Non-communicable disease risk factors and treatment preference of obese patients in Cape Town

Abstract

BackgroundInsights into the characteristics of treatment seekers for lifestyle changes and treatment preferences are necessary for intervention planning.AimTo compile a profile of treatment-seeking obese patients with non-communicable diseases (NCDs) or NCD risk factors and to compare patients who choose group-based (facility-based therapeutic group [FBTG]) versus usual care (individual consultations) treatment.SettingA primary healthcare facility in Cape Town, South Africa.MethodsOne hundred and ninety-three patients were recruited in this cross-sectional study. Ninety six chose FBTG while 97 chose usual care. A questionnaire, the hospital database and patients’ folders were used to collect data. Weight, height and waist circumference were measured. STATA 11.0 was used for descriptive statistics and to compare the two groups.ResultsThe subjects’ mean age was 50.4 years, 78% were women and of low education levels and income, and 41.5% had type 2 diabetes, 83.4% hypertension and 69.5% high cholesterol. Mean (s.d.) HbA1c was 9.1 (2.0)%, systolic BP 145.6 (21.0) mmHg, diastolic BP 84.5 (12.0) mmHg, cholesterol 5.4 (1.2) mmol/L), body mass indicator (BMI) 39.3 (7.3) kg/m2 and waist circumference 117 (12.6) cm). These figures were undesirable although pharmacological treatment for diabetes and hypertension was in place. Only 14% were physically active, while TV viewing was > 2h/day. Mean daily intake of fruit and vegetables (2.2 portions/day) was low while added sugar (5 teaspoons) and sugar-sweetened beverages (1.3 glasses) were high. Usual care patients had a higher smoking prevalence, HbA1c, number of NCD risk factors and refined carbohydrate intake, and a lower fruit and vegetable intake.ConclusionTreatment seekers were typically middle-aged, low income women with various modifiable and intermediate risk factors for NCDs. Patients choosing usual care could have more NCD risks.

Awareness, treatment, and control of dyslipidemia in rural South Africa: The HAALSI (Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa) study

“…which was a survey restricted to adults 35 years and older[ 8 ]. Manning et al (2016) identified a much higher prevalence rate of 69% for total cholesterol elevation (though a lower threshold of 4.5mmol/L) in Cape Town, but this was for obese subjects with ages 18 and older[ 9 ]. Finally, Maimela et al(2016) performed a survey of 20–59 year old subjects in the Dikgale area of Limpopo Province in Northeastern South Africa, which found a similar prevalence level for elevated total cholesterol of 25.6%[ 7 ].…”

“…Higher total cholesterol is less common in the Black African population, though dyslipidemia overall is grossly similar to global averages[ 6 ]. Community level assessments have found prevalence rates of dyslipidemia between 14% and 69%[ 7 – 9 ].In South Africa, the treatment effects of HIV/AIDS complicate the picture of dyslipidemia[ 10 ]. This is particularly true given the well-known effect of protease inhibitors, a common component of antiretroviral therapy, which can elevate serum lipids by over 25% and accelerate progression towards cardiovascular events, but is also notable for first-line non-nucleoside and nucleoside reverse transcriptase inhibitors[ 11 ].…”

Analysis of Modal Choice of Residents in Lagos State

“…About 5 percent of the patients with non-communicable diseases were estimated to have been associated with obesity (Banjare and Bhalerao 2016). Obesity was also shown to exacerbate other intermediate risk factors and noncommunicable diseases and increase the risk of disability and mortality (Manning et al 2016).…”

Behavioural risk factors for non-communicable diseases amongst adults aged 18 years and above in Collins Chabane Municipality of Vhembe District in Limpopo Province, South Africa

“…Kraja et al (2016) revealed that tobacco use, alcohol consumption, physical inactivity, unhealthy diet, and obesity are the behavioural risk factors for non-communicable diseases and many others account for 80% of mortality. Studies on the prevalence of such risk factors had been carried out in urban and rural villages around South Africa Maimela et al, 2016;Manning et al, 2016). Bearing in mind that the causes of NCDs may differ we conducted a study on the prevalence of behavioural risk factors in Collins Chabane municipality of Vhembe District.…”