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Bulamba RM, Nalugoda F, Nkale J, Kigozi G, Ochieng AM, Kyasanku E, Watya S, Olwa VO, Daama A, Nkwanzi V, Kiwanuka D, Mugamba S, Kigozi G, Wagman J, Ekström AM, Nakigozi G, Miller AP. Examining associations between mental health and Chronic Non-Communicable Diseases (C-NCDs) among older adults in Wakiso, Uganda. PLoS One 2024; 19:e0293993. [PMID: 38885211 PMCID: PMC11182548 DOI: 10.1371/journal.pone.0293993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 05/29/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND Globally, the prevalence of chronic non-communicable diseases (C-NCDs) and occurrence of multi-morbidity specifically, has been increasing and will continue to rise as life expectancy increases. The burden of mental health disorders has also been rising globally. In sub-Saharan Africa (SSA), literature on these health issues, which are interrelated, is scarce. This study assesses the prevalence of C-NCDs, and depressive and anxiety symptomology and examines the relationship between these issues among a sample of older adults in Uganda. METHODS Between 2021-2022, 604 consenting adults aged 35 years and older were surveyed on a broad range of health issues for the ongoing AMBSO Population Health Surveillance (APHS) cohort study in Wakiso district. Descriptive analyses were performed to characterize the burden of C-NCDs (e.g. diabetes, hypertension), depression (PHQ-9 using a cutoff of <5 scores for minimal/no and 5+ for mild to severe symptomology) and anxiety (GAD-7 using a cutoff of 5+ scores for mild to severe symptomology). Bivariate analysis and multivariable logistic regression models were built using STATA software version 16.0 to examine associations between mental health disorders and having at least one C-NCD. Our exposures of interest were depressive and anxiety symptoms and our outcomes of interest was presence of C-NCDs. RESULTS Majority of participants were females (63.6%), median age was 46 (IQR: 39-54). Any C-NCDs prevalence was 18.7%, while 18.9% and 11.4%, had screening scores indicative of depressive and anxiety symptomology, respectively. Three percent (3.2%) had PHQ-9 scores indicative of moderate to severe depressive symptomology. In models adjusted for sociodemographic characteristics, there was 12% increased odds of suffering from C-NCDs for every unit increase in PHQ-9 score (AOR = 1.12, 95% CI: 1.10-1.20). Participants with any anxiety symptoms had 2.1 greater odds of suffering from C-NCD compared to those who did not have anxiety symptoms (AOR = 2.10, 95% CI: 1.21-3.70). CONCLUSION C-NCDs were prevalent in older adults, particularly among those experiencing mental health symptoms. Screening for C-NCDs and mental health disorders should be integrated into routine health care for older adults in the country. Early screening and identification of these health issues through primary health care could significantly reduce the public health burden attributable to mental health disorders and the incidence of multi-morbidity in Uganda.
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Affiliation(s)
- Robert M. Bulamba
- Africa Medical and Behavioral Sciences Organization (AMBSO), Kampala, Uganda
| | - Fred Nalugoda
- Africa Medical and Behavioral Sciences Organization (AMBSO), Kampala, Uganda
| | - James Nkale
- Africa Medical and Behavioral Sciences Organization (AMBSO), Kampala, Uganda
| | - Godfrey Kigozi
- Africa Medical and Behavioral Sciences Organization (AMBSO), Kampala, Uganda
| | | | - Emmanuel Kyasanku
- Africa Medical and Behavioral Sciences Organization (AMBSO), Kampala, Uganda
| | - Stephen Watya
- Africa Medical and Behavioral Sciences Organization (AMBSO), Kampala, Uganda
| | - Vitalis Ofumbi Olwa
- Africa Medical and Behavioral Sciences Organization (AMBSO), Kampala, Uganda
| | - Alex Daama
- Africa Medical and Behavioral Sciences Organization (AMBSO), Kampala, Uganda
| | - Violet Nkwanzi
- East Tennessee State University, Johnson City, TN, United States of America
| | - Deusdedit Kiwanuka
- Africa Medical and Behavioral Sciences Organization (AMBSO), Kampala, Uganda
| | - Stephen Mugamba
- Africa Medical and Behavioral Sciences Organization (AMBSO), Kampala, Uganda
| | - Grace Kigozi
- Africa Medical and Behavioral Sciences Organization (AMBSO), Kampala, Uganda
| | - Jennifer Wagman
- University of California, Los Angeles, Los Angeles, CA, United States of America
| | | | - Gertrude Nakigozi
- Africa Medical and Behavioral Sciences Organization (AMBSO), Kampala, Uganda
| | - Amanda P. Miller
- San Diego State University, San Diego, CA, United States of America
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Avogo WA. Community characteristics and the risk of non-communicable diseases in Ghana. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0000692. [PMID: 36962739 PMCID: PMC10021620 DOI: 10.1371/journal.pgph.0000692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 12/12/2022] [Indexed: 06/18/2023]
Abstract
Non-communicable Diseases (NCDs) are rising quickly in low- and middle- income countries. In Ghana, chronic diseases are major causes of morbidity and mortality, yet data and the evidence- base for awareness, detection, and management of NCDs are lacking. Using data from the 2014 Ghana Demographic and Health Survey (GDHS), the first national study with information on hypertension and other risk factors, we examine the correlates and community characteristics associated with the risk of hypertension, obesity, and anemia among women. We find that hypertension prevalence in Ghana was 16 percent and 17 percent were overweight/obese, while 41 percent had anemia of any form. On community characteristics, the level of poverty in a community was significantly associated with lower risks of all three NCDs, while the aggregate level of employment had higher risks. On individual characteristics, the wealth of a household, women's educational level and urban residence were significant predictors of NCDs. We interpret the findings within the literature on neighborhood characteristics, the social gradient of health and in the context of speeding up the attainment of the Sustainable Development Goals (SGDS) to reduce premature deaths by one-third by 2030.
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Affiliation(s)
- Winfred A. Avogo
- Department of Sociology and Anthropology, Illinois State University, Normal, Illinois, United States of America
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Ssensamba JT, Nakafeero M, Musana H, Amollo M, Ssennyonjo A, Kiwanuka SN. Primary care provider notions on instituting community-based geriatric support in Uganda. BMC Geriatr 2022; 22:258. [PMID: 35351013 PMCID: PMC8962536 DOI: 10.1186/s12877-022-02897-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 03/04/2022] [Indexed: 11/10/2022] Open
Abstract
Background Understanding of the most economical and sustainable models of providing geriatric care to Africa’s rising ageing population is critical. In Uganda, the number of old adults (60 years and above) continues to rise against absence of policies and guidelines, and models for providing care to this critical population. Our study explored public primary health care provider views on how best community-based geriatric support (CBGS) could be instituted as an adaptable model for delivering geriatric care in Uganda’s resource-limited primary public health care settings. Methods We interviewed 20 key informants from four districts of Bukomansimbi, Kalungu, Rakai, and Lwengo in Southern Central Uganda. Respondents were leads (in-charges) of public primary health units that had spent at least 6 months at the fore said facilities. All interviews were audio-recorded, transcribed verbatim, and analysed based on Hsieh and Shannon’s approach to conventional manifest content analysis. Results During analysis, four themes emerged: 1) Structures to leverage for CBGS, 2) How to promote CBGS, 3) Who should be involved in CBGS, and 4) What activities need to be leveraged to advance CBGS? The majority of the respondents viewed using the existing village health team and local leadership structures as key to the successful institutionalization of CBGS; leveraging community education and sensitization using radio, television, and engaging health workers, family relatives, and neighbors. Health outreach activities were mentioned as one of the avenues that could be leveraged to provide CBGS. Conclusion Provider notions pointed to CBGS as a viable model for instituting geriatric care in Uganda’s public primary healthcare system. However, this requires policymakers to leverage existing village health team and local governance structures, conduct community education and sensitization about CBGS, and bring onboard health workers, family relatives, and neighbors. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-02897-9.
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Affiliation(s)
- Jude Thaddeus Ssensamba
- Division of Infectious Diseases and Geriatric Health, Center for Innovations in Health Africa, Kampala, Uganda. .,Health Care Programmes, VIVES University of Applied Sciences, Kortrijk, Belgium. .,School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda.
