Evaluation of health status and its predictor among university staff in Nigeria

Stage 2 Hypertension and Electrocardiogram Abnormality: Evaluating the Risk Factors of Cardiovascular Diseases in Nigeria

INTRODUCTION

This study evaluated the status of stage 2 hypertension, abnormal ECG and their co-occurrence as possible risk factors of cardiovascular disease and their predictors in a Nigerian University population.

METHODS

A total of 717 subjects participated in this study. Blood pressure (BP), resting electrocardiogram (ECG) and other clinical parameters were measured and categorised according to standard organisational guidelines. Bivariate correlation and multivariate logistic regression model were used to determine covariates and clinical parameter association at a 95 % significant level.

RESULTS

Stage 2 hypertension and abnormal ECG respectively occurred in 264 (37 %) and 217 (39.2 %) subjects, with co-occurrence and abnormal BMI in 85 (11.8 %) and 459 (64.8%) subjects, respectively. Sex (p = 0.001) and occupation (p = 0.022) were independently associated with abnormal BP and ECG, respectively, while age was independently associated (p < 0.001) with abnormal BP, ECG and co-occurrence of these conditions. Predictors of stage 2 hypertension and abnormal ECG were sex (adjusted odds ratio [aOR] = 1.652, 95 % CI 1.097-2.488) and occupation (aOR = 0.411, 95 % CI 0.217-0.779), respectively, while age was a predictor for stage 2 hypertension (aOR = 0.065, 95 % CI 0.015-0.283), abnormal ECG (aOR = 0.137, 95 % CI 0.053-0.351) and their co-occurrence (aOR = 0.039, 95 % CI 0.014-0.113).

CONCLUSIONS

This study shows prevalence rates of these risk factors are on the increase. It also suggests that ECG abnormality is a public health issue among stage 2 hypertensive patients that must be monitored. Therefore, appropriate interventions that prevent and control hypertension and identified risk factors should be put in place in addition to lifestyle changes, regular screening and surveillance.

Multilevel modeling, prevalence, and predictors of hypertension in Ghana: Evidence from Wave 2 of the World Health Organization's Study on global AGEing and adult health

BACKGROUND AND AIMS

Hypertension is a major public health issue, an important risk factor for cardiovascular diseases and stroke, especially in developing countries where the rates remain unacceptably high. In Africa, hypertension is the leading driver of cardiovascular disease and stroke deaths. Identification of critical risk factors of hypertension can help formulate targeted public health programs and policies aimed at reducing the prevalence and its associated morbidity, disability, and mortality. This study attempts to develop multilevel regression, an in-depth statistical model to identify critical risk factors of hypertension.

METHODS

This study used data on 4667 individuals aged ≥18 years from the nationally representative World Health Organization Study on global AGEing and adult health (SAGE) Ghana Wave 2 conducted in 2014/2015. Multilevel regression modeling was employed to identify critical risk factors for hypertension based on systolic blood pressure (SBP) (ie, SBP > 140 mmHg). Of the 4667, 27.3% were hypertensive. Final data on 4381 individuals residing in 3790 households were analyzed using multilevel models, and results were presented as adjusted odds ratios (aOR) and their associated 95% confidence intervals (CI).

RESULTS

Risk factors for hypertension identified were age (aOR) = 5.4, 95% CI: 4.11-7.09), obesity (aOR = 1.51, 95% CI: 1.19-1.91), marital status (aOR = 0.75, 95% CI: 0.64-0.89), perceived health state (moderate; aOR = 1.38, 95% CI: 1.15-1.65 and bad/very bad; aOR = 1.35, 95% CI: 1.0-1.83), and difficulty with self-care (aOR = 1.64, 95% CI: 1.1-2.44). We found unobserved significant differences in the likelihood of hypertension prevalence between different households.

CONCLUSION

Addressing the problem of obesity, targeting specific interventions to those aged over 50 years, and improvement in the general health of Ghanaians are paramount to reducing the prevalence and its associated morbidity, disability, and mortality. Lifestyle modification in the form of dietary intake, knowledge provision supported with strong public health message, and political will could be beneficial to the management and prevention of hypertension.

