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Mengome MFA, Kono HN, Bivigou EA, M’bondoukwe NP, Ngomo JMN, Ditombi BM, Ngondza BP, Bisseye C, Mawili-Mboumba DP, Bouyou Akotet MK. Prevalence of cardiometabolic risk factors according to urbanization level, gender and age, in apparently healthy adults living in Gabon, Central Africa. PLoS One 2024; 19:e0285907. [PMID: 38578783 PMCID: PMC10997135 DOI: 10.1371/journal.pone.0285907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 03/14/2024] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND The prevalence of cardiometabolic risk factors (CMRFs) is increasing in sub-Saharan Africa and represents a serious public health issue. Accurate data are required to implement adapted prevention programs and healthcare strategies. Thus, the aim of this study was to estimate the prevalence rates of CMRFs according to the level of urbanization, age and gender in Gabon. METHODS A cross-sectional study was conducted in northern (Bitam), western coast (Libreville, Melen) and southeast (Koulamoutou) areas of Gabon using the World Health Organization's (WHO) stepwise approach for the surveillance of chronic disease risk factors. Participants over 18 years of age, without known underlying disease, living in rural and urban areas of Gabon were included. Sociodemographic, biological, and behavioral data were collected. Univariate and multivariate analysis were used to identify the CMRFs. RESULTS Of the 978 participants, 499 lived in urban and 479 in rural areas. Their median age was 38[28-50] years. Tobacco (26.1% vs 6.2%; p < 0.01) and excessive alcohol consumption (19.4% vs 9.6%; p < 0.01) predominated in rural than in urban areas, respectively. Urban dwellers had more often insufficient physical activity than rural people (29.5% vs 16.3%; p < 0.01). In total, 79.9% of participants aged under 54 years had a high blood pressure;10.6% of the younger participants had pre-hypertension. Metabolic syndrome was more frequent in women (21.7%) than in men (10.0%) (p < 0.01); 6.4% of men and 2.5% of women had a high Framingham score (p = 0.03). Finally, 54.0% of the participants had three or four CMRFs. The multivariate analysis showed that men were more likely to be smokers and to be at risk of pre-hypertension or high blood pressure (p < 0.01). Women were more likely to be obese or to have a metabolic syndrome (p < 0.01). Living in urban areas was also a risk factor for hypertension, diabetes, metabolic syndrome and high LDL cholesterol level. CONCLUSION The prevalence of CMRFs was high in the study population. Disparities were observed according to urban and rural areas, gender and age. National prevention and healthcare strategies for cardiometabolic diseases in Gabon should consider these observed differences.
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Affiliation(s)
- Mérédith Flore Ada Mengome
- Département de Parasitologie-Mycologie, Université des Sciences de la Santé (USS), Libreville, Gabon
- Laboratoire de Biologie Moléculaire et Cellulaire (LABMC), Université des Sciences et Techniques de Masuku (USTM), Franceville, Gabon
| | - Héléna Noéline Kono
- Département de Parasitologie-Mycologie, Université des Sciences de la Santé (USS), Libreville, Gabon
- Laboratoire de Biologie Moléculaire et Cellulaire (LABMC), Université des Sciences et Techniques de Masuku (USTM), Franceville, Gabon
| | - Elsa Ayo Bivigou
- Faculté de Médecine, Département de Médecine, Université des Sciences de la Santé, Libreville, Gabon
| | - Noé Patrick M’bondoukwe
- Département de Parasitologie-Mycologie, Université des Sciences de la Santé (USS), Libreville, Gabon
| | - Jacques-Mari Ndong Ngomo
- Département de Parasitologie-Mycologie, Université des Sciences de la Santé (USS), Libreville, Gabon
| | - Bridy Moutombi Ditombi
- Département de Parasitologie-Mycologie, Université des Sciences de la Santé (USS), Libreville, Gabon
| | - Bedrich Pongui Ngondza
- Département de Parasitologie-Mycologie, Université des Sciences de la Santé (USS), Libreville, Gabon
| | - Cyrille Bisseye
- Laboratoire de Biologie Moléculaire et Cellulaire (LABMC), Université des Sciences et Techniques de Masuku (USTM), Franceville, Gabon
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Pasokh Z, Seif M, Ghaem H, Rezaianzadeh A, Johari MG. Age at natural menopause and development of chronic diseases in the female population of Kharameh, Iran: A historical cohort study. Health Sci Rep 2024; 7:e2042. [PMID: 38650726 PMCID: PMC11033488 DOI: 10.1002/hsr2.2042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 03/19/2024] [Accepted: 03/21/2024] [Indexed: 04/25/2024] Open
Abstract
Background and Aims Declines in estradiol levels after menopause have been reported to be associated with several health outcomes. This study aimed to determine the effect of age at natural menopause (ANM) on some of the most common chronic diseases. Methods This historical cohort study was performed on 2636 postmenopausal women aged 40-70 years participating in phase one of the PERSIAN cohort study in Kharameh, Iran, during 2015-2017. The effect of early (<45 years), intermediate (45-53 years), and late menopause (>53 years) on chronic diseases such as hypertension, diabetes, ischemic heart diseases, stroke, thyroid diseases, and depression was assessed using classic logistic regression for diseases with an incidence rate of more than 10% and Firth's logistic regression for diseases with an incidence of less than this amount. Results The mean age of women was 53.48 ± 8.59. Respectively, early and intermediate menopause was associated with ischemic heart disease (odds ratio [OR = 1.61, 95% confidence interval [CI]: 1.08-2.42; p = 0.020), (OR = 1.57, 95% CI: 1.13-2.21; p = 0.008) and thyroid diseases (OR = 3.10, 95% CI: 1.64-6.24; p < 0.001), (OR = 1.83, 95% CI: 1.02-3.57; p = 0.042). furthermore, early menopause was a risk factor for diabetes (OR = 1.46, 95% CI: 1.07-2.00; p = 0.018), depression (OR = 4.79, 95% CI: 2.20-11.79; p = <0.001) and stroke (OR = 3.00, 95% CI: 1.08-9.32; p = 0.034). Conclusions In this study, women with diabetes, ischemic heart diseases, stroke, thyroid disorders, and depression had a younger ANM compared to their healthy counterparts. Therefore, applying appropriate strategies to postpone the age of menopause, can reduce the incidence of these types of chronic diseases.
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Affiliation(s)
- Zahra Pasokh
- Student Research Committee, Department of Epidemiology, School of HealthShiraz University of Medical SciencesShirazIran
| | - Mozhgan Seif
- Non‐Communicable Diseases Research Center, Department of Epidemiology, School of HealthShiraz University of Medical SciencesShirazIran
| | - Haleh Ghaem
- Non‐Communicable Diseases Research Center, Department of Epidemiology, School of HealthShiraz University of Medical SciencesShirazIran
| | - Abbas Rezaianzadeh
- Colorectal Research Center, Department of Epidemiology, School of HealthShiraz University of Medical SciencesShirazIran
| | - Masoumeh Ghoddusi Johari
- Breast Diseases Research Center, Community Medicine DepartmentShiraz University of Medical SciencesShirazIran
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Manfo FPT, Nimako C, Nantia EA, Suh CF, Chenwi SP, Cho-Ngwa F, Moundipa PF, Nakayama SMM, Ishizuka M, Ikenaka Y. Exposure of Male Farmers and Nonfarmers to Neonicotinoid Pesticides in the South-West and Littoral Regions of Cameroon: A Comparative Study. ENVIRONMENTAL TOXICOLOGY AND CHEMISTRY 2024. [PMID: 38517100 DOI: 10.1002/etc.5842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 11/03/2023] [Accepted: 02/07/2024] [Indexed: 03/23/2024]
Abstract
Pesticides, especially the newly developed neonicotinoids, are increasingly used in many countries around the world, including Cameroon, to control pests involved in crop destruction or disease transmission. Unfortunately, the pesticides also pose tremendous environmental problems because a predominant amount of their residues enter environmental matrices to affect other nontargeted species including humans. This therefore calls for continuous biomonitoring of these insecticides in human populations. The present study sought to assess the neonicotinoid insecticide exposures in two agrarian regions of Cameroon, the South-West region and Littoral region. The study involved 188 men, including 125 farmers and 63 nonfarmers. Spot urine samples were obtained from these subjects and subjected to liquid chromatographic-tandem mass spectrometric analysis for concentrations of neonicotinoid compounds, including acetamiprid, clothianidin, dinotefuran, imidacloprid, thiacloprid, nitenpyram, thiamethoxam, and N-dm-acetamiprid. Neonicotinoid compounds were detected in all study participants, and residues of all the screened pesticides were detected among participants. N-dm-Acetamiprid and imidacloprid were the most prevalent among the subjects (100.0% and 93.1%, respectively), whereas nitenpyram was less common (3.2%). The median values of imidacloprid and total urinary neonicotinoid concentrations were elevated among farmers (0.258 vs. 0.126 µg/L and 0.829 vs. 0.312 µg/L, respectively). Altogether the findings showed that both the farmer and nonfarmer study populations of Cameroon were exposed to multiple residues of neonicotinoids, with relatively higher levels of pesticides generally recorded among farmers. Although exposure levels of the neonicotinoids were generally lower than their respective reference doses, these results warrant further research on the health risk evaluation of multiple residues of the pesticides and reinforcement of control measures to minimize the exposure risks, especially among farmers. Environ Toxicol Chem 2024;00:1-13. © 2024 SETAC.
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Affiliation(s)
- Faustin Pascal Tsagué Manfo
- Department of Biochemistry and Molecular Biology, Faculty of Science, University of Buea, Buea, Cameroon
- Laboratory for Drugs and Molecular Diagnostics Research (ANDI Centre of Excellence for Onchocerciasis Drug Research), Biotechnology Unit, Faculty of Science, University of Buea, Buea, Cameroon
| | - Collins Nimako
- Laboratory of Toxicology, Department of Environmental Veterinary Sciences, Faculty of Veterinary Medicine, Hokkaido University, Sapporo, Japan
- One Health Research Center, Hokkaido University, Hokkaido, Japan
| | - Edouard Akono Nantia
- Department of Biochemistry, Faculty of Science, University of Bamenda, Bambili, Cameroon
| | - Christian Fusi Suh
- Department of Biochemistry and Molecular Biology, Faculty of Science, University of Buea, Buea, Cameroon
| | - Shu Policap Chenwi
- Department of Biochemistry and Molecular Biology, Faculty of Science, University of Buea, Buea, Cameroon
| | - Fidelis Cho-Ngwa
- Laboratory for Drugs and Molecular Diagnostics Research (ANDI Centre of Excellence for Onchocerciasis Drug Research), Biotechnology Unit, Faculty of Science, University of Buea, Buea, Cameroon
- National Higher Polytechnic Institute, University of Bamenda, Bambili, Cameroon
| | - Paul Fewou Moundipa
- Laboratory of Pharmacology and Toxicology, Department of Biochemistry, Faculty of Science, University of Yaoundé I, Yaoundé, Cameroon
| | - Shouta M M Nakayama
- Laboratory of Toxicology, Department of Environmental Veterinary Sciences, Faculty of Veterinary Medicine, Hokkaido University, Sapporo, Japan
| | - Mayumi Ishizuka
- Laboratory of Toxicology, Department of Environmental Veterinary Sciences, Faculty of Veterinary Medicine, Hokkaido University, Sapporo, Japan
| | - Yoshinori Ikenaka
- Laboratory of Toxicology, Department of Environmental Veterinary Sciences, Faculty of Veterinary Medicine, Hokkaido University, Sapporo, Japan
- One Health Research Center, Hokkaido University, Hokkaido, Japan
- Water Research Group, Unit for Environmental Sciences and Management, North-West University, Potchefstroom, South Africa
- Translational Research Unit, Veterinary Teaching Hospital, Faculty of Veterinary Medicine, Hokkaido University, Sapporo, Japan
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Baspakova A, Aldanova A, Zinalieva A, Umbetova A, Makhashbay A, Rakhmanov Y. Aral Sea environmental disasters area population's physical activity level assessment - the first step for targeted health promotion. POLSKI MERKURIUSZ LEKARSKI : ORGAN POLSKIEGO TOWARZYSTWA LEKARSKIEGO 2024; 52:268-276. [PMID: 39007464 DOI: 10.36740/merkur202403102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/16/2024]
Abstract
OBJECTIVE Aim: We aimed to assess the physical activity and sedentary behavior of the population living in the Aral Sea area using the Global Physical Activity Questionnaire. PATIENTS AND METHODS Materials: Data was collected from seven out-patient settings involving 445 participants (47.6% females, 52.4% males). The age of 33.6% of respondents was over 65. RESULTS Results: Nearly a quarter (23.5%) of the participants did not meet World Health Organization physical activity recommendations. The Median Time spent on physical activity in recreation in all dispensaries among males (Md=34.29, IQR=66.43) was signif i cantly higher (Z=-4.78, p<0.001) than females (Md=12.86, IQR=51.43). A signif i cant association was observed between transport-related physical activity and gender (χ2= 5.60, p=0.018). The average percentage that comes from recreation-related activities among males (M=43.69, SD=26.90) was more signif i cant (MD=6.27, 95% CI: 0.46, 12.07) as compared to that of females (M=37.43, SD=31.66). A signif i cant association was observed between engagement in vigorous activity and gender (χ2= 30.77, p<0.001). CONCLUSION Conclusions: Environmental, economic, demographic, and cultural peculiarities of the Aral Sea area should be considered in elaborating specif i c health promotion programs to shift health-harming ambient into health-improving environment.
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Affiliation(s)
- Akmaral Baspakova
- WEST KAZAKHSTAN MARAT OSPANOV MEDICAL UNIVERCITY, AKTOBE, KAZAKHSTAN
| | | | - Ainur Zinalieva
- WEST KAZAKHSTAN MARAT OSPANOV MEDICAL UNIVERCITY, AKTOBE, KAZAKHSTAN
| | - Aigerim Umbetova
- WEST KAZAKHSTAN MARAT OSPANOV MEDICAL UNIVERCITY, AKTOBE, KAZAKHSTAN
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Nganou-Gnindjio CN, Kamdem F, Hamadou B, Bomda RM, Etoa Etoga MC, Ndobo V, Djibrilla S, Mfeukeu Kuate L, Amougou SN, Owona A, Mintom P, Ebene GM, Wafeu GS, Menanga AP. Performance of systolic pressure index for lower limb peripheral arterial disease in a group of elderly in sub-Saharan Africa. Ann Cardiol Angeiol (Paris) 2023; 72:101608. [PMID: 37269805 DOI: 10.1016/j.ancard.2023.101608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 05/04/2023] [Accepted: 05/10/2023] [Indexed: 06/05/2023]
Abstract
BACKGROUND The automatic measurement of the ankle-brachial index (ABI) constitutes a reliable, simple, safe, rapid, and inexpensive alternative diagnostic screening test compared with the Doppler method for peripheral arterial disease (PAD). We aimed to compare the diagnostic performance of automatic ABI measurement tests to Doppler ultrasound for PAD in a group of patients aged 65 years and above, in Sub-Saharan Africa. METHODS This was an experimental comparative study of the performance of Doppler ultrasound to the automated ABI test in the diagnosis of PAD in patients aged ≥ 65 years followed-up at the Yaoundé Central Hospital, Cameroon between January to June 2018. An ABI threshold < 0.90 is defined as a PAD. We compare the sensitivity, and specificity of the high ankle-brachial index (ABI-HIGH), low ankle-brachial index (ABI-LOW), and the mean ankle-brachial index (ABI-MEAN) for both tests. RESULTS We included 137 subjects with an average age of 71.7 ± 6.8 years. In the ABI-HIGH mode, the automatic device had a sensitivity of 55% and a specificity of 98.35% with a difference between the two techniques of d = 0.024 (p = 0.016). In the ABI-MEAN mode, it had a sensitivity of 40.63% and a specificity of 99.15%; d = 0.071 (p < 0.0001). In the ABI-LOW mode, it had a sensitivity of 30.95% and a specificity of 99.11%; d = 0.119 (p < 0.0001). CONCLUSION The Automatic measurement of systolic pressure index has a better diagnostic performance in the detection of Peripheral Arterial Disease compared to the reference method by continuous Doppler in sub-Saharan African subjects aged ≥ 65 years.