| | - Mary Nakafeero
- Division of Infectious Diseases and Geriatric Health, Center for Innovations in Health Africa, Kampala, Uganda.,School of Public Health, Department of Epidemiology and Biostatistics, Makerere University College of Health Sciences, Kampala, Uganda
| | - Hellen Musana
- Division of Infectious Diseases and Geriatric Health, Center for Innovations in Health Africa, Kampala, Uganda.,School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - Mathew Amollo
- School of Public Health, Department of Epidemiology and Biostatistics, Makerere University College of Health Sciences, Kampala, Uganda
| | - Aloysius Ssennyonjo
- School of Public Health, Department of Health Policy and Planning, Makerere University College of Health Sciences, Kampala, Uganda
| | - Suzanne N Kiwanuka
- School of Public Health, Department of Health Policy and Planning, Makerere University College of Health Sciences, Kampala, Uganda
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Lay Health Workers in Community-Based Care and Management of Dementia: A Qualitative ‘Pre’ and ‘Post’ Intervention Study in Southwestern Uganda. BIOMED RESEARCH INTERNATIONAL 2022; 2022:9443229. [PMID: 35372572 PMCID: PMC8967551 DOI: 10.1155/2022/9443229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 03/03/2022] [Indexed: 11/17/2022]
Abstract
Background The global need for efficient and cost-effective use of healthcare resources in low-income countries has led to the introduction of lay health workers (LHWs) as a link of the community to healthcare services. As such, the LHWs perform a variety of tasks such as education, support for care delivery, and social support across all disease types. However, little is known about their ability to support dementia care and management in the community. Purpose The goal of the pilot intervention was to evaluate the 5-day training intervention for LHWs in rural southwestern Uganda in community-based care and management of people with dementia, and implementation of the knowledge and skills gained. Methods This was a “pre” and “post” pilot intervention study which involved a qualitative assessment of LHWs' knowledge on community-based management and care for people with dementia. We focused on four core competency domains in the WHO dementia toolkit. The intervention included a five-day training of the LHWs on dementia care, eight weeks of implementation, and an evaluation of the experiences. Analysis focused on the needs assessment, early detection and management, community engagement, support for people with dementia; and evaluation of the eight weeks implementation. Results Before the training, the LHWs did not know much about what dementia-related support to provide in the community. Activities were limited to general support, including nutrition, and health education. After the training, LHWs had a basic understanding of dementia and began sensitizing the communities. They felt more comfortable working with people with dementia and reported a notable change in the attitude of family members. However, they reported challenges in differentiating the signs of early dementia from superstitious beliefs. Conclusion With enhanced capacity, LHWs may be able to support community-based management for people with dementia. A larger study is needed to explore potential roles for LHWs and further assess effectiveness of the LHWs' skills.
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Arhin N, Ssentongo P, Taylor M, Olecki EJ, Pameijer C, Shen C, Oh J, Eng C. Age-standardised incidence rate and epidemiology of colorectal cancer in Africa: a systematic review and meta-analysis. BMJ Open 2022; 12:e052376. [PMID: 35039287 PMCID: PMC8765019 DOI: 10.1136/bmjopen-2021-052376] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVES Colorectal cancer (CRC) is the second-leading cause of cancer deaths globally, with low-income and middle-income countries (LMICs) disproportionately affected. Estimates of CRC rates in LMIC are scarce. We aimed to (1) estimate sex-specific incidence of CRC, (2) estimate temporal trend and (3) determine regional variations of CRC rates on the African continent. DESIGN Systematic review and meta-analysis METHODS: PubMed (MEDLINE), OVID (MEDLINE), Scopus and Cochrane Library databases were systematically searched from inception to 12 December 2020. We included population-based studies that reported the incidence or prevalence estimates of CRC in Africa. Studies not conducted in humans or did not directly report the rates of CRC were excluded. Random effects model was used to pool the estimates. The methodological quality of studies was assessed with the Newcastle-Ottawa Scale. OUTCOME MEASURES Overall and sex-specific annual age-standardised incidence rates (ASIR) of CRC per 100 000 population. RESULTS The meta-analysis included 14 studies consisting of 3365 individuals with CRC (mean age, 58 years, 53% male). The overall ASIR of CRC in Africa per 100 000 population was 5.25 (95% CI 4.08 to 6.75). The rates were slightly higher in males (4.76) than in females (4.18), but not significantly different. Subgroup analysis indicated greater point estimates in North Africa (8.66) compared with sub-Saharan Africa (5.91); and higher estimates in Eastern (8.29) and Northern (8.66) Africa compared with Western (3.55) and Southern (3.57) Africa, but not statistically significant. The overall trend in ASIR has remained constant at nearly 5 per 100 000 population for the last 6 decades. CONCLUSION CRC estimates in Africa are heterogeneous and could be underestimated. High-quality data collection systems such as population-based cancer registries may facilitate accurate estimation of country-specific rates and provide critical information which would be lucrative to the consideration of resources needed for screening, early detection, treatment and improving overall patient outcomes.
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Affiliation(s)
- Nina Arhin
- Department of Medicine, Division of Hematology/Oncology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Paddy Ssentongo
- Department of Public Health Sciences, Penn State Health Milton S Hershey Medical Center, Hershey, Pennsylvania, USA
| | - Morris Taylor
- Department of Public Health Sciences, Penn State Health Milton S Hershey Medical Center, Hershey, Pennsylvania, USA
| | | | - Colette Pameijer
- Department of Surgery, Penn State Health Milton S Hershey Medical Center, Hershey, Pennsylvania, USA
| | - Chan Shen
- Department of Surgery, Penn State Health Milton S Hershey Medical Center, Hershey, Pennsylvania, USA
| | - John Oh
- Department of Surgery, Penn State Health Milton S Hershey Medical Center, Hershey, Pennsylvania, USA
| | - Cathy Eng
- Department of Medicine, Division of Hematology/Oncology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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Saha S, Mukherjee U, Miller M, Peng LL, Napier C, Grobbelaar H, Oldewage-Theron W. Food and beverages promoting elderly health: six food-based dietary guidelines to plan good mixed meals for elderly South Africans. SOUTH AFRICAN JOURNAL OF CLINICAL NUTRITION 2021. [DOI: 10.1080/16070658.2021.1956232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Sanjoy Saha
- Department of Nutritional Sciences, Texas Tech University, Lubbock, Texas, USA
| | - Upasana Mukherjee
- Department of Nutritional Sciences, Texas Tech University, Lubbock, Texas, USA
| | - Makenzie Miller
- Department of Nutritional Sciences, Texas Tech University, Lubbock, Texas, USA
| | - Li-Ling Peng
- Department of Nutritional Sciences, Texas Tech University, Lubbock, Texas, USA
| | - Carin Napier
- Department of Food & Nutrition Consumer Sciences, Durban University of Technology, Durban, South Africa
- Centre for Longitudinal Research, The University of Auckland, Auckland, New Zealand
| | - Heleen Grobbelaar
- Department of Food & Nutrition Consumer Sciences, Durban University of Technology, Durban, South Africa
| | - Wilna Oldewage-Theron
- Department of Nutritional Sciences, Texas Tech University, Lubbock, Texas, USA
- Department of Sustainable Food Systems and Development, University of the Free State, Bloemfontein, South Africa
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7
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de Vlieg RA, van Empel E, Montana L, Xavier Gómez-Olivé F, Kahn K, Tollman S, Berkman L, Bärnighausen TW, Manne-Goehler J. Alcohol Consumption and Sexual Risk Behavior in an Aging Population in Rural South Africa. AIDS Behav 2021; 25:2023-2032. [PMID: 33387135 PMCID: PMC8169519 DOI: 10.1007/s10461-020-03132-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/07/2020] [Indexed: 10/22/2022]
Abstract
We sought to characterize the relationship between alcohol consumption and sexual risk-taking in an aging population in rural South Africa. A cross-sectional analysis was conducted using baseline data from the Health and Ageing in Africa: a Longitudinal Study of an INDEPTH Community (HAALSI) cohort. We elicited information on sexual risk behavior and self-reported frequency of alcohol consumption among 5059 adults ≥ 40 years old. Multivariable models showed that more frequent alcohol consumption is associated with a higher number of sexual partners (β: 1.38, p < .001) and greater odds of having sex for money (OR: 42.58, p < .001) in older adults in South Africa. Additionally, daily drinkers were more likely to have sex without a condom (OR: 2.67, p = .01). Older adults who drank more alcohol were more likely to engage in sexual risk-taking. Behavioral interventions to reduce alcohol intake should be considered to reduce STI and HIV transmission.
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Affiliation(s)
- Rebecca A de Vlieg
- Harvard Center for Population and Development Studies, Harvard University, 9 Bow Street, Cambridge, MA, 02138, USA.
- Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
| | - Eva van Empel
- Harvard Center for Population and Development Studies, Harvard University, 9 Bow Street, Cambridge, MA, 02138, USA
- Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Livia Montana
- Harvard Center for Population and Development Studies, Harvard University, 9 Bow Street, Cambridge, MA, 02138, USA
| | - F Xavier Gómez-Olivé
- Medical Research Council/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Kathleen Kahn
- Medical Research Council/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Stephen Tollman
- Medical Research Council/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Lisa Berkman
- Harvard Center for Population and Development Studies, Harvard University, 9 Bow Street, Cambridge, MA, 02138, USA
- Medical Research Council/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Till W Bärnighausen
- Medical Research Council/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
- Division of Infectious Diseases, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Africa Health Research Institute (AHRI), Mtubatuba, South Africa
- Institute of Public Health, University of Heidelberg, Heidelberg, Germany
| | - Jennifer Manne-Goehler
- Division of Infectious Diseases, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Medical Practice Evaluation Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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Selemane C, Jamisse L, Arroz J, Túlsidas S, Morais AG, Carrilho C, Modcoicar P, Sidat M, Rodrigues J, Moreira-Gonçalves D, Ismail M, Santos LL. Demographic, clinical and pathological characterisation of patients with colorectal and anal cancer followed between 2013 and 2016 at Maputo Central Hospital, Mozambique. Ecancermedicalscience 2021; 15:1205. [PMID: 33912230 PMCID: PMC8057776 DOI: 10.3332/ecancer.2021.1205] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Indexed: 12/05/2022] Open
Abstract
Purpose The aim of this study was to investigate colorectal cancer (CRC) data and anal cancer data from Maputo Central Hospital (MCH), the largest hospital and a reference for oncological diseases in Mozambique, with the aim of characterising the disease profile in view to define an appropriate control programme. Methods MCH records from the Pathology and Surgery Services and MCH Cancer Registry database were assessed to obtain retrospective clinical and pathologic data of patients with CRC or anal cancer admitted to and treated between 13 December 2013 and 23 March 2016. Results The female gender was more prevalent (54.8%), even when anal cancers were excluded. Median age was 54 years (20–99). Most patients (51.6%) lived in the city of Maputo. The most common presenting symptom was found to be rectal bleeding. Adenocarcinoma was the most frequent histological type, and the most prevalent anatomical site was the rectum. Most of the cases were diagnosed at MCH in advanced stages. Colostomy was the most frequent surgical procedure and performed in 38.7% of the patients. Most cases of anal cancer occurred in human immunodeficiency virus-infected patients. Most patients had a poor prognosis due to advanced stage at first diagnosis. Conclusion We observed an increase in cases of CRC and anal cancer in Mozambique and mostly diagnosed at advanced stages, which anticipates a dismal prognosis. Our data supports the urgent need of a comprehensive public health programme dedicated to solving this growing concern.
