Hawassa University, Medical Faculty, Hawassa, Ethiopia.
BACKGROUND Hypertension is an important public health challenge in both economically developed and developing countries. OBJECTIVE To asses the magnitude of hypertension in rural and urban southern Ethiopia. PATIENTS AND METHODS A cross sectional survey was conducted on 979 study participants in Sidama Zone, South Ethiopia from November 1-30, 2008. Data were collected using a structured questionnaire and standardized procedures recommended by the WHO MONICA project for the measurement of the anthopometric variables. Analysis was done using SPSS 15.0 version. RESULTS Out of 979 participating subjects. 485 were from urban and 494 were from rural. The prevalence of hypertension was 9.9% with 10.1% in urban and 9.7% in rural areas ranging from 4.2% in those below 30 years to 29.4% in those above 60 years. Bivariate analysis showed hypertension was highly occurred more in those above 30 years old, in those with the family history of hypertension, and a BMI > or =25 kg/m2. Hypertension also correlated with, less physical activity, extended family size, personal and family history of diabetes mellitus, measured dysglycemia, excess meat consumption and drinking alcohol. Multivariate analysis showed similar correlation of increased possibility of hypertension with being over 30 years, having a family history of hypertension, a BMI > or =25 kg/m2. and excess meat consumption. Tea drinking was found as a protective factor for hypertension on bivariate and multivariate analysis. CONCLUSIONS Hypertension has equal public health importance in urban and rural settings of southern Ethiopia. Hypertension is common among those age over 30years. overweight, consume excess meat and have family history of hypertension. Drinking tea may have a protective effect for hypertension.
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BMC Public Health. 2011 ;11 :342 21595897
Married women's decision making power on modern contraceptive use in urban and rural southern Ethiopia.
Department of Public Health, Arba Minch University, Arba Minch, Ethiopia.
Women in developing countries are either under collective decision making with their partners or completely rely on the male partner's decision on issues that affect their reproductive live. Identifying the major barriers of married women's decision making power on contraceptive use has significant relevance for planning contextually appropriate family planning interventions. The objective of this study was to determine current modern contraceptive practices and decision making power among married women in Tercha Town and surrounding rural areas of Dawro zone, Southern Ethiopia. Community based comparative cross-sectional design with both quantitative and Qualitative study has been employed in March and April 2010. The respondents were 699 married women of child bearing age from urban and rural parts of Dawro zone. After conducting census, we took the sample using simple random sampling technique. Current modern contraceptive use among married women in the urban was 293 (87.5%) and 243 (72.8%) in rural. Married women who reside in urban area were more likely to decide on the use of modern contraceptive method than rural women. Having better knowledge about modern contraceptive methods, gender equitable attitude, better involvement in decisions related to children, socio-cultural and family relations were statistically significant factors for decision making power of women on the use of modern contraceptive methods in the urban setting. Better knowledge, fear of partner's opposition or negligence, involvement in decisions about child and economic affairs were statistically significant factors for better decision making power of women on the use of modern contraceptive methods in the rural part. High level of current modern contraceptive practice with reduced urban-rural difference was found as compared to regional and national figures. Urban women had better power to make decisions on modern contraceptive than rural women. Modern family planning interventions in the area should be promoted by considering empowering of women on modern contraceptive use decision making.
Current and projected prevalence of arterial hypertension in sub-Saharan Africa by sex, age and habitat: an estimate from population studies.
Marc Twagirumukiza, Dirk De Bacquer, Jan G Kips, Guy de Backer, Robert Vander Stichele, Luc M Van Bortel
Faculty of Medicine, National University of Rwanda, Butare, Republic of Rwanda, Belgium.
