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López-Bueno R, Núñez-Cortés R, Calatayud J, Salazar-Méndez J, Petermann-Rocha F, López-Gil JF, Del Pozo Cruz B. Global prevalence of cardiovascular risk factors based on the Life's Essential 8 score: an overview of systematic reviews and meta-analysis. Cardiovasc Res 2024; 120:13-33. [PMID: 38033266 DOI: 10.1093/cvr/cvad176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 09/25/2023] [Accepted: 10/20/2023] [Indexed: 12/02/2023] Open
Abstract
Cardiovascular health (CVH) is a critical issue for global health. However, no previous study has determined the prevalence of cardiovascular risk factors based on the American Heart Association's (AHA) Life's Essential 8 (LE8). Therefore, we aimed to estimate the global prevalence of the eight cardiovascular risk factors identified in the LE8. A systematic search of systematic reviews with meta-analysis on cardiovascular risk factors covering data reported between 2000 and 2019 was conducted on PubMed, Epistemonikos, and the Cochrane Library until 1 May 2023. After applying exclusion criteria, 79 studies remained in the final selection for the narrative synthesis in the systematic review, of which 33 of them were used in the meta-analysis which included 2 555 639 participants from 104 countries. The overall pooled prevalence of cardiovascular risk factors was as follows: insufficient physical activity, 26.3% (95% CI 2.3%-63.4%), no adherence to a healthy diet, 34.1% (95% CI 5.8%-71.2%), nicotine exposure, 15.4% (95% CI 10.4%-21.2%), insufficient sleep quality, 38.5% (95% CI 14.0%-66.7%), obesity, 17.3% (95% CI 6.1%-32.6%), dyslipidemia, 34.1% (95% CI 33.8%-34.4%), diabetes, 12.0% (95% CI 7.0%-18.2%), and hypertension, 29.4% (95% CI 23.3%-35.8%). These results warrant prevention strategies aimed at reducing insufficient sleep quality, and no adherence to a healthy diet as leading cardiovascular risk factors worldwide. The high prevalence of hypertension among children and adults is concerning and should also be adequately addressed through global policies.
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Affiliation(s)
- Rubén López-Bueno
- Department of Physical Medicine and Nursing, University of Zaragoza, Zaragoza, Spain
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Rodrigo Núñez-Cortés
- Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile
- Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - Joaquín Calatayud
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | | | - Fanny Petermann-Rocha
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
- Centro de Investigación Biomédica, Facultad de Medicina, Universidad Diego Portales, Santiago, Chile
| | | | - Borja Del Pozo Cruz
- Faculty of Education, University of Cádiz, Cádiz, Spain
- Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Puerta del Mar University Hospital, University of Cádiz, Cádiz, Spain
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
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Endale F, Nigussie A, Tamene A, Habte A, Ermias D, Beyamo A, Tadesse T, Sulamo D, Belachew T. Abdominal obesity and associated factors among urban adults in Southwest Ethiopia: a community-based cross-sectional study. Pan Afr Med J 2024; 47:47. [PMID: 38681102 PMCID: PMC11055183 DOI: 10.11604/pamj.2024.47.47.34746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 01/25/2024] [Indexed: 05/01/2024] Open
Abstract
Introduction the obesity epidemic is growing faster in developing countries with no exception of Ethiopia. Currently, abdominal obesity is identified as a major risk factor for chronic diseases due to the accumulation of liable fat. However, despite the evidence of certain documented data, abdominal obesity has been on the rise in Ethiopia, especially in urban areas. Therefore, this study aimed to assess the prevalence and factors associated with abdominal obesity among adults in Jimma town, Southwest Ethiopia. Methods a community-based cross-sectional study was employed on 845 adults selected using a multi-stage sampling technique. Data were collected using a pretested interviewer-administered questionnaire. Data were entered using Epi-data version 3.1 and exported to STATA version 14 for analysis. Simple linear regression was conducted to identify candidate variables. A multivariable linear regression model was fitted to identify factors associated with abdominal obesity. P-value<0.05 was used to declare statistical significance. Results a total of 806 respondents participated in this study, making a response rate of 95.4%. The magnitude of abdominal obesity was found to be 24.6% (95% CI: 21.5, 27.5). Physical activity (β= -2.053; 95%CI: -3.353, -0.454), alcohol consumption (β=1.631; 95%CI: 0.176, 3.087), and age (β=0.319; 95%CI: 0.250, 0.389) were significantly associated with abdominal obesity. Conclusion the magnitude of abdominal obesity among adults in the study area was high compared to previous studies. Alcohol drinking, being physically inactive, and age were predictors of abdominal obesity. There is a need for intervention for adults with physical inactivity and alcohol consumption to reduce abdominal obesity.
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Affiliation(s)
- Fitsum Endale
- School of Public Health, College of Medicine and Health Sciences, Wachemo University, Hosanna, Ethiopia
| | - Aderajew Nigussie
- Department of Nutrition and Dietetics, Institute of Health Sciences, Jimma University, Jimma, Ethiopia
| | - Aiggan Tamene
- School of Public Health, College of Medicine and Health Sciences, Wachemo University, Hosanna, Ethiopia
| | - Aklilu Habte
- School of Public Health, College of Medicine and Health Sciences, Wachemo University, Hosanna, Ethiopia
| | - Dejene Ermias
- School of Public Health, College of Medicine and Health Sciences, Wachemo University, Hosanna, Ethiopia
| | - Abera Beyamo
- School of Public Health, College of Medicine and Health Sciences, Wachemo University, Hosanna, Ethiopia
| | - Tegegn Tadesse
- School of Public Health, College of Medicine and Health Sciences, Wachemo University, Hosanna, Ethiopia
| | - Dawit Sulamo
- School of Public Health, College of Medicine and Health Sciences, Wachemo University, Hosanna, Ethiopia
| | - Tefera Belachew
- Department of Nutrition and Dietetics, Institute of Health Sciences, Jimma University, Jimma, Ethiopia
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Wade AN, Maposa I, Agongo G, Asiki G, Boua P, Choma SSR, Gómez-Olivé FX, Maimela E, Micklesfield LK, Mohamed SF, Nonterah EA, Norris SA, Sorgho H, Ramsay M, Crowther NJ. Diabetes care cascade and associated factors in 10 700 middle-aged adults in four sub-Saharan African countries: a cross-sectional study. BMJ Open 2023; 13:e069193. [PMID: 37105688 PMCID: PMC10151877 DOI: 10.1136/bmjopen-2022-069193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/29/2023] Open
Abstract
OBJECTIVES We investigated progression through the care cascade and associated factors for people with diabetes in sub-Saharan Africa to identify attrition stages that may be most appropriate for targeted intervention. DESIGN Cross-sectional study. SETTING Community-based study in four sub-Saharan African countries. PARTICIPANTS 10 700 individuals, aged 40-60 years. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome measure was the diabetes cascade of care defined as the age-adjusted diabetes prevalence (self-report of diabetes, fasting plasma glucose (FPG) ≥7 mmol/L or random plasma glucose ≥11.1 mmol/L) and proportions of those who reported awareness of having diabetes, ever having received treatment for diabetes and those who achieved glycaemic control (FPG <7.2 mmol/L). Secondary outcome measures were factors associated with having diabetes and being aware of the diagnosis. RESULTS Diabetes prevalence was 5.5% (95% CI 4.4% to 6.5%). Approximately half of those with diabetes were aware (54%; 95% CI 50% to 58%); 73% (95% CI 67% to 79%) of aware individuals reported ever having received treatment. However, only 38% (95% CI 30% to 46%) of those ever having received treatment were adequately controlled. Increasing age (OR 1.1; 95% CI 1.0 to 1.1), urban residence (OR 2.3; 95% CI 1.6 to 3.5), hypertension (OR 1.9; 95% CI 1.5 to 2.4), family history of diabetes (OR 3.9; 95% CI 3.0 to 5.1) and measures of central adiposity were associated with higher odds of having diabetes. Increasing age (OR 1.1; 95% CI 1.0 to 1.1), semi-rural residence (OR 2.5; 95% CI 1.1 to 5.7), secondary education (OR 2.4; 95% CI 1.2 to 4.9), hypertension (OR 1.6; 95% CI 1.0 to 2.4) and known HIV positivity (OR 2.3; 95% CI 1.2 to 4.4) were associated with greater likelihood of awareness of having diabetes. CONCLUSIONS There is attrition at each stage of the diabetes care cascade in sub-Saharan Africa. Public health strategies should target improving diagnosis in high-risk individuals and intensifying therapy in individuals treated for diabetes.
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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 Faculty of Health Sciences, Johannesburg, South Africa
| | - Innocent Maposa
- Division of Epidemiology and Biostatistics, University of the Witwatersrand Johannesburg Faculty of Health Sciences, Johannesburg, South Africa
| | - Godfred Agongo
- Navrongo Health Research Centre, Navrongo, Ghana
- Department of Biochemistry and Forensic Sciences, School of Chemical and Biochemical Sciences, C. K. Tedam University of Technology and Applied Sciences, Navrongo, Ghana
| | - Gershim Asiki
- Health and Systems for Health Unit, African Population and Health Research Center, Nairobi, Kenya
| | - Palwende Boua
- Clinical Research Unit of Nanoro, Institut de Recherche en Sciences de la Sante, Ouagadougou, Burkina Faso
| | - Solomon S R Choma
- Department of Pathology and Medical Sciences, DIMAMO Population Health Research Centre, University of Limpopo, Sovenga, 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 Faculty of Health Sciences, Johannesburg, South Africa
| | - Eric Maimela
- Department of Public Health, University of Limpopo, Sovenga, 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
| | - Shukri F Mohamed
- Health and Systems for Health Unit, African Population and Health Research Center, Nairobi, Kenya
| | | | - 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
- Global Health Research Institute, School of Health and Human Development, University of Southampton, Southampton, UK
| | - Hermann Sorgho
- Clinical Research Unit of Nanoro, Institut de Recherche en Sciences de la Sante, Ouagadougou, Burkina Faso
| | - Michele Ramsay
- Sydney Brenner Institute for Molecular Bioscience, University of the Witwatersrand Johannesburg Faculty of Health Sciences, Johannesburg, South Africa
| | - Nigel J Crowther
- Department of Chemical Pathology, National Health Laboratory Service, University of the Witwatersrand Johannesburg Faculty of Health Sciences, Johannesburg, South Africa
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Diawara A, Coulibaly DM, Hussain TYA, Cisse C, Li J, Wele M, Diakite M, Traore K, Doumbia SO, Shaffer JG. Type 2 diabetes prevalence, awareness, and risk factors in rural Mali: a cross-sectional study. Sci Rep 2023; 13:3718. [PMID: 36878951 PMCID: PMC9987397 DOI: 10.1038/s41598-023-29743-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 02/09/2023] [Indexed: 03/08/2023] Open
Abstract
Diabetes is currently a crisis in sub-Saharan West Africa (SSWA) with dramatic implications for public health and national budgets prioritizing infectious diseases. There is limited recent literature about the prevalence, awareness, and risk factors for type 2 diabetes (T2D) in rural parts of SSWA. This study characterized T2D prevalence and risk factors for the rural Malian community of Nièna, which is situated in Mali's second-largest province of Sikasso. Between December 2020 and July 2021, a cross-sectional study of 412 participants was conducted in the Nièna community using clinical questionnaires and rapid diagnostic tests. Among 412 participants, there were 143 (34.7%) and 269 (65.3%) males and females, respectively. The overall prevalence of T2D in Nièna was 7.5% (31/412), and prevalence rates were 8.6% (23/269) and 5.6% (8/143) for females and males, respectively. Age, family history of diabetes, hypertension, waist circumference, and fetal macrosomia were significantly associated with T2D (p = 0.007, p < 0.001, p = 0.003, p = 0.013, and p < 0.001, respectively). Notably, 61.3% (19/31) of T2D subjects were unaware of their diabetic status before the study. Field surveys have considerable utility in driving T2D awareness in rural African settings.
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Affiliation(s)
- Abdoulaye Diawara
- University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali.
| | | | | | - Cheickna Cisse
- University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Jian Li
- Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Mamadou Wele
- University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Mahamadou Diakite
- University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | | | - Seydou O Doumbia
- University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali.
| | - Jeffrey G Shaffer
- Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA.
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Enyew A, Nigussie K, Mihrete T, Jemal M, kedir S, Alemu E, Mohammed B. Prevalence and associated factors of physical inactivity among adult diabetes mellitus patients in Felege Hiwot Referral Hospital, Bahir Dar, Northwest Ethiopia. Sci Rep 2023; 13:118. [PMID: 36599905 PMCID: PMC9813006 DOI: 10.1038/s41598-022-26895-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 12/21/2022] [Indexed: 01/06/2023] Open
Abstract
Physical inactivity has been viewed as an emerging public health problem in developing countries including Ethiopia. Diabetes mellitus (DM) is a group metabolic disorder characterized by chronic hyperglycemia resulting from defects in insulin secretion, function, or both. Its prevalence increases with changing lifestyles including physical inactivity across the globe. However, there is limited research, and not yet received attention in Ethiopia. This study aimed to assess the prevalence and associated factors of physical inactivity among adult diabetic patients in Felege Hiwot Referral Hospital, Bahir Dar, Northwest Ethiopia. An institutional-based cross-sectional study design was conducted among 308 participants from February to June 2018 at Felege Hiwot Referral Hospital. A face-to-face interview was conducted using a structured questionnaire by trained data collectors. Participants were selected through a systematic random sampling technique. Physical inactivity was assessed by the international physical activity questionnaire (IPAQ). Collected data were entered in Epi info version 7 and transferred to SPSS version 20 for analysis. A summary of descriptive statistics and multiple binary logistic regression analyses were computed to identify associated factors of physical inactivity among adult diabetic patients. P < 0.05 with 95% CI was considered statistically significant. The overall prevalence of physical inactivity among diabetic patients was 30.5% ( 95% CI: 22.8-33.5%). Gender (AOR = 1.5, 95% CI: 1.1, 3.62), Old age (AOR = 18.17, 95% CI: 22.7, 61.9) Residence (AOR = 4.24, 95% CI: 1,12,16.028), Low self-efficacy (AOR = 20.59, 95% CI: 10.598, 41.608), Poor attitude (AOR = 2.75, 95%CI: 1.44,5.28), and Lack of social support (AOR = 4.22, 95% CI: 1.28,4.07) were found significantly predictor factors of physical inactivity. The prevalence of physical inactivity in this study was high. Being female, old age, dwelling in an urban, having low efficacy, poor attitude, and lack of social support was greater risk factors for being physically inactive. Diabetic education should focus on engagement in physical activity by overcoming barriers to performing physical activity. Government and health professionals should emphasize that evidence-based physical activity important to change their attitudes and require reaching a consensus on social support by their families.
