Prevalence and lifestyle-associated risk factors of metabolic syndrome among commercial motor vehicle drivers in a metropolitan city in Ghana

Epidemiology of non-communicable diseases among professional drivers in LMICs: a systematic review and meta-analysis

This systematic review collected evidence on the burden of non-communicable diseases (NCDs) among professional drivers and reported on the most common factors that increase the risk of NCDs in this specific population in low- and middle-income countries (LMICs). The protocol for this systematic review was registered in the International Prospective Register of Systematic Reviews (PROSPERO). We conducted a thorough search on PubMed/MEDLINE, EMBASE, Scopus, Global Health, Web of Science and Africa-wide information databases on 11 May 2023. We adapted the Joanna Briggs Institute (JBI) tool to assess the quality of the studies. We estimated the prevalence of hypertension, prediabetes, diabetes mellitus (DM), overweight and obesity among professional drivers using a random effect model to compute pooled and subgroup analyses. In addition, we conducted a narrative synthesis of the risk factors and recommendations presented in the included studies. Forty-one studies, including 48 414 study participants, met the criteria for inclusion. The pooled prevalence of hypertension, DM and obesity among professional drivers was 36.7% [95% confidence interval (CI): 31.8-41.6%], 15.2% (95% CI: 7.0-23.4%) and 27.2% (95% CI: 18.7-35.8%), respectively. Unsupportive environment, work stress, sedentary lifestyle, consumption of unhealthy foods and shift work were the most common modifiable risk factors reported. Our findings also show a significant burden of hypertension, DM and obesity among professional drivers in LMICs. The prevalence of DM and obesity was two- and three-fold higher than findings in general populations, respectively. Our findings indicate an urgent need for tailored interventions for different occupation-related risk factors for NCDs among professional drivers in LMICs.

Cardiovascular risk assessment of people living in prison in the Northern region of Ghana

PURPOSE

The health of people living in prisons (PLP) frequently remains marginalised in national development discourse, particularly in resource-constrained settings like Ghana. This study aims to determine the prevalence of cardiovascular disease (CVD) risk factors among PLP at a prison facility in the Northern Region of Ghana.

DESIGN/METHODOLOGY/APPROACH

A cross-sectional study involving 134 male persons in prison, aged 18-79 years, was conducted to assess their dietary habits, tobacco use, alcohol consumption, sleep behaviour and physical activity practices. Serum lipid profile, fasting blood glucose (FBG), blood pressure (BP) and body mass indices of participants were also measured.

FINDINGS

Almost half (48.1%) of the participants had abnormal lipid levels. Those with FBG in the diabetes range (= 7.0 mmol/l) constituted 3.9%, while 16.7% were in the impaired FBG range (6.1-6.9 mmol/l). Participants with BP within the pre-hypertension range were 54.5%. The majority of participants (92%) had a low daily intake of fruits and vegetables. Few participants were active smokers (5%) and alcohol users (2%). The average sleep duration at night among the participants was 5.54 ± 2.07 h. The majority (74%) of the participants were sedentary. About a quarter of the participants (24.6%) had overweight/obesity.

ORIGINALITY/VALUE

This study highlights the CVD risks among PLP. Findings suggest the need for targeted interventions, such as dietary and lifestyle modification strategies, regular physical activity and routine screening for diabetes, dyslipidaemia and hypertension. These interventions within the prison space could significantly improve the cardiovascular health of PLP in resource-limited settings.

10-year level, trends and socio-demographic disparities of obesity among Ghanaian adults-A systematic review and meta-analysis of observational studies

