School of International Development and Global Studies, University of Ottawa, 120 University Private, Ottawa, ON, K1N 6N5, Canada.
Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria.
BMC Public Health. 2018 Oct 11;18(1):1168. doi: 10.1186/s12889-018-6085-2.
Even with the widespread recognition of non- communicable diseases (NCDs) in sub-Saharan Africa region, yet, sufficient evidence-based surveillance systems to confirm the prevalence and correlates of these diseases is lacking. In an attempt to understand the problem of NCDs in resource-constrained settings, this study was conducted to establish the pattern of the risk factors of NCDs in sub-Sahara Africa region.
The current Demographic and Health Survey (DHS) data sets from 33 countries in sub-Sahara Africa region were used in this study. The individual woman component of DHS 2008-2016 was used. The outcome variables include anemia, hypertension and body mass index (underweight, overweight and obesity). BMI was categorized into; underweight (BMI < 18.5 kg/m), normal (BMI 18.5-24.9 kg/m), overweight (BMI 25.0-29.9 kg/m) and obesity (BMI ≥30 kg/m). Hemoglobin level: anemic < 12.0 g/dL (< 120 g/L) for women. Hypertension was defined as systolic blood pressure (SBP) ≥140 mmHg and/or diastolic blood pressure (DBP) ≥90 mmHg. Binary and multinomial logistic regression models were used to investigate the correlates of the variables.
The percentage of hypertension was highest among women in Lesotho with about 17.3% and lowest among women in Burundi (1.0%). Anemia was prevalent among sub-Saharan Africa women; where more than half of the women from several countries were anemic with Gabon (60.6%) reporting the highest prevalence. The percentage of obesity in sub-Saharan Africa showed that Lesotho (19.9%), Gabon (18.9%) and Ghana (15.6%) were the prominent countries with obese women, while Madagascar (1.1%) had the minimum obese women. Body mass index was significantly associated with hypertension and anemia. The behavioural or modifiable factors of hypertension and body mass index were; smoking, fruits, vegetables and alcohol consumption. While the non-modifiable significant factors include; age, residence, religion, education, wealth index, marital status, employment and number of children ever born. However, anemia shared similar factors except that smoking and vegetable consumption were not statistically significant. In addition, involvement in exercise was associated with anemia and hypertension.
The problem of NCDs and associated factors remains high among women of reproductive age in sub-Sahara region. The findings of this study suggest that promotion of regular positive health care-seeking behaviour, screening and early treatment are essential to mitigate the burden of NCDs. Furthermore, preventive interventions of NCDs risk factors should be strengthened among key population through behavior change communication with support from government and stakeholders in health care.
尽管撒哈拉以南非洲地区普遍认识到非传染性疾病（NCDs）的存在，但仍缺乏足够的基于证据的监测系统来证实这些疾病的流行程度和相关因素。为了深入了解资源有限环境下 NCDs 的问题，本研究旨在确定撒哈拉以南非洲地区 NCDs 风险因素的模式。
本研究使用了撒哈拉以南非洲地区 33 个国家的当前人口与健康调查（DHS）数据集。使用了 2008-2016 年 DHS 中女性个体的组成部分。结果变量包括贫血、高血压和体重指数（体重过轻、超重和肥胖）。体重指数分为：体重过轻（BMI<18.5kg/m）、正常（BMI 18.5-24.9kg/m）、超重（BMI 25.0-29.9kg/m）和肥胖（BMI≥30kg/m）。血红蛋白水平：女性贫血的血红蛋白水平<12.0g/dL（<120g/L）。高血压定义为收缩压（SBP）≥140mmHg 和/或舒张压（DBP）≥90mmHg。采用二元和多项逻辑回归模型来研究变量的相关性。
在莱索托，高血压在女性中的比例最高，约为 17.3%，而在布隆迪，高血压在女性中的比例最低（1.0%）。贫血在撒哈拉以南非洲地区的女性中较为普遍；有超过一半的女性来自几个国家患有贫血，其中加蓬（60.6%）的贫血患病率最高。撒哈拉以南非洲地区的肥胖比例显示，莱索托（19.9%）、加蓬（18.9%）和加纳（15.6%）是肥胖女性比例较高的国家，而马达加斯加（1.1%）的肥胖女性比例最低。体重指数与高血压和贫血显著相关。高血压和体重指数的行为或可改变因素包括：吸烟、水果、蔬菜和饮酒。而非可改变的显著因素包括：年龄、居住地、宗教、教育、财富指数、婚姻状况、就业和生育子女总数。然而，贫血的相关因素除了吸烟和蔬菜摄入没有统计学意义外，与高血压的相关因素相似。此外，运动的参与与贫血和高血压有关。
撒哈拉以南非洲地区生育年龄女性的 NCDs 及其相关因素问题仍然严重。本研究结果表明，促进定期积极的医疗保健寻求行为、筛查和早期治疗对于减轻 NCDs 的负担至关重要。此外，应通过政府和卫生保健利益相关者的支持，在重点人群中加强针对 NCDs 风险因素的预防干预措施。
