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Prevalence and Risk Factors of Elevated Blood Pressure and Elevated Blood Glucose among Residents of Kajiado County, Kenya: A Population-Based Cross-Sectional Survey

Ongosi, Anita Nyaboke 京都大学 DOI:10.14989/doctor.k23093

2021.03.23

概要

Background: Kenya is experiencing a rising burden of noncommunicable diseases (NCDs). The national survey (2015) estimated the prevalence of hypertension at 24.5% and diabetes at 2.4%. It is projected that if the current policy directions and interventions that give more emphasis on communicable diseases (CDs) are sustained, deaths from CDs may reduce by 48%, but deaths from NCDs increase by 55% by 2030, yet data to inform effective interventions are limited. The rise of NCDs has been attributed mainly to economic transition, rapid urbanization, demographic transition and lifestyle changes. In Kenya, 22.3% of the population is urban, with an annual urbanization growth rate of 4.2%, which is almost double the national population growth rate of 2.4%. Therefore, to tackle NCDs, it is important to investigate the NCDs risk factors, focusing on rapidly urbanizing areas.

In this study the prevalence of elevated blood pressure (EBP, pre-hypertension and hypertension), elevated blood glucose (EBG, pre-diabetes and diabetes) and their determinants were investigated in Kajiado County, a typical rapidly urbanizing area spreading over 21,292.7 km2 to the south of Nairobi, the capital of Kenya.

Methods: 221 men and 372 women (25–64 years) were recruited using a stratified multi-stage cluster sampling method between November 2016 and August 2017 in Kajiado County. Data on socio-demographics, dietary and behavioural risk factors were collected using a questionnaire. Anthropometric, blood pressure, blood glucose, plasma lipids and urinary biomarkers were measured using standardized procedures. Multivariable logistic regression models assessed correlates of EBP and EBG.

Results: The prevalence of pre-hypertension and hypertension were 49.0% and 31.6% in men and 43.7% and 20.1% in women, respectively, while those of pre-diabetes and diabetes were 8.4% and 8.0% in men and 11.6% and 7.4% in women, respectively. The prevalence of body mass index (BMI) ≥25 kg/m2 was higher in women (60.2%) than in men (39.7%). However, the association of EBP was stronger among men (adjusted odds ratio [AOR]= 3.23 [95%CI 1.20, 8.68] for BMI ≥25–29 kg/m2 and 17.13 [95%CI 1.85–158.5] for BMI ≥30 kg/m2 ) than among women (AOR = 1.47 [95%CI 0.86, 2.51] and 2.30 [95% CI 1.23, 4.33]).
Likewise, the association of EBG was stronger among men (AOR = 2.49 [95% CI 0.89–6.91] for BMI 25–29 kg/m2 and 5.33 [95% CI 1.78–16.00] for BMI ≥30kg/m2) than among women (AOR = 0.74 [95% CI 0.33, 1.68] and 2.43 [95% CI 1.16–5.06]). Additionally, low physical activity, low vegetable/fruit intake and high urinary Na/K ratio (>2.0) were prevalent in both sexes.

Conclusion: This is the first study to determine the distribution of EBP and EBG and their correlates in Kajiado County. The high prevalence rates of EBP, EBG and overweight/obesity coupled with low physical activity and low fruit and vegetable intake appeared to predispose this population to a higher NCD risk. Interventions to mitigate this risk considering the sex differences are urgently required, including sensitization programs to increase awareness on the adequate physical activity, consumption of healthy foods, and increased awareness of NCDs which will promote screening, early diagnosis, treatment and rehabilitation.

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