INTRODUCTION In sub-Saharan Africa (SSA), data on hypertension prevalence in terms of urban or rural and sex difference are lacking, heterogeneous or contradictory. In addition, there are no accurate estimates of hypertension burden. OBJECTIVE To estimate the age-specific and sex-specific prevalence of arterial hypertension in SSA in urban and rural adult populations. METHODS We searched for population studies, conducted from 1998 through 2008 in SSA. We extracted data from selected studies on available prevalences and used a logistic regression model to estimate all age/sex/habitat (urban/rural)/country-specific prevalences for SSA up to 2008 and 2025. On the basis of the United Nations Population Fund data for 2008 and predictions for 2025, we estimated the number of hypertensives in both years. RESULTS Seventeen studies pertaining to 11 countries were analysed. The overall prevalence rate of hypertension in SSA for 2008 was estimated at 16.2%[95% confidence interval (CI) 14.1-20.3], ranging from 10.6% in Ethiopia to 26.9% in Ghana. The estimated prevalence was 13.7% in rural areas, 20.7% in urban areas, 16.8% in males, and 15.7% in women. The total number of hypertensives in SSA was estimated at 75 million (95% CI 65-93 million) in 2008 and at 125.5 million (95% CI 111.0-162.9 million) by 2025. CONCLUSION The estimated number of hypertensives in 2008 is nearly four times higher than the last (2005) estimate of the World Health Organization Regional Office for Africa. Prevalences were significantly higher in urban than in rural populations. Population data are lacking in many countries underlining the need for national surveys.
Isolated Systolic Hypertension and its Determinants - A Cross-sectional Study in the Adult Population of Lucknow District in North India.
Department of Community Medicine (SPM), GSVM Medical College, Kanpur, India.
OBJECTIVES: 1) To determine the prevalence of isolated systolic hypertension (ISH) in the adult population of Lucknow district. 2) To study the determinants of ISH especially the relationship with age. MATERIALS AND METHODS: A community-based cross-sectional study was conducted in four randomly selected areas of Lucknow district. A total of 800 subjects, aged 20 years and above, 400 from urban and 400 from rural area of Lucknow district were included in the study. The statistical tools used for analysis were Pearson's Chi-square test and multiple logistic regression. RESULTS: The prevalence of ISH according to JNC-7 criteria was 4.3%, which was 5.1% in men and 3.6% in women. A significant increase in the prevalence of ISH was seen with an increase in age. Multivariate logistic regression analysis of the determinants showed that age, BMI and smoking were significant independent risk factors of ISH. CONCLUSIONS: Given the risk of cardiovascular disease associated with ISH, the findings of this study emphasize the need for further research to document the impact of modifiable risk factors of ISH and the effect of hypertension screening and specific health promotion in bringing down the burden of ISH and related cardiovascular morbidity.
[Survey on central obesity among middle-aged and elderly people of Uygurs and Hans ethnicities in Xinjiang].
Department of Cardiology, The First Affiliated Hospital, Xinjiang Medical University, Urumqi, China.
OBJECTIVE To study central obesity among middle-aged and elderly residents of Xinjiang Uygur and Han ethnicities, living in rural and urban areas. METHODS Multi-stage stratified random cluster sampling approaches were adopted to collect data from 6 areas in Southern, Eastern, Northern Xinjiang and Urumqi city community, from July of 2005 to June of 2007. RESULTS 8284 people were investigated to have found that the crude prevalence rate and the adjusted standardized incidence were 50.11% and 55.40% respectively, on central obesity. The figures were higher than the national level, according to the 2000 census age composition of Xinjiang. The prevalence rate of central obesity was higher in males than in females (P<0.05) higher in residents of Uygur than in Han ethnicities (P<0.05). The prevalent rates of the central obesity hypertension, diabetes and dyslipidemia were higher than those of non-obese ones (P<0.05). CONCLUSION The standardized prevalence rates of central obesity in residents with Xinjiang Uygur and Han ethnicities were higher than data from the national statistics. Differences were found in ethnicity, gender and age. The prevalence rates of hypertension, diabetes and dyslipidemia in people having central obesity were higher than the non-obese ones.
Suppasin Soontrapa, Sukree Soontrapa, Narong Bunyaratavej, Sattaya Rojanasthien, Nipat Kittimanon, Songkiat Lektrakul
Department of Orthopaedics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand. email@example.com
Vitamin D insufficiency of Thai elderly women in urban area were higher than in rural area because of the difference in life style. Until now there are no any evidences about vitamin D status in Thai premenopausal women. This study was the multicenters study from 5 provinces of Thailand which cover all region of Thailand except southern area. The mean (SE) of calcidiol level of Thai premenopausal women was 29.09 (0.42) ng/ml, and with the cut point of < or = 35 ng/ml; the prevalence of vitamin D insufficiency was 77.81%. Chiang Mai had lowest calcidiol level (25.09 ng/ml) and had highest PTH, and bone resorption markers. The prevalence of vitamin D insufficiency was highest in Khon Kaen (88.78%) and Chiang Mai (84.62%) province respectively. Life style modification to expose more sunlight should be advised for increasing the serum vitamin D and lowering the risk of osteoporosis.
