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Joshi S, Thapa BB. Socioeconomic risk factors of hypertension and blood pressure among persons aged 15-49 in Nepal: a cross-sectional study. BMJ Open 2022; 12:e057383. [PMID: 35649602 PMCID: PMC9161073 DOI: 10.1136/bmjopen-2021-057383] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES This study estimated the prevalence of hypertension, in accordance with the American College of Cardiology and American Heart Association's 2017 guidelines, and examined the association between various socioeconomic factors and systolic blood pressure (SBP), diastolic blood pressure (DBP) and hypertension. SETTING AND DESIGN We used nationally representative data from the 2016 Nepal Demographic and Health Survey. Multivariate analysis was used to study the association of hypertension with socioeconomic factors: logistic regression was used for hypertension and linear regression was used for DBP and SBP. PARTICIPANTS Our sample consisted of 9827 adults between the ages of 15 and 49 years. RESULTS The prevalence of hypertension was 36%. The mean DBP and SBP were 76.4 and 111.5, respectively. Janjatis (adjusted OR (AOR): 1.34, CI: 1.12 to 1.59), Other Terai castes (AOR: 1.38, CI: 1.03 to 1.84), Muslim and other ethnicities (AOR: 1.64, CI: 1.15 to 2.33) and Dalits (AOR: 1.26, CI: 1.00 to 1.58) had higher odds of hypertension. Individuals employed in professional, technical and managerial professions collectively (AOR: 1.62; CI: 1.18 to 2.21) also had higher odds of hypertension. Moderately food insecure household had lower odds of hypertension (AOR: 0.84; CI: 0.72 to 0.99) compared with households with no issue of food insecurity. Results were similar for SBP and DBP. When stratified by sex, there were differences mainly in terms of occupation and ethnicity. CONCLUSION There are substantial disparities in hypertension prevalence in Nepal. These disparities extend across ethnic groups, occupational status and food security status. Differences also persist across different provinces. As hypertension continues to be increasingly more significant, more research is needed to better understand the disparities and gradients that exist across various socioeconomic factors.
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Affiliation(s)
- Sushant Joshi
- Public Policy and Management, University of Southern California Sol Price School of Public Policy, Los Angeles, California, USA
| | - Bishnu Bahadur Thapa
- Health Services, Policy and Practice, Brown University School of Public Health, Providence, Rhode Island, USA
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Denekew TW, Gautam Y, Bhandari D, Gautam GP, Sherchand JB, Pokhrel AK, Jha AR. Prevalence and determinants of hypertension in underrepresented indigenous populations of Nepal. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000133. [PMID: 36962278 PMCID: PMC10021878 DOI: 10.1371/journal.pgph.0000133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 11/29/2021] [Indexed: 11/19/2022]
Abstract
Indigenous populations residing in low- and middle-income countries (LMICs) are highly underrepresented in medicine and public health research. Specifically, data on non-communicable diseases (NCDs) from indigenous populations remains scarce. Despite the increasing burden of NCDs in the Himalayan region, their prevalence in many indigenous populations remains understudied. The nationally representative public health surveys often do not include the indigenous communities, especially those that reside in rural areas or exist in small numbers. This observational cross-sectional survey study aimed to assess the prevalence of three NCD risk factors namely obesity, hypertension, and tachycardia and identify dietary and lifestyle variables associated with them across underrepresented indigenous populations of Nepal. A total of 311 individuals (53.3% women, 46.7% men) with mean age 43±15 years from 12 indigenous Nepali communities residing in rural (47.9%) or semi-urban (52.1%) areas volunteered to participate in this study. Univariate tests and multivariable logistic regressions were used to analyze the survey data. The mean systolic and diastolic blood pressures were 121.3±19.5 mmHg and 81.3±11.8 mmHg respectively. Overall, the prevalence of obesity and tachycardia was low (0.64% and 3.22%, respectively) but hypertension was prevalent at 23.8%. Hypertension was not significantly different across populations, but it was associated with age, BMI, and tobacco use, and collectively, these variables explained 13.9% variation in hypertension prevalence. Although we were unable to detect direct associations between individual determinants of hypertension identified in non-indigenous Nepalis, such as education levels, alcohol consumption, and smoking in this study, having one or more determinants increased the odds of hypertension in the indigenous participants. Furthermore, ~14% of the hypertensive individuals had none of the universally identified hypertension risk factors. The lack of association between previously identified risk factors for hypertension in these individuals indicates that the additional determinants of hypertension remain to be identified in indigenous Nepali populations.
