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Hamid I, Raveloson SNS, Spiral GJ, Ravelonjanahary S, Raharivololona BM, Randria JM, Zafimaro M, Randriambola TA, Andriantsoa RM, Andriamahefa TJ, Rafidison BFL, Mughal M, Emde AK, Hendershott M, LeBaron von Baeyer S, Wasik KA, Ranaivoarisoa JF, Yerges-Armstrong L, Castel SE, Rakotoarivony R. Mid-pass whole-genome sequencing in a Malagasy cohort uncovers body composition associations. HGG ADVANCES 2024; 5:100343. [PMID: 39169618 DOI: 10.1016/j.xhgg.2024.100343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 08/17/2024] [Accepted: 08/19/2024] [Indexed: 08/23/2024] Open
Abstract
The majority of human genomic research studies have been conducted in European-ancestry cohorts, reducing the likelihood of detecting potentially novel and globally impactful findings. Here, we present mid-pass whole-genome sequencing data and a genome-wide association study in a cohort of 264 self-reported Malagasy individuals from three locations on the island of Madagascar. We describe genetic variation in this Malagasy cohort, providing insight into the shared and unique patterns of genetic variation across the island. We observe phenotypic variation by location and find high rates of hypertension, particularly in the Southern Highlands sampling site, as well as elevated self-reported malaria prevalence in the West Coast site relative to other sites. After filtering to a subset of 214 minimally related individuals, we find a number of genetic associations with body composition traits, including many variants that are only observed in African populations or populations with admixed African ancestry from the 1000 Genomes Project. This study highlights the importance of including diverse populations in genomic research for the potential to gain novel insights, even with small cohort sizes. This project was conducted in partnership and consultation with local stakeholders in Madagascar and serves as an example of genomic research that prioritizes community engagement and potentially impacts our understanding of human health and disease.
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Affiliation(s)
- Iman Hamid
- Variant Bio, Inc., Seattle, WA 98109, USA
| | | | - Germain Jules Spiral
- University of Antananarivo, Faculty of Sciences, Mention Anthropobiologie et Développement Durable, Antananarivo 101, Madagascar
| | - Soanorolalao Ravelonjanahary
- University of Antananarivo, Faculty of Sciences, Mention Anthropobiologie et Développement Durable, Antananarivo 101, Madagascar
| | - Brigitte Marie Raharivololona
- University of Antananarivo, Faculty of Sciences, Mention Anthropobiologie et Développement Durable, Antananarivo 101, Madagascar
| | - José Mahenina Randria
- University of Antananarivo, Faculty of Medicine, Ministry of Public Health, Antananarivo 101, Madagascar
| | - Mosa Zafimaro
- University of Antananarivo, Faculty of Medicine, Ministry of Public Health, Antananarivo 101, Madagascar
| | - Tsiorimanitra Aimée Randriambola
- University of Antananarivo, Faculty of Sciences, Mention Anthropobiologie et Développement Durable, Antananarivo 101, Madagascar
| | - Rota Mamimbahiny Andriantsoa
- University of Antananarivo, Faculty of Sciences, Mention Anthropobiologie et Développement Durable, Antananarivo 101, Madagascar
| | - Tojo Julio Andriamahefa
- University of Antananarivo, Faculty of Sciences, Mention Anthropobiologie et Développement Durable, Antananarivo 101, Madagascar
| | | | | | | | | | | | | | - Jean Freddy Ranaivoarisoa
- University of Antananarivo, Faculty of Sciences, Mention Anthropobiologie et Développement Durable, Antananarivo 101, Madagascar
| | | | | | - Rindra Rakotoarivony
- University of Antananarivo, Faculty of Sciences, Mention Anthropobiologie et Développement Durable, Antananarivo 101, Madagascar.
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Nsanya MK, Abramson R, Kisigo GA, Hickner A, Nyanza EC, Peck RN, Kapiga SH. Hypertension among adolescents in sub-Saharan Africa: a systematic review. Front Cardiovasc Med 2023; 10:1251817. [PMID: 38155990 PMCID: PMC10754047 DOI: 10.3389/fcvm.2023.1251817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 10/18/2023] [Indexed: 12/30/2023] Open
Abstract
Introduction Hypertension (HTN) among adolescents is common in high-income countries, and leads to increased premature cardiovascular diseases (CVD). In sub-Saharan Africa (SSA), the prevalence of HTN among adolescents, associated risk factors and CVD complications are not well-described. Such data is needed for planning public health programs to prevent premature CVD in SSA. Methods We systematically searched 5 databases (MEDLINE, Embase, Google Scholar, Web of Science, and African Index Medicus) from their establishment to December 2021. Key search terms were: adolescent, arterial hypertension, and names of the 48 countries in SSA. We used Covidence® to manage the search results. The review was registered in the Open Science Framework (OSF) https://osf.io/p5sbt/. Results We identified 4,008 articles out of which we screened 3,088 abstracts, and reviewed 583 full-text articles. We finally included 92 articles that were published between 1968 to December 2021. The majority were cross-sectional studies (80%) and conducted in school settings (78%). The risk of bias was low for 59 studies (64.1%), moderate for 29 studies (31.5%), and high for 4 studies (4.3%). Overall, the prevalence of HTN varied widely from 0.18% to 34.0% with a median (IQR) of 5.5% (3.1%, 11.1%). It was relatively higher in studies using automated blood pressure (BP) devices, and in studies defining HTN using thresholds based on percentile BP distribution for one's height, age, and sex. In addition, the prevalence of HTN was significantly higher in studies from Southern Africa region of SSA and positively correlated with the year of publication. Across studies, traditional risk factors such as age, sex, body mass index, and physical inactivity, were commonly found to be associated with HTN. In contrast, non-traditional risk factors related to poverty and tropical diseases were rarely assessed. Only three studies investigated the CVD complications related to HTN in the study population. Conclusion The prevalence of HTN among adolescents in SSA is high indicating that this is a major health problem. Data on non-traditional risk factors and complications are scarce. Longitudinal studies are needed to clearly define the rates, causes, and complications of HTN. Systematic Review Registration https://osf.io/p5sbt/, identifier (10.17605/OSF.IO/P5SBT).
