Cardiovascular Journal of Africa: Vol 28 No 6 (November/December 2017)

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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 28, No 6, November/December 2017 378 AFRICA
At the end of July 2010, the University workforce comprised
a total of 2 603 people (1 793 senior and 810 junior staff).
The minimum sample size (380) was calculated from the Kish
formula,11 using the prevalence of hypertension (as this is the
NCD with the highest prevalence) and a precision of 5%.
Sensitisation of the university staff members was carried out
using invitation letters through the various directorate heads,
announcements on the university FM radio station, and banners
placed at strategic places such as the entrances and exits of the
university and the health clinic two months prior to and during
the study period.
All employees of the university who subsequently presented
to the university health clinic during the study period were
recruited into the study. Pregnant and menstruating women were
excluded from the study as anthropometric measurements and
urine testing for abnormalities would not be useable.
The Human Research and Ethics Committee of the Jos
University Teaching Hospital approved the study. All
participants gave written informed consent before participation.
All participants had the opportunity to be counselled on healthy
lifestyles, and participants found to have NCDs were referred for
appropriate care.
All the participants were evaluated using a modified version
of the World Health Organisation (WHO) STEPwise approach
to non-communicable disease.12 STEP 1 entailed history taking,
looking particularly for risk factors for NCDs and the lifestyle
of the subjects.
STEP 2 involved a physical examination in which the height
and weight were measured using an electronic weighing scale,
stadiometer and non-stretch tape measure, respectively. The
body mass index (BMI) was calculated from the Quetelet
index.13 Blood pressure was measured using the OMRON digital
sphygmomanometer.
STEP 3 involved obtaining blood samples for casual plasma
glucose, serum creatinine, total cholesterol and high-density
lipoprotein cholesterol levels, and urine testing for proteinuria and
haematuria. Casual plasma glucose (CPG) level was estimated
using the glucose oxidase method. Serum creatinine was assayed
using the kinetic enzymatic method, and estimated glomerular
filtration rate (eGFR) from the measured serum creatinine level
using the CKD-EPI calculator.14 The laboratory analyses of the
tests were carried out at the commercial laboratory of APIN, Jos
University Teaching Hospital, Jos.
Generalised obesity, hypertension, diabetes mellitus and
dyslipidaemia were defined according to internationally accepted
guidelines.13,15-17 Chronic kidney disease (CKD) was regarded as
the presence of proteinuria using urine dipsticks and/or eGFR
< 60 ml/min/1.73 m2.18
Statistical analysis
Data obtained were analysed using the Epi Info 7 statistical
software (CDC, Atlanta, GA). Means ± SD were used to describe
normally distributed continuous variables, and proportions for
categorical variables. Median with range was used to describe
non-normally distributed continuous variables. The Student’s
t-test was used to compare group means and the chi-squared test
to compare proportions. The Fisher exact test was used when
cells contained less than five observations. The non-parametric
Mann–Whitney U-test was used to compare non-normally
distributed continuous variables. A p -value < 0.05 was considered
significant.
Results
A total of 883 (521; 59.0% males) employees with a slight
predominance of junior-cadre workers participated in the study
(Table 1). The majority were between 31 and 60 years old with
a mean age of 44 ± 10 years. Women were older than the men
and half had completed tertiary level education. The majority
(80.5%) were married, with a median monthly household income
of US$400 equivalent (US$1:00 exchanged for N150:00 as at the
time of the study).
The median (IQR) number of NCD risk factors was three
(two to three) per participant. The most common NCD risk
factors were inadequate intake of fruit and vegetables (94.6%;
95% CI: 92.8–95.9), physical inactivity (77.8%; 95% CI: 74.9–
80.5%) and dyslipidaemia (51.8%; 95% CI: 48.4–51.6%). Details
of NCD risk factors by sociodemographic variables are shown
in Table 2.
No participant admitted to passive (second-hand) smoking
at home or in the work environment and none used smokeless
tobacco. As shown in Fig. 1, tobacco use (Fig. 1A), obesity and
dyslipidaemia (Fig. 1B) increased with age.
A low intake of fruit and vegetables was common in participants
with a formal education (Fig. 1C), as were physical inactivity,
obesity and dyslipidaemia (Fig. 1D), compared to those without
Table 1. Characteristics of 883 staff members of the
University of Jos evaluated for select non-communicable
diseases between February and June 2014
Variable
Total
(n = 883)
Males
(n = 521)
Females
(n = 362) p-value
Mean age, years 44 ± 10 43 ± 10 45 ± 9 0.002
Age group, years, n (%)*
< 20 3 (0.3) 2 (0.4) 1 (0.3) < 0.0001
21–30 83 (9.4) 61 (11.7) 22 (6.1)
31–40 257 (29.1) 166 (31.9) 91 (25.1)
41–50 294 (33.3) 155 (29.8) 139 (38.4)
51–60 215 (24.3) 115 (22.1) 100 (27.6)
> 60 31 (3.5) 22 (4.2) 9 (2.5)
Married (n = 878); n (%) 707 (80.5) 437 (84.2) 270 (75.2) < 0.0001
Tertiary education completed
(n = 876); n (%)
440 (50.2) 243 (46.9) 197 (55.0) 0.02
Junior staff (n = 843); n (%) 466 (55.3) 319 (63.0) 147 (43.6) < 0.0001
Monthly income, USD, median 400 333.33 466.66 < 0.0001
BMI (kg/m2 ) 27.2 ± 5.1 25.1 ± 3.5 30.2 ± 5.7 < 0.0001
SBP (mmHg) 129 ± 19 130 ± 19 127 ± 20 0.06
DBP (mmHg) 79 ± 12 79 ± 12 80 ± 11 0.4
CPG, median (mg/dl) 85.0 85.0 86.0 0.10
[mmol/l] [4.72] [4.72] [4.77]
Proteinuria (n = 883) (%) 116 (13.2) 72 (13.8) 44 (12.2) 1.15
Serum creatinine (mmol/l) 74.5 ± 19.3 81.8 ± 19.7 64.0 ± 13.1 < 0.0001
eGFR (ml/min/1.73m2 ) 114.2 ± 20.5 115.1 ± 20.7 113.1 ± 20.2 0.15
Reduced eGFR 4 (0.4) 2 (0.4) 2 (0.5) 0.69
TC (mg/dl) 193.4 ± 43.9 201.4 ± 46.2 187.9 ± 41.4 < 0.0001
[mmol/l] [5.01 ± 1.14] [5.22± 1.20] [4.87 ± 1.07]
HDL-C (mg/dl) 56.6 ± 16.4 60.7± 16.5 53.8 ± 15.7 < 0.0001
[mmol/l] [1.47 ± 0.42] [1.57± 0.43] [1.39 ± 0.41]
*Fisher exact test; USD: United States Dollars; BMI: body mass index; SBP: systolic
blood pressure; DBP: diastolic blood pressure; CPG: casual plasma glucose; eGFR:
estimated glomerular filtration rate; TC: total cholesterol; HDL-C: high-density lipo-
protein cholesterol.