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Affiliation(s)
- Tsedenia Workneh Denekew
- Genetic Heritage Group, Program in Biology, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Yoshina Gautam
- Genetic Heritage Group, Program in Biology, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
- Himalayan Diversity Project, Department of Biomedical Data Science, Stanford University, Stanford, Palo Alto, United States of America
| | - Dinesh Bhandari
- School of Public Health, University of Adelaide, Adelaide, Australia
- Public Health Research Lab, Tribhuvan University Institute of Medicine, Maharajgunj, Nepal
| | | | | | - Amod K Pokhrel
- Society for Legal and Environmental Analysis and Development Research, Kathmandu, Nepal
- On-Campus/On-Line MPH program, School of Public Health, University of California, Berkeley, CA, United States of America
| | - Aashish R Jha
- Genetic Heritage Group, Program in Biology, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
- Himalayan Diversity Project, Department of Biomedical Data Science, Stanford University, Stanford, Palo Alto, United States of America
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Bhattarai S, Tandstad B, Shrestha A, Karmacharya B, Sen A. Socioeconomic Status and Its Relation to Hypertension in Rural Nepal. Int J Hypertens 2021; 2021:5542438. [PMID: 34497724 PMCID: PMC8419497 DOI: 10.1155/2021/5542438] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 06/16/2021] [Accepted: 08/18/2021] [Indexed: 01/13/2023] Open
Abstract
INTRODUCTION Hypertension and its association with socioeconomic positions are well established. However, the gradient of these relationships and the mediating role of lifestyle factors among rural population in low- and middle-income countries such as Nepal are not fully understood. We sought to assess the association between socioeconomic factors (education, income, and employment status) and hypertension. Also, we assessed whether the effect of education and income level on hypertension was mediated by lifestyle factors. METHODS This cross-sectional study was conducted among 260 participants aged ≥18 years attending a rural health center in Dolakha, Nepal. Self-reported data on demographic, socioeconomic, and lifestyle factors were collected, and blood pressure, weight, and height were measured for all study participants. Those with systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg or administrating high blood pressure-lowering medicines were regarded as hypertensives. Poisson regression models were used to estimate the prevalence ratios and corresponding 95% confidence intervals to assess the association between socioeconomic factors and hypertension. We explored mediation, using the medeff command in Stata for causal mediation analysis of nonlinear models. RESULTS Of the 50 hypertensive participants, sixty percent were aware of their status. The age-standardized prevalence of hypertension was two times higher for those with higher education or high-income category. Compared to low-income and unemployed groups, the prevalence ratio of hypertension was 1.33 and 2.26 times more for those belonging to the high-income and employed groups, respectively. No evidence of mediation by lifestyle factors was observed between socioeconomic status and hypertension. CONCLUSIONS Socioeconomic positions were positively associated with hypertension prevalence in rural Nepal. Further studies using longitudinal settings are necessary to validate our findings especially in low- and middle-income countries such as Nepal.
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Affiliation(s)
- Sanju Bhattarai
- Department of Community Programs, Dhulikhel Hospital Kathmandu University Hospital, Dhulikhel, Nepal
| | - Birgit Tandstad
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
| | - Archana Shrestha
- Department of Public Health, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
- Institute of Implementation Science and Health, Kathmandu, Nepal
- Department of Chronic Disease Epidemiology Center of Methods for Implementation and Prevention Science, Yale School of Public Health, New Haven, USA
| | - Biraj Karmacharya
- Department of Public Health, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
- Institute of Implementation Science and Health, Kathmandu, Nepal
| | - Abhijit Sen
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
- Oral Health Services and Research Center, (TkMidt), Trondheim, Norway
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Paudel P, Chalise S, Neupane DR, Adhikari N, Paudel S, Dangi NB. Prevalence of Hypertension in a Community. ACTA ACUST UNITED AC 2020; 58:1011-1017. [PMID: 34506387 PMCID: PMC8028540 DOI: 10.31729/jnma.5316] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Indexed: 11/03/2022]
Abstract
INTRODUCTION Hypertension is one of the leading risk factors for the global burden of disease and is of rising public health concerns in the developing world including Nepal. However, few studies have focused on awareness, treatment, and control of hypertension among people living with this condition. In this scenario, this study aimed to find out the prevalence of hypertension and its awareness, treatment, and control among hypertensive patients residing in different parts of Kaski district, Nepal. METHODS A descriptive cross-sectional study was performed among 977 family members of 290 households from August to December 2017. Ethical approval was taken from the Institutional Review Committee (reference number:73/074/75) of the Pokhara University Research Center. Simple random sampling was done. Hypertension screening was performed through averaging three values obtained by standardized aneroid sphygmomanometer in three observations. Primary data was collected through self-administered questionnaires and face-to-face interviews based on the participant's preferences. Collected data were analyzed using Statistical Package for the Social Sciences version 20. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. RESULTS Out Of total 997 family members screened, 294 (29.49%) (26.66-32.32 at 95% confidence interval) had hypertension whereas only 127 (43.2%) were completely aware of their disease condition. 279 (94.9%) were taking antihypertensive medication and 201 (68.4%) had their blood pressure controlled. CONCLUSIONS We found that almost one-fourth of the adult population in the community suffered from hypertension but less than half of the hypertensive patients are aware of their conditions.
