Cardiometabolic syndrome and associated factors among Ethiopian public servants, Addis Ababa, Ethiopia

Prevalence and Mitigation of Cardiovascular Disease Risk Factors Among the Corporate Workforce in Sub-Saharan Africa: A Systematic Review and Meta-Analysis

Cardiovascular disease (CVDs) is the leading cause of mortality worldwide. Corporate workplaces have been identified as important environmental factors that can increase the risk and severity of CVDs. Evidence indicates that the risk and severity of CVDs can be effectively reduced by mitigating modifiable behavioural and intermediate risk factors. Although the prevalence of CVDs and their associated risk factors is increasing in sub-Saharan Africa (SSA), most published data from the region are hospital-based and may not be true estimates. This study investigated the prevalence and distribution of CVD risk factors among the corporate workforce in SSA and the effects of workplace wellness programmes (WWP) on these risk factors. Accordingly, a systematic search was performed using Google Scholar, Cochrane Library, PubMed, MEDLINE, Scopus and Science Direct for articles published between January 2010 and March 2024. A total of 105 studies (n = 76,027) across nine countries met the eligibility criteria and were analysed. The pooled prevalence of the risk factors was unhealthy diet (80%), high salt intake (32%), stress (58%), poor sleep (59%), physical inactivity (PI, 59%), alcohol consumption (29%), harmful alcohol consumption (26%), tobacco smoking (7%), khat chewing (6%), overweight (36%), obesity (23%), central obesity (44%), high blood pressure (29%), high total cholesterol (33%), high low-density lipoprotein cholesterol (LDL-c) (41%), low high-density lipoprotein cholesterol (HDL-c) (45%), hypertriglyceridaemia (17%), dysglycaemia (9%), and metabolic syndrome (MS; 45%). The highest prevalence of unhealthy diet and PI was recorded in East Africa and Central Africa, respectively, whereas West Africa had the highest prevalence of high body mass index (BMI). Ethiopia had the highest prevalence of unhealthy diets, whereas Nigeria had the highest prevalence of stress and poor sleep. The healthcare sector had the highest cluster of risk factors and the highest prevalence of unhealthy diets. Only 5.7% of the studies implemented WWP, which had significant mitigating effects on most risk factors. This study concluded that the prevalence of most modifiable CVD risk factors is high among the corporate workforce in SSA, which is higher than that in the general population in most cases, and a well-designed WWP can significantly mitigate these risk factors.

Metabolic syndrome and its associated factors among adults with cardiac diseases: A cross-sectional comparative group study

Objective

There is limited information about the extent of metabolic syndrome (MetS) among subjects with cardiac diseases in Ethiopia. Therefore, this study aimed to determine the prevalence and associated factors of MetS among adults with cardiac diseases.

Methods

A cross-sectional study was conducted at Hawassa University Comprehensive Specialized Hospital in southern-Ethiopia between May 2021 and August 2021. Data pertaining to the study were collected from 319 participants (153 cardiac and 166 non-cardiac groups) using the WHO stepwise approach. The International Diabetes Federation (IDF) and the revised National Cholesterol Education Program: Adult Treatment Panel III (ATP) were used to define MetS.

Results

The prevalence of MetS was 44.2% and 50.2% in IDF and ATP III, respectively. Among the cardiac group, 54.9% had MetS in IDF criteria, compared to 34.3% in the non-cardiac group (p < .001); whereas, it was 60.1% in the cardiac group and 41% in non-cardiac group (p < .001) by ATP III. Age >60 years, waist-height ratio ≥5, high waist-hip ratio, body mass index 25-29.9 and ≥30 kg/m2 were significantly associated with higher odds of MetS in both IDF and ATP III. Also, smoking history and monthly income were associated with MetS by ATP III, while being female was associated with higher odds of MetS by IDF.

Conclusion

More than half of the subjects with cardiac diseases developed MetS as compared to non-cardiac controls. Periodic screening and focusing on the identified modifiable high-risk factors such as body weight, smoking, and central adiposity is important to effectively mitigate the risk of further comorbidity and complications in this high-risk population.

Prevalence of the metabolic syndrome in African populations: A systematic review and meta-analysis

BACKGROUND

The metabolic syndrome (MS) is a leading cause of death worldwide. Several studies have found MS to be prevalent in various African regions. However, no specific estimates of MS prevalence in African populations exist. The aim of this study was to estimate the overall prevalence of MS in the African populations.

METHODS

A systematic review was conducted in PubMed, Web of Science, Africa Index Medicus, and African Journal Online Scopus to find studies published up to the 15th of August 2022. Pooled prevalence was calculated based on six diagnostic methods. The pooled prevalence of MS was estimated using a random-effects model. Our risk of bias analysis was based on the Hoy et al. tool. A Heterogeneity (I2) assessment was performed, as well as an Egger test for publication bias. PROSPERO number CRD42021275176 was assigned to this study.

