Differences in hypertension between informal and formal areas of Ouagadougou, a sub-Saharan African city

BMC Public Health

Maria Victoria Zunzunegui²  Abdramane Soura³  Clémentine Rossier¹  Séni Kouanda⁴  Boukaré Doulougou⁴ 

[1] Institut d’Études Démographique et du parcours de vie (I-DEMO), Université de Genève, 40 Boulevard du pont d’Arve, 1211 Genève, Suisse;Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montréal, QC, Canada;Institut Supérieur des Sciences de la Population (ISSP), Université de Ouagadougou, Ouagadougou, 03 BP 7118, Burkina Faso;Institut de Recherche en Sciences de la Santé (IRSS), Ouagadougou, 03 BP 7192, Burkina Faso

关键词: Ouagadougou;    Rural-to-urban migrants;    Adult population;    Risk factors;    Prevalence;    Hypertension;   

Others  :  1128113
DOI  :  10.1186/1471-2458-14-893

 received in 2014-04-28, accepted in 2014-08-26,  发布年份 2014

【 摘 要 】

Background

Countries of sub-Saharan Africa are increasingly confronted with hypertension and urbanization is considered to favor its emergence. This study aims to assess the difference in the prevalence of hypertension between formal and informal urban areas of Ouagadougou and to determine the risk factors associated with hypertension in these urban populations of sub-Saharan Africa.

Methods

A cross-sectional survey was conducted in 2010 on 2041 adults aged 18 years and older in formal and informal areas of Ouagadougou. Data was collected through personal interviews conducted at home. Blood pressure and anthropometric measurements were taken by trained interviewers. Logistic regressions were fitted to identify factors associated with hypertension.

Results

The overall prevalence of hypertension was 18.6% (95% confidence interval [CI], 16.9-20.3) and its detection was 27.4% (95% CI, 22.9-31.9). Prevalence of hypertension in formal settings was 21.4% (95% CI, 19.0-23.8), significantly higher than prevalence in informal settings: 15.3% (95% CI, 13.0-17.6). However, this difference disappeared after adjusting for age. In addition to age, being an unmarried woman (odds ratio [OR] = 1.7; 95% CI, 1.1-2.4), recent rural-to-urban migration (OR = 1.8; 95% CI, 1.2-2.8), obesity (OR = 1.8; 95% CI, 1.1-3.1) and physical inactivity (OR = 1.9; 95% CI, 1.2-3.0), were independent risk factors for hypertension.

Conclusions

Hypertension is common among the adult population of Ouagadougou but its detection is low. While there are no differences between formal and informal areas of the city, rural-to-urban migration emerges as an independent risk factor. Known risk factors as obesity and physical inactivity are confirmed while the vulnerability of unmarried women and rural-to-urban migrants maybe specific to this west African population.