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Affiliation(s)
- Pradeep Paudel
- Faculty of Health Sciences, School of Health and Allied Sciences, Pokhara University, Kaski, Nepal
| | - Samir Chalise
- Faculty of Health Sciences, School of Health and Allied Sciences, Pokhara University, Kaski, Nepal
| | - Dinesh Raj Neupane
- Faculty of Health Sciences, School of Health and Allied Sciences, Pokhara University, Kaski, Nepal
| | - Narayan Adhikari
- Faculty of Health Sciences, School of Health and Allied Sciences, Pokhara University, Kaski, Nepal
| | - Shishir Paudel
- Department of Public Health, Manmohan Memorial Institute of Health Sciences, Kathmandu, Nepal
| | - Nim Bahadur Dangi
- Faculty of Health Sciences, School of Health and Allied Sciences, Pokhara University, Kaski, Nepal
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Hasan MM, Tasnim F, Tariqujjaman M, Ahmed S, Cleary A, Mamun A. Examining the prevalence, correlates and inequalities of undiagnosed hypertension in Nepal: a population-based cross-sectional study. BMJ Open 2020; 10:e037592. [PMID: 33004393 PMCID: PMC7534699 DOI: 10.1136/bmjopen-2020-037592] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVE To examine the prevalence, correlates and sociodemographic inequalities of undiagnosed hypertension in Nepal. DESIGN This study used cross-sectional 2016 Nepal Demographic and Health Survey (NDHS) data. Undiagnosed patients with hypertension were defined as an NDHS respondent who was diagnosed as hypertensive (systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg) during the survey, but never took any prescribed anti-hypertensive medicine to lower/control blood pressure and was never identified as having hypertension by a health professional prior the survey. Multiple binary logistic regression analysis was performed, and Concentration Index was measured. SETTING Nepal. PARTICIPANTS Adult patients with hypertension. RESULTS Among 3334 patients with hypertension, 50.4% remained undiagnosed during the survey in Nepal. Adjusted model reveals that patients who were male, belonged to households other than the highest wealth quintile, and lived in province 4 and province 5 were at higher risk of remaining undiagnosed for hypertension. Patients who were ≥65 years of age and were overweight/obese were at lower risk of remaining undiagnosed for hypertension. The poor-rich gap was 24.6 percentage points (Q1=64.1% vs Q5=39.6%) and poor:rich ratio was 1.6 (Q1/Q5=1.6) in the prevalence of undiagnosed hypertension. Undiagnosed hypertension was disproportionately higher among lower socioeconomic status groups (Concentration Index, C=-0.18). Inequalities in the prevalence of undiagnosed hypertension further varied across other geographic locations, including place of residence, ecological zones and administrative provinces. CONCLUSIONS Undiagnosed hypertension was highly prevalent in Nepal and there were substantial inequalities by sociodemographics and subnational levels. Increasing awareness, strengthening routine screening to diagnose hypertension at primary health service facilities and enactment of social health insurance policy may help Nepal to prevent and control this burden.
