PO 8550 NATURE AND PREVALENCE OF MULTI-MORBIDITY IN FISHING COMMUNITIES ON LAKE VICTORIA, KENYA

IntroductionMultimorbidity, coexistence of two or more chronic conditions, is becoming more common across different demographic groups in sub-Saharan Africa. We investigate the nature and prevalence of multimorbidity in fishing communities on Lake Victoria in Kenya.MethodsWe conducted a cross-sectional survey enrolling 679participants in the fishing communities to establish theprevalence of HIV and non-communicable diseases (NCDs)and associated risk factors. The NCDs targeted included diabetes mellitus detected by random blood glucose (RBG) and kidney dysfuction detected by serum creatinine level and proteniuria. Hypertension was defined as systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg. Diabetes mellitus was defined as RBG >7.8 mmol/L and renal dysfunction was defined as estimated glomerular filtration rate (eGFR) <60 mL/min or proteinuria. HIV was tested using rapid Determine assays and reactive results confirmed with UniGold assays. Additionally, participants were determined as having the condition if they reported being on medication for the condition. We analysed the results using descriptive statistics and used Chi-square test to discern if there were statistically significant differences by gender.ResultsOverall, HIV prevalence was 36% while 15%, 12% and 8% of the participants were suspected to have kidney dysfuction, hypertension and diabetes mellitus, respectively. Overall, 12% of the participants had multimorbidity. The most common multimorbidity among those with any of the four chronic conditions was HIV and kidney dysfunction (29%), followed by hypertension and kidney dysfuction (22%), HIV and hypertension (20%), HIV and diabetes (18%), diabetes and kidney disease (6%) and, lastly, diabetes and hypertension (5%). Apart from HIV, we observed no statistically significant gender differences for any of the NCDs or various multimorbidity conditions.ConclusionThese fishing communities have a high burden of both HIV and NCDs resulting in high prevalence of different multimorbidities.

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Antenatal Care Practices Among Hard-to-Reach Fishing Communities on Lake Victoria: A Community-Based Cross-Sectional Survey

Journal of Primary Care & Community Health ◽

10.1177/2150132720923101 ◽

2020 ◽

Vol 11 ◽

pp. 215013272092310 ◽

Cited By ~ 1

Author(s):

Ali Ssetaala ◽

Joan Nabawanuka ◽

Gideon Matovu ◽

Nusula Nakiragga ◽

Judith Namugga ◽

...

Keyword(s):

Antenatal Care ◽

Lake Victoria ◽

Public Health Facility ◽

Adverse Outcomes ◽

Sub Saharan Africa ◽

Fishing Communities ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Care Community ◽

Late Start

Background: Uganda has one of the highest maternal deaths in sub-Saharan Africa, with a mortality ratio of 336 per 100 000 live births. Early regular antenatal care (ANC) helps prevent adverse outcomes, including deaths, through prevention, identification, treatment, and/or referral of at-risk women. We explored ANC practices and associated factors among women from hard-to-reach Lake Victoria islands fishing communities in Kalangala district, Uganda. Methods: A cross-sectional survey among 486 consenting women aged 15 to 49 years, who were pregnant or had a birth or abortion in the past 6 months was conducted in 6 island fishing communities of Kalangala district, Uganda, during January to May 2018. ODK software interviewer-administered questionnaires were used to collect data on sociodemographics and ANC practices. Regression modeling using STATA version 15 was used to determine factors associated with ANC visits. Results: Women’s median (range) age was 26 (15-45) years, 63% (304/486) had up to primary level education, 45% (219/486) were housewives (stay home mums), 87% (423/486) were married. ANC visits ranged from 0 to 10, with over three-fifths of women having their first visit late after 3 months of being pregnant (63%, 198/316). Women without a history of pregnancy loss (adjusted odds ratio [AOR] = 1.8, 95% CI 1.1-3.0), those not staying with their partners (AOR = 2.5, 95% CI 1.1-6.0), and those whose partners were working in fishing-related activities (AOR = 1.8, 95% CI 1.0-3.0) were likely to have started care late. Women from communities with a public health facility and those with partners working in none fishing-related activities had the highest predicted number of visits. Conclusion: Antenatal practices among these communities are characterized by late start of care. Community-led early ANC awareness interventions are needed. Targeted health policies need to consider public ANC facilities for each island for improved antenatal outcomes and maternal health.

