Njelekela Marina A, Mpembeni Rose, Muhihi Alfa, Mligiliche Nuru L, Spiegelman Donna, Hertzmark Ellen, Liu Enju, Finkelstein Julia L, Fawzi Wafaie W, Willett Walter C, Mtabaji Jacob
Department of Physiology, Muhimbili University of Health and Allied Sciences, PO Box 65001, Dar es Salaam, Tanzania.
BMC Cardiovasc Disord. 2009 Jul 17;9:30. doi: 10.1186/1471-2261-9-30.
Urban areas in Africa suffer a serious problem with dual burden of infectious diseases and emerging chronic diseases such as cardiovascular diseases (CVD) and diabetes which pose a serious threat to population health and health care resources. However in East Africa, there is limited literature in this research area. The objective of this study was to examine the prevalence of cardiovascular disease risk factors and their correlates among adults in Temeke, Dar es Salaam, Tanzania. Results of this study will help inform future research and potential preventive and therapeutic interventions against such chronic diseases.
The study design was a cross sectional epidemiological study. A total of 209 participants aged between 44 and 66 years were included in the study. A structured questionnaire was used to evaluate socioeconomic and lifestyle characteristics. Blood samples were collected and analyzed to measure lipid profile and fasting glucose levels. Cardiovascular risk factors were defined using World Health Organization criteria.
The age-adjusted prevalence of obesity (BMI > or = 30) was 13% and 35%, among men and women (p = 0.0003), respectively. The prevalence of abdominal obesity was 11% and 58% (p < 0.0001), and high WHR (men: >0.9, women: >0.85) was 51% and 73% (p = 0.002) for men and women respectively. Women had 4.3 times greater odds of obesity (95% CI: 1.9-10.1), 14.2-fold increased odds for abdominal adiposity (95% CI: 5.8-34.6), and 2.8 times greater odds of high waist-hip-ratio (95% CI: 1.4-5.7), compared to men. Women had more than three-fold greater odds of having metabolic syndrome (p = 0.001) compared to male counterparts, including abdominal obesity, low HDL-cholesterol, and high fasting blood glucose components. In contrast, female participants had 50% lower odds of having hypertension, compared to men (95%CI: 0.3-1.0). Among men, BMI and waist circumference were significantly correlated with blood pressure, triglycerides, total, LDL-, and HDL-cholesterol (BMI only), and fasting glucose; in contrast, only blood pressure was positively associated with BMI and waist circumference in women.
The prevalence of CVD risk factors was high in this population, particularly among women. Health promotion, primary prevention, and health screening strategies are needed to reduce the burden of cardiovascular disease in Tanzania.
非洲城市地区面临传染病和诸如心血管疾病（CVD）及糖尿病等新兴慢性病双重负担的严重问题，这对人口健康和医疗资源构成严重威胁。然而，在东非，该研究领域的文献有限。本研究的目的是调查坦桑尼亚达累斯萨拉姆特梅克地区成年人中心血管疾病风险因素的患病率及其相关因素。本研究结果将有助于为未来针对此类慢性病的研究以及潜在的预防和治疗干预提供信息。
本研究设计为横断面流行病学研究。共有209名年龄在44至66岁之间的参与者纳入研究。使用结构化问卷评估社会经济和生活方式特征。采集血样并进行分析以测量血脂谱和空腹血糖水平。心血管风险因素依据世界卫生组织标准进行定义。
按年龄调整后的肥胖患病率（BMI≥30）在男性和女性中分别为13%和35%（p = 0.0003）。腹型肥胖患病率在男性和女性中分别为11%和58%（p < 0.0001），高腰臀比（男性：>0.9，女性：>0.85）在男性和女性中分别为51%和73%（p = 0.002）。与男性相比，女性肥胖几率高4.3倍（95%置信区间：1.9 - 10.1），腹型肥胖几率高14.2倍（95%置信区间：5.8 - 34.6），高腰臀比几率高2.8倍（95%置信区间：1.4 - 5.7）。与男性相比，女性患代谢综合征的几率高出三倍多（p = 0.001），包括腹型肥胖、低高密度脂蛋白胆固醇和高空腹血糖成分。相比之下，女性参与者患高血压的几率比男性低50%（95%置信区间：0.3 - 1.0）。在男性中，BMI和腰围与血压、甘油三酯、总胆固醇、低密度脂蛋白胆固醇和高密度脂蛋白胆固醇（仅BMI）以及空腹血糖显著相关；相比之下，在女性中只有血压与BMI和腰围呈正相关。
该人群中心血管疾病风险因素的患病率较高，尤其是在女性中。需要开展健康促进、一级预防和健康筛查策略以减轻坦桑尼亚的心血管疾病负担。
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