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Affiliation(s)
- Md Mehedi Hasan
- Institute for Social Science Research, The University of Queensland, Indooroopilly, Queensland, Australia
- ARC Centre of Excellence for Children and Families over the Life Course (The Life Course Centre), The University of Queensland, Indooroopilly, Queensland, Australia
| | - Fariha Tasnim
- Maternal and Child Health DIvision, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Md Tariqujjaman
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Sayem Ahmed
- Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, UK
- Health Economics and Policy Research Group, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - Anne Cleary
- Institute for Social Science Research, The University of Queensland, Indooroopilly, Queensland, Australia
| | - Abdullah Mamun
- Institute for Social Science Research, The University of Queensland, Indooroopilly, Queensland, Australia
- ARC Centre of Excellence for Children and Families over the Life Course (The Life Course Centre), The University of Queensland, Indooroopilly, Queensland, Australia
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Thapa R, Khanal S, Tan HS, Thapa SS, van Rens GHMB. Prevalence, Pattern and Risk Factors of Retinal Diseases Among an Elderly Population in Nepal: The Bhaktapur Retina Study. Clin Ophthalmol 2020; 14:2109-2118. [PMID: 32801619 PMCID: PMC7399464 DOI: 10.2147/opth.s262131] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 07/09/2020] [Indexed: 12/01/2022] Open
Abstract
Introduction Retinal diseases are an emerging cause of visual impairment in the developing world. The aim of this study was to explore the prevalence, pattern, and risk factors of retinal diseases in Nepal. Methods This is a population-based, cross-sectional study conducted from 2013 to 2015. The sample size was 2100 subjects age 60 years and above from 30 clusters of Bhaktapur district, Nepal. Detailed history, visual acuity, and anterior and posterior segment examinations were performed. Blood sugar and blood pressure were measured. Results Complete information was available for 1860 (88.57%) subjects. Mean age was 69.64±7.31 years, ranging from 60 to 95 years. The prevalence of any retinal disorder was 52.37% (95% confidence interval (CI): 50.07–54.66%). The prevalence of retinal disorders increased with ageing: 51.26% between 60 and 69 years and 53.05% among those age 80 years and above. Age-related macular degeneration (AMD) was the most common retinal disease (35.43%), followed by hypertensive retinopathy (4.35%), epiretinal membrane (ERM) (3.66%), branch retinal vein occlusion (BRVO) (2.90%), and diabetic retinopathy (DR) (2.15%). Other rare retinal disorders included myopic fundus (0.86%), chorioretinal scar (0.54%), retinal holes (0.32%), retinitis pigmentosa (0.32%), retinal detachment (0.16%), and coloboma (0.11%). In multivariate logistic regression analysis, those with prior cataract surgery (odds ratio (OR), 1.71; 95% CI: 1.32–2.22, p < 0.001) and systemic hypertension (OR, 1.21; 95% CI: 1.001–1.47, p = 0.049) had significantly increased retinal disorders. Conclusion Prevalence of retinal disorder was 52.37% at age 60 years and above. AMD, hypertensive retinopathy, ERM, BRVO, and DR were the most common retinal disorders. Retinal disorders increased with ageing. Retinal disorders were found associated with hypertension and prior cataract surgery. Timely screening, control of blood sugar and high blood pressure, and regular eye check-ups could help to save vision from retinal diseases.
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Affiliation(s)
- Raba Thapa
- Tilganga Institute of Ophthalmology, Kathmandu, Nepal
| | - Shankar Khanal
- Central Department of Statistics, Tribhuvan University, Kirtipur, Nepal
| | - Hendra Stevie Tan
- Department of Ophthalmology, Amsterdam University Medical Center, Vrije University Amsterdam, Amsterdam, the Netherlands
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Nam KD, Van NB, Hoang LV, Duc TP, Thi Ha TT, Tuan VT, Dinh PP, Thi Thu HT, Show PL, Nga VT, Minh LB, Chu DT. Hypertension in a mountainous province of Vietnam: prevalence and risk factors. Heliyon 2020; 6:e03383. [PMID: 32072063 PMCID: PMC7015972 DOI: 10.1016/j.heliyon.2020.e03383] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Revised: 12/18/2019] [Accepted: 02/04/2020] [Indexed: 01/20/2023] Open
Abstract
Background Hypertension (HTN) significantly contributes to global disease burden, and its prevalence varies amongst different countries and regions. This work is aimed to characterize the hypertensive prevalence and identify risk factors for HTN among the residents in five locations (four communes and one town) of Moc Chau district (Son La province, Vietnam). Methods A cross-sectional study with a cross-sectional methodology was done in selected places from August 2018 to December 2018. We interviewed 197 participants aged equal to or more than 18 years old and measured their blood pressure (BP). Univariate and multivariate logistic regression were applied. Results The overall HTN prevalence of 30.0% was recorded. The differences of HTN prevalence rates were seen by several characters including age groups (p <0.001), accompanying disease (p <0.001) and alcohol drinking (p <0.05). Factors independently associated with hypertension were age (ORs: 3.1 [1.1–9.1]; 6.1 [1.7–22.3]), much salty consumption (OR: 2.6 [1.1–6.6]), alcohol use (OR: 3.1 [1.2–8.1]), HTN familial history (OR: 4.2 [1.3–13.3]) and at least one suffering disease (OR: 5.2 [2.1–12.7]). Conclusions Thus, this study highlighted the high overall HTN prevalence in the Vietnam Northwestern region. Significant differences of HTN rate were observed among several characteristics such as age groups, accompanying disease and alcohol drinking. Age group, much salty consumption, alcohol use, hypertension familial history and at least one suffering disease were risk factors for HTN in study group.