The Influence of Social Isolation on the Preventive Behaviors for Non-Communicable Diseases in Community-Dwelling Older Adults in Japan

This study aimed to examine the relationship between one’s physical status related to non-communicable diseases (NCDs) and social isolation, and to identify lifestyle behaviors for the prevention of NCDs associated with social isolation among community-dwelling older adults in Japan. A cross-sectional study was conducted to investigate lifestyle behaviors for NCD prevention associated with social isolation in Japanese adults aged 60 years and above in a community setting. Out of 57 participants, 17.5% were not socially participative, 66.7% hardly ever, 29.8% sometimes, and 3.5% often felt loneliness. Non-social participation and loneliness were negatively related to the frequency of vegetable and fruit intake. Additionally, loneliness was positively associated with one’s duration of smoking and current smoking habits, and negatively associated with the frequency of moderate-intensity activities, with marginal significance. Those with non-social participation or loneliness were less likely to eat a healthy diet and live a smoke-free lifestyle. The findings of this study suggest that a mutual health support system in the community and the development of community-based approaches for the prevention of NCDs among Japanese older adults are needed.

Metabolic Syndrome Among Working Adults in Eastern Ethiopia

PURPOSE

Metabolic syndrome (MetS) has become a public health challenge in low-income countries due to changing lifestyle and the food environment. However, studies on the prevalence of metabolic syndrome and associated factors are limited in Ethiopia. Therefore, this study assessed the prevalence of MetS and its associated factors among working adults in eastern Ethiopia.

METHODS

A cross-sectional study was conducted involving 1,164 working adults from December 2018 to February 2019. Data were collected following the World Health Organization (WHO) STEPwise approach. The data collection tools include a structured questionnaire, anthropometric, and biochemical measurements. Prevalence was calculated using International Diabetes Federation criteria. A Poisson regression model with robust variance estimation was used to investigate the independent variable's association with MetS. An adjusted prevalence ratio with 95% confidence interval was reported to show associations.

RESULTS

The prevalence of MetS was 20.1% (95% CI=17.8-22.4) among the participants. It was more prevalent among females (APR:=1.62, 95% CI=1.31-2.00), those of 35-44 years of age (APR:=3.14, 95% CI=1.19-8.28), 45-54 years of age (APR=4.42, 95% CI=1.66-11.77), and 55-64 years of age (APR=6.03, 95% CI=2.27-16.06), khat chewers (APR=1.30, 95% CI=1.06-1.60), those with 8 or more hours of sedentary behavior (APR=2.29, 95% CI=1.88-2.80), and those consuming alcohol 5-6 days per week (APR=1.81, 95% CI=1.20-2.74). The prevalence was significantly lower in those eating five or more fruits and vegetables servings per day (APR=0.04, 95% CI=0.01-0.27).

CONCLUSION

A high prevalence of MetS was observed among working adults in eastern Ethiopia. Strengthening workplace health promotion programs is necessary to reduce the negative consequences of MetS in workplaces and protect productivity.

Epidemiology of General, Central Obesity and Associated Cardio-Metabolic Risks Among University Employees, Ethiopia: A Cross-Sectional Study

BACKGROUND

Evidence suggests that middle and low-income countries such as Ethiopia are facing the growing epidemic of both communicable and non-communicable diseases creating a burden on their economy and healthcare system. The increasing prevalence of non-communicable diseases is attributed to sedentarism, lifestyle changes, nutritional transition, and the presence of other cardiometabolic risk factors. Therefore this study was designed to assess the prevalence and association of overweight, obesity, and cardio-metabolic risks and to explore if there was any agreement among the anthropometric measurements among the academic employees of the University of Gondar, Ethiopia.

METHODS

An institutional-based cross-sectional study was conducted using the WHO stepwise approach and recommendations on 381 academic staff of the university. In addition, physical measurements such as weight, height, waist and hip circumferences, and biochemical measures such as blood pressure and fasting blood glucose level (peripheral blood samples by finger puncture) were measured using standardized tools.

