficance (P ≤ 6.7 × 10−7) with various phenotypes including fat mass, PFM, WHR linked to BC in this African cohort, however the associations were driven by different sentinel SNPs. More importantly, DXA-derived BC measures revealed stronger genetic associations than simple anthropometric measures. Association signals generated in this study were shared by European and African populations, as well as unique to this African cohort. Moreover, sophisticated estimates like DXA measures enabled an enhanced characterisation of genetic associations for BC traits. Conclusion Results from this study suggest that in-depth genomic studies in larger African cohorts may reveal novel SNPs for body composition and adiposity, which will provide greater insight into the aetiology of obesity.
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Affiliation(s)
- Venesa Sahibdeen
- Division of Human Genetics, School of Pathology, Faculty of Health Sciences, National Health Laboratory Service & University of the Witwatersrand, Johannesburg, South Africa. .,Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
| | - Nigel J Crowther
- Department of Chemical Pathology, School of Pathology, Faculty of Health Sciences, National Health Laboratory Service & University of the Witwatersrand, Johannesburg, South Africa
| | - Himla Soodyall
- Division of Human Genetics, School of Pathology, Faculty of Health Sciences, National Health Laboratory Service & University of the Witwatersrand, Johannesburg, South Africa
| | - Liesl M Hendry
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.,School of Molecular and Cell Biology, Faculty of Science, University of the Witwatersrand, Johannesburg, South Africa
| | - Richard J Munthali
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.,School of Molecular and Cell Biology, Faculty of Science, University of the Witwatersrand, Johannesburg, South Africa.,MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Scott Hazelhurst
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.,School of Electrical and Information Engineering, University of the Witwatersrand, Johannesburg, South Africa
| | - Ananyo Choudhury
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Shane A Norris
- MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Michèle Ramsay
- Division of Human Genetics, School of Pathology, Faculty of Health Sciences, National Health Laboratory Service & University of the Witwatersrand, Johannesburg, South Africa.,Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Zané Lombard
- Division of Human Genetics, School of Pathology, Faculty of Health Sciences, National Health Laboratory Service & University of the Witwatersrand, Johannesburg, South Africa.,Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.,School of Molecular and Cell Biology, Faculty of Science, University of the Witwatersrand, Johannesburg, South Africa
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92
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Mulder N, Abimiku A, Adebamowo SN, de Vries J, Matimba A, Olowoyo P, Ramsay M, Skelton M, Stein DJ. H3Africa: current perspectives. PHARMACOGENOMICS & PERSONALIZED MEDICINE 2018; 11:59-66. [PMID: 29692621 PMCID: PMC5903476 DOI: 10.2147/pgpm.s141546] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Precision medicine is being enabled in high-income countries by the growing availability of health data, increasing knowledge of the genetic determinants of disease and variation in response to treatment (pharmacogenomics), and the decreasing costs of data generation, which promote routine application of genomic technologies in the health sector. However, there is uncertainty about the feasibility of applying precision medicine approaches in low- and middle-income countries, due to the lack of population-specific knowledge, skills, and resources. The Human Heredity and Health in Africa (H3Africa) initiative was established to drive new research into the genetic and environmental basis for human diseases of relevance to Africans as well as to build capacity for genomic research on the continent. Precision medicine requires this capacity, in addition to reference data on local populations, and skills to analyze and interpret genomic data from the bedside. The H3Africa consortium is collectively processing samples and data for over 70,000 participants across the continent, accompanied in most cases by rich clinical information on a variety of non-communicable and infectious diseases. These projects are increasingly providing novel insights into the genetic basis of diseases in indigenous populations, insights that have the potential to drive the development of new diagnostics and treatments. The consortium has also invested significant resources into establishing high-quality biorepositories in Africa, a bioinformatic network, and a strong training program that has developed skills in genomic data analysis and interpretation among bioinformaticians, wet-lab researchers, and health-care professionals. Here, we describe the current perspectives of the H3Africa consortium and how it can contribute to making precision medicine in Africa a reality.