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Affiliation(s)
- Khanh Do Nam
- Institute of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Viet Nam
| | - Nhon Bui Van
- Department of Science and Technology, Hanoi Medical University, Hanoi, Viet Nam.,Cardiovascular Center, Hanoi Medical University Hospital, Hanoi Medical University, Hanoi, Viet Nam
| | - Long Vo Hoang
- Institute of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Viet Nam
| | - Toan Pham Duc
- Department of Nursing, Hanoi Medical University, Hanoi, Viet Nam
| | - Thu Tran Thi Ha
- Institute of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Viet Nam
| | - Viet Tran Tuan
- Department of Cardiology, Hanoi Medical University, Hanoi, Viet Nam
| | - Phong Phan Dinh
- Department of Cardiology, Hanoi Medical University, Hanoi, Viet Nam
| | - Huong Trinh Thi Thu
- Dong A Hospital, Hanoi, Viet Nam.,Department of Traditional Medicine, Hanoi Medical University, Hanoi, Viet Nam
| | - Pau Loke Show
- University of Nottingham Malaysia Campus, Jalan Broga, 43500 Semenyih, Selangor Darul Ehsan, Malaysia
| | - Vu Thi Nga
- Institute for Research and Development, Duy Tan University, Danang, Viet Nam
| | - Le Bui Minh
- NTT Hi-tech Institute, Nguyen Tat Thanh University, 300A Nguyen Tat Thanh St., Ward 13, District 4, Ho Chi Minh City, Viet Nam
| | - Dinh-Toi Chu
- Department of Human and Animal Physiology, Faculty of Biology, Hanoi National University of Education, Hanoi, Viet Nam.,School of Odonto Stomatology, Hanoi Medical University, Hanoi, Viet Nam
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Das Gupta R, Haider SS, Hashan MR, Rahman MA, Sarker M. Association between height and hypertension in the adult Nepalese population: Findings from a nationally representative survey. Health Sci Rep 2019; 2:e141. [PMID: 31890899 PMCID: PMC6920697 DOI: 10.1002/hsr2.141] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 09/27/2019] [Accepted: 10/07/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND AND AIMS The burden of hypertension is increasing in Nepal. Different studies have evaluated the relationship between height and blood pressure in different regions, with mixed results. The relationship between height and hypertension has not yet been explored in the Nepalese context. Given this knowledge gap, this study aims to determine the relationship between height and hypertension among Nepalese adults (aged ≥18 years). METHODS This study utilized the dataset from the Nepal Demographic and Health Survey (NDHS) 2016. Hypertension was defined as systolic blood pressure ≥ 140 mmHg and/or a diastolic blood pressure ≥ 90 mmHg. Height, measured in centimeters (cm), was analyzed as a continuous variable. Based on previous evidence, the following covariates were considered: age, sex, presence of overweight or obesity, educational status, household wealth status, and place, province, and ecological zone of residence. Multilevel multivariable logistic regression was done to evaluate the association between height and hypertension. Both crude odds ratio (COR) and adjusted odds ratio (AOR) are reported, along with a 95% confidence interval (CI). Sample weight of NDHS was adjusted during analysis. RESULTS Among 13 393 weighted individuals over the age of 18 years, the prevalence of hypertension in Nepal was found to be 21.1% (95% CI, 19.9%-22.4%). In the final multivariable model, after adjusting for relevant covariates, it was found that height was inversely associated with hypertension. For a Nepalese adult, the odds of hypertension decreased by 10% with each 10-cm increase in height (AOR 0.9; 95% CI 0.8-0.9; P = 0.003). CONCLUSION Awareness should be raised among people with low stature for prevention of hypertension. Longitudinal studies are recommended to include genetic and social/environmental determinants of stature in the analyses.