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Prevalence and associated risk factors of hypertension among persons aged 15–49 in India: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2019-029714 ◽

2019 ◽

Vol 9 (12) ◽

pp. e029714 ◽

Cited By ~ 3

Author(s):

Soumitra Ghosh ◽

Manish Kumar

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Family Health ◽

Cross Sectional Study ◽

Secondary Outcome ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Effective Interventions ◽

Life Style Changes ◽

Associated Risk Factors

ObjectivesThis is the first attempt to provide estimates on the prevalence of hypertension at the national, state and district level, a prerequisite for designing effective interventions. Besides, the study aims to identify the risk factors of hypertension.DesignWe analysed cross-sectional survey data from the fourth round (2015–2016) of National Family Health Survey (NFHS). NFHS was conducted between January 2015 and December 2016, gathering information on a range of indicators including blood pressure. The age adjusted prevalence of hypertension was calculated for state comparison, while multilevel logistic regression analysis was done to assess the correlates of hypertension.Setting and participantsIndia (2015–2016; n=811 917) aged 15–49.Primary and secondary outcome measuresThe primary outcome is hypertension, which has been defined as systolic blood pressure ≥140 mm Hg and/or diastolic blood pressure ≥90 mm Hg.ResultsThe age-adjusted prevalence of hypertension in India was 11.3% (95% CI 11.16% to 11.43%) among persons aged between 15 and 49 and was four percentage points higher among males 13.8% (95% CI 13.46% to 14.19%) than among females 10.9% (95% CI 10.79% to 11.06%). Persons in the urban location (12.5%, 95% CI 12.25% to 12.80%) had a marginally higher prevalence than persons in rural location (10.6%, 95% CI 10.50% to 10.78%). The proportion of population suffering from hypertension varied greatly between states, with a prevalence of 8.2% (95% CI 7.58% to 8.85%) in Kerala to 20.3% (95% CI 18.81% to 21.77%) in Sikkim. Advancing age, obesity/overweight, male sex, socioeconomic status and consumption of alcohol were found to be the major predictors of hypertension.ConclusionsHypertension prevalence is now becoming more concentrated among the poor. Policy measures should be taken to improve the hazardous working conditions and growing social pressures of survival responsible for ‘life-style’ changes such as consumption of high calorie food and alcohol.

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Prevalence of Hyperhomocysteinaemia and Associated Factors among Ethiopian Adult Population in a 2015 National Survey

BioMed Research International ◽

10.1155/2020/9210261 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7

Author(s):

Feyissa Challa ◽

Tigist Getahun ◽

Meron Sileshi ◽

Bikila Nigassie ◽

Zeleke Geto ◽

...

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Vegetable Consumption ◽

Adult Population ◽

Noncommunicable Diseases ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Middle Income ◽

Steps Survey ◽

Associated Risk Factors

Hyperhomocysteinaemia (HHcy) is an independent risk factor for major cardiovascular diseases, but data on the prevalence and predictors of HHcy in low- and middle-income countries like Ethiopia are scant. The aim of this study was to estimate the prevalence of HHcy and associated risk factors in the Ethiopian adult population. A cross-sectional survey on risks of noncommunicable diseases (NCDs) using the STEPwise approach to surveillance (STEPS) survey was conducted between April and June 2015. A total of 4,175 study participants were surveyed. Serum homocysteine (Hcy) and metabolic profile were determined using Cobas Integra 400 Plus and CardioChek PA analyzer, respectively. Factors associated with HHcy were determined using logistic regression. The mean serum tHcy concentration was 14.6 μmol/L, with 16.4 μmol/L in males and 13.4 μmol/L in females. Overall, 38% had HHcy, with figures in males (49%) higher than females (30%). Increased age, being male, and high blood pressure and/or taking blood pressure medication, as well as low consumption of fruit and/or vegetables, were independent risk factors for HHcy. In conclusion, the prevalence of HHcy among the adult Ethiopian population is alarmingly high. Improving diets through the promotion of fruit and vegetable consumption is needed to reduce the risk of NCDs.

