High prevalence of hypertension and of risk factors for non-communicable diseases NCDs: a population based cross-sectional survey of NCDS and HIV infection in Northwestern Tanzania and Southern UgandaReport as inadecuate




High prevalence of hypertension and of risk factors for non-communicable diseases NCDs: a population based cross-sectional survey of NCDS and HIV infection in Northwestern Tanzania and Southern Uganda - Download this document for free, or read online. Document in PDF available to download.

BMC Medicine

, 13:126

First Online: 29 May 2015Received: 13 January 2015Accepted: 30 April 2015DOI: 10.1186-s12916-015-0357-9

Cite this article as: Kavishe, B., Biraro, S., Baisley, K. et al. BMC Med 2015 13: 126. doi:10.1186-s12916-015-0357-9

Abstract

BackgroundThe burden of non-communicable diseases NCDs is increasing in sub-Saharan Africa, but data available for intervention planning are inadequate. We determined the prevalence of selected NCDs and HIV infection, and NCD risk factors in northwestern Tanzania and southern Uganda.

MethodsA population-based cross-sectional survey was conducted, enrolling households using multistage sampling with five strata per country one municipality, two towns, two rural areas. Consenting adults ≥18 years were interviewed using the WHO STEPS survey instrument, examined, and tested for HIV and diabetes mellitus DM. Adjusting for survey design, we estimated population prevalences of hypertension, DM, obstructive pulmonary disease, cardiac failure, epilepsy and HIV, and investigated factors associated with hypertension using logistic regression.

ResultsAcross strata, hypertension prevalence ranged from 16 % 95 % confidence interval CI: 12 % to 22 % to 17 % CI: 14 % to 22 % in Tanzania, and from 19 % CI: 14 % to 26 % to 26 % CI: 23 % to 30 % in Uganda. It was high in both urban and rural areas, affecting many young participants. The prevalence of DM 1 % to 4 % and other NCDs was generally low. HIV prevalence ranged from 6 % to 10 % in Tanzania, and 6 % to 12 % in Uganda. Current smoking was reported by 12 % to 23 % of men in different strata, and 1 % to 3 % of women. Problem drinking defined by Alcohol Use Disorder Identification Test criteria affected 6 % to 15 % men and 1 % to 6 % women. Up to 46 % of participants were overweight, affecting women more than men and urban more than rural areas. Most patients with hypertension and other NCDs were unaware of their condition, and hypertension in treated patients was mostly uncontrolled. Hypertension was associated with older age, male sex, being divorced-widowed, lower education, higher BMI and, inversely, with smoking.

ConclusionsThe high prevalence of NCD risk factors and unrecognized and untreated hypertension represent major problems. The low prevalence of DM and other preventable NCDs provides an opportunity for prevention. HIV prevalence was in line with national data. In Tanzania, Uganda and probably elsewhere in Africa, major efforts are needed to strengthen health services for the PREVENTION, early detection and treatment of chronic diseases.

KeywordsNon-communicable diseases hypertension diabetes mellitus heart failure obstructive pulmonary disease HIV infection NCD risk factors WHO STEPS survey Africa AbbreviationsaORadjusted odds ratio

ARTantiretroviral therapy

AUDITAlcohol Use Disorders Identification Test

BPblood pressure

BMIbody mass index

CDchronic disease

CIconfidence interval

COPDchronic obstructive pulmonary diseases

DMdiabetes mellitus

FBGfasting blood glucose

FEV1forced expiratory volume in the first second

FVCforced vital capacity

HHhouseholds

HIVhuman immunodeficiency virus

IQRinterquartile range

Nn, number

NCDnon-communicable disease

ORodds ratio

PAFpopulation attributable fraction

PNDparoxysmal nocturnal dyspnea

RBGrandom blood glucose

SSASubsaharan Africa

STEPSSTEPwise approach to surveillance of NCD risk factors WHO

USDUnites States dollars

WHOWorld Health Organisation

Bazil Kavishe and Samuel Biraro contributed equally to this work.

Electronic supplementary materialThe online version of this article doi:10.1186-s12916-015-0357-9 contains supplementary material, which is available to authorized users.

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Author: Bazil Kavishe - Samuel Biraro - Kathy Baisley - Fiona Vanobberghen - Saidi Kapiga - Paula Munderi - Liam Smeeth - Robert P

Source: https://link.springer.com/







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