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Affiliation(s)
- Rajat Das Gupta
- Centre of Excellence for Non‐Communicable Diseases and Nutrition, BRAC James P Grant School of Public HealthBRAC UniversityDhakaBangladesh
- Centre of Excellence for Science of Implementation and Scale‐Up, BRAC James P Grant School of Public HealthBRAC UniversityDhakaBangladesh
- Department of Epidemiology and Biostatistics, Arnold School of Public HealthUniversity of South CarolinaColumbiaSouth CarolinaUnited States of America
| | - Shams Shabab Haider
- Centre of Excellence for Science of Implementation and Scale‐Up, BRAC James P Grant School of Public HealthBRAC UniversityDhakaBangladesh
| | - Mohammad Rashidul Hashan
- Infectious Diseases DivisionInternational Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)DhakaBangladesh
| | - Muhammad Aziz Rahman
- School of Nursing and Healthcare ProfessionsFederation UniversityVictoriaAustralia
- School of Nursing and MidwiferyLa Trobe UniversityHeidelbergAustralia
| | - Malabika Sarker
- Centre of Excellence for Non‐Communicable Diseases and Nutrition, BRAC James P Grant School of Public HealthBRAC UniversityDhakaBangladesh
- Centre of Excellence for Science of Implementation and Scale‐Up, BRAC James P Grant School of Public HealthBRAC UniversityDhakaBangladesh
- Institute of Public HealthHeidelberg UniversityHeidelbergGermany
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Mahiroh H, Astutik E, Pratama RA. The Association of Body Mass Index, Physical Activity and Hypertension in Indonesia. JURNAL NERS 2019. [DOI: 10.20473/jn.v14i1.12811] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Introduction: Hypertension can cause cardiovascular disease, and it is still aserious global problem. The Prevalence of hypertension has increased every year.Some of the factors associated with hypertension are obesity and physical activity.The prevalence of obesity has increased every year, and many people have lowerlevels of physical activity. This study aims to analyse the correlation between BodyMass Index (BMI), physical activity and hypertension in Indonesia.Methods: This study used a cross-sectional study design using secondary datafrom the Indonesia Family Life Survey 5 (IFLS5) conducted in 2014 - 2015. Thesample consisted of individuals in the households interviewed and 26,472Respondents fulfilled the criteria. The data were analysed using multivariate logisticregression.Results: The results showed that most of the respondents were of productive age.More than half of the respondents were female (52.05%). The respondents whoHad hypertension totalled 22.63 %. After being controlled by the covariatevariables, the results showed that the obese respondents had 4.08 times higherodds of experiencing hypertension compared to the normal respondents (AOR=4.08, 95% CI = 3.68-4.53, p-value = 0.000) and that the respondents who wereoverweight were 2.49 times likely to get hypertension compared to therespondents who were normal (AOR = 2.49, 95% CI = 2.32-2.67, p-value = 0.000).Meanwhile, the respondents with an underweight BMI were 0.58 times more likelyto have hypertension compared to the respondents who were normal (AOR = 0.58,95% CI = 0.52-0.65, p-value = 0.000).Conclusion: Individuals with a higher BMI will be more at risk of hypertensionWhile physical activity is not related to hypertension. The government and healthservices need to increase the promotion of a healthy lifestyle, exceptionally robustdiet programs, to encourage the population to maintain ideal body weight andto reduce the rate of hypertension.
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Prevalence, awareness, treatment and control of hypertension in Nepal: data from nationally representative population-based cross-sectional study. J Hypertens 2019; 36:1680-1688. [PMID: 29621067 DOI: 10.1097/hjh.0000000000001745] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND Previous studies in Nepal noted an alarming increase in prevalence of hypertension. However, these studies were geographically sparse and coverage of population, mostly limited to single site. The current study fills this gap by examining the current status of prevalence, awareness, treatment and control of hypertension, using recently collected population-based data. METHODS We used the Nepal Demographic Health Survey 2016 data. Sample selection was based on stratified two-stage cluster sampling in rural areas and three stages in urban areas. Blood pressure was measured in all women and men aged 15 and above. RESULTS A total of 13 598 participants: 5593 men and 8005 women aged 15-69 had their blood pressures measured. Overall, 18% (95% CI 16.7-19.2) of the participants aged 15-69 years were hypertensive. Prevalence of hypertension was more among men (22%; 95% CI 21.1-23.5), aged 45-69 years (34%), with no formal education (22%), richest quintile (25%), formerly/ever married (32%), urban dwellers (19%), residents of Province 4 (24%), residents of hills (21%), and obese (41.6%). Among the total hypertensive individuals, only 38% were aware of their hypertensive status and 18% were taking antihypertensive medication. Only half of the hypertensive participants on treatment (52%) had their blood pressure under control. CONCLUSION This nationally representative survey data showed that the prevalence of hypertension is high in Nepal, whereas its awareness, treatment and control rates are low at entire population level.