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Skilled Birth Attendance among Women in Tharaka-Nithi County, Kenya

Advances in Public Health ◽

10.1155/2017/9740196 ◽

2017 ◽

Vol 2017 ◽

pp. 1-5

Author(s):

Eliphas Gitonga

Keyword(s):

Family Income ◽

Skilled Birth Attendance ◽

Sub Saharan Africa ◽

Systematic Sampling ◽

Birth Preparedness ◽

Cross Sectional Survey ◽

Skilled Attendant ◽

Chi Square ◽

Cross Sectional ◽

Birth Attendance

Background. The burden of maternal mortality is concentrated in sub-Saharan Africa with an estimation of 500 000 deaths annually. In 2012, about forty million births occurred without a skilled attendant in developing countries. Skilled birth attendance improves maternal and newborn survival. The aim of this study therefore was to establish the level of skilled birth attendance and the associated factors. Methods. A cross-sectional survey was carried out using structured questionnaires as tools of data collection. Systematic sampling was used to select the respondents from the facilities that were stratified. The dependent variable was skilled birth attendance. Descriptive statistics were used to generate proportions and percentages while chi-square and Fisher’s exact tests were used to draw inferences. Association was significant if P<0.05. Results. The level of utilisation of skilled birth attendance was 77%. Skilled birth attendance was noted to be associated with age, level of education, average family income, parity, distance to the health facility, timing of initiation of antenatal care, level of facility attended during pregnancy, and birth preparedness status. Conclusion. The level of skilled birth attendance among women in Tharaka-Nithi County, Kenya, despite being higher than in some counties, requires improvement.

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Correlates of family planning knowledge among people in fishing communities of Lake Victoria in Uganda

10.21203/rs.3.rs-15612/v1 ◽

2020 ◽

Author(s):

Annet Nanvubya ◽

R.K. Wanyenze ◽

T. Nakaweesa ◽

J. Mpendo ◽

B. Kawoozo ◽

...

Keyword(s):

Family Planning ◽

Side Effects ◽

Hiv Prevention ◽

Lake Victoria ◽

Cultural Beliefs ◽

Fishing Communities ◽

Modern Contraceptive ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Prevention Trials

Abstract BackgroundFamily planning (FP) is a key component in the conduct of HIV prevention trials and FP knowledge is a determinant of modern contraceptive use. Although fishing communities (FCs) participate in HIV prevention trials, knowledge about FP in this population is scarcely known. We determined correlates of FP knowledge in FCs of L. Victoria in Uganda to inform improvements in FP interventions in preparation for other HIV prevention trials.MethodsWe conducted a cross-sectional survey among participants aged 16-49 years in Kigungu and Nsazi FCs. A semi-structured questionnaire was administered to assess FP knowledge. A composite score with 5 parameters including; awareness about FP methods, knowledge about ideal number of children for a couple, knowledge about ideal birth spacing interval, knowledge about FP methods and their side effects and interval between the last 2 children was used to determine whether participant’s knowledge was or wasn’t satisfactory. Satisfactory FP knowledge was attributed to a score of ≥80% from the five parameters. We also conducted 10 in-depth interviews and 4 focus group discussions.ResultsOf the 1,410 screened participants, 95% were aware of at least one FP method while only 21% had satisfactory knowledge. Participants aged 30-39 years, those engaged in trade/business, housewives, those from Nsazi, the married or those who were divorced, separated or widowed were more likely to have satisfactory FP knowledge compared to those aged 16-29 years (aOR: 1.59 95% CI: 1.14-2.22), farmers (aOR: 3.14 95% CI: 1.21-8.17), and (aOR: 3.69 95% CI: 1.35-10.1), those from Kigungu (aOR: 1.58 95%CI: 1.09-2.30), those who were single (aOR: 6.96 95% CI: 3.42-14.13) or (aOR: 17.67 95% CI: 8.54-36.54).There were concerns about side effects and effectiveness of some modern FP methods. Misconceptions about effects of FP like sterility, cancers and foetal abnormalities were common. Cultural beliefs on contraception are key barriers to FP information.ConclusionPeople from FCs in Uganda are aware of FP but their knowledge is largely unsatisfactory. Concerns about method safety, effectiveness of some methods, misconceptions and cultural barriers exist. A FP education tool tailored for a mobile, high risk and remote population is recommended to improve FP knowledge.