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Affiliation(s)
- Mussa K Nsanya
- Mwanza Intervention Trials Unit/National Institute for Medical Research, Mwanza, Tanzania
| | - Rachel Abramson
- Weill Cornell Medicine - Cornell University, New York, NY, United States
| | - Godfrey A Kisigo
- Mwanza Intervention Trials Unit/National Institute for Medical Research, Mwanza, Tanzania
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Andy Hickner
- Weill Cornell Medicine - Cornell University, New York, NY, United States
| | - Elias C Nyanza
- Catholic University of Health and Allied Sciences, School of Public Health, Mwanza, Tanzania
| | - Robert N Peck
- Mwanza Intervention Trials Unit/National Institute for Medical Research, Mwanza, Tanzania
- Weill Cornell Medicine - Cornell University, New York, NY, United States
- Catholic University of Health and Allied Sciences, School of Public Health, Mwanza, Tanzania
| | - Saidi H Kapiga
- Mwanza Intervention Trials Unit/National Institute for Medical Research, Mwanza, Tanzania
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Feren N, Thapar R, Unnikrishnan B, Mithra P, Kumar N, Holla R, BB D, Kotian H. Effectiveness of multi-component modular intervention among adults with prehypertension in a village of Dakshina Kannada district - a community-based interventional study - protocol. F1000Res 2023; 12:667. [PMID: 38577228 PMCID: PMC10993661 DOI: 10.12688/f1000research.129131.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/14/2023] [Indexed: 04/06/2024] Open
Abstract
INTRODUCTION The Joint National Committee (JNC 7) report on Prevention, Detection, Evaluation, and Treatment of Hypertension, defined "prehypertension," as individuals with a Systolic Blood Pressure (SBP) in the range of 120-139 mmHg and a (diastolic blood pressure) DBP of 80-89 mmHg. Prehypertension is directly linked with hypertension which is a precursor of CVDs. Owing to its high conversion rate to hypertension, it is important to identify individuals with blood pressures in this category and bring about lifestyle modifications in them that can prevent them from being hypertensive and from developing cardiovascular diseases later in life. METHODS This randomized controlled trial will be done among the selected pre-hypertensive adults of all genders residing in Kateel Gram panchayat, Dakshina Kannada district, Karnataka. A baseline survey will be done initially to assess the level of prehypertension among the study population. To study the effectiveness of the intervention, 142 individuals will be randomly allocated using block randomization technique to intervention and control groups. A multi-component module (educational intervention) will be developed, validated, and administered to participants in the intervention group, while the control group receives standard care. Each participant will then be followed up once in four months till the end of the study period of one year to assess for changes in SBP, DBP, WHR, BMI, stress levels, and usage of tobacco and alcohol. ETHICS AND DISSEMINATION Institutional Ethics Committee approval was obtained from Kasturba Medical College in Mangalore, India. The plans for dissemination of findings include presenting at scientific conferences and publishing in scholarly journals.
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Affiliation(s)
- Neneh Feren
- Department of Community Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Rekha Thapar
- Department of Community Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - B Unnikrishnan
- Department of Community Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Prasanna Mithra
- Department of Community Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Nithin Kumar
- Department of Community Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Ramesh Holla
- Department of Community Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Darshan BB
- Department of Community Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Himani Kotian
- Department of Community Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
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Tam HL, Chung SF, Wang Q. Urban-rural disparities in hypertension management among middle-aged and older patients: Results of a 2018 Chinese national study. Chronic Illn 2023; 19:581-590. [PMID: 35603631 DOI: 10.1177/17423953221102627] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Hypertension is a well-known global risk factor associated with significant morbidity and mortality. Medication use and urban-rural disparities in medication usage patterns affect hypertension management. We investigated patient characteristics across different geographical areas to determine factors that affect medication use among Chinese patients aged ≥ 45 years, diagnosed with hypertension. METHODS Data were extracted from the China Health and Retirement Longitudinal Study 2018. We recorded differences in medication use, advice from healthcare providers, and health-related behaviors between urban and rural areas. RESULTS The study included 2115 patients with hypertension (mean age 62.06 years). Advice received and medication use were significantly lower in patients from rural areas than in those from urban areas. Our findings showed that urban residence, comorbidities, advice regarding lifestyle changes, and smoking were positive predictors of medication use, whereas alcohol consumption and regular exercise reduced the likelihood of medication use. DISCUSSION We observed urban-rural disparities in hypertension management, and several strategies, including distribution of reminders and written materials can be integrated into current clinical practice to improve the rate of medication use among rural residents with hypertension.
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Affiliation(s)
- Hon Lon Tam
- Kiang Wu Nursing College of Macau, Macau, China
| | | | - Qun Wang
- School of Nursing, Shenzhen University, Shenzhen, China
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Riedmann J, Solonavalona AF, Rakotozafy AR, Ralamboson S, Endres M, Siegerink B, Siebert E, Knauss S, Emmrich JV. Proportion of stroke types in Madagascar: A tertiary-level hospital-based case series. PLoS One 2022; 17:e0276199. [PMID: 36240194 PMCID: PMC9565373 DOI: 10.1371/journal.pone.0276199] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 09/30/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Like other countries in sub-Saharan Africa, Madagascar has a high burden of stroke. The Malagasy population is unique in sharing both African and Asian ancestry. The proportion of ischemic and hemorrhagic stroke types is unknown for this population. AIM Our aim was to establish the proportion of stroke types and known risk factors for the Malagasy population. METHODS We conducted a single-center, tertiary-level hospital-based case series. We included all patients with a CT-imaging confirmed stroke who presented at the emergency ward of the study hospital between January 1, 2017, and November 20, 2018. RESULTS Of 223 patients with CT-confirmed stroke, 57.4% (128/223, 95% CI: 51-64%) had an ischemic stroke and 42.6% (95/223, 95% CI: 36-49%) had an intracranial hemorrhage. The majority (89.5%; 85/95, 95% CI: 83-96%) of intracranial hemorrhages were intracerebral; 4.2% (4/95, 95% CI: 0-8%) had a subdural hematoma, 5.3% (5/95, 95% CI: 1-10%) had a subarachnoid hemorrhage, there was one isolated intraventricular hemorrhage (1.1%; 1/95, 95% CI: -1-3%). The prevalence of hypertension among stroke patients was high (86.6%; 187/216, 95% CI: 82-91%). CONCLUSIONS Our study is the first to report the proportion of stroke types and known risk factors in Madagascar. We find that the proportion of hemorrhagic strokes was unexpectedly higher than that reported from other countries in sub-Saharan Africa. Our findings highlight the need for a country-specific approach to stroke prevention, treatment, and rehabilitation and provide guidance on public health resource allocation in Madagascar.