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Affiliation(s)
- Addis Enyew
- grid.59547.3a0000 0000 8539 4635Department of Physiotherapy, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Kalkidan Nigussie
- grid.59547.3a0000 0000 8539 4635Department of Physiotherapy, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Tewodros Mihrete
- grid.59547.3a0000 0000 8539 4635Department of Physiotherapy, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Musa Jemal
- Department of Public Health, College of Medicine and Health Science, Werabe University, Werabe, Ethiopia
| | - Shemsu kedir
- Department of Public Health, College of Medicine and Health Science, Werabe University, Werabe, Ethiopia
| | - Emana Alemu
- grid.452387.f0000 0001 0508 7211Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Bekri Mohammed
- grid.59547.3a0000 0000 8539 4635Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Physical Activity Measured by Pedometer in a Peri-Urban Mozambican Population. J Phys Act Health 2022; 19:777-785. [DOI: 10.1123/jpah.2022-0003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 08/30/2022] [Accepted: 09/01/2022] [Indexed: 11/06/2022]
Abstract
Aim: This study was performed to describe physical activity behavior and its demographic associations in a peri-urban population from Mozambique, using device-based data. Methods: Physical activity was assessed by pedometers in a sample of 15- to 64-year-old subjects from Maputo, Mozambique. Participants wore a pedometer for 7 consecutive days, and physical inactivity was classified using a variety of approaches: sedentary (<5000 steps/d), physically inactive (<7500 steps/d), and no moderate-to-vigorous physical activity (MVPA < 1 min/d). Results: The percentage of sedentary subjects was 17.8%, and the percentage who were physically inactive was 41.8%. A total of 9.0% of participants participated in no MVPA (<1 min/d). Logistic regression analysis showed that females had a higher odds of being sedentary or inactive and having no MVPA compared with males. Unemployed participants were more sedentary and inactive than those who were employed. Socioeconomic status and body mass index did not show any significant association with physical activity. Conclusions: Findings suggest that physical activity levels of this peri-urban African city population are insufficient relative to the amount of activity recommended to improve health. Moreover, being sedentary and inactive was associated with occupation and gender but not with other sociodemographic characteristics and body mass index.
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Zenbaba D, Yassin A, Abdulkadir A, Mama M. Geographical variation and correlates of substance use among married men in Ethiopia: spatial and multilevel analysis from Ethiopian Demographic and Health Survey 2016. BMJ Open 2022; 12:e062060. [PMID: 36153037 PMCID: PMC9511580 DOI: 10.1136/bmjopen-2022-062060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE The use of substances has become one of the world's most serious public health and socioeconomic issues. Most nations in sub-Saharan Africa, including Ethiopia, are undergoing significant economic transitions, creating a favourable environment for socially destructive substance use. This study aimed to determine the geographical variation, prevalence and correlates of substance use among ever-married men in Ethiopia. DESIGN A community-based cross-sectional survey was undertaken from 18 January 2016 to 27 June 2016. DATA SOURCE Data were used from the 2016 Ethiopian Demographic and Health Survey (EDHS). DATA EXTRACTION AND ANALYSIS Data from the 2016 EDHS was used, and a total of 7793 ever-married men were involved in the analysis. The spatial autocorrelation statistic (Global Moran's I) was used to determine whether substance use was dispersed, clustered or randomly distributed. A multilevel logistic regression model was used to identify the correlates with substance use, and statistical significance was declared at p<0.05 and 95% CI. RESULTS Of all ever-married men, 72.5% (95% CI 71.5% to 73.4%) were currently using at least one of the three substances (alcohol, cigarettes and chat). The highest hotspot areas of substance use were observed in Ahmara and Tigray regions. The age (adjusted OR, AOR 1.80; 95% CI 1.32 to 2.45), educational status (AOR 0.64; 95% CI 0.51 to 0.82), occupation (AOR 1.36; 95% CI 1.05 to 1.76), watching television (AOR 1.50; 95% CI 1.25 to 1.81) and living in the city (AOR 2.25; 95% CI to 1.36 to 3.74) were individual and community-level correlates found to have a statistically significant association with substance use. CONCLUSION In this study, nearly three-fourths of married men used one of the three substances. Given these findings, it is critical to reducing the problem by improving modifiable individual-level variables such as educational status and reducing substance advertising.
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Affiliation(s)
- Demisu Zenbaba
- Public Health, Madda Walabu University, Goba, Oromia, Ethiopia
| | - Ahmed Yassin
- Public Health, Madda Walabu University, Goba, Oromia, Ethiopia
| | - Adem Abdulkadir
- Public Health, Madda Walabu University, Goba, Oromia, Ethiopia
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Motala AA, Mbanya JC, Ramaiya K, Pirie FJ, Ekoru K. Type 2 diabetes mellitus in sub-Saharan Africa: challenges and opportunities. Nat Rev Endocrinol 2022; 18:219-229. [PMID: 34983969 DOI: 10.1038/s41574-021-00613-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/25/2021] [Indexed: 12/26/2022]
Abstract
Type 2 diabetes mellitus (T2DM), which was once thought to be rare in sub-Saharan Africa (SSA), is now well established in this region. The SSA region is undergoing a rapid but variable epidemiological transition fuelled by the pace of urbanization, with disease burden profiles shifting from communicable diseases to non-communicable diseases (NCDs). Information on the epidemiology of T2DM has increased, but wide variations in study methods, diagnostic biomarkers and criteria hamper analytical comparison, and data from high-quality studies are limited. The prevalence of T2DM is still low in some rural populations but moderate or high rates are reported in many countries/regions, with evidence for an increase in some. In addition, the proportion of undiagnosed T2DM is still high. The prevalence of T2DM is highest in African people living in urban areas, and the gradient between African people living in urban areas and people in the African diaspora is rapidly fading. However, data from longitudinal studies are lacking and there is limited information on chronic complications and the genetics of T2DM. The large unmet needs for T2DM care call for greater investment of resources into health systems to manage NCDs in SSA. Proposed health-system paradigms are being developed in some countries/regions. However, national NCD programmes need to be adequately funded and coordinated to stem the tide of T2DM and its complications.
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Affiliation(s)
- Ayesha A Motala
- Inkosi Albert Luthuli Central Hospital, Durban, South Africa.
- Department of Diabetes and Endocrinology, University of KwaZulu-Natal, Durban, South Africa.
| | - Jean Claude Mbanya
- Department of Internal Medicine and Specialities, Faculty of Medicine and Biomedical Sciences University of Yaounde 1, Yaounde, Cameroon
| | | | - Fraser J Pirie
- Inkosi Albert Luthuli Central Hospital, Durban, South Africa
- Department of Diabetes and Endocrinology, University of KwaZulu-Natal, Durban, South Africa
| | - Kenneth Ekoru
- Centre for Research on Genomics and Global Health, National Human Genome Research Institute, National Institute of Health, Bethesda, MD, USA
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Peimani M, Bandarian F, Namazi N, Larijani B, Nasli-Esfahani E. Physical Activity Behavior During the COVID-19 Outbreak in Individuals with Type 2 Diabetes: Role of Social Support and Other Covariates. Int J Endocrinol Metab 2022; 20:e120867. [PMID: 36060451 PMCID: PMC9363939 DOI: 10.5812/ijem-120867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 04/12/2022] [Accepted: 04/24/2022] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVES This study was performed to investigate whether social support and other psychological predictors were associated with physical activity during the prolonged social isolation due to the coronavirus disease 2019 outbreak in Iran. METHODS This cross-sectional study was performed on 494 individuals with type 2 diabetes (T2D) in a diabetes specialty clinic. The questionnaire package comprised five parts, including sociodemographic and clinical characteristics, physical activity level, diabetes-specific social support, feelings of isolation, and diabetes-related distress. Clinical and hemoglobin A1c data were obtained from electronic medical records. Descriptive statistics, Pearson's chi-square test, and multivariable logistic regressions were conducted to analyze the data. RESULTS Approximately 71% of the participants participated in low/insufficient levels of physical activity. The participants who received support from family/friends (odds ratio [OR] = 1.77; 95% confidence interval [CI]: 1.47 - 2.74), diabetes care team (OR = 1.42; 95% CI: 1.15 - 1.77), and neighbors (OR = 1.53; 95% CI: 1.20 - 2.08) were more likely to have sufficient physical activity than those who did not receive these supports. There was also an association between physical activity behavior with feelings of isolation and diabetes distress. CONCLUSIONS This study points to the importance of social support as an amplifier mechanism for the maintenance of physical activity behavior in individuals with T2D during critical times.
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Affiliation(s)
- Maryam Peimani
- Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Bandarian
- Metabolomics and Genomics Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institutes, Tehran University of Medical Sciences, Tehran, Iran
| | - Nazli Namazi
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Bagher Larijani
- Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ensieh Nasli-Esfahani
- Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Corresponding Author: Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, P. O. Box: 1411713137, Tehran, Iran. Tel : +98-2188631298, Fax : +98-2188220052,
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Bockarie T, Odland ML, Wurie H, Ansumana R, Lamin J, Witham M, Oyebode O, Davies J. Prevalence and socio-demographic associations of diet and physical activity risk-factors for cardiovascular disease in Bo, Sierra Leone. BMC Public Health 2021; 21:1530. [PMID: 34376163 PMCID: PMC8353867 DOI: 10.1186/s12889-021-11422-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 06/07/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Little is known about modifiable dietary and physical activity risk factors for cardiovascular diseases (CVDs) in Sierra Leone. This information is critical to the development of health improvement interventions to reduce the prevalence of these diseases. This cross-sectional study investigated the prevalence and socio-demographic correlates of dietary and physical activity risk behaviours amongst adults in Bo District, Sierra Leone. METHODS Adults aged 40+ were recruited from 10 urban and 30 rural sub-districts in Bo. We examined risk factors including: ≤150 min of moderate or vigorous-intensity physical activity (MVPA) weekly, physical inactivity for ≥3 h daily, ≤5 daily portions of fruit and vegetables, and salt consumption (during cooking, at the table, and in salty snacks). We used logistic regression to investigate the relationship between these outcomes and participants' socio-demographic characteristics. RESULTS 1978 eligible participants (39.1% urban, 55.6% female) were included in the study. The prevalence of behavioural risk factors was 83.6% for ≤5 daily portions of fruit and vegetables; 41.4 and 91.6% for adding salt at the table or during cooking, respectively and 31.1% for eating salty snacks; 26.1% for MVPA ≤150 min weekly, and 45.6% for being physically inactive ≥3 h daily. Most MVPA was accrued at work (nearly 24 h weekly). Multivariable analysis showed that urban individuals were more likely than rural individuals to consume ≤5 daily portions of fruit and vegetables (Odds Ratio (OR) 1.09, 95% Confidence Interval (1.04-1.15)), add salt at the Table (OR 1.88 (1.82-1.94)), eat salty snacks (OR 2.00 (1.94-2.07)), and do MVPA ≤150 min weekly (OR 1.16 (1.12-1.21)). Male individuals were more likely to add salt at the Table (OR 1.23 (1.20-1.27)) or consume salty snacks (OR 1.35 (1.31-1.40)) than female individuals but were less likely to report the other behavioural risk-factors examined. Generally, people in lower wealth quintiles had lower odds of each risk factor than those in the higher wealth quintiles. CONCLUSION Dietary risk factors for CVD are highly prevalent, particularly among urban residents, of Bo District, Sierra Leone. Our findings highlight that forthcoming policies in Sierra Leone need to consider modifiable risk factors for CVD in the context of urbanisation.
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Affiliation(s)
- Tahir Bockarie
- Warwick Medical School, University of Warwick, Coventry, CV4 7AL UK
| | - Maria Lisa Odland
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, B15 2TT UK
| | - Haja Wurie
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Western Area Sierra Leone
| | - Rashid Ansumana
- School of Community Health Sciences, Njala University, Bo Campus, Bo, Sierra Leone
| | - Joseph Lamin
- School of Community Health Sciences, Njala University, Bo Campus, Bo, Sierra Leone
- Mercy Hospital Research Laboratory, Bo, Sierra Leone
| | - Miles Witham
- AGE Research Group, NIHR Newcastle Biomedical Research Centre, Newcastle University, Newcastle upon Tyne, UK
- Newcastle upon Tyne Hospitals Trust, Newcastle upon Tyne, UK
- MRC/Wits Rural Public Health & Health Transitions Research Unit (Agincourt), University of the Witwatersrand, Johannesburg, South Africa
| | - Oyinlola Oyebode
- Warwick Medical School, University of Warwick, Coventry, CV4 7AL UK
| | - Justine Davies
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, B15 2TT UK
- MRC/Wits Rural Public Health & Health Transitions Research Unit (Agincourt), University of the Witwatersrand, Johannesburg, South Africa
- Department for Global Health, Centre for Global Surgery, Stellenbosch University, Stellenbosch, South Africa
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Nsimbo KBA, Erumeda N, Pretorius D. Food insecurity and its impact on glycaemic control in diabetic patients attending Jabulani Dumani community health centre, Gauteng province, South Africa. Afr J Prim Health Care Fam Med 2021; 13:e1-e6. [PMID: 34082551 PMCID: PMC8182565 DOI: 10.4102/phcfm.v13i1.2906] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 04/08/2021] [Accepted: 04/17/2021] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND To the best of our knowledge no studies have been conducted to assess the relationship between food insecurity and poor glycaemic control in diabetic patients in peri-urban settings of the South African context. AIM The study aimed to assess food insecurity and its relationships with glycaemic control and other patient characteristics amongst diabetic patients attending Jabulani Dumani Community Health Centre. SETTING The study was conducted in a primary healthcare facility in the south sub-district of Ekurhuleni health district, the Gauteng province, South Africa. METHODS This was a cross-sectional descriptive study involving 250 patients. Data were collected by using an interview-administered Household Food Insecurity Access Scale questionnaire. Descriptive and inferential statistical analyses by using Stata 14.0 statistical software were performed. Chi square and logistic regression tests assessed the association between socio-demographic characteristics, glycaemic control and food insecurity. RESULTS Amongst 250 recruited participants, 82.4% were above 50 years, 64% women, 88.8% South African citizens and 42.4% had a household size of ≥ 5 people. Sixty-four percent and 69.9% were classified as having food insecurity and poor glycaemic control, respectively. On further analysis, food insecurity was associated with unemployment (adjusted odds ratio [AOR] = 2.94; 95% confidence interval [CI]: 1.51-5.75), being a South African citizen (AOR = 1.60; 95% CI: 0.66-3.86), household size of ≥ 5 people (AOR = 1.77; 95% CI: 0.98-3.19) and uncontrolled glycaemic level (AOR = 5.38; 95% CI: 2.91-9.96). CONCLUSION Food insecurity in diabetic patients constitutes a serious challenge for glycaemic control. It is critical for healthcare providers in primary care settings to ensure screening for early identification and management of food insecurity and take measures to prevent poor glycaemic control.
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Affiliation(s)
- Kayumba B A Nsimbo
- Division of Family Medicine, School of Clinical Medicine, University of the Witwatersrand, Johannesburg.
