Prevalence of and factors associated with hypertension, diabetes, stroke and heart attack multimorbidity in Botswana: Evidence from STEPS 2014 survey

Alcohol consumption among persons living with hypertension: evidence from a population-based study in Cape Verde

BACKGROUND

Despite the well-documented effects of alcohol consumption on hypertension risk, there are persons living with hypertension who consume alcohol and may be at risk of alcohol use disorder (AUD). This paradox poses a critical public health concern and underscores a need to understand the alcohol consumption behavior of persons living with hypertension. This study investigates the prevalence and factors associated with alcohol consumption and AUD among persons living with hypertension in Cape Verde.

METHODS

Using the 2020 WHO STEPS survey, we analyzed the observations of 1,136 adults in Cape Verde. Cross-tabulations, bivariable and multivariable logistic regression were performed in STATA version 18. The results from the multivariable logistic regression model were reported in their adjusted odds ratio (AOR) and corresponding 95% confidence interval (CI).

RESULTS

Overall, 784 (69.1%) of the total sample reported consuming alcohol. The study revealed that 22.8% of those who consumed alcohol experienced AUD. Specifically, alcohol dependence symptoms were prevalent in 13.7% of participants who consumed alcohol in the last 12 months. Social/family problem and functional impairments were prevalent in 11.6% and 8.2%, respectively. Women were significantly less likely to consume alcohol [AOR = 0.17; 95% CI: 0.12-0.25] and experience AUD [AOR = 0.32; 95%CI: 0.20-0.51] compared to men. Additionally, individuals who consumed processed foods high in salt had more than twice the odds of consuming alcohol [AOR = 2.34; 95% CI: 1.62-3.39]. Urban residents [AOR = 1.76; 95% CI: 1.33-2.31] and current smokers [AOR = 2.23; 95% CI: 1.13-4.38] were more likely to consume alcohol. Individuals with higher education [AOR = 4.34; 95% CI: 1.97-9.55] were more likely to consume alcohol but less likely to experience AUD [AOR = 0.09, 95%CI: 0.02-1.87].

CONCLUSION

The high prevalence of alcohol consumption and AUD among persons living with hypertension in Cape Verde signals a critical need for targeted public health strategies. Interventions should prioritize men, urban residents, current smokers, and individuals with higher education, given their higher likelihood of alcohol consumption. Additionally, given the lower likelihood of AUD among highly educated individuals, yet their higher alcohol consumption rates, interventions should balance education on the risks of excessive alcohol use while promoting responsible drinking.

Hypertension in sub-Saharan Africa: the current profile, recent advances, gaps, and priorities

Recent global and regional reports consistently confirm the high and increasing prevalence of hypertension in sub-Saharan Africa (SSA), with poor detection, treatment, and control rates. This narrative review summarises the burden of hypertension in SSA and recent findings from community-based hypertension management strategies. We further outline prominent risk factors according to recent data and associated underlying mechanisms for hypertension development. An extensive review of literature showed that most countries have reported on the prevalence of hypertension during 2017-2023, despite limitations linked to the lack of nationally representative studies, heterogeneity of sampling and data collection methods. Task-shifting approaches that assign roles to model patients and community health workers reported improved linkage to healthcare services and adherence to medication, with inconsistent findings on blood pressure (BP)-lowering effects over time. The regularly reported risk factors include unhealthy diet, sedentary lifestyle, increased adiposity and underweight, ageing, level of education, and/or income as well as psychosocial factors. Newer data on the pathophysiological mechanisms leading to hypertension and potential areas of intervention are reported from children and adults and include, among others, salt-handling and volume overload, endothelial function, BP dipping patterns and the role of human immunodeficiency virus . To conclude, significant strides have been made in data reporting from SSA on the burden of hypertension in the region as well as biomarker research to improve understanding and identification of areas of intervention. However, gaps remain on linkage between knowledge generation, translation, and implementation research. Coordinated studies addressing both discovery science and public health are crucial to curb hypertension development and improve management in SSA.

Prevalence and associated factors of diabetes among adult populations of Hawassa town, southern Ethiopia: A community based cross-sectional study

INTRODUCTION

Knowing the magnitude and preventable risk factors of diabetes has a significant contribution in targeted prevention intervention which ultimately ensures the existence of healthier and productive individuals in a country. Diabetes has untoward impact on health, social and economic consequences. Exploring preventable risk factors are extremely important because of their potential association and interaction with diabetes. Therefore, the aim of this study was to investigate the magnitude and modifiable risk factors of diabetes among adult populations in Hawassa town, southern Ethiopia.

