An integrative methodology for classifying physical activity level in apparently healthy populations for use in public health

Screening for diabetes in the adult population above the age of 20 years among inhabitants of rural agricultural and rural desert areas of Egypt

AIMS

The present study focused on identifying the current prevalence of diabetes mellitus (DM) in rural desert and rural agricultural areas of Egypt and comparing these findings to those of previous studies that reported lower prevalence rates of DM in rural desert versus rural agricultural areas.

METHODS

The study included a total of 15,000 participants aged 20 years or older; 10,000 were from rural agricultural areas and 5000 were from rural desert areas in Egypt. The prevalence of DM and impaired fasting glucose for each group was recorded, participants were interviewed, medical history was obtained, physical examinations were performed, and fasting plasma glucose was used for diagnosis of DM and IFG using American Diabetes Association criteria.

RESULTS

The prevalence of DM was 12.7% in agricultural areas and 4.7% in desert areas. The prevalence of newly diagnosed cases was 15.8% and 9.9% in agricultural and desert areas, respectively. The prevalence of IFG was 11.14% in agricultural and 8.04% in desert areas. These results suggest that living in a rural area makes patients at a higher risk of developing DM (OR = 2.968 CI (2.570-3.428) p < 0.001) and IFG (OR = 1.43, CI (1.272-1.616), p < 0.001). Logistic regression analysis revealed that increased age, living in agricultural areas, higher body mass index and positive family history of diabetes were the significant predictors affecting the prevalence of DM.

CONCLUSIONS

The prevalence of DM, IFG, and overall dysglycemia (DM + IFG) in Egypt has generally increased in rural areas, with a lower prevalence in rural desert compared to rural agricultural areas.

Epidemiological characteristics of different patterns of obesity among adults in rural communities of south-east Nigeria: a population-based cross-sectional study

Background

Obesity is a complex disease characterised by excess fat accumulation and health risks. There is paucity of data on epidemiology of obesity patterns among adults in rural Nigeria. This study aimed to provide current data on the prevalence and predictors of three patterns of obesity (abdominal obesity alone, general obesity alone and a combination of both) among adults in three rural communities of Enugu State, South-east Nigeria to enhance specific obesity prevention and control programmes/interventions.

Methods

This population-based cross-sectional study involved 500 adults selected through a six-stage random sampling technique. Questionnaire was used to obtain data on socio-economic, dietary and lifestyle characteristics of the respondents. Weight, height and waist circumference were measured by standard procedures. Body mass index was used to assess general obesity while abdominal obesity was assessed through waist circumference. Each respondent was classified under only one of the three patterns: general obesity alone, abdominal obesity alone and combined obesity. Binary and multivariate logistic regression analyses were used to assess the predictors. Significance was set P<0.05.

Results

Prevalence of abdominal obesity alone was 6.0%. General obesity alone was found among 31.4% and 45.6% were affected by combined obesity. Being a female (AOR:0.35, 95% C.I.: 0.14, 0.88) and not skipping meals (AOR:0.24, 95% C.I.: 0.10, 0.55) were associated with less likelihood of abdominal obesity but ≥3 times daily meal intake increased the risk by 2.52 (AOR:2.52, 95% C.I.:1.10, 5.75). Predictors of general obesity alone were age 41-60 years (AOR:1.84, 95% C.I.:1.14, 2.97), being a female (AOR:7.65, 95% C.I.:4.77, 12.26) and having any form of formal education (AOR:2.55, 95% C.I.:1.10, 5.91). Combined obesity was less likely among 41-60 year-olds (AOR:0.36, 95% C.I.:0.23, 0.56) and females (AOR:0.21, 95% C.I.:0.13, 0.32). Never married (AOR:1.94, 95% C.I.:1.03, 3.67) and vigorous physical activities (AOR:1.81, 95% C.I.:1.08, 3.02) increased the risk of combined obesity by almost 2.

Conclusions

Prevalence of abdominal obesity alone, general obesity alone and combined obesity were high. They were functions of age, sex, never married, having any form of formal education, skipping meals, ≥3 daily meal intake and self-reported vigorous physical activity. Focused nutrition and health education are recommended strategies for prevention and control of obesity.