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Affiliation(s)
- Nicola Mulder
- Computational Biology Division, Department of Integrative Biomedical Sciences, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
| | - Alash'le Abimiku
- International Research Center of Excellence, Institute of Human Virology, Abuja, Nigeria
| | - Sally N Adebamowo
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Jantina de Vries
- Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Alice Matimba
- Advanced Courses and Scientific Conferences, Wellcome Genome Campus, Hinxton, UK
| | - Paul Olowoyo
- Federal Teaching Hospital, College of Medicine and Health Sciences, Afe Babalola University, Ado-Ekiti, Nigeria
| | - Michele Ramsay
- Sydney Brenner Institute for Molecular Bioscience, Division of Human Genetics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg
| | - Michelle Skelton
- Computational Biology Division, Department of Integrative Biomedical Sciences, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
| | - Dan J Stein
- Department of Psychiatry and Mental Health, University of Cape Town.,MRC Unit on Risk and Resilience in Mental Disorders, Cape Town, South Africa
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93
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Hendry LM, Sahibdeen V, Choudhury A, Norris SA, Ramsay M, Lombard Z. Insights into the genetics of blood pressure in black South African individuals: the Birth to Twenty cohort. BMC Med Genomics 2018; 11:2. [PMID: 29343252 PMCID: PMC5773038 DOI: 10.1186/s12920-018-0321-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 01/03/2018] [Indexed: 02/08/2023] Open
Abstract
Background Cardiovascular diseases (CVDs) are the leading cause of non-communicable disease deaths globally, with hypertension being a major risk factor contributing to CVDs. Blood pressure is a heritable trait, with relatively few genetic studies having been performed in Africans. This study aimed to identify genetic variants associated with variance in systolic (SBP) and diastolic (DBP) blood pressure in black South Africans. Methods Genotyping was performed using the Metabochip in a subset of participants (mixed sex; median age 17.9) and their adult female caregivers (median age 41.0) from the Birth to Twenty cohort (n = 1947). Data were analysed as a merged dataset (all participants and caregivers together) in GEMMA (v0.94.1) using univariate linear mixed models, incorporating a centered relatedness matrix to account for the relatedness between individuals and with adjustments for age, sex, BMI and principal components of the genotype information. Results Association analysis identified regions of interest in the NOS1AP (DBP: rs112468105 - p = 7.18 × 10−5 and SBP: rs4657181 - p = 4.04 × 10−5), MYRF (SBP: rs11230796 - p = 2.16 × 10−7, rs400075 - p = 2.88 × 10−7) and POC1B (SBP: rs770373 - p = 7.05 × 10−5, rs770374 - p = 9.05 × 10−5) genes and some intergenic regions (DACH1|LOC440145 (DBP: rs17240498 - p = 4.91 × 10−6 and SBP: rs17240498 - p = 2.10 × 10−5) and INTS10|LPL (SBP: rs55830938 - p = 1.30 × 10−5, rs73599609 - p = 5.78 × 10−5, rs73667448 - p = 6.86 × 10−5)). Conclusions The study provided further insight into the contribution of genetic variants to blood pressure in black South Africans. Future functional and replication studies in larger samples are required to confirm the role of the identified loci in blood pressure regulation and whether or not these variants are African-specific. Electronic supplementary material The online version of this article (10.1186/s12920-018-0321-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Liesl M Hendry
- School of Molecular & Cell Biology, Faculty of Science, University of the Witwatersrand, Johannesburg, South Africa. .,Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
| | - Venesa Sahibdeen
- Division of Human Genetics, School of Pathology, Faculty of Health Sciences, National Health Laboratory Service & University of the Witwatersrand, Johannesburg, South Africa
| | - Ananyo Choudhury
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Shane A Norris
- MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Michèle Ramsay
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.,Division of Human Genetics, School of Pathology, Faculty of Health Sciences, National Health Laboratory Service & University of the Witwatersrand, Johannesburg, South Africa
| | - Zané Lombard