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Affiliation(s)
- Carlos Selemane
- Surgical Department, Maputo Central Hospital, 1653 Av Eduardo Mondlane, Maputo, Mozambique
| | - Luisa Jamisse
- Pathology Department, Maputo Central Hospital, 1653 Av Eduardo Mondlane, Maputo, Mozambique
| | - Jorge Arroz
- Save the Children, P.O.Box 1854, Rua de Tchamba nº 398, Maputo, Mozambique
| | - Satish Túlsidas
- Medical Oncology Department, Maputo Central Hospital, 1653 Av Eduardo Mondlane, Maputo, Mozambique
| | - António Gudo Morais
- Radiotherapy Service, Maputo Central Hospital, 1653 Av Eduardo Mondlane, Maputo, Mozambique
| | - Carla Carrilho
- Pathology Department, Maputo Central Hospital, 1653 Av Eduardo Mondlane, Maputo, Mozambique.,Department of Pathology, Faculty of Medicine, Eduardo Mondlane University, 3453 Avenida Julius Nyerere, Maputo, Moçambique
| | - Prassad Modcoicar
- Gastroenterology Department, Maputo Central Hospital, 1653 Av Eduardo Mondlane, Maputo, Mozambique
| | - Moshin Sidat
- Department of Community Health, University of Eduardo Mondlane, 1653 Av Eduardo Mondlane, Maputo, Mozambique.,Global Health and Tropical Medicine, Institute of Hygiene and Tropical Medicine, Nova University of Lisbon,R. da Junqueira 100, 1349-008 Lisboa, Portugal
| | - Jessica Rodrigues
- Epidemiology Service, Portuguese Institute of oncology, Rua Dr. António Bernardino de Almeida 4200-072, Porto, Portugal
| | - Daniel Moreira-Gonçalves
- Research Center in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto, R. Dr. Plácido da Costa 91, 4200-450, Porto, Portugal.,Experimental Pathology and Therapeutics Research Group, Portuguese Institute of oncology, Rua Dr. António Bernardino de Almeida 4200-072, Porto, Portugal
| | - Mamudo Ismail
- Pathology Department, Maputo Central Hospital, 1653 Av Eduardo Mondlane, Maputo, Mozambique.,Department of Pathology, Faculty of Medicine, Eduardo Mondlane University, 3453 Avenida Julius Nyerere, Maputo, Moçambique
| | - Lúcio Lara Santos
- Experimental Pathology and Therapeutics Research Group, Portuguese Institute of oncology, Rua Dr. António Bernardino de Almeida 4200-072, Porto, Portugal.,Surgical Oncology Department, Portuguese Institute of oncology, Rua Dr. António Bernardino de Almeida 4200-072, Porto, Portugal.,ONCOCIR-Education and Care in Oncology, Lusophone , Africa, Rua de Quires 168-10J, Moreira da Maia , Portugal
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Oduro-Mensah E, Tetteh J, Adomako I, Adjei-Mensah E, Owoo C, Yawson AO, Oliver-Commey JA, Puplampu P, Samba A, Yawson AE, Lartey M. Clinical features of COVID-19 in Ghana: symptomatology, illness severity and comorbid non-communicable diseases. Ghana Med J 2020; 54:23-32. [PMID: 33976438 PMCID: PMC8087366 DOI: 10.4314/gmj.v54i4s.5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE This analysis described the clinical features of COVID-19 in the early phase of the pandemic in Ghana. METHODS Data were extracted from two national COVID-19 treatment centers in Ghana for over 11 weeks(from March to May 2020). Descriptive and inferential statistics were performed. Modified Ordered Logistic and Negative Binomial Regression analysis were applied to establish factors associated with illness severity and Non-communicable Disease (NCDs) counts respectively. All analysis was conducted at the 95% confidence level (p-value ≤ 0.05) using Stata 16. RESULTS Among the 275 patients, the average age was 40.7±16.4, with a preponderance of males (54.5%). The three commonest symptoms presented were cough (21.3%), headache (15.7%), and sore throat (11.7%). Only 7.6% of the patients had a history of fever. Most patients were asymptomatic (51.65). Approximately 38.9% have an underlying co-morbid NCDs, with Hypertension (32.1%), Diabetes (9.9%), and Asthma (5.2%) being the three commonest. The odds of Moderate/severe (MoS) was significantly higher for those with unknown exposures to similar illness [aOR(95%CI) = 4.27(1.12-10.2)] compared with non-exposure to similar illness. An increased unit of NCD's count significantly increased the odds of COVID-19 MoS illness by 26%[cOR(95%CI) =1.26(1.09-1.84)] and 67% (adjusting for age) [aOR(95%CI)=1.67(1.13-2.49)]. CONCLUSION The presence of cardiovascular co-morbidities dictated the frequency of reported symptoms and severity of COVID-19 infection in this sample of Ghanaians. Physicians should be aware of the presence of co-morbid NCDs and prepare to manage effectively among COVID-19 patients. FUNDING None declared.
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Affiliation(s)
- Ebenezer Oduro-Mensah
- National COVID-19 Treatment Centre, Ga East Municipal Hospital, Ghana Health Service (GHS)
- National COVID-19 Case Management Team, Ministry of Health, Accra, Ghana
| | - John Tetteh
- Department of Community Health, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Isaac Adomako
- Department of Community Health, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Evelyn Adjei-Mensah
- Department of Community Health, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Christian Owoo
- National COVID-19 Treatment Centre, Ga East Municipal Hospital, Ghana Health Service (GHS)
- National COVID-19 Case Management Team, Ministry of Health, Accra, Ghana
- National COVID-19 Treatment Centre, University of Ghana Medical Centre, Accra, Ghana
- Department of Anaesthesia, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Anita O Yawson
- National COVID-19 Treatment Centre, Ga East Municipal Hospital, Ghana Health Service (GHS)
- Department of Anaesthesia, Korle-Bu Teaching Hospital, Accra, Ghana
| | - Joseph A Oliver-Commey
- National COVID-19 Treatment Centre, Ga East Municipal Hospital, Ghana Health Service (GHS)
- National COVID-19 Case Management Team, Ministry of Health, Accra, Ghana
- LEKMA Hospital, La Dadekotopon Municipality, Ghana Health Service, Accra, Ghana
| | - Peter Puplampu
- National COVID-19 Case Management Team, Ministry of Health, Accra, Ghana
- Department of Medicine and Therapeutics, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
- Pentecost Convention Centre- National CoOVID-19 Treatment Centre, Central Region, Ghana
| | - Ali Samba
- Department of Obstetrics & Gynaecology, Korle-Bu Teaching Hospital, Accra, Ghana
| | - Alfred E Yawson
- Department of Community Health, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Margaret Lartey
- Department of Medicine and Therapeutics, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
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Lloyd-Sherlock P, Agrawal S, Gómez-Olivé FX. Pensions, consumption and health: evidence from rural South Africa. BMC Public Health 2020; 20:1577. [PMID: 33081729 PMCID: PMC7576783 DOI: 10.1186/s12889-020-09666-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Accepted: 10/08/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Increasing numbers of older people in sub-Saharan Africa are gaining access to pension benefits and it is often claimed that these benefits promote healthy forms of consumption, which contribute to significant improvements in their health status. However, evidence to support these claims is limited. METHODS The paper uses data for 2701 people aged 60 or over who participated in a population-based study in rural north-eastern South Africa. It analyses effects of receiving a pension on reported food scarcity, body mass index and patterns of consumption. RESULTS The paper finds that living in a pension household is associated with a reduced risk of reported food scarcity and with higher levels of consumption of food and drink. The paper does not find that living in a pension household is associated with a higher prevalence of current smoking nor current alcohol consumption. However, the paper still finds that tobacco and alcohol make up over 40% of reported food and drink consumption, and that the correlation between reported food scarcity and body mass index status is imperfect. CONCLUSIONS The paper does not show significant associations between pension receipt and the selected risk factors. However, the context of prevalent obesity and high shares of household spending allocated to tobacco and alcohol call into question widely-made claims that pensions enhance healthy consumption among older people in low and middle-income countries.