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Affiliation(s)
- Julia Riedmann
- Department of Neurology, Charité—Universitätsmedizin Berlin, Berlin, Germany
| | | | | | - Solofo Ralamboson
- Soavinandriana Military Hospital (CENHOSOA), Antananarivo, Madagascar
| | - Matthias Endres
- Department of Neurology, Charité—Universitätsmedizin Berlin, Berlin, Germany
- Center for Stroke Research, Charité—Universitätsmedizin Berlin, Berlin, Germany
- German Center for Neurodegenerative Diseases (DZNE), Partner Site Berlin, Göttingen, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Göttingen, Germany
- ExcellenceCluster NeuroCure, Berlin, Germany
- Berlin Institute of Health, Berlin, Germany
| | - Bob Siegerink
- Center for Stroke Research, Charité—Universitätsmedizin Berlin, Berlin, Germany
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden University, Leiden, The Netherlands
| | - Eberhard Siebert
- Institute of Neuroradiology, Charité—Universitätsmedizin Berlin, Berlin, Germany
| | - Samuel Knauss
- Department of Neurology, Charité—Universitätsmedizin Berlin, Berlin, Germany
- Berlin Institute of Health, Berlin, Germany
- Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany
| | - Julius Valentin Emmrich
- Department of Neurology, Charité—Universitätsmedizin Berlin, Berlin, Germany
- Berlin Institute of Health, Berlin, Germany
- Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany
- * E-mail:
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Amponsem-Boateng C, Oppong TB, Zhang W, Boakye-Yiadom J, Wang L, Acheampong K, Opolot G. Screening of hypertension, risks, knowledge/awareness in second-cycle schools in Ghana. A national cross-sectional study among students aged 12-22. J Hum Hypertens 2022; 36:405-415. [PMID: 33790406 DOI: 10.1038/s41371-021-00502-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
In Ghana, the management of hypertension in primary health care is a cost-effective way of addressing premature deaths from vascular disorders that include hypertension. There is little or no evidence of large-scale studies on the prevalence, risk, and knowledge/awareness of hypertension in students aged 12-22 years in Ghana. In a cross-sectional study, blood pressure, anthropometric indices, and knowledge/awareness assessment of students at second-cycle schools were recorded from 2018 to 2020 in three regions of Ghana. Multistage cluster sampling was used in selecting regions and the schools. Prevalence of prehypertension and hypertension was categorized by the Joint National Committee 7, where appropriate, chi-square, scatter plots, and correlations were used in showing associations. A total of 3165 students comprising 1776 (56.1%) females and 1389 (43.9%) males participated in this study within three regions of Ghana. The minimum age was 12 years and the maximum age was 22 years. The mean age was 17.21 with standard deviation (SD: 1.59) years. A 95% confidence interval was set for estimations and a P value < 0.05 was set as significant. The prevalence rate of overall hypertension was 19.91% and elevated (prehypertension) was 26.07%. Risk indicators such as weight, BMI, waist circumference, physical activity, and form of the diet were positively correlated with hypertension. Among Ghanaian students currently in second-cycle educational institutions, 19.91% were hypertensive and 26.07% were prehypertensive. This may indicate a probable high prevalence of hypertension in the future adult population if measures are not taken to curb the associated risks.
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Affiliation(s)
- Cecilia Amponsem-Boateng
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Timothy Bonney Oppong
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Weidong Zhang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China.
| | | | - Lianke Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Kwabena Acheampong
- Department of Epidemiology and Health Statistics, Central South University, Changsha, PR China
| | - Godfrey Opolot
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
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Paulose T, Nkosi ZZ, Endriyas M. Prevalence of hypertension and its associated factors in Hawassa city administration, Southern Ethiopia: Community based cross-sectional study. PLoS One 2022; 17:e0264679. [PMID: 35231073 PMCID: PMC8887727 DOI: 10.1371/journal.pone.0264679] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Accepted: 02/16/2022] [Indexed: 11/20/2022] Open
Abstract
Background In association with the epidemiological, nutritional and demographic transition, many research findings showed that the number of risk factors that leads to increased prevalence of hypertension in low and middle income countries like Ethiopia is increasing. Several urban specific studies conducted in Ethiopia showed varying prevalence of hypertension. The aim of this study was to determine prevalence of hypertension and to identify factors associated with hypertension in Hawassa city administration, Southern Ethiopia. Methods A community-based cross sectional study was carried out in Hawassa city administration in 2017. A multi-stage sampling technique was used to select 612 study participants. Descriptive statistics was used to describe socio-demographic, behavioral and anthropometric variables. The economic status of household, ‘wealth index’, was constructed by running principal component analysis. Binary logistic regression analysis was performed to assess factors associated with hypertension at 95%CI. Results The overall prevalence of hypertension was 21.2% (95% CI: 18.1–24.7), (24.5% for urban and 14.7% for peri-urban). About two fifths of hypertension cases (42.3%) were newly diagnosed with elevated blood pressure during data collection. Age, occupation, wealth status, consuming vegetables and animal fat, usual mode of transport, body mass index (BMI), family history of hypertension and existence of diabetes were associated with presence of hypertension at 95%CI. The average diastolic blood pressure for urban was 2.18mmHg higher than that of peri-urban groups (p-0.01). Conclusion More than one fifth of study participants had hypertension and about two fifths of hypertension cases were newly diagnosed. Health communication should be strengthened focusing on identified risk factors and attention should be given to early detect and tackle the effects of hypertension in resource limited setting.
