20 research outputs found
Factors Associated with Poor Therapeutic Compliance Among Diabetic Patients in Health Facilities of Kinshasa
No full textMagloire Atantama,1 Danny Mafuta Munganga,1 Remy Kapongo Yobo,1 Joseph Bidingija Mabika,1 Jeje-Paul Mikobi Minga,1 Christian Kisoka Lusunsi,2 Jean-Bosco Kasiam Lasi On’Kin,1 Noël Otshudi Onembo,2 Pascal Bayauli Mwasa1 1Unit of Endocrinology and Nuclear Medicine, Department of Internal Medicine, Kinshasa University Hospital, Kinshasa, Democratic Republic of the Congo; 2Cardiology Unit, Department of Internal Medicine, Kinshasa University Hospital, Kinshasa, Democratic Republic of the CongoCorrespondence: Magloire Atantama, Unit of Endocrinology and Nuclear Medicine, Department of Internal Medicine, Kinshasa University Hospital, Kinshasa, Democratic Republic of the Congo, Email [email protected]: Poor therapeutic compliance among diabetic patients is one of the public health issues contributing to inadequate diabetes mellitus control and an increased risk of chronic complications. This study aimed to determine the frequency and factors associated with poor therapeutic compliance among diabetic patients in Kinshasa.Methods: A cross-sectional study was conducted between November 2021 and November 2022 on diabetic patients aged at least 18 years who visited four health facilities in Kinshasa. The Morisky questionnaire was used to assess therapeutic compliance. Data analysis was carried out using SPSS 26 software. Descriptive analyses, Pearson’s chi-square test, Mann–Whitney U-test, and logistic regression were applied. A p-value < 0.05 was considered statistically significant.Results: A total of 131 participants were enrolled, of which 88 (67.1%) had poor compliance. The mean age was 53.8 ± 16.5 years, with male participants representing 67.9%. Median values of blood glucose, glycated hemoglobin (HbA1c), triglycerides (TG), and LDL-cholesterol were high in the non-compliant group with respectively 147.5 mg/dL, 8.5%, 146.9 mg/dL, and 116.5 mg/dL. Inadequate self-monitoring (AOR: 10.144, 95% CI 3.543– 29.040, p< 0.001), treatment mode combining oral antidiabetic drugs (OADs) and insulin (AOR: 3.098 95% CI 1.078– 8.904, p=0.036) were significantly associated with poor compliance with treatment.Conclusion: The present study revealed a suboptimal level of therapeutic compliance among participants while highlighting associated factors such as treatment type and inadequate self-monitoring. Thus, setting up a team focusing on therapeutic education is required for better disease management.Keywords: non-compliance, diabetes mellitus, Kinshas
Cardiovascular risk factors among the inhabitants of an urban Congolese community: results of the VITARAA Study
No full textAbstractObjectiveThe objective is to assess cardiovascular risk profile in an urban Congolese population.Design and MethodsFrom July 2007 to March 2008, we investigated 1824 inhabitants (≥10year old) randomly recruited from the Adoula quarter (Kinshasa, Congo). Measurements included: anthropometry, medical history and lifestyle habits via questionnaire, blood pressure and pulse rate (Omron M6, HEM 7001E), blood glucose, plasma lipids, and semi-quantitative proteinuria tests. We used stepwise logistic regression to model the odds for hypertension and diabetes.ResultsIn 1292 adult participants ≥20years (56.6% women, mean age 37±15years), the prevalence of hypertension and known diabetes was 30.9% and 4.2%, respectively. Among participants with hypertension respectively 46.6%, 29.3% and 18.3% were aware, on treatment and controlled. Control was better among women and subjects below age 55, but lower in overweight/obese subjects. The odds for hypertension independently increased with age (P<0.0001), overweight/obesity (P<0.0001), pulse rate (P=0.0249) and high legumes consumption (P=0.0453). The odds for diabetes increased with age (P=0.0009) and overweight/obesity (P=0.0016). The prevalence of other risk factors was 5.5%, 42.2%, 42.8% and 30.9%, for smoking, overweight/obesity, abdominal adiposity and hypercholesterolemia; 4.6% of participants had proteinuria. Smoking predominated in men (10.8% vs. 1.4%), obesity (8.6% vs. 21.5%) and hypercholesterolemia (23.2% vs. 37.4%) in women. Hypertension clustered with three or more risk factors including diabetes or proteinuria in 68.7%.ConclusionOur findings highlight the staggering rates of cardiovascular risk factors in sub-Saharan Africa and underscore the pressing need to move their prevention and control higher on the political agenda