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Affiliation(s)
- Peter Lloyd-Sherlock
- School of International Development, University of East Anglia, Norwich, NR4 7QE, UK.
| | | | - Francesc Xavier Gómez-Olivé
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, University of the Witwatersrand, South Africa. Harvard Center for Population and Development Studies, Harvard University, Harvard, USA
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11
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Mamo Y, Dukessa T, Mortimore A, Dee D, Luintel A, Fordham I, Phillips DIW, Parry EHO, Levene D. Non-communicable disease clinics in rural Ethiopia: why patients are lost to follow-up. Public Health Action 2019; 9:102-106. [PMID: 31803581 DOI: 10.5588/pha.18.0095] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 05/23/2019] [Indexed: 11/10/2022] Open
Abstract
Background Providing medical care for non-communicable diseases (NCDs) in rural sub-Saharan Africa has proved to be difficult because of poor treatment adherence and frequent loss to follow-up (LTFU). The reasons for this are poorly understood. Objective To investigate LTFU among patients with two different but common NCDs who attended rural Ethiopian health centres. Method The study was based in five health centres in southern Ethiopia with established NCD clinics run by nurses and health officers. Patients with epilepsy or hypertension who were lost to follow-up and non-LTFU comparison patients were identified and traced; a questionnaire was administered enquiring about the reasons for LTFU. Results Of the 147 LTFU patients successfully located, 62 had died, moved away or were attending other medical facilities. The remaining 85 patients were compared with 211 non-LFTU patients. The major factors associated with LTFU were distance from the clinic, associated costs and a preference for traditional treatments, together with a misunderstanding of the nature of NCD management. Conclusions The delivery of affordable care closer to the patients' homes has the greatest potential to address the problem of LTFU. Also needed are increased levels of patient education and interaction with traditional healers to explain the nature of NCDs and the need for life-long management.
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Affiliation(s)
- Y Mamo
- Jimma University Chronic Disease Project, Jimma, Ethiopia
| | - T Dukessa
- Jimma University Chronic Disease Project, Jimma, Ethiopia
| | - A Mortimore
- Academic Unit of Primary Care and Population Sciences, University of Southampton, Southampton, UK
| | - D Dee
- Barts and the London School of Medicine, Queen Mary University of London, London, UK
| | - A Luintel
- Hospital for Tropical Diseases, University College, London, UK
| | - I Fordham
- Queen Elizabeth Hospital, Woolwich, London, UK
| | - D I W Phillips
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - E H O Parry
- London School of Hygiene & Tropical Medicine, London, UK
| | - D Levene
- School of Humanities, University of Southampton, Southampton, UK
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Ghimire S, Mishra SR, Baral BK, Dhimal M, Callahan KE, Bista B, Aryal KK. Noncommunicable disease risk factors among older adults aged 60-69 years in Nepal: findings from the STEPS survey 2013. J Hum Hypertens 2019; 33:602-612. [PMID: 30647463 DOI: 10.1038/s41371-019-0161-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 12/04/2018] [Accepted: 12/21/2018] [Indexed: 12/21/2022]
Abstract
Both the noncommunicable diseases (NCDs) burden and the population of older adults are increasing in Nepal. This study aims to estimate the prevalence of behavioral and biological risk factors of common NCDs among Nepali older adults aged 60-69 years. A subsample analysis of data from the 2013 Nepal STEPwise approach to Surveillance (STEPS) survey was conducted with 526 older adults aged 60-69 years. STEPS sample weighting and domain analyses were used to include the entire sample for variance estimation and to obtain prevalence estimates and corresponding 95% confidence intervals (CI) for our selected population of older adults. All participants had at least one risk factor for NCDs; about one-fourth had four. Of the eight examined risk factors, inadequate fruit/vegetable intake (98.6%, 95% CI: 96.9-100.0), hypertension (57.2%, 95% CI: 51.0-63.4), and hypercholesterolemia (37.9%, 95% CI: 30.8-44.9) were ranked the three most prevalent risk factors while physical inactivity (2.5%, 95% CI: 1.0-4.0) was least prevalent. Prevalence of smoking was 31% (95% CI: 24.9-37.2), overweight/obesity was 19% (95% CI: 13.1-25.2), alcohol use was 18% (95% CI: 12.2-23.5), diabetes was 15% (95% CI: 8.5-21.4), and 36% (95% CI: 30.9-42.0) of the older participants suffered discomfort due to oral health problems. Several risk factors, including current alcohol consumption, daily servings of fruit/vegetable intake, and overweight/obesity showed signficant variation in prevalence by gender, ethnicity, and place of residence, urban vs. rural. Epidemiological and demographic transitions are two emerging public health issues in Nepal. The baseline information provided by this study on the prevalence of NCD risk factors among Nepali older adults aged 60-69 years can inform policies and programs that focus on maximizing the health and well-being of older adults.
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Affiliation(s)
- Saruna Ghimire
- School of Community Health Sciences, University of Nevada, Las Vegas, NV, 89154, USA.
| | | | - Binaya Kumar Baral
- Department of Biochemistry, Nepal Medical College and Teaching Hospital, Kathmandu, Nepal
| | - Meghnath Dhimal
- Nepal Health Research Council (NHRC), Ramshah Path, Kathmandu, Nepal
| | - Karen E Callahan
- School of Community Health Sciences, University of Nevada, Las Vegas, NV, 89154, USA
| | - Bihungum Bista
- Nepal Health Research Council (NHRC), Ramshah Path, Kathmandu, Nepal
| | - Krishna Kumar Aryal
- Nepal Health Sector Programme 3 (NHSP3), Monitoring Evaluation and Operational Research Project, Abt Associates, Lalitpur, Nepal
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Trends of mortality attributable to child and maternal undernutrition, overweight/obesity and dietary risk factors of non-communicable diseases in sub-Saharan Africa, 1990-2015: findings from the Global Burden of Disease Study 2015. Public Health Nutr 2018; 22:827-840. [PMID: 30509334 DOI: 10.1017/s1368980018002975] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To assess trends of mortality attributable to child and maternal undernutrition (CMU), overweight/obesity and dietary risks of non-communicable diseases (NCD) in sub-Saharan Africa (SSA) using data from the Global Burden of Disease (GBD) Study 2015. DESIGN For each risk factor, a systematic review of data was used to compute the exposure level and the effect size. A Bayesian hierarchical meta-regression analysis was used to estimate the exposure level of the risk factors by age, sex, geography and year. The burden of all-cause mortality attributable to CMU, fourteen dietary risk factors (eight diets, five nutrients and fibre intake) and overweight/obesity was estimated. SETTING Sub-Saharan Africa.ParticipantsAll age groups and both sexes. RESULTS In 2015, CMU, overweight/obesity and dietary risks of NCD accounted for 826204 (95 % uncertainty interval (UI) 737346, 923789), 266768 (95 % UI 189051, 353096) and 558578 (95 % UI 453433, 680197) deaths, respectively, representing 10·3 % (95 % UI 9·1, 11·6 %), 3·3 % (95 % UI 2·4, 4·4 %) and 7·0 % (95 % UI 5·8, 8·3 %) of all-cause mortality. While the age-standardized proportion of all-cause mortality accounted for by CMU decreased by 55·2 % between 1990 and 2015 in SSA, it increased by 63·3 and 17·2 % for overweight/obesity and dietary risks of NCD, respectively. CONCLUSIONS The increasing burden of diet- and obesity-related diseases and the reduction of mortality attributable to CMU indicate that SSA is undergoing a rapid nutritional transition. To tackle the impact in SSA, interventions and international development agendas should also target dietary risks associated with NCD and overweight/obesity.
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14
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Endriyas M, Mekonnen E, Dana T, Daka K, Misganaw T, Ayele S, Shiferaw M, Tessema T, Getachew T. Burden of NCDs in SNNP region, Ethiopia: a retrospective study. BMC Health Serv Res 2018; 18:520. [PMID: 29973219 PMCID: PMC6031105 DOI: 10.1186/s12913-018-3298-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 06/14/2018] [Indexed: 12/19/2022] Open
Abstract
Background Non-communicable diseases (NCDs) are medical conditions or diseases that are non-transmissible. As NCDs are becoming one of major public health problem, providing local description of diseases and injuries is key to health decision- making and planning processes. So, this study aimed to describe caseload of NCDs in Southern Nations Nationalities and People’s Region, Ethiopia. Methods A facility based retrospective study was conducted in February 2015 in SNNPR, Ethiopia. A total of 22,320 records of three years retrieved from 23 health facilities using systematic sampling. Data were entered in to Epi-Info 3.5.3 and descriptive analysis was carried out using SPSS version 20. Results From 22,320 records reviewed, 6633 (29.7%) clients visited health facilities due to Non-Communicable Diseases (NCDs). Majority (37.2%) of NCD cases were in productive age groups (20–35 year). Near to half (43%) of NCD cases were from rural and 45.8% were females. Digestive disorder (26.7%), cardiovascular diseases (18.8%) and Diabetes Mellitus (13.1%) were the most prevalent types of NCDs. Conclusion Health facilities are burdened with significant proportion of clients with NCDs. Young population accounts large share and NCDs are becoming public health problem of urban and rural area within a health care system that focus on communicable diseases. There is a need to strengthen the health system to work towards NCDs, and investigate risk factors associated with NCDs at individual level.