The double burden of malnutrition has assumed severer forms in Low and Middle Income Countries (LMICs) arising from sharper increases in prevalence rates of overweight and obesity in these countries compared to higher income countries. Considering that LMICs already have fragile health systems, the rising obesity levels may just be a ticking time bomb requiring expeditious implementation of priority actions by all global and national actors to prevent an explosion of cardiovascular disease related deaths. The aim of this systematic review and meta-analysis was to provide a current estimate of obesity and overweight prevalence among Ghanaian adults and assess socio-demographic disparities following the PRISMA guidelines. We searched Pubmed with Medline, Embase, Science direct and African Journals Online (AJOL) for studies on overweight and obesity published between 2013 and January 2023. Applying a quality effects model, pooled mean Body Mass Index (BMI) and prevalence of overweight and obesity were obtained from 42 studies conducted across all three geographical locations of Ghana with a combined sample size of 29137. From the analysis, the mean BMI of adults in Ghana was 24.7 kgm-2 while overweight and obesity prevalence was estimated as 23.1% and 13.3% respectively. Temporal analysis showed sharper increases in overweight and obesity prevalence from 2017/2018. Mean BMI (Females: 25.3kgm-2 vrs Males: 23.1 kgm-2), overweight (Females: 25.9% vrs Males: 16.5%) and obesity (Females: 17.4% vrs Males: 5.5%) prevalence were higher among females than males. Gender differences in mean BMI and obesity prevalence were both significant at p<0.001. Urban dwellers had higher mean BMI than their rural counterparts (24.9kgm-2 vrs 24.4kgm-2). Overweight (27.6% vrs 18.2%) and obesity (17.3% vrs 11.0%) prevalence were also higher in urban areas than in rural areas. Body weight indicators for the various geographical areas of Ghana were; southern sector: 25.4kgm-2, 28.9% and 15.4%, middle sector: 24.8kgm-2, 26.4% and 16.2% and northern sector: 24.2kgm-2, 15.4% and 8.5% for mean BMI, overweight and obesity prevalence respectively. The southern part of Ghana was similar to the middle part in terms of mean BMI, overweight and obesity but higher than the northern part. We conclude that overweight and obesity prevalence in Ghana has risen to high levels in recent years with women and urban dwellers disproportionately more affected. There is a possible implication for increased cardiovascular diseases and a generally poor quality of life for the people. Evidence-based public health interventions are needed to reverse the current situation.

Prevalence of the metabolic syndrome in African populations: A systematic review and meta-analysis

BACKGROUND

The metabolic syndrome (MS) is a leading cause of death worldwide. Several studies have found MS to be prevalent in various African regions. However, no specific estimates of MS prevalence in African populations exist. The aim of this study was to estimate the overall prevalence of MS in the African populations.

METHODS

A systematic review was conducted in PubMed, Web of Science, Africa Index Medicus, and African Journal Online Scopus to find studies published up to the 15th of August 2022. Pooled prevalence was calculated based on six diagnostic methods. The pooled prevalence of MS was estimated using a random-effects model. Our risk of bias analysis was based on the Hoy et al. tool. A Heterogeneity (I2) assessment was performed, as well as an Egger test for publication bias. PROSPERO number CRD42021275176 was assigned to this study.

RESULTS

In total, 297 studies corresponding to 345 prevalence data from 29 African countries and involving 156 464 participants were included. The overall prevalence of MS in Africa was 32.4% (95% CI: 30.2-34.7) with significant heterogeneity (I2 = 98.9%; P<0.001). We obtained prevalence rates of 44.8% (95% CI: 24.8-65.7), 39.7% (95% CI: 31.7-48.1), 33.1% (95% CI: 28.5-37.8), 31.6% (95% CI: 27.8-35.6) and 29.3% (95% CI: 25.7-33) using the WHO, revised NCEP-ATP III, JIS, NCEP/ATP III and IDF definition criteria, respectively. The prevalence of MS was significantly higher in adults >18 years with 33.1% (95%CI: 30.8-35.5) compared to children <18 years with 13.3% (95%CI: 7.3-20.6) (P<0.001). MS prevalence was significantly higher in females with 36.9% (95%CI: 33.2-40.7) compared to males with 26.7% (95%CI: 23.1-30.5) (P<0.001). The prevalence of MS was highest among Type 2 diabetes patients with 66.9% (95%CI: 60.3-73.1), followed by patients with coronary artery disease with 55.2% (95%CI: 50.8-59.6) and cardiovascular diseases with 48.3% (95%CI: 33.5-63.3) (P<0.001). With 33.6% (95% CI: 28.3-39.1), the southern African region was the most affected, followed by upper-middle income economies with 35% (95% CI: 29.5-40.6).

CONCLUSION

This study, regardless of the definition used, reveals a high prevalence of MS in Africa, confirming the ongoing epidemiological transition in African countries. Early prevention and treatment strategies are urgently needed to reverse this trend.

