Fayaz Said Hafizullah, Hamajima Nobuyuki, Frozanfar Muhammad Kamel, Hamrah Mohammad Hassan, Inthaphatha Souphalak, Nishino Kimihiro, Yamamoto Eiko
Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan.
National Heart, Lung and Blood Institute, National Institute of Health, Bethesda, USA.
Nagoya J Med Sci. 2024 Nov;86(4):564-577. doi: 10.18999/nagjms.86.4.564.
Afghanistan has an increasing trend of mortality due to non-communicable diseases but most studies were conducted in urban areas. This study aimed to assess the prevalence and factors associated with diabetes mellitus and hypertension in a rural area in Afghanistan. A cross-sectional study was conducted from September to October 2019 including 373 people who were 18-79 years old and lived in Andkhoy District, Afghanistan. Demographic and lifestyle data was collected by face-to-face interviews after informed consent was obtained. Height, body weight, blood pressure, waist circumference, and blood sugar level were measured by the data collection team. A logistic regression model was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). The prevalence of diabetes mellitus and hypertension was 9.7% and 29.5%, respectively. Factors associated with diabetes mellitus were male gender (adjusted OR [AOR]=9.81, 95% CI: 2.48-38.90), family history of diabetes mellitus (AOR=3.84, 95% CI: 1.30-11.38), low physical activity (AOR=4.53, 95% CI: 1.13-18.26), and high waist circumference (AOR=7.93, 95% CI: 2.40-26.20). Snuff users were negatively associated with diabetes mellitus (AOR=0.18, 95% CI: 0.04-0.75). Factors associated with hypertension were the age group of 40-59 years (AOR=4.22, 95% CI: 1.99-8.95) and 60-79 years (AOR=19.83, 95% CI: 7.19-54.71) compared to 18-39 years, family history of hypertension (AOR=2.17, 95% CI: 1.15-4.10), and palaw intake of 3 times per week or more (AOR=1.86, 95% CI: 1.03-3.38). Lifestyle interventions for increasing physical activity should be introduced and health education about snuff usage and salt intake should be promoted in communities in Afghanistan.
阿富汗非传染性疾病导致的死亡率呈上升趋势，但大多数研究是在城市地区进行的。本研究旨在评估阿富汗农村地区糖尿病和高血压的患病率及相关因素。2019年9月至10月进行了一项横断面研究，纳入了373名年龄在18 - 79岁、居住在阿富汗安德胡伊区的居民。在获得知情同意后，通过面对面访谈收集人口统计学和生活方式数据。数据收集团队测量身高、体重、血压、腰围和血糖水平。采用逻辑回归模型估计比值比（OR）和95%置信区间（CI）。糖尿病和高血压的患病率分别为9.7%和29.5%。与糖尿病相关的因素有男性（调整后OR [AOR]=9.81，95% CI：2.48 - 38.90）、糖尿病家族史（AOR=3.84，95% CI：1.30 - 11.38）、低体力活动（AOR=4.53，95% CI：1.13 - 18.26）和高腰围（AOR=7.93，95% CI：2.40 - 26.20）。鼻烟使用者与糖尿病呈负相关（AOR=0.18，95% CI：0.04 - 0.75）。与高血压相关的因素有40 - 59岁年龄组（与18 - 39岁相比，AOR=4.22，95% CI：1.99 - 8.95）和60 - 79岁年龄组（AOR=19.83，95% CI：7.19 - 54.71）、高血压家族史（AOR=2.17，95% CI：1.15 - 4.10）以及每周食用3次或更多次抓饭（AOR=1.86，95% CI：1.03 - 3.38）。阿富汗社区应引入增加体力活动的生活方式干预措施，并加强关于鼻烟使用和盐摄入的健康教育。