- School of Molecular & Cell Biology, Faculty of Science, University of the Witwatersrand, Johannesburg, South Africa.,Division of Human Genetics, School of Pathology, Faculty of Health Sciences, National Health Laboratory Service & University of the Witwatersrand, Johannesburg, South Africa
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94
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Nonterah EA, Debpuur C, Agongo G, Amenga-Etego L, Crowther NJ, Ramsay M. Socio-demographic and behavioural determinants of body mass index among an adult population in rural Northern Ghana: the AWI-Gen study. Glob Health Action 2018; 11:1467588. [PMID: 29992851 PMCID: PMC6041816 DOI: 10.1080/16549716.2018.1467588] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Accepted: 04/17/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Obesity and associated cardiometabolic diseases are increasing in urban sub-Saharan Africa due to a complex epidemiological and nutritional transition. Related data on rural communities is scarce. OBJECTIVES The study characterized the socio-demographic and behavioural factors influencing body mass index (BMI) among adults in rural Northern Ghana Methods: A population-based cross-sectional study involving adults aged 40-60 years residing in the Kassena-Nankana districts was undertaken. Demographic, socio-economic and behavioural data were collected along with measures of anthropometry. We determined factors associated with BMI among women and men. RESULTS A total of 2014 adults were studied. The median age was 51 (IQR 45-57) years and 54% were women. The prevalence of overweight/obesity was higher among women than men (18.4% vs. 7.2%; p < 0.001), whilst underweight was more prevalent in men (18.3% vs. 13.1%; p = 0.001). Participants with the highest level of education and a high household socio-economic status had higher BMIs than those in the lowest strata in both men (β = 0.074, p = 0.028 and β = 0.072, p < 0.001, respectively) and women (β = 0.174, p = 0.001 and β = 0.109, p < 0.001, respectively). Men (β = -0.050; p < 0.001) and women (β = -0.073; p < 0.001) of the Nankana ethnic group had a lower BMI than the Kassena ethnic group. Among men, alcohol consumption (β = -0.021; p = 0.001) and smoking (β = -0.216; p < 0.001) were associated with lower BMI. Smokeless tobacco was associated with lower BMI among women. Pesticide exposure was associated with higher BMI (β = 0.022; p = 0.022) among men. CONCLUSION Age, sex, ethno-linguistic group and prevailing socio-demographic and behavioural factors within this rural community in Northern Ghana influence BMI. The observed positive association between pesticide use and BMI warrants further investigation.
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Affiliation(s)
- Engelbert Adamwaba Nonterah
- Navrongo Health Research Centre (NHRC), Navrongo, Ghana
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
| | | | - Godfred Agongo
- Navrongo Health Research Centre (NHRC), Navrongo, Ghana
- Sydney Brenner Institute for Molecular Bioscience and Division of Human Genetics, School of Pathology, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Nigel J. Crowther
- Department of Chemical Pathology, National Health Laboratory Service, University of the Witwatersrand, Johannesburg, South Africa
| | - Michèle Ramsay
- Sydney Brenner Institute for Molecular Bioscience and Division of Human Genetics, School of Pathology, University of the Witwatersrand, Johannesburg, South Africa
| | - Rexford OduroAbraham
a
as members of AWI-Gen and the H3Africa Consortium
- Navrongo Health Research Centre (NHRC), Navrongo, Ghana
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
- Sydney Brenner Institute for Molecular Bioscience and Division of Human Genetics, School of Pathology, University of the Witwatersrand, Johannesburg, South Africa
- Department of Chemical Pathology, National Health Laboratory Service, University of the Witwatersrand, Johannesburg, South Africa
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95