The Association between Plant-Based Diets and Dietary Patterns with Cardiometabolic Risk in a Sample of Commercial Taxi Drivers in South Africa

The consumption of unhealthy foods and a sedentary lifestyle predispose individuals to non-communicable diseases. This study investigated the distribution and the association of plant-based diets (PBDs) and dietary patterns in relation to the cardiometabolic risks in commercial taxi drivers. A cross-sectional analysis was conducted among males (≥19 years) who consumed street foods sold by vendors in the Cape Metropole. A validated questionnaire was administered, including a quantified 24 h dietary recall, and fasting blood samples were collected for biochemical analyses. Statistical analyses were performed to investigate the association between dietary habits and cardiometabolic risks, while adjusting for confounding variables. The analytic sample consisted of 189 males with a median age of 38 years. The taxi drivers who ranked in the top-third of the healthy plant-based diet index (hPDI) had a 1–4% lower likelihood of having raised triglycerides (TG). Furthermore, consumption patterns including refined grains and meat conferred a 33% lower likelihood of dysglycaemia (p = 0.049), while fish/seafood, potatoes, and vegetables conferred a 43% greater likelihood of low high-density lipoprotein cholesterol (HDL-C) (p = 0.026) and 44% greater probability of raised low-density lipoprotein cholesterol (LDL-C) (p = 0.027). Consumption patterns, including sugar-sweetened beverages and eggs, conferred a 37% greater probability of hypertension (p = 0.047) and 53% greater likelihood of subclinical inflammation (p = 0.017). These preliminary findings require larger and more elaborate studies to explore the associations between PBDs and dietary patterns in at-risk African populations, with or without sedentary lifestyles, and exposure to unhealthy food environments.

Sociodemographic and lifestyle factors and the risk of metabolic syndrome in taxi drivers: A focus on street food

Background

In South Africa, similar to other populous countries, the taxi industry is an important form of transportation that contributes to the country's development. As a result, minibus taxi driving is an occupation characterized by strenuous activities such as long hours of driving, limited rest, and challenges related to securing passengers, among several others. Consequently, to combat stress, some commercial drivers resort to smoking, overeating unhealthy food sold at transportation interchange areas (i.e., taxi ranks), and participating in sedentary behaviors. Most of these activities are risk factors for metabolic syndrome (MetS).

Aim

Therefore, this study aimed to investigate the sociodemographic and lifestyle factors that predispose South African taxi drivers who work in the Cape Town Metropole area to the risk of developing MetS.

Methods

This cross-sectional study used a convenient sampling method that included 185 male minibus taxi drivers aged 20 years or above. The participants were interviewed using a validated questionnaire to gather information regarding their sociodemographic characteristics and lifestyle practices. They also underwent physical and metabolic assessments, and the International Diabetes Federation (IDF) criteria were used to diagnose people with MetS.

Results

Overall, the mean age and driving experience of the taxi drivers were 40.0 years (SD: 10.7) and 9.1 years (SD: 7.4), respectively, with those with MetS being significantly older and having more driving experience than those without. Older participants were 3 and 2.9 times more likely to be diagnosed with MetS than the younger participants. Most taxi drivers (70%) met the IDF diagnostic criteria for MetS. Smokers, those who spent more than 100 ZAR (USD 5.9) and those who spent less than 1.4 MET-minutes per week on physical activity were 1.96, 2.0, and 13.6 times more likely to suffer from MetS that those who were nonsmokers, those who spent less than 100 ZAR and those who spent <1.4 MET-minutes per week on physical activity. Consumption of alcohol and sugar-sweetened beverages (SSBs), as well as takeaway and fried foods, snacks, and sold by the SF vendors, increased the likelihood of developing MetS, abnormal HDL-C, TG, and hypertension, while avoiding takeaway and fried foods decreased this likelihood. Taxi drivers who also avoided consuming fresh fruits had abnormal HDL-C.

Conclusion

These findings have significant public health implications, highlighting the need for South African policymakers to adopt a system-level approach to promote lifestyle changes among taxi drivers within the taxi industry. This can help reduce the health risks faced by these drivers and improve their overall health profile.

Factors Affecting the Deterioration of the Physical Health Status of Taxi Drivers by Age Group

With the rapidly aging population, taxi drivers are aging at a fast pace, and competition in the taxi industry is intensifying due to the emergence of various transportation platforms. A descriptive secondary data study was conducted (on a total of 936 subjects) to determine the factors affecting the deterioration of taxi drivers’ physical health status (PHS) according to their age group. The increased incidence of chronic diseases and cognitive decline among taxi drivers aged 55−64 years had the greatest influence on the deterioration of their PHS. Driver obesity was more likely to be related to deterioration of the PHS in the drivers aged 55−64 years (OR: 2.459, <0.001) and 35−54 years (OR: 2.133, <0.001). Among the financial factors, a driver’s income and their number of dependent family members were correlated with the deterioration of the PHS for drivers aged 55 years or over. Therefore, chronic diseases, obesity and cognitive decline were related with deterioration of the physical health status. This suggests that attention should be paid to healthcare policies not only for the elderly aged over 65 years but also those aged 50 to 64 years, i.e., middle-aged people at the beginning of the transition to old age.