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RISK FACTORS FOR CARDIOVASCULAR EVENTS IN RURAL NIGERIA: A CROSS SECTIONAL SURVEY AND A REVIEW OF THE CURRENT LITERATURE

Innovative Journal of Medical and Health Science ◽

10.15520/ijmhs.v9i4.2533 ◽

2019 ◽

Vol 9 (4) ◽

pp. 370-375

Author(s):

Anthonia A. Ikpeme*,Nchiewe E. Ani, Edoise M. Isiwele, Andrew E. Ekpenyong,Emmanuel E. Ekanem

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Rural Areas ◽

Demographic Data ◽

Cross Sectional Study ◽

Sub Saharan Africa ◽

Cross Sectional Survey ◽

Chi Square ◽

Cross Sectional ◽

Cross River State

Introduction: Over 80% of cardiovascular deaths take place in low and middle incomecountries. These cardiovascular deaths are caused by modifiable risk factors. Evidenceis emerging that some of these factors maybe even more prevalent in rural areas whichare generally underserved.Aim: The aim of this study was to record risk factors for cardiovascular disease inrural communities in south southern Nigeria and review some related literature.Methods: A cross sectional study during clinical outreach activities that took placein 2016 to 2018 in several rural and few urban communities in Cross River State,Nigeria. Participating individuals gave full consent and ethical clearance obtained.Socio-demographic data, Anthropometric data and Blood sugar measurements wereobtained. Data extracted was transferred into EXCEL thereafter analysis was doneusing SPSS version 21. p values less than 0.05 were deemed statistically significant.Tests of significance included Anova, chi square and student t- tests.Results: Total population investigated over the 3 year period was 504. (2016-33.1%),(2017 -37.9%), (2018 – 28%) with a Female: Male distribution of 1:1.Most participants tended to be overweight across the years 59.7%, 59.1%, 73.7%,2016, 2017, and 2018 respectively. The prevalence of Hypertension was 10.71%. Nosignificant gender difference in the prevalence of Hypertension (6.94% males to 3.77%females, p=0.097). The prevalence of Diabetes Mellitus was 10.67%. There was nosignificant gender prevalence (6.67% males to 4.00% females, p =0.431)Conclusion: Cardiovascular disease remains relatively uncommon in Sub-SaharanAfrica, despite an increasing prevalence of risk factors, but it’s incidence is rising.Steps should be taken in Sub-Saharan Africa to prevent an epidemic. This involvesdetailed and regular screening for cardiovascular risk factors in rural communities.Key words: RISK FACTORS, Cardio vascular disease, South South Nigeria.

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May Measurement Month 2019: an analysis of blood pressure screening results from Benin–Sub-Saharan Africa

European Heart Journal Supplements ◽

10.1093/eurheartj/suab018 ◽

2021 ◽

Vol 23 (Supplement_B) ◽

pp. B24-B26

Author(s):

Corine Houehanou ◽

Léopold Codjo ◽

Philippe Adjagba ◽

Arnaud Sonou ◽

Hugues Dohou ◽

...