May Measurement Month 2019: an analysis of blood pressure screening results from the Democratic Republic of the Congo
No full textHypertension, the foremost cause of global morbi-mortality, is linked with a high mortality from numerous cardiovascular endpoints. The May Measurement Month (MMM) campaign is an annual initiative of the International Society of Hypertension (ISH) to collect information on blood pressure (BP) and other risk factors for cardiovascular disease (CVD) in adults. MMM2019 in the Democratic Republic of the Congo (DRC) was an opportunistic cross-sectional survey of volunteers aged ≥18 years that took place in Kinshasa and Mbuji-Mayi after the training of observers to familiarize with the ISH ad hoc methods. We screened 29 857 individuals (mean age: 40 years; 40% female). Hypertension was present in 7624 (25.5%) individuals. Of them, 2520 (33.1%) were aware, 1768 (23.2%) on treatment with 910 (51.5%) controlled BP (systolic BP <140 mmHg and/or diastolic BP <90 mmHg). Of all hypertensives screened, 11.9% had controlled BP. Of all respondents, 16.7% had participated in MMM18 and 60.5% did not have their BP verified during the last year. Fasting, pregnancy, and underweight status were linked with lower BP levels whilst smoking, drinking, antihypertensive medication, previous stroke, diabetes as well as being overweight/obese were associated with higher BP levels. Our results reflect the high rate of hypertension in the DRC with low levels of awareness, treatment, and control. A nationally representative sample is required to establish the nationwide hypertension prevalence
May Measurement Month 2021: an analysis of blood pressure screening results from a suburban community in the Democratic Republic of the Congo
No full textHypertension remains the most powerful contributor to the global morbidity and mortality. May Measurement Month (MMM), a worldwide screening campaign initiated by the International Society of Hypertension (ISH), is organized annually to increase awareness of high blood pressure (BP). We screened 20 913 adult (≥18 years) residents of suburb hamlets of Mbujimayi (mean age 35.1 ± 15.1 years; Black ethnicity: 98.8%; women: 29.6%; diabetes: 1.6%; alcohol drinkers: 16.8% and smokers: 6.7%, previous myocardial infarction: 1.4%; stroke: 0.8%; taking aspirin: 3.2%; taking statins: 1.9%). Three sitting BP readings were taken, and hypertension was defined as a systolic BP ≥ 140 mmHg or diastolic BP ≥ 90 mmHg or being on antihypertensive medication. Half of the participants had never had their BP checked, whilst 4.2% of respondents had participated in the MMM19 campaign. 0.9% and 1.7% reported COVID-19 vaccination and positive test, respectively. After multiple imputation of missing BP readings, 14.0% of respondents had hypertension of which 35.8% were aware, 28.0% were on antihypertensive medication and 14.1% had controlled BP. Of those on antihypertensive medication, 40.4% were on monotherapy, 37.2% adhered to taking their medication regularly, and 50.4% had controlled BP (<140/90 mmHg). In regression analyses adjusted for age, sex, and antihypertensive treatment, smoking was associated with lower systolic BP, having more years of education was associated with higher systolic and diastolic BP, and physical activity was associated with lower systolic and diastolic BP. This campaign contributes somewhat to reducing the 'black hole' on the prevalence of hypertension in DRC pending systematic countrywide BP screening