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Affiliation(s)
| | - Félicité Kamdem
- Faculty of Medicine and Pharmaceuticals Sciences, University of Douala, Cameroon
| | - Bâ Hamadou
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Cameroon
| | | | | | - Valérie Ndobo
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Cameroon
| | | | | | | | - Amalia Owona
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Cameroon
| | - Pierre Mintom
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Cameroon
| | - Guy Manon Ebene
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Cameroon
| | - Guy Sadeu Wafeu
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Cameroon
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Issaka A, Stevenson C, Paradies Y, Houehanou YCN, Bosu WK, Kiwallo JB, Wesseh CS, Houinato DS, Nazoum DJP, Cameron AJ. Association between urban-rural location and prevalence of type 2 diabetes and impaired fasting glucose in West Africa: a cross-sectional population-based epidemiological study. BMJ Open 2023; 13:e063318. [PMID: 37734888 PMCID: PMC10514614 DOI: 10.1136/bmjopen-2022-063318] [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: 03/29/2022] [Accepted: 07/13/2023] [Indexed: 09/23/2023] Open
Abstract
OBJECTIVES We investigated the association between urban/rural location and both type 2 diabetes mellitus (T2DM) and pre-diabetes among populations of five West African countries. DESIGN Cross-sectional studies, using the WHO Stepwise (STEPs) survey data. SETTING National representative data of both urban and rural areas from Benin, Burkina Faso, Ghana, Liberia and Mali. PARTICIPANTS Adults comprising 15 468 participants (6774 men and 8746 women; 7663 urban and 7805 rural residents) aged between 25 and 64 years. RESULTS The age and sex-adjusted prevalence of T2DM was 6.2% for urban areas and 2.5% for rural areas. The prevalence of impaired fasting glucose (IFG) was 6.6% for urban areas, and 3.0% for rural areas. No differences by sex were observed. The crude relative risk (RR) and 95% CI of T2DM and IFG in urban compared with rural areas were 2.69 (1.85 to 3.91) and 2.37 (1.53 to 3.66), respectively. This reduced to RR: 2.03, 95% CI (1.34 to 3.08) and RR: 2.04, 95% CI (1.27 to 3.28), respectively, after adjusting for covariables. CONCLUSION The prevalence of both T2DM and IFG was more than two times as high in urban areas compared with rural areas in West Africa. Behavioural risk factors are common among urban populations, with ongoing urbanisation expected to drive increases in the prevalence of T2DM. These results could guide planning for T2DM screening, preventive strategies and resource allocation in West Africa.
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Affiliation(s)
- Ayuba Issaka
- School of Health and Social Development, Global Obesity Centre (GLOBE), Institute for Health Transformation (IHT), Faculty of Health, Deakin University, Geelong, Victoria, Australia
- Non-Communicable Diseases and Implementation Science Unit, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
- Alfred Deakin Institute for Citizenship and Globalisation, Faculty of Arts and Education, Deakin University, Geelong, Victoria, Australia
| | - Christopher Stevenson
- School of Health and Social Development, Global Obesity Centre (GLOBE), Institute for Health Transformation (IHT), Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Yin Paradies
- Alfred Deakin Institute for Citizenship and Globalisation, Faculty of Arts and Education, Deakin University, Geelong, Victoria, Australia
| | - Yessito Corine N Houehanou
- National School of Senior Technicians Training in Public Health and Epidemiological Surveillance, University of Parakou, Parakou, Borgou, Benin
| | - William K Bosu
- Department of Public Health and Research, West African Health Organisation, Bobo-Dioulasso, Haut-Bassin, Burkina Faso
| | - Jean Baptiste Kiwallo
- Directorate of Population Health Protection (DPSP) of Burkina Faso, Ministry of Health, Ouagadougou, Burkina Faso
| | - Chea Sanford Wesseh
- Republic of Liberia Ministry of Health, Congo Town, Monrovia, Montserrado, Liberia
| | - Dismand Stephan Houinato
- Laboratory of Epidemiology of Chronic and Neurological Diseases (LEMACEN), Faculty of Health Sciences, University of Abomey Calavi, Cotonou, Benin
| | - Diarra J P Nazoum
- Non-Communicable Diseases and National Directorate of Health, Ministry of Health and Public Hygiene, Bamako, Mali
| | - Adrian J Cameron
- School of Health and Social Development, Global Obesity Centre (GLOBE), Institute for Health Transformation (IHT), Faculty of Health, Deakin University, Geelong, Victoria, Australia
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Akob FA, Pillay K, Wiles N, Siwela M. A comparative study of the anthropometric status of adults and children in urban and rural communities of the North West Region of Cameroon. BMC Nutr 2023; 9:81. [PMID: 37420262 DOI: 10.1186/s40795-023-00734-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 06/21/2023] [Indexed: 07/09/2023] Open
Abstract
BACKGROUND Cameroon, like many other developing countries, is experiencing a double burden of malnutrition. With increasing urbanization, communities are exposed to high calorie diets and sedentary lifestyles, which contribute to overnutrition. However, the nutritional status of the communities may vary with geographic location. The aim of the current study was to investigate the prevalence of underweight, overweight and abdominal obesity among adults as well as overweight, underweight, stunting and wasting among children in selected urban and rural communities of the North West Region (NWR) of Cameroon. The study also compared these parameters between selected urban and rural areas. METHODS Cross-sectional study design was used to investigate the anthropometric status of adults (18-65 years) and children (1-5 years) from two rural (Mankon and Mendakwe) and two urban (Mankon and Nkwen) communities in the NWR of Cameroon. The study included 156 adults and 156 children per study site from different households. A multistage sampling technique was used to select the participants and study sites Anthropometric measurements were taken using standardised methods for selected indices: weight, height, waist circumference and mid-upper arm circumference (MUAC). Data were analyzed using Statistical Package for the Social Sciences (SPSS) version 25 and a p-value of < 0.05 was considered statistically significant. RESULTS Adults from Nkwen (urban) were either overweight (n = 74; 47.4%) or obese (n = 44; 28.2%) with 43.6% (n = 68) from urban Mankon obese, whilst adults from rural Mankon were normal weight (49.4%; n = 77), 2.6% (n = 4) from Mendakwe (rural) were underweight and 64.1% (n = 100) were normal weight. Children in the rural areas were severely underweight (n = 45; 14.4%), while children in the urban areas were either normal (n = 158; 50.6) or overweight (n = 43; 13.8%). More females in the urban sites (n = 39; 53.4% in Nkwen and n = 43; 69.4% in urban Mankon) had a large waist circumference (WC) compared to those in the rural sites (n = 17; 22.1% in Mendakwe and n = 24; 38.1% in rural Mankon). Males in the urban areas had large WC compared to those in the rural sites (n = 19; 24.4% in Nkwen; n = 23; 24.7% in urban Mankon; n = 15; 16.1% in rural Mankon and n = 2; 2.6% in Mendakwe). Mid-upper arm circumference (MUAC) values indicated that most children in both urban (n = 147; 94.2% in Nkwen; n = 152; 97.4% in urban Mankon) and rural areas (n = 142; 91.0% in rural Mankon; n = 154; 98.7% in Mendakwe) were not acutely malnourished. CONCLUSIONS This study found a higher prevalence of overweight and obesity among adults and children in the urban areas of Nkwen and Mankon, compared to rural Mankon and Mendakwe. Thus, there is a need to investigate and address the causes of the high prevalence of overweight and obesity in these urban areas.
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Affiliation(s)
- Faith Asangha Akob
- Dietetics and Human Nutrition, School of Agricultural, Earth and Environmental Sciences, University of KwaZulu-Natal, Private Bag X01, Scottsville 3209, Pietermaritzburg, 3201, South Africa
- School of Health and Medical Sciences, Catholic University of Cameroon, (CATUC), P.O Box 782, Mankon Bamenda, Cameroon
| | - Kirthee Pillay
- Dietetics and Human Nutrition, School of Agricultural, Earth and Environmental Sciences, University of KwaZulu-Natal, Private Bag X01, Scottsville 3209, Pietermaritzburg, 3201, South Africa.
| | - Nicola Wiles
- Dietetics and Human Nutrition, School of Agricultural, Earth and Environmental Sciences, University of KwaZulu-Natal, Private Bag X01, Scottsville 3209, Pietermaritzburg, 3201, South Africa
| | - Muthulisi Siwela
- Dietetics and Human Nutrition, School of Agricultural, Earth and Environmental Sciences, University of KwaZulu-Natal, Private Bag X01, Scottsville 3209, Pietermaritzburg, 3201, South Africa
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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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Jana A, Chattopadhyay A. Prevalence and potential determinants of chronic disease among elderly in India: Rural-urban perspectives. PLoS One 2022; 17:e0264937. [PMID: 35275937 PMCID: PMC8916671 DOI: 10.1371/journal.pone.0264937] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 02/18/2022] [Indexed: 12/13/2022] Open
Abstract
Chronic diseases are the leading causes of disability and premature death among the elderly population in India. The study, using data from the 75th round of the NSSO survey (N = 44,631), examined the prevalence and determinants of chronic diseases among the population aged 60+ in India by applying bivariate and logistic regression analyses and used a non-linear decomposition technique to understand the urban-rural differences in the prevalence of chronic diseases. About 21% of the elderly in India reportedly have at least one chronic disease. Seventeen percent elderly in rural areas and 29% in urban areas suffer from a chronic disease. Hypertension and diabetes account for about 68% of all chronic diseases. The prevalence of chronic diseases is the highest in Kerala (54%), followed by Andhra Pradesh (43), West Bengal (36), and Goa (32). Those with higher levels of education, staying in urban areas, those who are economically dependent on others, staying alone or without spouse and children, and belonging to wealthy households have a higher likelihood of having a chronic disease. The probability of having a chronic disease is 1.15 times higher among urban residents as compared to their rural counterparts. Elderly rural women, compared to elderly rural men, and never-married, widowed, and divorced elderly urban women, compared to married elderly urban men, are significantly more likely to suffer from chronic ailments. Differences in education, wealth status, and caste are the three most significant contributors to the urban-rural gap in chronic diseases. The high risk of chronic diseases among certain subsets of the elderly population must be recognized as a key public health concern. The findings of our study will likely help promote healthy ageing in India.
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Affiliation(s)
- Arup Jana
- Department of Population & Development, International Institute for Population Sciences, Mumbai, Maharashtra, India
- * E-mail:
| | - Aparajita Chattopadhyay
- Department of Population & Development, International Institute for Population Sciences, Mumbai, Maharashtra, India
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Marbaniang SP, Lhungdim H, Chungkham HS. Identifying the latent classes of modifiable risk behaviours among diabetic and hypertensive individuals in Northeastern India: a population-based cross-sectional study. BMJ Open 2022; 12:e053757. [PMID: 35210340 PMCID: PMC8883275 DOI: 10.1136/bmjopen-2021-053757] [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: 11/05/2022] Open
Abstract
OBJECTIVE To identify the latent classes of modifiable risk factors among the patients with diabetes and hypertension based on the observed indicator variables: smoking, alcohol, aerated drinks, overweight or obesity, diabetes and hypertension. We hypothesised that the study population diagnosed with diabetes or hypertension is homogeneous with respect to the modifiable risk factors. DESIGN A cross-sectional study using a stratified random sampling method and a nationally representative large-scale survey. SETTING AND PARTICIPANTS Data come from the fourth round of the Indian National Family Health Survey, 2015-2016. Respondents aged 15-49 years who were diagnosed with either diabetes or hypertension or both were included. The total sample is 22 249, out of which 3284 were men and 18 965 were women. PRIMARY AND SECONDARY OUTCOME MEASURES The observed variables used as latent indicators are the following: smoking, alcohol, aerated drinks, overweight or obesity, diabetes and hypertension. The concomitant variables include age, gender, education, marital status and household wealth index. Latent class model was used to simultaneously identify the latent class and to determine the association between the concomitant variables and the latent classes. RESULTS Three latent classes were identified and labelled as class 1: 'diabetic with low-risk lifestyle' (21%), class 2: 'high-risk lifestyle' (8%) and class 3: 'hypertensive with low-risk lifestyle' (71%). Class 1 is characterised by those with a high probability of having diabetes and low probability of smoking and drinking alcohol. Class 2 is characterised by a high probability of smoking and drinking alcohol and class 3 by a high probability of having high blood pressure and low probability of smoking and drinking alcohol. CONCLUSIONS Co-occurrence of smoking and alcohol consumption was prevalent in men, while excess body weight and high blood pressure were prevalent in women. Policy and programmes in Northeastern India should focus on targeting multiple modifiable risk behaviours that co-occur within an individual.
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Affiliation(s)
- Strong P Marbaniang
- Public Health and Mortality Studies, International Institute for Population Sciences, Mumbai, India
| | - Hemkhothang Lhungdim
- Public Health and Mortality Studies, International Institute for Population Sciences, Mumbai, India
| | - Holendro Singh Chungkham
- Applied and Official Statistics Unit, Indian Statistical Institute, North-East Centre at Tezpur, Tezpur, India
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11
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Marbaniang SP, Chungkham HS, Lhungdim H. A structured additive modeling of diabetes and hypertension in Northeast India. PLoS One 2022; 17:e0262560. [PMID: 35025967 PMCID: PMC8758063 DOI: 10.1371/journal.pone.0262560] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 12/30/2021] [Indexed: 12/12/2022] Open
Abstract
Background Multiple factors are associated with the risk of diabetes and hypertension. In India, they vary widely even from one district to another. Therefore, strategies for controlling diabetes and hypertension should appropriately address local risk factors and take into account the specific causes of the prevalence of diabetes and hypertension at sub-population levels and in specific settings. This paper examines the demographic and socioeconomic risk factors as well as the spatial disparity of diabetes and hypertension among adults aged 15–49 years in Northeast India. Methods The study used data from the Indian Demographic Health Survey, which was conducted across the country between 2015 and 2016. All men and women between the ages of 15 and 49 years were tested for diabetes and hypertension as part of the survey. A Bayesian geo-additive model was used to determine the risk factors of diabetes and hypertension. Results The prevalence rates of diabetes and hypertension in Northeast India were, respectively, 6.38% and 16.21%. The prevalence was higher among males, urban residents, and those who were widowed/divorced/separated. The functional relationship between household wealth index and diabetes and hypertension was found to be an inverted U-shape. As the household wealth status increased, its effect on diabetes also increased. However, interestingly, the inverse was observed in the case of hypertension, that is, as the household wealth status increased, its effect on hypertension decreased. The unstructured spatial variation in diabetes was mainly due to the unobserved risk factors present within a district that were not related to the nearby districts, while for hypertension, the structured spatial variation was due to the unobserved factors that were related to the nearby districts. Conclusion Diabetes and hypertension control measures should consider both local and non-local factors that contribute to the spatial heterogeneity. More importance should be given to efforts aimed at evaluating district-specific factors in the prevalence of diabetes within a region.