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Ali SA, Soo C, Agongo G, Alberts M, Amenga-Etego L, Boua RP, Choudhury A, Crowther NJ, Depuur C, Gómez-Olivé FX, Guiraud I, Haregu TN, Hazelhurst S, Kahn K, Khayeka-Wandabwa C, Kyobutungi C, Lombard Z, Mashinya F, Micklesfield L, Mohamed SF, Mukomana F, Nakanabo-Diallo S, Natama HM, Ngomi N, Nonterah EA, Norris SA, Oduro AR, Somé AM, Sorgho H, Tindana P, Tinto H, Tollman S, Twine R, Wade A, Sankoh O, Ramsay M. Genomic and environmental risk factors for cardiometabolic diseases in Africa: methods used for Phase 1 of the AWI-Gen population cross-sectional study. Glob Health Action 2018; 11:1507133. [PMID: 30259792 PMCID: PMC6161608 DOI: 10.1080/16549716.2018.1507133] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 07/12/2018] [Indexed: 01/20/2023] Open
Abstract
There is an alarming tide of cardiovascular and metabolic disease (CMD) sweeping across Africa. This may be a result of an increasingly urbanized lifestyle characterized by the growing consumption of processed and calorie-dense food, combined with physical inactivity and more sedentary behaviour. While the link between lifestyle and public health has been extensively studied in Caucasian and African American populations, few studies have been conducted in Africa. This paper describes the detailed methods for Phase 1 of the AWI-Gen study that were used to capture phenotype data and assess the associated risk factors and end points for CMD in persons over the age of 40 years in sub-Saharan Africa (SSA). We developed a population-based cross-sectional study of disease burden and phenotype in Africans, across six centres in SSA. These centres are in West Africa (Nanoro, Burkina Faso, and Navrongo, Ghana), in East Africa (Nairobi, Kenya) and in South Africa (Agincourt, Dikgale and Soweto). A total of 10,702 individuals between the ages of 40 and 60 years were recruited into the study across the six centres, plus an additional 1021 participants over the age of 60 years from the Agincourt centre. We collected socio-demographic, anthropometric, medical history, diet, physical activity, fat distribution and alcohol/tobacco consumption data from participants. Blood samples were collected for disease-related biomarker assays, and genomic DNA extraction for genome-wide association studies. Urine samples were collected to assess kidney function. The study provides base-line data for the development of a series of cohorts with a second wave of data collection in Phase 2 of the study. These data will provide valuable insights into the genetic and environmental influences on CMD on the African continent.
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Affiliation(s)
- Stuart A. Ali
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Cassandra Soo
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Faculty of Health Sciences University of the Witwatersrand, Division of Human Genetics, National Health Laboratory Service and School of Pathology, Johannesburg, South Africa
| | - Godfred Agongo
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Navrongo Health Research Centre, Navrongo, Ghana
| | - Marianne Alberts
- Department of Pathology and Medical Science, School of Health Care Sciences, Faculty of Health Sciences, University of Limpopo, Polokwane, South Africa
| | | | - Romuald P. Boua
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Faculty of Health Sciences University of the Witwatersrand, Division of Human Genetics, National Health Laboratory Service and School of Pathology, Johannesburg, South Africa
- Clinical Research Unit of Nanoro, Institut de Recherche en Sciences de la Sante, Nanoro, Burkina Faso
| | - Ananyo Choudhury
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Nigel J. Crowther
- Department of Chemical Pathology, National Health Laboratory Service, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | | | - F. Xavier Gómez-Olivé
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Issa Guiraud
- Clinical Research Unit of Nanoro, Institut de Recherche en Sciences de la Sante, Nanoro, Burkina Faso
| | | | - Scott Hazelhurst
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- School of Electrical & Information Engineering, University of the Witwatersrand, Johannesburg, South Africa
| | - Kathleen Kahn
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- INDEPTH Network, Accra, Ghana
| | | | | | - Zané Lombard
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Faculty of Health Sciences University of the Witwatersrand, Division of Human Genetics, National Health Laboratory Service and School of Pathology, Johannesburg, South Africa
| | - Felistas Mashinya
- Department of Pathology and Medical Science, School of Health Care Sciences, Faculty of Health Sciences, University of Limpopo, Polokwane, South Africa