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Affiliation(s)
- Tsegab Paulose
- Health Studies Department, University of South Africa Ethiopia, Regional Learning Center, Addis Ababa, Ethiopia
- * E-mail:
| | - Zerish Zethu Nkosi
- Health Studies Department, University of South Africa, Pretoria, South Africa
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Calas L, Subiros M, Ruello M, Hassani Y, Gabet A, Angue M, Pointeau O, Olié V, Grave C. Hypertension prevalence, awareness, treatment and control in 2019 in the adult population of Mayotte. Eur J Public Health 2022; 32:408-414. [PMID: 35195255 PMCID: PMC9159308 DOI: 10.1093/eurpub/ckac015] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Mayotte is a French overseas territory with significant socio-economic and health challenges. This study updates the prevalence of hypertension in Mayotte to estimate the awareness, treatment and control of this disease and identify any associated factors. METHODS Data were taken from the cross-sectional Unono Wa Maore survey conducted in Mayotte in 2019. Analyses were based on the adult population aged 18-69 years who underwent a clinical examination with at least two blood pressure measurements (n = 2620). RESULTS In 2019, the prevalence of hypertension was estimated at 38.4% (36.1-40.7%) in the Mayotte population aged 18-69 years. The prevalence was similar in men (38.5%) and women (38.3%; P = 0.95). The prevalence of certain risk factors was high, with 75% of hypertensives being overweight or obese, 13% reporting diabetes and 69% being occupationally inactive. Among the hypertensives, 48% was aware of their diagnosis, with women more likely to be aware than men (P < 0.0001). Of those who were aware, 45% were treated pharmacologically and 49% reported engaging in physical activity to lower their blood pressure. The control rate was 30.2% among pharmacologically treated hypertensives. Overall, 80% of hypertensive patients had too high blood pressure during the survey's clinical examination. CONCLUSION The prevalence of hypertension remains high in Mayotte, where certain risk factors like obesity are particularly common in the population. Awareness, treatment and control remain insufficient. Primary prevention measures, access to a healthy food, and screening and treatment of hypertension should be encouraged by targeting the most affected populations.
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Affiliation(s)
- Lucinda Calas
- Santé Publique France, French Public Health Agency, Saint-Maurice, France
| | - Marion Subiros
- Santé Publique France, French Public Health Agency, Saint-Maurice, France
| | - Marc Ruello
- Santé Publique France, French Public Health Agency, Saint-Maurice, France
| | - Youssouf Hassani
- Santé Publique France, French Public Health Agency, Saint-Maurice, France
| | - Amélie Gabet
- Santé Publique France, French Public Health Agency, Saint-Maurice, France
| | - Marion Angue
- Department of Cardiology, Centre Hospitalier de Mayotte, Mamoudzou, France
| | - Odile Pointeau
- Department of Cardiology, Centre Hospitalier de Mayotte, Mamoudzou, France
| | - Valérie Olié
- Santé Publique France, French Public Health Agency, Saint-Maurice, France
| | - Clémence Grave
- Santé Publique France, French Public Health Agency, Saint-Maurice, France
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Menashe-Oren A, Masquelier B. The shifting rural-urban gap in mortality over the life course in low- and middle-income countries. Population Studies 2022; 76:37-61. [PMID: 35075983 DOI: 10.1080/00324728.2021.2020326] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Studies have shown that children in rural areas face excess risks of dying, but the little research on spatial inequalities in adult mortality has reached mixed conclusions. We examine rural-urban differences in mortality in 53 low- and middle-income countries. We consider how the rural-urban mortality gap evolves from birth to age 60 by estimating mortality based on birth and sibling histories from 138 Demographic and Health Surveys run between 1992 and 2018. We observe excess rural mortality until age 15, finding the largest differences between urban and rural sectors among 1-59-month-olds. While we cannot claim higher mortality among urban adults than those in rural areas, we find a reduced gap between the sectors over the life course and a diminishing urban advantage in adult mortality with age. This shift over the life course reflects a divergence in the epidemiologic transition between the rural and urban sectors.
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Opoku S, Addo-Yobo E, Trofimovitch D, Opoku RB, Lasong J, Gan Y, Lu Z. Increased prevalence of hypertension in Ghana: New 2017 American College of Cardiology/American Hypertension Association hypertension guidelines application. J Glob Health 2020; 10:020408. [PMID: 33282222 PMCID: PMC7688293 DOI: 10.7189/jogh.10.020408] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background We estimated the prevalence and socio-demographic risk factors of hypertension among Ghanaian adults as per the Joint National Committee 7 and the 2017 American College of Cardiology/American Hypertension Association hypertension thresholds used for diagnosis and treatment. Methods This cross-sectional analysis included 12 151 adults (8295 females and 3856 males) aged 18 years or older who participated in the 2014 Ghana Demographic and health Survey. Multiple logistic regression models were applied to obtain risk factors associated with hypertension as per both guidelines. Results Overall, 30.43% (n = 3698) and 11.48% (n = 1395) respondents had hypertension as per the 2017 ACC/AHA and JNC7 guidelines, respectively. The following factors were significant according to the 2017 ACC/AHA guideline: 55-64 years (adjusted odds ratio (aOR) = 6.42, 95% confidence interval (CI): 4.70-8.77), 45-54 years (aOR = 5.72, 95% CI = 4.70-6.85), 3544 years (aOR = 3.91, 95% CI = 3.33-4.59), and 25-34 years (aOR = 2.05, 95% CI = 1.77-2.37) age groups. Males (aOR = 1.39, 95% CI = 1.23-1.53), and urban residents (aOR = 1.18, 95% CI = 1.05-1.38). All the above risk factors were significant according to the JNC7 guideline too. Factors positively associated with only the 2017 ACC/AHA guideline included: middle income (aOR = 1.20, 95% CI = 1.02-1.42) and richest (aOR = 1.36, 95% CI = 1.10-1.69) wealth quintiles, whereas manual (aOR = 1.37, 95% CI = 1.02-1.86) was positively associated with the JNC7 guidelines only. Conclusions We conclude that adopting the ACC/AHA guidelines would lead to a substantial increase in the prevalence of hypertension among Ghanaian adults, thus, hypertension prevention and control should be prioritized.
