A cross-sectional study of vascular risk factors in a rural South African population: data from the Southern African Stroke Prevention Initiative (SASPI)

Thorogood, Margaret; Connor, Myles; Tollman, Stephen; Hundt, Gillian Lewando; Fowkes, Gerry; Marsh, Jennifer

doi:10.1186/1471-2458-7-326

Cited by 88 publications

(104 citation statements)

References 26 publications

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“…Blood pressure and HbA1c values for the community sample are in keeping with other general SA community samples, as is their use of medication. [8,9] The community sample was significantly more overweight than the CLI group, in keeping with other SA studies. [9,10] In SA, clinical nurse practitioners are the main primary healthcare providers.…”

Section: Discussionsupporting

confidence: 87%

Chronic diseases are not being managed effectively in either high-risk or low-risk populations in South Africa

et al. 2013

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Background. Primary healthcare is the foundation of a country's healthcare system. Without an efficient and cost-effective programme, the level of healthcare offered across all levels of health management is adversely affected. Objective. To analyse the effectiveness of the management of hypertension and diabetes mellitus (DM) among two distinct patient populations, one with significant cardiovascular risk factors and the other without. Method. We performed a case control study of a high-risk group of patients presenting with chronic critical limb ischaemia (CLI) to the Divisions of Vascular Surgery at Charlotte Maxeke Johannesburg Academic Hospital and Chris Hani Baragwanath Academic Hospital, and a randomly selected group of 'healthy' community participants from Johannesburg's South Western Townships (Soweto). Results. We assessed 217 patients with CLI and 1 030 participants from the community. We assessed the number of patients who were not achieving their therapeuatic targets, among those known to be hypertensive (CLI: 44.7%; community: 59.9%) and diabetic (CLI: 83.5%; community: 66%). Undiagnosed diabetes affected 10.8% of patients with CLI and 11% of the community sample. Conclusion. Traditional vascular risk factors are managed poorly at both primary healthcare and at tertiary care levels. There is a need to identify factors that will address this issue.

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Section: Discussionsupporting

confidence: 87%

Chronic diseases are not being managed effectively in either high-risk or low-risk populations in South Africa

et al. 2013

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“…and 42% respectively, (12) a figure much higher than that reported for other rural areas in SSA. (13) Data from the same sub-district…”

Section: Risk Factors In South Africacontrasting

confidence: 60%

A hidden menace: Cardiovascular disease in South Africa and the costs of an inadequate policy response

Maredza

Hofman

Tollman

2017

SAHJ

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A hidden menace: Cardiovascular disease in South Africa and the costs of an inadequate policy response and unhealthy diets. Even in rural SA, associated diffusion of urban behaviours is fostering the CVD epidemic. The United Nations projects that the percentage of population above 60 years will more than double between 1999 and 2050 in SA, with the burden due to CVD predicted to become the prime contributor to total morbidity and mortality in the over 50-year age group.(4) However, CVD is taking its toll even amongst the younger age groups, with deaths projected to increase by over 40% in the 35-to 64-year age group by 2030. This is further complicated by the growing number of HIV survivors, now estimated at 5.8% of the population older than 50 years. (5,6) This poses several challenges regarding the management of this emerging epidemic in the face of persisting undernutrition and Assuming a 4% rate of inflation, and a higher prevalence of CVD, the overall costs for CVD in 2010 would be more than double that 20 years ago. rIsk fActors In south AfrIcAThe major risk factors namely high blood pressure, tobacco use, high cholesterol, obesity, physical inactivity and unhealthy diets are increasingly prevalent in Africa, both in urban and rural settings.The national prevalence of hypertension in sub-Saharan African countries (SSA) ranges from about 4% to 10%, with SA at the upperend of this spectrum. The prevalence of hypertension amongst males and females in one rural Mpumalanga district was 44%and 42% respectively, (12) a figure much higher than that reported for other rural areas in SSA. Several disease specific guidelines for hypertension, chronic diseases of lifestyle (CDL) and for type 2 diabetes mellitus have been developed. (17,18) These guidelines provide information on the management and control and include interventions that have been shown to be cost-effective in middle and lower-income countries.However, available evidence suggests that primary prevention and management of common cardiac conditions is limited even with these guidelines "in place".Prioritisation of interventions for the primary prevention of chronic diseases is minimal. For example, the guideline on primary prevention of CDL lists a variety of interventions for management. Whilst focus on CVD has been minimal, the revised South African guideline for managing ischaemic stroke and transient ischaemic attack is a notable step. (24) This guideline puts forward a protocol for management that considers both the current epidemiological context and the strength of evidence of interventions for stroke care. The comprehensive plan that spans across all aspects of care including primary prevention, acute management, secondary prevention and rehabilitation, offers hope for mitigating the burden of disease due to stroke. ApproAchEs to prEVEntIonTwo approaches are conventionally advocated for CVD prevention. Population-wide approaches targeting the entire population and addressing the causes rather than the consequences; and those that target individual...

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“…This questionnaire was first translated and back translated again in French by Beninese neurologists. For each student, we collected the data concerning height and weight in the register of local clinic (those data are available for each student since before registration a clinical examination was done systematically and the weight and height were taken according the standard criteria) [13]. Then the body mass index (BMI) was calculated by dividing the weight (kilogram) by the square of the height (meter).…”

Section: Diagnostic Criteriamentioning

confidence: 99%

Prevalence of migraine among university students at Parakou, Benin: A cross-sectional study

Adoukonou¹,

Tognon-Tchegnonsi²,

Philomène³

et al. 2014

WJNS

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Objective: To determine the prevalence of migraine and its associated factors in students at the University of Parakou. Methods: It was a cross-sectional study carried out from February 1st to April 30th 2011. It included all students registered during the academic year 2010-2011 and selected by systematic random sampling. Migraine was defined according to IHS 2004 criteria. To assess the link between migraine and body mass index we collected height and weight of each student. Multivariate analysis was used to study the factors associated with migraine, odds-ratio and their confidence interval were estimated. SPSS Soft-ware was used to perform statistical analysis. Results: During the study period 1200, students returned their questionnaires. They were 842 males and 358 females. 171 fulfilled migraine criteria, and the overall prevalence of migraine was 14.2% (CI 95%: 11.6% -17.4%). The main associated factors were the sex with an OR: 2.3 (CI 95%: 1.6 -3.2) and family history of headache with an OR: 1.6 (CI 95%: 1.1 -2.4). Migraine with aura was the frequent form (59.1%) and visual aura the frequent form of aura. No association was found between migraine and body mass index but students with obesity had high risk of migraine with aura OR: 3.8 (CI 95%: 1.5 -9.7) compared with those with normal weight. The main triggering factors were sleeplessness (90.1%) and mental fatigue (85.4%). Conclusion: The results suggest a high prevalence of migraine among students at Parakou University and no association between obesity and migraine.

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A cross-sectional study of vascular risk factors in a rural South African population: data from the Southern African Stroke Prevention Initiative (SASPI)

Cited by 88 publications

References 26 publications

Chronic diseases are not being managed effectively in either high-risk or low-risk populations in South Africa

Chronic diseases are not being managed effectively in either high-risk or low-risk populations in South Africa

A hidden menace: Cardiovascular disease in South Africa and the costs of an inadequate policy response

Prevalence of migraine among university students at Parakou, Benin: A cross-sectional study

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