| | - Lisa Micklesfield
- MRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Freedom Mukomana
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Seydou Nakanabo-Diallo
- Clinical Research Unit of Nanoro, Institut de Recherche en Sciences de la Sante, Nanoro, Burkina Faso
| | - Hamtandi M. Natama
- Clinical Research Unit of Nanoro, Institut de Recherche en Sciences de la Sante, Nanoro, Burkina Faso
| | - Nicholas Ngomi
- African Population and Health Research Center, Nairobi, Kenya
| | - Engelbert A. Nonterah
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Navrongo Health Research Centre, Navrongo, Ghana
| | - Shane A. Norris
- MRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Athanase M. Somé
- Clinical Research Unit of Nanoro, Institut de Recherche en Sciences de la Sante, Nanoro, Burkina Faso
| | - Hermann Sorgho
- Clinical Research Unit of Nanoro, Institut de Recherche en Sciences de la Sante, Nanoro, Burkina Faso
| | | | - Halidou Tinto
- Clinical Research Unit of Nanoro, Institut de Recherche en Sciences de la Sante, Nanoro, Burkina Faso
| | - Stephen Tollman
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- INDEPTH Network, Accra, Ghana
| | - Rhian Twine
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Alisha Wade
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Osman Sankoh
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- INDEPTH Network, Accra, Ghana
- Statistics Sierra Leone, Tower Hill, Freetown, Sierra Leone
- Department of Community Medicine, College of Medicine and Allied Health Sciences,University of Sierra Leone, Freetown, Sierra Leone
| | - Michèle Ramsay
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Faculty of Health Sciences University of the Witwatersrand, Division of Human Genetics, National Health Laboratory Service and School of Pathology, Johannesburg, South Africa
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96
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Mashinya F, Alberts M, Cook I, Ntuli S. Determinants of body mass index by gender in the Dikgale Health and Demographic Surveillance System site, South Africa. Glob Health Action 2018; 11:1537613. [PMID: 30392446 PMCID: PMC6225484 DOI: 10.1080/16549716.2018.1537613] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2018] [Accepted: 10/13/2018] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND The study was conducted in the Dikgale Health and Demographic Surveillance System (DHDSS) site where we have observed increasing obesity levels, particularly in women, despite evidence of high physical activity (PA) and a relatively low daily energy intake. OBJECTIVE This study aimed to assess the socio-demographic, behavioural and biological determinants of body mass index (BMI) in adult residents permanently residing in the DHDSS. METHODS A cross-sectional study was conducted in which socio-demographic, behavioural and biological characteristics from 1143 participants (aged 40-60 years) were collected using a paper questionnaire and standard anthropometric measures. Human immunodeficiency virus (HIV) testing was performed on all participants except those who indicated that they had tested positive. Chi-square and Mann-Whitney tests were used to analyze categorical and continuous variables, respectively, while hierarchical multivariate regression was used to analyze predictors of BMI. RESULTS The median age of women and men was 51 (46-56) and 50 (45-55) years, respectively. The prevalence of overweight-obesity was 76% in women and 21% in men. A significant negative association of BMI with HIV and smoking and a significant positive association with socio-economic status (SES) was observed in both sexes. In women, BMI was negatively associated with sleep duration (p = 0.015) and age (p = 0.012), but positively associated with sugar-sweetened beverages (SSBs) (p = 0.08). In men, BMI was negatively associated with alcohol use (p = 0.016) and positively associated with being married (p < 0.001). PA was not associated with BMI in either sexes. Full models explained 9.2% and 20% of the variance in BMI in women and men, respectively. CONCLUSION BMI in DHDSS adults is not associated with physical inactivity but is associated wealth, marital status, sleep, smoking, alcohol use, and HIV status. Future studies should explore the contribution of nutrition, stunting, psycho-social and genetic factors to overweight and obesity in DHDSS.