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Affiliation(s)
- Sampson Opoku
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | | | - Diana Trofimovitch
- Department of Internal Medicine, East Tennessee State University, Johnson City, Tennessee, USA
| | - Rebekah Bless Opoku
- Community 8, Number 3, Junior High School, Ghana Education Service, Tema, Ghana
| | - Joseph Lasong
- Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yong Gan
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zuxun Lu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Ratovoson R, Masquelier B, Andriatahina T, Mangahasimbola R, Andrianirina Z, Pison G, Baril L. Inequalities in cause-specific mortality in children and adolescents in the Moramanga health survey, Madagascar. Int J Public Health 2020; 65:781-790. [PMID: 32566965 DOI: 10.1007/s00038-020-01409-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 06/04/2020] [Accepted: 06/09/2020] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES One child or young adolescent dies every 10 min in Madagascar and large disparities in survival persist. We estimated cause-specific mortality in a cohort of children aged 0-14 in the Moramanga district and explored how causes of death shape these inequalities. METHODS Children were followed prospectively between 2012 and 2017. Causes of death were established based on verbal autopsies. Incidence rate ratios were estimated in Poisson regression models. RESULTS The risk of dying before age 15 was 68.1 per thousand live births. Risks of dying were highest in the first year of life (31.2‰) and lowest in children aged 10-14 (6.4‰). The male-to-female sex ratios of mortality increased with age and reached 2.3 among adolescents aged 10-14. Communicable, nutritional and neonatal causes accounted for 79.5% of deaths below age 5 and 47.0% above age 5. Mortality was positively associated with household poverty, lack of education of the household head, and rural residence. CONCLUSIONS Interventions should be designed with an equity lens to reduce large disparities in survival and be tailored to the needs of each age-group.
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Affiliation(s)
- Rila Ratovoson
- Epidemiology and Clinical Research Unit, Institut Pasteur de Madagascar, Ambatofotsikely Avaradoha, Po Box 1274, 101, Antananarivo, Madagascar. .,UR 15 DEMOSUD, Institut national d'études démographiques, Paris, France.
| | - Bruno Masquelier
- UR 15 DEMOSUD, Institut national d'études démographiques, Paris, France.,Centre de Recherche en Démographie, Université Catholique de Louvain, Louvain-la-Neuve, Belgium
| | | | - Reziky Mangahasimbola
- Epidemiology and Clinical Research Unit, Institut Pasteur de Madagascar, Ambatofotsikely Avaradoha, Po Box 1274, 101, Antananarivo, Madagascar
| | - Zo Andrianirina
- Pediatric and Neonatal Unit, Soavinandriana Hospital, Antananarivo, Madagascar
| | - Gilles Pison
- UR 15 DEMOSUD, Institut national d'études démographiques, Paris, France.,Eco-Anthropology Research Unit, National Museum of Natural History, Paris, France
| | - Laurence Baril
- Epidemiology and Clinical Research Unit, Institut Pasteur de Madagascar, Ambatofotsikely Avaradoha, Po Box 1274, 101, Antananarivo, Madagascar.,Institut Pasteur of Cambodia, Phnom Penh, Cambodia
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12
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Ratovoson R, Randremanana R, Rakotomanana F, Andriamandimby SF, Mangahasimbola R, Masquelier B, Richard V, Piola P, Pison G, Baril L. Cohort Profile: Moramanga health survey in urban and rural areas in Madagascar (MHURAM project). Int J Epidemiol 2019; 48:1754-1755i. [PMID: 31665291 DOI: 10.1093/ije/dyz215] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2019] [Indexed: 11/15/2022] Open
Affiliation(s)
- Rila Ratovoson
- Epidemiology and Clinical Research Unit, Institut Pasteur de Madagascar, Antananarivo, Madagascar.,DemoSud Research Unit, Institut National d'Etudes Démographiques, Paris, France
| | - Rindra Randremanana
- Epidemiology and Clinical Research Unit, Institut Pasteur de Madagascar, Antananarivo, Madagascar
| | - Fanjasoa Rakotomanana
- Epidemiology and Clinical Research Unit, Institut Pasteur de Madagascar, Antananarivo, Madagascar
| | | | - Reziky Mangahasimbola
- Epidemiology and Clinical Research Unit, Institut Pasteur de Madagascar, Antananarivo, Madagascar
| | - Bruno Masquelier
- DemoSud Research Unit, Institut National d'Etudes Démographiques, Paris, France.,Center for Demographic Research, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Vincent Richard
- Direction of International Affairs, Institut Pasteur, Paris, France
| | - Patrice Piola
- Epidemiology and Public Health Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodia
| | - Gilles Pison
- DemoSud Research Unit, Institut National d'Etudes Démographiques, Paris, France.,Eco-Anthropology Research Unit, National Museum of Natural History, Paris, France
| | - Laurence Baril
- Epidemiology and Clinical Research Unit, Institut Pasteur de Madagascar, Antananarivo, Madagascar
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13
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Manus MB, Bloomfield GS, Leonard AS, Guidera LN, Samson DR, Nunn CL. High prevalence of hypertension in an agricultural village in Madagascar. PLoS One 2018; 13:e0201616. [PMID: 30114223 PMCID: PMC6095505 DOI: 10.1371/journal.pone.0201616] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 07/18/2018] [Indexed: 01/19/2023] Open
Abstract
Elevated blood pressure presents a global health threat, with rates of hypertension increasing in low and middle-income countries. Lifestyle changes may be an important driver of these increases in blood pressure. Hypertension is particularly prevalent in African countries, though the majority of studies have focused on mainland Africa. We collected demographic and health data from 513 adults living in a community in rural Madagascar. We used generalized linear mixed models to assess body mass index (BMI), age, sex, and attributes related to household composition and lifestyle as predictors of blood pressure and hypertension. The prevalence of hypertension in this cohort was 49.1% (both sexes combined: N = 513; females: 50.3%, N = 290; males: 47.5%, N = 223). Blood pressure, as well as hypertensive state, was positively associated with age and BMI. Lifestyle and household factors had no significant relationships with blood pressure. The prevalence of hypertension was similar to that found in urban centers of other African countries, yet almost double what has been previously found in Madagascar. Future research should investigate the drivers of hypertension in rural communities worldwide, as well as the lifestyle, cultural, and genetic factors that underlie variation in hypertension across space and time.