RESULTS

The mean age of the participants was 33.5 (95% CI: 32.7, 34.2) years. The prevalence of obesity among the study participants calculated by body mass index, waist circumference (WC), waist-height ratio (WHtR), and waist-hip ratio (WHR) was 13.1%, 33.6%, 51.9%, and 58.5% respectively. The prevalence of diabetes was 4.7% among which 1.3% was not diagnosed prior to this study. About 53 (13.9%) of the study sample were found to be hypertensive (HTN) (6.3% known versus 29 7.6% newly diagnosed). Among the participants, 39.4% and 23.4% were found to be pre-hypertensive and pre-diabetic respectively. WC was significantly associated with hypertension (AOR = 5.14; 2.503, 9.72), pre-DM (AOR = 4.03; 2.974, 5.96), DM (AOR = 3.29; 1.099, 6.01). In addition, WHtR was significantly associated with Pre-HTN (AOR = 2.69; 1.49, 4.58), HTN (AOR = 2.066; 1.008, 6.31), and DM (AOR = 1.855; 0.76, 4.32). On the contrary, both WHR and general obesity measured by BMI were not significantly associated with pre-HTN, HTN, pre-DM and DM groups.

CONCLUSION

This study results revealed the variable prevalence between general obesity and the anthropometric indices (IDF cutoff) defining central obesity; WC, WHtR, and WHR among the participants. The result of this study suggests that the constructs of central obesity, not BMI has to be used to screen risks of cardio-metabolic risks among Ethiopians.

Developing and Pilot Testing an Integrated Technology-Moderated Institutional Health Promotion Model Using Operational Research Approach

The study aimed to develop and pilot test an Integrated Technology-Moderated Institutional Health Promotion Model for university staff in Nigeria. An operational research approach using mixed concurrent design was adopted to develop the model, and pretest-posttest method was used to evaluate the utilization and effectiveness of the developed model. The participants in the study were university staff. Health-promoting lifestyle behavior and health status were measured via the adapted Health-Promoting Lifestyle Profile II instrument. The emerging model (an Integrated Technology-Moderated Institutional Health Promotion Model, which is an Android phone app named Tertiary Staff Health Promotion App) was deployed. Data were collected before and 12 weeks after the app deployment. The quantitative and qualitative data findings were combined to develop an integrated technology-moderated institutional health promotion model as a means to enhance health-promoting lifestyle behavior and health status of staff. The result of the pilot testing of the model showed that the model enhances health-promoting lifestyle behaviors and improves the health status of staff. Nurses, especially in community/public health nursing practice, can provide innovative interventions to drive and enhance health-promoting lifestyle behavior and improve health status of workers and other population groups through effective use of information and communication technology.

Determinants of systemic hypertension in older adults in Africa: a systematic review

BACKGROUND

An estimated 55% of older adults in Africa have systemic hypertension, a major risk factor for stroke, heart failure and dementia in the region. The risk factors associated with hypertension in this population group in Africa have not been systematically evaluated. We, therefore, undertook a systematic review to identify these risk factors.

METHODS

We searched for population-based studies of adults aged ≥50 years living in Africa and reporting an estimate of hypertension and associated risk factors. We included articles published in any language between January 1980 and May 2018 using a comprehensive search strategy. We extracted data including the sample characteristics, prevalence of hypertension and risk factors with their effect sizes.

RESULTS

From an initial 10,719 records, we retained 63 eligible full text articles for review out of which we analyzed 23 studies made up of 19 primary and four multiple publications which had data on risk factors from bivariate or multivariable analysis. The primary studies, published from 2010 to 2018, involved a total of 30,500 participants in 12 different countries with mean ages ranging from 62.7 ± 9 years to 76.9 ± 8.4 years. Through narrative synthesis, we found consistent determinants of hypertension (overweight/obesity and history of stroke), less consistent but frequent determinants (including older age group, female sex and urban residence), inconsistent determinants (including education, wealth index, alcohol intake and physical activity) and nonsignificant covariates (marital status and having health insurance). Overall, the highest adjusted odds ratios were those associated with obesity and history of stroke.

CONCLUSION

The key determinants of systemic hypertension in older adults in Africa are older age group, overweight/obesity, history of stroke and female sex. Health programmes should promote weight reduction throughout the life course, including during the middle and older age of African adults.