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Affiliation(s)
- Strong P. Marbaniang
- Department of Public Health & Mortality studies, International Institute for Population Sciences, Mumbai, India
- Department of Statistics, Sankardev College, Shillong, Meghalaya, India
- * E-mail:
| | - Holendro Singh Chungkham
- Indian Statistical Institute, North-East Centre, Tezpur, Assam, India
- Stress Research Institute, Stockholm University, Stockholm, Sweden
| | - Hemkhothang Lhungdim
- Department of Public Health & Mortality studies, International Institute for Population Sciences, Mumbai, India
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Lin Z, Zhu S, Cheng J, Lin Q, Lawrence WR, Zhang W, Huang Y, Chen Y, Gao Y. The mediating effect of engagement in physical activity over a 24-hour period on chronic disease and depression: Using compositional mediation model. J Affect Disord 2022; 299:264-272. [PMID: 34902506 DOI: 10.1016/j.jad.2021.12.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 12/04/2021] [Accepted: 12/09/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Popular mediation method only considers a single activity as a mediator instead of all 24-hour physical activity, such as a four-way decomposition method. We investigated the mediation of 24-hour movement continuum between chronic diseases (cardiovascular disease [CVD] and diabetes) and depression using a novel compositional mediation model. METHODS 24-hour activity data measured by accelerometer were obtained from NHANES 2005-2006. Adjusted coefficient with 95% confidence interval (95% CI) for PHQ-9 total score and adjusted odds ratio (OR) with 95% CI for depression were computed from compositional mediation models. RESULTS In total, 2,375 participants aged ≥ 20 were included in our analysis. Both diabetes and CVD were associated with increased sedentary behavior (SB) and sleep and reduced moderate-to-vigorous physical activity (MVPA) and light-intensity physical activity (LPA), leading to an increased likelihood of depression. Although not all component indirect effects were associated with PHQ-9 total score and depression, the total indirect effect was significantly associated with both PHQ-9 total score (coefficient (95% CI) for diabetes: 0.162 (0.081, 0.261); coefficient (95% CI) for CVD: 1.139 (1.061, 1.240)) and depression (OR (95% CI) for diabetes: 0.235 (0.126, 0.362); OR (95% CI) for CVD: 1.200 (1.088, 1.346)) using the compositional mediation model. CONCLUSION We developed a compositional mediation model for continuous and binary outcomes, which can handle entire compositional mediators as a unit. The mediation of 24-hour movement continuum mediated the association between diabetes, CVD, and depression. Our findings present potential interventions for reducing risk of depression among patients with CVD and diabetes.
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Affiliation(s)
- Ziqiang Lin
- Department of Preventive Medicine, School of Basic Medicine and Public Health, Jinan University, Guangzhou, 510632, China; Department of Psychiatry, New York University School of Medicine, One Park Ave, New York, NY 10016, Unites States; Department of Mathematics and Statistics, College of Arts and Sciences, University at Albany, State University of New York, 1400 Washington Ave, Albany, NY 12222, Unites States
| | - Sui Zhu
- Department of Preventive Medicine, School of Basic Medicine and Public Health, Jinan University, Guangzhou, 510632, China
| | - Jinqun Cheng
- Guangdong Provincial Engineering Research Center of Public Health Detection and Assessment, Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, 510310, China
| | - Qiaoxuan Lin
- Department of Statistics, Guangzhou Health Technology Identification & Human Resources Assessment Center, Guangzhou, Guangdong, 510000, China
| | - Wayne R Lawrence
- Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, State University of New York, 1 University Place, Rensselaer, NY 12144, Unites States
| | - Wangjian Zhang
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Yanhong Huang
- Guangdong Provincial Engineering Research Center of Public Health Detection and Assessment, Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, 510310, China
| | - Yue Chen
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, K1G5Z3, Canada
| | - Yanhui Gao
- Department of Preventive Medicine, School of Basic Medicine and Public Health, Jinan University, Guangzhou, 510632, China.
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Pradeepa R, Subashini R, Venkatesan U, Ningombam S, Purty A, John M, Reang T, Luaia R, Tripathy SK, Modi S, Mokta JK, Desai A, Dash K, Deepa M, Nirmal E, Unnikrishnan R, Anjana RM, Kaur T, Dhaliwal RS, Mohan V. Effect of internal migration on diabetes and metabolic abnormalities in India - The ICMR-INDIAB study. J Diabetes Complications 2021; 35:108051. [PMID: 34607777 DOI: 10.1016/j.jdiacomp.2021.108051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 09/20/2021] [Accepted: 09/21/2021] [Indexed: 11/26/2022]
Abstract
AIMS To assess the effect of migration (rural-to-urban and vice versa) on prevalence of diabetes and metabolic disorders in Asian Indians participating in the Indian Council of Medical Research-India Diabetes (ICMR-INDIAB) study. MATERIALS AND METHODS The ICMR-INDIAB study is a national study on diabetes and associated cardiometabolic disorders in individuals aged ≥20 years from 28 states and 2 union territories of India. Individuals who moved to a different place from their place of birth and had resided in the new location for at least one year were considered as migrants. Anthropometric measurements, blood pressure estimation and a capillary oral glucose tolerance test were performed. RESULTS Of the 113,043 participants, 66.4% were non-migrant rural dwellers, 19.4% non-migrant urban dwellers, 8.4% rural-urban migrants, 3.8% multiple migrants and 2.0% urban-rural migrants. Weighted prevalence of diabetes was highest in rural-urban migrants followed by urban dwellers, urban-rural migrants and rural dwellers [14.7%, 13.2%, 12.7% and 7.7% respectively (p < 0.001)]. Rural-urban migrants had highest prevalence of abdominal obesity (50.5%) compared to the other three groups. The risk for diabetes was 1.9 times higher in rural-urban migrants than among rural dwellers. Five risk factors [hypertension, abdominal and generalized obesity, physical inactivity and low fruit and vegetable intake] together explained 69.8% (partial population attributable risk) of diabetes among rural-urban migrants and 66.4% among non-migrant urban dwellers. CONCLUSIONS Rural-to-urban migration is associated with increased risk of developing diabetes and other cardiometabolic abnormalities. Adoption of healthier lifestyle patterns among migrants could help prevent/delay onset of these abnormalities in this population.
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Affiliation(s)
- Rajendra Pradeepa
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, ICMR Centre for Advanced Research on Diabetes, Chennai, India.
| | - Radhakrishnan Subashini
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, ICMR Centre for Advanced Research on Diabetes, Chennai, India
| | - Ulagamathesan Venkatesan
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, ICMR Centre for Advanced Research on Diabetes, Chennai, India
| | | | - Anil Purty
- Pondicherry Institute of Medical Sciences, Puducherry, India
| | - Mary John
- Christian Medical College & Hospital, Ludhiana, India
| | | | | | | | - Sagar Modi
- Himalayan Institute of Medical Sciences, Dehradun, India
| | | | | | | | - Mohan Deepa
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, ICMR Centre for Advanced Research on Diabetes, Chennai, India
| | - Elangovan Nirmal
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, ICMR Centre for Advanced Research on Diabetes, Chennai, India
| | - Ranjit Unnikrishnan
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, ICMR Centre for Advanced Research on Diabetes, Chennai, India
| | - Ranjit Mohan Anjana
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, ICMR Centre for Advanced Research on Diabetes, Chennai, India
| | - Tanvir Kaur
- Non-Communicable Disease Division, Indian Council of Medical Research, New Delhi, India
| | | | - Viswanathan Mohan
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, ICMR Centre for Advanced Research on Diabetes, Chennai, India
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Clark SN, Bennett JE, Arku RE, Hill AG, Fink G, Adanu RM, Biritwum RB, Darko R, Bawah A, Duda RB, Ezzati M. Small area variations and factors associated with blood pressure and body-mass index in adult women in Accra, Ghana: Bayesian spatial analysis of a representative population survey and census data. PLoS Med 2021; 18:e1003850. [PMID: 34762663 PMCID: PMC8584976 DOI: 10.1371/journal.pmed.1003850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 10/14/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Body-mass index (BMI) and blood pressure (BP) levels are rising in sub-Saharan African cities, particularly among women. However, there is very limited information on how much they vary within cities, which could inform targeted and equitable health policies. Our study aimed to analyse spatial variations in BMI and BP for adult women at the small area level in the city of Accra, Ghana. METHODS AND FINDINGS We combined a representative survey of adult women's health in Accra, Ghana (2008 to 2009) with a 10% random sample of the national census (2010). We applied a hierarchical model with a spatial term to estimate the associations of BMI and systolic blood pressure (SBP) and diastolic blood pressure (DBP) with demographic, socioeconomic, behavioural, and environmental factors. We then used the model to estimate BMI and BP for all women in the census in Accra and calculated mean BMI, SBP, and DBP for each enumeration area (EA). BMI and/or BP were positively associated with age, ethnicity (Ga), being currently married, and religion (Muslim) as their 95% credible intervals (95% CrIs) did not include zero, while BP was also negatively associated with literacy and physical activity. BMI and BP had opposite associations with socioeconomic status (SES) and alcohol consumption. In 2010, 26% of women aged 18 and older had obesity (BMI ≥ 30 kg/m2), and 21% had uncontrolled hypertension (SBP ≥ 140 and/or DBP ≥ 90 mm Hg). The differences in mean BMI and BP between EAs at the 10th and 90th percentiles were 2.7 kg/m2 (BMI) and in BP 7.9 mm Hg (SBP) and 4.8 mm Hg (DBP). BMI was generally higher in the more affluent eastern parts of Accra, and BP was higher in the western part of the city. A limitation of our study was that the 2010 census dataset used for predicting small area variations is potentially outdated; the results should be updated when the next census data are available, to the contemporary population, and changes over time should be evaluated. CONCLUSIONS We observed that variation of BMI and BP across neighbourhoods within Accra was almost as large as variation across countries among women globally. Localised measures are needed to address this unequal public health challenge in Accra.
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Affiliation(s)
- Sierra N. Clark
- Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom
- MRC Centre for Environment and Health, Imperial College London, United Kingdom
| | - James E. Bennett
- Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom
- MRC Centre for Environment and Health, Imperial College London, United Kingdom
| | - Raphael E. Arku
- Department of Environmental Health Sciences, School of Public Health and Health Sciences, University of Massachusetts, Amherst, Massachusetts, United States of America
| | - Allan G. Hill
- Department of Social Statistics and Demography, University of Southampton, Southampton, United Kingdom
| | - Günther Fink
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute and University of Basel, Basel, Switzerland
| | - Richard M. Adanu
- Department of Population, Family, and Reproductive Health, University of Ghana, Accra, Ghana
| | | | - Rudolph Darko
- School of Medicine, University of Ghana, Accra, Ghana
| | - Ayaga Bawah
- Regional Institute for Population Studies, University of Ghana, Accra, Ghana
| | - Rosemary B. Duda
- Harvard Medical School, Harvard University, Boston, Massachusetts, United States of America
| | - Majid Ezzati
- Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom
- MRC Centre for Environment and Health, Imperial College London, United Kingdom
- Regional Institute for Population Studies, University of Ghana, Accra, Ghana
- Abdul Latif Jameel Institute for Disease and Emergency Analytics, Imperial College London, London, United Kingdom
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Marbaniang SP, Lhungdim H, Chauhan S, Srivastava S. Interaction of multiple risk factors and population attributable fraction for type 2 diabetes and hypertension among adults aged 15-49 years in Northeast India. Diabetes Metab Syndr 2021; 15:102227. [PMID: 34311195 DOI: 10.1016/j.dsx.2021.102227] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 07/15/2021] [Accepted: 07/17/2021] [Indexed: 12/27/2022]
Abstract
AIMS The aim is to assess the association and population attributable fraction (PAF) of multiple risk factors combination for diabetes and hypertension among adults in the Northeast region of India. METHODS Data used is from the Indian Demographic Health Survey conducted in 2015-16. The study comprised 107, 766 respondents (95,153 females and 12, 613 males) aged 15-49 years. We examined four modifiable risk factors: smoking, alcohol consumption, aerated drinks consumption, and overweight or obesity. PAF was calculated using the relative risk from the multivariable logistic regression models. RESULTS Overweight or obesity in conjunction with smoking was associated with 43.9 % of patients with diabetes. Smoking in conjunction with alcohol and overweight or obesity contributed to 53% of patients with diabetes (PAF = 53 %). The three risk factors combination (i.e., smoking, alcohol, and overweight or obesity) is associated with the most hypertension cases (PAF = 50.7 %). Experiencing all four risk factors is associated with 50.3 % of patients with hypertension. In women, the four-risk combination contributed the most hypertension cases (PAF = 46.8 %). CONCLUSIONS Overweight or obesity was the single most significant factor leading to hypertension and diabetes among the study population. Also, smoking, alcohol, and overweight or obesity together are prominent risk factors for hypertension and diabetes.
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Affiliation(s)
- Strong P Marbaniang
- Department of Public Health and Mortality Studies, International Institute for Population Sciences, Mumbai, 400088, India.
| | - Hemkhothang Lhungdim
- Department of Public Health and Mortality Studies, International Institute for Population Sciences, Mumbai, 400088, India
| | - Shekhar Chauhan
- Department of Population Policies and Programmes, International Institute for Population Sciences, Mumbai, 400088, India
| | - Shobhit Srivastava
- Department of Mathematical Demography and Statistics, International Institute for Population Sciences, Mumbai, 400088, India
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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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Konkor I, Dogoli MA, Kuuire V, Wilson K. Examining the Relationship Between Occupational Physical Activity and Hypertension Status: Evidence from the Ghana WHO Study on Global Ageing and Adult Health. Ann Work Expo Health 2021; 65:1050-1060. [PMID: 34089319 DOI: 10.1093/annweh/wxab035] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 03/18/2021] [Accepted: 04/23/2021] [Indexed: 11/13/2022] Open
Abstract
The employment landscape has changed significantly over the past few years in emerging economies including Ghana where many people are rapidly transitioning from livelihood activities that originally involved physical exertion to work environments where performance of duties are mostly non-physical. Working under non-active conditions could, however, exacerbate the risk of developing chronic diseases that are increasingly becoming problematic in many developing countries. Drawing on a cross-sectional nationally representative sample data of 4425 adult Ghanaian workers collected by the WHO Study on Global Ageing and Adult Health in developing countries, we examined the relationship between occupational physical activity and hypertensive status. We employed the complementary log-log analysis technique to build nested models with results presented in odds ratios. After controlling for several relevant variables, the results show that performing sedentary related work (AOR = 1.23, CI = 1.06-1.42) is significantly associated with a higher likelihood of being hypertensive compared with those whose work involved moderate physical activity. Other factors that were significantly associated with being hypertensive included tobacco use (AOR = 1.33, CI = 1.05-1.70), living in an urban environment (AOR = 1.15, CI = 1.01-1.32), and being a female (AOR = 1.18, CI = 1.01-1.37) and being an older person. Policies on reducing the risk of developing chronic conditions especially hypertension need to recognize the contributions of the work environment in emerging developing economies.