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Affiliation(s)
- Melissa B. Manus
- Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
- Department of Evolutionary Anthropology, Duke University, Durham, North Carolina, United States of America
| | - Gerald S. Bloomfield
- Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
- Department of Medicine and Duke Clinical Research Institute, Duke University, Durham, North Carolina, United States of America
| | - Ashley Sobel Leonard
- Department of Biology, Duke University, Durham, North Carolina, United States of America
| | - Laura N. Guidera
- Department of Biology, Duke University, Durham, North Carolina, United States of America
| | - David R. Samson
- Department of Anthropology, University of Toronto, Mississauga, Canada
| | - Charles L. Nunn
- Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
- Department of Evolutionary Anthropology, Duke University, Durham, North Carolina, United States of America
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14
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Wang J, Sun W, Wells GA, Li Z, Li T, Wu J, Zhang Y, Liu Y, Li L, Yu Y, Liu Y, Qi C, Lu Y, Liu N, Yan Y, Liu L, Hui G, Liu B. Differences in prevalence of hypertension and associated risk factors in urban and rural residents of the northeastern region of the People's Republic of China: A cross-sectional study. PLoS One 2018; 13:e0195340. [PMID: 29621328 PMCID: PMC5886571 DOI: 10.1371/journal.pone.0195340] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 03/20/2018] [Indexed: 02/01/2023] Open
Abstract
Background Hypertension is a significant global public health problem and recognized as an important risk factor for cardiovascular diseases. This study was designed to assess the current prevalence of hypertension and to explore risk factors associated with hypertension by urban and rural status to guide the prevention and control of hypertension in Jilin province. Methods A multi-stage stratified random cluster sampling method was used to obtain data on hypertension, which was investigated by physical examination and face-to-face questionnaire in July 2014-December 2015. Sample data were analyzed by complex weighted statistical analysis to estimate blood pressure levels and prevalence of hypertension in the province. Multivariable logistic regression analysis was used to identify factors influencing hypertension rates. Results The prevalence of hypertension was significantly higher in rural areas than urban areas (25.93% versus 22.73%, respectively). The rates of hypertension known (46.7% versus 38.1%, respectively), control (13.7% versus 5.0%, respectively), and controlled among treated subjects (38.3% versus 17.5%, respectively) were higher in urban areas than in rural areas (all p < 0.001), while the treatment rate was not statistically significantly different between urban and rural areas (35.9% versus 28.4%, respectively). After adjusting for demographic covariates, hypertension prevalence in rural areas was still significantly greater than in urban areas (adjusted OR = 1.22; 95%CI: 1.10, 1.36; p < 0.001). Common risk factors for hypertension among urban and rural residents included older age; male; married; employed; less education; overweight/obese; greater abdominal waist circumference; family history of hypertension, stroke, or coronary heart disease; current smoker; alcohol consumption; higher visceral adiposity index; and higher body fat percentage. Conclusions This study identified an increased risk for hypertension in rural regions of Jilin province, suggesting that rural hypertension screening and treatment guidelines should receive greater attention.
