scholarly journals Determinants of change in blood pressure in Ghana: Longitudinal data from WHO-SAGE Waves 1–3

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0244807
Author(s):  
Elias K. Menyanu ◽  
Barbara Corso ◽  
Nadia Minicuci ◽  
Ilaria Rocco ◽  
Joanna C. Russell ◽  
...  

The prevalence of hypertension is increasing in low- and middle-income countries, however statistics are generally derived from cross sectional surveys that utilize different methodologies and population samples. We investigated blood pressure (BP) changes over 11–12 years in a large cohort of adults aged 50 years and older (n = 820) included in the World Health Organization’s Study on global AGEing and adult health (WHO-SAGE Ghana) Wave 1 (2007/8) with follow up in Wave 3 (2019). Participants’ BP were measured in triplicate and a survey completed at both time points. Survey instruments collected information on sociodemographic characteristics, lifestyle, health behaviors and chronic conditions. While no significant difference was found in systolic BP between Waves 1 and 3, diastolic BP decreased by 9.7mmHg (mean = 88.6, 15.4 to 78.9, 13.6 respectively) and pulse pressure increased by 9.5mmHg (44.8, 13.7 to 54.3, 14.1). Awareness of hypertension increased by 37%, from (20% to 57%), but no differences were found for the proportion of hypertensives receiving treatment nor those that had controlled BP. Mixed effects modelling showed a decrease in diastolic BP was associated with increasing age, living in rural areas and having health insurance. Factors associated with an increased awareness of hypertension were residing in urban areas, having health insurance and increasing body mass index. While diagnosis of hypertension has improved over time in Ghana, there is an ongoing need to improve its treatment in older adults.

2013 ◽  
Vol 60 (3) ◽  
pp. 139-146
Author(s):  
Aleksandra Djeri ◽  
Irena Kuzmanovic-Radman ◽  
Milkica Grabez ◽  
Zorislava Bajic ◽  
Alma Prtina ◽  
...  

Introduction. Children with hearing impairment do not understand speech without specific instructions and cannot meet daily life requirements. Children with hearing and speech impairment have higher DMFT index and poorer oral hygiene than healthy children of the same age. The aim of this study was to determine oral health status and the prevalence of dental caries in children attending The Center for Education and Rehabilitation of Speech and Hearing in Banjaluka. Material and Methods. The study was conducted as a cross-sectional study and it included 66 children of both genders, age 3 to 18 years, with deciduous, mixed and permanent dentition. General information about the respondents, their socioeconomic status, dental hygiene habits and frequency of dental visits were obtained using a questionnaire. Dental examination was performed using a dental mirror, regular and proximal probe on the daylight, in accordance with World Health Organization guidelines. Oral examination included: number of present teeth, presence of caries, restorations, number of extracted teeth. These data was entered in each patient?s dental record. The DMFT index was used for the assessment of dental status. Results. Results showed that the mean DMFT value in the total sample was 7.79. There was no significant difference in the DMFT index between genders (p=0.19). The significant difference was not found between children who live with parents and those who live in foster families (p=0.15). It was observed that the respondents from rural areas had higher DMFT index (8.68) than respondents from urban areas (5.83). The DMFT index increased with age and school age (p<0.001). Examined patients were most affected with dental caries (6.62%) and least affected with extracted teeth (0.38%). It was revealed that 6% of respondents do not brush their teeth, and 25.8% of respondents had never visited dentist. Conclusion. Children with hearing and speech impairment from Banjaluka have low level of oral health. The DMFT index, as one of the most important parameters of oral health in these children was much higher compared to European countries and other countries in the region.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mohammad Hassan Emamian ◽  
Hossein Ebrahimi ◽  
Hassan Hashemi ◽  
Akbar Fotouhi

Abstract Background Previous studies have reported a high prevalence of hypertension in Iranian students, especially in rural areas. The aim of this study was to investigate the daily intake of salt in students and its association with high blood pressure. Methods A random sub-sample was selected from the participants of the second phase of Shahroud schoolchildren eye cohort study and then a random urine sample was tested for sodium, potassium and creatinine. Urine electrolyte esexcretion and daily salt intake were calculated by Tanaka et al.’s formula. Results Among 1455 participants (including 230 participants from rural area and 472 girls), the mean age was 12.9 ± 1.7 year and the mean daily salt intake was 9.7 ± 2.6 g (95% CI 9.5–9.8). The mean salt consumption in rural areas [10.8 (95% CI 10.4–11.2)] was higher than urban areas [9.4 (95% CI 9.3–9.6)], in people with hypertension [10.8 (95% CI 10.3–11.3)] was more than people with normal blood pressure [9.4 (95% CI 9.3–9.6)], and in boys [9.8 (95% CI 9.7–10.0)] was more than girls [9.3 (95% CI 9.1–9.6)]. Higher age, BMI z-score, male sex and rural life, were associated with increased daily salt intake. Increased salt intake was associated with increased systolic and diastolic blood pressure. Conclusion Daily salt intake in Iranian adolescents was about 2 times the recommended amount of the World Health Organization, was higher in rural areas and was associated with blood pressure. Reducing salt intake should be considered as an important intervention, especially in rural areas.


