喀麦隆农村地区成年人高血压的患病率及相关危险因素:以翁贝为例

Prevalence and risk factors associated with hypertension among adults in a rural setting: the case of Ombe, Cameroon.

作者信息

Princewel Fuh, Cumber Samuel Nambile, Kimbi Judith Anchang, Nkfusai Claude Ngwayu, Keka Elsie Indah, Viyoff Vecheusi Zennobia, Beteck Terence Epie, Bede Fala, Tsoka-Gwegweni Joyce Mahlako, Akum Eric Achidi

机构信息

Department of Microbiology and Parasitology, Faculty of Science, University of Buea, Buea, Cameroon.

Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa.

出版信息

Pan Afr Med J. 2019 Nov 14;34:147. doi: 10.11604/pamj.2019.34.147.17518. eCollection 2019.

Abstract

INTRODUCTION

High blood pressure is the most common cardiovascular disorder affecting approximately one billion people globally and remains a major contributor to the global burden of non-communicable diseases and mortality. Hypertension, once rare in traditional African societies, is now a major public health problem probably because of a rise in its risk factors. In sub-Saharan Africa, an estimated 74.7 million individuals live with hypertension. This study was designed to determine the prevalence and identify risk factors associated with hypertension in adults aged 21 years and above in Ombe village, a rural Cameroonian setting in sub-Saharan Africa.

METHODS

This study was a cross-sectional community based survey from March to September 2016 (seven months) in the village of Ombe, a rural community in the southwest region of Cameroon. Following ethical clearance from the Institutional Review Board (IRB) of the Faculty of Health Science, University of Buea and administrative authorization, 243 participants (141 males and 102 females) through multi-stage sampling were randomly selected to take part in the study following consent which was voluntary and without any form of coercion. The principal research instrument was a questionnaire adapted from the WHO STEPwise approach to chronic disease risk factor surveillance- Instrument v2.1 which was administered to participants. The self-administered questionnaire collected socio-demographic information, data related to knowledge and practices related to hypertension, anthropometric data (weight and height from which the body mass index (BMI) was calculated). The blood pressure of study participants was measured. Data was entered using Microsoft Excel, then imported and analysed in SPSS v22.0. Frequencies and percentages were determined for categorical variables. Means and standard deviations (mean ± SD). Univariate and multivariate logistic regression analysis were used to investigate factors associated with high blood pressure (hypertension).

RESULTS

The results showed that 19.8% of the adult population had hypertension. Of the 243 respondents, 77.7% understood what is hypertension, 85% indicated that they could tell some consequences of high blood pressure (they indicated hypertension affects the heart, brain and kidneys) and 63.3% of study participants had never checked their blood pressure. Age greater than 40 years, harmful alcohol intake for more than 10 years, physical inactivity and obesity (BMI ≥ 25Kg/m) were variables associated with hypertension on univariate analysis. Following multivariate analysis, independent risk factors for hypertension in our study were: physical inactivity (Adj. OR 2.6, 95%CI: 1.3-4.4, p = 0.021), regular alcohol consumption for more than 10 years (Adj. OR 2.9, 95%CI: 1.6-5.1, p = 0.014) and being older than 40 years of age: Adj. OR 2.5, 95%CI: 1.02-4.1, p = 0.002 in age category 41-60 years and this age related risk was even higher in persons older than 60 years of age Adj. OR 4.5, 95%CI: 2.1-6.3, p = 0.002.

CONCLUSION

The findings of this study showed the prevalence of high blood pressure among adults in Ombe (a rural community in Cameroon) was 19.8%. Old age, alcohol consumption, and physical inactivity were independent risk factors for hypertension. Despite the population demonstrating knowledge about hypertension and its possible poor consequences on health, less than half had ever gone for blood pressure checks. Interventions to improve physical activity, reduce alcohol consumption and boost health seeking (high blood pressure screening) behaviour will be beneficial as preventive measures in combatting hypertension.

摘要

引言

高血压是最常见的心血管疾病,全球约有10亿人受其影响,它仍然是全球非传染性疾病负担和死亡率的主要促成因素。高血压在传统非洲社会曾经罕见,现在却是一个主要的公共卫生问题,这可能是由于其风险因素增加所致。在撒哈拉以南非洲,估计有7470万人患有高血压。本研究旨在确定喀麦隆西南部撒哈拉以南非洲农村地区翁贝村21岁及以上成年人中高血压的患病率,并识别与之相关的风险因素。

方法

本研究是一项于2016年3月至9月(七个月)在喀麦隆西南部农村社区翁贝村进行的基于社区的横断面调查。在获得布埃亚大学健康科学学院机构审查委员会(IRB)的伦理批准和行政授权后,通过多阶段抽样随机选择了243名参与者(141名男性和102名女性),在他们自愿且无任何形式胁迫的同意后参与研究。主要研究工具是一份根据世界卫生组织慢性病风险因素监测逐步方法 - 工具v2.1改编的问卷,该问卷被发放给参与者。这份自填式问卷收集了社会人口统计学信息、与高血压相关的知识和实践数据、人体测量数据(体重和身高,据此计算体重指数(BMI))。测量了研究参与者的血压。数据使用Microsoft Excel录入,然后导入SPSS v22.0进行分析。确定分类变量的频率和百分比。计算均值和标准差(均值±标准差)。使用单变量和多变量逻辑回归分析来研究与高血压相关的因素。

结果

结果显示,成年人口中19.8%患有高血压。在243名受访者中,77.7%了解什么是高血压,85%表示他们能说出高血压的一些后果(他们指出高血压会影响心脏、大脑和肾脏),63.3%的研究参与者从未检查过自己的血压。单变量分析显示,年龄大于40岁、有害饮酒超过10年、缺乏身体活动和肥胖(BMI≥25Kg/m)是与高血压相关的变量。经过多变量分析,我们研究中高血压的独立风险因素为:缺乏身体活动(调整后比值比2.6,95%置信区间:1.3 - 4.4,p = 0.021)、规律饮酒超过10年(调整后比值比2.9,95%置信区间:1.6 - 5.1,p = 0.014)以及年龄大于40岁:41 - 60岁年龄组调整后比值比2.5,95%置信区间:1.02 - 4.1,p = 0.002,且这种与年龄相关的风险在60岁以上人群中更高,调整后比值比4.5,95%置信区间:2.1 - 6.3,p = 0.002。

结论

本研究结果表明,翁贝村(喀麦隆的一个农村社区)成年人中高血压患病率为19.8%。老年、饮酒和缺乏身体活动是高血压的独立风险因素。尽管该人群表现出对高血压及其可能对健康造成的不良后果有所了解,但不到一半的人曾进行过血压检查。作为对抗高血压的预防措施,改善身体活动、减少饮酒和促进寻求健康(高血压筛查)行为的干预措施将是有益的。

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