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Mishra SR, Ghimire S, Shrestha N, Shrestha A, Virani SS. Socio-economic inequalities in hypertension burden and cascade of services: nationwide cross-sectional study in Nepal. J Hum Hypertens 2019; 33:613-625. [DOI: 10.1038/s41371-019-0165-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 11/24/2018] [Accepted: 12/17/2018] [Indexed: 12/12/2022]
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Huang Y, Guo P, Karmacharya BM, Seeruttun SR, Xu DR, Hao Y. Prevalence of hypertension and prehypertension in Nepal: a systematic review and meta-analysis. Glob Health Res Policy 2019; 4:11. [PMID: 31165100 PMCID: PMC6489280 DOI: 10.1186/s41256-019-0102-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 04/08/2019] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Studies regarding blood pressure of Nepal have demonstrated a contrasting prevalence. We aimed at providing a generalized estimate of the prevalence of hypertension and prehypertension in urban, suburban, and rural areas of Nepal. METHODS This systematic review followed PRISMA guidelines. A thorough search of PubMed, EMBASE, and Web of Science was performed, and studies satisfying the eligibility criteria were reviewed. Pooled prevalence was calculated by random-effects model, and the sources of heterogeneity were explored with meta-regression and subgroup analysis. RESULTS Twenty-three studies with 99,792 subjects were identified, and the estimated rate of hypertension and prehypertension were found to be 27.3% (95% CI: 23.8-30.9) and 35.4% (30.3-40.8). The prevalence of hypertension was 28.4% (22.4-34.7), 25.5% (21.4-29.8), and 24.4% (17.9-31.6) among urban, suburban, and rural populations, respectively. Moreover, rates of hypertension were found to be substantially higher in male (31.6%, 27.3-36.1) compared to female (20.0%, 14.2-26.6), and significantly higher among the middle-aged (≥40 years; 36.8%, 29.4-44.5) than among younger adults (< 40 years; 13.2%, 9.2-17.7). Further, prehypertension prevalence was found to be highest in rural areas (40.4%, 25.4-56.4) followed by urban areas (29.3%, 20.8-38.5) and lowest in suburban areas (25.5%, 18.9-32.7). CONCLUSIONS Our study identified an alarming situation of hypertension among Nepalese males and middle-aged, and a situation of concern with prehypertension in rural areas affecting almost 40 % of the population.
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Affiliation(s)
- Yun Huang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, No. 74 Zhongshan Road II, Guangzhou, 510080 Guangdong Province People’s Republic of China
| | - Pi Guo
- Department of Preventive Medicine, Shantou University Medical College, Shantou, 515041 Guangdong Province China
| | - Biraj M. Karmacharya
- Sun Yat-sen Global Health Institute (SGHI), School of Public Health and Institute of National Governance of Sun Yat-sen University, Guangzhou, 510275 Guangdong Province China
| | - Sharvesh Raj Seeruttun
- Department of Gastric Surgery, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060 Guangdong Province China
| | - Dong Roman Xu
- Sun Yat-sen Global Health Institute (SGHI), School of Public Health and Institute of National Governance of Sun Yat-sen University, Guangzhou, 510275 Guangdong Province China
| | - Yuantao Hao
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, No. 74 Zhongshan Road II, Guangzhou, 510080 Guangdong Province People’s Republic of China
- Sun Yat-sen Global Health Institute (SGHI), School of Public Health and Institute of National Governance of Sun Yat-sen University, Guangzhou, 510275 Guangdong Province China
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Prevalence and determinants of hypertension among adult population in Nepal: Data from Nepal Demographic and Health Survey 2016. PLoS One 2018; 13:e0198028. [PMID: 29852006 PMCID: PMC5978874 DOI: 10.1371/journal.pone.0198028] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 05/11/2018] [Indexed: 01/19/2023] Open
Abstract
Like other developing countries, Nepal is currently going through epidemiological transition along with rising burden of Non-communicable Diseases. However, since 2013, no study investigated the prevalence and determinants of hypertension in Nepal involving nationally representative sample. Therefore, this study aimed to find out the current prevalence of hypertension in Nepal and its determinants using the latest nationally representative data obtained from Nepal Demographic and Health Survey (NDHS) 2016. The NDHS 2016 collected data on hypertension from 13,304 men and women aged 18 years and above from 5,520 urban and 5,970 rural households covering seven administrative provinces and three ecological zones. Participants were considered as hypertensive when their systolic blood pressure was ≥140 mmHg and/or diastolic blood pressure was ≥90 mmHg and/or they reported taking antihypertensive medication. A total of 19.9% study participants were diagnosed as hypertensive of which majority were male (male-24.3%, female-16.9%), ever married (ever married-21.7%, unmarried-6.1%) and residents of urban area (urban-20.9%, rural-18.3%). Hypertension prevalence has shown growing trend with the increase of age. This prevalence was also higher among rich and overweight/obese individuals. In multivariable logistic regression analysis, older age, male gender, better education, residence at urban area and province 4 and 5 and being overweight/obese were found positive association with having hypertension. When the determinants of hypertension were stratified by sex of the participants, difference was observed in case of age group, education and place of residence. As one out of every five individuals in Nepal are hypertensive, public health initiatives are immediately required for prevention and control of hypertension to reduce mortality and morbidity associated with this progressive disease.