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Affiliation(s)
- Felistas Mashinya
- Faculty of Health Sciences, University of Limpopo, Polokwane, South Africa
| | - Marianne Alberts
- Faculty of Health Sciences, University of Limpopo, Polokwane, South Africa
| | - Ian Cook
- Faculty of Humanities, University of Limpopo, Polokwane, South Africa
| | - Sam Ntuli
- Faculty of Health Sciences, University of Limpopo, Polokwane, South Africa
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97
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Boua RP, Sorgho H, Rouamba T, Nakanabo Diallo S, Bognini JD, Konkobo SZ, Valia D, Lingani M, Ouoba S, Tougma AS, Bihoun B, Crowther NJ, Norris SA, Ramsay M, Tinto H. Gender differences in sociodemographic and behavioural factors associated with BMI in an adult population in rural Burkina Faso - an AWI-Gen sub-study. Glob Health Action 2018; 11:1527557. [PMID: 30311555 PMCID: PMC6197018 DOI: 10.1080/16549716.2018.1527557] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 09/19/2018] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The global health transition is linked with an increased burden of non-communicable diseases with cardiovascular diseases leading the epidemic. In sub-Saharan Africa (SSA), the prevalence of obesity has increased during the past decades and there is a need to investigate the associated driving factors. In Burkina Faso obesity remains low, especially in rural areas. In this study we recruited middle-aged adults, as part of a larger study on genetic and environmental contributions to cardiometabolic disease among Africans. OBJECTIVES To investigate the distribution of BMI and prevalence of obesity in a cross-sectional population-based study and to determine the sociodemographic and behavioural correlates with BMI. METHODS Participants (N = 2,076) were recruited from the Nanoro Health and Demographic Surveillance System area and were aged 40-60 years. We applied hierarchical modelling to identify factors associated with BMI and structural equation modelling to identify mediated effects of sociodemographic and behavioural variables on BMI. RESULTS Data are presented on 2,076 participants (49.9% female). Men had significantly higher BMI than women with medians of 21.1 (19.2 - 23.4) vs 19.8 (18.1 - 21.6) (p < 0.001), and there were significantly more underweight women compared to men (31.0% vs 17.4%) (p < 0.001). More men were overweight and obese than women (11.9% vs 5.2% and 2.2% vs 1.4%). Socioeconomic status was the major contributor to increased BMI for men, and education was the main contributor in women. Tobacco smoking and chewing, and problematic alcohol consumption were associated with a decrease in BMI in men and women. CONCLUSION Overweight and obesity are relatively low among adults in rural Burkina Faso, and men had a higher median BMI than women. Behavioural factors, including tobacco use and alcohol consumption, contributed to a decrease in BMI, whereas socioeconomic status and education (which were both generally low in this community) contributed to an increase in BMI.
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Affiliation(s)
- Romuald Palwende Boua
- Institut de Recherche en Sciences de la Santé, Clinical Research Unit of Nanoro (IRSS/CRUN), Nanoro, Burkina Faso
- Sydney Brenner Institute of Molecular Bioscience (SBIMB), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Division of Human Genetics, National Health Laboratory Service and School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Hermann Sorgho
- Institut de Recherche en Sciences de la Santé, Clinical Research Unit of Nanoro (IRSS/CRUN), Nanoro, Burkina Faso
| | - Toussaint Rouamba
- Centre de Recherche en Epidémiologie, Biostatistique et Recherche Clinique, Ecole de Santé Publique, Université libre de Bruxelles, Brussels, Belgium
| | - Seydou Nakanabo Diallo
- Institut de Recherche en Sciences de la Santé, Clinical Research Unit of Nanoro (IRSS/CRUN), Nanoro, Burkina Faso
| | - Joel D. Bognini
- Institut de Recherche en Sciences de la Santé, Clinical Research Unit of Nanoro (IRSS/CRUN), Nanoro, Burkina Faso
| | - Sophie Z. Konkobo
- Institut de Recherche en Sciences de la Santé, Clinical Research Unit of Nanoro (IRSS/CRUN), Nanoro, Burkina Faso
| | - Daniel Valia
- Institut de Recherche en Sciences de la Santé, Clinical Research Unit of Nanoro (IRSS/CRUN), Nanoro, Burkina Faso
| | - Moussa Lingani
- Institut de Recherche en Sciences de la Santé, Clinical Research Unit of Nanoro (IRSS/CRUN), Nanoro, Burkina Faso
| | - Serge Ouoba
