Gender differences in sociodemographic and behavioural factors associated with BMI in an adult population in rural Burkina Faso - an AWI-Gen sub-study

Prevalence of Obesity and Anemia Among Early Adolescents in Junior Secondary Schools: A Cross-Sectional Study in Ouagadougou, Burkina Faso

BACKGROUND

The school presents an ideal environment to positively impact the long-term health and nutrition outcomes of early adolescents, who are at risk of obesity and anemia.

METHODS

In this cross-sectional survey, we described differences in weight and anemia by sociodemographic, diet and physical activity indicators among 1059 students aged 11 to 15 years from 22 junior secondary schools in Ouagadougou, Burkina Faso. Weight was based on body mass index (BMI) z-scores according to the WHO reference and anemia status was defined by standardized hemoglobin (Hb) measure cut-offs. We calculated dietary diversity scores (DDS) from a 24-hour dietary recall and a global diet quality score (GDQS) from a 7-day dietary recall.

RESULTS

The prevalence of obesity (5%) and anemia (50%) was relatively high among the students, which differed significantly between gender, household wealth and school grade, but not age groups. Eighteen percent of the female adolescents were overweight or obese and 22% were moderately anemic compared to 13% and 16% of the male adolescents. Dietary diversity was significantly different between weight categories, but not anemia status. For physical activity, those taking transportation to school were significantly more likely to be overweight or obese. In adjusted multivariable Poisson regression analyses, only the DDS was significantly associated with thinness and both thinness and anemia, while taking transportation to school was significantly associated with overweight among adolescents.

CONCLUSION

We encourage the promotion of school-based interventions and provision of a curriculum on health and healthy eating in order to reduce obesity, anemia, and its comorbidities.

Prevalence and factors associated with stroke risk factors in an urban community of Parakou, Northern Benin, 2016

Sub-Saharan Africa faces a heavy burden of stroke due to the growth of its risk factors. We aimed to estimate the prevalence of stroke risk factors and identify the factors associated with metabolic risk factors in the district of Titirou, in Parakou (northern Benin) in 2016. A cross-sectional study was conducted. It included people aged at least 15 years, living in Titirou for at least 6 months, and who had given their written consent to participate in the study. A door-to-door survey was performed from 15 march to 15 July 2016 in each neighborhood until the pre-determined number was reached. Sociodemographic data, medical histories, anthropometric and blood pressure measures were recorded using the WHO STEPS approach. The prevalence of stroke risk factors was calculated, and a multivariable logistic regression was done to identify the factors associated with metabolic risk factors for stroke. A total of 4671 participants were included with a mean age of 27.7±12.9 years and a sex ratio of 0.98. Concerning the behavioral risk factors for stroke, 17.2% were alcohol consumers, 3.5% were smokers, 21.5% had low fruit and vegetable intake, and 51.1% had low physical activity practice. The prevalence of metabolic risk factors for stroke was respectively of 8.7% for obesity, 7.1% for high blood pressure, 1.7% for self-reported diabetes, and 2.2% for dyslipidemia. Age (p<0.001), sex (p<0.001), marital status (p<0.001) and professional occupation (p = 0.010) were associated with obesity. Age was also associated with high blood pressure (p<0.001) and diabetes (p<0.001). Dyslipidemia varied according to smoking (p = 0.033) and low physical activity practice (p = 0.003). The study revealed a significant prevalence of some stroke risk factors. Targeted local interventions for primary prevention of stroke should be promoted in this community.

Associations between dental problems and underweight status among rural women in Burkina Faso: results from the first WHO Stepwise Approach to Surveillance (STEPS) survey

OBJECTIVE

To explore the relationships between dental problems and underweight status among rural women in Burkina Faso by using nationally representative data.

DESIGN

This was a cross-sectional secondary study of primary data obtained by the 2013 WHO Stepwise Approach to Surveillance survey conducted in Burkina Faso. Descriptive and analytical analyses were performed using Student's t test, ANOVA, the χ2 test, Fisher's exact test and logistic regression.

SETTING

All thirteen Burkinabè regions were categorised using quartiles of urbanisation rates.

PARTICIPANTS

The participants were 1730 rural women aged 25-64 years.