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Affiliation(s)
| | | | - Tadele Dana
- College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Kassa Daka
- College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | | | | | | | | | - Tewodros Getachew
- College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
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15
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Tianyi FL, Agbor VN, Njamnshi AK. Prevalence, awareness, treatment, and control of hypertension in Cameroonians aged 50 years and older: A community-based study. Health Sci Rep 2018; 1:e44. [PMID: 30623073 PMCID: PMC6266375 DOI: 10.1002/hsr2.44] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 02/18/2018] [Accepted: 04/02/2018] [Indexed: 01/11/2023] Open
Abstract
AIMS To assess the prevalence of hypertension (HTN) in a rural elderly population (50 y and older) in Cameroon; evaluate the rates of awareness, treatment, and control of HTN in this population; and describe factors associated with HTN in this population. METHODS AND RESULTS A total of 501 participants aged 50 years and older were randomly recruited from May to July 2013 in a house-to-house survey of the Batibo Health District. Data were measured using standardized methods modelled after the World Health Organization STEPwise approach to Surveillance. The Statistical Package for the Social Sciences version 20.0 was used for statistical analysis. Chi-square, Fisher's exact or Student T test were used to compare variables. A multivariable logistic regression analysis was used to identify factors associated with HTN in this population. In our study population, 31% of the participants were men, with a mean age of 65.4 ± 8 years; women had a mean age of 61.4 ± 9 years. The prevalence of HTN was 57.3% (95% CI, 52.9-61.6). The awareness rate was 63.4%, treatment rate 96.7%, and control rate 32.4%. Being overweight/obese was independently associated with HTN in this group (odds ratio = 3.46; 95% CI, 2.38-5.03; P < .001). CONCLUSION The prevalence of HTN amongst the elderly in the Batibo Health District is high. Emphasis should be on patient education to improve the rates of blood pressure control amongst patients on treatment for HTN. Healthy lifestyle measures such as reduction in salt intake and increase in physical exercise should be encouraged amongst the elderly.
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Affiliation(s)
- Frank L. Tianyi
- Mayo‐Darlé Sub‐divisional HospitalBanyoAdamawa RegionCameroon
| | | | - Alfred K. Njamnshi
- Faculty of Medicine and Biomedical SciencesThe University of Yaoundé IYaoundéCameroon
- Brain Research Africa Initiative (BRAIN)YaoundeCameroon
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16
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Bosu WK, Aheto JMK, Zucchelli E, Reilly S. Prevalence, awareness, and associated risk factors of hypertension in older adults in Africa: a systematic review and meta-analysis protocol. Syst Rev 2017; 6:192. [PMID: 28978358 PMCID: PMC5628476 DOI: 10.1186/s13643-017-0585-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Accepted: 09/22/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The health of older persons has not been a major priority in many African countries. Hypertension is one of the common health problems of older persons. However, there is little information on the prevalence of hypertension in older adults in Africa. This is in spite of the fact that Africa has the highest age-standardized prevalence of hypertension in the world. We therefore present this protocol to conduct a systematic review and meta-analysis on the prevalence of hypertension and the level of its awareness among older persons living in Africa. METHODS Major databases (EMBASE, MEDLINE, Academic Search Complete, CINAHL, PsycINFO) and unpublished literature will be searched to identify population-based studies on hypertension in adults aged 50 years and older living in Africa. Eligible articles are those which use the 140/90-mmHg cutoff to diagnose hypertension and were published from 1980 to present. We will exclude subjects in restricted environments such as patients and refugees. Articles will be independently evaluated by two reviewers to determine if they meet the inclusion criteria. They will also evaluate the quality of included studies using a validated tool by Hoy and colleagues for prevalence studies. The main outcome is the prevalence of hypertension while the explanatory variables include demographic, socio-economic, dietary, lifestyle and behavioural factors. Effect sizes in bivariate and multivariate analyses will be presented as odds or prevalence ratios. We will explore for heterogeneity of the standard errors across the studies, and if appropriate, we will perform a meta-analysis using a random-effects model to present a summary estimate of the prevalence of hypertension in this population. DISCUSSION The estimates of the prevalence, the risk factors and the level of awareness of hypertension could help in galvanizing efforts at prioritizing the cardiovascular health of older persons in Africa. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42017056474.
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Affiliation(s)
- William K Bosu
- West African Health Organisation (WAHO), 175 Avenue Ouezzin Coulibaly, 01 BP 153, Bobo-Dioulasso, Burkina Faso. .,Division of Health Research, Faculty of Health & Medicine, Lancaster University, Furness Building, Lancaster, LA1 4YG, UK.
| | - Justice M K Aheto
- School of Public Health, University of Ghana, LG 13, Legon, Accra, Ghana
| | - Eugenio Zucchelli
- Division of Health Research, Faculty of Health & Medicine, Lancaster University, Furness Building, Lancaster, LA1 4YG, UK
| | - Siobhan Reilly
- Division of Health Research, Faculty of Health & Medicine, Lancaster University, Furness Building, Lancaster, LA1 4YG, UK
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Tenkorang EY, Kuuire VZ. Noncommunicable Diseases in Ghana: Does the Theory of Social Gradient in Health Hold? HEALTH EDUCATION & BEHAVIOR 2017; 43:25S-36S. [PMID: 27037145 DOI: 10.1177/1090198115602675] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The theory of social gradient in health posits that individuals with lower socioeconomic status (SES) have poorer health outcomes, compared with those in higher socioeconomic brackets. Applied to noncommunicable diseases (NCDs), this theory has largely been corroborated by studies from the West. However, evidence from sub-Saharan Africa are mixed, with those from Ghana conspicuously missing in the literature. Using data from the Study on Global Ageing and Adult Health, and applying random-effects C log-log models, this study examined the relationship between SES and the risks of living with NCDs in Ghana. Results confirmed a negative social gradient, as Ghanaians with higher SES were more likely to live with NCDs compared with those with low SES. The addition of lifestyle factors attenuated the risks of living with NCDs among Ghanaian men and women with higher SES. This study underscores the need for policies targeted at specific socioeconomic and demographic groups, such as the emerging middle and upper class Ghanaians. It is similarly important for interventions to move beyond biomedical solutions that put more emphasis on epidemiological risk factors to strategies that embrace psychosocial factors as important correlates of cardiovascular health.
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Affiliation(s)
- Eric Y Tenkorang
- Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada
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18
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Melaku YA, Temesgen AM, Deribew A, Tessema GA, Deribe K, Sahle BW, Abera SF, Bekele T, Lemma F, Amare AT, Seid O, Endris K, Hiruye A, Worku A, Adams R, Taylor AW, Gill TK, Shi Z, Afshin A, Forouzanfar MH. The impact of dietary risk factors on the burden of non-communicable diseases in Ethiopia: findings from the Global Burden of Disease study 2013. Int J Behav Nutr Phys Act 2016; 13:122. [PMID: 27978839 PMCID: PMC5159959 DOI: 10.1186/s12966-016-0447-x] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Accepted: 11/10/2016] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The burden of non-communicable diseases (NCDs) has increased in sub-Saharan countries, including Ethiopia. The contribution of dietary behaviours to the NCD burden in Ethiopia has not been evaluated. This study, therefore, aimed to assess diet-related burden of disease in Ethiopia between 1990 and 2013. METHOD We used the 2013 Global Burden of Disease (GBD) data to estimate deaths, years of life lost (YLLs) and disability-adjusted life years (DALYs) related to eight food types, five nutrients and fibre intake. Dietary exposure was estimated using a Bayesian hierarchical meta-regression. The effect size of each diet-disease pair was obtained based on meta-analyses of prospective observational studies and randomized controlled trials. A comparative risk assessment approach was used to quantify the proportion of NCD burden associated with dietary risk factors. RESULTS In 2013, dietary factors were responsible for 60,402 deaths (95% Uncertainty Interval [UI]: 44,943-74,898) in Ethiopia-almost a quarter (23.0%) of all NCD deaths. Nearly nine in every ten diet-related deaths (88.0%) were from cardiovascular diseases (CVD) and 44.0% of all CVD deaths were related to poor diet. Suboptimal diet accounted for 1,353,407 DALYs (95% UI: 1,010,433-1,672,828) and 1,291,703 YLLs (95% UI: 961,915-1,599,985). Low intake of fruits and vegetables and high intake of sodium were the most important dietary factors. The proportion of NCD deaths associated with low fruit consumption slightly increased (11.3% in 1990 and 11.9% in 2013). In these years, the rate of burden of disease related to poor diet slightly decreased; however, their contribution to NCDs remained stable. CONCLUSIONS Dietary behaviour contributes significantly to the NCD burden in Ethiopia. Intakes of diet low in fruits and vegetables and high in sodium are the leading dietary risks. To effectively mitigate the oncoming NCD burden in Ethiopia, multisectoral interventions are required; and nutrition policies and dietary guidelines should be developed.