Cardiovascular risk factors among the inhabitants of an urban Congolese community: Results of the VITARAA Study
No full textObjective: The objective is to assess cardiovascular risk profile in an urban Congolese population. Design and Methods: From July 2007 to March 2008, we investigated 1824 inhabitants (≥. 10. year old) randomly recruited from the Adoula quarter (Kinshasa, Congo). Measurements included: anthropometry, medical history and lifestyle habits via questionnaire, blood pressure and pulse rate (Omron M6, HEM 7001E), blood glucose, plasma lipids, and semi-quantitative proteinuria tests. We used stepwise logistic regression to model the odds for hypertension and diabetes. Results: In 1292 adult participants ≥. 20. years (56.6% women, mean age 37. ±. 15. years), the prevalence of hypertension and known diabetes was 30.9% and 4.2%, respectively. Among participants with hypertension respectively 46.6%, 29.3% and 18.3% were aware, on treatment and controlled. Control was better among women and subjects below age 55, but lower in overweight/obese subjects. The odds for hypertension independently increased with age (. P<. 0.0001), overweight/obesity (. P<. 0.0001), pulse rate (. P=. 0.0249) and high legumes consumption (. P=. 0.0453). The odds for diabetes increased with age (. P=. 0.0009) and overweight/obesity (. P=. 0.0016). The prevalence of other risk factors was 5.5%, 42.2%, 42.8% and 30.9%, for smoking, overweight/obesity, abdominal adiposity and hypercholesterolemia; 4.6% of participants had proteinuria. Smoking predominated in men (10.8% vs. 1.4%), obesity (8.6% vs. 21.5%) and hypercholesterolemia (23.2% vs. 37.4%) in women. Hypertension clustered with three or more risk factors including diabetes or proteinuria in 68.7%. Conclusion: Our findings highlight the staggering rates of cardiovascular risk factors in sub-Saharan Africa and underscore the pressing need to move their prevention and control higher on the political agenda.SCOPUS: ar.jinfo:eu-repo/semantics/publishe
Diminishing benefits of urban living for children and adolescents’ growth and development
No full textOptimal growth and development in childhood and adolescence is crucial for lifelong health and well-being1–6. Here we used data from 2,325 population-based studies, with measurements of height and weight from 71 million participants, to report the height and body-mass index (BMI) of children and adolescents aged 5–19 years on the basis of rural and urban place of residence in 200 countries and territories from 1990 to 2020. In 1990, children and adolescents residing in cities were taller than their rural counterparts in all but a few high-income countries. By 2020, the urban height advantage became smaller in most countries, and in many high-income western countries it reversed into a small urban-based disadvantage. The exception was for boys in most countries in sub-Saharan Africa and in some countries in Oceania, south Asia and the region of central Asia, Middle East and north Africa. In these countries, successive cohorts of boys from rural places either did not gain height or possibly became shorter, and hence fell further behind their urban peers. The difference between the age-standardized mean BMI of children in urban and rural areas was &lt;1.1 kg m–2 in the vast majority of countries. Within this small range, BMI increased slightly more in cities than in rural areas, except in south Asia, sub-Saharan Africa and some countries in central and eastern Europe. Our results show that in much of the world, the growth and developmental advantages of living in cities have diminished in the twenty-first century, whereas in much of sub-Saharan Africa they have amplified. © 2023, The Author(s)
Analysis of blood pressure and selected cardiovascular risk factors in the Democratic Republic of the Congo: the may measurement month 2018 results.