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12
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Nimusiima E, Wafula ST, Mendoza H, Ndejjo R, Atusingwize E. Physical activity levels and sociodemographic factors associated with meeting recommended levels among shop attendants in Mbarara municipality, Uganda. Int Health 2021; 14:183-188. [PMID: 34013315 PMCID: PMC8890800 DOI: 10.1093/inthealth/ihab027] [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: 02/02/2021] [Revised: 04/11/2021] [Accepted: 04/30/2021] [Indexed: 11/24/2022] Open
Abstract
Background Shop attendants are urban dwellers who may spend significant periods in sedentary lifestyles exposing them to non-communicable diseases. This study assessed the physical activity levels and sociodemographic factors associated with meeting the WHO recommended physical activity levels among shop attendants in Mbarara municipality, Uganda. Methods We conducted a cross-sectional study among 301 shop attendants. We used the global physical activity questionnaire to assess participants’ physical activity levels. Modified Poisson regression was used to assess the sociodemographic factors associated with meeting recommended physical activity levels. Results Of the 301 participants, 234 (77.7%) met the WHO physical activity recommendations, especially through work-related physical activity of moderate intensity 194 (64.5%). The median weekly duration of all moderate-intensity physical activity was 180 min (IQR=90 to 360). The median daily sedentary time was 300 min (IQR=300 to 360). Being male (adjusted prevalence ratio=1.33, 95% CI 1.17 to 1.51) was significantly associated with meeting recommended physical activity levels. Conclusion The physical activity levels among shop attendants were high and were mostly achieved through work-related activities of moderate intensity, with males being more likely to meet recommended physical activity levels. Findings suggest a need for gender-sensitive initiatives to increase physical activity levels, especially among female shop attendants.
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Affiliation(s)
- Evas Nimusiima
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, P.O Box 7072 Kampala, Uganda
| | - Solomon T Wafula
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, P.O Box 7072 Kampala, Uganda
| | - Hilbert Mendoza
- Department of Community Health and Behavioural Sciences, School of Public Health, College of Health Sciences, Makerere University, P.O Box 7072 Kampala, Uganda
| | - Rawlance Ndejjo
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, P.O Box 7072 Kampala, Uganda
| | - Edwinah Atusingwize
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, P.O Box 7072 Kampala, Uganda
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Turner-Moss E, Razavi A, Unwin N, Foley L. Evidence for factors associated with diet and physical activity in African and Caribbean countries. Bull World Health Organ 2021; 99:464-472I. [PMID: 34108757 PMCID: PMC8164182 DOI: 10.2471/blt.20.269308] [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: 06/05/2020] [Revised: 01/28/2021] [Accepted: 02/11/2021] [Indexed: 12/18/2022] Open
Abstract
Objective To identify and describe summarized evidence on factors associated with diet and physical activity in low- and middle-income countries in Africa and the Caribbean by performing a scoping review of reviews. Methods We searched the Medline®, LILACS, Scopus, Global Health and Web of Science databases for reviews of factors associated with diet or physical activity published between 1998 and 2019. At least 25% of studies in reviews had to come from African or Caribbean countries. Factors were categorized using Dahlgren and Whitehead's social model of health. There was no quality appraisal. Findings We identified 25 reviews: 13 on diet, four on physical activity and eight on both. Eighteen articles were quantitative systematic reviews. In 12 reviews, 25-50% of studies were from Africa or the Caribbean. Only three included evidence from the Caribbean. Together, the 25 reviews included primary evidence published between 1926 and 2018. Little of the summarized evidence concerned associations between international health or political factors and diet or associations between any factor and physical activity across all categories of the social model of health. Conclusion The scoping review found a wide range of factors reported to be associated with diet and physical activity in Africa and the Caribbean, but summarized evidence that could help inform policies encouraging behaviours linked to healthy diets and physical activity in these regions were lacking. Further reviews are needed to inform policy where the evidence exists, and to establish whether additional primary research is needed.
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Affiliation(s)
- Eleanor Turner-Moss
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, England
| | - Ahmed Razavi
- Global Public Health Division, Public Health England, London, England
| | - Nigel Unwin
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, England
| | - Louise Foley
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, England
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Afrifa-Anane E, DE-Graft Aikins A, A C Meeks K, Beune E, Addo J, Smeeth L, Bahendeka S, Stronks K, Agyemang C. Physical Inactivity among Ghanaians in Ghana and Ghanaian Migrants in Europe. Med Sci Sports Exerc 2021; 52:2152-2161. [PMID: 32301855 DOI: 10.1249/mss.0000000000002357] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
PURPOSE There is a paucity of data on physical activity (PA) among migrants from sub-Saharan Africa, yet physical inactivity is a key risk factor for noncommunicable diseases. We examined the levels of physical inactivity and its determinants among Ghanaians in different geographical locations. METHODS We used the Research on Obesity and Diabetes among African Migrants data of Ghanaian adults (n = 4760) age 25-70 yr in rural and urban Ghana and three European cities (Amsterdam, London, and Berlin). Using total physical activity metabolic equivalent of task, physical inactivity was defined as total physical activity metabolic equivalent of task minutes per week less than 600. Logistic regression was used to examine the differences in the levels and the determinants of physical inactivity across sites. RESULTS Physical inactivity was higher among Ghanaian migrants (14.6% in Amsterdam, 24.1% in Berlin, and 36.6% in London) and urban Ghanaians (29.0%) compared with rural Ghanaians (11.2%). After adjustment for covariates (age, sex, education, health status, smoking status, body mass index, and social network) using rural Ghanaians as the comparator group, the odds ratios for physical inactivity in men ranged from 3.67 (95% confidence interval, 2.19-6.16) in urban Ghanaians to 10.37 (5.96-18.02) in London Ghanaians, and from 3.27 (2.46-4.35) in urban Ghanaians to 4.41 (3.12-6.22) in London Ghanaians in women. Migrants in London and Berlin had higher odds of physical inactivity compared with Amsterdam. Increased age, university education, and overweight/obesity were positively associated with physical inactivity, whereas social support was inversely associated with physical inactivity with variability across sites. CONCLUSIONS Findings indicate high prevalence of physical inactivity among Ghanaians in all sites, particularly among Ghanaians in Europe. Hence, there is the need to take local context into account to improve PA.
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Affiliation(s)
| | | | | | - Erik Beune
- Department of Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the NETHERLANDS
| | - Juliet Addo
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UNITED KINGDOM
| | - Liam Smeeth
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UNITED KINGDOM
| | - Silver Bahendeka
- Mother Kevin Postgraduate Medical School (MKPGMS), Uganda Martyrs University, Kampala, UGANDA
| | - Karien Stronks
- Department of Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the NETHERLANDS
| | - Charles Agyemang
- Department of Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the NETHERLANDS
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Sharma JR, Mabhida SE, Myers B, Apalata T, Nicol E, Benjeddou M, Muller C, Johnson R. Prevalence of Hypertension and Its Associated Risk Factors in a Rural Black Population of Mthatha Town, South Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:1215. [PMID: 33572921 PMCID: PMC7908535 DOI: 10.3390/ijerph18031215] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 12/18/2020] [Accepted: 12/24/2020] [Indexed: 11/16/2022]
Abstract
Background: The occurrence of hypertension has been increasing alarmingly in both low and middle-income countries. Despite acknowledging hypertension as the most common life-threatening risk factor for cardiovascular disease (CVD), a dearth of data is available on the prevalence, awareness, and determinants of hypertension in rural parts of South Africa. The principal aim of the current study is to determine the prevalence and associated risk factors of hypertension among a black rural African population from the Mtatha town of Eastern Cape Province. Methods: This was a cross-sectional study, and individuals over 18 years of age were randomly screened using a World Health Organization stepwise questionnaire. Sociodemographic information, anthropometric measurements, fasting blood glucose levels, and three independent blood pressure (BP) readings were measured. Blood pressure measurements were classified according to the American Heart Association guidelines. Univariate and multivariate analyses were performed to determine the significant predictors of hypertension. Results: Of the total participants (n = 556), 71% of individuals had BP scores in the hypertensive range. In univariate analysis, age, westernized diet, education, income, and diabetic status, as well as overweight/obese status were positively associated with the prevalence of hypertension. However, in a multivariate logistic regression analysis only, age, body mass index (BMI), diabetic status, and westernized diet were significantly associated with a higher risk of developing hypertension. Gender, age, and BMI were potential factors having a significant association with the treatment of hypertension. Individuals who did not consider the importance of medicine had higher chances of having their hypertension being untreated. Conclusions: Prevalence of hypertension was high among the black rural African population of Mthatha town. Gender, age, westernized diet, education level, income status, diabetic as well as overweight/obese status were the most significant predictors of hypertension.
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Affiliation(s)
- Jyoti Rajan Sharma
- Biomedical Research and Innovation Platform, South African Medical Research Council, Tygerberg, Cape Town 7505, South Africa; (J.R.S.); (S.E.M.); (C.M.)
| | - Sihle E. Mabhida
- Biomedical Research and Innovation Platform, South African Medical Research Council, Tygerberg, Cape Town 7505, South Africa; (J.R.S.); (S.E.M.); (C.M.)
- Department of Biotechnology, Faculty of Natural Sciences, University of the Western Cape, Bellville, Cape Town 7535, South Africa;
| | - Bronwyn Myers
- Division of Alcohol Tobacco and Other Drug Research Unit, South African Medical Research Council, Tygerberg, Cape Town 7505, South Africa;
- Division of Addiction Psychiatry, Department of Psychiatry and Mental Health, Groote Schuur Hospital, University of Cape Town, Observatory, Cape Town 7925, South Africa
| | - Teke Apalata
- Division of Medical Microbiology, Department of Pathology and Laboratory-Medicine, Faculty of Health Sciences, Walter Sisulu University, Mthatha 5117, South Africa;
| | - Edward Nicol
- Burden of Disease Research Unit, South African Medical Research Council, Cape Town 7505, South Africa;
- Division of Health Systems and Public Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, Cape Town 7505, South Africa
| | - Mongi Benjeddou
- Department of Biotechnology, Faculty of Natural Sciences, University of the Western Cape, Bellville, Cape Town 7535, South Africa;
| | - Christo Muller
- Biomedical Research and Innovation Platform, South African Medical Research Council, Tygerberg, Cape Town 7505, South Africa; (J.R.S.); (S.E.M.); (C.M.)
- Division of Medical Physiology, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, Cape Town 7505, South Africa
| | - Rabia Johnson
- Biomedical Research and Innovation Platform, South African Medical Research Council, Tygerberg, Cape Town 7505, South Africa; (J.R.S.); (S.E.M.); (C.M.)
- Division of Medical Physiology, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, Cape Town 7505, South Africa
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Abstract
OBJECTIVE Identifying hot spots for the overweight aids in effective public health interventions due to the associated public health burden and morbidities. This study, therefore aimed to explore and determine the spatial disparities in the overweight/obesity prevalence among women in Ghana. The study also aims at modelling the average body mass index (BMI) values using the spatial regression and the performance compared with the standard regression model. DESIGN This is a cross-sectional study using data from the 2014 Ghana Demographic and Health Survey (GDHS). SETTING The study was set in Ghana. PARTICIPANTS AND METHODS Data on 4393 non-pregnant women aged 15-49 years from the 2014 GDHS. Both global (Moran's I) and the local indicators for spatial dependence were examined through the mapped BMI values across the country by clusters. An estimated spatial lag model was used to explain the spatial differences in the average body sizes of women. RESULTS The overall prevalence of overweight/obesity among reproductive women in Ghana was 35.4%, and this was highly prevalent among educated women (p<0.001), those from wealthy households (p<0.001) and dwelling in an urban setting (p<0.001). Significant clustering (Moran's I=0.3145, p<0.01) of overweight/obesity was observed with hot spots (clustering) in Greater Accra, Central, Western and Ashanti regions. The spatial lag model was the best fit based on the Likelihood ratio test and the Akaike information criterion and Bayesian information criterion values. The mean age of women and household wealth were significant factors accounting for the increase in the average cluster body size (BMI) of women and the spatial differences. CONCLUSION The prevalence of overweight/obesity was high and spatially clustered in the southern, middle and coastal regions. Geographic specific and effective public health interventions and strategies are needed to address the growing morbidity burden associated with the rise in the average body sizes of reproductive women.
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Affiliation(s)
| | - Atinuke Olusola Adebanji
- Department of Statistics and Actuarial Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ashanti, Ghana
| | - Iddrisu Wahab Abdul
- Mathematics and Statistics, University of Energy and Natural Resources, Sunyani, Ghana
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Peer N, Baatiema L, Kengne AP. Ischaemic heart disease, stroke, and their cardiometabolic risk factors in Africa: current challenges and outlook for the future. Expert Rev Cardiovasc Ther 2020; 19:129-140. [PMID: 33305637 DOI: 10.1080/14779072.2021.1855975] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
INTRODUCTION Although cardiovascular diseases (CVDs) are among the leading causes of death in Sub-Saharan Africa (SSA), prevention is not a priority and effective treatments are not widely available. This perspective discusses the burden, challenges, and potential opportunities for improvement of CVD prevention and control efforts in SSA. AREAS COVERED This paper focuses on ischemic heart disease and stroke, and their key contributors of obesity, hypertension, diabetes and dyslipidaemia which are well-established, rapidly rising, and significant contributors to disease burden in SSA. However, their prevention, detection, treatment and control of are currently disorganized, inconsistent, unreliable, and insufficient with most SSA countries not geared to respond to this growing problem. National policies are frequently lacking or, if available, remain poorly implemented, for the control of these conditions. Primary healthcare systems have not adapted to cope with these rising CVD burdens and remain weak, underfunded and under resourced. Numerous barriers at the healthcare service, healthcare provider, and patient levels prevent optimal CVD risk factor care. EXPERT OPINION Innovative approaches such as task-shifting with the reallocation of care to lower-level healthcare workers and the potential use of inexpensive technological options should be encouraged to provide equitable CVD preventive and curative solutions to SSA's poor.
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Affiliation(s)
- Nasheeta Peer
- Non-communicable Diseases Research Unit, South African Medical Research Council, Durban and Cape Town, South Africa.,Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Leonard Baatiema
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Andre-Pascal Kengne
- Non-communicable Diseases Research Unit, South African Medical Research Council, Durban and Cape Town, South Africa.,Department of Medicine, University of Cape Town, Cape Town, South Africa
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Assessing physical activity, nutrient intake and obesity in middle-aged adults in Akuse, Lower Manya Krobo, Ghana. JOURNAL OF HEALTH RESEARCH 2020. [DOI: 10.1108/jhr-03-2020-0068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
PurposeThe purpose of this paper is to assess physical activity and nutrient intake and their association with obesity in apparently healthy middle-aged adults in Akuse, a rural community in the Eastern region of Ghana.Design/methodology/approachThis cross-sectional study assessed demography and anthropometry, nutrient intakes using a 3-day repeated 24 h dietary recall and physical activity using the global physical activity questionnaire (GPAQ). Data were entered into Microsoft excel and analyzed with SPSS version 25.FindingsThere were 118 respondents (55 males, 46.6% and 63 females, 53.4%) in the study with mean age of 45.62 ± 6.88 years. About 90% of respondents were physically active based on WHO physical activity recommendation. Prevalence of overweight/obesity was higher among inactive participants compared to active participants and sitting/reclining hours was significantly (p-value = 0.042) associated positively with BMI after a bivariate correlation analysis, suggesting that physical activity plays a role in obesity. About one in five respondents were obese. Mean energy intake exceeded RDA for females. Sodium intake far exceeded RDA for both males and females, putting the population at potential risk of hypertension.Practical implicationsThis study demonstrates the need for intensifying health education and other obesity prevention interventions to curb the rising obesity prevalence in rural communities.Originality/valueThe study revealed that overweight/ obesity in this rural community is higher than previously reported for rural Ghana.