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Affiliation(s)
- Irenius Konkor
- Department of Geography, Geomatics and Environment, University of Toronto Mississauga, Mississauga, ON, Canada
| | - Maurice Anfaara Dogoli
- Department of Geography and Environmental Management, University of Waterloo, Waterloo, ON N2L, Canada
| | - Vincent Kuuire
- Department of Geography, Geomatics and Environment, University of Toronto Mississauga, Mississauga, ON, Canada
| | - Kathi Wilson
- Department of Geography, Geomatics and Environment, University of Toronto Mississauga, Mississauga, ON, Canada
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Tulu SN, Al Salmi N, Jones J. Understanding cardiovascular disease in day-to-day living for African people: a qualitative metasynthesis. BMC Public Health 2021; 21:745. [PMID: 33865359 PMCID: PMC8052642 DOI: 10.1186/s12889-021-10781-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 04/07/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Globally, cardiovascular disease (CVD) accounts for 45% of all chronic non-communicable disease deaths and 31% of all deaths. CVD has remained the primary cause of death in the world for the past fifteen years. Compared to other continents, CVD and its risk factors are highly prevalent in Africa, but the continent also displays a low-level of knowledge and awareness of CVD, and poor perception of its risk factors. Little research has been done on the connection between the daily lived experiences of African people and the high prevalence and poor perception of CVD and its risk factors on the African continent. The aim of this study is to provide an in-depth understanding of the daily, lived experiences of African people and the connections between these experiences and the prevention, control, and management of CVD and its risk factors. METHODS A systematic search was performed in PubMed, CINAHL, EMBASE, Psych INFO, and Web of Science databases to identify published English qualitative studies of CVD and its risk factors. Qualitative metasynthesis included structured techniques of data immersion and quality appraisal, thematic synthesis, and reciprocal translation. RESULTS Seven studies met the inclusion criteria. Four major themes were identified from the metasynthesis: 1) understanding and beliefs about CVD; 2) perceived causes/risk factors for CVD; 3) understanding and belief about obesity; 4) perceived treatment options for CVD. The metasynthesis identified a consistent disconnect among African people between seeing CVD as a deadly and chronic disease and their perceptions of the minimal signs and symptoms of the disease in the early stages. This was further compounded by the gap between traditional healers and health care professionals. CONCLUSIONS Perceptions of CVD, its risk factors, and treatments were influenced by religious and cultural factors. Given the minimal signs and symptoms experienced in the early stages of the disease, there was a consistent disconnect among African people between seeing CVD as a deadly and chronic illness. Further investigations of the religious and cultural influences and educational programs related to these areas of disconnect are needed to improve the knowledge, attitudes, and beliefs of African people.
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Affiliation(s)
- Seifu Nigussie Tulu
- College of Nursing, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
| | - Nasser Al Salmi
- College of Nursing, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Jacqueline Jones
- College of Nursing, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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Simo LP, Agbor VN, Temgoua FZ, Fozeu LCF, Bonghaseh DT, Mbonda AGN, Yurika R, Dotse-Gborgbortsi W, Mbanya D. Prevalence and factors associated with overweight and obesity in selected health areas in a rural health district in Cameroon: a cross-sectional analysis. BMC Public Health 2021; 21:475. [PMID: 33691650 PMCID: PMC7944596 DOI: 10.1186/s12889-021-10403-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Accepted: 02/07/2021] [Indexed: 12/28/2022] Open
Abstract
Background Overweight and obesity are major public health problems worldwide, with projections suggesting a proportional increase in the number of affected individuals in developing countries by the year 2030. Evidence-based preventive strategies are needed to reduce the burden of overweight and obesity in developing countries. We assessed the prevalence of, and factors associated with overweight and obesity in selected health areas in West Cameroon. Methods Data were collected from a community-based cross-sectional study, involving the consecutive recruitment of participants aged 18 years or older. Overweight and obesity were defined according to the WHO classification. The statistical software R (version 3.5.1, The R Foundation for statistical computing, Vienna, Austria) was used for statistical analysis. Multivariable logistic regression analysis was used to assess independent factors associated with overweight and obesity, and obesity. Results Records of 485 participants were included for analysis. The age and sex-standardized prevalence of overweight, obesity, and overweight and obesity were 31.1% (95% CI, 27.0–35.2), 18.9% (95% CI, 14.9–22.9), and 50.1% (95% CI, 45.7–54.6), respectively. In multivariable analysis, being female (adjusted OR [aOR] = 2.79, 95% CI = 1.69–4.63), married (aOR = 3.90, 95% CI = 2.23–6.95), and having secondary or tertiary education (aOR = 3.27, 95% CI = 1.77–6.17) were associated with higher odds of overweight and obesity, while current smokers had lower odds of overweight and obesity (aOR = 0.37, 95% CI = 0.16–0.82) when compared to their respective counterpart. Compared to their respective reference categories, being female being (aOR = 3.74, 95% CI = 2.01–7.30), married (aOR = 2.58, 95% CI = 1.37–5.05) and having secondary or tertiary education (aOR = 2.03, 95% CI = 1.00–4.23) were associated with higher odds of obesity after adjustments for confounding. Conclusion We observed a high prevalence of overweight and obesity in this study. The odds of overweight and obesity was higher in females, married participants, and those with higher levels of education. Community-based interventions to control overweight and obesity should consider targeting these groups. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10403-w.
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Affiliation(s)
- Larissa Pone Simo
- Clinical Research Education, Networking & Consultancy (CRENC), Douala, Cameroon
| | - Valirie Ndip Agbor
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK. .,Department of Clinical Research, Health Education and Research Organization (HERO), Douala, Cameroon.
| | | | | | | | | | - Raymond Yurika
- Technical Group for Tuberculosis Control, North West Regional Delegation of Public Health, Bamenda, Cameroon
| | - Winfred Dotse-Gborgbortsi
- School of Geography and Environmental Science, Highfield, University of Southampton, Southampton, SO17 1BJ, UK
| | - Dora Mbanya
- Faculty of Health Sciences, the University of Bamenda, Bamenda, Cameroon.,Yaoundé University Teaching Hospital (YUTH), Yaoundé, Cameroon
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"It Is Like Medicine": Using Sports to Promote Adult Women's Health in Rural Kenya. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052347. [PMID: 33673712 PMCID: PMC7967769 DOI: 10.3390/ijerph18052347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 02/20/2021] [Accepted: 02/23/2021] [Indexed: 11/23/2022]
Abstract
Despite the well-documented health benefits of recreational sports, few opportunities exist in lower- and middle-income countries for adult women to participate in recreational physical activities. An explanatory sequential mixed methods approach was used to explore associations between an innovative soccer program for adult women and self-reported health status. Cross-sectional survey data were collected in 2018–2019 from 702 women in the Nikumbuke Project, a health and literacy program in southeastern rural Kenya, followed by focus group discussions with 225 women who also participated in the Project’s soccer program. Quantitative findings suggest that women who participated in soccer had 67% greater odds of reporting good or excellent health than their non-soccer playing peers. Thematic analysis of qualitative data indicated that women credited soccer with less pain, fatigue, and stress, as well as weight loss and reduced dependence on medicine for hypertension, pain, and sleep problems. Women equated health benefits with greater ease and efficiency in completing chores, reduced worries, youthful energy, male-like strength, and pleased husbands. Soccer programs for adult women may be particularly effective interventions in settings where access to health care is limited and where lack of opportunity to engage in physical aerobic activity increases women’s risks for poor health outcomes.
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Hasan M, Khan MSA, Sutradhar I, Hossain MM, Hossaine M, Yoshimura Y, Choudhury SR, Sarker M, Mridha MK. Prevalence and associated factors of hypertension in selected urban and rural areas of Dhaka, Bangladesh: findings from SHASTO baseline survey. BMJ Open 2021; 11:e038975. [PMID: 33472770 PMCID: PMC7818822 DOI: 10.1136/bmjopen-2020-038975] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE We implemented this study to report the prevalence and associated risk factors of hypertension among adult men and women aged >30 years residing in selected urban and rural areas of Dhaka division, Bangladesh. DESIGN Cross-sectional study. SETTING Two urban (Dhaka city north and Dhaka city south) and two rural (Narsinghdi and Gazipur district) areas of the Dhaka division. PARTICIPANTS A total of 4856 male and female participants were included in the final analysis, of whom 2340 (48.2%) were from urban and 2516 (51.8%) were from rural areas. PRIMARY OUTCOME Hypertension was the dependent variable for this study and was operationally defined as systolic blood pressure >140 mm of Hg and/or diastolic blood pressure >90 mm of Hg, and/or persons with already diagnosed hypertension. RESULTS The overall prevalence of hypertension was 31.0%, and the prevalence was higher among urban participants (urban: 36.9%, rural: 30.6%). Age (across all categories), female (urban-adjusted OR (AOR): 1.3, 95% CI: 1.0 to 1.5 and rural-AOR: 1.7, 95% CI: 1.4 to 2.1)), higher educational status (urban-AOR: 1.7, 95% CI: 1.3 to 2.2 and rural-AOR: 2.1, 95% CI: 1.5 to 3.1), inadequate physical activity (urban-AOR: 1.3, 95% CI: 1.0 to 1.7 and rural-AOR: 1.5, 95% CI: 1.2 to 1.9) and overweight/obesity (urban-AOR: 2.7, 95% CI: 2.1 to 3.3 and rural-AOR: 2.1, 95% CI: 1.7 to 2.5) were associated with hypertension in both urban and rural areas. Women who were not currently married during the survey had higher odds of hypertension only in the rural areas (rural-AOR: 1.8, 95% CI: 1.3 to 2.4), and respondents who were not working during the survey had higher odds of hypertension only in the urban areas (AOR: 1.7, 95% CI: 1.0 to 2.6). CONCLUSION Since the prevalence of hypertension was high in urban and rural areas, the government of Bangladesh should consider implementing hypertension prevention programmes focusing young population of Dhaka division. In addition, early screening programmes and management of hypertension need to be strengthened for people with hypertension in both the areas.
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Affiliation(s)
- Mehedi Hasan
- Centre for Non-communicable Diseases and Nutrition, BRAC University James P Grant School of Public Health, Dhaka, Dhaka District, Bangladesh
| | - Md Showkat Ali Khan
- Centre for Non-communicable Diseases and Nutrition, BRAC University James P Grant School of Public Health, Dhaka, Dhaka District, Bangladesh
| | - Ipsita Sutradhar
- Centre for Science of Implementation and Scale-up, BRAC James P Grant School of Public Health, BRAC University, Dhaka, Dhaka District, Bangladesh
| | - Md Mokbul Hossain
- Centre for Non-communicable Diseases and Nutrition, BRAC University James P Grant School of Public Health, Dhaka, Dhaka District, Bangladesh
| | - Moyazzam Hossaine
- Centre for Non-communicable Diseases and Nutrition, BRAC University James P Grant School of Public Health, Dhaka, Dhaka District, Bangladesh
| | - Yukie Yoshimura
- Japan International Cooperation Agency, Chiyoda-ku, Tokyo, Japan
| | - Sohel Reza Choudhury
- Department of Epidemiology and Research, National Heart Foundation Hospital and Research Institute, Dhaka, Bangladesh
| | - Malabika Sarker
- Centre for Science of Implementation and Scale-up, BRAC James P Grant School of Public Health, BRAC University, Dhaka, Dhaka District, Bangladesh
| | - Malay Kanti Mridha
- Centre for Non-communicable Diseases and Nutrition, BRAC University James P Grant School of Public Health, Dhaka, Dhaka District, Bangladesh
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S Machado IB, Tofanelli MR, Saldanha da Silva AA, Simões E Silva AC. Factors Associated with Primary Hypertension in Pediatric Patients: An Up-to-Date. Curr Pediatr Rev 2021; 17:15-37. [PMID: 33430749 DOI: 10.2174/1573396317999210111200222] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 11/09/2020] [Accepted: 11/09/2020] [Indexed: 01/14/2023]
Abstract
BACKGROUND Arterial hypertension in children is considered a common alteration nowadays, mainly because obesity is a growing worldwide problem closely related to increased blood pressure. Childhood hypertension can be classified as primary or secondary, depending on the etiology. Primary or essential hypertension still has its pathophysiology not fully elucidated, and there is no consensus in the literature on most underlying mechanisms. In this review, genetic and environmental factors, including sodium and potassium intake, socioeconomic status, ethnicity, family structure, obesity, sedentary lifestyle, prematurity and low birth weight, prenatal and postnatal exposures are highlighted. OBJECTIVE The present study aimed to perform an update on primary hypertension in childhood, providing clinicians and researchers an overview of the current state of the literature regarding the influence of genetic and environmental factors. METHODS This integrative review searched for articles on genetic and environmental factors related to primary hypertension in pediatric patients. The databases evaluated were PubMed and Scopus. RESULTS The studies have provided insights regarding many genetic and environmental factors, in addition to their association with the pathophysiology of primary hypertension in childhood. Findings corroborated the idea that primary hypertension is a multifactorial disease. Further studies in the pediatric population are needed to elucidate the underlying mechanisms. CONCLUSION The study of primary hypertension in pediatrics has utmost importance for the adoption of preventive measures and the development of more efficient treatments, therefore reducing childhood morbidity and the incidence of cardiovascular diseases and other health consequences later in life.
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Affiliation(s)
- Isabella Barreto S Machado
- Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Matheus Rampinelli Tofanelli
- Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Ariadna A Saldanha da Silva
- Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Ana Cristina Simões E Silva
- Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
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Alharbi AA, Altalhi SM, Shurrab ME, Alsaigh SI, Babkair OS, Aljohani HM, Bohairi MA, Alsubaihi AA, Alqarni KA, Albaqami AM. An Overview on the Role of Family Physicians in Diagnosis and Management of Hypertension. ARCHIVES OF PHARMACY PRACTICE 2021. [DOI: 10.51847/yhtfscsdy9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Thondoo M, Mueller N, Rojas-Rueda D, de Vries D, Gupta J, Nieuwenhuijsen MJ. Participatory quantitative health impact assessment of urban transport planning: A case study from Eastern Africa. ENVIRONMENT INTERNATIONAL 2020; 144:106027. [PMID: 32827806 PMCID: PMC7434638 DOI: 10.1016/j.envint.2020.106027] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 07/19/2020] [Accepted: 07/31/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND High rates of motorization in urban areas of Africa have adverse effects on public health. Transport-related mortality will increase as a result of inadequate transport infrastructure, air pollution and sedentary lifestyles. Health Impact Assessments (HIAs) have proven to be a successful tool to predict and mitigate negative health impact of urban transport planning policies, programmes or projects. Yet, there is a gap of evidence on transport and health in African countries. The aim of this study is assessing the health impacts of transport scenarios in Port Louis (city of 119,018 inhabitants in Mauritius) using a full chain participatory HIA model. METHODS We estimated health and economic impacts associated to transport scenarios with qualitative data and quantitative comparative risk assessment methods. The health impact modeling was based on differences between the baseline and three transport scenarios (worse, good, ideal), estimating the averted deaths per year and economic outcomes by assessing health determinants of air pollution (AP), traffic deaths and physical activity (PA). Data on air pollution and traffic fatalities were obtained from public data sources. Data used to construct scenarios, establish baseline travel mode shares and physical activity were collected through (a) open-ended individual interviews (IDIs) with 14 stakeholders (b) closed-ended survey questions to 600 citizens and (c) 2 focus group discussions (FGDs) with the same 14 stakeholders from (a). RESULTS In Port Louis, the worse-case transport scenario (doubling in car trips and a reduction in walking, motorcycle, and public transport), resulted in a total increment of 3.28 premature deaths per year. The good-case scenario (reducing car trips by half and increasing walking, motorcycle, and public transport trips) resulted in a total increment of 0.79 premature deaths per year. The ideal-case scenario (reduction in car and motorcycle trips and an increase in walking and public transport trips) resulted in a total reduction of 13.72 premature deaths per year. We estimated USD 23 millions of economic benefits related to mortality if the ideal-case was achieved. CONCLUSION Participatory HIA shows that implementing transport policies aiming for less than an ideal situation may not be adequate or sufficient to avoid negative transport-related mortality in Mauritius. Urban transport planning is an opportunity to encourage physical activity in rapidly urbanizing settings of Africa. Transport policies should aim to restrict all forms of private motorized vehicles and promote active and public transport to support public health. We highly recommend the use of participatory approaches in quantitative HIA to ensure context specificity and policy relevance.