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Affiliation(s)
- Yohannes Adama Melaku
- School of Public Health, Mekelle University, Mekelle, Ethiopia
- Population Research and Outcome Studies, School of Medicine, The University of Adelaide, Adelaide, SA Australia
| | | | - Amare Deribew
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
- Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
- St. Paul Millennium Medical College, Addis Ababa, Ethiopia
| | - Gizachew Assefa Tessema
- Department of Reproductive Health, University of Gondar, Gondar, Ethiopia
- School of Public Health, The University of Adelaide, Adelaide, Australia
| | - Kebede Deribe
- Brighton & Sussex Medical School, Brighton, UK
- School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
- Federal Ministry of Health, Addis Ababa, Ethiopia
| | - Berhe W. Sahle
- School of Public Health, Mekelle University, Mekelle, Ethiopia
- Centre of Cardiovascular Research & Education in Therapeutics, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC Australia
| | - Semaw Ferede Abera
- School of Public Health, Mekelle University, Mekelle, Ethiopia
- Institute of Biological Chemistry and Nutrition, Hohenheim University, Stuttgart, Germany
| | - Tolesa Bekele
- Department of Public Health, Madda Walabu University, Bale Goba, Ethiopia
| | - Ferew Lemma
- Federal Ministry of Health, Addis Ababa, Ethiopia
| | - Azmeraw T. Amare
- Discipline of Psychiatry, School of Medicine, The University of Adelaide, Adelaide, Australia
- School of Medicine and Health Sciences, Bahir dar University, Bahir Dar, Ethiopia
- Department of Epidemiology, University Medical Center Groningen, the University of Groningen, Groningen, The Netherlands
| | - Oumer Seid
- School of Public Health, Mekelle University, Mekelle, Ethiopia
| | - Kedir Endris
- School of Public Health, Mekelle University, Mekelle, Ethiopia
| | - Abiy Hiruye
- Federal Ministry of Health, Addis Ababa, Ethiopia
| | - Amare Worku
- Department of Public Health, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | - Robert Adams
- Health observatory, Discipline of Medicine, The Queen Elizabeth Hospital Campus, The University of Adelaide, Adelaide, Australia
| | - Anne W. Taylor
- Population Research and Outcome Studies, School of Medicine, The University of Adelaide, Adelaide, SA Australia
| | - Tiffany K. Gill
- Population Research and Outcome Studies, School of Medicine, The University of Adelaide, Adelaide, SA Australia
| | - Zumin Shi
- Population Research and Outcome Studies, School of Medicine, The University of Adelaide, Adelaide, SA Australia
| | - Ashkan Afshin
- Institute of Health Metrics and Evaluation, University of Washington, Seattle, USA
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Mugisha JO, Schatz EJ, Randell M, Kuteesa M, Kowal P, Negin J, Seeley J. Chronic disease, risk factors and disability in adults aged 50 and above living with and without HIV: findings from the Wellbeing of Older People Study in Uganda. Glob Health Action 2016; 9:31098. [PMID: 27225792 PMCID: PMC4880619 DOI: 10.3402/gha.v9.31098] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 04/27/2016] [Accepted: 04/27/2016] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Data on the prevalence of chronic conditions, their risk factors, and their associations with disability in older people living with and without HIV are scarce in sub-Saharan Africa. OBJECTIVES In older people living with and without HIV in sub-Saharan Africa: 1) to describe the prevalence of chronic conditions and their risk factors and 2) to draw attention to associations between chronic conditions and disability. METHODS Cross-sectional individual-level survey data from people aged 50 years and over living with and without HIV were analyzed from three study sites in Uganda. Diagnoses of chronic conditions were made through self-report, and disability was determined using the WHO Disability Assessment Schedule (WHODAS). We used ordered logistic regression and calculated predicted probabilities to show differences in the prevalence of multiple chronic conditions across HIV status, age groups, and locality. We used linear regression to determine associations between chronic conditions and the WHODAS. RESULTS In total, 471 participants were surveyed; about half the respondents were living with HIV. The prevalence of chronic obstructive pulmonary disease and eye problems (except for those aged 60-69 years) was higher in the HIV-positive participants and increased with age. The prevalence of diabetes and angina was higher in HIV-negative participants. The odds of having one or more compared with no chronic conditions were higher in women (OR 1.6, 95% CI 1.1-2.3) and in those aged 70 years and above (OR 2.1, 95% CI 1.2-3.6). Sleep problems (coefficient 14.2, 95% CI 7.3-21.0) and depression (coefficient 9.4, 95% CI 1.2-17.0) were strongly associated with higher disability scores. CONCLUSION Chronic conditions are common in older adults and affect their functioning. Many of these conditions are not currently addressed by health services in Uganda. There is a need to revise health care policy and practice in Uganda to consider the health needs of older people, particularly as the numbers of people living into older age with HIV and other chronic conditions are increasing.
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Affiliation(s)
- Joseph O Mugisha
- MRC/UVRI, Uganda Research Unit on AIDS, Uganda
- Department of Health Sciences, University of Missouri Columbia, Missouri, USA;
| | - Enid J Schatz
- Department of Health Sciences, University of Missouri Columbia, Missouri, USA
| | | | | | - Paul Kowal
- World Health Organization, Study on global AGEing and adult health, Geneva, Switzerland
- Research Centre for Gender, Health and Ageing, University of Newcastle, Australia
| | - Joel Negin
- School of Public Health, University of Sydney, Australia
| | - Janet Seeley
- MRC/UVRI, Uganda Research Unit on AIDS, Uganda
- London School of Hygiene and Tropical Medicine, London UK
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Guidolin BL, Silva Filho IGD, Nogueira EL, Ribeiro Junior FP, Cataldo Neto A. Patterns of alcohol use in an elderly sample enrolled in the Family Health Strategy program in the city of Porto Alegre, Brazil. CIENCIA & SAUDE COLETIVA 2016; 21:27-35. [PMID: 26816160 DOI: 10.1590/1413-81232015211.10032015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Accepted: 08/24/2015] [Indexed: 11/22/2022] Open
Abstract
This article aims to determine the pattern of alcohol use in the elderly and its associations with sociodemographic characteristics in an elderly sample of patients from the city of Porto Alegre, Rio Grande do Sul, Brazil. A cross-sectional study was conducted involving 557 seniors, aged 60 years or more, through application of the Mini International Neuropsychiatric Interview and a global assessment questionnaire for the elderly. The majority of the 557 senior citizens did not complete elementary school (58.3%), were white (65.1%), married (37.6%), had no caregiver (62.2%), were catholic (65.5%) and practicing their religion (68.6%), were retired (67.7%), and had a personal income of up to one minimum salary (56.1%). The study revealed 67 (12%) elderly people with a history of alcoholism, of which 17 (3.1%) had a diagnosis of current alcoholism, 50 (9%) had a history of alcohol dependence in the past and 16 (2.9%) had a current alcohol abuse problem. Men had a prevalence ratio of 11.6 times for a history of alcoholism in comparison to women. The results confirm that alcoholism is frequent in the population of Brazilian elderly, drawing attention to some socio-demographic characteristics that can make a difference in the early diagnosis of alcoholism.
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Affiliation(s)
- Bruno Luiz Guidolin
- Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brasil,
| | | | | | | | - Alfredo Cataldo Neto
- Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brasil,
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Kimani K, Namukwaya E, Grant L, Murray SA. What is known about heart failure in sub-Saharan Africa: a scoping review of the English literature. BMJ Support Palliat Care 2016; 7:122-127. [DOI: 10.1136/bmjspcare-2015-000924] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Revised: 11/10/2015] [Accepted: 12/17/2015] [Indexed: 11/03/2022]
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Wandera SO, Kwagala B, Ntozi J. Prevalence and risk factors for self-reported non-communicable diseases among older Ugandans: a cross-sectional study. Glob Health Action 2015. [PMID: 26205363 PMCID: PMC4513181 DOI: 10.3402/gha.v8.27923] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background There is limited evidence about the prevalence and risk factors for non-communicable diseases (NCDs) among older Ugandans. Therefore, this article is aimed at investigating the prevalence of self-reported NCDs and their associated risk factors using a nationally representative sample. Design We conducted a secondary analysis of the 2010 Uganda National Household Survey (UNHS) using a weighted sample of 2,382 older people. Frequency distributions for descriptive statistics and Pearson chi-square tests to identify the association between self-reported NCDs and selected explanatory variables were done. Finally, multivariable complementary log–log regressions to estimate the risk factors for self-reported NCDs among older people in Uganda were done. Results About 2 in 10 (23%) older persons reported at least one NCD [including hypertension (16%), diabetes (3%), and heart disease (9%)]. Among all older people, reporting NCDs was higher among those aged 60–69 and 70–79; Muslims; and Pentecostals and Seventh Day Adventists (SDAs). In addition, the likelihood of reporting NCDs was higher among older persons who depended on remittances and earned wages; owned a bicycle; were sick in the last 30 days; were disabled; and were women. Conversely, the odds of reporting NCDs were lower for those who were relatives of household heads and were poor. Conclusions In Uganda, self-reported NCDs were associated with advanced age, being a woman, having a disability, ill health in the past 30 days, being rich, depended on remittances and earning wages, being Muslim, Pentecostal and SDAs, and household headship. The Ministry of Health should prevent and manage NCDs by creating awareness in the public and improving the supply of essential drugs for these health conditions. Finally, there is a need for specialised surveillance studies of older people to monitor the trends and patterns of NCDs over time.