- Institut de Recherche en Sciences de la Santé, Clinical Research Unit of Nanoro (IRSS/CRUN), Nanoro, Burkina Faso
| | - Alain S. Tougma
- Institut de Recherche en Sciences de la Santé, Clinical Research Unit of Nanoro (IRSS/CRUN), Nanoro, Burkina Faso
| | - Biebo Bihoun
- Institut de Recherche en Sciences de la Santé, Clinical Research Unit of Nanoro (IRSS/CRUN), Nanoro, Burkina Faso
| | - Nigel J. Crowther
- Department of Chemical Pathology, National Health Laboratory Service, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Shane A. Norris
- MRC/Wits Developmental Pathways for Health Research Unit (DPHRU), University of the Witwatersrand, Johannesburg, South Africa
| | - Michèle Ramsay
- Sydney Brenner Institute of Molecular Bioscience (SBIMB), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Division of Human Genetics, National Health Laboratory Service and School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Halidou Tinto
- Institut de Recherche en Sciences de la Santé, Clinical Research Unit of Nanoro (IRSS/CRUN), Nanoro, Burkina Faso
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98
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Micklesfield LK, Kagura J, Munthali R, Crowther NJ, Jaff N, Gradidge P, Ramsay M. Demographic, socio-economic and behavioural correlates of BMI in middle-aged black men and women from urban Johannesburg, South Africa. Glob Health Action 2018; 11:1448250. [PMID: 30079826 PMCID: PMC6084500 DOI: 10.1080/16549716.2018.1448250] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Accepted: 03/02/2018] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND There is a high and increasing prevalence of overweight and obesity in South Africans of all ages. Risk factors associated with overweight and obesity must be identified to provide targets for intervention. OBJECTIVE To identify the demographic, socio-economic and behavioural factors associated with body mass index (BMI) in middle-aged black South African men and women. METHODS Data on demographic and socio-economic factors were collected via questionnaire on 1027 men and 1008 women from Soweto Johannesburg, South Africa. Weight and height were measured and BMI was determined. Behavioural factors included tobacco use and consumption of alcohol, and physical activity data were collected using the Global Physical Activity Questionnaire. Menopausal status was determined for the women, and HIV status was available for 93.6% of the men and 39.9% of the women. RESULTS Significantly more women were overweight or obese than men (87.9 vs. 44.9%). Smoking prevalence (current or former) and minutes spent in moderate to vigorous intensity physical activity was significantly different between the sexes (both p < 0.0001). In the final hierarchical model, marital status (+ married/cohabiting), household asset score (+), current smoking (-), moderate to vigorous physical activity (-) and HIV status (- HIV infected) significantly contributed to 26% of the variance in BMI in the men. In the women, home language (Tswana-speaking compared to Zulu-speaking), marital status (+ unmarried/cohabiting), education (-), current smoking (-) and HIV status (- HIV infected) significantly contributed to 14% of the variance in BMI. CONCLUSIONS The sex difference in BMI and the prevalence of overweight and obesity between black South African men and women from Soweto, as well as the sex-specific associations with various demographic, socio-economic and behavioural factors, highlight the need for more tailored interventions to slow down the obesity epidemic.
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Affiliation(s)
- Lisa K. Micklesfield
- MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Juliana Kagura
- MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Richard Munthali
- MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Nigel J. Crowther
- Department of Chemical Pathology, National Health Laboratory Service, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Nicole Jaff
- MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Department of Chemical Pathology, National Health Laboratory Service, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Philippe Gradidge
- MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Centre for Exercise Science and Sports Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Michèle Ramsay
- Sydney Brenner Institute for Molecular Bioscience and Division of Human Genetics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - http://orcid.org/0000-0001-7124-3788NorrisShane A.