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Affiliation(s)
- Junnan Wang
- Department of Cardiology, the Second Hospital of Jilin University, Changchun, Jilin, China
| | - Wei Sun
- Department of Cardiology, the Second Hospital of Jilin University, Changchun, Jilin, China
| | - George A. Wells
- Department of Cardiovascular Research Methods Centre, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Zhibo Li
- Department of Cardiology, the Second Hospital of Jilin University, Changchun, Jilin, China
| | - Tianyi Li
- Department of Cardiology, the Second Hospital of Jilin University, Changchun, Jilin, China
| | - Junduo Wu
- Department of Cardiology, the Second Hospital of Jilin University, Changchun, Jilin, China
| | - Yangyu Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Yingyu Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Longbo Li
- Department of Cardiology, the Second Hospital of Jilin University, Changchun, Jilin, China
| | - Yunpeng Yu
- Department of Cardiology, the Second Hospital of Jilin University, Changchun, Jilin, China
| | - Yihang Liu
- Department of Cardiology, the Second Hospital of Jilin University, Changchun, Jilin, China
| | - Chao Qi
- Department of Cardiology, the Second Hospital of Jilin University, Changchun, Jilin, China
| | - Yang Lu
- Department of Cardiology, the Second Hospital of Jilin University, Changchun, Jilin, China
| | - Ning Liu
- Department of Cardiology, the Second Hospital of Jilin University, Changchun, Jilin, China
| | - Youyou Yan
- Department of Cardiology, the Second Hospital of Jilin University, Changchun, Jilin, China
| | - Lulu Liu
- Department of Cardiology, the Second Hospital of Jilin University, Changchun, Jilin, China
| | - Gang Hui
- Department of Cardiology, the Second Hospital of Jilin University, Changchun, Jilin, China
| | - Bin Liu
- Department of Cardiology, the Second Hospital of Jilin University, Changchun, Jilin, China
- * E-mail:
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15
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Stenumgård PS, Rakotondranaivo MJ, Sletvold O, Follestad T, Ellekjær H. Stroke in a resource-constrained hospital in Madagascar. BMC Res Notes 2017; 10:307. [PMID: 28738901 PMCID: PMC5525216 DOI: 10.1186/s13104-017-2627-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Accepted: 07/13/2017] [Indexed: 11/11/2022] Open
Abstract
Background Stroke is reported as the most frequent cause of in-hospital death in Madagascar. However, no descriptive data on hospitalized stroke patients in the country have been published. In the present study, we sought to investigate the feasibility of collecting data on stroke patients in a resource-constrained hospital in Madagascar. We also aimed to characterize patients hospitalized with stroke. Methods We registered socio-demographics, clinical characteristics, and early outcomes of patients admitted for stroke between 23 September 2014 and 3 December 2014. We used several validated scales for the evaluation. Stroke severity was measured by the National Institutes of Health Stroke Scale (NIHSS), disability by the modified Rankin Scale (mRS), and function by the Barthel Index (BI). Results We studied 30 patients. Sixteen were males. The median age was 62.5 years (IQR 58–67). The NIHSS and mRS were completed for all of the patients, and BI was used for the survivors. Three patients received a computed tomography (CT) brain scan. The access to laboratory investigations was limited. Electrocardiographs (ECGs) were not performed. The median NIHSS score was 16.5 (IQR 10–35). The in-hospital stroke mortality was 30%. At discharge, the median mRS score was 5 (IQR 4–6), and the median BI score was 45 (IQR 0–72.5). Conclusions Although the access to brain imaging and supporting investigations was deficient, this small-scale study suggests that it is feasible to collect essential data on stroke patients in a resource-constrained hospital in Madagascar. Such data should be useful for improving stroke services and planning further research. The hospitalized stroke patients had severe symptoms. The in-hospital stroke mortality was high. At discharge, the disability category was high, and functional status low.
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Affiliation(s)
- Pål Sigurd Stenumgård
- Department of Geriatrics, St. Olavs Hospital, Postbox 3250, Sluppen, 7006, Trondheim, Norway. .,Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Postbox 8905, 7491, Trondheim, Norway.
| | | | - Olav Sletvold
- Department of Geriatrics, St. Olavs Hospital, Postbox 3250, Sluppen, 7006, Trondheim, Norway.,Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Postbox 8905, 7491, Trondheim, Norway
| | - Turid Follestad
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Postbox 8905, 7491, Trondheim, Norway
| | - Hanne Ellekjær
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Postbox 8905, 7491, Trondheim, Norway.,Stroke Unit, St. Olavs Hospital, Postbox 3250, Sluppen, 7006, Trondheim, Norway
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16
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Raji YR, Abiona T, Gureje O. Awareness of hypertension and its impact on blood pressure control among elderly nigerians: report from the Ibadan study of aging. Pan Afr Med J 2017; 27:190. [PMID: 28904715 PMCID: PMC5579467 DOI: 10.11604/pamj.2017.27.190.11682] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 07/04/2017] [Indexed: 01/13/2023] Open
Abstract
INTRODUCTION Hypertension is highly prevalent among the elderly. Its awareness has a direct influence on control through drug adherence. Earlier studies have shown that awareness of hypertension is low among sub-Saharan African populations but only a few studies have looked at the prevalence and awareness of hypertension among the elderly. METHODS The Ibadan Study of Ageing is a longitudinal cohort study of the mental and physical health status as well as the functioning of elderly persons residing in the Yoruba-speaking areas of Nigeria. Study was conducted in multiple waves from 2003/2004 to 2009. This report is based on the sample studied in 2007 (N = 1469). Respondents, aged ≥ 65 years, were assessed for the presence of hypertension, its awareness, receipt of and adherence to medication for the condition, and effectiveness of treatment on the control of blood pressure. Blood pressure was measured with the use of digital monitors (Omron MS - 2 Basic Model). Awareness of the diagnosis of hypertension was ascertained by self-reports. We explored social, economic, demographic and clinical correlates of the presence of hypertension, its awareness and control using multiple logistic regression analyses. RESULTS The sample was composed of 809 (55.1%) females and 666 (44.9%) males. The mean age of the participants was 76.9 ± 8.4 years. Hypertension (defined as previous diagnosis by a health provider or a measured blood pressure higher than or equal to 140/90 mm Hg) was recorded in 973 (62.2%) participants, with females having a prevalence of 61.4% and males that of 70.1%. Other than female gender, residing in urban/semi urban areas and being overweight or obesity were associated with the occurrence of hypertension. Among those assessed to have hypertension, 78% were not previously aware of its presence. Factors independently associated with lack of awareness of hypertension included low socioeconomic class (OR 8.21, 95% CI 3.72-18.11, P < 0.001), and BMI >25kg/m2 (OR 3.11, 95% CI 1.36-7.09, P < 0.009). Among those who were aware of the presence of hypertension and were on treatment, 77.3% still had uncontrolled hypertension. Only obesity or overweight (OR 5.56, 95% CI 1.35 - 22.83, P < 0.016) was independently associated with poor blood pressure control. CONCLUSION The prevalence of hypertension among elderly Nigerians is high and those affected are often not aware of having the condition. Only a minority of those who receive treatment for the condition have adequate blood pressure control. The findings highlight the need for improved healthcare for the growing population of elderly persons, with particular attention to early detection and effective control of the condition.