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Affiliation(s)
- Stephen Ojiambo Wandera
- Department of Population Studies, School of Statistics and Planning, College of Business and Management Sciences, Makerere University, Kampala, Uganda;
| | - Betty Kwagala
- Department of Population Studies, School of Statistics and Planning, College of Business and Management Sciences, Makerere University, Kampala, Uganda
| | - James Ntozi
- Department of Population Studies, School of Statistics and Planning, College of Business and Management Sciences, Makerere University, Kampala, Uganda
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Wu F, Guo Y, Chatterji S, Zheng Y, Naidoo N, Jiang Y, Biritwum R, Yawson A, Minicuci N, Salinas-Rodriguez A, Manrique-Espinoza B, Maximova T, Peltzer K, Phaswanamafuya N, Snodgrass JJ, Thiele E, Ng N, Kowal P. Common risk factors for chronic non-communicable diseases among older adults in China, Ghana, Mexico, India, Russia and South Africa: the study on global AGEing and adult health (SAGE) wave 1. BMC Public Health 2015; 15:88. [PMID: 25885218 PMCID: PMC4335695 DOI: 10.1186/s12889-015-1407-0] [Citation(s) in RCA: 101] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2014] [Accepted: 01/13/2015] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Behavioral risk factors such as tobacco use, unhealthy diet, insufficient physical activity and the harmful use of alcohol are known and modifiable contributors to a number of NCDs and health mediators. The purpose of this paper is to describe the distribution of main risk factors for NCDs by socioeconomic status (SES) among adults aged 50 years and older within a country and compare these risk factors across six lower- and upper-middle income countries. METHODS The study population in this paper draw from SAGE Wave 1 and consisted of adults aged 50-plus from China (N=13,157), Ghana (N=4,305), India (N=6,560), Mexico (N=2,318), the Russian Federation (N=3,938) and South Africa (N=3,836). Seven main common risk factors for NCDs were identified: daily tobacco use, frequent heavy drinking, low level physical activity, insufficient vegetable and fruit intake, high risk waist-hip ratio, obesity and hypertension. Multiple risk factors were also calculated by summing all these risk factors. RESULTS The prevalence of daily tobacco use ranged from 7.7% (Ghana) to 46.9% (India), frequent heavy drinker was the highest in China (6.3%) and lowest in India (0.2%), and the highest prevalence of low physical activity was in South Africa (59.7%). The highest prevalence of respondents with high waist-to-hip ratio risk was 84.5% in Mexico, and the prevalence of self-reported hypertension ranging from 33% (India) to 78% (South Africa). Obesity was more common in South Africa, the Russia Federation and Mexico (45.2%, 36% and 28.6%, respectively) compared with China, India and Ghana (15.3%, 9.7% and 6.4%, respectively). China, Ghana and India had a higher prevalence of respondents with multiple risk factors than Mexico, the Russia Federation and South Africa. The occurrence of three and four risk factors was more prevalent in Mexico, the Russia Federation and South Africa. CONCLUSION There were substantial variations across countries and settings, even between upper-middle income countries and lower-middle income countries. The baseline information on the magnitude of the problem of risk factors provided by this study can help countries and health policymakers to set up interventions addressing the global non-communicable disease epidemic.
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Affiliation(s)
- Fan Wu
- Shanghai Municipal Centre for Disease Control (Shanghai CDC), 1380 Zhongshan Rd (W), Shanghai, 200336, P.R. China.
| | - Yanfei Guo
- Shanghai Municipal Centre for Disease Control (Shanghai CDC), 1380 Zhongshan Rd (W), Shanghai, 200336, P.R. China.
| | | | - Yang Zheng
- Shanghai Municipal Centre for Disease Control (Shanghai CDC), 1380 Zhongshan Rd (W), Shanghai, 200336, P.R. China.
| | - Nirmala Naidoo
- World Health Organization, HIS/HSI/MCS, Geneva, Switzerland.
| | - Yong Jiang
- National Center for Chronic and Noncommunicable Disease Control and Prevention (NCNCD), Chinese Center for Disease Control and Prevention (China CDC), Beijing, P.R. China.
| | - Richard Biritwum
- Department of Community Health, University of Ghana Medical School, Accra, Ghana.
| | - Alfred Yawson
- Department of Community Health, University of Ghana Medical School, Accra, Ghana.
| | - Nadia Minicuci
- Department of Community Health, University of Ghana Medical School, Accra, Ghana.
- National Research Council, Institute of Neuroscience, Padova, Italy.
| | | | | | - Tamara Maximova
- Russian Academy of Medical Sciences, Moscow, Russian Federation.
| | - Karl Peltzer
- University of Limpopo, Turfloop, South Africa.
- Mahidol University, Salaya, Thailand.
- Human Sciences Research Council, Port Elizabeth/Pretoria, South Africa.
| | - Nancy Phaswanamafuya
- Human Sciences Research Council, Port Elizabeth/Pretoria, South Africa.
- Office of the Deputy Vice Chancellor: Research and Engagement, Nelson Mandela Metropolitan University, Port Elizabeth, South Africa.
| | - James J Snodgrass
- Department of Anthropology, University of Oregon, Eugene, Oregon, USA.
| | | | - Nawi Ng
- Epidemiology and Global Health, Umeå University, Umeå, Sweden.
| | - Paul Kowal
- World Health Organization, HIS/HSI/MCS, Geneva, Switzerland.
- University of Newcastle Research Centre for Gender, Health and Ageing, Newcastle, Australia.
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Adeloye D, Basquill C. Estimating the prevalence and awareness rates of hypertension in Africa: a systematic analysis. PLoS One 2014; 9:e104300. [PMID: 25090232 PMCID: PMC4121276 DOI: 10.1371/journal.pone.0104300] [Citation(s) in RCA: 155] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2014] [Accepted: 07/10/2014] [Indexed: 12/14/2022] Open
Abstract
Background The burden of hypertension is high in Africa, and due to rapid population growth and ageing, the exact burden on the continent is still far from being known. We aimed to estimate the prevalence and awareness rates of hypertension in Africa based on the cut off “≥140/90 mm Hg”. Methods We conducted a systematic search of Medline, EMBASE and Global Health. Search date was set from January 1980 to December 2013. We included population-based studies on hypertension, conducted among people aged ≥15 years and providing numerical estimates on the prevalence of hypertension in Africa. Overall pooled prevalence of hypertension in mixed, rural and urban settings in Africa were estimated from reported crude prevalence rates. A meta-regression epidemiological modelling, using United Nations population demographics for the years 1990, 2000, 2010 and 2030, was applied to determine the prevalence rates and number of cases of hypertension in Africa separately for these four years. Results Our search returned 7680 publications, 92 of which met the selection criteria. The overall pooled prevalence of hypertension in Africa was 19.7% in 1990, 27.4% in 2000 and 30.8% in 2010, each with a pooled awareness rate (expressed as percentage of hypertensive cases) of 16.9%, 29.2% and 33.7%, respectively. From the modelling, over 54.6 million cases of hypertension were estimated in 1990, 92.3 million cases in 2000, 130.2 million cases in 2010, and a projected increase to 216.8 million cases of hypertension by 2030; each with an age-adjusted prevalence of 19.1% (13.9, 25.5), 24.3% (23.3, 31.6), 25.9% (23.5, 34.0), and 25.3% (24.3, 39.7), respectively. Conclusion Our findings suggest the prevalence of hypertension is increasing in Africa, and many hypertensive individuals are not aware of their condition. We hope this research will prompt appropriate policy response towards improving the awareness, control and overall management of hypertension in Africa.
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Affiliation(s)
- Davies Adeloye
- Centre for Population Health Sciences, University of Edinburgh Medical School, Edinburgh, Midlothian, United Kingdom
- * E-mail:
| | - Catriona Basquill
- Centre for Population Health Sciences, University of Edinburgh Medical School, Edinburgh, Midlothian, United Kingdom
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Peltzer K, Phaswana-Mafuya N. Tobacco Use and Associated Factors in Older Adults in South Africa. JOURNAL OF PSYCHOLOGY IN AFRICA 2014. [DOI: 10.1080/14330237.2012.10820532] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Karl Peltzer
- Human Sciences Research Council, Pretoria, South Africa University of Limpopo, Turfloop, South Africa
| | - Nancy Phaswana-Mafuya
- Human Sciences Research Council, Pretoria, South Africa Nelson Mandela Metropolitan University, Port Elizabeth, South Africa
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Peltzer K, Phaswana-Mafuya N. Hypertension and associated factors in older adults in South Africa. Cardiovasc J Afr 2014; 24:67-71. [PMID: 23736129 PMCID: PMC3721893 DOI: 10.5830/cvja-2013-002] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2012] [Accepted: 01/11/2013] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Older adults are disproportionately affected by hypertension, which is an established risk factor for cardiovascular disease. Little attention has been focused on hypertension and associated factors among older adults in Africa. Therefore, this study aimed to investigate the prevalence and associated factors of hypertension in a national sample of older South Africans who participated in the Study of Global Ageing and Adults' Health (SAGE) in 2008. METHODS In 2008 we conducted a national, population-based, cross-sectional study of a sample of 3 840 subjects aged 50 years or older in South Africa. The questionnaire included socio-demographic characteristics, health variables, and anthropometric and blood pressure measurements. RESULTS The prevalence of hypertension in the sample population was 77.3% (male 74.4%, female 79.6%). The rates of awareness, treatment and control among the hypertensive participants were 38.1, 32.7 and 17.1%, respectively. The results of multivariate logistic regression analysis revealed that the prevalence of hypertension was associated with being in the Coloured population group, having had a stroke, being overweight or obese and having had five or more out-patients care visits in the past 12 months. Hypertension was inversely associated with current alcohol use. CONCLUSION This study revealed high rates of hypertension among older adults (50 years and more) in South Africa, which puts them at risk for cardiovascular disease. The percentages of hypertensive subjects who were aware, treated and controlled were very low. These data underscore the urgent need to strengthen the public health education and blood pressure-monitoring systems to better manage hypertension among older adults in South Africa.
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Affiliation(s)
- Karl Peltzer
- HIV/AIDS/SIT and TB HAST, Human Sciences Research Council, Pretoria, South Africa.