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van der Linden EL, Meeks K, Beune E, de-Graft Aikins A, Addo J, Owusu-Dabo E, Mockenhaupt FP, Bahendeka S, Danquah I, Schulze MB, Spranger J, Klipstein-Grobusch K, Tetteh Appiah L, Smeeth L, Stronks K, Agyemang C. The prevalence of metabolic syndrome among Ghanaian migrants and their homeland counterparts: the Research on Obesity and type 2 Diabetes among African Migrants (RODAM) study. Eur J Public Health 2020; 29:906-913. [PMID: 31220248 PMCID: PMC6761842 DOI: 10.1093/eurpub/ckz051] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Background Metabolic syndrome (MetSyn) is an important risk factor for cardiovascular diseases and type 2 diabetes. It is unknown whether the MetSyn prevalence differs within a homogenous population residing in different settings in Africa and Europe. We therefore assessed the prevalence of MetSyn among Ghanaians living in rural- and urban-Ghana and Ghanaian migrants living in Europe. Methods We used data from the cross-sectional multi-centre RODAM study that was conducted among Ghanaian adults aged 25–70 years residing in rural- and urban-Ghana and in London, Amsterdam and Berlin (n = 5659). MetSyn was defined according to the 2009 harmonized definition. Geographical locations were compared using age-standardized prevalence rates, and prevalence ratios (PRs), adjusted for age, education, physical activity, and smoking and stratified for sex. Results In men, the age-standardized prevalence of MetSyn was 8.3% in rural Ghana and showed a positive gradient through urban Ghana (23.6%, adjusted PR = 1.85, 95% confidence interval 1.17–2.92) to Europe, with the highest prevalence in Amsterdam (31.4%; PR = 4.45, 2.94–6.75). In women, there was a rural-to-urban gradient in age-standardized MetSyn prevalence (rural Ghana 25%, urban Ghana 34.4%, PR = 1.38, 1.13–1.68), but small differences in MetSyn prevalence between urban-Ghanaian and European-Ghanaian women (Amsterdam 38.4%; London 38.2%). Conclusion MetSyn is highly prevalent in Ghana as well as in Ghanaian migrants in Europe. To assist prevention efforts, further research is needed to understand the mechanisms driving the geographical differences in MetSyn prevalence between migrant and non-migrant Ghanaians.
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Affiliation(s)
- Eva L van der Linden
- Department of Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Karlijn Meeks
- Department of Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Erik Beune
- Department of Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Ama de-Graft Aikins
- Regional Institute for Population Studies, University of Ghana, Legon, Ghana
| | - Juliet Addo
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Ellis Owusu-Dabo
- School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Frank P Mockenhaupt
- Institute of Tropical Medicine and International Health, Charité Universitätsmedizin Berlin, Berlin, Germany
| | | | - Ina Danquah
- Institute for Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Berlin, Germany.,Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany
| | - Matthias B Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany
| | - Joachim Spranger
- Department of Endocrinology and Metabolism, Charité Universitätsmedizin Berlin, Berlin, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany.,Center for Cardiovascular Research (CCR), Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Kerstin Klipstein-Grobusch
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, The Netherlands.,Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Lambert Tetteh Appiah
- Regional Institute for Population Studies, University of Ghana, Legon, Ghana.,Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Liam Smeeth
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Karien Stronks
- Department of Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Charles Agyemang
- Department of Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
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Kgokong D, Parker R. Physical activity in physiotherapy students: Levels of physical activity and perceived benefits and barriers to exercise. SOUTH AFRICAN JOURNAL OF PHYSIOTHERAPY 2020; 76:1399. [PMID: 32391443 PMCID: PMC7203537 DOI: 10.4102/sajp.v76i1.1399] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Accepted: 02/26/2020] [Indexed: 11/01/2022] Open
Abstract
Background Physiotherapists have been identified as key role players in health promotion, prevention and treatment of non-communicable diseases. Objectives The aim of this study is to describe the perceived benefits and barriers to exercise and their association with levels of physical activity (PA) in physiotherapy students attending university in the Western Cape province of South Africa. Method This study follows a quantitative, cross-sectional, survey design. Two hundred and ninety-six participants were recruited from three universities in the Western Cape. Participants completed a demographic questionnaire (DQ), Exercise Benefits and Barriers Scale (EBBS) and the International Physical Activity Questionnaire (IPAQ). Results Female students accounted for 83% of the sample. Out of the 296 participants, 58% lived off-campus and 65% were involved in sporting activities six hours per week. The median score on the EBBS was 136 (54-167) for all years. Responses with the highest agreement for perceived benefits were associated with physical performance. Alternatively, responses with the highest agreement for perceived barriers were associated with physical exertion. Only 37.5% students engaged in high PA. Conclusion Undergraduate physiotherapy students in the Western Cape across all three universities do not engage in adequate PA. In this group of students, benefits associated with high PA related to physical performance and barriers associated with low levels of PA related to physical exertion. Clinical implications Physiotherapists who do not practise what they preach are not effective role models and may not be effective in obtaining behaviour change through PA-related health promotion.
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Affiliation(s)
- Diana Kgokong
- Department of Physiotherapy, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Romy Parker
- Pain Management Unit, Department of Anaesthesia and Perioperative Medicine, Neuroscience Institute, University of Cape Town, Cape Town, South Africa.,Groote Schuur Hospital, Cape Town, South Africa
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Padilla-Martínez F, Collin F, Kwasniewski M, Kretowski A. Systematic Review of Polygenic Risk Scores for Type 1 and Type 2 Diabetes. Int J Mol Sci 2020; 21:E1703. [PMID: 32131491 PMCID: PMC7084489 DOI: 10.3390/ijms21051703] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 02/28/2020] [Accepted: 02/28/2020] [Indexed: 02/07/2023] Open
Abstract
Recent studies have led to considerable advances in the identification of genetic variants associated with type 1 and type 2 diabetes. An approach for converting genetic data into a predictive measure of disease susceptibility is to add the risk effects of loci into a polygenic risk score. In order to summarize the recent findings, we conducted a systematic review of studies comparing the accuracy of polygenic risk scores developed during the last two decades. We selected 15 risk scores from three databases (Scopus, Web of Science and PubMed) enrolled in this systematic review. We identified three polygenic risk scores that discriminate between type 1 diabetes patients and healthy people, one that discriminate between type 1 and type 2 diabetes, two that discriminate between type 1 and monogenic diabetes and nine polygenic risk scores that discriminate between type 2 diabetes patients and healthy people. Prediction accuracy of polygenic risk scores was assessed by comparing the area under the curve. The actual benefits, potential obstacles and possible solutions for the implementation of polygenic risk scores in clinical practice were also discussed. Develop strategies to establish the clinical validity of polygenic risk scores by creating a framework for the interpretation of findings and their translation into actual evidence, are the way to demonstrate their utility in medical practice.
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Affiliation(s)
- Felipe Padilla-Martínez
- Centre for Bioinformatics and Data Analysis, Medical University of Bialystok, 15-276 Bialystok, Poland; (F.C.); (M.K.)
- Clinical Research Centre, Medical University of Bialystok, 15-276 Bialystok, Poland;
| | - Francois Collin
- Centre for Bioinformatics and Data Analysis, Medical University of Bialystok, 15-276 Bialystok, Poland; (F.C.); (M.K.)
| | - Miroslaw Kwasniewski
- Centre for Bioinformatics and Data Analysis, Medical University of Bialystok, 15-276 Bialystok, Poland; (F.C.); (M.K.)
| | - Adam Kretowski
- Clinical Research Centre, Medical University of Bialystok, 15-276 Bialystok, Poland;
- Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Bialystok, 15-276 Bialystok, Poland
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Gedif T, Azale T, Nigusie A. Substance use and associated factors among Gumuz people in Benishangul-Gumuz regional state, Mandura woreda, Northwest Ethiopia. SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY 2019; 14:36. [PMID: 31481091 PMCID: PMC6724341 DOI: 10.1186/s13011-019-0225-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 08/26/2019] [Indexed: 01/27/2023]
Abstract
Background Substance use related health and social problems are on the rise in sub-Saharan Africa. Currently, substance abuse is one of the most burning public health problems in Ethiopia. Although it has been known that this public health problem is an urgent issue, the real extent and magnitude of substance abuse is not yet properly explored. The purpose of this study was to assess substance use and associated factors among Gumuz people in Mandura Woreda, northwest Ethiopia. Methods A community based cross sectional study was conducted involving 1588 adults, recruited using multi stage stratified simple random sampling technique. The data were collected at the household level by using pre tested Standardized questionnaire of Alcohol, Smoking and Substance Involvement Screening Test (ASSIST), Oslo social support scale and substance use questionnaire. The data was entered and cleaned using Epi Data version 3.1 and analyzed using Statistical Package for Social Science (SPSS) version 22 statistical package. Descriptive statistics and logistic regression were performed to examine the prevalence and predictors of substance use. An Adjusted odds ratio with 95% confidence interval was computed to determine the level of significance. Result The overall life time substance use prevalence in the current study was 25.9% (95% CI = 23.7, 28.0). The three-month prevalence of Alcohol and tobacco use was 48.4 and 15.8% respectively. The three-month prevalence of hazardous alcohol and tobacco use were 25.8 and 7.8% respectively. Able to read and write (AOR = 3.79; 95%CI 2.34–6.15) in educational status and Strong social support (AOR = 0.39; 95%CI 0.27–0.58) were significantly associated with substance use. Conclusion High level of substance use was detected in the current study setting. This high prevalence (three-month) of substance use affects the productive age groups which influence on the family and cause the rise of major public health and socio economic problems. The finding informed the need to integrate services for hazardous substance use such as brief intervention at different levels of primary care services in the district. Public health interventions to reduce hazardous substance especially on alcohol and smoking use also need to be initiate.
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Affiliation(s)
- Tesfa Gedif
- Public Health Officer, Metekel Zone Health Department, Benishangul-Gumuz Regional State Health Bureau, Asosa, Ethiopia
| | - Telake Azale
- Department of Health Education and Behavioral Science, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, 196, Gondar, Ethiopia
| | - Adane Nigusie
- Department of Health Education and Behavioral Science, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, 196, Gondar, Ethiopia.
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The Association Between Acculturation and Cardiovascular Disease Risk in Ghanaian and Nigerian-born African Immigrants in the United States: The Afro-Cardiac Study. J Immigr Minor Health 2019; 20:1137-1146. [PMID: 28852948 DOI: 10.1007/s10903-017-0644-y] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The burden of cardiovascular disease (CVD) risk in ethnic minorities in the United States (US) is high. Acculturation may worsen or improve cardiovascular health in immigrants. We sought to examine the association between acculturation and elevated cardiovascular disease risk in African immigrants, a growing immigrant population in the US. We conducted a cross-sectional study of Ghanaian and Nigerian born-African immigrants in the US. To determine whether acculturation was associated with having elevated CVD risk (defined as ≥3 CVD risk factors or Pooled Cohort Equations score ≥7.5%), we performed unadjusted and adjusted logistic regression analyses. For both outcomes, sex-specific models were fitted. Participants (N = 253) were aged 35-74 years and resided in Baltimore-Washington-D.C. The mean age (SD) was 49.5 (9.2) years and 58% were female. Residing in the US for ≥10 years was associated with an almost fourfold (95% CI 1.05-14.35) and eightfold (95% CI 2.09-30.80) greater odds of overweight/obesity and elevated CVD risk respectively in males. Females residing in the US for ≥10 years had 2.60 times (95% CI 1.04-6.551) greater odds of hypertension than newer residents. Participants were classified according to acculturation strategies: Integrationists, 166 (66%); Traditionalists, 80 (32%); Marginalists, 5 (2%); and Assimilationists, 2 (1%). Integrationists had a 0.46 (95% CI 0.24-0.87) lower odds of having ≥3 CVD risk factors and 0.38 (95% CI 0.18-0.78) lower odds of having elevated CVD risk (Pooled Cohort Equations score ≥7.5%) than Traditionalists. Although longer length of stay was associated with CVD risk, Integrationists had lower CVD risk than Traditionalists. Our results suggest that coordinated public health responses to the epidemic of CVD risk factors in the US should target this understudied population. Acculturation should be considered as a meaningful contributor of increased CVD risk and acculturation strategies may be used to tailor interventions in African immigrants. Promoting successful integration may reduce immigrants' CVD risk.
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Zhou Y, Wu J, Zhang S, Yan S, He L, Mkandawire N, Song X, Gan Y, Li W, Yang T, Li J, Zeng X, Wang Z, Lu Z. Prevalence and risk factors of physical inactivity among middle-aged and older Chinese in Shenzhen: a cross-sectional study. BMJ Open 2018; 8:e019775. [PMID: 30327395 PMCID: PMC6194397 DOI: 10.1136/bmjopen-2017-019775] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVE Investigations on physical inactivity are common around the world; however, little is known about the status of physical inactivity in mainland China. The aim of this study was to examine the prevalence and risk factors associated with physical inactivity in Shenzhen in Southern China. DESIGN A community-based, cross-sectional study. SETTING A multistage-stratified, random cluster survey was conducted in Xixiang Street, Bao'an District of Shenzhen in Southeast China. PARTICIPANTS 3920 adults aged 40 years or more were recruited to the study and completed the International Physical Activity Questionnaire Short Form between 1 March 2015 and 30 July 2016. MAIN OUTCOME MEASURES Physical inactivity was defined as engaging in physical activity levels insufficient to reach the current guidelines. Bivariate and multivariate analyses were undertaken to assess the prevalence and risk factors associated with physical inactivity. RESULTS The prevalence of physical inactivity was 63.1% for all participants, 63.9% for women and 61.9% for men, respectively. Participants who were older (OR=1.31, 95% CI 1.11 to 1.54), who were female (OR=1.22, 95% CI 1.04 to 1.43), who had higher education experience (OR=1.38, 95% CI 1.19 to 1.61), who are under economic pressure (OR=2.17, 95% CI 1.48 to 3.17), who ever smoked a cigarette (OR=1.44, 95% CI 1.13 to 1.82) and drank alcohol (OR=1.42, 95% CI 1.14 to 1.77), and participants in the lowest body mass index category (OR=1.40, 95% CI 1.03 to 1.89), were more likely to report physical inactivity. CONCLUSIONS These findings indicate that physical inactivity is prevalent in Southern China. Interventions and programmes aimed at increasing physical activity among middle-aged and older Chinese adults may also be tailored to participants under economic pressure and those with unhealthy behaviours such as smoking and drinking.