No full textHypertension (HT) is the largest contributor to cardiovascular disease mortality and is characterized by high prevalence and low awareness, treatment, and control rates in sub-Saharan Africa. May Measurement Month (MMM) is an international campaign intended to increase awareness of high blood pressure (BP) among the population and advocate for its importance to the health authorities. This study aimed to increase awareness of raised BP in a country where its nationwide prevalence is yet unestablished. Investigators trained and tested how to use the campaign materials, collected participants' demographic data, lifestyle habits, and obtained from each one three BP measurements. Hypertension was defined as a BP ≥140/90 mmHg, or use of antihypertensive medication. Of the 18 719 screened (mean age 41 years; 61.4% men), 26.1% were found to be hypertensive of whom 46.3% were aware of their condition and 29.6% were taking antihypertensive medication. The control rate of HT was 43.0% in those on medication and 12.7% among all hypertensive respondents. Comorbidities found were-diabetes (3.3%), overweight/obesity (35.5%); and a previous stroke and a previous myocardial infarction were reported by 1.2% and 2.0%, respectively. Imputed age- and sex-standardized BP was higher in treated hypertensive individuals (135/85 mmHg) than those not treated (124/78 mmHg). Based on linear regression models adjusted for age and sex (and an interaction) and antihypertensive medication, stroke survivors, those who drank once or more per week (vs. never/rarely), and overweight/obese participants were associated with higher BP. MMM18 results in the Democratic Republic of the Congo corroborated the high prevalence of HT in Kinshasa screenees with low rates of treatment and control. Extension of the MMM campaign to other parts of the country is advisable
General and abdominal adiposity and hypertension in eight world regions: a pooled analysis of 837 population-based studies with 7·5 million participants
No full textInternational audienceSummaryBackground Adiposity can be measured using BMI (which is based on weight and height) as well as indices of abdominal adiposity. We examined the association between BMI and waist-to-height ratio (WHtR) within and across populations of different world regions and quantified how well these two metrics discriminate between people with and without hypertension.MethodsWe used data from studies carried out from 1990 to 2023 on BMI, WHtR and hypertension in people aged 20–64 years in representative samples of the general population in eight world regions. We graphically compared the regional distributions of BMI and WHtR, and calculated Pearson’s correlation coefficients between BMI and WHtR within each region. We used mixed-effects linear regression to estimate the extent to which WHtR varies across regions at the same BMI. We graphically examined the prevalence of hypertension and the distribution of people who have hypertension both in relation to BMI and WHtR, and we assessed how closely BMI and WHtR discriminate between participants with and without hypertension using C-statistic and net reclassification improvement (NRI).FindingsThe correlation between BMI and WHtR ranged from 0·76 to 0·89 within different regions. After adjusting for age and BMI, mean WHtR was highest in south Asia for both sexes, followed by Latin America and the Caribbean and the region of central Asia, Middle East and north Africa. Mean WHtR was lowest in central and eastern Europe for both sexes, in the high-income western region for women, and in Oceania for men. Conversely, to achieve an equivalent WHtR, the BMI of the population of south Asia would need to be, on average, 2·79 kg/m² (95% CI 2·31–3·28) lower for women and 1·28 kg/m² (1·02–1·54) lower for men than in the high-income western region. In every region, hypertension prevalence increased with both BMI and WHtR. Models with either of these two adiposity metrics had virtually identical C-statistics and NRIs for every region and sex, with C-statistics ranging from 0·72 to 0·81 and NRIs ranging from 0·34 to 0·57 in different region and sex combinations. When both BMI and WHtR were used, performance improved only slightly compared with using either adiposity measure alone.InterpretationBMI can distinguish young and middle-aged adults with higher versus lower amounts of abdominal adiposity with moderate-to-high accuracy, and both BMI and WHtR distinguish people with or without hypertension. However, at the same BMI level, people in south Asia, Latin America and the Caribbean, and the region of central Asia, Middle East and north Africa, have higher WHtR than in the other regions
Worldwide trends in underweight and obesity from 1990 to 2022 : a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults
No full textA list of authors and their affiliations appears online. A supplementary appendix is herewith attached.Background: Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories.
Methods: We used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5–19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI 2 SD above the median).
Findings: From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in 11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and 140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%) with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and 42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents, the increases in double burden were driven by increases in obesity, and decreases in double burden by declining underweight or thinness.
Interpretation: The combined burden of underweight and obesity has increased in most countries, driven by an increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesity.peer-reviewe