RESULTS

The prevalence of underweight was 16·0 %, and 24·1 % of participants experienced dental problems during the 12-month period. The women with dental problems were more frequently underweight (19·9 % and 14·7 %; P < 0·05) and had a lower mean BMI (21·1 ± 3·2 and 21·6 ± 3·7 kg/m2, P < 0·01) than those without dental problems. More risk factors for underweight were observed in less urbanised regions among elderly individuals (> 49 years old) and smokeless tobacco users. Age > 49 years, professions with inconsistent income, a lack of education, smokeless tobacco use and low BMI were factors that were significantly associated with dental problems, while residency in a low-urbanisation area was a protective factor.

CONCLUSION

The prevalence of underweight in rural Burkinabè women is among the highest in sub-Saharan Africa, and women with dental problems are more frequently affected than those without dental problems. Public health measures for the prevention of these disorders should specifically target women aged over 49 years and smokeless tobacco users.

Prevalence and factors associated with overweight and obesity among rural and urban women in Burkina Faso

Introduction

Low- and middle-income countries, including Burkina Faso, are facing increasing urbanization with health challenges related to nutrition transition that impact body weight change. This study reported the prevalence and factors associated with overweight/obesity among women living in rural and urban Burkina Faso.

Methods

We conducted a secondary analysis using data from the Burkina Faso 2013 WHO STEPwise survey. Data included socio-demographic, clinical (anthropometric, systolic/diastolic blood pressure (SBP/DBP), oral/dental symptoms), biological (total and high-density lipoprotein cholesterol and fasting blood sugar), and alcohol and tobacco consumption data. A total of 2191 participants with complete data were considered in the analysis. We categorized the 13 Burkinabe regions by urbanization rate quartiles. We then performed Student's t, chi-squared, and Fisher's exact tests and backward stepwise regressions.

Results

The overall prevalence of overweight/obesity was 19.6% (13.1% and 44% in rural and urban women respectively, p=0.0001). Common factors positively associated with overweight/obesity in both rural and urban women were being a resident of a region in the highest urbanization rate quartile, having a high level of total cholesterol (alone or via an interaction with age) and having a high DBP. In urban women only, overweight/obesity was also associated with a high SBP.

Conclusion

The prevalence of overweight/obesity in urban women in Burkina was among the highest levels in urban sub-Saharan Africa and roughly mimicked the urbanization profile of the country. In overweight/obesity conditions, cardiovascular concerns, such as increase in total cholesterol and blood pressure, were objective, and the blood pressure increase was more severe in urban women than in rural women.

Regional and sex-specific variation in BMI distribution in four sub-Saharan African countries: The H3Africa AWI-Gen study

Background: African populations are characterised by diversity at many levels including: demographic history, genetic ancestry, language, wealth, socio-political landscape, culture and behaviour. Several of these have a profound impact on body fat mass. Obesity, a key risk factor for cardiovascular and metabolic diseases, in the wake of the epidemiological and health transitions across the continent, requires detailed analysis together with other major risk factors.

Objective: To compare regional and sex-specific body mass index (BMI) distributions, using a cross-sectional study design, in adults aged 40–60 years across six study sites in four sub-Saharan African (SSA) countries and to compare the determinants of BMI at each.

Methods: Anthropometric measurements were standardised across sites and BMI calculated. Median BMI and prevalence of underweight, lean, overweight and obesity were compared between the sexes and across sites. Data from multivariable linear regression models for the principal determinants of BMI were summarised from the site-specific studies.

Results: BMI was calculated in 10,702 participants (55% female) and was significantly higher in women than men at nearly all sites. The highest prevalence of obesity was observed at the three South African sites (42.3–66.6% in women and 2.81–17.5% in men) and the lowest in West Africa (1.25–4.22% in women and 1.19–2.20% in men). Across sites, higher socio-economic status and educational level were associated with higher BMI. Being married and increased dietary intake were associated with higher BMI in some communities, whilst smoking and alcohol intake were associated with lower BMI, as was HIV infection in the regions where it was prevalent.

Conclusion: In SSA there is a marked variation in the prevalence of obesity both regionally and between men and women. Our data suggest that the drive for social upliftment within Africa will be associated with rising levels of obesity, which will require the initiation of targeted sex-specific intervention programmes across specific African communities.