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Affiliation(s)
- Yanfeng Zhou
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Epidemiology and Health Statistics, School of Public Health, Xiangnan University, Chenzhou, China
| | - Jiang Wu
- Bao’an Central Hospital of Shenzhen, Shenzhen, China
| | | | - Shijiao Yan
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Liping He
- Department of Epidemiology and Health Statistics, School of Public Health, Xiangnan University, Chenzhou, China
| | - Naomie Mkandawire
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xinyue Song
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yong Gan
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wenzhen Li
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tingting Yang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jing Li
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaozhou Zeng
- Bao’an Central Hospital of Shenzhen, Shenzhen, China
| | - Zhihong Wang
- Department of Neurosurgery, Shenzhen Second People’s Hospital, Shenzhen University, Shenzhen, China
| | - Zuxun Lu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Diaba-Nuhoho P, Ofori EK, Asare-Anane H, Oppong SY, Boamah I, Blackhurst D. Impact of exercise intensity on oxidative stress and selected metabolic markers in young adults in Ghana. BMC Res Notes 2018; 11:634. [PMID: 30176917 PMCID: PMC6126417 DOI: 10.1186/s13104-018-3758-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 08/31/2018] [Indexed: 12/13/2022] Open
Abstract
Objective This study aimed to evaluate the effect of different levels of exercise on markers of oxidative stress and selected metabolic parameters in Ghanaian young adults. Results Significant increases in a marker of oxidative stress malondialdehyde and antioxidants such as superoxide dismutase and uric acid were observed in the exercisers compared with the inactive group (p < 0.05). Total cholesterol and high density lipoprotein levels were significantly different (p < 0.05) between the two groups. Positive associations between exercise intensity, antioxidant concentration and malondialdehyde were observed within the exercise group for vigorous exercise with regards to uric acid, superoxide dismutase and malondialdehyde (r = 0.512, p = 0.004; r = 0.810, p = 0.001; r = 0.715, p = 0.001) respectively and moderate exercise vs malondialdehyde (r = 0.841, p = 0.001) compared to the inactive group. Exercise participants performed more vigorous exercise (p < 0.001), moderate exercise (p < 0.001) and more walking (p < 0.001) compared with the inactive group while the inactive group exhibited more sitting (p < 0.001). The study provides a first report on the risk associated with increase in oxidative stress and the importance of walking as a health promotion intervention among young Ghanaian adults. Electronic supplementary material The online version of this article (10.1186/s13104-018-3758-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Patrick Diaba-Nuhoho
- Division of Vascular Endothelium and Microcirculation, Department of Medicine III, University of Technology Dresden, Fetscherstr. 74, 01307, Dresden, Germany.
| | | | - Henry Asare-Anane
- Department of Chemical Pathology, University of Ghana, Korle-Bu, Accra, Ghana
| | | | - Isaac Boamah
- Department of Microbiology, University of Ghana School of Medicine and Dentistry, Korle-Bu, Accra, Ghana
| | - Dee Blackhurst
- Division of Chemical Pathology, University of Cape Town, Observatory, Cape Town, 7925, South Africa
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Correlates of Physical Activity Among Middle-Aged and Older Adults With Hazardous Drinking Habits in Six Low- and Middle-Income Countries. J Aging Phys Act 2018; 26:589-598. [PMID: 29345520 DOI: 10.1123/japa.2017-0213] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
We investigated physical activity (PA) correlates among middle-aged and older adults (aged ≥50 years) with hazardous drinking patterns in six low- and middle-income countries. Cross-sectional data were analyzed from the World Health Organization's Study on Global Ageing and Adult Health. Hazardous drinking was defined as consuming >7 (females) or >14 (males) standard drinks per week. Participants were dichotomized into low (i.e., not meeting 150 min of moderate PA/week) and moderate-high physically active groups. Associations between PA and a range of correlates were examined using multivariable logistic regressions. The prevalence of low PA in 1,835 hazardous drinkers (60.5 ± 13.1 years; 87.9% males) was 16.2% (95% confidence interval [13.9%, 18.9%]). Older age, living in an urban setting, being unemployed, depression, underweight, obesity, asthma, visual impairment, poor self-rated health, and higher levels of disability were identified as significant PA correlates. The current data provide important guidance for future interventions to assist older hazardous drinkers to engage in regular PA.
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Mudumbi JBN, Ntwampe SKO, Mekuto L, Matsha T, Itoba-Tombo EF. The role of pollutants in type 2 diabetes mellitus (T2DM) and their prospective impact on phytomedicinal treatment strategies. ENVIRONMENTAL MONITORING AND ASSESSMENT 2018; 190:262. [PMID: 29610974 DOI: 10.1007/s10661-018-6634-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Accepted: 03/22/2018] [Indexed: 06/08/2023]
Abstract
Type 2 diabetes mellitus (T2DM) is the most common form of diabetes and it is characterized by high blood sugar and abnormal sera lipid levels. Although the specific reasons for the development of these abnormalities are still not well understood, traditionally, genetic and lifestyle behavior have been reported as the leading causes of this disease. In the last three decades, the number of diabetic patients has drastically increased worldwide, with current statistics suggesting the number is to double in the next two decades. To combat this incurable ailment, orthodox medicines, to which economically disadvantaged patients have minimal access to, have been used. Thus, a considerable amalgamation of medicinal plants has recently been proven to possess therapeutic capabilities to manage T2DM, and this has prompted studies primarily focusing on the healing aspect of these plants, and ultimately, their commercialization. Hence, this review aims to highlight the potential threat of pollutants, i.e., polyfluoroalkyl compounds (PFCs), endocrine disrupting chemicals (EDCs) and heavy metals, to medicinal plants, and their prospective impact on the phytomedicinal therapy strategies for T2DM. It is further suggested that auxiliary research be undertaken to better comprehend the factors that influence the uptake of these compounds by these plants. This should include a comprehensive risk assessment of phytomedicinal products destined for the treatment of T2DM. Regulations that control the use of PFC-precursors in certain developing countries are also long overdue.
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Affiliation(s)
- John Baptist Nzukizi Mudumbi
- Bioresource Engineering Research Group (BioERG), Department of Biotechnology, Cape Peninsula University of Technology, PO Box 652, Cape Town, 8000, South Africa.
| | - Seteno Karabo Obed Ntwampe
- Bioresource Engineering Research Group (BioERG), Department of Biotechnology, Cape Peninsula University of Technology, PO Box 652, Cape Town, 8000, South Africa
| | - Lukhanyo Mekuto
- Department of Chemical Engineering, University of Johannesburg, PO Box 17011, Johannesburg, Gauteng, 2028, South Africa
| | - Tandi Matsha
- Department of Bio-Medical sciences, Faculty of Health and Wellness Science, Cape Peninsula University of Technology, PO Box 1906, Bellville, 7535, South Africa
| | - Elie Fereche Itoba-Tombo
- Bioresource Engineering Research Group (BioERG), Department of Biotechnology, Cape Peninsula University of Technology, PO Box 652, Cape Town, 8000, South Africa
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Amugsi DA, Dimbuene ZT, Mberu B, Muthuri S, Ezeh AC. Prevalence and time trends in overweight and obesity among urban women: an analysis of demographic and health surveys data from 24 African countries, 1991 -2014. BMJ Open 2017; 7:e017344. [PMID: 29079606 PMCID: PMC5665233 DOI: 10.1136/bmjopen-2017-017344] [Citation(s) in RCA: 92] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVE To examine the prevalence and trends in overweight and obesity among non-pregnant urban women in Africa over the past two and a half decades. DESIGN Cross-sectional surveys conducted between 1991 and 2014. SETTINGS Demographic and Health Surveys (DHS), repeated cross-sectional data collected in 24 African countries. PARTICIPANTS Adult non-pregnant women aged 15-49 years. The earlier DHS collected anthropometric data on only those women who had children aged 0-5 years. The main analyses were limited to this subgroup. The participants were classified as overweight (25.0-29.9 kg/m2) and obese (≥30.0 kg/m2). RESULTS The prevalence of overweight and obesity among women increased in all the 24 countries. Trends were statistically significant in 17 of the 24 countries in the case of obesity and 13 of the 24 for overweight. In Ghana, overweight almost doubled (p=0.001) while obesity tripled (p=0.001) between 1993 and 2014. Egypt has the highest levels of overweight and obesity at 44% (95% CI 42%, 46.5%) and 39% (95% CI 36.6%, 41.8%), respectively, in 2014 and the trend showed significant increase (p=0.005) from 1995 levels. Also, obesity doubled in Kenya, Benin, Niger, Rwanda, Ivory Coast and Uganda, while tripled in Zambia, Burkina Faso, Mali, Malawi and Tanzania. Ethiopia and Madagascar had the lowest prevalence of both obesity and overweight, with overweight ranging from 7% to 12% and obesity from 1% to 4%. CONCLUSIONS Overweight and obesity are increasing among women of reproductive age in urban Africa, with obesity among this age group having more than doubled or tripled in 12 of the 24 countries. There is an urgent need for deliberate policies and interventions to encourage active lifestyles and healthy eating behaviour to curb this trend in urban Africa.
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Affiliation(s)
| | - Zacharie T Dimbuene
- Department of Population Sciences and Development, University of Kinshasa, Kinshasa, Congo
- Statistics Canada, Social Analysis and Modeling Division, Ottawa, Canada
| | - Blessing Mberu
- African Population and Health Research Center, APHRC Campus, Nairobi, Kenya
| | - Stella Muthuri
- African Population and Health Research Center, APHRC Campus, Nairobi, Kenya
| | - Alex C Ezeh
- African Population and Health Research Center, APHRC Campus, Nairobi, Kenya
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Duboz P, Boëtsch G, Gueye L, Macia E. Type 2 diabetes in a Senegalese rural area. World J Diabetes 2017; 8:351-357. [PMID: 28751958 PMCID: PMC5507832 DOI: 10.4239/wjd.v8.i7.351] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 12/16/2016] [Accepted: 01/18/2017] [Indexed: 02/05/2023] Open
Abstract
AIM To estimate the prevalence of diabetes in the rural population of Tessekere (Senegal) and investigate associated risk factors.
METHODS Data from a 2015 survey of 500 individuals age 20 and over representative of the population of the municipality of Tessekere were used. Sociodemographic characteristics, health related variables, capillary whole blood glucose, and weight and height measurements of individuals were collected during face-to-face interviews. Statistical analyses used were bivariate tests and binary logistic regressions.
RESULTS The percentage of individuals having impaired fasting glucose (IFG) is 6.6%. Those with fasting blood glucose (FBG) levels ≥ 126 mg/dL and/or currently being treated for diabetes is 4.2%. Only mean body mass index (BMI) is significantly higher among diabetic individuals and among those having FBG levels ≥ 110 mg/dL. After adjustment for sex, age, educational level, BMI and hypertension, only BMI is associated with diabetes.
CONCLUSION Prevalence of diabetes and IFG in our study correspond to the high range of rural sub-Saharan Africa prevalence. Diabetes is thus becoming a pressing public health concern, even in rural areas. But the risk factors identified in Tessekere suggest that the diabetes epidemic is still in the early stages, such that concerted action would make it possible to contain the devastating impact of this chronic condition.
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Abstract
Over the last several decades, the global incidence and prevalence of diabetes mellitus has increased significantly. The raised incidence rate is projected to continue as greater numbers of persons adopt a Western lifestyle and diet. Patients with diabetes mellitus are at heightened risk of both adverse microvascular and cardiovascular events. Moreover, once cardiovascular disease develops, diabetes mellitus exacerbates progression and worsens outcomes. The medical management of patients with diabetes mellitus mandates comprehensive risk factor modification and antiplatelet therapy. Recent clinical trials of new medical therapies continue to inform the care of patients with diabetes mellitus to reduce both cardiovascular morbidity and mortality.
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Affiliation(s)
- Joshua A Beckman
- From the Department of Medicine, Section of Vascular Medicine, Cardiovascular Division, Vanderbilt University School of Medicine, Nashville, TN (J.A.B.); and Department of Medicine, Heart and Vascular Center, Dartmouth-Hitchcock Medical Center, Geisel School of Medicine at Dartmouth, Lebanon, NH (M.A.C.).
| | - Mark A Creager
- From the Department of Medicine, Section of Vascular Medicine, Cardiovascular Division, Vanderbilt University School of Medicine, Nashville, TN (J.A.B.); and Department of Medicine, Heart and Vascular Center, Dartmouth-Hitchcock Medical Center, Geisel School of Medicine at Dartmouth, Lebanon, NH (M.A.C.)
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31
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Nautiyal J. Transcriptional coregulator RIP140: an essential regulator of physiology. J Mol Endocrinol 2017; 58:R147-R158. [PMID: 28073818 DOI: 10.1530/jme-16-0156] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2016] [Accepted: 01/10/2017] [Indexed: 12/26/2022]
Abstract
Transcriptional coregulators drive gene regulatory decisions in the transcriptional space. Although transcription factors including all nuclear receptors provide a docking platform for coregulators to bind, these proteins bring enzymatic capabilities to the gene regulatory sites. RIP140 is a transcriptional coregulator essential for several physiological processes, and aberrations in its function may lead to diseased states. Unlike several other coregulators that are known either for their coactivating or corepressing roles, in gene regulation, RIP140 is capable of acting both as a coactivator and a corepressor. The role of RIP140 in female reproductive axis and recent findings of its role in carcinogenesis and adipose biology have been summarised.
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Affiliation(s)
- Jaya Nautiyal
- Institute of Reproductive and Developmental BiologyFaculty of Medicine, Imperial College London, London, UK
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Sarfo-Kantanka O, Sarfo FS, Ansah EO, Kyei I. Spectrum of Endocrine Disorders in Central Ghana. Int J Endocrinol 2017; 2017:5470731. [PMID: 28326101 PMCID: PMC5343284 DOI: 10.1155/2017/5470731] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 11/25/2016] [Accepted: 11/27/2016] [Indexed: 12/24/2022] Open
Abstract
Background. Although an increasing burden of endocrine disorders is recorded worldwide, the greatest increase is occurring in developing countries. However, the spectrum of these disorders is not well described in most developing countries. Objective. The objective of this study was to profile the frequency of endocrine disorders and their basic demographic characteristics in an endocrine outpatient clinic in Kumasi, central Ghana. Methods. A retrospective review was conducted on endocrine disorders seen over a five-year period between January 2011 and December 2015 at the outpatient endocrine clinic of Komfo Anokye Teaching Hospital. All medical records of patients seen at the endocrine clinic were reviewed by endocrinologists and all endocrinological diagnoses were classified according to ICD-10. Results. 3070 adults enrolled for care in the endocrine outpatient service between 2011 and 2015. This comprised 2056 females and 1014 males (female : male ratio of 2.0 : 1.0) with an overall median age of 54 (IQR, 41-64) years. The commonest primary endocrine disorders seen were diabetes, thyroid, and adrenal disorders at frequencies of 79.1%, 13.1%, and 2.2%, respectively. Conclusions. Type 2 diabetes and thyroid disorders represent by far the two commonest disorders seen at the endocrine clinic. The increased frequency and wide spectrum of endocrine disorders suggest the need for well-trained endocrinologists to improve the health of the population.