Keyword(s):

Blood Pressure ◽

Urban Areas ◽

Antihypertensive Medication ◽

Sub Saharan Africa ◽

Health Concern ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Rural And Urban Areas ◽

Rural And Urban ◽

Sub Saharan

Abstract Hypertension constitutes a major health concern worldwide and particularly in Sub-Saharan Africa. May Measurement Month (MMM) is a global initiative of the International Society of Hypertension for raising awareness of high blood pressure (BP). This work aims to determine the prevalence, awareness and levels of treatment and control of hypertension among adults participating in the MMM Campaign in Benin in 2019 (MMM19). A cross-sectional survey including volunteers aged ≥18 years was carried out in June 2019 in 13 rural and urban areas in Benin. BP measurement followed the MMM19 protocol. Hypertension was defined as a systolic BP ≥140 mmHg, or a diastolic BP ≥90 mmHg (based on the mean of the second and third readings) or taking antihypertensive medication. A total of 3637 people were screened with a female predominance (61.4%) and a mean age of 44.4 ± 16.1 years. A total of 1363 (37.5%) participants had hypertension. Of 1363 participants with hypertension: 64.5% were aware of their status and 43.9% were taking antihypertensive medication. Among 598 participants taking anti-hypertensive medication, 34.9% had controlled BP (systolic BP <140 mmHg and diastolic BP <90 mmHg). The results suggest a high prevalence of hypertension in Benin and that intensifying actions for its primary prevention, early detection and effective management should be encouraged.

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Components of antenatal care received by women in fishing communities on Lake Victoria, Uganda; a cross sectional survey

10.21203/rs.3.rs-20221/v3 ◽

2020 ◽

Author(s):

Ali Ssetaala ◽

Joan Nabawanuka ◽

Gideon Matovu ◽

Nusula Nakiragga ◽

Judith Namugga ◽

...

Keyword(s):

Antenatal Care ◽

Health Workers ◽

Lake Victoria ◽

Cost Effective ◽

Fishing Communities ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Island Communities ◽

Development Goals ◽

Victoria Island

Abstract Background: Uganda has one of the highest maternal deaths at a ratio of 336 per 100,000 live births. As Uganda strives to achieve sustainable development goals, appropriate antenatal care is key to reduction of maternal mortality. We explored women’s reported receipt of seven of the Uganda guidelines components of antenatal care, and associated factors in hard to reach Lake Victoria island fishing communities of Kalangala district.Methods: A cross sectional survey among 486 consenting women aged 15-49 years, who were pregnant at any time in the past 6 months was conducted in 6 island fishing communities of Kalangala district, Uganda, during January-May 2018. Interviewer administered questionnaires, were used to collect data on socio-demographics and receipt of seven of the Uganda guidelines components of antenatal care. Regression modeling was used to determine factors associated with receipt of all seven components. Results: Over three fifths (65.0%) had at least one ANC visit during current or most recent pregnancy. Fewer than a quarter of women who reported attending care at least four times received all seven ANC components [(23.6%), P<0.05]. Women who reported receipt of ANC from the mainland were twice as likely to have received all seven components as those who received care from islands (aOR=1.8; 95% CI:0.9-3.7). Receipt of care from a doctor was associated with thrice likelihood of receiving all components relative to ANC by a midwife or nurse (aOR=3.2; 95% CI:1.1-9.1). Conclusions: We observed that the delivery of antenatal care components per Ugandan guidelines is poor in these communities. Cost effective endeavors to improve components of antenatal care received by women are urgently needed. Task shifting some components of ANC to community health workers may improve care in these island communities.Trial Registration: PACTR201903906459874 (Retrospectively registered).

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Components of antenatal care received by women in fishing communities on Lake Victoria, Uganda; a cross sectional survey

10.21203/rs.3.rs-20221/v2 ◽

2020 ◽

Author(s):

Ali Ssetaala ◽

Joan Nabawanuka ◽

Gideon Matovu ◽

Nusula Nakiragga ◽

Judith Namugga ◽

...

