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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 28, No 6, November/December 2017
AFRICA
381
Generally, this finding is in contrast to the findings in southern
Africa, Asia
20,28
and the Western world,
29-31
where smoking
constitutes a major public health hazard.
Clustering of risk factors was prevalent in this study, with
the median number of risk factors being three (IQR 2–3) per
participant. This finding corroborates the findings of previous
studies. In a study of over 3 800 South African adults aged 50
years and above, Phaswana-Mafuya and associates
32
reported
a mean incidence of risk factors of three. In a recent German
survey, 45.1% of participants had multiple risk factors.
33
Similar
clustering has been reported by the SAGE wave 1 study that
evaluated older adults across six countries.
34
A study among Senegalese private sector workers revealed
that more than half of the participants had two or more
cardiovascular risk factors.
35
Villegas and co-workers
36
reported
that 67.6% of men and women sampled across 17 general
practice settings in Ireland had more than one cardiovascular
risk factor. This scenario is the typical clustering in patients and
deserves attention to reverse or limit their contribution to NCD
and its related mortality.
The prevalence of the selected NCDs parallels that obtained
in the literature from the Western world and the African region.
Hypertension was present in nearly half of the participants;
CKD was present in a little over a 10th of the population, and
DM in nearly a 10th. In the SAGE wave 1 study, the prevalence
of hypertension ranged from as low as 17.9% in Bangladesh to as
high as 78% in South Africa among older persons.
34
A prevalence
of 47.2% was reported among Irish hospital attendees in a study
that evaluated over 1 000 patients recruited from several general
practices.
Oluyombo and colleagues,
37
working in south-west Nigeria,
reported a prevalence of 47.2% among residents of a semi-urban
community. A slightly lower prevalence of 31.4% was recently
reported from south-east Nigeria.
21
In a large community
survey that evaluated 5 206 adults in Malawi, Msyamboza and
associates
38
reported a prevalence of 33% among persons aged
25 to 64 years. A recent review by Bosu
7
demonstrated that the
prevalence of hypertension among workers in the West African
sub-region has steadily increased from 12.9% in the 1980s to
37.5% in 2014, while figures up to 51.6% (95% CI: 49.8–53.4) and
43% (95% CI: 42.1–43.9) have been recently reported in Nigeria
among urban and rural populations, respectively.
4
CKD, anemergingNCD, has gainedattention inrecent times as
it is both an end-point of communicable and non-communicable
diseases and a strong cardiovascular risk factor. It has become
a pandemic, affecting both developed and developing countries.
CKD was present in a significant proportion of the participants
in our study. Similar reports exist regarding the prevalence of
CKD from the Western world and Asia.
39-41,
However, varying reports from the African region exist. In a
recent community survey from Senegal that studied 1 037 adults,
CKD was present in 4.9% of the participants.
42
In a similar study
from Cameroun, the prevalence of CKD ranged from 11.0 to
14.2%, depending on the prediction equation used.
43
In a study
that evaluated 402 private sector IT workers in Dakar, Senegal
in late 2010, 22.4% had CKD.
35
The prevalence of CKD in
Nigeria in various subsets of the population has been reported
to range from 7.8% among public sector employees,
44
to 11.4%
in the community
45
and 43.5% among retirees,
46
depending on
the criteria used.
Age group (years)
21–30 31–40 41–50 51–60 61–70
Prevalence of risk factors (%)
90
80
70
60
50
40
30
20
10
0
Hypertension
Diabetes
mellitus
Chronic kidney
disease
Income quintiles
Lowest
Second Third Fourth Fifth
Prevalence of risk factors (%)
60
50
40
30
20
10
0
Hypertension
Diabetes
mellitus
Chronic kidney
disease
Number of years educated
A
B
C
D
Prevalence of risk factors (%)
80
70
60
50
40
30
20
10
0
A: no formal education, B: 1–7 years of education,
C: 8–11 years of education, D: ≥ 12 years of education
Hypertension
Diabetes
mellitus
Chronic kidney
disease
Fig. 2.
Prevalence of non-communicable diseases in relation
to some sociodemographic characteristics among 883
staff members of the University of Jos.
A
B
C