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Affiliation(s)
| | - Fred Stephen Sarfo
- Komfo Anokye Teaching Hospital, Kumasi, Ghana
- Kwame Nkrumah University of Science & Technology, Kumasi, Ghana
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Sarfo-Kantanka O, Sarfo FS, Oparebea Ansah E, Eghan B, Ayisi-Boateng NK, Acheamfour-Akowuah E. Secular Trends in Admissions and Mortality Rates from Diabetes Mellitus in the Central Belt of Ghana: A 31-Year Review. PLoS One 2016; 11:e0165905. [PMID: 27875539 PMCID: PMC5119733 DOI: 10.1371/journal.pone.0165905] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2016] [Accepted: 10/19/2016] [Indexed: 01/25/2023] Open
Abstract
Introduction Diabetes Mellitus is currently a leading cause of morbidity and mortality throughout the world, particularly in sub-Saharan Africa where a significant proportion of diabetes cases are now found. Longitudinal profiling of in-patient admissions and mortality trends from diabetes provide useful insights into the magnitude of the burden of diabetes, serve as a sentinel on the state of out-patient diabetes care and provide effective tools for planning, delivering and evaluating the health care needs relating to the disease in sub-Saharan Africa. Objective To evaluate the 31-year trend in diabetic admissions and mortality rates in central Ghana. Methods This is a retrospective analysis of data on diabetes admissions and deaths at a tertiary referral hospital in central Ghana between 1983 and 2014. Rates of diabetes admissions or deaths were expressed as diabetes admissions or deaths divided by the total number of admissions or deaths respectively. Yearly crude fatality rates for diabetes were calculated. Trends were analysed for in patient diabetes admissions and mortality for the period. Predictors of diabetes mortality were determined using multiple logistic regression. Results A total of 11,414 diabetes patients were admitted over the period with a female predominance; female:male ratio of 1.3:1.0. Over the study period, diabetes admission rates increased significantly from 2.36 per 1000 admissions in 1983 to 14.94 per 1000 admissions in 2014 (p<0.0001for linear trend), representing a 633% rise over the 31-year period. In-patient diabetes fatality rates increased from 7.6 per 1000 deaths in 1983 to 30 per 1000 deaths in 2012. The average 28-day mortality rate was 18.5%. The median age of patients increased significantly over the period. So was the proportion of females admitted over the years. Predictors of in-patient mortality were increasing age- aOR of 1.23 (CI: 1.15–1.32) for age > 80 years compared with < 20 years, admissions in 2000s compared to 1980s-aOR of 1.56 (1.21–2.01), male gender-aOR of 1.45 (1.19–1.61), the presence of glycemic complications such as ketoacidosis- aOR-2.67(CI: 2.21–3.21), hyperosmolar hyperglycemic states- aOR 1.52 (1.33–1.73) symptomatic hypoglycemia- aOR 1.64 (1.24–2.17) and presence of end organ complications including peripheral neuropathic ulcers- aOR 1.31 (1.12–1.56), nephropathy- aOR -1.11 (1.03–1.23), cerebrovascular disease—aOR-1.52 (1.32–1.98), coronary artery disease- aOR-3.21 (1.91–5.15) and peripheral artery disease- aOR-1.15 (1.12–1.21) were associated with increased risk of death compared with normoglycemic diabetic admissions and admissions without end organ complications respectively. Conclusion Diabetes admission and mortality rates have increased significantly over the past three decades in central Ghana. More intensive education on the risk factors for diabetes, acute diabetes care as well as instituting hospital guidelines for diabetes control and reduction of modifiable risk factors for diabetes are urgently needed to reduce the poor case fatality associated with diabetes in resource-limited settings.
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Affiliation(s)
- Osei Sarfo-Kantanka
- Directorate of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana
- * E-mail:
| | - Fred Stephen Sarfo
- Directorate of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana
- Department of Medicine, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - Benjamin Eghan
- Directorate of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana
- Department of Medicine, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Agyemang C, Meeks K, Beune E, Owusu-Dabo E, Mockenhaupt FP, Addo J, de Graft Aikins A, Bahendeka S, Danquah I, Schulze MB, Spranger J, Burr T, Agyei-Baffour P, Amoah SK, Galbete C, Henneman P, Klipstein-Grobusch K, Nicolaou M, Adeyemo A, van Straalen J, Smeeth L, Stronks K. Obesity and type 2 diabetes in sub-Saharan Africans - Is the burden in today's Africa similar to African migrants in Europe? The RODAM study. BMC Med 2016; 14:166. [PMID: 27769239 PMCID: PMC5075171 DOI: 10.1186/s12916-016-0709-0] [Citation(s) in RCA: 116] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 10/01/2016] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Rising rates of obesity and type 2 diabetes (T2D) are impending major threats to the health of African populations, but the extent to which they differ between rural and urban settings in Africa and upon migration to Europe is unknown. We assessed the burden of obesity and T2D among Ghanaians living in rural and urban Ghana and Ghanaian migrants living in different European countries. METHODS A multi-centre cross-sectional study was conducted among Ghanaian adults (n = 5659) aged 25-70 years residing in rural and urban Ghana and three European cities (Amsterdam, London and Berlin). Comparisons between groups were made using prevalence ratios (PRs) with adjustments for age and education. RESULTS In rural Ghana, the prevalence of obesity was 1.3 % in men and 8.3 % in women. The prevalence was considerably higher in urban Ghana (men, 6.9 %; PR: 5.26, 95 % CI, 2.04-13.57; women, 33.9 %; PR: 4.11, 3.13-5.40) and even more so in Europe, especially in London (men, 21.4 %; PR: 15.04, 5.98-37.84; women, 54.2 %; PR: 6.63, 5.04-8.72). The prevalence of T2D was low at 3.6 % and 5.5 % in rural Ghanaian men and women, and increased in urban Ghanaians (men, 10.3 %; PR: 3.06; 1.73-5.40; women, 9.2 %; PR: 1.81, 1.25-2.64) and highest in Berlin (men, 15.3 %; PR: 4.47; 2.50-7.98; women, 10.2 %; PR: 2.21, 1.30-3.75). Impaired fasting glycaemia prevalence was comparatively higher only in Amsterdam, and in London, men compared with rural Ghana. CONCLUSION Our study shows high risks of obesity and T2D among sub-Saharan African populations living in Europe. In Ghana, similarly high prevalence rates were seen in an urban environment, whereas in rural areas, the prevalence of obesity among women is already remarkable. Similar processes underlying the high burden of obesity and T2D following migration may also be at play in sub-Saharan Africa as a consequence of urbanisation.
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Affiliation(s)
- Charles Agyemang
- Department of Public Health, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105, AZ, Amsterdam, The Netherlands.
| | - Karlijn Meeks
- Department of Public Health, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105, AZ, Amsterdam, The Netherlands
| | - Erik Beune
- Department of Public Health, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105, AZ, Amsterdam, The Netherlands
| | - Ellis Owusu-Dabo
- School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Frank P Mockenhaupt
- Institute of Tropical Medicine and International Health, Charité - University Medicine Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Juliet Addo
- Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Ama de Graft Aikins
- Regional Institute for Population Studies, University of Ghana, P.O. Box LG 96, Legon, Ghana
| | | | - Ina Danquah
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Arthur-Scheunert-Allee 114-116, 14558, Nuthetal, Germany
| | - Matthias B Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Arthur-Scheunert-Allee 114-116, 14558, Nuthetal, Germany
| | - Joachim Spranger
- Department of Endocrinology and Metabolism; DZHK (German Centre for Cardiovascular Research), partner site Berlin; Center for Cardiovascular Research (CCR), Charite Universitaetsmedizin Berlin, Berlin, Germany
| | - Tom Burr
- Source BioScience, Nottingham, UK
| | - Peter Agyei-Baffour
- School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Stephen K Amoah
- Institute of Tropical Medicine and International Health, Charité - University Medicine Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.,ResearchGate, Invalidenstrasse 115, D-10115, Berlin, Germany
| | - Cecilia Galbete
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Arthur-Scheunert-Allee 114-116, 14558, Nuthetal, Germany
| | - Peter Henneman
- Department of Clinical Genetics, Academic Medical Center, Amsterdam, The Netherlands
| | - Kerstin Klipstein-Grobusch
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.,Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Mary Nicolaou
- Department of Public Health, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105, AZ, Amsterdam, The Netherlands
| | - Adebowale Adeyemo
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, 12 South Drive, MSC 5635, Bethesda, MD, USA
| | - Jan van Straalen
- Department of Clinical Chemistry, Academic Medical Center, Amsterdam, The Netherlands
| | - Liam Smeeth
- Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Karien Stronks
- Department of Public Health, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105, AZ, Amsterdam, The Netherlands
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Müller AM, Alley S, Schoeppe S, Vandelanotte C. The effectiveness of e-& mHealth interventions to promote physical activity and healthy diets in developing countries: A systematic review. Int J Behav Nutr Phys Act 2016; 13:109. [PMID: 27724911 PMCID: PMC5057225 DOI: 10.1186/s12966-016-0434-2] [Citation(s) in RCA: 126] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Accepted: 10/05/2016] [Indexed: 11/10/2022] Open
Abstract
Background Promoting physical activity and healthy eating is important to combat the unprecedented rise in NCDs in many developing countries. Using modern information-and communication technologies to deliver physical activity and diet interventions is particularly promising considering the increased proliferation of such technologies in many developing countries. The objective of this systematic review is to investigate the effectiveness of e-& mHealth interventions to promote physical activity and healthy diets in developing countries. Methods Major databases and grey literature sources were searched to retrieve studies that quantitatively examined the effectiveness of e-& mHealth interventions on physical activity and diet outcomes in developing countries. Additional studies were retrieved through citation alerts and scientific social media allowing study inclusion until August 2016. The CONSORT checklist was used to assess the risk of bias of the included studies. Results A total of 15 studies conducted in 13 developing countries in Europe, Africa, Latin-and South America and Asia were included in the review. The majority of studies enrolled adults who were healthy or at risk of diabetes or hypertension. The average intervention length was 6.4 months, and text messages and the Internet were the most frequently used intervention delivery channels. Risk of bias across the studies was moderate (55.7 % of the criteria fulfilled). Eleven studies reported significant positive effects of an e-& mHealth intervention on physical activity and/or diet behaviour. Respectively, 50 % and 70 % of the interventions were effective in promoting physical activity and healthy diets. Conclusions The majority of studies demonstrated that e-& mHealth interventions were effective in promoting physical activity and healthy diets in developing countries. Future interventions should use more rigorous study designs, investigate the cost-effectiveness and reach of interventions, and focus on emerging technologies, such as smart phone apps and wearable activity trackers. Trial registration The review protocol can be retrieved from the PROSPERO database (Registration ID: CRD42015029240). Electronic supplementary material The online version of this article (doi:10.1186/s12966-016-0434-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Andre Matthias Müller
- Centre for Community and Clinical Applications of Health Psychology; Faculty of Social, Human and Mathematical Sciences, University of Southampton, Southampton, SO17 1BJ, UK.
| | - Stephanie Alley
- Physical Activity Research Group, School of Human, Health and Social Sciences, Central Queensland University, Building 77, Bruce Highway, Rockhampton, QLD 4702, Australia
| | - Stephanie Schoeppe
- Physical Activity Research Group, School of Human, Health and Social Sciences, Central Queensland University, Building 77, Bruce Highway, Rockhampton, QLD 4702, Australia
| | - Corneel Vandelanotte
- Physical Activity Research Group, School of Human, Health and Social Sciences, Central Queensland University, Building 77, Bruce Highway, Rockhampton, QLD 4702, Australia
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Owoeye O, Tomori A, Akinbo S. Pedometer-determined physical activity profile of healthcare professionals in a Nigerian tertiary hospital. Niger Med J 2016; 57:99-103. [PMID: 27226683 PMCID: PMC4872499 DOI: 10.4103/0300-1652.182070] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background: Healthcare professionals (HCPs) are perceived as statutory advocates for healthy living and promotion of healthy behaviors such as regular participation in physical activity (PA). This study assessed and compared pedometer-determined PA of different urban HCPs in a Nigerian tertiary hospital. Materials and Methods: A cross-sectional study involving 180 HCPs from a tertiary hospital in Lagos, Nigeria. PA was measured by daily walking steps using a pedometer. Results: The mean step count obtained was 7,396.94 ± 2,714.63 steps/day. Only 20% of the HCPs met a minimum PA of 10,000 steps/day. About one-third (34.4%) of the HCPs were low active and less than a quarter (23.9%) were somewhat active. Further, less than half (43.9%) of the HCPs were found to have PA levels ≥7,500 steps/day. Overall, nurses had the highest step counts (7,980 steps/day) followed by physiotherapists (7,332 steps/day), while pharmacists had the lowest step counts (6,201 steps/day). There was however no significant difference in the mean step counts of the various cadres of the HCPs (P > 0.05). Step counts of HCPs were found to significantly negatively correlate with their age (r = −0.53; P < 0.001), body mass index (r = −0.39; P < 0.001), and body fat percentage (r = −0.42; P < 0.001). Conclusion: PA profile of the HCPs was mostly characterized by a low active PA level and less than a quarter met the recommended minimum of 10,000 steps/day.
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Affiliation(s)
- Oluwatoyosi Owoeye
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada; Department of Physiotherapy, College of Medicine, University of Lagos, Idi-Araba, Nigeria
| | - Adetipe Tomori
- Department of Physiotherapy, National Orthopaedic Hospital, Igbobi, Lagos, Nigeria
| | - Sunday Akinbo
- Department of Physiotherapy, College of Medicine, University of Lagos, Idi-Araba, Nigeria
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Steiniche D, Jespersen S, Erikstrup C, Krarup H, Handberg A, Østergaard L, Haraldsdottir T, Medina C, Gomes Correira F, Laursen AL, Bjerregaard-Andersen M, Wejse C, Hønge BL. Diabetes mellitus and impaired fasting glucose in ART-naïve patients with HIV-1, HIV-2 and HIV-1/2 dual infection in Guinea-Bissau: a cross-sectional study. Trans R Soc Trop Med Hyg 2016; 110:219-27. [PMID: 27076509 PMCID: PMC4830405 DOI: 10.1093/trstmh/trw017] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Revised: 02/12/2016] [Accepted: 03/01/2016] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The prevalence of diabetes mellitus (DM) is expected to increase in sub-Saharan Africa. Patients with HIV are at particular risk. We investigated the DM burden among antiretroviral therapy (ART)-naïve patients with HIV in Guinea-Bissau. METHODS Patients were consecutively included. Demographic and lifestyle data were collected and one fasting blood glucose (FBG) measurement was used to diagnose DM (FBG≥7.0 mmol/L) and impaired fasting glucose (IFG) (FBG≥6.1 and <7.0 mmol/L). RESULTS By June 2015, 953 newly diagnosed ART-naïve patients with HIV had been included in the study of whom 893 (93.7%) were fasting at the time of inclusion. Median age among the fasting patients was 37 years (IQR 30-46 years) and 562 (62.9%) were women. The prevalence of DM was 5.8% (52/893) while 5.6% (50/893) had IFG. DM was associated with family history of DM (OR 3.92, 95% CI 1.78 to 8.63), being 41-50 years (OR 2.98, 95% CI 1.18 to 7.49) or older than 50 years (OR 3.14, 95% CI 1.09 to 9.07) and Fula ethnicity (OR 2.72, 95% CI 1.12 to 6.62). CONCLUSIONS DM prevalence was higher among younger patients compared with the background population in Bissau. Traditional risk factors for DM such as advancing age and a family history of DM apply also for ART-naïve patients with HIV.
