Schwarz MacKenna, Gyawali Bishal, Nkonge-Ngumba Dorothy Mwari, Anekha Sylvia Khamati, Ngure Miriam, Dræbel Tania Aase
Department of Public Health, Global Health Section, University of Copenhagen, Copenhagen, Denmark.
London School of Hygiene and Tropical Medicine, London, UK.
BMC Health Serv Res. 2024 Dec 19;24(1):1624. doi: 10.1186/s12913-024-12088-4.
Hypertension and type 2 diabetes are among the most common non-communicable diseases that contribute to a large number of adult morbidity and mortality in Kenya. The impact of these conditions may pose great challenges in rural areas with limited access to healthcare services. The objective of the study was to assess socio-demographic factors associated with self-reported self-care practices for hypertension and type 2 diabetes among adults living in rural Kenya.
This study used data from the 2019 Baseline Assessment of the Prevention and Control of Non-Communicable Disease Project in Imenti South, Meru County conducted by the Kenyan Red Cross Society. A community-based study using a cross-sectional design was conducted among four hundred and thirty-five participants in Imenti South sub-County, Meru County in Kenya in November 2019. Chi-square test and logistic regression analyses were conducted to explore sociodemographic factors associated with self-reported self-care practices for hypertension and type 2 diabetes. Crude and Adjusted Odds Ratios with a 95% Confidence Interval (CI) were reported.
Among the 435 participants, 37.0% self-reported hypertension, while 15.4% reported having type 2 diabetes. Variances in self-care practices were evident between the conditions, notably in terms of adequate fruit and vegetable intake and blood pressure screening. Among individuals with type 2 diabetes, 94% lacked sufficient fruit and vegetable consumption, contrasting with 98.7% among hypertensive participants (p = 0.042). Similarly, a significant majority of individuals with hypertension (71.4%) had blood pressure screening (p = 0.031). Multivariable logistic regression analysis revealed that individuals over 40 years exhibited higher odds of good self-care practice for hypertension compared to their younger counterparts (AOR: 4.67, 95% CI: 1.53-14.27, p = 0.007), whereas those residing in Mitunguu were 71% less likely to engage in such practices than those in Abogeta (AOR: 0.29, 95% CI: 0.09-0.90, p = 0.033). However, none of the variables demonstrated a significant association with self-reported self-care practices for type 2 diabetes following adjustment for potential confounding variables in the multivariable logistic regression analysis.
Our study identified socio-demographic factors, including age (> 40 years) and ward (Mitunguu), associated with self-reported self-care practices for hypertension among adults living in rural Kenya. However, we did not find significant associations between sociodemographic factors and self-care practices for type 2 diabetes. Furthermore, factors such as gender, education level, marital status, religion, employment status, and average monthly income did not show significant associations with self-care practices for hypertension or type 2 diabetes. These results provide insights regarding sociodemographic factors associated with self-care practices for hypertension among adults living in rural Kenya. Our study underscores the relevance of considering socio-demographic factors when making evidence-based policy decisions and designing intervention strategies tailored to the adult population in rural Kenya.
高血压和2型糖尿病是肯尼亚导致大量成年人发病和死亡的最常见非传染性疾病。在医疗服务有限的农村地区,这些疾病的影响可能带来巨大挑战。本研究的目的是评估肯尼亚农村地区成年人自我报告的高血压和2型糖尿病自我护理行为的社会人口学因素。
本研究使用了肯尼亚红十字会在梅鲁县伊门蒂南区开展的2019年非传染性疾病预防与控制项目基线评估数据。2019年11月,在肯尼亚梅鲁县伊门蒂南区的435名参与者中进行了一项采用横断面设计的社区研究。进行卡方检验和逻辑回归分析,以探讨与自我报告的高血压和2型糖尿病自我护理行为相关的社会人口学因素。报告了粗比值比和调整后的比值比以及95%置信区间(CI)。
在435名参与者中,37.0%自我报告患有高血压,而15.4%报告患有2型糖尿病。不同疾病的自我护理行为存在差异,特别是在水果和蔬菜摄入量充足以及血压筛查方面。在2型糖尿病患者中,94%的人水果和蔬菜摄入量不足,而高血压参与者中这一比例为98.7%(p = 0.042)。同样,绝大多数高血压患者(71.4%)进行了血压筛查(p = 0.031)。多变量逻辑回归分析显示,40岁以上的人相比年轻人,高血压自我护理行为良好的几率更高(调整后的比值比:4.67,95%置信区间:1.53 - 14.27,p = 0.007),而居住在米通古的人进行此类行为的可能性比阿博盖塔的人低71%(调整后的比值比:0.29,95%置信区间:0.09 - 0.90,p = 0.033)。然而,在多变量逻辑回归分析中对潜在混杂变量进行调整后,没有变量显示与2型糖尿病自我报告的自我护理行为有显著关联。
我们的研究确定了社会人口学因素,包括年龄(>40岁)和选区(米通古),与肯尼亚农村地区成年人自我报告的高血压自我护理行为相关。然而,我们没有发现社会人口学因素与2型糖尿病自我护理行为之间的显著关联。此外,性别、教育水平、婚姻状况、宗教、就业状况和月平均收入等因素与高血压或2型糖尿病的自我护理行为没有显著关联。这些结果为肯尼亚农村地区成年人高血压自我护理行为的社会人口学因素提供了见解。我们的研究强调了在做出基于证据的政策决策和设计针对肯尼亚农村成年人口的干预策略时考虑社会人口学因素的相关性。