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Ogunmola OJ, Olaifa AO, Oladapo OO, Babatunde OA. Prevalence of cardiovascular risk factors among adults without obvious cardiovascular disease in a rural community in Ekiti State, Southwest Nigeria. BMC Cardiovasc Disord 2013; 13:89. [PMID: 24138186 PMCID: PMC4016363 DOI: 10.1186/1471-2261-13-89] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2013] [Accepted: 10/10/2013] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Cardiovascular disease worldwide is largely driven by modifiable risk factors. This study sought to identify and determine the prevalence of traditional cardiovascular risk factors according to sex in inhabitants of a rural community in a developing country. METHODS This cross-sectional study included participants aged ≥40 years in the rural community of Aaye Ekiti, Ekiti State, Southwest Nigeria. All participants who met the inclusion criteria were drawn from the 161 households in the community. Data on the following were collected: arterial hypertension, diabetes mellitus, obesity, dyslipidaemia, smoking, physical activity, alcohol consumption, and sociodemographic parameters. These were analysed with SPSS version 16.0 software. RESULTS The 104 participants (33 male, 71 female) had a mean age (± standard deviation) of 66.77 ± 12.06 years (range, 40-88 years). The majority of the participants (56.7%) were aged 60-79 years. Hypertension was present in 66.4%, diabetes mellitus in 4.8%, abdominal obesity in 38.46%, smoking in 2.9%, physical inactivity in 29.8%, and high alcohol consumption in 1%. Dyslipidaemia, as represented by low HDL-C, occurred in 30%. There were borderline high levels of TC in 4.5%, LDL-C in 1.1%, and TG in 12.5%, but no subject had a high level. Abdominal obesity, alcohol consumption and smoking were statistically significantly associated with sex. CONCLUSION In this study, traditional cardiovascular risk factors, apart from hypertension, obesity, physical inactivity and low HDL-C had a low prevalence in the rural Nigerian community. However, the high prevalence of hypertension in this poor community suggests a high risk of a future cardiovascular event.
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Affiliation(s)
- Olarinde J Ogunmola
- Department of Internal Medicine, Cardiac Centre, Federal Medical Centre, Ido-Ekiti, Ekiti State, Nigeria
| | - Adeleke O Olaifa
- Department of Internal Medicine, Federal Medical Centre, Ido-Ekiti, Ekiti State, Nigeria
| | - Olutoyin O Oladapo
- Division of Cardiovascular Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Oluwole A Babatunde
- Department of Community Medicine, Federal Medical Centre, Ido-Ekiti, Ekiti State, Nigeria
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Phaswana-Mafuya N, Peltzer K, Chirinda W, Musekiwa A, Kose Z. Sociodemographic predictors of multiple non-communicable disease risk factors among older adults in South Africa. Glob Health Action 2013; 6:20680. [PMID: 24044582 PMCID: PMC3776324 DOI: 10.3402/gha.v6i0.20680] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Revised: 08/22/2013] [Accepted: 08/24/2013] [Indexed: 01/22/2023] Open
Abstract
Background and objective Unhealthy lifestyle behaviours are important risk factors of morbidity and mortality. This study aimed to explore the sociodemographic predictors of multiple non-communicable disease (NCD) risk factors experienced by elderly South Africans. Methods We conducted a national population-based cross-sectional survey with a sample of 3,840 individuals aged 50 years or above in South Africa in 2008. The outcome variable was the co-existence of multiple NCD risk factors (tobacco use, alcohol, physical inactivity, fruit and vegetable intake, overweight or obesity, and hypertension) in each individual. The exposure variables were sociodemographic characteristics, namely, age, gender, education, wealth status, population group, marital status, and residence. Multivariate linear regression was used to assess the association between sociodemographic variables and multiple NCD risk factors. Results The mean number of NCD risk factors among all participants was three (95% confidence interval: 2.81–3.10). Multivariate linear regression analysis revealed that being female, being in the age group of 60–69 years, and being from the Coloured and Black African race were associated with a higher number of NCD risk factors. Marital status, educational level, wealth, and residence were not significantly associated with the number of NCD risk factors experienced. Conclusions The co-existence of multiple lifestyle NCD risk factors among the elderly is a public health concern. Comprehensive health-promotion interventions addressing the co-existence of multiple NCD risk factors tailored for specific sociodemographic groups are needed.
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Affiliation(s)
- Nancy Phaswana-Mafuya
- HIV/AIDS/STI/and TB (HAST), Human Sciences Research Council, Pretoria, Port Elizabeth, South Africa; Office of the Deputy Vice Chancellor, Nelson Mandela Metropolitan University, Port Elizabeth, South Africa;
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Peltzer K, Phaswana-Mafuya N. Problem drinking and associated factors in older adults in South Africa. ACTA ACUST UNITED AC 2013; 16:104-9. [PMID: 23595529 DOI: 10.4314/ajpsy.v16i2.13] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2012] [Accepted: 02/28/2012] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Alcohol abuse poses special risks for increased morbidity and mortality among older adults. Little attention has focused on assessing alcohol use and associated factors among older adults in transitional societies such as South Africa. This study aimed to determine the prevalence of alcohol use and associated factors in older South Africans who participated in the Study of Global Ageing and Adults Health (SAGE) in 2008. METHOD We conducted a national population-based cross-sectional study with a sample of 3840 aged 50 years or older in South Africa in 2008. In this study we analysed data from all 2144 participants who were over 60 years old. The questionnaire included socio-demographic characteristics, alcohol intake as well as comorbidity. Risky drinking was defined in two ways: heavy drinkers (>7 drinks/week) and binge drinkers (>3 drinks/one occasion/week). RESULTS Four percent of participants reported heavy drinking and 3.7% binge drinking. Male gender (Odds Ratio (OR) =3.79, Confidence Interval (CI) =1.38-10.37) and white population group (OR=3.01, CI=1.31-6.89) were associated with risky drinking in multivariate analysis; as well as tobacco use (OR=5.25, CI=2.20-12.52) and not being obese (OR=0.14, CI=0.05-0.35). Hypertension, diabetes and depression were not associated. CONCLUSION This study reveals moderate rates of risky drinking among older adults (60 years and more) in South Africa that puts them at risk of morbidity. Alcohol problems among older adults are commonly under-recognized, indicating a need for health care worker intervention.
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Affiliation(s)
- K Peltzer
- Human Sciences Research Council, Pretoria South Africa.
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Lo TQ, Oeltmann JE, Odhiambo FO, Beynon C, Pevzner E, Cain KP, Laserson KF, Phillips-Howard PA. Alcohol use, drunkenness and tobacco smoking in rural western Kenya. Trop Med Int Health 2013; 18:506-15. [PMID: 23489316 DOI: 10.1111/tmi.12066] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To describe the prevalence of smoking and alcohol use and abuse in an impoverished rural region of western Kenya. METHODS Picked from a population-based longitudinal database of demographic and health census data, 72 292 adults (≥18 years) were asked to self-report their recent (within the past 30 days) and lifetime use of tobacco and alcohol and frequency of recent 'drunkenness'. RESULTS Overall prevalence of ever smoking was 11.2% (11.0-11.5) and of ever drinking, 20.7% (20.4-21.0). The prevalence of current smoking was 6.3% (6.1-6.5); 5.7% (5.5-5.9) smoked daily. 7.3% (7.1-7.5) reported drinking alcohol within the past 30 days. Of these, 60.3% (58.9-61.6) reported being drunk on half or more of all drinking occasions. The percentage of current smokers rose with the number of drinking days in a month (P < 0.0001). Tobacco and alcohol use increased with decreasing socio-economic status and amongst women in the oldest age group (P < 0.0001). CONCLUSIONS Tobacco and alcohol use are prevalent in this rural region of Kenya. Abuse of alcohol is common and likely influenced by the availability of cheap, home-manufactured alcohol. Appropriate evidence-based policies to reduce alcohol and tobacco use should be widely implemented and complemented by public health efforts to increase awareness of their harmful effects.
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Affiliation(s)
- T Q Lo
- Centers for Disease Control and Prevention, Division of Tuberculosis Elimination, Atlanta, GA 30333, USA.
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Graham A, Adeloye D, Grant L, Theodoratou E, Campbell H. Estimating the incidence of colorectal cancer in Sub-Saharan Africa: A systematic analysis. J Glob Health 2013; 2:020404. [PMID: 23289079 PMCID: PMC3529315 DOI: 10.7189/jogh.02.020204] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Background Nearly two–thirds of annual mortality worldwide is attributable to non–communicable diseases (NCDs), with 70% estimated to occur in low– and middle–income countries (LMIC). Colorectal cancer (CRC) accounts for over 600 000 deaths annually, but data concerning cancer rates in LMIC is very poor. This study analyses the data available to produce an estimate of the incidence of colorectal cancer in Sub–Saharan Africa (SSA). Methods Data for this analysis came from two main sources: a systematic search of Medline, EMBASE and Global Health which found 15 published data sets, and an additional 42 unpublished data sets which were sourced from the IARC and individual cancer registries. Data for case rates by age and sex, as well as population denominators were extracted and analysed to produce an estimate of incidence. Results The crude incidence of CRC in SSA for both sexes was found to be 4.04 per 100 000 population (4.38 for men and 3.69 for women). Incidence increased with age with the highest rates in Southern Africa, particularly in South Africa. The rates of CRC in SSA were much lower than those reported for high–income countries. Conclusion Few health services in SSA are equipped to provide timely diagnosis and treatment of cancer in SSA. In addition, data collection systems are weak, meaning that the available statistics may underestimate the burden of disease. In order to improve health care services it is vital that accurate measurements of disease burden are available to policy makers.
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Affiliation(s)
- Alice Graham
- Centre for Population Health Sciences and Global Health Academy, The University of Edinburgh Medical School, Edinburgh, Scotland, UK
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Graham A, Adeloye D, Grant L, Theodoratou E, Campbell H. Estimating the incidence of colorectal cancer in Sub–Saharan Africa: A systematic analysis. J Glob Health 2012. [DOI: 10.7189/jogh.02.020404] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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