Department of Medicine, University of Burundi, Bujumbura, Burundi.
Department of Statistics, Lake Tanganyika University, Mutanga, Burundi.
PLoS One. 2021 Dec 13;16(12):e0260225. doi: 10.1371/journal.pone.0260225. eCollection 2021.
Hypertension is a major threat to public health globally. Especially in sub-Saharan African countries, this coexists with high burden of other infectious diseases, creating a complex public health situation which is difficult to address. Tackling this will require targeted public health intervention based on evidence that well defines the at risk population. In this study, using retrospective data from two referral hospitals in Burundi, we model the risk factors of hypertension in Burundi.
Retrospective data of a sample of 353 randomly selected from a population of 4,380 patients admitted in 2019 in two referral hospitals in Burundi: Military and University teaching hospital of Kamenge. The predictive risk factors were carried out by fixed effect logistic regression. Model performance was assessed with Area under Curve (AUC) method. Model was internally validated using bootstrapping method with 2000 replications. Both data processing and data analysis were done using R software.
Overall, 16.7% of the patients were found to be hypertensive. This study didn't showed any significant difference of hypertension's prevalences among women (16%) and men (17.7%). After adjustment of the model for cofounding covariates, associated risk factors found were advanced age (40-59 years) and above 60 years, high education level, chronic kidney failure, high body mass index, familial history of hypertension. In absence of these highlighted risk factors, the risk of hypertension occurrence was about 2 per 1000 persons. This probability is more than 90% in patients with more than three risk factors.
The relatively high prevalence and associated risk factors of hypertension in Burundi raises a call for concern especially in this context where there exist an equally high burden of infectious diseases, other chronic diseases including chronic malnutrition. Targeting interventions based on these identified risk factors will allow judicious channel of resources and effective public health planning.
高血压是全球公共卫生的主要威胁。特别是在撒哈拉以南的非洲国家，这种情况与其他传染病的高负担并存，造成了难以解决的复杂公共卫生状况。解决这一问题需要根据明确高危人群的证据，采取有针对性的公共卫生干预措施。在这项研究中，我们利用布隆迪两家转诊医院的回顾性数据，建立布隆迪高血压的风险因素模型。
回顾性数据来自 2019 年布隆迪两所转诊医院（军事和大学教学医院卡门格）的 4380 名住院患者中随机抽取的 353 名患者的样本。采用固定效应逻辑回归进行预测风险因素分析。使用曲线下面积（AUC）方法评估模型性能。使用 2000 次重复的自举法对内进行模型验证。数据处理和数据分析均使用 R 软件完成。
总体而言，16.7%的患者患有高血压。本研究未发现女性（16%）和男性（17.7%）高血压患病率存在显著差异。在调整了混杂因素的模型后，发现相关的危险因素是年龄在 40-59 岁和 60 岁以上、高教育水平、慢性肾功能衰竭、高体重指数、高血压家族史。在没有这些突出的危险因素的情况下，高血压发生的风险约为每 1000 人 2 人。在有超过三个危险因素的患者中，这种概率超过 90%。
布隆迪高血压的高患病率和相关风险因素引起了关注，特别是在这种情况下，存在同样高的传染病负担，以及其他慢性疾病，包括慢性营养不良。针对这些已确定的风险因素的干预措施将允许明智地调配资源，并进行有效的公共卫生规划。