Keyword(s):

Antenatal Care ◽

Health Workers ◽

Lake Victoria ◽

Cost Effective ◽

Fishing Communities ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Island Communities ◽

Development Goals ◽

Victoria Island

Abstract Background: Uganda has one of the highest maternal deaths at a ratio of 336 per 100,000 live births. As Uganda strives to achieve sustainable development goals, appropriate antenatal care is key to reduction of maternal mortality. We explored women’s reported receipt of seven of the Uganda guidelines components of antenatal care, and associated factors in hard to reach Lake Victoria island fishing communities of Kalangala district. Methods: A cross sectional survey among 486 consenting women aged 15-49 years, who were pregnant at any time in the past 6 months was conducted in 6 island fishing communities of Kalangala district, Uganda, during January-May 2018. Interviewer administered questionnaires, were used to collect data on socio-demographics and receipt of seven of the Uganda guidelines components of antenatal care. Regression modeling was used to determine factors associated with receipt of all seven components. Results: Over three fifths (65.0%) had at least one ANC visit during current or most recent pregnancy. Fewer than a quarter of women who reported attending care at least four times received all seven ANC components [(23.6%), P<0.05]. Women who reported receipt of ANC from the mainland were twice as likely to have received all seven components as those who received care from islands (aOR=1.8; 95% CI:0.9-3.7). Receipt of care from a doctor was associated with thrice likelihood of receiving all components relative to ANC by a midwife or nurse (aOR=3.2; 95% CI:1.1-9.1). Conclusions: We observed that the delivery of antenatal care components per Ugandan guidelines is poor in these communities. Cost effective endeavors to improve components of antenatal care received by women are urgently needed. Task shifting some components of ANC to community health workers may improve care in these island communities. Trial Registration: PACTR201903906459874 (Retrospectively registered).

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Correlates of knowledge of family planning among people living in fishing communities of Lake Victoria, Uganda

10.21203/rs.3.rs-15612/v4 ◽

2020 ◽

Author(s):

Annet Nanvubya ◽

R.K. Wanyenze ◽

T. Nakaweesa ◽

J. Mpendo ◽

B. Kawoozo ◽

...

Keyword(s):

Family Planning ◽

Clinical Research ◽

Lake Victoria ◽

Good Knowledge ◽

Fishing Communities ◽

Access To Health Services ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Poor Knowledge ◽

The Mean

Abstract Knowledge of family planning (FP) is a key determinant of contraceptive use which ultimately plays a role in attainment of good health and in conduct of clinical research. People living in fishing communities (FCs) have limited access to health services including FP and are targeted for future clinical research but their knowledge of FP and its correlates are scantily known. We determined correlates of knowledge of FP among people living in FCs of L. Victoria in Uganda to inform future FP education programs in FCs. We conducted a comparative cross-sectional survey among participants aged 15-49 years from Kigungu and Nsazi. Participants were asked if they were aware of any FP method. All those who responded in the affirmative were further asked to mention what FP methods they had heard of or knew. Those who reported knowledge of at least one FP method were asked a series of questions about FP methods and their side effects. Knowledge was categorized into good or poor knowledge based on their mean total score. Poor knowledge constituted a score below the mean while good knowledge constituted a score of more than or equal to the mean total score. To further explore attitudes and perceptions of FP, ten in-depth interviews and four focus group discussions were conducted. Of the 1,410 screened participants, 94.5% were aware of at least one FP method. Pills and injectable hormonal methods were the most commonly known methods. Slightly over a third (38%) had good knowledge of FP. Correlates of knowledge of FP were; being female (aOR: 1.92 95% CI: 1.39-2.67), residing in Kigungu (aOR: 4.01 95% CI: 2.77-5.81), being married (aOR: 1.59 95% CI: 1.11-2.28) and currently being in a sexual relationship (aOR: 1.75 95% CI: 1.18-2.60). Concerns about safety and effectiveness of some modern FP methods exist. Misconceptions on effects of FP like sterility, cancers and foetal abnormalities were common. FP awareness among people living in FCs of L. Victoria in Uganda is high. However, good knowledge about specific methods tends to be low. Correlates of knowledge of FP include gender, residence, marital status and sexual engagement.

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