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Affiliation(s)
- M Thondoo
- Barcelona Institute for Global Health (ISGlobal), Centre for Research in Environmental Epidemiology (CREAL), 08003 Barcelona, Spain; Amsterdam Institute for Social Science Research (AISSR), University of Amsterdam, 1018 WV Amsterdam, the Netherlands; Faculty of Medicine and Health Sciences, University of Barcelona (UB), 08036 Barcelona, Spain.
| | - N Mueller
- Barcelona Institute for Global Health (ISGlobal), Centre for Research in Environmental Epidemiology (CREAL), 08003 Barcelona, Spain; Department of Biomedicine, University Pompeu Fabra (UPF), 08005 Barcelona, Spain; Department of Epidemiology and Public Health, CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
| | - D Rojas-Rueda
- Department of Environmental and Radiological Health Sciences, Colorado State University, 80523 Fort Collins, CO, USA
| | - D de Vries
- Amsterdam Institute for Social Science Research (AISSR), University of Amsterdam, 1018 WV Amsterdam, the Netherlands
| | - J Gupta
- Amsterdam Institute for Social Science Research (AISSR), University of Amsterdam, 1018 WV Amsterdam, the Netherlands
| | - M J Nieuwenhuijsen
- Barcelona Institute for Global Health (ISGlobal), Centre for Research in Environmental Epidemiology (CREAL), 08003 Barcelona, Spain; Department of Biomedicine, University Pompeu Fabra (UPF), 08005 Barcelona, Spain; Department of Environmental Epidemiology, Municipal Institute of Medical Research (IMIM-Hospital del Mar), 08003 Barcelona, Spain; Department of Epidemiology and Public Health, CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain.
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Otovwe A, Akpojubaro EH. Diabetes mellitus in primary and secondary schools in Africa: an exploratory review. ALEXANDRIA JOURNAL OF MEDICINE 2020. [DOI: 10.1080/20905068.2020.1833278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- Agofure Otovwe
- Department of Public and Community Health, College of Health Sciences, Novena University Ogume, Ogume, Nigeria
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Pratt M, Sallis JF, Cain KL, Conway TL, Palacios-Lopez A, Zezza A, Spoon C, Geremia CM, Gaddis I, Amankwah A, Friedman J, Kilic T. Physical activity and sedentary time in a rural adult population in Malawi compared with an age-matched US urban population. BMJ Open Sport Exerc Med 2020; 6:e000812. [PMID: 33180060 PMCID: PMC7640500 DOI: 10.1136/bmjsem-2020-000812] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/17/2020] [Indexed: 12/18/2022] Open
Abstract
Objectives This study was designed to assess patterns of objectively measured physical activity (PA) and sedentary behaviour in a sample of adults in a rural setting from a low-income Sub-Saharan African country (Malawi). The patterns of PA and sedentary behaviour in Malawi were compared with US data collected and analysed using the same methodology. Methods The Malawi PA data were collected as part of a survey experiment on the measurement of agricultural labor conducted under the World Bank Living Standards Measurement Study program. ActiGraph accelerometers (model GT3X) were worn on the right hip in a household-based sample of 414 working-age adults (15-85 years). Results Mean total and 95% CIs for PA by category in min/day for Malawi adults were: sedentary 387.6 (377.4-397.8), low-light 222.1 (214.7-229.5), high-light 136.3 (132.7-139.9), moderate 71.6 (68.8-74.5), vigorous 1.1 (0.5-1.8) and moderate-to-vigorous physical activity (MVPA) 72.8 (69.7-75.9). Mean of PA and sedentary behavior (min/day) summed across age and sex groups are compared between Malawi and US samples: sedentary behaviour, 387.6 vs 525.8 (p<0.001); low-light, 222.1 vs 217.0 (p=ns); high-light, 136.3 vs 45.6 (p<0.001); moderate, 71.6 vs 28.0 (p<0.001); vigorous, 1.1 vs 2.5 (p<0.001); MVPA, 72.8 vs 30.5 (p<0.001). Compared with the USA, Malawi participants averaged consistently less sedentary time/day and more minutes/day in all intensity levels of PA, except for low-light and vigorous PA. Conclusion Overall, levels of MVPA and high-light activity in adults in Malawi were substantially higher and sedentary time was substantially lower than those observed in US samples using near identical data collection, scoring and analysis.
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Affiliation(s)
- Michael Pratt
- Institute for Public Health, University of California, San Diego, La Jolla, California, USA
| | - James F Sallis
- Family Medicine and Public Health, University of California San Diego, San Diego, California, USA
| | - Kelli L Cain
- Family Medicine and Public Health, University of California San Diego, San Diego, California, USA
| | - Terry L Conway
- Family Medicine and Public Health, University of California San Diego, San Diego, California, USA
| | | | - Alberto Zezza
- World Bank Group, Washington, District of Columbia, USA
| | - Chad Spoon
- Family Medicine and Public Health, University of California San Diego, San Diego, California, USA
| | - Carrie M Geremia
- Family Medicine and Public Health, University of California San Diego, San Diego, California, USA
| | - Isis Gaddis
- World Bank Group, Washington, District of Columbia, USA
| | | | - Jed Friedman
- World Bank Group, Washington, District of Columbia, USA
| | - Talip Kilic
- World Bank Group, Washington, District of Columbia, USA
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Kouitcheu Mabeku LB, Noundjeu Ngamga ML, Leundji H. Helicobacter pylori infection, a risk factor for Type 2 diabetes mellitus: a hospital-based cross-sectional study among dyspeptic patients in Douala-Cameroon. Sci Rep 2020; 10:12141. [PMID: 32699242 PMCID: PMC7376106 DOI: 10.1038/s41598-020-69208-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 04/03/2020] [Indexed: 02/07/2023] Open
Abstract
Diabetic mellitus patients are usually prone to chronic infections. However, there have been contradictory reports about the association between H. pylori infection and type II diabetes. The present study is aimed at evaluating the prevalence of Helicobacter pylori infection among type 2 dyspeptic diabetic patients in the littoral region of Cameroon. This cross sectional study comprised 93 type 2 diabetic dyspeptic patients and 112 non-diabetic dyspeptic patients attending the Gastroenterology Department at two reference hospitals in Douala-Cameroon. The study was approved by the local Ethical Committee of Medical Sciences. Participants were screened for the presence of both type 2 diabetes and H. pylori infection. Body mass index (BMI) of all the participants was also recorded. Data was analyzed using SSPS statistical package. H. pylori infection was found in 73.11% of diabetic patients versus 58.05% in non-diabetic participants, this difference was found to be significant (OR = 1.472, p = 0.0279). This relationship persists even when adjusted to factors such as age and income level of participants. Infected participants from age group ≥ 55 years and those with high income were those with a higher risk to develop diabetes. Infected patients with high BMI were more prone to develops diabetic mellitus compared with infected patients with normal BMI (p = 0.0034). Also, participant with high BMI were more prone to develops diabetic mellitus whether they were infected or not. Patients having both H. pylori + ve and BMI ≥ 25 kg/m2 were significantly more affected by diabetic mellitus than those in the others combined groups (p < 0.0001), suggested that high BMI and H. pylori infection together or not are factors that favor diabetes mellitus development. Separately or not, H. pylori infection and high BMI were risk factor for diabetes mellitus in our milieu.
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Affiliation(s)
- Laure Brigitte Kouitcheu Mabeku
- Microbiology and Pharmacology Laboratory, Department of Biochemistry, Faculty of Science, University of Dschang, P. O. Box 67, Dschang, Cameroon.
| | - Michelle Larissa Noundjeu Ngamga
- Microbiology and Pharmacology Laboratory, Department of Biochemistry, Faculty of Science, University of Dschang, P. O. Box 67, Dschang, Cameroon
| | - Hubert Leundji
- Gastroenterology Department, Laquintinie Hospital of Douala, P. O. Box 4035, Douala, Cameroon
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Socio-economic and reproductive concomitants of abdominal adiposity and hypertension: A study on Bengali-speaking Hindu women of Habra, North 24 Parganas, West Bengal, India. ANTHROPOLOGICAL REVIEW 2020. [DOI: 10.2478/anre-2020-0015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Obesity and hypertension have become a global epidemic among the women, especially as they experience additional stressful events compared to men. The epidemiology of these two metabolic disorders is regulated by various biological, socio-economic, reproductive and lifestyle factors related to women. However, inconsistency in the nature and magnitude of the effects of these traits indicates exploring the areas where little emphasis has been given. In this context, the present study attempted to determine the effect of socio-economic and reproductive traits on hypertension and abdominal adiposity among women living in the North 24 Parganas district of West Bengal, India. Data on socio-demographic and reproductive traits were collected from 319 adult women from both rural and urban sectors of Habra block I. Anthropometric measurements and Blood pressure levels were measured following standard protocols. Results highlighted that the prevalence of obese individuals and hypertensive individuals were 73.4 and 50.5 per cent respectively. Women with low income (OR=0.51) were at lower risk and post-menopausal women (OR=1.71) were at higher risk of developing abdominal adiposity. The risk of developing hypertension increased with higher educational attainment (OR=2.43). Post-menopausal women (OR=0.46) and shifting workers (OR=0.40) were at lower risk of developing hypertension. The risk also decreased with increased age (OR=0.96). Present study revealed that menopause is a significant event to predict abdominal adiposity and hypertension among Bengali-speaking Hindu women.
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Tumwesigye NM, Mutungi G, Bahendeka S, Wesonga R, Katureebe A, Biribawa C, Guwatudde D. Alcohol consumption, hypertension and obesity: Relationship patterns along different age groups in Uganda. Prev Med Rep 2020; 19:101141. [PMID: 32685360 PMCID: PMC7358719 DOI: 10.1016/j.pmedr.2020.101141] [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: 02/04/2020] [Revised: 06/02/2020] [Accepted: 06/04/2020] [Indexed: 12/29/2022] Open
Abstract
Hypertension prevalence ratios don’t rise with age groups among frequent drinkers. Alcohol consumption pattern partly modifies the age-hypertension relationship. Alcohol consumption pattern does not modify obesity-age relationship.
The prevalence of non-communicable diseases including hypertension and obesity is rising and alcohol consumption is a predisposing factor. This study explored the effect of alcohol consumption patterns on the hypertension-age group and obesity-age group relationships. The data were extracted from the 2014 National NCD Survey of adults aged 18–69 years. Hypertension was defined as a condition of having systolic blood pressure ≥140 mmHg or diastolic blood pressure ≥90 mmHg while obesity was defined as having a body mass index ≥30 kg/m2. Frequent alcohol consumption was measured as alcohol use ≥3 times a week. Multivariable log binomial regression analysis was used to assess independent relationship between the outcomes and alcohol consumption. The prevalences of hypertension, frequent alcohol consumption and obesity increased across age groups but were divergent towards last age group. Hypertension prevalence ratios were higher with higher age groups among moderate and nondrinkers but not among frequent drinkers. Alcohol drinking pattern modified the age hypertension relationship in a model with ungrouped age. The drinking pattern did not modify obesity-age relationship. Alcohol consumption pattern appeared to modify the hypertension-age group relationship. However, more research is needed to explain why prevalence ratios are higher with higher age groups among moderate drinkers and abstainers while they stagnate among the frequent drinkers. There was no evidence to show the effect of alcohol consumption on obesity-age group relationship.
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Affiliation(s)
| | - Gerald Mutungi
- Control of Non-communicable Diseases Desk, Ministry of Health, Kampala, Uganda
| | - Silver Bahendeka
- Department of Internal Medicine St. Francis Hospital Nsambya, Kampala, Uganda
| | - Ronald Wesonga
- School of Statistics and Planning, Makerere University, Kampala, Uganda
| | - Agaba Katureebe
- Department of Epidemiology and Biostatistics, Makerere University School of Public Health, Uganda
| | - Claire Biribawa
- Department of Epidemiology and Biostatistics, Makerere University School of Public Health, Uganda
| | - David Guwatudde
- Department of Epidemiology and Biostatistics, Makerere University School of Public Health, Uganda
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Esposito L, Villaseñor A, Rodríguez EC, Millett C. The economic gradient of obesity in Mexico: Independent predictive roles of absolute and relative wealth by gender. Soc Sci Med 2020; 250:112870. [PMID: 32146237 DOI: 10.1016/j.socscimed.2020.112870] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 01/03/2020] [Accepted: 02/19/2020] [Indexed: 12/12/2022]
Abstract
Despite the vast literature on the economic gradient of obesity, no study investigates the independent predictive roles of absolute and relative standards of living using a large nationally representative adult sample. This gap limits our ability to discern 'material' and 'psychosocial' pathways to obesity as well as our understanding of the role played by economic inequality in the growing obesity epidemic. Using a large and nationally representative Mexican dataset, we find that absolute wealth and relative deprivation are independently related to obesity, and that such relationships are patterned by sex. Absolute wealth predicts body mass index as well as abdominal obesity according to an inverted-U shape for both sexes, and more markedly so for females. Relative deprivation predicts higher body mass index for females and higher waist circumference for both sexes, with highly relatively deprived females being 24.29% (95% CI [24.26, 24.31]) more likely to be obese and 34.46% (95% CI [34.40,34.53]) more likely to be abdominal obese, and highly relatively deprived males being 14.91% (95% CI [14.88,14.93] more likely to be abdominal obese. Our results offer a new perspective on the economic gradient of obesity and highlight the potential impact of economic inequality, especially for women. Greater awareness of the independent and sex-specific roles of the absolute and relative facets of economic status is needed to better understand and address the obesity epidemic.
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Affiliation(s)
- Lucio Esposito
- School of International Development, University of East Anglia, Norwich Research Park, NR47TJ, Norwich, UK.
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Simeni Njonnou SR, Boombhi J, Etoa Etoga MC, Tiodoung Timnou A, Jingi AM, Nkem Efon K, Mbono Samba Eloumba EA, Ntsama Essomba MJ, Kengni Kebiwo O, Tsitsol Meke AN, Talbit Ndjonya S, Dehayem Yefou M, Sobngwi E. Prevalence of Diabetes and Associated Risk Factors among a Group of Prisoners in the Yaoundé Central Prison. J Diabetes Res 2020; 2020:5016327. [PMID: 32047824 PMCID: PMC7003275 DOI: 10.1155/2020/5016327] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Revised: 12/10/2019] [Accepted: 12/24/2019] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Diabetes is a public health problem worldwide, associated with increased morbidity and mortality. According to the International Diabetes Federation (IDF) 2017 data, around 425 million people worldwide suffer from diabetes. This number is expected to increase to 629 million in 2045. Various occidental studies reported the increased prevalence and lower control of diabetes among prisoners. However, there is no data on the characteristics of inmates with diabetes in sub-Saharan Africa. METHODS A cross-sectional study among incarcerated detainees from the Yaoundé Central Prison was conducted from January to July 2017. Diabetes was defined according to the American Diabetes Association (ADA) criteria. Analyzed variables included phenotypic characteristics, lifestyle, the reason for detention, the sentence severity, and the length of detention. RESULTS We recruited 437 inmates (344 men) with an average age of 37.0 (95% CI: 35.9-38.3) years. The most frequent age group was 20 to 39 years with 281 (64.7%) inmates, and the mean prison stay was 29.1 (95% CI: 25.7-32.8) months. The prevalence of diabetes in the Yaoundé Central Prison was 9.4%. The main cardiovascular risk factors were a sedentary lifestyle (91.1%), hypertension (39.6%), smoking (31.6%), and alcohol consumption (28.1%). Hypertension (p = 0.005), obesity (p = 0.005), obesity (p = 0.005), obesity (p = 0.005), obesity (p = 0.005), obesity (p = 0.005), obesity (. CONCLUSION Diabetes prevalence in the Yaoundé Central Prison was high, at 9.4%, compared to that in the general population. It was associated with other classical cardiovascular risk factors and factors linked to the sentence (minor and major crimes). This trial is registered with CE00617/CRERSHC/2016.