2021 ◽  
Vol 10 (23) ◽  
pp. 5656
Author(s):  
Krzysztof Studziński ◽  
Tomasz Tomasik ◽  
Adam Windak ◽  
Maciej Banach ◽  
Ewa Wójtowicz ◽  
...  

A nationwide cross-sectional study, LIPIDOGRAM2015, was carried out in Poland in the years 2015 and 2016. A total of 438 primary care physicians enrolled 13,724 adult patients that sought medical care in primary health care practices. The prevalence of hypertension, diabetes mellitus, dyslipidaemia, and CVD were similar in urban and rural areas (49.5 vs. 49.4%; 13.7 vs. 13.1%; 84.2 vs. 85.2%; 14.4 vs. 14.2%, respectively). The prevalence of obesity (32.3 vs. 37.5%, p < 0.01) and excessive waist circumference (77.5 vs. 80.7%, p < 0.01), as well as abdominal obesity (p = 43.2 vs. 46.4%, p < 0.01), were higher in rural areas in both genders. Mean levels of LDL-C (128 vs. 130 mg/dL, p = 0.04) and non-HDL-C (147 vs. 148 mg/dL, p = 0.03) were slightly higher in rural populations. Altogether, 14.3% of patients with CVD from urban areas and 11.3% from rural areas reached LDL <70 mg/dL (p = 0.04). There were no important differences in the prevalence of hypertension, diabetes, dyslipidaemia, and CVD, or in mean levels of blood pressure, cholesterol fractions, glucose, and HbA1c between Polish urban and rural primary care patient populations. A high proportion of patients in cities and an even-higher proportion in rural areas did not reach the recommended targets for blood pressure, LDL-C, and HbA1c, indicating the need for novel CVD-prevention programs.


2018 ◽  
Vol 12 (05) ◽  
pp. 373-379 ◽  
Author(s):  
Stéphanie Jupsa-Mbiandou ◽  
Samuel Fosso ◽  
Edimo Billé ◽  
Tito T Mélachio-Tanekou ◽  
Gideon Ajeagah-Aghaindum ◽  
...  

Introduction: Blastocystis spp. is a protist found in humans. Although usually the most frequent protozoa found in stool samples of both symptomatic and healthy subjects, its pathogenic or rather opportunistic role is yet to be clearly elucidated. To attempt to fill this gap, a cross-sectional study was conducted to compare the frequency of Blastocystis spp. in HIV positive (HIV+) versus HIV negative (HIV-) individuals in four health facilities of the Center Region of Cameroon. Methodology: Stool samples were collected from 283 HIV positive and 245 HIV negative subjects and analyzed using direct diagnostic tests. Results: A total of 46 (8.7%) individuals were found infected with Blastocystis spp., including 6.7% HIV positive and 11.0% HIV negative. This species was more frequent in urban and semi-urban areas than in rural areas, but evenly distributed among genders and age groups as well as among all sectors of activity. The prevalence of Blastocystis spp. (11.3%) was higher in HIV+ patients with a CD4 count ≥ 500 cells / mm3, but no significant difference was found among HIV clinical stages. Likewise prevalence, the mean number of cysts per gram of stool was similar between HIV positive and HIV negative individuals. People infected with Blastocystis spp. showed diverse clinical signs, but only flatulence was significantly more prevalent. The frequencies of these clinical signs were not related to HIV status. Conclusion: No clear relationship links the infection with Blastocystis spp. to HIV, although its presence was associated with digestive disorder, suggesting that this parasite might not be opportunist.


e-CliniC ◽  
2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Erald J. Lanes ◽  
Suzanna P. Mongan ◽  
John J. E. Wantania