METHODS

A community based cross-sectional study was conducted from September, 2023 to November, 2023 among adult populations. A multi-stage sampling technique was employed to select 1,113 study participants between the ages of 20-69 years. An interviewer-administered questionnaire was used to collect data. Additionally, participants were also instructed to fast overnight, after which the standard fasting blood glucose test was conducted. A binary logistic regression model was fitted to identify independent predictors of diabetes.

RESULTS

The overall prevalence of diabetes was 14.4% (95% Confidence Interval (CI): 12.4%, 16.4%). Being male (Adjusted Odds Ratio (AOR):2.10; 95% CI: 1.34, 3.29), being unable to read and write (AOR: 3.38; 95% CI: 1.09, 10.47), read and write (AOR: 3.38; 95% CI: 1.09, 10.47) and medium cycle (AOR 2.79; 95% CI: 1.02, 7.63) compared to college and above, consume less than 5 servings of fruits on daily base (AOR: 2.80; 95% CI: 1.18, 6.62), having ever chewed khat (AOR 6.50; 95% CI: 4.07, 10.39) and being overweight and obese (AOR: 2.43; 95% CI: 1.54, 3.83) were independently associated with diabetes mellitus (DM).

CONCLUSION

This study identified a high prevalence of diabetes among adults in Hawassa, driven by various risk factors. This presents an opportunity to mitigate diabetes risk through public health measures, including avoiding khat chewing, promoting healthy diets, managing overweight and obesity, implementing community-based screening, enhancing health literacy, and integrating health information into daily life.

Multimorbidity and its associated risk factors among adults in northern Sudan: a community-based cross-sectional study

BACKGROUND

Multimorbidity (having two or more coexisting long-term conditions) is a growing global challenge. However, data on multimorbidity among adults in Africa, including Sudan, are scarce. Thus, this study aimed to investigate the prevalence of multimorbidity and its associated risk factors among adults in Sudan.

METHODS

A community-based cross-sectional study was conducted in northern Sudan from March 2022 to May 2022. Participants' sociodemographic characteristics were assessed using a questionnaire. Multimorbidity was defined as having two or more coexisting long-term conditions, including diabetes mellitus (DM), hypertension, obesity, anaemia and depression-anxiety. Multivariate logistic regression analyses were performed to determine the associated factors.

RESULTS

The participants included 250 adults: 119 (47.6%) males and 131(52.4%) females. The median interquartile range (IQR) of the enrolled adults of the age was 43.0 (30.0‒55.0) years. Of the 250 adults, 82(32.8%), 17(6.8%), 84(33.6%), and 67(26.8%) were normal weight, underweight, overweight, and obese, respectively; 148(59.2%), 72(28.8%), 63(25.2%), 67(26.8%), and 98(39.2%) had hypertension, DM, anaemia, obesity, and depression-anxiety, respectively. A total of 154 adults (61.6%) had multimorbidity: 97(38.8%), 49(19.6%), and 8(3.2%) had two, three, and four morbidities, respectively. The remaining 21 (8.4%), and 75 (30.0%) adults had no morbidity, and one morbidity, respectively. In amultivariate logistic regression analysis, increasing age (adjusted odd ratio [AOR] = 1.03, 95% CI = 1.01‒1.05), and female sex (AOR = 2.17, 95% CI = 1.16‒4.06) were associated with multimorbidity.

CONCLUSIONS

The high prevalence of multimorbidity revealed in this study uncovers a major public health problem among Sudanese adults. Our results show that increasing age and female sex are associated with multimorbidity. Additional extensive studies are necessary to evaluate the magnitude of multimorbidity for improved future planning and establishing effective health systems.

Multimorbidity in African ancestry populations: a scoping review

OBJECTIVES

Multimorbidity (MM) is a growing concern linked to poor outcomes and higher healthcare costs. While most MM research targets European ancestry populations, the prevalence and patterns in African ancestry groups remain underexplored. This study aimed to identify and summarise the available literature on MM in populations with African ancestry, on the continent, and in the diaspora.

DESIGN

A scoping review was conducted in five databases (PubMed, Web of Science, Scopus, Science Direct and JSTOR) in July 2022. Studies were selected based on predefined criteria, with data extraction focusing on methodology and findings. Descriptive statistics summarised the data, and a narrative synthesis highlighted key themes.