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Affiliation(s)
- Yemi Raheem Raji
- Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Taiwo Abiona
- Department of Community Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Oye Gureje
- Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria
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17
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Hypertension, an Emerging Problem in Rural Cameroon: Prevalence, Risk Factors, and Control. Int J Hypertens 2016; 2016:5639146. [PMID: 28053779 PMCID: PMC5178358 DOI: 10.1155/2016/5639146] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2016] [Accepted: 11/15/2016] [Indexed: 11/18/2022] Open
Abstract
Background. Despite the increasing trends suggesting that hypertension is a growing public health problem in developing countries, studies on its prevalence, associated risk factors, and extent of blood pressure control have been inequitably done in urban and rural communities in these countries. We therefore aimed to determine the prevalence of hypertension and extent of blood pressure control in rural Cameroon. Methods. This was a community-based cross-sectional study conducted in rural Cameroon (the Moliwe Health Area). Participants aged 21 years and above were recruited by a probability proportional to size multistage sampling method, using systematic sampling for household selection and random sampling for participant selection. Blood pressure, weight, and height were measured by standard methods. Hypertension was defined as BP ≥ 140/90 mmHg. Results. The prevalence of hypertension among the 733 participants recruited was 31.1% (95% CI: 27.8-34.6) and 71% (95% CI: 58.7-81.7) of these hypertensive patients were newly diagnosed. Only 21.2% (95% CI: 12.1-33.3) of known hypertensives had a well controlled BP. Age, obesity, low educational status, and being married were associated with HTN after adjusting for confounders. Conclusions. The high prevalence of hypertension and inadequate BP control among known hypertensives in rural Cameroon warrants greater sensitization and regular screening to reduce hypertension-related morbidity and mortality.
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18
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Krishnadath ISK, Jaddoe VWV, Nahar-van Venrooij LM, Toelsie JR. Ethnic differences in prevalence and risk factors for hypertension in the Suriname Health Study: a cross sectional population study. Popul Health Metr 2016; 14:33. [PMID: 27660556 PMCID: PMC5026769 DOI: 10.1186/s12963-016-0102-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Accepted: 09/09/2016] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Limited information is available about the prevalence, ethnic disparities, and risk factors of hypertension within developing countries. We used data from a nationwide study on non-communicable disease (NCD) risk factors to estimate, explore, and compare the prevalence of hypertension overall and in subgroups of risk factors among different ethnic groups in Suriname. METHOD The Suriname Health Study used the World Health Organization Steps design to select respondents with a stratified multistage cluster sample of households. The overall and ethnic specific prevalences of hypertension were calculated in general and in subgroups of sex, age, marital status, educational level, income status, employment, smoking status, residence, physical activity, body mass index (BMI), and waist circumference (WC). Differences in the prevalence between ethnic subgroups were assessed using the Chi-square test. We used several adjustment models to explore whether the observed ethnic differences were explained by biological, demographic, lifestyle, or anthropometric risk factors. RESULTS The prevalence of hypertension was 26.2 % (95 % confidence interval 25.1 %-27.4 %). Men had higher mean values for systolic and diastolic blood pressure compared to women. Blood pressure increased with age. The prevalence was highest for Creole, Hindustani, and Javanese and lowest for Amerindians, Mixed, and Maroons. Differences between ethnic groups were measured in the prevalence of hypertension in subcategories of sex, marital status, education, income, smoking, physical activity, and BMI. The major difference in association of ethnic groups with hypertension was between Hindustani and Amerindians. CONCLUSION The prevalence of hypertension in Suriname was in the range of developing countries. The highest prevalence was found in Creoles, Hindustani, and Javanese. Differences in the prevalence of hypertension were observed between ethnic subgroups with biological, demographic, lifestyle, and anthropometric risk factors. These findings emphasize the need for ethnic-specific research and prevention and intervention programs.
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Affiliation(s)
- Ingrid S. K. Krishnadath
- Department of Public Health, Faculty of Medical Sciences, Anton de Kom University of Suriname, Paramaribo, Suriname
| | - Vincent W. V. Jaddoe
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Lenny M. Nahar-van Venrooij
- Department of Public Health, Faculty of Medical Sciences, Anton de Kom University of Suriname, Paramaribo, Suriname
| | - Jerry R. Toelsie
- Department of Physiology, Faculty of Medical Sciences, Anton de Kom University of Suriname, Paramaribo, Suriname
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Paquissi FC, Cuvinje ABP, Cuvinje AB, Paquissi AM. Hypertension among Outpatients at a General Hospital in South Angola: Prevalence, Awareness, Treatment, and Control. CLINICAL MEDICINE INSIGHTS-CARDIOLOGY 2016; 10:111-6. [PMID: 27398036 PMCID: PMC4933533 DOI: 10.4137/cmc.s39561] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Revised: 05/22/2016] [Accepted: 05/27/2016] [Indexed: 12/29/2022]
Abstract
OBJECTIVE This study aimed to assess the prevalence, awareness, treatment, and control of hypertension in patients attending an outpatient clinic at a general hospital in Huambo, South Angola. METHODS A total of 265 subjects aged 18 years and older were included. Evaluation included complete interview and blood pressure measurement using a validated automatic device. RESULTS The prevalence rates of hypertension and prehypertension were 38.5% (95% confidence interval [CI]: 32.83%-44.90%) and 30.20% (95% CI: 24.52%-36.22%), respectively. Hypertension was associated with age (>35 years; odds ratio [OR] = 10.09, 95% CI: 5.46-18.66, P < 0.01) and female gender (OR = 1.81, 95% CI: 1.08-3.05, P = 0.02). Among total hypertensive patients, 54.9% were aware of their diagnosis, 28.43% were in treatment, and 7.84% had controlled blood pressure. Lack of awareness was significantly higher in younger (age ≤ 37 years; OR = 3.28, 95% CI: 1.13-9.49, P = 0.02). CONCLUSION This study revealed a high prevalence of hypertension, with low awareness, treatment, and control rates. Greater efforts are necessary to overcome these challenges.
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Affiliation(s)
| | | | - Almeida B Cuvinje
- Biomedical Scientist, José Eduardo dos Santos University, Huambo, Republic of Angola
| | - Arlindo M Paquissi
- Intensive Care Unit, Emergency Department, Clínica Multiperfil, Luanda, Republic of Angola
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