【 授权许可】

   
2014 Doulougou et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Maher D, Smeeth L, Sekajugo J: Health transition in Africa: practical policy proposals for primary care. Bull World Health Organ 2010, 88(12):943-948.
• [2]Omran AR: The epidemiologic transition. A theory of the epidemiology of population change. Milbank Mem Fund Q 1971, 49(4):509-538.
• [3]Delisle H, Ntandou-Bouzitou G, Agueh V, Sodjinou R, Fayomi B: Urbanisation, nutrition transition and cardiometabolic risk: the Benin study. Br J Nutr 2012, 107(10):1534-1544.
• [4]Godfrey R, Julien M: Urbanisation and health. Clin Med 2005, 5(2):137-141.
• [5]World Health Organization: Global status report on noncommunicable diseases 2010. 2011. http://whqlibdoc.who.int/publications/2011/9789240686458_eng.pdf webcite
• [6]Murray CJ, Lopez AD: Mortality by cause for eight regions of the world: Global Burden of Disease Study. Lancet 1997, 349(9061):1269-1276.
• [7]Addo J, Smeeth L, Leon DA: Hypertension in sub-saharan Africa: a systematic review. Hypertension 2007, 50(6):1012-1018.
• [8]Damasceno A, Azevedo A, Silva-Matos C, Prista A, Diogo D, Lunet N: Hypertension prevalence, awareness, treatment, and control in mozambique: urban/rural gap during epidemiological transition. Hypertension 2009, 54(1):77-83.
• [9]Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, He J: Global burden of hypertension: analysis of worldwide data. Lancet 2005, 365(9455):217-223.
• [10]Agyemang C: Rural and urban differences in blood pressure and hypertension in Ghana, West Africa. Public Health 2006, 120(6):525-533.
• [11]Doulougou B, Kouanda S, Bado A, Nikiéma L, Zunzunegui MV: Hypertension in the adult population of Kaya Health and Demographic Surveillance System in Burkina Faso: Prevalence and associated factors. International Journal of Tropical Disease and Health 2014, 4(1):94-110.
• [12]United Nations: The Millennium Development Goals Reports 2012. New York: United Nations; 2012. http://www.un.org/millenniumgoals/pdf/MDG%20Report%202012.pdf webcite
• [13]Niakara A, Nebie LV, Zagre NM, Ouedraogo NA, Megnigbeto AC: Connaissances d’une population urbaine sur l’hypertension arterielle: enquete prospective menee a Ouagadougou. Burkina Faso Bull Soc Pathol Exot 2003, 96(3):219-222.
• [14]Niakara A, Fournet F, Gary J, Harang M, Nebie LV, Salem G: Hypertension, urbanization, social and spatial disparities: a cross-sectional population-based survey in a West African urban environment (Ouagadougou, Burkina Faso). Trans R Soc Trop Med Hyg 2007, 101(11):1136-1142.
• [15]Rossier C, Soura A, Baya B, Compaore G, Dabire B, Dos Santos S, Duthe G, Gnoumou B, Kobiane JF, Kouanda S, Lankoande B, Legrand T, Mbacke C, Millogo R, Mondain N, Montgomery M, Nikiema A, Ouili I, Pison G, Randall S, Sangli G, Schoumaker B, Zourkaleini Y: Profile: the Ouagadougou Health and Demographic Surveillance System. Int J Epidemiol 2012, 41(3):658-666.
• [16]World Health Organization: The STEPS Instrument and Support Materials. Geneva: World Health Organization; 2006. http://www.who.int/chp/steps/instrument/en/index.html# webcite
• [17]Babor TF, Higgins-Biddle JC, Saunders JB, Monteiro MG: AUDIT: The Alcohol Use Disorders Identification Test. Geneva: World Health Organization; 2001. http://www.talkingalcohol.com/files/pdfs/WHO_audit.pdf webcite
• [18]Agyemang C, Bruijnzeels MA, Owusu-Dabo E: Factors associated with hypertension awareness, treatment, and control in Ghana, West Africa. J Hum Hypertens 2006, 20(1):67-71.
• [19]Jenson A, Omar AL, Omar MA, Rishad AS, Khoshnood K: Assessment of hypertension control in a district of Mombasa, Kenya. Global public health 2011, 6(3):293-306.
• [20]Tesfaye F, Byass P, Wall S: Population based prevalence of high blood pressure among adults in Addis Ababa: uncovering a silent epidemic. BMC Cardiovasc Disord 2009, 9:39. BioMed Central Full Text
• [21]van de Vijver SJ, Oti SO, Agyemang C, Gomez GB, Kyobutungi C: Prevalence, awareness, treatment and control of hypertension among slum dwellers in Nairobi, Kenya. J Hypertens 2013, 31(5):1018-1024.
• [22]Agyemang C, Nicolaou M, Boateng L, Dijkshoorn H, van de Born BJ, Stronks K: Prevalence, awareness, treatment, and control of hypertension among Ghanaian population in Amsterdam, The Netherlands: the GHAIA study. European journal of preventive cardiology 2013, 20(6):938-946.
• [23]Gibson J, Stillman S, McKenzie D, Rohorua H: Natural experiment evidence on the effect of migration on blood pressure and hypertension. Health Econ 2013, 22(6):655-672.
• [24]Unwin N, James P, McLarty D, Machybia H, Nkulila P, Tamin B, Nguluma M, McNally R: Rural to urban migration and changes in cardiovascular risk factors in Tanzania: a prospective cohort study. BMC Public Health 2010, 10:272. BioMed Central Full Text
• [25]Duboz P, Macia E, Chapuis-Lucciani N, Boetsch G, Gueye L: Migration and hypertension in Dakar, Senegal. Am J Phys Anthropol 2012, 149(2):250-258.
• [26]Zhang Z, Hayward M: Gender, the marital life course, and cardivascular diseases in late midlife. J Marriage Fam 2006, 68:639-657.
• [27]Briasoulis A, Agarwal V, Messerli FH: Alcohol consumption and the risk of hypertension in men and women: a systematic review and meta-analysis. J Clin Hypertens (Greenwich) 2012, 14(11):792-798.
• [28]Pires JE, Sebastiao YV, Langa AJ, Nery SV: Hypertension in Northern Angola: prevalence, associated factors, awareness, treatment and control. BMC Public Health 2013, 13(1):90. BioMed Central Full Text
• [29]Addo J, Amoah AGB, Koram KA: The changing patterns of hypertension in Ghana: A study of four rural communities in the Ga District. Ethn Dis 2006, 16:894-899.
• [30]Fezeu L, Kengne AP, Balkau B, Awah PK, Mbanya JC: Ten-year change in blood pressure levels and prevalence of hypertension in urban and rural Cameroon. J Epidemiol Community Health 2010, 64(4):360-365.
• [31]Zeba AN, Delisle HF, Renier G, Savadogo B, Baya B: The double burden of malnutrition and cardiometabolic risk widens the gender and socio-economic health gap: a study among adults in Burkina Faso (West Africa). Public Health Nutr 2012, 15(12):2210-2219.
• [32]Rose G: Sick individuals and sick populations. Int J Epidemiol 1985, 14(1):32-38.
• [33]De Ramirez SS, Enquobahrie DA, Nyadzi G, Mjungu D, Magombo F, Ramirez M, Sachs SE, Willett W: Prevalence and correlates of hypertension: a cross-sectional study among rural populations in sub-Saharan Africa. J Hum Hypertens 2010, 24(12):786-795.
• [34]Bosu WK: Epidemic of hypertension in Ghana: a systematic review. BMC Public Health 2010, 10:418. BioMed Central Full Text