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Affiliation(s)
- Sylvain Raoul Simeni Njonnou
- Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - Jérôme Boombhi
- Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
- Yaoundé General Hospital, Yaoundé, Cameroon
| | - Martine Claude Etoa Etoga
- Department of Clinical Sciences, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
- Yaoundé Central Hospital, Yaoundé, Cameroon
| | - Aimée Tiodoung Timnou
- Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - Ahmadou Musa Jingi
- Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - Kevin Nkem Efon
- Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
- Yaoundé Central Prison, Yaoundé, Cameroon
| | | | - Marie-Josiane Ntsama Essomba
- Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
- Yaoundé Central Hospital, Yaoundé, Cameroon
| | - Odette Kengni Kebiwo
- Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - Alice Ninon Tsitsol Meke
- Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - Stéphane Talbit Ndjonya
- Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - Mesmin Dehayem Yefou
- Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
- Yaoundé Central Hospital, Yaoundé, Cameroon
| | - Eugène Sobngwi
- Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
- Yaoundé Central Hospital, Yaoundé, Cameroon
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Central obesity and hypertension among rural adults of Paschim Medinipur, West Bengal, India. ANTHROPOLOGICAL REVIEW 2019. [DOI: 10.2478/anre-2019-0017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Obesity is generally classified into generalized obesity (BMI ≥30 kg/m2) and abdominal or central obesity (WC ≥90 cm for men and WC ≥80 cm for women) based on World Health Organization recommendation for Asians. Hypertension is one of the most common obesity-related complications, and about 30% of hypertensive individuals can be classified as being obese. The present study aimed to investigate the effect of different age groups (years) on the anthropometric and derived variables. It determined the correlation between anthropometric and derived variables and also estimated the frequency of central obesity and hypertension. Finally, it investigated the relationship between central obesity and blood pressure among rural Bengalee adults of Dirghagram village of Ghatal Block, Paschim Medinipur, West Bengal, India. The present cross-sectional study was undertaken among 310 rural adults (154 males; 156 females) aged over 18 years. Our study was carried out during March, 2017. Height (cm), weight (kg), waist circumference (cm), hip circumference (cm) and blood pressure (systolic and diastolic) were measured using standard procedures. One way ANOVA analysis on most of the anthropometric and derived variables showed a statistically significant increase from younger to older age group in both sexes (p<0.001;p<0.01; p<0.05). In addition to that, more females had central obesity using waist circumference (55.8% vs. 19.5%), waist hip ratio (87.2% vs. 35.7%), waist height ratio (73.7% vs. 44.2%), and conicity index (87.2% vs. 57.8%) criteria, and hypertension (52.5% vs. 27.3%). The prevalence of central obesity was much higher in case of hypertensive individuals. Therefore, the present study showed a high prevalence of central obesity among the rural adults of Dirghagram village. Furthermore, central obesity contributed in increasing hypertension among the villagers.
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Mkuu RS, Gilreath TD, Wekullo C, Reyes GA, Harvey IS. Social determinants of hypertension and type-2 diabetes in Kenya: A latent class analysis of a nationally representative sample. PLoS One 2019; 14:e0221257. [PMID: 31425539 PMCID: PMC6699668 DOI: 10.1371/journal.pone.0221257] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 08/03/2019] [Indexed: 11/19/2022] Open
Abstract
Introduction Cardiovascular disease is among the leading causes of death in Kenya and type II diabetes (T2D) is a growing chronic health concern in the country. However, a gap exists in examining how demographic and social characteristics coalesce to identify individuals at high risk for hypertension and/or T2D in Kenya. The current study examined demographic typologies associated with self-report diagnoses. Methods Nationally representative cross-sectional study using 43,898 individuals from the Kenya Demographic and Health Survey 2014. Main Outcome Measures were self-reported Hypertension and Type 2 Diabetes diagnosis. Descriptive analyses were conducted using STATA 14. Latent class analysis (LCA) was conducted using Mplus 7.4. Results Approximately 5% reported hypertension and 1% reported T2D. Latent class analysis suggested a 4-class solution. The class with the highest likelihood to report previous diagnosis of hypertension (10.4%), consisted of high proportion of married adult women. The second highest prevalence of previous diagnosis of hypertension (4.4%) consisted of a high proportion of married middle aged men with high probability of being smokers. The results suggest that Kenyan women over 30 years may be at increased risk of hypertension compared to men. Future studies should include additional socio-demographic and behavioral characteristics to better understand gender differences in correlates for hypertension to be used for targeted and tailored health promotion-interventions.
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Affiliation(s)
- Rahma S. Mkuu
- Transdisciplinary Center for Health Equity Research, Department of Health & Kinesiology, Texas A&M University, College Station, Texas, United States of America
- * E-mail:
| | - Tamika D. Gilreath
- Transdisciplinary Center for Health Equity Research, Department of Health & Kinesiology, Texas A&M University, College Station, Texas, United States of America
| | - Caroline Wekullo
- Post Graduate Studies, Masinde Muliro University of Science and Technology, Kakamega, Kenya
| | - Gabriela A. Reyes
- Colorado School of Public Health, Colorado University, Denver-Anschutz Medical Campus, Denver, Colorado, United States of America
| | - Idethia S. Harvey
- Transdisciplinary Center for Health Equity Research, Department of Health & Kinesiology, Texas A&M University, College Station, Texas, United States of America
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Ali RAB, Hannoun Z, Harraqui K, Zeghari L, Aboussaleh Y, Mohamed S, Anssoufouddine M, Bour A. Profile of diabetes and cardiovascular risk factors in adults Anjouan Island (Comoros). Pan Afr Med J 2019; 33:140. [PMID: 31558938 PMCID: PMC6754860 DOI: 10.11604/pamj.2019.33.140.19016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 06/18/2019] [Indexed: 11/11/2022] Open
Abstract
Introduction The aim of this study was to estimate the prevalence of Diabetes Mellitus (DM) and Impaired Fasting Glucose (IFG) in the peri-urban adult population living in the island of Anjouan, Comoros and to investigate the factors associated with diabetes mellitus. Methods The survey was a cross-sectional study, in which a sample of 902 individuals (540 women and 362 men) aged 25 to 64 was selected using empirical sampling "quotas" or "reasoned choice" survey method. Hypertension and obesity abdominal measurements of these subjects were collected during face-to-face interviews and following day fasting blood glucose was measured in capillary blood. Results Participation rate was 83.5%. The mean age of subjects was 39.5 ± 11.63 years. The sex ratio was 0.67. Overall crude diabetes and IFG prevalence were 8.5% and 8.1%, respectively. The risk factors for diabetes type 2 onset were a family history of diabetes (P = 0.006), older age (P = 0.000), glycemic control (P = 0.010), excess waist circumference (P = 0.03) and hypertension (p = 0.000), were significantly positively associated with DM, contrary to sex (P = 0.142). Conclusion These high figures confirm that diabetes and factors associated do not spare Anjouan population. Awareness, primary prevention, are to set up for a better control of non-communicable diseases.
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Affiliation(s)
- Rachmat Attoumane Ben Ali
- Laboratoire des Essais Biologiques, Faculty of Sciences, Ibn Tofail University, Kenitra 14000, Morocco
| | - Zineb Hannoun
- Laboratoire des Essais Biologiques, Faculty of Sciences, Ibn Tofail University, Kenitra 14000, Morocco
| | - Khouloud Harraqui
- Laboratoire des Essais Biologiques, Faculty of Sciences, Ibn Tofail University, Kenitra 14000, Morocco
| | - Lotfi Zeghari
- Laboratoire de Nutrition, Santé et Environnement, Faculty of Sciences, Ibn Tofail University, Kenitra 14000, Morocco
| | - Youssef Aboussaleh
- Laboratoire de Nutrition, Santé et Environnement, Faculty of Sciences, Ibn Tofail University, Kenitra 14000, Morocco
| | - Samir Mohamed
- Medical Service, Regional Hospital Center of Anjouan, Mutsamudu, Union of Comoros
| | | | - Abdellatif Bour
- Laboratoire des Essais Biologiques, Faculty of Sciences, Ibn Tofail University, Kenitra 14000, Morocco
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Gichu M, Asiki G, Juma P, Kibachio J, Kyobutungi C, Ogola E. Prevalence and predictors of physical inactivity levels among Kenyan adults (18-69 years): an analysis of STEPS survey 2015. BMC Public Health 2018; 18:1217. [PMID: 30400897 PMCID: PMC6218999 DOI: 10.1186/s12889-018-6059-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Physical inactivity accounts for more than 3 million deaths worldwide, and is implicated in causing 6% of coronary heart diseases, 7% of diabetes, and 10% of colon or breast cancer. Globally, research has shown that modifying four commonly shared risky behaviours, including poor nutrition, tobacco use, harmful use of alcohol, and physical inactivity, can reduce occurrence of non-communicable diseases (NCDs). Risk factor surveillance through population-based periodic surveys, has been identified as an effective strategy to inform public health interventions in NCD control. The stepwise approach to surveillance (STEPS) survey is one such initiative, and Kenya carried out its first survey in 2015. This study sought to describe the physical inactivity risk factors from the findings of the Kenya STEPS survey. METHODS This study employed countrywide representative survey administered between April and June 2015. A three stage cluster sampling design was used to select clusters, households and eligible individuals. All adults between 18 and 69 years in selected households were eligible. Data on demographic, behavioural, and biochemical characteristics were collected. Prevalence of physical inactivity was computed. Logistic regression used to explore factors associated with physical inactivity. RESULTS A total of 4500 individuals consented to participate from eligible 6000 households. The mean age was 40.5 (39.9-41.1) years, with 51.3% of the respondents being female. Overall 346 (7.7%) of respondents were classified as physically inactive. Physical inactivity was associated with female gender, middle age (30-49 years), and increasing level of education, increasing wealth index and low levels of High Density Lipoproteins (HDL). CONCLUSION A modest prevalence of physical inactivity slightly higher than in neighbouring countries was found in this study. Gender, age, education level and wealth index are evident areas that predict physical inactivity which can be focused on to develop programs that would work towards reducing physical inactivity among adults in Kenya.
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Affiliation(s)
- Muthoni Gichu
- Division of Non Communicable Diseases, Ministry of Health, Nairobi, Kenya
| | - Gershim Asiki
- The Institute of Global Health, Faculty of Medicine, University of Geneva (UNIGE), Geneva, Switzerland
| | - Pamela Juma
- The Institute of Global Health, Faculty of Medicine, University of Geneva (UNIGE), Geneva, Switzerland
| | - Joseph Kibachio
- The Institute of Global Health, Faculty of Medicine, University of Geneva (UNIGE), Geneva, Switzerland
- African Population and Health Research Center, Nairobi, Kenya
| | - Catherine Kyobutungi
- The Institute of Global Health, Faculty of Medicine, University of Geneva (UNIGE), Geneva, Switzerland
| | - Elijah Ogola
- Clinical Medicine, University of Nairobi, Nairobi, Kenya
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Kadia BM, Chichom-Mefire A, Halle-Ekane GE. Exploring the role of obesity and overweight in predicting postoperative outcome of abdominal surgery in a sub-Saharan African setting: a prospective cohort study. BMC Res Notes 2018; 11:742. [PMID: 30340649 PMCID: PMC6194574 DOI: 10.1186/s13104-018-3853-0] [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: 09/04/2018] [Accepted: 10/12/2018] [Indexed: 11/10/2022] Open
Abstract
Objective Current literature on the role of excess weight in predicting surgical outcome is controversial. In sub-Saharan Africa, there is extreme paucity of data regarding this issue in spite of the increasing rates of obesity and overweight in the region. This prospective cohort study, carried out over a period of 4 months at Limbe Regional Hospital in the Southwest region of Cameroon, assessed 30-day postoperative outcome of abdominal surgery among consecutive adults with body mass index (BMI) ≥ 25 kg/m2. Adverse postoperative events were reported as per Clavien–Dindo classification. Results A total of 103 patients were enrolled. Of these, 68.9% were female. The mean age was 38.2 ± 13.7 years. Sixty-four (62.1%) of the patients were overweight and the mean BMI was 29.2 ±4.3 kg/m2. The physical status scores of the patients were either I or II. Appendectomy, myomectomy and hernia repair were the most performed procedures. The overall complication rate was 13/103 (12.6%), with 61.5% being Clavien–Dindo grades II or higher. From the lowest to the highest BMI category, there was a significant increase in the proportion of patients with complications; 25–29.9 kg/m2: 6.25%, 30–34.9 kg/m2: 18.75%, 35–39.9 kg/m2: 25.0%, and ≥ 40 kg/m2: 66.70%; p = 0.0086.
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Affiliation(s)
- Benjamin Momo Kadia
- Grace Community Health and Development Association, Kumba, Southwest Region, Cameroon. .,Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.
| | - Alain Chichom-Mefire
- Faculty of Health Sciences, University of Buea, Buea, Southwest Region, Cameroon
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Gender and Physical Activity: Are they Associated with Body Mass Index in Elderly Jordanian People? ROMANIAN JOURNAL OF DIABETES NUTRITION AND METABOLIC DISEASES 2018. [DOI: 10.2478/rjdnmd-2018-0027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Background: The number of elderly people is increasing worldwide, and elevated body mass index is a common problem that occur with elderly people, which can be directly or indirectly affected by level of physical activity and gender. So, it is essential to study the effect of both physical activity and gender on body mass index in elderly people.
Material and methods: A cross-sectional, observational study was conducted on 120 elderly Jordanian people who live in Amman (62 women; 58 men) and evaluated for body mass index. Those participants were 40 elderly persons who attended the gym at least twice a week for the last 2 years, and 80 elderly who were home resident or physically inactive. A structured questionnaire was used to collect data about personal, social, health and life-style information including the daily activities and the anthropometric measurements for the study participants.
Results: The results of this study showed that as elderly people become physically inactive, their body mass index will increase to become as overweight or obese. The results of this study also showed that body mass index of 30 and more was associated with gender, with majority of female elderly (50%) having body mass index of 30 or more.
Conclusion: Physical activity should be maintained by both genders in order to prevent obesity, primarily in women as they are more likely to become obese that men. Furthermore, body mass index should not exceed 30 in elderly. Physical activity is essential in order to obtain healthy weight.