Ten-year change in blood pressure levels and prevalence of hypertension in urban and rural Cameroon.
George Institute for International Health, Level 10, KGV Building, Missenden Road, Camperdown, 2050 NSW, Australia.
BACKGROUND Hypertension is becoming increasingly important in sub-Saharan Africa. However, evidences in support of this trend with time are still not available. The aim of this study was to evaluate the 10-year change in blood pressure levels and prevalence of hypertension in rural and urban Cameroon. METHODS Two cross-sectional population-based surveys in Yaounde (urban area) and Evodoula (rural area) in 1994 (1762 subjects) and 2003 (1398 subjects) used similar methodologies in women and men aged >or=24 years. Data on systolic and diastolic blood pressures (SBP and DBP), body mass index, educational level, alcohol consumption and tobacco smoking were collected during the two periods. RESULTS Between 1994 and 2003, blood pressure levels significantly increased in rural women (SBP,+18.2 mm Hg; DBP,+11.9 mm Hg) and men (SBP,+18.8 mm Hg; DBP,+11.6 mm Hg), all p<0.001. In the urban area, SBP increased in women (+8.1 mm Hg, p<0.001) and men (+6.5 mm Hg, p<0.001), and DBP increased only in women (+3.3 mm Hg, p<0.001). The OR (95% CI) adjusted on confounders comparing the prevalence of hypertension (blood pressure >or= 140/90 mm Hg and/or treatment) between 2003 and 1994 ranged from 1.5 (1.1 to 2.2) in urban men to 5.3 (3.2 to 8.9) in rural men. CONCLUSION Blood pressure levels of this population have deteriorated over time, and the prevalence of hypertension has increased by twofold to fivefold. Adverse effects of risk factors could account for some of these changes. Prevention and control programmes are needed to reverse these trends and to avoid the looming complications.
Department of Medicine, Tikrit University, Iraq. firstname.lastname@example.org
We sought to determine the prevalence of skin diseases in Iraq. Most such studies performed in Iraq have been hospital based. One community based study was performed in the southern area of Iraq but involved only an urban population. Our study was carried out in two Iraqi governorates, Tikrit and Kirkuk, and involved 1545 randomly selected households, 829 from urban areas and 716 from rural areas. The total sample size was 8000 individuals representing a wide range of ages, 3735 (47%) males and 4268 (53%) females. The overall prevalence of skin diseases was 27%. The rate was similar in males (27%) and females (27%), and in rural (28%) compared with urban (26%) areas. Dermatitis was the most common disease category (33%) in the community based population, and skin infections (32%) in the hospital based group. Community and hospital based studies demonstrate that skin diseases represent a major public health problem which may confer significant personal and financial burdens on Iraq.
Mali Med. 2006 ;21 (3):19-22 19435002
Service de Cardiologie, CHU d'Ignace Deen-Conakry.
The objectives of this transverse study were to clarify the prevalence of the hypertension in Foutah-Djallon in Guinea, the influence of the environment (rural or urban areas) and to identify the associated metabolic abnormalities (AMA)(hyperglycaemia, weighty excess). 1537 subjects of 35 and more years old living in urban zones (Labé, n=886) and in rural areas (Fellö-Koundoua in Tougué, n=651), were selected by a cluster sampling, and examined between February 1st and March 31st, 2003.The prevalence of the hypertension (blood pressure: BP > or = 140/90 mm of Hg) was 43.6% in urban areas, 14.9% in rural areas (p < 0.001). The subjects living in urban areas had more often a weighty excess and were more sedentary. Among them, 3.6% presented an AMA (waist measurement > or = 95 cms in the man and > or = 88 cms in the woman, BP > or = 130/85 mm of Hg, and fasting capillary blood glycaemia > or = 1.10 g/l) against 0.3% in the subjects living in rural areas. These results confirm the important role of the changes of way of life (urbanization and sedentary) in the increase of the prevalence of the hypertension and the AMA in Africa. Appropriate programs educational sanitary in wide scale are indispensable.
