Physical Behaviors and Their Association With Adiposity in Men and Women From a Low-Resourced African Setting

BACKGROUND

We first explored the associations between physical behaviors and total and regional adiposity. Second, we examined how reallocating time in different physical behaviors was associated with total body fat mass in men and women from a low-income South African setting.

METHODS

This cross-sectional study included a sample of 692 participants (384 men and 308 women) aged 41-72 years. Physical behaviors were measured using integrated hip and thigh accelerometry to estimate total movement volume and time spent in sleeping, sitting/lying, standing, light physical activity, and moderate to vigorous physical activity (MVPA). Total body fat mass and regional adiposity were measured using dual-energy X-ray absorptiometry.

RESULTS

The associations between total movement volume and measures of regional obesity were mediated by total body adiposity. In men, reallocating 30 minutes of sitting/lying to 30 minutes of MVPA was associated with 1.0% lower fat mass. In women, reallocation of 30 minutes of sitting/lying to MVPA and 30 minutes of standing to MVPA were associated with a 0.3% and 1.4% lower fat mass, respectively.

CONCLUSIONS

Although the association between physical behaviors and fat mass differed between men and women, the overall public health message is similar; reallocating sedentary time to MVPA is associated with a reduction in fat mass in both men and women.

Retention of health care workers at health facility, trends in the retention of knowledge and correlates at 3rd year following training of health care workers on the prevention of mother-to-child transmission (PMTCT) of HIV-National Assessment

BACKGROUND

Knowledgeable Health Care Workers (HCWs) are indispensable for the proper management of clients. We investigated retention of HCWs at health facility and retention of knowledge at 18, 24 and 36 months after training and correlates for retention of knowledge at 3rd year.

METHODS

A cross-sectional study was conducted among 1000 HCWs, 710 were trained and 290 untrained working at the PMTCT of HIV services in health facilities of the ten regions of Cameroon. A Multiple Choice Questionnaire (MCQ) on HIV management with focus on PMTCT of HIV was used to assess retention of HCWs at the health facility and retention of knowledge. Summary statistics described mean scores for retention of HCWs and retention of knowledge. One-way Analysis of Variance summarized the differences in retention of knowledge over time after training. Correlates for retention of knowledge were investigated by logistic regression analysis.

RESULTS

The retention of HCWs at health facilities in PMTCT of HIV services was 85%. Trained HCWs had higher mean scores for retention of knowledge than untrained HCWs, p < 0.001. Knowledge attrition was observed from 18, 24 to 36 months following training. Differences in the mean scores for retention of knowledge were observed between state-owned with private and confessionary health facilities but not among trained HCWs at 18, 24 or 36 months. Highest mean scores for retention of knowledge were observed in District Hospitals, Sub-Divisional Hospitals, and Integrated Health Centres. Correlates for retention of knowledge were: gender, type of health facility, location, longevity at PMTCT services, trained others and had means to apply what was trained to do.

CONCLUSION

Retention of trained HCWs at health facilities was high, mean scores for retention of knowledge was average and knowledge attrition was observed over time. This research is critical to understand where interventions may be most effective.

Protocol for systematic review and meta-analysis of sex hormones and diabetes risk in ageing men and women of African ancestry

AIM

To present the protocol of a systematic review and meta-analysis of the available evidence examining the association between sex hormones and type 2 diabetes risk in ageing men and women of African descent.

METHODS

We shall conduct a comprehensive search of published studies that examined the association between sex hormones and type 2 diabetes risk in men and women aged ≥40 years from 01/01/1980 to 31/03/2018 with no language restriction. Databases to be searched include: PubMed, Scopus, Cochrane Library, Cumulative Index to Nursing and Allied Health, ISI Web of Science, Clinical Trial registries, Google Scholar and institutional websites such as the WHO, American Diabetes Association, International Diabetes Federation, World Diabetes Foundation, European Association for the Study of Diabetes, African Journal Online and ProQuest databases. This protocol is developed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols guidelines. Independent screening for eligible studies using defined criteria and data extraction, will be completed in duplicate. Discrepancies will be resolved by consensus or consultation with a third researcher. Risk of bias of included studies will be assessed by the appropriate Cochrane risk of bias tool. The overall association estimates will be pooled using appropriate meta-analytic techniques. Heterogeneity will be assessed using Cochrane Q statistic and the inconsistency index (I2). The random effects model will be used to calculate a pooled estimate.

ETHICS AND DISSEMINATION

No ethics clearance is required as no primary data will be collected. The systematic review and meta-analysis are part of a PhD project at WITS University (Johannesburg, South Africa) and results will be presented at conferences and published in a peer-review journal. The results will guide future population specific interventions.

PROSPERO REGISTRATION NUMBER

CRD42017074581.

Distribution and patterning of non-communicable disease risk factors in indigenous Mbororo and non-autochthonous populations in Cameroon: cross sectional study

BACKGROUND

Data on Non-Communicable Diseases (NCDs) among indigenous populations are needed for interventions to improve health care. We conducted a survey in 2013 among rural indigenous Mbororo, Fulbe and other ethnic groups to determine the distribution of risk factors of NCDs in Cameroon.

METHODS

We selected seven targets of NCD risk factors: tobacco use, alcohol use, diet (salt/sugar intake, vegetable/fruit consumption), raised blood pressure, raised blood glucose, physical inactivity and weight measures. The WHO STEPwise approach was used to collect data from 1921 consenting participants aged ≥20 years. Prevalence of NCD risk factors was summarised by descriptive statistics.

RESULTS

Underweight was widespread, Mbororo (50.8%) and Fulbe (37.2%). Increase in prevalence of six risk factors was observed among the Fulbe when compared to Mbororo. Participants aged 20-39 years had low levels of physical activity, poor diet and higher levels of alcohol consumption (except Mbororo) and those aged ≥40 years had higher prevalence of diabetes, hypertension, current smoking and overweight/obesity. Men and women differed in current smoking, occasional/daily alcohol consumption, pre-hypertension and hypertension, continuous walking for at least ten minutes, and weight measures for Fulbe and Mbororo, p < 0.05.

CONCLUSION

Distribution of NCD risk factors was high among settled Fulani (Fulbe) when compared to indigenous nomadic Fulani (Mbororo). Change from nomadic to settled life might be accompanied by higher prevalence of NCDs. This data should be used to develop intervention programmes to curb the rising burden of NCDs in rural indigenous and non-indigenous populations.