a
as members of AWI-Gen the H3Africa Consortium
- MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Sydney Brenner Institute for Molecular Bioscience and Division of Human Genetics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Department of Chemical Pathology, National Health Laboratory Service, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Centre for Exercise Science and Sports Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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99
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Gómez-Olivé FX, Ali SA, Made F, Kyobutungi C, Nonterah E, Micklesfield L, Alberts M, Boua R, Hazelhurst S, Debpuur C, Mashinya F, Dikotope S, Sorgho H, Cook I, Muthuri S, Soo C, Mukomana F, Agongo G, Wandabwa C, Afolabi S, Oduro A, Tinto H, Wagner RG, Haregu T, Wade A, Kahn K, Norris SA, Crowther NJ, Tollman S, Sankoh O, Ramsay M. Regional and Sex Differences in the Prevalence and Awareness of Hypertension: An H3Africa AWI-Gen Study Across 6 Sites in Sub-Saharan Africa. Glob Heart 2017; 12:81-90. [PMID: 28302553 DOI: 10.1016/j.gheart.2017.01.007] [Citation(s) in RCA: 94] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 01/13/2017] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND There is a high prevalence of hypertension and related cardiovascular diseases in sub-Saharan Africa, yet few large studies exploring hypertension in Africa are available. The actual burden of disease is poorly understood and awareness and treatment to control it is often suboptimal. OBJECTIVES The study sought to report the prevalence of measured hypertension and to assess awareness and control of blood pressure among older adults in rural and urban settings in 6 sites located in West, East, and Southern Africa. In addition, we examined regional, sex, and age differences related to hypertension. METHODS A population-based cross-sectional study was performed at 6 sites in 4 African countries: Burkina Faso (Nanoro), Ghana (Navrongo), Kenya (Nairobi), and South Africa (Agincourt, Dikgale, Soweto). Blood pressure measurements were taken using standardized procedures on 10,696 adults 40 to 60 years of age. Hypertension was defined as systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg or taking antihypertensive medication. RESULTS The mean prevalence of hypertension ranged from 15.1% in Nanoro to 54.1% in Soweto. All 3 of the South African sites had a mean prevalence of hypertension of over 40.0%, significantly higher than in Nairobi (25.6%) and Navrongo (24.5%). Prevalence increased with age in both sexes and at all sites. A significantly higher prevalence of hypertension was observed in women in Agincourt, Dikgale, and Nairobi, whereas in Nanoro this trend was reversed. Within the hypertensive group the average proportion of participants who were aware of their blood pressure status was only 39.4% for men and 53.8% for women, and varied widely across sites. CONCLUSIONS Our study demonstrates that the prevalence of hypertension and the level of disease awareness differ not only between but also within sub-Saharan African countries. Each nation must tailor their regional hypertension awareness and screening programs to match the characteristics of their local populations.
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Affiliation(s)
- F Xavier Gómez-Olivé
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; INDEPTH Network, Accra, Ghana; Harvard Center for Population and Development Studies, Harvard T.H. Chan School of Public Health, Harvard University, Cambridge, MA, USA
| | - Stuart A Ali
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Felix Made
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | | | | | - Lisa Micklesfield
- MRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Marianne Alberts
- Department of Pathology and Medical Sciences, School of Health Care Sciences, Faculty of Health Sciences, University of Limpopo, Polokwane, South Africa
| | - Romuald Boua
- Institut de Recherche en Sciences de la Sante, Clinical Research Unit of Nanoro, Nanoro, Burkina Faso
| | - Scott Hazelhurst
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; School of Electrical & Information Engineering, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Felistas Mashinya
- Department of Pathology and Medical Sciences, School of Health Care Sciences, Faculty of Health Sciences, University of Limpopo, Polokwane, South Africa
| | - Sekgothe Dikotope
- Department of Pathology and Medical Sciences, School of Health Care Sciences, Faculty of Health Sciences, University of Limpopo, Polokwane, South Africa
| | - Hermann Sorgho
- Institut de Recherche en Sciences de la Sante, Clinical Research Unit of Nanoro, Nanoro, Burkina Faso
| | - Ian Cook
- Physical Activity Epidemiology Laboratory (EDST), School of Education, Faculty of Humanities, University of Limpopo, Polokwane, South Africa
| | - Stella Muthuri
- African Population and Health Research Center, Nairobi, Kenya
| | - Cassandra Soo
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Freedom Mukomana
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | | | | | - Sulaimon Afolabi
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Halidou Tinto
- Institut de Recherche en Sciences de la Sante, Clinical Research Unit of Nanoro, Nanoro, Burkina Faso
| | - Ryan G Wagner
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Tilahun Haregu
- African Population and Health Research Center, Nairobi, Kenya
| | - Alisha Wade
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Kathleen Kahn
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Shane A Norris
- MRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Nigel J Crowther
- Department of Chemical Pathology, National Health Laboratory Service, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Stephen Tollman
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Osman Sankoh
- INDEPTH Network, Accra, Ghana; School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Department of Mathematics and Statistics, Njala University, Njala, Sierra Leone
| | - Michèle Ramsay
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Division of Human Genetics, National Health Laboratory Service and School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
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