Abstract: Premarital sexual behavior in adolescence is a high risk factor for sexually transmitted infections. Sexually transmitted infections (STIs) are infections that are generally transmitted through sexual contact. Differences in social, cultural, and economic factors were found to affect the incidence and prevalence of sexually transmitted infections between different groups in a population. These are likely caused by differences in the knowledge and attitudes of adolescents living in urban and rural areas. This study was aimed to obtain the differences in the level of knowledge and attitudes toward STIs of adolescents in urban and rural area schools. This was a descriptive study with a cross-sectional design conducted on 50 adolescents of urban senior high schools and 50 adolescents of rural senior high schools/vocational high schools. Questionnaires were distributed via email by using Google form. The results showed that adolescents living in urban areas had good knowledge about STIs meanwhile adolescents living in rural areas had fair knowledge. The attitudes about STIs of most adolescents living in urban areas and rural areas were good. In conclusion, adolescents living in urban areas had better knowledge about STIs than those living in rural areas, however, there was no significant difference in attitudes about STI between the two regions. Equal distribution of education in Indonesia is needed in urban as well as in rural areas.Keywords: sexually transmitted infections, adolescents, knowledge, attitudes, urban and rural Abstrak: Perilaku seksual pranikah pada usia remaja merupakan faktor risiko tinggi terhadap infeksi menular seksual (IMS). Infeksi menular seksual merupakan infeksi yang umumnya ditularkan melalui hubungan seksual. Perbedaan faktor sosial, kultural maupun ekonomi dapat memengaruhi insiden dan prevalensi IMS antara kelompok yang berbeda dalam suatu populasi. Hal tersebut kemungkinan besar disebabkan oleh adanya perbedaan pengetahuan dan sikap remaja yang tinggal di wilayah perkotaan dan pedesaan. Penelitian ini bertujuan untuk mengetahui perbedaan tingkat pengetahuan dan sikap remaja terhadap IMS di sekolah wilayah perkotaan dan pedesaan. Jenis penelitian ialah deskriptif dengan desain potong lintang dan kuesioner didistribusikan secara daring menggunakan Google Form. Responden ialah 50 remaja di SMA wilayah perkotaan dan 50 remaja di SMA/SMK wilayah pedesaan. Hasil penelitian mendapatkan bahwa pengetahuan remaja tentang IMS pada siswa SMA perkotaan sebagian besar berada dalam kategori baik sedangkan pada siswa SMA/SMK pedesaan sebagian besar berada dalam kategori cukup. Sikap remaja tentang IMS pada siswa SMA/SMK perkotaan dan pedesaan sebagian besar baik. Simpulan penelitian ini ialah remaja perkotaan memiliki pengetahuan yang lebih baik mengenai IMS dibandingkan remaja di pedesaan namun tidak terdapat perbedaan sikap remaja yang bermakna mengenai IMS antara kedua wilayah. Pemerataan pendidikan di Indonesia dibutuhkan di wilayah perkotaan dan pedesaan.Kata kunci: infeksi menular seksual, remaja, pengetahuan, sikap, perkotaan dan pedesaan


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Grace Sum ◽  
Gerald Choon-Huat Koh ◽  
Stewart W. Mercer ◽  
Lim Yee Wei ◽  
Azeem Majeed ◽  
...  

Abstract Background The burden of non-communicable diseases (NCDs) is rising rapidly in middle-income countries (MICs), where NCDs are often undiagnosed, untreated and uncontrolled. How comorbidity impacts diagnosis, treatment, and control of NCDs is an emerging area of research inquiry and have important clinical implications as highlighted in the recent National Institute for Health and Care Excellence guidelines for treating patients suffering from multiple NCDs. This is the first study to examine the association between increasing numbers of comorbidities with being undiagnosed, untreated, and uncontrolled for NCDs, in 6 large MICs. Methods Cross-sectional analysis of the World Health Organisation Study of Global Ageing and Adult Health (WHO SAGE) Wave 1 (2007–10), which consisted of adults aged ≥18 years from 6 populous MICs, including China, Ghana, India, Mexico, Russia and South Africa (overall n = 41, 557). Results A higher number of comorbidities was associated with better odds of diagnosis for hypertension, angina, and arthritis, and higher odds of having treatment for hypertension and angina. However, more comorbidities were associated with increased odds of uncontrolled hypertension, angina, arthritis, and asthma. Comorbidity with concordant conditions was associated with improved diagnosis and treatment of hypertension and angina. Conclusion Patients with more comorbidities have better diagnosis of chronic conditions, but this does not translate into better management and control of these conditions. Patients with multiple NCDs are high users of health services and are at an increased risk of adverse health outcomes. Hence, improving their access to care is a priority for healthcare systems.