Department of Medicine, Monilek Hospital and Research Centre, Jawahar Nagar, Jaipur 302004, India. email@example.com
Coronary heart disease (CHD) is epidemic in India and one of the major causes of disease-burden and deaths. Mortality data from the Registrar General of India shows that cardiovascular diseases are a major cause of death in India now. Studies to determine the precise causes of death in urban Chennai and rural areas of Andhra Pradesh have revealed that cardiovascular diseases cause about 40% of the deaths in urban areas and 30% in rural areas. Analysis of cross-sectional CHD epidemiological studies performed over the past 50 years reveals that this condition is increasing in both urban and rural areas. The adult prevalence has increased in urban areas from about 2% in 1960 to 6.5% in 1970, 7.0% in 1980, 9.7% in 1990 and 10.5% in 2000; while in rural areas, it increased from 2% in 1970, to 2.5% in 1980, 4% in 1990, and 4.5% in 2000. In terms of absolute numbers this translates into 30 million CHD patients in the country. The disease occurs at a much younger age in Indians as compared to those in North America and Western Europe. Rural-urban differences reveal that risk factors like obesity, truncal obesity, hypertension, high cholesterol, low HDL cholesterol and diabetes are more in urban areas. Case-control studies also confirm the importance of these risk factors. The INTERHEART-South Asia study identified that eight established coronary risk factors--abnormal lipids, smoking, hypertension, diabetes, abdominal obesity, psychosocial factors, low fruit and vegetable consumption, and lack of physical activity--accounted for 89% of the cases of acute myocardial infarction in Indians. There is epidemiological evidence that all these risk factors are increasing. Over the past fifty years prevalence of obesity, hypertension, hypercholesterolemia, and diabetes have increased significantly in urban (R2 0.45-0.74) and slowly in rural areas (R2 0.19-0.29). There is an urgent need for development and implementation of suitable primordial, primary, and secondary prevention approaches for control of this epidemic. An urgent and sincere bureaucratic, political, and social will to initiate steps in this direction is required.
Rajesh Kumar, Megha C Singh, Sushil K Ahlawat, Jarnai S Thakur, Ashok Srivastava, Manoj K Sharma, Pankaj Malhotra, Harinder K Bali, Savita Kumari
School of Public health, Post Graduate Institute of Medical Education and Research, Chandigarh, India. firstname.lastname@example.org
BACKGROUND In the West, urbanization has been accompanied by a rise in the rate of coronary heart disease. This trend has gone hand in hand with an increased consumption of processed, energy-dense food and dependence on machines for physical work. To examine whether a similar trend is underway in northern India, the prevalence of and risk factors for coronary heart disease were compared in rural, semi-urban and urban communities. METHODS AND RESULTS A total of 7,169 adults were interviewed and examined during 1995-2000 in cross-sectional cluster sample surveys from a rural area of Haryana (Raipur Rani block), two semi-urban areas of Punjab (Mandi Gobindgarh and Morinda), and Chandigarh city. The study, which covered people in the age-group of 35+ years, also estimated the lipid, glucose and insulin levels of a sub-sample of 186 persons who did not have coronary heart disease or hypertension. The prevalence of coronary heart disease among males in the villages, towns and city was 1.7%, 2.5% and 7.4%, respectively, and among females, 1.5%, 3.4% and 7.1%,respectively. The age- and sex-adjusted prevalence odds ratio of coronary heart disease, in comparison to the villages, was 1.9 (95% CI; 1.1-3.2) in the towns and 4.9 (95% CI: 2.9-8.2) in the city. Hypertension, diabetes, obesity and physical inactivity were significantly more common in the urban areas, while the rate of tobacco smoking was significantly higher in the rural areas ( p< 0.05). The alcohol consumption rates for the urban and rural communities were similar (p> 0.05). The quantity of the food items commonly consumed, as well as the frequency with which particular items were consumed, varied across the rural, semi-urban and urban areas ( p< 0.05). The urban population had significantly higher levels of lipids and serum insulin than did the rural population, but a lower level of plasma glucose ( p< 0.05). CONCLUSION The urban way of living is leading to an increase in the prevalence of the well-known risk factors for, as well as the rate of, coronary heart disease. Attempts to preserve the traditional lifestyle are necessary in order to prevent an epidemic of coronary heart disease in the developing countries.