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Freitas FV, Barbosa WM, Silva LAA, Garozi MJDO, Pinheiro JDA, Borçoi AR, Conti CL, Arpini JK, de Paula H, de Oliveira MM, Archanjo AB, de Freitas ÉAS, de Oliveira DR, Borloti EB, Louro ID, Alvares-da-Silva AM. Psychosocial stress and central adiposity: A Brazilian study with a representative sample of the public health system users. PLoS One 2018; 13:e0197699. [PMID: 30063700 PMCID: PMC6067710 DOI: 10.1371/journal.pone.0197699] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 07/17/2018] [Indexed: 11/18/2022] Open
Abstract
Objective To assess the association between indicators of psychosocial stress and central adiposity in adult users of the Unified Health System (SUS) from Southeast of Brazil. Methods This cross-sectional study was conducted with 384 adults (20 to 59 years old) from the city of Alegre, Southeastern Brazil. The simple random sample represented the population using the public health system of the municipality. The prevalence of obesity was based on the Body Mass Index, and central adiposity (dependent variable) was measured by waist circumference in centimeters. The independent variables were the following indicators of psychosocial stress: food and nutrition insecurity (yes/no), serum cortisol (μg/dL), symptoms suggestive of depression using the Beck Depression Inventory-II ≥ 17 (yes/no), and altered blood pressure ≥ 130/85 mmHg (yes/no). Univariate linear regression was performed between central adiposity and each stress indicator, and later the models were adjusted for socioeconomic, health, and lifestyle variables. All analyses were made separately by rural and urban location. Results The prevalence of weight excess, by the classification of the Body Mass Index ≥ 25.0 kg/m2, was 68.3% and, by waist circumference, 71.5% of individuals presented an increased risk for metabolic complications related to central adiposity. Mean waist circumference scores for the rural and urban population were 89.3 ± 12.7 cm and 92.9 ± 14.7 cm, respectively (p = 0.012). Indicators of stress that were associated with central adiposity were: cortisol in the rural population (β = -0.60; 95% CI = -1.09;-0.11) and altered blood pressure in the urban population (β = 6.66; 95% CI = 2.14;11.18). This occurred both in the raw analysis and in the models adjusted for confounding factors. Conclusion Central adiposity was inversely associated with cortisol in the rural population and directly associated with higher arterial blood pressure in the urban population, suggesting a local influence on how individuals react to stress.
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Affiliation(s)
- Flávia Vitorino Freitas
- Biotechnology/Renorbio Graduate Program, Federal University of Espirito Santo, Vitoria, ES, Brazil
- Pharmacy and Nutrition Department, Federal University of Espirito Santo, Alegre, ES, Brazil
- * E-mail:
| | - Wagner Miranda Barbosa
- Pharmacy and Nutrition Department, Federal University of Espirito Santo, Alegre, ES, Brazil
| | | | | | - Júlia de Assis Pinheiro
- Biotechnology/Renorbio Graduate Program, Federal University of Espirito Santo, Vitoria, ES, Brazil
| | - Aline Ribeiro Borçoi
- Biotechnology/Renorbio Graduate Program, Federal University of Espirito Santo, Vitoria, ES, Brazil
| | - Catarine Lima Conti
- Biotechnology/Renorbio Graduate Program, Federal University of Espirito Santo, Vitoria, ES, Brazil
| | | | - Heberth de Paula
- Pharmacy and Nutrition Department, Federal University of Espirito Santo, Alegre, ES, Brazil
| | - Mayara Mota de Oliveira
- Biotechnology/Renorbio Graduate Program, Federal University of Espirito Santo, Vitoria, ES, Brazil
| | - Anderson Barros Archanjo
- Biotechnology/Renorbio Graduate Program, Federal University of Espirito Santo, Vitoria, ES, Brazil
| | | | | | | | - Iuri Drumond Louro
- Biotechnology/Renorbio Graduate Program, Federal University of Espirito Santo, Vitoria, ES, Brazil
| | - Adriana Madeira Alvares-da-Silva
- Biotechnology/Renorbio Graduate Program, Federal University of Espirito Santo, Vitoria, ES, Brazil
- Department of Biology, Federal University of Espirito Santo, Alegre, ES, Brazil
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Engle-Stone R, Nankap M, Ndjebayi AO, Friedman A, Tarini A, Brown KH, Kaiser L. Prevalence and predictors of overweight and obesity among Cameroonian women in a national survey and relationships with waist circumference and inflammation in Yaoundé and Douala. MATERNAL AND CHILD NUTRITION 2018; 14:e12648. [PMID: 30047256 PMCID: PMC6174999 DOI: 10.1111/mcn.12648] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Revised: 06/04/2018] [Accepted: 06/06/2018] [Indexed: 12/28/2022]
Abstract
Information on the distribution and predictors of obesity in Africa is needed to identify populations at risk and explore intervention options. Our objectives were to (a) examine the prevalence and geographic distribution of overweight and obesity among Cameroonian women; (b) evaluate change in anthropometric indicators among urban women between 2009 and 2012; (c) examine associations between household and individual characteristics and overweight and obesity; and (d) examine relationships between body mass index (BMI), abdominal obesity, and inflammation. We analysed data from a nationally representative survey conducted in 3 geographic strata (North, South, and Yaoundé/Douala) in Cameroon in 2009 and a survey in Yaoundé/Douala in 2012. Participants selected for this analysis were nonpregnant women, ages 15-49 years (n = 704 in 2009; n = 243 in 2012). In 2009, ~8% of women were underweight (BMI < 18.5) and 32% overweight or obese (BMI ≥ 25.0). Underweight was most common in the North (19%) and overweight and obesity in the South (40%) and Yaoundé/Douala (49%). Prevalence of BMI ≥ 25.0 in Yaoundé/Douala did not differ in 2012 compared with 2009 (55.5% vs. 48.7%; P = 0.16). Residence in urban areas, greater maternal age, and TV ownership were independently related to overweight and obesity in national and stratified analyses. In Yaoundé/Douala in 2012, 48% (waist-to-hip ratio > 0.85) to 73% (waist circumference > 80 cm) had abdominal obesity. Body mass index was positively associated with abdominal obesity and inflammation. Though causal inferences cannot be drawn, these findings indicate population subgroups at greatest risk for overweight and associated health consequences in Cameroon.
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Affiliation(s)
- Reina Engle-Stone
- Department of Nutrition, University of California, Davis, California
| | - Martin Nankap
- Helen Keller International, Cameroon, Yaoundé, Cameroon
| | | | | | - Ann Tarini
- Helen Keller International, Cameroon, Yaoundé, Cameroon
| | - Kenneth H Brown
- Department of Nutrition, University of California, Davis, California.,Bill & Melinda Gates Foundation, Seattle, Washington
| | - Lucia Kaiser
- Department of Nutrition, University of California, Davis, California
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Gowshall M, Taylor-Robinson SD. The increasing prevalence of non-communicable diseases in low-middle income countries: the view from Malawi. Int J Gen Med 2018; 11:255-264. [PMID: 29988742 PMCID: PMC6029598 DOI: 10.2147/ijgm.s157987] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Non-communicable diseases (NCDs) are the leading cause of death globally, the majority of these being due to cardiovascular disease, cancer, chronic respiratory diseases, or diabetes. Mortality from many NCDs continues to increase worldwide, with a disproportionately larger impact in low-middle income countries (LMIs), where almost 75% of global deaths occur from these causes. As a low-income African country that consistently ranks amongst the world's poorest nations, Malawi as a case study demonstrates how transition due to societal change and increasing urbanization is often accompanied by a rise in the rate of NCDs. Other factors apart from changing lifestyle factors can explain at least some of this increase, such as the complex relationship between communicable and NCD and growing environmental, occupational, and cultural pressures. Malawi and other LMIs are struggling to manage the increasing challenge of NCDs, in addition to an already high communicable disease burden. However, health care policy implementation, specific health promotion campaigns, and further epidemiological research may be key to attenuating this impending health crisis, both in Malawi and elsewhere. This review aims to examine the effects of the major NCDs in Malawi to help inform future public health care policy in the region.
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Affiliation(s)
- Matthew Gowshall
- Division of Digestive Health, Department of Surgery and Cancer, Imperial College London, London, UK, ,
- Barts and the London School of Medicine and Dentistry, London, UK,
| | - Simon D Taylor-Robinson
- Division of Digestive Health, Department of Surgery and Cancer, Imperial College London, London, UK, ,
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Physical Activity and Health-Related Quality of Life in Adults from Braşov, Romania. EDUCATION SCIENCES 2018. [DOI: 10.3390/educsci8020052] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Glezeva N, Chisale M, McDonald K, Ledwidge M, Gallagher J, Watson CJ. Diabetes and complications of the heart in Sub-Saharan Africa: An urgent need for improved awareness, diagnostics and management. Diabetes Res Clin Pract 2018; 137:10-19. [PMID: 29287838 DOI: 10.1016/j.diabres.2017.12.019] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 11/21/2017] [Accepted: 12/21/2017] [Indexed: 12/24/2022]
Abstract
Type 2 diabetes mellitus is no longer a disease of high income countries but a global health pandemic. With the continued and rapid increase in its prevalence worldwide it is forecasted that diabetes will be a leading cause of morbidity and mortality. A major concern stems from its role in development and progression of cardiovascular disease, including cardiac dysfunction and heart failure. Within low- and middle-income areas such as Sub-Saharan Africa the burden of diabetes is already significant driven by many factors, including, socioeconomic (urbanisation), nutritional (high-calorie "western-diet", obesity) and lifestyle (physical inactivity) changes. Insufficient economic and community resources, poor health care system development and chronic disease management, poor education, and a lack of preventative and diagnostic measures further aggravate the severity of the diabetes problem. This review outlines the burden of type 2 diabetes mellitus in Sub-Saharan Africa and highlights the need for improved community health care and regulations to reduce its epidemiological spread and devastating impact on health.
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Affiliation(s)
- Nadezhda Glezeva
- gHealth Research Group, UCD Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Ireland
| | | | - Kenneth McDonald
- gHealth Research Group, UCD Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Ireland
| | - Mark Ledwidge
- gHealth Research Group, UCD Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Ireland
| | - Joe Gallagher
- gHealth Research Group, UCD Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Ireland
| | - Chris J Watson
- Centre for Experimental Medicine, Queen's University Belfast, Northern Ireland, United Kingdom.
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Bigna JJ, Nansseu JR, Katte JC, Noubiap JJ. Prevalence of prediabetes and diabetes mellitus among adults residing in Cameroon: A systematic review and meta-analysis. Diabetes Res Clin Pract 2018; 137:109-118. [PMID: 29325776 DOI: 10.1016/j.diabres.2017.12.005] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 11/22/2017] [Accepted: 12/12/2017] [Indexed: 01/12/2023]
Abstract
AIMS To summarize current data on the prevalence of prediabetes and diabetes mellitus in Cameroon. METHODS Population-based cross-sectional studies published between January 1, 2000 and April 30, 2017 including apparently healthy adults residing in Cameroon were searched in PubMed, EMBASE, African Journals Online, and African Index Medicus. We used a random-effects model to pool data. RESULTS All included studies had a low risk of bias. Six studies were conducted in an urban setting only, one in a rural setting only, and five in both settings. The overall prevalence of diabetes mellitus was 5.8% (95%CI 4.1-7.9; 12 studies) in a pooled sample of 37,147 participants. The prevalence of prediabetes was 7.1% (95%CI: 3.0-21.9; 4 studies) in a pooled sample of 5,872 people. In univariable meta-regression analysis, the prevalence of diabetes mellitus increased with age, hypertension, overweight and obesity. There was no difference for sex and settings (rural versus urban). CONCLUSIONS This study reports a relatively high prevalence of diabetes mellitus and prediabetes in Cameroon, with no difference between urban and rural settings and between sexes. The main drivers include increasing age, overweight and obesity. Community-based educational programs are needed to tackle the burden of the disease in the country.
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Affiliation(s)
- Jean Joel Bigna
- Department of Epidemiology and Public Health, Centre Pasteur of Cameroon, Yaoundé, Cameroon; School of Public Health, Faculty of Medicine, University of Paris Sud XI, Le Kremlin Bicêtre, France.
| | - Jobert Richie Nansseu
- Department of Public Health, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon; Department of Disease, Epidemics and Pandemics Control, Ministry of Public Health, Yaoundé, Cameroon.
| | - Jean-Claude Katte
- Department of Public Health, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon.
| | - Jean Jacques Noubiap
- Department of Medicine, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa.
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Physical Environment Correlates of Physical Activity in Developing Countries: A Review. J Phys Act Health 2017; 15:303-314. [PMID: 29278043 DOI: 10.1123/jpah.2017-0184] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Noncommunicable diseases and obesity are considered problems of wealthy, developed countries. These conditions are rising dramatically in developing countries. Most existing research on the role of the physical environment to support physical activity examines developed countries only. OBJECTIVES This review identifies physical environment factors that are associated with physical activity in developing countries. METHODS This review is modeled on a highly cited review by Saelens and Handy in 2008. The current review analyzes findings from 159 empirical studies in the 138 developing countries. RESULTS Results discuss the association of physical environment features and physical activity for all developing countries and identify the patterns within regions. The review supports the association of traffic safety with physical activity for transportation. Rural (vs urban) residence, distance to nonresidential land uses, and "composite" features of the physical environment are associated with general physical activity. Rural (vs urban) residence is associated with physical activity for work. CONCLUSIONS More research is needed on associations between the physical environment and physical activity in developing countries. Research should identify specific physical environment features in urban areas that are associated with higher activity levels.
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Lipodystrophy among HIV-Infected Patients Attending Care and Treatment Clinics in Dar es Salaam. AIDS Res Treat 2017; 2017:3896539. [PMID: 29158917 PMCID: PMC5660755 DOI: 10.1155/2017/3896539] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 09/06/2017] [Indexed: 12/16/2022] Open
Abstract
Background HIV infection and long-term HAART use are associated with metabolic and morphological changes. We assessed prevalence, types, and risk factors associated with lipodystrophy among HIV-infected adults attending CTC in Dar es Salaam, Tanzania. Methods Analysis included 466 HIV-infected patients. Study protocol involved administration of structured questionnaire to collect sociodemographic and clinical information. Diagnosis of lipodystrophy was based on physician clinical assessment. Results Lipodystrophy was present in 95 (20.4%) of the study participants, with lipoatrophy being the most common (49.5%) followed by mixed lipodystrophy (37.9%), and lipohypertrophy was the least prevalent (12.6%). Male gender, older age, long duration on HAART, and use of Stavudine containing regimen were associated with lipodystrophy (all p < 0.05). The risk for lipodystrophy was 1.6 times (AOR = 1.66, 95% CI = 1.01-2.72) for male participants and 13.3 times (AOR = 13.3, 95% CI = 6.4-27.7) for those on HAART. Long duration on HAART and use of Stavudine containing regimen were also associated with increased risk for lipodystrophy. Lipodystrophy was associated with poor perception about own body image and decreased social interactions. Conclusions Lipodystrophy is common among HIV-infected patients in Tanzania, especially among male patients and those on HAART. Regular screening, monitoring, and patient awareness are needed for early identification and appropriate management.
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Awotidebe TO, Adeyeye VO, Ogunyemi SA, Bisiriyu LA, Adedoyin RA, Balogun MO, Adebayo RA, Amosun OD. Joint predictability of physical activity and body weight status on health-related quality of life of patients with hypertension. J Exerc Rehabil 2017; 13:588-598. [PMID: 29114535 PMCID: PMC5667607 DOI: 10.12965/jer.1735088.544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Accepted: 10/08/2017] [Indexed: 11/22/2022] Open
Abstract
This study investigated the predictability of physical activity (PA) and body weight status (BWS) on health-related quality of life (HRQoL) of patients with hypertension. A cross-sectional study involved 250 patients with hypertension (≥140/90≤179/109 mmHg) selected from government hospitals in Osun State, Nigeria. Purposive sampling technique was used to select participants. Socio-demographic characteristics and cardiovascular parameters were recorded. PA and HRQoL were assessed using the International Physical Activity Questionnaire and Short Form health survey questionnaire respectively. Sufficient PA equals ≥150 min/wk while BWS was defined using body mass index classification. Data were analyzed using descriptive and inferential statistics. Alpha level was set at P<0.05. Of all participants, 63.6% reported sufficient PA and 78.4% was either overweight or obese. The HRQoL of participants become poorer in all domains with higher body weight. The HRQoL including role limitation due to physical health (RLdPhp) and emotional problems (RLdEmp) had worst scores. Participants in the categories of normal and overweight/obese with sufficient PA demonstrated higher (better) HRQoL in all domains than those with insufficient PA (P<0.05). When adjusted for body weight, significant differences were found in all domains of HRQoL except in RLdPhp, RldEmp, and bodily pain (P>0.05). There were significant correlations between PA and all domains of HRQoL except in RldEmp, emotional well-being and bodily pain (P>0.05). Regression models established PA as a significant predictor of HRQoL. Sufficient PA is a better predictor of HRQoL among patients with hypertension irrespective of BWS. Regular PA is recommended for improving HRQoL among patients with hypertension.