RESULTS

Of the 232 publications on MM in African-ancestry groups from 2010 to June 2022-113 examined continental African populations, 100 the diaspora and 19 both. Findings revealed diverse MM patterns within and beyond continental Africa. Cardiovascular and metabolic diseases are predominant in both groups (80% continental and 70% diaspora). Infectious diseases featured more in continental studies (58% continental and 16% diaspora). Although many papers did not specifically address these features, as in previous studies, older age, being women and having a lower socioeconomic status were associated with a higher prevalence of MM, with important exceptions. Research gaps identified included limited data on African-ancestry individuals, inadequate representation, under-represented disease groups, non-standardised methodologies, the need for innovative data strategies, and insufficient translational research.

CONCLUSION

The growing global MM prevalence is mirrored in African-ancestry populations. Recognising the unique contexts of African-ancestry populations is essential when addressing the burden of MM. This review emphasises the need for additional research to guide and enhance healthcare approaches for African-ancestry populations, regardless of their geographic location.

Exploring factors related to heart attack complicated with hypertension using a Bayesian network model: a study based on the China Health and Retirement Longitudinal Study

Objectives

While Bayesian networks (BNs) represents a good approach to discussing factors related to many diseases, little attention has been poured into heart attack combined with hypertension (HAH) using BNs. This study aimed to explore the complex network relationships between HAH and its related factors, and to achieve the Bayesian reasoning for HAH, thereby, offering a scientific reference for the prevention and treatment of HAH.

Methods

The data was downloaded from the Online Open Database of CHARLS 2018, a population-based longitudinal survey. In this study, we included 16 variables from data on demographic background, health status and functioning, and lifestyle. First, Elastic Net was first used to make a feature selection for highly-related variables for HAH, which were then included into BN model construction. The structural learning of BNs was achieved using Tabu algorithm and the parameter learning was conducted using maximum likelihood estimation.

Results

Among 19,752 individuals (9,313 men and 10,439 women) aged 64.73 ± 10.32 years, Among 19,752 individuals (9,313 men and 10,439 women), there are 8,370 ones without HAH (42.4%) and 11,382 ones with HAH (57.6%). What's more, after feature selection using Elastic Net, Physical activity, Residence, Internet access, Asset, Marital status, Sleep duration, Social activity, Educational levels, Alcohol consumption, Nap, BADL, IADL, Self report on health, and age were included into BN model establishment. BNs were constructed with 15 nodes and 25 directed edges. The results showed that age, sleep duration, physical activity and self-report on health are directly associated with HAH. Besides, educational levels and IADL could indirectly connect to HAH through physical activity; IADL and BADL could indirectly connect to HAH through Self report on health.

Conclusion

BNs could graphically reveal the complex network relationship between HAH and its related factors. Besides, BNs allows for risk reasoning for HAH through Bayesian reasoning, which is more consistent with clinical practice and thus holds some application prospects.

Socioeconomic inequalities in diabetes prevalence: the case of South Africa between 2003 and 2016

BACKGROUND

Diabetes is a growing epidemic worldwide and the effect of socioeconomic status (SES) is frequently acknowledged in the literature. This study aims to compare the effect of SES on diabetes prevalence in South Africa between 2003 and 2016. In addition, vulnerable groups regarding diabetes development in 2016 will be identified.

METHODS

Using DHS data there were 8,006 participants (59.19% women) in 2003 and 10,292 participants (59.42% women) in 2016. Logistic regression and odds ratios (ORs) with 95% confidence intervals (CIs) were calculated for diabetes by age, gender, educational level and place of residence. To identify vulnerable groups with high risk of developing diabetes in 2016, the method of p-value based regression tree analysis was applied using "wealth index" and "weight perception" as additional variables.

RESULTS

There was an increase in diabetes prevalence from 3.86% in 2003 to 4.46% in 2016. Women had more risk of developing diabetes at both time points (27% in 2003 and 24% in 2016 more risk). Increase in age and living in urban areas were associated with more risk of developing diabetes at both time points. There was no specific pattern regarding risk of developing diabetes and educational level in case of women. However, men who completed secondary school or had a higher diploma or above had more risk of developing diabetes in 2016 (OR = 2.24 and 4.67 respectively). Vulnerable groups who have higher risk of developing diabetes in 2016 were participants aged "60 years or older" with a wealth index of "rich" or "richer", followed by participants from the same age group who were "poor" or "poorer" and participants aged "40-59 years" with a wealth index of "rich" or "richer". Subsequently were participants from the age group "15-39 years" with a weight perception of "overweight" or "obese".

CONCLUSION

Diabetes prevalence increased in South Africa between 2003 and 2016. Main risk factors were age, gender and living in urban areas. Men with high educational level were more at risk of developing diabetes in 2016. Vulnerable groups in 2016 were participants 40 years and older, particularly with high SES. This was followed by younger participants who were obese or overweight.