RESULTS

In total, 297 studies corresponding to 345 prevalence data from 29 African countries and involving 156 464 participants were included. The overall prevalence of MS in Africa was 32.4% (95% CI: 30.2-34.7) with significant heterogeneity (I2 = 98.9%; P<0.001). We obtained prevalence rates of 44.8% (95% CI: 24.8-65.7), 39.7% (95% CI: 31.7-48.1), 33.1% (95% CI: 28.5-37.8), 31.6% (95% CI: 27.8-35.6) and 29.3% (95% CI: 25.7-33) using the WHO, revised NCEP-ATP III, JIS, NCEP/ATP III and IDF definition criteria, respectively. The prevalence of MS was significantly higher in adults >18 years with 33.1% (95%CI: 30.8-35.5) compared to children <18 years with 13.3% (95%CI: 7.3-20.6) (P<0.001). MS prevalence was significantly higher in females with 36.9% (95%CI: 33.2-40.7) compared to males with 26.7% (95%CI: 23.1-30.5) (P<0.001). The prevalence of MS was highest among Type 2 diabetes patients with 66.9% (95%CI: 60.3-73.1), followed by patients with coronary artery disease with 55.2% (95%CI: 50.8-59.6) and cardiovascular diseases with 48.3% (95%CI: 33.5-63.3) (P<0.001). With 33.6% (95% CI: 28.3-39.1), the southern African region was the most affected, followed by upper-middle income economies with 35% (95% CI: 29.5-40.6).

CONCLUSION

This study, regardless of the definition used, reveals a high prevalence of MS in Africa, confirming the ongoing epidemiological transition in African countries. Early prevention and treatment strategies are urgently needed to reverse this trend.

Central obesity and its associated factors among cancer patients at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia

Purpose

Obesity, especially the hidden type of obesity (central obesity), has been believed to be the major risk factor for developing and progressing non-communicable diseases, including cancers. However, there are limited studies regarding the issue in Ethiopia and the study area. Therefore, this study aimed to evaluate the magnitude of central obesity and its associated factors among cancer patients visited the oncology unit of the University of Gondar Comprehensive Specialized Hospital.

Methods

An institutional-based cross-sectional study was conducted from January 10 to March 10, 2021. A total of 384 study participants were enrolled using a systematic sampling technique. The data were collected using a semi-structured interviewer-administered questionnaire and were pretested to address the quality of assurance. The weight of the participants was assessed using body mass index (BMI) and central obesity. Both bivariate and multivariate logistic regressions were conducted to identify the factors associated with central obesity, and p-values less than 0.05 with multivariate were considered statistically significant associations.

Result

Most respondents (60.16%) were stage I cancer patients. The study found that about 19.27% of the participants were prevalent central obesity, and none of them were obese by body mass index (BMI) categorization criteria. However, about 12.24% and 7.03% of the participants were found to be underweight and overweight, respectively. The variables associated with central obesity were sex (AOR=14.40; 95% CI: 5.26 - 39.50), occupation (AOR=4.32; 95%CI: 1.10 - 17.01), and residency (AOR=0.30; 95% CI: 0.13 - 0.70).

Conclusion

A significant number of the respondents (19.27%) were centrally obese. Being female, urban residency and having an occupation other than a farmer, merchant, and governmental were the factors associated with central obesity. Hence, cancer patients may be centrally obese with average body weight.

Prevalence of central obesity and associated factors in Ethiopia: A systematic review and meta-analysis

INTRODUCTION

Obesity is a global public health concern that is now on the rise, especially in low- and middle-income nations. Despite the fact that there are several studies reporting the prevalence of central obesity among adults in Ethiopia, there is a lack of a systematic review and meta-analysis synthesizing the existing observational studies. Therefore, this systematic review and meta-analysis aimed to determine the prevalence of central obesity and its associated factors in Ethiopia.

METHODS

Online libraries such as PubMed, Google Scholar, Scopus, Science Direct, and Addis Ababa University were searched. Data were extracted using Microsoft Excel and analyzed using STATA statistical software (v. 16). Forest plots, Begg's rank test, and Egger's regression test were all used to check for publication bias. To look for heterogeneity, I² was computed, and an overall estimated analysis was carried out. Subgroup analysis was done by region and study setting. In addition, the pooled odds ratio for related covariates was calculated.

RESULTS

Out of 685 studies assessed, 20 met our criteria and were included in the study. A total of 12,603 people were included in the study. The prevalence of central obesity was estimated to be 37.31% [95% confidence interval (CI): 29.55-45.07]. According to subgroup analysis by study region and setting, the highest prevalence was observed in the Dire Dawa region (61.27%) and community-based studies (41.83%), respectively. Being a woman (AOR = 6.93; 95% CI: 3.02-10.85), having better socioeconomic class (AOR = 5.45; 95% CI: 0.56-10.34), being of age 55 and above (AOR = 5.23; 95% CI: 2.37-8.09), being physically inactive (AOR = 1.80; 95% CI: 1.37-2.24), being overweight (AOR = 4.00; 95% CI: 2.58-5.41), being obese (AOR = 6.82; 95% CI: 2.21-11.43), and having hypertension (AOR = 3.84; 95% CI: 1.29-6.40) were the factors associated with central obesity.

CONCLUSION

The prevalence of central obesity was high in Ethiopia. Being a woman, having a higher socioeconomic class, being older, being physically inactive, being overweight or obese, and having hypertension were all associated. Therefore, it is vital for the government and health organizations to design and implement preventive measures like early detection, close monitoring, and positive reversal of central obesity in all patients and the general population. High-quality investigations on the prevalence of central obesity in the Ethiopian people are required to better understand the status of central obesity in Ethiopia.

SYSTEMATIC REVIEW REGISTRATION

https://www.crd.york.ac.uk/PROSPERO, identifier: CRD42022329234.