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Affiliation(s)
- Ditte Steiniche
- Bandim Health Project, Indepth Network, 1004 Bissau, Guinea-Bissau Department of Infectious Diseases, Aarhus University Hospital, 8200 Aarhus N, Denmark
| | - Sanne Jespersen
- Bandim Health Project, Indepth Network, 1004 Bissau, Guinea-Bissau Department of Infectious Diseases, Aarhus University Hospital, 8200 Aarhus N, Denmark
| | - Christian Erikstrup
- Department of Clinical Immunology, Aarhus University Hospital, 8200 Aarhus N, Denmark
| | - Henrik Krarup
- Section of Molecular Diagnostics, Clinical Biochemistry, Aalborg University Hospital, 9000 Aalborg, Denmark
| | - Aase Handberg
- Department of Clinical Biochemistry, Aalborg University Hospital, 9000 Aalborg, Denmark
| | - Lars Østergaard
- Department of Infectious Diseases, Aarhus University Hospital, 8200 Aarhus N, Denmark
| | | | - Candida Medina
- National HIV Programme, Ministry of Health, 1004 Bissau, Guinea-Bissau
| | | | - Alex Lund Laursen
- Department of Infectious Diseases, Aarhus University Hospital, 8200 Aarhus N, Denmark
| | - Morten Bjerregaard-Andersen
- Bandim Health Project, Indepth Network, 1004 Bissau, Guinea-Bissau Department of Endocrinology, Odense University Hospital, 5000 Odense, Denmark Research Center for Vitamins and Vaccines, Statens Serum Institute, Copenhagen, Denmark
| | - Christian Wejse
- Bandim Health Project, Indepth Network, 1004 Bissau, Guinea-Bissau Department of Infectious Diseases, Aarhus University Hospital, 8200 Aarhus N, Denmark GloHAU, Center for Global Health, School of Public Health, Aarhus University, 8000 Aarhus Denmark
| | - Bo Langhoff Hønge
- Bandim Health Project, Indepth Network, 1004 Bissau, Guinea-Bissau Department of Clinical Immunology, Aarhus University Hospital, 8200 Aarhus N, Denmark
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Adeniyi OV, Yogeswaran P, Longo-Mbenza B, Goon DT. Uncontrolled Hypertension and Its Determinants in Patients with Concomitant Type 2 Diabetes Mellitus (T2DM) in Rural South Africa. PLoS One 2016; 11:e0150033. [PMID: 26930050 PMCID: PMC4773066 DOI: 10.1371/journal.pone.0150033] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Accepted: 02/08/2016] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Paucity of data on the prevalence, treatment and control of hypertension in individuals living with type 2 diabetes mellitus (T2DM) in the rural communities of South Africa may undermine efforts to reduce the morbidity and mortality associated with cardiovascular diseases. This study examines the socio-demographic and clinical determinants of uncontrolled hypertension among individuals living with T2DM in the rural communities of Mthatha, South Africa. METHODS This cross-sectional study involved a serially selected sample of 265 individuals living with T2DM and hypertension at Mthatha General Hospital, Mthatha. Uncontrolled hypertension was defined as systolic blood pressure greater than or equal to 140 mmHg and diastolic blood pressure greater than or equal to 90mmHg in accordance with the Eight Joint National Committee Report (JNC 8) (2014). We performed univariate and multivariate logistic regression analyses to identify the significant determinants of uncontrolled hypertension. RESULTS Of the total participants (n = 265), the prevalence of uncontrolled hypertension was 75.5% (n = 200). In univariate analysis of all participants, male gender (p = 0.029), age≥65 years (p = 0.016), unemployed status (p<0.0001), excessive alcohol intake (p = 0.005) and consumption of western-type diet (p<0.0001) were positively associated with uncontrolled hypertension. In multivariate logistic regression (LR method) analysis, unemployed status (p<0.0001), excessive alcohol intake (p = 0.007) and consumption of western-type diet (p<0.0001) were independently and significantly associated with uncontrolled hypertension. There is significant association between increasing number and classes of anti-hypertensive drugs and uncontrolled hypertension (p = 0.05 and 0.02, respectively). CONCLUSION Prevalence of uncontrolled hypertension was high in individuals with concomitant hypertension and T2DM in the study population. Male sex, aging, clinic inertia, unemployed status and nutritional transitions are the most important determinants of uncontrolled hypertension in T2DM in Mthatha, South Africa. Treatment to blood pressure targets, though feasible in our setting, would require concerted efforts by addressing these determinants and clinic inertia.
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Ale OK, Braimoh RW, Olayemi SO. The approach of general practitioners in Lagos to the detection and evaluation of hypertension. Clin Hypertens 2016; 21:10. [PMID: 26893922 PMCID: PMC4750797 DOI: 10.1186/s40885-015-0017-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Accepted: 03/02/2015] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Hypertension (HTN) control is a major public health and clinical challenge. A number of guidelines exist globally to assist in tackling this challenge. The aim of this study was to determine conformity of the HTN detection and evaluation practices of a sample of Lagos-based general practitioners (GPs) to international guidelines. METHODS Self-administered structured questionnaires were used to collect data from a cohort of GPs attending continuing medical education programs in Lagos. RESULTS Out of the 460 GPs that were approached, 435 agreed to participate in the study, with questionnaires from 403 GPs analyzed. The average age and number of years post-registration of the GPs were 40.0 ± 11.3 years and 14.3 ± 11.1 years, respectively. Two thirds (n = 269) were in private practice. Their daily average total and HTN patients' loads were 17.4 ± 14.3 and 4.4 ± 3.5, respectively. Awareness of HTN guidelines was 46.7% (n = 188), while 18.1% (n = 73) was able to name one or more HTN guidelines. The approaches of these GPs to the detection and evaluation of HTN and their relationships to the GPs' experience were heterogeneous. DISCUSSION The approach of the GPs to detection and evaluation of HTN though heterogeneous is unsatisfactory and may partly contribute to poor HTN control in Nigeria. Strengthening the capacity of GPs in this regard through continuous medical education may greatly improve HTN control.
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Affiliation(s)
- Olagoke Korede Ale
- Cardiology Unit, Department of Medicine, University of Lagos/Lagos University Teaching Hospital, Lagos, Nigeria
| | - Rotimi William Braimoh
- Nephrology Unit, Department of Medicine, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Sunday O Olayemi
- Nephrology Unit, Department of Medicine, College of Medicine, University of Lagos, Lagos, Nigeria
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Oguoma VM, Nwose EU, Skinner TC, Richards RS, Digban KA, Onyia IC. Association of physical activity with metabolic syndrome in a predominantly rural Nigerian population. Diabetes Metab Syndr 2016; 10:13-18. [PMID: 26327395 DOI: 10.1016/j.dsx.2015.08.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIMS Physical activity is an essential determinant of health. However, there is dearth of evidence regarding prevalence of physical activity in developing countries, especially its association with metabolic syndrome risk factors. This study assessed the association of physical activity with metabolic syndrome in a Nigerian population. MATERIALS AND METHODS A cross-sectional study was carried out on apparently healthy persons who are ≥ 18 years old. The World Health Organisation (WHO) Global Physical Activity Questionnaire (GPAQ) was used to collect five domains of physical activity. Participants were classified as physically active or inactive based on meeting the cut-off value of 600 MET-min/week. Metabolic syndrome was diagnosed using the Joint Scientific Statement on Harmonizing the Metabolic Syndrome criteria. RESULTS Overall prevalence of physically active individuals was 50.1% (CI: 45.6-54.7%). Physical inactivity is significantly more in females (p<0.01) and among participants >40 years old (p<0.0001). Whereas individuals with metabolic syndrome appeared more likely to be physically active (OR=1.48, CI: 0.71-3.09); physical inactivity showed to exist more among participants who were living in urban area (OR=6.61, CI: 3.40-12.85, p<0.001). Participants with prediabetes (OR=1.69, CI: 0.62-4.61) and diabetes (OR=1.91, CI: 0.65-5.63) were more likely to be physically inactive as compared to other metabolic syndrome risk factors. CONCLUSION The high prevalence of physical inactivity in this study population is a clear indication that concerted efforts to improve physical activity may be required. However, it seems that metabolic syndrome is not improved by being physically active. This suggests that interventions directed at physical activity alone may not produce optimal efficacy in this study population.
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Affiliation(s)
- Victor M Oguoma
- School of Psychological and Clinical Sciences, Charles Darwin University, Northern Territory, Australia.
| | - Ezekiel U Nwose
- School of Community Health, Charles Sturt University, New South Wales, Australia; Department of Public and Community Health, Novena University Ogume, Delta State, Nigeria
| | - Timothy C Skinner
- School of Psychological and Clinical Sciences, Charles Darwin University, Northern Territory, Australia
| | - Ross S Richards
- School of Community Health, Charles Sturt University, New South Wales, Australia
| | - Kester A Digban
- Department of Public and Community Health, Novena University Ogume, Delta State, Nigeria
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Mutowo MP, Owen AJ, Billah B, Lorgelly PK, Gumbie KE, Mangwiro JC, Renzaho AMN. Burden attributable to Cardiometabolic Diseases in Zimbabwe: a retrospective cross-sectional study of national mortality data. BMC Public Health 2015; 15:1213. [PMID: 26644134 PMCID: PMC4672515 DOI: 10.1186/s12889-015-2554-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 12/01/2015] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Cardiometabolic diseases (CMDs) are an important cause of mortality worldwide and the burden associated with them is increasing in Sub-Saharan Africa. The tracking of mortality helps support evidence based health policy and priority setting. Given the growing prevalence of non-communicable diseases in Zimbabwe, a study was designed to determine the mortality attributable to CMDs in Zimbabwe. METHODS The study design was a retrospective cross-sectional analysis of national mortality from 1996 to 2007, collated by the Ministry of Health and Child Welfare in Zimbabwe. We employed generalized additive models to flexibly estimate the trend of the CMD mortality and a logistic regression model was used to find significant factors (cause of death according to the death certificate) of the CMD mortality and predict CMD mortality to 2040. RESULTS CMDs accounted for 8.13% (95% CI: 8.08% - 8.18%) of all deaths during 1996 to 2007 (p = 0.005). During the study period CMD mortality rate increased by 29.4% (95% CI: 19.9% - 41.1%). The association between gender and CMD mortality indicated female mortality was higher for diabetes (p < 0.001), hypertensive disease (p < 0.001), CVD (p < 0.001) and pulmonary disease (p < 0.001), while male mortality was higher for ischaemic (p = 0.010) and urinary diseases (p < 0.001). There was no gender difference for endocrine disease (p = 0.893). Overall, females have 1.65% higher mortality than males (p < 0.001). CMD mortality is predicted to increase from 9.6 (95% CI: 8.0% - 11.1%) in 2015 to 13.7% (95% CI: 10.2% - 17.2%) in 2040 for males, and from 11.6% (95% CI: 10.2% - 12.9%) in 2015 to 16.2% (95% CI: 13.1% - 19.3%) in 2040 in females. CONCLUSION The findings of this study indicate a growing prevalence of CMDs and related mortality in Zimbabwe. Health policy decisions and cost-effective preventive strategies to reduce the burden of CMDs are urgently required.
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Affiliation(s)
- Mutsa P Mutowo
- School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004, Australia.
| | - Alice J Owen
- School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004, Australia.
| | - Baki Billah
- School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004, Australia.
| | - Paula K Lorgelly
- Centre for Health Economics, Monash University, Melbourne, 3004, Australia.
| | - Kudzai E Gumbie
- Fellow of the Institute of Actuaries (FIA) , Harare, Zimbabwe.
| | - John C Mangwiro
- Zimbabwe Diabetes Association, PO Box 1797, Harare, Zimbabwe.
| | - Andre M N Renzaho
- School of Social Science and Psychology, University of Western Sydney, Sydney, 2751, , New South Wales, Australia.
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Tandon S, Chew M, Eklu-Gadegbeku CK, Shermock KM, Morisky DE. Validation and psychometric properties of the 8-item Morisky Medication Adherence Scale (MMAS-8) in Type 2 diabetes patients in sub-Saharan Africa. Diabetes Res Clin Pract 2015; 110:129-36. [PMID: 26515909 DOI: 10.1016/j.diabres.2015.10.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Revised: 09/04/2015] [Accepted: 10/01/2015] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Research in the field of adherence to medications has not been explored in sub-Saharan Africa. The goal of this manuscript is to (1) validate the use of an adherence tool: a translated 8-item Morisky Medication Adherence Scale (MMAS-8) for Type 2 diabetes and (2) assess association between levels of adherence and psychometric properties. METHODS 154 Type 2 diabetic patients being chronically treated were surveyed from Togolese Diabetes Association using a demographic survey, 4-item Morisky Medication Adherence Scale (MMAS-4) and MMAS-8 from January to March 2012. RESULTS Internal reliability for the 8-item scale showed the Cronbach alpha being 0.47. The MMAS-8 and MMAS-4 showed a Pearson's correlation of 0.6851. For known groups validity, the chi-square (χ(2)) tests of proportions showed a significant relationship between blood glucose control and MMAS-8 (χ(2)=12.17; p=0.002). The sensitivity, specificity, positive predictive value and negative predictive value were 75%, 48.39%, 56.76%, and 68.18% respectively. CONCLUSIONS Psychometric analyses showed that the MMAS-8 was a suitable way of measuring medication adherence in the study population given its low cost, ease of use, and the low income status of the country.
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Affiliation(s)
- Sangeeta Tandon
- Department of Pharmacy, The Johns Hopkins Hospital, Baltimore, MD, USA.
| | - Melissa Chew
- Bloomberg School of Public Health, The Johns Hopkins Medical Institutions, USA
| | | | - Kenneth M Shermock
- Department of Pharmacy, The Johns Hopkins Hospital, Baltimore, MD, USA; Center for Pharmaceutical Outcomes, The Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Donald E Morisky
- Department of Community Health Sciences, UCLA Fielding School of Public Health, 650 Charles E. Young Drive South, Los Angeles, CA, USA
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The Afro-Cardiac Study: Cardiovascular Disease Risk and Acculturation in West African Immigrants in the United States: Rationale and Study Design. J Immigr Minor Health 2015; 18:1301-1308. [DOI: 10.1007/s10903-015-0291-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Commodore-Mensah Y, Himmelfarb CD, Agyemang C, Sumner AE. Cardiometabolic Health in African Immigrants to the United States: A Call to Re-examine Research on African-descent populations. Ethn Dis 2015; 25:373-80. [PMID: 26675140 DOI: 10.18865/ed.25.3.373] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
In the 20th century, Africans in Sub-Saharan Africa had lower rates of cardiometabolic disease than Africans who migrated. However, in the 21st century, beyond infectious diseases, the triple epidemics of obesity, diabetes and hypertension have taken hold in Africa. Therefore, Africans are acquiring these chronic diseases at different rates and different intensity prior to migration. To ensure optimal care and health outcomes, the United States practice of grouping all African-descent populations into the "Black/African American" category without regard to country of origin masks socioeconomic and cultural differences and needs re-evaluation. Overall, research on African-descent populations would benefit from a shift from a racial to an ethnic perspective. To demonstrate the value of disaggregating data on African-descent populations, the epidemiologic transition, social, economic, and health characteristics of African immigrants are presented.