2020 ◽  
Author(s):  
Elena Flores-Guillen ◽  
Itandehui Castro-Quezada ◽  
Hector Ochoa ◽  
Rosario Garcia-Miranda ◽  
Miguel Cruz ◽  
...  

Objectives: The objective of this study was to determine the prevalence of cardiovascular risk factors among different sociodemographic and geographic areas of adolescents from indigenous areas of Chiapas, Mexico. Design: A cross-sectional study. Setting: Communities in the Totzil - Tseltal and Selva region of Chiapas, Mexico, were studied. Urban and rural areas of high marginalization according to the Human Development Index. Participants: 253 adolescents were studied, of which 48.2% were girls and 51.8% were boys. Primary and secondary outcome measures: a descriptive analysis of the quantitative variables was performed through central tendency and dispersion measures. Prevalence of cardiovascular risk factors and 95% confidence intervals (95% CI), stratified by sex, geographic area (rural/urban), schooling and ethnicity of mothers were estimated. Results: the predominant risk factor in the study population was low HDL-c (51%). Higher prevalences of abdominal obesity and high triglycerides in girls were found and abnormal diastolic blood pressure in boys was identified. In urban areas were found greater prevalences of overweight/obesity and of insulin resistance while abnormal blood pressure levels were more prevalent in rural areas. Differences were found in the educational levels and ethnicity of the adolescents' mothers. Prevalence of metabolic syndrome was 10% according to NCEP-ATPIII. Conclusions: In this study, sociodemographic and geographical disparities were found in cardiovascular risk factors. Prevalence of risk factors was high, affecting mostly girls and urban population. Thus, there is a great need to promote healthy lifestyles and health, social and economic interventions to prevent chronic diseases in adulthood.


2021 ◽  
Vol 66 ◽  
Author(s):  
Anna Marzà-Florensa ◽  
Daniel Boateng ◽  
Charles Agyemang ◽  
Erik Beune ◽  
Karlijn A. C. Meeks ◽  
...  

Objectives: Multimorbidity is a growing public health concern due to the increasing burden of non-communicable diseases, yet information about multimorbidity in low- and middle-income countries and migrant populations is scarce. We aimed to investigate the distribution and patterns of multimorbidity in rural and urban areas in Ghana and Ghanaian migrants in Europe.Methods: The RODAM cross-sectional study included 4,833 participants. Multimorbidity was defined as presence of multiple non-communicable chronic conditions. Patterns were determined from frequent combination of conditions. Prevalence ratios were estimated by logistic regression.Results: Prevalence of multimorbidity was higher in women and in urban Ghana and Europe. We observed a cardiometabolic pattern in all sites as well as circulatory-musculoskeletal and metabolic-musculoskeletal combinations in Ghana. Multimorbidity prevalence ratios were higher in Europe (men 1.47, 95% CI 1.34–1.59, women 1.18, 1.10–1.26) and urban Ghana (men 1.46, 1.31–1.59, women 1.27, 1.19–1.34).Conclusion: Distribution and patterns of multimorbidity differed by sex and site. With a higher burden of multimorbidity in urban areas, prevention strategies should focus on forestalling its increase in rapidly growing rural areas.


Author(s):  
Septi Kurnia Lestari ◽  
Nawi Ng ◽  
Paul Kowal ◽  
Ailiana Santosa

The low- and middle-income countries (LMICs) are experiencing rapid population ageing, yet knowledge about disability among older populations in these countries is scarce. This study aims to identify the prevalence and factors associated with disability among people aged 50 years and over in six LMICs. Cross-sectional data from the World Health Organization (WHO) Study on global AGEing and adult health Wave 1 (2007–2010) in China, Ghana, India, Mexico, the Russian Federation, and South Africa was used. Multivariable logistic regression analyses were undertaken to examine the association between sociodemographic factors, health behaviours, chronic conditions, and activities of daily living (ADL) disability. The prevalence of disability among older adults ranged from 16.2% in China to 55.7% in India. Older age, multimorbidity, and depression were the most common factors related to disability in all six countries. Gender was significant in China (OR = 1.14, 95% CI: 1.01–1.29), Ghana (OR = 1.22, 95% CI: 1.01–1.48) and India (OR = 1.65, 95% CI: 1.37–1.99). Having no access to social capital was significantly associated with ADL disability in China (OR = 2.57, 95% CI: 1.54–4.31) and South Africa (OR = 4.11, 95% CI: 1.79–9.43). Prevalence data is valuable in these six ageing countries, with important evidence on mitigating factors for each. Identifying determinants associated with ADL disability among older people in LMICs can inform how to best implement health prevention programmes considering different country-specific factors.


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