44 / 78
CARDIOVASCULAR JOURNAL OF AFRICA • Volume 28, No 6, November/December 2017
382
AFRICA
The prevalence of DM in this study parallels the estimated
global prevalence of 9%, the WHO estimated prevalence of
7.9% in Nigeria in 2014,
1
and the 9.7% recently reported
from Senegal.
35
It is however slightly lower than the 11%
obtained among university employees in south-western Nigeria.
8
However, our study differed from theirs as they relied on self-
reported diagnosis, which is subject to recall bias. Oluyombo
and associates
37
recently reported that 6.8% of 750 respondents
had DM. Our finding together with the foregoing support the
assertion that the prevalence of DM is on the increase in Nigeria.
However, the prevalence of DM in our study was higher than
the 2.5% reported by Oladapo and co-workers
47
in south-west
Nigeria, and the 3.6% by Okpechi and colleagues
21
in south-
eastern Nigeria.
That sociodemographic characteristics impact on NCDs and
their risk factors was confirmed by the findings of our study. The
prevalence of hypertension, CKD and DM rose with increasing
age, as expected. Their prevalence also increased with increasing
income, as a result of the concomitant rise in the prevalence of
some of the risk factors with increasing income. It is noteworthy
that hypertension decreased with increasing educational level.
This confirms the results of prior studies that reported an inverse
relationship between educational level and hypertension.
19,48
This
provides an opportunity for intervention in order to halt the
rising trends in NCD.
Together with the existing literature, our study has implications
for the subset of employees at this university and the general
population at large, as large numbers of these individuals are
at an elevated risk of NCD-related events. In a recent review of
national policies addressing NCDs in low- and middle-income
countries, Lachat and colleagues
22
demonstrated the disconnect
that exists between the burden of NCDs and the response of
the respective governments, including Nigeria. Concerted efforts
are needed to stem the high prevalence of NCDs and their risk
factors in our environment, so as to achieve the 2025 voluntary
global targets of the Global NCD Action Plan.
1
Limitations
The findings of this study must be interpreted within the
limitations inherent in the study design. We studied only
employees of the university hence the generalisability of the
findings is limited. The purposive sampling process used may
also have introduced selection bias in the study. A stratified
systematic sampling would have yielded a more representative
sample. However we invited all the staff members of the
university to participate in the study.
We were unable to measure triglyceride levels so we used
non-fasting blood samples for the determination of lipid levels.
At first glance, one may assume that assessing lipid abnormalities
using casual plasma samples (and not in the fasted state) as we did
in this study would constitute a limitation. However, the lack of
effect of fasting on levels of serum total cholesterol and reduced
high-density lipoprotein cholesterol has been documented and
therefore casual plasma sampling is used in field studies.
49,50
We were also unable to repeat proteinuria assessments or
eGFR after three months and therefore the prevalence of CKD
may have been spuriously high. Finally, we could not establish
causality as our study was cross-sectional in design. Despite
these limitations, we have studied the largest sample of university
employees in Nigeria to date. Our study therefore provides the
fulcrum for further studies of this nature to elucidate the burden
of NCDs in this category of workers.
Conclusion
This study identified that the most prevalent NCD risk factors
among employees of a university are behavioural and therefore
modifiable. We also demonstrated that the NCDs and their risk
factors are impacted upon by sociodemographic characteristics.
Given the burden of NCDs and their risk factors among this
subset of the general population, there is a need for workplace
policies aimed at health promotion to be put in place in order to
stem the rising trend of NCDs. Multicentre studies addressing
the burden of NCDs among university employees are imperative.
This study was funded in part by the Tertiary Education Trust Fund of the
Federal Government of Nigeria. The authors acknowledge the contribu-
tion of the management of the University health centre and the leaders and
members of the various associations at the University of Jos for participating
in the study. We also appreciate the efforts of the physicians who participated
in data collection, and Mr Chime of the Jos University Teaching Hospital
for data entry.
References
1.
WHO. Global status report on noncommunicable diseases 2014.
World
Health
2014:
176
. doi: ISBN 9789241564854.
2.
World Health Organization. WHO Nigeria non-communicable disease
data 2014. 2014: 2014. doi: 10.1093/obo/9780199743292-0090.
3.
Ibekwe R. Modifiable risk factors of hypertension and socio-demo-
graphic profile in Oghara, Delta State; prevalence and correlates.
Ann
Med Health Sci Res
2015;
5
(1): 71–77. doi: 10.4103/2141-9248.149793.
4.
Akinlua JT, Meakin R, Umar AM, Freemantle N. Current prevalence
pattern of hypertension in Nigeria: A systematic review.
PLoS One
2015;
10
(10): 1–18. doi: 10.1371/journal.pone.0140021.
5.
Salaudeen AG, Musa OI, Babatunde OA, Atoyebi OA, Durowade KA,
Omokanye LO. Knowledge and prevalence of risk factors for arterial
hypertension and blood pressure pattern among bankers and traffic
wardens in Ilorin, Nigeria.
Afr Health Sci
2014;
14
(3): 593–599. doi:
10.4314/ahs.v14i3.14.
6.
Oladimeji AM, Fawole O, Nguku P, Nsubuga P. Prevalence and factors
associated with hypertension and obesity among civil servants in
Kaduna, Kaduna State, June 2012.
Pan Afr Med J
2014;
18
(Suppl 1,
June 2012): 13. doi: 10.11694/pamj.supp.2014.18.1.3260.
7.
Bosu WK. The prevalence, awareness, and control of hypertension
among workers in West Africa: A systematic review.
Glob Health Action
2015;
8
(1). doi: 10.3402/gha.v8.26227.
8.
Ige OK, Owoaje ET, Adebiyi OA. Non communicable disease and risky
behaviour in an urban university community Nigeria.
Afr Health Sci
2013. doi: 10.4314/ahs.v13i1.9.
9.
Ordinioha B. The prevalence of hypertension and its modifiable risk
factors among lecturers of a medical school in Port Harcourt, south-
south Nigeria: Implications for control effort.
Niger J Clin Pract
2013;
16
(1): 1–4. doi: 10.4103/1119-3077.106704.
10. WHOWEF_report_JAN2008_FINAL.
11. Singh A, Masuku M. Sampling techniques and determination of sample
size in applied statistics research: an overview.
IjecmCoUk
2014;
II
(11):
1–22.
http://ijecm.co.uk/wp-content/uploads/2014/11/21131.pdf.12. Who-Steps. DISTRIBUTION: GENERAL STEPS: A framework for