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Affiliation(s)
| | | | - Charles Agyemang
- 2. Department of Public Health, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Anne E Sumner
- 3. Diabetes, Endocrinology and Obesity Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institute of Health, Bethesda, Maryland
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Seifu W. Prevalence and Risk Factors For Diabetes Mellitus and Impaired Fasting Glucose among Adults Aged 15-64 Years in Gilgel Gibe Field Research Center, Southwest Ethiopia, 2013:Through a Who Step Wise Approach. ACTA ACUST UNITED AC 2015. [DOI: 10.15406/mojph.2015.02.00035] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Baldew SSM, Krishnadath ISK, Smits CCF, Toelsie JR, Vanhees L, Cornelissen V. Self-reported physical activity behavior of a multi-ethnic adult population within the urban and rural setting in Suriname. BMC Public Health 2015; 15:485. [PMID: 25959031 PMCID: PMC4440279 DOI: 10.1186/s12889-015-1807-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Accepted: 04/27/2015] [Indexed: 11/27/2022] Open
Abstract
Background Physical activity (PA) plays an important role in the combat against noncommunicable diseases including cardiovascular diseases. In order to develop appropriate PA intervention programs, there is a need to evaluate PA behavior. So far, there are no published data on PA available for Suriname. Therefore, we aim to describe PA behavior among the multi-ethnic population living in urban and rural areas of Suriname. Methods The World Health Organization (WHO) STEPwise approach to chronic disease risk factor surveillance (STEPS) was conducted in a national representative sample (N = 5751; 48.6% men) aged 15–64 years between March and September 2013. Physical activity data were assessed using the Global physical activity questionnaire (GPAQ) and analyzed according to the GPAQ guidelines. The prevalence of meeting the recommended PA level and prevalence ratios (PR) were computed. Results Only 55.5% of the overall population met the WHO recommended PA levels (urban coastal area: 55.7%, rural coastal area: 57.9%, rural interior area: 49.1%). Women were less likely to meet the recommended PA level (49% vs 62.4%; p < 0.0001) and with increasing age the PR for recommended level of PA decreased (p < 0.0001). Compared to the Hindustani’s, the largest ethnic group, the Javanese reported the lowest percentage of people meeting recommended PA level (PR = 0.92; p = 0.07). Conclusion Around half of the population meets the recommended PA level. Future lifestyle interventions aiming at increasing PA should especially focus on women and older individuals as they are less likely to meet the recommended levels of PA.
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Affiliation(s)
- Se-Sergio M Baldew
- Department of Physical Therapy, Faculty of Medical Sciences, Anton de Kom University of Suriname, Paramaribo, Suriname. .,Department of Rehabilitation Sciences, Research Center for Cardiovascular Rehabilitation, Faculty of Kinesiology and Rehabilitation Sciences, Katholieke Universiteit Leuven, Leuven, Belgium.
| | - Ingrid S K Krishnadath
- Department of Public Health, Faculty of Medical Sciences, Anton de Kom University of Suriname, Paramaribo, Suriname.
| | - Christel C F Smits
- Department of Public Health, Faculty of Medical Sciences, Anton de Kom University of Suriname, Paramaribo, Suriname.
| | - Jerry R Toelsie
- Department of Physiology, Faculty of Medical Sciences, Anton de Kom University of Suriname, Paramaribo, Suriname.
| | - Luc Vanhees
- Department of Rehabilitation Sciences, Research Center for Cardiovascular Rehabilitation, Faculty of Kinesiology and Rehabilitation Sciences, Katholieke Universiteit Leuven, Leuven, Belgium.
| | - Veronique Cornelissen
- Department of Rehabilitation Sciences, Research Center for Cardiovascular Rehabilitation, Faculty of Kinesiology and Rehabilitation Sciences, Katholieke Universiteit Leuven, Leuven, Belgium.
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Haraldsdottir TL, Rudolf F, Bjerregaard-Andersen M, Joaquím LC, Stochholm K, Gomes VF, Beck-Nielsen H, Ostergaard L, Aaby P, Wejse C. Diabetes mellitus prevalence in tuberculosis patients and the background population in Guinea-Bissau: a disease burden study from the capital Bissau. Trans R Soc Trop Med Hyg 2015; 109:400-7. [PMID: 25918218 DOI: 10.1093/trstmh/trv030] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2015] [Accepted: 03/23/2015] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Data regarding the association between diabetes mellitus (DM) and tuberculosis (TB) in Africa are scare. We did a DM screening survey among TB patients and non-TB controls in Guinea-Bissau. METHODS The study was conducted at the Bandim Health Project (BHP) in the capital Bissau. From July 2010 to July 2011, newly diagnosed TB cases were identified through a TB notification system. Concurrently, non-TB controls were selected randomly from the BHP's demographic surveillance database and visited at home. Participants were tested using fasting blood glucose (FBG) measurements. DM was diagnosed as FBG ≥ 7 mmol/l. Our survey was linked to the patient database at the only existing Diabetes Clinic in Bissau. RESULTS TB patients (n=110) were older than the controls (n=572) (35 vs 31 years; p=0.02), more often male (55% vs 37%; p<0.001) and had a lower body mass index (18.7 vs 24.2 kg/m(2); p<0.001). The prevalence of DM was 2.8% (3/107) for TB patients and 2.1% (11/531) for controls (p=0.64). Excluding two controls already receiving anti-diabetic treatment, the prevalence of DM was 2.8% (3/107) vs 1.7% (9/529) (p=0.44). CONCLUSIONS The prevalence of DM was low, also among TB patients. No association between DM and TB was found.
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Affiliation(s)
- Thorny L Haraldsdottir
- Bandim Health Project, Apartado 861, 1004 Bissau Codex, Guinea-Bissau Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark
| | - Frauke Rudolf
- Bandim Health Project, Apartado 861, 1004 Bissau Codex, Guinea-Bissau Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark
| | - Morten Bjerregaard-Andersen
- Bandim Health Project, Apartado 861, 1004 Bissau Codex, Guinea-Bissau Research Center for Vitamins and Vaccines (CVIVA), Statens Serum Institute, Copenhagen, Denmark Department of Endocrinology, Odense University Hospital, Odense, Denmark
| | - Luis Carlos Joaquím
- Bandim Health Project, Apartado 861, 1004 Bissau Codex, Guinea-Bissau The National Diabetes Association (ANDD), Bissau, Guinea-Bissau
| | - Kirstine Stochholm
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Victor F Gomes
- Bandim Health Project, Apartado 861, 1004 Bissau Codex, Guinea-Bissau
| | | | - Lars Ostergaard
- Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark
| | - Peter Aaby
- Bandim Health Project, Apartado 861, 1004 Bissau Codex, Guinea-Bissau Research Center for Vitamins and Vaccines (CVIVA), Statens Serum Institute, Copenhagen, Denmark
| | - Christian Wejse
- Bandim Health Project, Apartado 861, 1004 Bissau Codex, Guinea-Bissau Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark GloHAU, Center for Global Health, Department of Public Health, Aarhus University, Denmark
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Modesti PA, Bianchi S, Borghi C, Cameli M, Capasso G, Ceriello A, Ciccone MM, Germanò G, Maiello M, Muiesan ML, Novo S, Padeletti L, Palmiero P, Pillon S, Rotella CM, Saba PS, Scicchitano P, Trimarco B, Volpe M, Pedrinelli R, Di Biase M. Cardiovascular health in migrants: current status and issues for prevention. A collaborative multidisciplinary task force report. J Cardiovasc Med (Hagerstown) 2015; 15:683-92. [PMID: 25090156 DOI: 10.2459/jcm.0000000000000069] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVES To review information on cardiovascular health and migration, to stress the attention of researchers that much needs to be done in the collection of sound data in Italy and to allow policy makers identifying this issue as an important public health concern. BACKGROUND In Italy, the rate of immigrants in the total number of residents increased from 2.5% in 1990 to 7.4% in 2010, and currently exceeds 10% in regions such as Lombardia, Emilia Romagna and Toscana. METHODS A consensus statement was developed by approaching relevant Italian national scientific societies involved in cardiovascular prevention. Task force members were identified by the president and/or the boards of each relevant scientific society or working group, as appropriate. To obtain a widespread consensus, drafts were merged and distributed to the scientific societies for local evaluation and revision by as many experts as possible. The ensuing final draft was finally approved by scientific societies. RESULTS In several western European countries, the prevalence of hypertension, diabetes, chronic kidney disease, obesity and metabolic syndrome was found to be higher among immigrants than in the native population. Although migrants are often initially healthier than non-migrant populations in their host countries, genetic factors, and changing environments with lifestyle changes, social exclusion and insufficient medical control may expose them to health challenges. Cultural reasons may also hamper both the dissemination of prevention strategies and migrant communication with healthcare providers. However, great diversity exists across and within different groups of migrants, making generalizations very difficult and many countries do not collect registry or survey data for migrant's health. CONCLUSIONS In the present economic context, the European Union is placing great attention to improve data collection for migrant health and to support the implementation of specific prevention policies aimed at limiting the future burden of cardiovascular and renal disease, and the consequent load for health systems. Wider initiatives on the topic are awaited in Italy.
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Affiliation(s)
- Pietro A Modesti
- aDepartment of Medicina Sperimentale e Clinica, University of Florence, Florence bDepartment of Medicina Interna, Nefrologia e Dialisi, Ospedali Riuniti di Livorno, Livorno cDepartment of Scienze Mediche e Chirurgiche, S.Orsola-Malpighi University Hospital, Bologna dDepartment of Malattie Cardiovascolari, University of Siena, Siena eDepartment of Nephrology, Second University of Naples, Naples, Italy fInstitute d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain gDepartment of Emergenza e dei trapianti d'Organo DETO, Sezione di Malattie dell'Apparato Cardiovascolare, University of Bari, Bari hDepartment of Scienze Cardiovascolari, Respiratorie, Geriatriche e Nefrologiche, University 'La Sapienza', Rome iAS Department of Cardiology, Brindisi District jDepartment of Clinical and Experimental Sciences, University of Brescia, Brescia kDivision of Cardiology, Dipartimanto di Medicina Interna, Malattie Cardiovascolari e Nefrourologiche, University of Palermo, Palermo lDepartment of Medicina Sperimentale e Clinica, University of Florence, Florence mDivision of Cardiology, ASL BR, Brindisi nUOD Telemedicina, Dipartimento Cardiovascolare, A.O.San Camillo-Forlanini, Roma oDivision of Cardiology, Department of Fisiopatologia Clinica - Sezione di Endocrinologia, University of Florence, Florence pDivision of Cardiology, AOU Sassari, Sassari qDepartment of Emergenza e dei trapianti d'Organo DETO, Sezione di Malattie dell'Apparato Cardiovascolare, University of Bari, Bari rDepartment of Advanced Biomedical Sciences, Federico II University, Naples sDivision of Cardiology, Department of Medicina Clinica e Molecolare, Facoltà di Medicina e Psicologia Università di Roma 'Sapienza' - Azienda Ospedaliera Sant'Andrea, and IRCCS Neuromed, Rome tDepartment Cardio Toracico e Vascolare, University of Pisa, Pisa uDepartment of Scienze Mediche e Chirurgiche, University of Foggia, Foggia, Italy
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Adeniyi OV, Longo-Mbenza B, Ter Goon D. Female sex, poverty and globalization as determinants of obesity among rural South African type 2 diabetics: a cross-sectional study. BMC Public Health 2015; 15:298. [PMID: 25880927 PMCID: PMC4380244 DOI: 10.1186/s12889-015-1622-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2014] [Accepted: 03/09/2015] [Indexed: 02/06/2023] Open
Abstract
Background Countries in Sub-Saharan Africa have recently been experiencing increases in the prevalence of obesity, type 2 diabetes mellitus (T2DM) and other non-communicable diseases in both urban and rural areas. Despite their growing influence on population health in the region, there is a paucity of epidemiological studies on the twin epidemic of obesity and T2DM, particularly in the rural communities in South Africa. We investigated the prevalence and the determinants of overall obesity among patients with T2DM in rural and semi-urban areas surrounding the town of Mthatha, South Africa. Methods This hospital-based cross-sectional study was conducted among patients with T2DM attending the outpatient department at Mthatha General Hospital, Eastern Cape Province, South Africa. Data were obtained from 327 participants using standardized questionnaires that included items on sex, age, level of education, type of residence, employment status, smoking status, physical activity, diet and alcohol intake. After taking measurements of height and weight, participants were defined as obese if their body mass index exceeded 30 kg/m2. Univariate and multivariate logistic regression analyses were performed to identify the determinants of obesity in our sample population. Results We found that 60.2% of our sample population were defined as obese. In our univariate analyses, female sex (p < 0.001), age ≥50 years (p = 0.023), rural residence (p < 0.001), excessive alcohol intake (p = 0.002), current cigarette smoking (p < 0.001), level of education (p < 0.001), regular consumption of soft drinks (p < 0.001) and unemployment (p = 0.043) were found to be positively and significantly associated with obesity. In the multivariate logistic regression analysis, female sex (p < 0.001), unemployment (p = 0.012) and level of education (p < 0.001) were found to be independent determinants of obesity. Conclusion We found that female sex, educational attainment, unemployment and current cigarette smoking were positively associated with obesity among the study participants. Lifestyle changes, poverty reduction and public education are urgently needed to address the growing obesity epidemic in rural areas of South Africa.
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Affiliation(s)
- Oladele Vincent Adeniyi
- Department of Family Medicine, Senior Specialist, Faculty of Health Sciences, Walter Sisulu University, Cecilia Makiwane Hospital, East London Hospital Complex, Private Bag X 9047, Mdantsane, East London, South Africa, 5200.
| | - Benjamin Longo-Mbenza
- Department of Community Medicine, Research Champion Professor, Faculty of Health Sciences, Walter Sisulu University, Private Bag X1, Mthatha, South Africa, 5117.
| | - Daniel Ter Goon
- Department of Nursing Science, Senior Researcher, School of Health Sciences, University of Fort Hare, Private Bag X9083, East London, South Africa, 5201.
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Sherif S, Sumpio BE. Economic development and diabetes prevalence in MENA countries: Egypt and Saudi Arabia comparison. World J Diabetes 2015; 6:304-311. [PMID: 25789111 PMCID: PMC4360423 DOI: 10.4239/wjd.v6.i2.304] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Revised: 11/25/2014] [Accepted: 12/19/2014] [Indexed: 02/06/2023] Open
Abstract
Diabetes is increasing in epidemic proportions globally, exhibiting the most striking increase in third world countries with emerging economies. This phenomena is particularly evident in the Middle East and North Africa (MENA) region, which has the highest prevalence of diabetes in adults. The most concerning indirect cost of diabetes is the missed work by the adult population coupled with the economic burden of loss of productivity. The major drivers of this epidemic are the demographic changes with increased life expectancy and lifestyle changes due to rapid urbanization and industrialization. Our focus is to compare MENA region countries, particularly Egypt and Saudi Arabia, in terms of their economic development, labor force diversity and the prevalence of diabetes.
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