Metabolic Syndrome and Its Components among Taxi Drivers in the City of Tshwane, South Africa

The occupation of taxi driving predisposes drivers to health risks, including obesity, cardiovascular and metabolic disorders. Although individual components of metabolic syndrome (MetS) are documented, data is scarce on concurrent metabolic disturbances among commercial drivers. The prevalence of MetS and its components were determined in a cross-sectional study among taxi drivers (n = 362) in the City of Tshwane, South Africa. Sociodemographic, occupational, and lifestyle factors were assessed using a structured questionnaire. Anthropometry, blood pressure, and glucose were measured. MetS was defined based on BMI strata, hypertension, and glucose levels. Data was analyzed using SPSS. The mean age of taxi drivers was 42 ± 10.9 years. Overall prevalence of MetS was 17.1%, with higher prevalence observed among older taxi drivers (24.2%) and those with longer experience in the industry (22.9%). Individual components of MetS were obesity (36%), hypertension (36%) and diabetes (46%), while smoking (30%), alcohol use (59%), and physical inactivity (71%) were observed. MetS was associated with duration in the taxi industry, and family history of diabetes among taxi drivers. The presence of MetS and its components among taxi drivers calls for early identification of cardiometabolic risks in the taxi industry and efforts towards achieving a healthier workforce.

Metabolic syndrome and its determinants among professional drivers: a systematic review and meta-analysis

Background

Drivers are one of the trade unions that are most exposed to various health-related risks, especially metabolic diseases. The present study aimed to systematically assess the overall prevalence of metabolic syndrome and its determinants among drivers in the world.

Methods

All retrospective, cross-sectional, or prospective studies evaluating the prevalence and risk for metabolic syndrome and its main components among male professional drivers were eligible for the initial assessment. PRISMA guideline was used. Two blinded reviewers independently screened the titles and abstracts of the manuscripts followed by a deep assessment of the full texts for determining the inclusion appropriateness.

Results

In the final, 12 articles were eligible for the final analysis. Overall, 19,350 professional male drivers with a total average age of 43.06 years (ranged from 35.5 to 51.1 years) were included in the study. The prevalence of metabolic syndrome was estimated to be 32.8% (95%CI: 32.1% to 33.5%), and the major determinants of appearing this syndrome among professional drivers were advanced age, years of driving experience, higher body mass index, smoking, high cholesterol dietary regimen, high Framingham risk score, low regular exercising, history of diabetes mellitus, history of gout, and shift work pattern.

Conclusion

According to the 32.8% prevalence rate of metabolic syndrome among drivers, managerial measures are needed to prevent and control metabolic disturbances among professional drivers are recommended.

Hydration and water intake practices of commercial long-distance drivers in Ghana: what do they know and why does it matter?

BACKGROUND

The World Health Organization indicates that hydration is indispensable to human life. A long-period of dehydration can result in fatigue, drowsiness and mental confusion which can result in committing serious blunders. For commercial drivers, however, these blunders can be life-threatening and their hydration cannot be overemphasized.

AIM

This study was therefore undertaken to assess the water intake practices of Commercial Long-Distance drivers (CLDDs). The study was also aimed at assessing their knowledge levels on the role of water in promoting a healthy body and the consequences of dehydration.

SETTING

CLDDs in Ghana who ply between Accra - Cape Coast - Takoradi or Accra - Kumasi.

METHODS

A cross-sectional study which involved 256 CLDDs was conducted at six (6) commercial bus stations in Accra and Cape Coast from December 2019 to January 2020. Structured questionnaires were administered to obtain socio-demographic and water intake practices of CLDDs. SPSS was used to generate descriptive statistics based on the data collected.

RESULTS

A high proportion (57.8%) of the CLDDs reported that they drunk about 2500ml-3000ml of water on a daily basis. Most (53.1%) relied on their thirst feeling to prompt them to drink water. A little over half (51.1%) consumed energy drinks believed to hydrate the body. A major barrier to drinking water regularly was to avoid frequent stop-overs to use the washroom while travelling.

CONCLUSION

The findings reveal concerns about knowledge gaps with regard to the importance of water consumption and barriers to adequate drinking of water among CLDDs. Findings also suggest that many CLDDs relied on their thirst perceptions to prompt them to drink water. Health Education programmes targeting CLDDs should include conveying the importance of water intake and healthy hydration practices for optimal physical and cognitive performance.