Objective: FFQ are often used to estimate food and nutrient intakes to rank individuals by their level of intake. We evaluated the relative validity of a semiquantitative FFQ created for use in Tanzania by comparing it with two 24 h diet recalls. Design: We measured relative validity of the FFQ with deattenuated energyadjusted rank correlations for nutrients, deattenuated rank correlations for food groups, and performed a cross-classification analysis of energy-adjusted nutrient quartiles using percentage of agreement and Bland-Altman analysis. Setting: Interviews were conducted in 2014 in participants' homes in Ukonga, Dar es Salaam, Tanzania. Subjects: We surveyed 317 adults aged 40 years or older from the general public. Results: Deattenuated energy-adjusted rank correlation coefficients of nutrients ranged from −0·03 for riboflavin to 0·41 for percentage of energy from carbohydrates, with a median correlation of 0·21. Coefficients for food groups ranged from 0·00 for root vegetables to 0·51 for alcohol, with a median of 0·35. Relative to the average of the two 24 h diet recalls, the FFQ overestimated energy intake and intakes of all nutrients and food groups, other than tea, with ratios among nutrients ranging from 1·34 for SFA to 7·08 for vitamin A; and among food groups from 0·92 for tea to 9·00 for fruit. The percentage of participants classified into the same nutrient intake quartile ranged from 23 % for SFA to 32 % for both niacin and pantothenic acid, with a median of 28 %. Conclusions: The FFQ performed moderately well in urban Tanzanian adults.
We study the relationship between the food environment (FE) and the food purchase patterns, dietary intakes, and nutritional status of individuals in peri-urban Tanzania. In Africa, the prevailing high density of informal vendors creates challenges to characterizing the FE. We present a protocol and tool developed as part of the Diet, Environment, and Choices of positive living (DECIDE) study to measure characteristics of the FE. We mapped 6627 food vendors in a peri-urban settlement of Dar es Salaam, of which over 60% were semi-formal and informal (mobile) vendors. We compute and compare four FE metrics inspired by landscape ecology—density, dispersion, diversity, and dominance—to better understand how the informal food environment relates to food purchase patterns, diets, and nutritional status among households with persons living with human immunodeficiency virus (PLHIV).
Objectives
We assessed prevalence and determinants of high blood pressure, and
barriers to diagnosis and treatment, in Dar es Salaam, Tanzania.
Methods
We surveyed and screened 2,174 community-dwelling adults aged
≥40 years in 2014 and conducted a follow-up after one year.
Results
Median blood pressure was 131/81 mmHg and hypertension prevalence was
37%. Mean adjusted difference in SBP was 4.0 mmHg for overweight,
6.3 mmHg for obese class I, and 10.5 mmHg for obese class II/III compared
with normal weight participants. Those who were physically inactive had 4.8
mmHg higher SBP compared to those with more than 24 hours of moderate or
vigorous activity per week. Drinkers of at least 10 grams of alcohol per day
had 4.5 mmHg higher SBP than did non-drinkers.
Among hypertensives, 48% were diagnosed, 22% were
treated, and 10% were controlled. Hypertensives without health
insurance were 12% less likely to be diagnosed than insured
hypertensives. Of referred participants, 68% sought care, but only
27% were on treatment and 8% had controlled blood pressure
at follow-up. Reasons for not seeking care included lack of symptoms, cost
of visit, and lack of time. Reasons for not being on treatment included lack
of symptoms, not being prescribed treatment, and having finished one course
of treatment.
Conclusions
Major risk factors for hypertension in Dar es Salaam are overweight,
obesity, inadequate physical activity, and limited access to quality medical
care. Increased insurance coverage and community-based screening, along with
quality medical care and patient education, may help control this burgeoning
epidemic.
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