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Affiliation(s)
- Taofeek O. Awotidebe
- Department of Medical Rehabilitation, College of Health Sciences, Obafemi Awolowo University, Ile - Ife, Nigeria
| | - Victor O. Adeyeye
- Cardiac Care Unit, Medical Out-Patient Department, Ife Hospital Unit, Obafemi Awolowo University Teaching Hospitals Complex, Ile - Ife, Nigeria
| | - Suraj A. Ogunyemi
- Cardiac Care Unit, Medical Out-Patient Department, Ife Hospital Unit, Obafemi Awolowo University Teaching Hospitals Complex, Ile - Ife, Nigeria
- Department of Medicine, College of Health Sciences, Obafemi Awolowo University, Ile - Ife, Nigeria
| | - Luqman A. Bisiriyu
- Department of Demography and Social Statistics, Faculty of Social Sciences, Obafemi Awolowo University, Ile - Ife, Nigeria
| | - Rufus A. Adedoyin
- Department of Medical Rehabilitation, College of Health Sciences, Obafemi Awolowo University, Ile - Ife, Nigeria
| | - Michael O. Balogun
- Cardiac Care Unit, Medical Out-Patient Department, Ife Hospital Unit, Obafemi Awolowo University Teaching Hospitals Complex, Ile - Ife, Nigeria
- Department of Medicine, College of Health Sciences, Obafemi Awolowo University, Ile - Ife, Nigeria
| | - Rasaaq A. Adebayo
- Cardiac Care Unit, Medical Out-Patient Department, Ife Hospital Unit, Obafemi Awolowo University Teaching Hospitals Complex, Ile - Ife, Nigeria
- Department of Medicine, College of Health Sciences, Obafemi Awolowo University, Ile - Ife, Nigeria
| | - Omolara D. Amosun
- Department of Medical Rehabilitation, College of Health Sciences, Obafemi Awolowo University, Ile - Ife, Nigeria
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Mutyambizi C, Chola L, Groot W, Pavlova M, Labadarios D, Hongoro C. The extent and determinants of diabetes and cardiovascular disease comorbidity in South Africa - results from the South African National Health and Nutrition Examination Survey (SANHANES-1). BMC Public Health 2017; 17:745. [PMID: 28950847 PMCID: PMC5615430 DOI: 10.1186/s12889-017-4792-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2017] [Accepted: 09/21/2017] [Indexed: 11/22/2022] Open
Abstract
Background Diabetes is a major health problem and cause of death worldwide. It is predicted that the prevalence of diabetes will increase from 415 million in 2015 to 642 million in 2040. However, the burden of diabetes in low- and middle-income countries is not clearly understood, particularly its interaction with other chronic illnesses. This study investigates the self-reported prevalence of and factors associated with diabetes and cardiovascular comorbidity in South Africa. Methods Data used in this study are from the 2012 South African National Health and Nutrition Examination Survey; a nationally representative cross-sectional household survey (N = 25,532). Diabetes and cardiovascular disease comorbidity was defined as the coexistence of diabetes plus one or more cardiovascular diseases reported at the time of the survey. This study makes use of multinomial logistic regression models to analyse the relationship between diabetes - cardiovascular disease comorbidity and several predictors including race, income, socio-economic status and obesity. Results According to the survey data we analysed, 5% of South Africans aged 15 and above had self-reported diabetes in 2011–2012. Among those with self-reported diabetes, 73% had at least one additional cardiovascular chronic illness. Diabetes and its cardiovascular disease comorbidity was more prevalent in Africans (66%), females (66%), those who lived in urban areas (75%), had secondary education (44%) and were unemployed (62%). Factors strongly associated with diabetes - cardiovascular disease comorbidity were older age (Odds ratio [OR] 1.09; 95% Confidence Interval [CI] 1.06–1.12), high household income (0.27; 0.10–0.76) versus low income, moderate (0.33; 0.11–0.96) and good self-rated health (0.24; 0.08–0.68) versus bad self-rated health, occasional (0.29; 0.10–0.88) and regular smokers (0.25; 0.12–0.53) versus non-smokers and physical activity (0.15; 0.03–0.68) versus no physical activity. Conclusion The study provides insight into the factors associated with cardiovascular disease comorbidity in diabetic individuals. The findings indicate that there are differences in the factors associated with diabetes and those associated with diabetes - cardiovascular disease comorbidity. This provides information, which can be used to design programmes that encourage healthy lifestyles in people living with diabetes.
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Affiliation(s)
- Chipo Mutyambizi
- Population Health, Health Systems and Innovation, Human Sciences Research Council, HSRC Building, 134 Pretorius Street, Pretoria, 0002, South Africa.
| | - Lumbwe Chola
- Population Health, Health Systems and Innovation, Human Sciences Research Council, HSRC Building, 134 Pretorius Street, Pretoria, 0002, South Africa.,School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Wim Groot
- Department of Health Services Research, CAPHRI, Maastricht University Medical Centre, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Milena Pavlova
- Department of Health Services Research, CAPHRI, Maastricht University Medical Centre, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Demetre Labadarios
- Population Health, Health Systems and Innovation, Human Sciences Research Council, HSRC Building, 134 Pretorius Street, Pretoria, 0002, South Africa
| | - Charles Hongoro
- Population Health, Health Systems and Innovation, Human Sciences Research Council, HSRC Building, 134 Pretorius Street, Pretoria, 0002, South Africa
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Christoph MJ, Grigsby-Toussaint DS, Baingana R, Ntambi JM. Physical Activity, Sleep, and BMI Percentile in Rural and Urban Ugandan Youth. Ann Glob Health 2017; 83:311-319. [PMID: 28619406 DOI: 10.1016/j.aogh.2017.04.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Uganda is experiencing a dual burden of over- and undernutrition, with overweight prevalence increasing while underweight remains common. Potential weight-related factors, particularly physical activity, sleep, and rural/urban status, are not currently well understood or commonly assessed in Ugandan youth. OBJECTIVE The purpose of this study was to pilot test a survey measuring weight-related factors in rural and urban Ugandan schoolchildren. METHODS A cross-sectional survey measured sociodemographics, physical activity, sleep patterns, and dietary factors in 148 rural and urban schoolchildren aged 11-16 in central Uganda. Height and weight were objectively measured. Rural and urban youth were compared on these factors using χ2 and t tests. Regression was used to identify correlates of higher body mass index (BMI) percentile in the full sample and nonstunted youth. FINDINGS Youth were on average 12.1 ± 1.1 years old; underweight (10%) was more common than overweight (1.4%). Self-reported sleep duration and subjective sleep quality did not differ by rural/urban residence. Rural children overall had higher BMI percentile and marginally higher stunting prevalence. In adjusted analyses in both the full and nonstunted samples, higher BMI percentile was related to living in a rural area, higher frequency of physical activity, and higher subjective sleep quality; it was negatively related to being active on weekends. In the full sample, higher BMI percentile was also related to female gender, whereas in nonstunted youth, higher BMI was related to age. BMI percentile was unrelated to sedentary time, performance of active chores and sports, and dietary factors. CONCLUSIONS This study is one of the first to pilot test a survey assessing weight-related factors, particularly physical activity and sleep, in Ugandan schoolchildren. BMI percentile was related to several sociodemographic, sleep, and physical activity factors among primarily normal-weight school children in Uganda, providing a basis for understanding weight status in the context of the nutrition transition.
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Affiliation(s)
| | - Diana S Grigsby-Toussaint
- Department of Kinesiology and Community Health and Division of Nutritional Sciences, University of Illinois Urbana-Champaign, Champaign, IL.
| | - Rhona Baingana
- Department of Biochemistry and Sports Science, College of Natural Sciences, Makerere University, Kampala, Uganda
| | - James M Ntambi
- Departments of Biochemistry and Nutritional Sciences, University of Wisconsin-Madison, Madison, WI
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Nguimmo-Metsadjio A, Atogho-Tiedeu B, Noubiap JJN, Evehe MS, Djokam-Dadjeu R, Donfack OS, Nanfa D, Mato EPM, Ngwa EN, Guewo-Fokeng M, Pokam-Fosso P, Mbacham WF, Mbanya JC, Sobngwi E. Investigation of the association between the TCF7L2 rs7903146 (C/T) gene polymorphism and obesity in a Cameroonian population: a pilot study. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2017; 36:12. [PMID: 28420445 PMCID: PMC5395748 DOI: 10.1186/s41043-017-0087-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2016] [Accepted: 03/22/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE This study aimed at investigating the association between the rs7903146 (C/T) polymorphism of the TCF7L2 gene with obesity in a Cameroonian population. METHOD This was a case-control pilot study including 61 obese and 61 non-obese Cameroonian adults. Anthropometric indices of obesity, blood pressure, fasting blood glucose, and blood lipids were measured. The rs7903146 (C/T) polymorphism of the TCF7L2 gene was genotyped using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP), and genotypes were correlated with clinical and biological parameters. RESULTS The T allele was predominant in the study population with a frequency of 93%. No statistically significant difference was however observed between the genotypic (p = 0.50) and allelic frequencies (p = 0.58) of obese and non-obese subjects. Comparison of clinical and biochemical parameters of C allele carriers (CX = CC + CT) with those of TT genotype showed that there was no significant difference between the lipid profile of these two groups. CONCLUSION The rs7903146 (C/T) polymorphism of the TCF7L2 gene might not be associated with obesity in the Cameroonian population.
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Affiliation(s)
- Aurelie Nguimmo-Metsadjio
- Department of Biochemistry, Faculty of Science, University of Yaoundé I, Yaoundé, Cameroon
- Laboratory for Molecular Medicine and Metabolism, Biotechnology Center, University of Yaoundé I, Yaoundé, Cameroon
| | - Barbara Atogho-Tiedeu
- Department of Biochemistry, Faculty of Science, University of Yaoundé I, Yaoundé, Cameroon
- Laboratory for Molecular Medicine and Metabolism, Biotechnology Center, University of Yaoundé I, Yaoundé, Cameroon
| | - Jean Jacques N. Noubiap
- Department of Medicine, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa
- Medical Diagnostic Center, Yaoundé, Cameroon
| | - Marie-Solange Evehe
- Department of Biochemistry, Faculty of Science, University of Yaoundé I, Yaoundé, Cameroon
- Laboratory for Molecular Medicine and Metabolism, Biotechnology Center, University of Yaoundé I, Yaoundé, Cameroon
| | - Rosine Djokam-Dadjeu
- Department of Biochemistry, Faculty of Science, University of Yaoundé I, Yaoundé, Cameroon
- Laboratory for Molecular Medicine and Metabolism, Biotechnology Center, University of Yaoundé I, Yaoundé, Cameroon
| | - Olivier Sontsa Donfack
- Department of Biochemistry, Faculty of Science, University of Yaoundé I, Yaoundé, Cameroon
- Laboratory for Molecular Medicine and Metabolism, Biotechnology Center, University of Yaoundé I, Yaoundé, Cameroon
| | - Dieudonne Nanfa
- Department of Biochemistry, Faculty of Science, University of Yaoundé I, Yaoundé, Cameroon
- Laboratory for Molecular Medicine and Metabolism, Biotechnology Center, University of Yaoundé I, Yaoundé, Cameroon
| | - Edith Pascale M. Mato
- Department of Biochemistry, Faculty of Science, University of Yaoundé I, Yaoundé, Cameroon
- Laboratory for Molecular Medicine and Metabolism, Biotechnology Center, University of Yaoundé I, Yaoundé, Cameroon
| | - Elvis Ndonwi Ngwa
- Department of Biochemistry, Faculty of Science, University of Yaoundé I, Yaoundé, Cameroon
- Laboratory for Molecular Medicine and Metabolism, Biotechnology Center, University of Yaoundé I, Yaoundé, Cameroon
| | - Magellan Guewo-Fokeng
- Department of Biochemistry, Faculty of Science, University of Yaoundé I, Yaoundé, Cameroon
- Laboratory for Molecular Medicine and Metabolism, Biotechnology Center, University of Yaoundé I, Yaoundé, Cameroon
| | - Priscille Pokam-Fosso
- Department of Biochemistry, Faculty of Science, University of Yaoundé I, Yaoundé, Cameroon
- Laboratory for Molecular Medicine and Metabolism, Biotechnology Center, University of Yaoundé I, Yaoundé, Cameroon
| | - Wilfred F. Mbacham
- Department of Biochemistry, Faculty of Science, University of Yaoundé I, Yaoundé, Cameroon
- Laboratory for Public Health Research Biotechnologies, Biotechnology Center, University of Yaoundé I, Yaoundé, Cameroon
| | - Jean Claude Mbanya
- Laboratory for Molecular Medicine and Metabolism, Biotechnology Center, University of Yaoundé I, Yaoundé, Cameroon
- Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
- National Obesity Center, Yaoundé Central Hospital, Yaoundé, Cameroon
| | - Eugene Sobngwi
- Laboratory for Molecular Medicine and Metabolism, Biotechnology Center, University of Yaoundé I, Yaoundé, Cameroon
- Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
- National Obesity Center, Yaoundé Central Hospital, Yaoundé, Cameroon
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Cheah YK, Azahadi M, Phang SN, Hazilah N. Factors affecting participation decision and amount of physical activity among urban dwellers in Malaysia. Public Health 2017; 146:84-91. [PMID: 28404478 DOI: 10.1016/j.puhe.2017.01.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 12/27/2016] [Accepted: 01/06/2017] [Indexed: 11/17/2022]
Abstract
OBJECTIVES The rapid rise in the prevalence of physical inactivity-related diseases has become a serious public health issue worldwide. The objective of the present study is to examine the factors affecting participation in physical activity among urban dwellers in Malaysia. STUDY DESIGN This cross-sectional study measures physical activity using a rigorous regression model. METHODS Data are obtained from the National Health and Morbidity Survey 2011 (NHMS 2011). A lognormal hurdle model is used to analyse the participation decision and the amount decision of physical activity. RESULTS The results show that income, gender, ethnicity, marital status and employment status are significantly associated with participation decision and amount decision. However, age, insurance and self-rated health only affect participation decision, whereas family size, education and smoking only affect amount decision. CONCLUSIONS It can, thus, be concluded that sociodemographic, insurance, lifestyle and health factors play an important role in determining physical activity behaviour among urban dwellers. When formulating policies, special attention must be paid to these factors.
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Affiliation(s)
- Y K Cheah
- School of Economics, Finance and Banking, College of Business, Universiti Utara Malaysia, UUM Sintok, 06010 Kedah Darul Aman, Malaysia.
| | - M Azahadi
- Centre for Burden of Disease Research, Institute for Public Health, Ministry of Health Malaysia, Jalan Bangsar, 50590 Kuala Lumpur, Malaysia.
| | - S N Phang
- School of Government, College of Law, Government and International Studies, Universiti Utara Malaysia, UUM Sintok, 06010 Kedah Darul Aman, Malaysia.
| | - N Hazilah
- Department of Business Administration, Faculty of Economics and Management Sciences, International Islamic University Malaysia, 50728 Kuala Lumpur, Malaysia.
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