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The prevalence of alcohol dependence and its association with hypertension: a population-based cross-sectional study4 in Xuzhou city, China. BMC Public Health 2018; 18:364. [PMID: 29548314 PMCID: PMC5857079 DOI: 10.1186/s12889-018-5276-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Accepted: 03/08/2018] [Indexed: 01/28/2023] Open
Abstract
Background To describe the prevalence of alcohol dependence and to explore the relationship between alcohol dependence and newly detected hypertension in China. Methods A multistage stratified cluster sampling method was used to obtain samples from February to June 2013. The Michigan Alcoholism Screening Test was used to estimate alcohol dependence level. A standard questionnaire measured other independent variables. Enumeration data were analyzed using chi-square; quantitative data were analyzed using t-tests. Spearman correlation analysis and multivariate logistic regression analysis were performed to identify the relationship between alcohol dependence and hypertension. Results The alcohol dependence rate was 11.56%; 22.02% of males (3854/17501) and 1.74% of females (324/18656) were classified as alcohol dependent. The newly detected hypertension rate was 9.46% (3422/36157). Significant associations were found between alcohol dependence levels and blood pressure (P < 0.01). Alcohol dependence was positively correlated with systolic blood pressure (r = 0.071, P < 0.01) and diastolic blood pressure (r = 0.077, P < 0.01) and was an independent risk factor for hypertension after adjusting for confounders (low alcohol dependence: odds ratio [OR] = 1.44, 95% confidence intervals [CI] = 1.14–1.81, P < 0.01; light alcohol dependence: OR = 1.35, 95% CI = 1.11–1.64, P < 0.01; medium alcohol dependence: OR = 1.83, 95% CI = 1.40–2.41, P < 0.01). Conclusion Alcohol dependence was high and associated with hypertension. Health education and precautions against alcoholism should be implemented in Xuzhou city.
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Prevalence and correlates of alcohol use in a central Nepal district: secondary analysis of a population-based cross-sectional study. Glob Ment Health (Camb) 2018; 5:e37. [PMID: 30637110 PMCID: PMC6315279 DOI: 10.1017/gmh.2018.28] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2018] [Revised: 08/23/2018] [Accepted: 08/30/2018] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND As reported from studies conducted in Nepal, between 15% and 57% of adults had ever consumed alcohol and between 1.5% and 25% of adults have alcohol use disorders (AUD). Few studies in Nepal have identified the correlates of consumption or described the help-seeking patterns and stigma among those affected with AUD. METHODS Interviewers administered the Alcohol Use Disorders Identification Test (AUDIT) as part of population-based surveys of adults in Chitwan District between 2013 and 2017. We conducted a secondary analysis to identify sociodemographic and health-related correlates of recent alcohol consumption using the χ2 test, to identify correlates of total AUDIT scores among men who drink using negative binomial regression, and to describe the treatment-seeking and stigma beliefs of men with AUD. RESULTS Over half (53.7%, 95% CI 50.4-57.0) of men (n = 1130) recently consumed alcohol, and there were associations between being a drinker with age, religion, caste, education, occupation and tobacco use. Nearly one in four (23.8%, 95% CI 20.2-27.8%) male drinkers screened positive for AUD, and AUDIT scores were associated with age, caste, marital status, occupation, tobacco use, depression, functional status and suicidal ideation. Few (13.3%, 95% CI 11.7-15.0) women (n = 2352) recently consumed alcohol, and 5.3% (95% CI 3.0-9.1) of female drinkers screened positive for AUD. Among AUDIT-positive men, 38% spoke to another person about their problems and 80% had internalized stigma. CONCLUSIONS This study revealed that nearly one in four men who drink likely have AUD. Higher AUDIT scores were associated with depression, suicidality, dysfunctionality and internalized stigma.
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Khanal MK, Dhungana RR, Bhandari P, Gurung Y, Paudel KN. Prevalence, associated factors, awareness, treatment, and control of hypertension: Findings from a cross sectional study conducted as a part of a community based intervention trial in Surkhet, Mid-western region of Nepal. PLoS One 2017; 12:e0185806. [PMID: 28982159 PMCID: PMC5628876 DOI: 10.1371/journal.pone.0185806] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 09/19/2017] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Hypertension is one of the leading public health problems globally. About half of the deaths from cardiovascular diseases were attributed to hypertension in 2008. Reduction of blood pressure to normal range is one of the major challenges in preventing complications and future burden of cardiovascular diseases. Therefore, this study aims to determine prevalence, awareness, treatment and control of hypertension and its associated factors in Nepal. METHODS This was a community based cross-sectional study conducted as a part of a community based intervention trial in Birendranagar Municipality of Surkhet district located at the Mid-western region of Nepal. We enrolled 1159 subjects aged 30 years and above. Out of 12 wards (administrative unit), four wards were selected randomly. Three hundred participants were recruited from each selected ward. Trained enumerator collected socio-demographic, anthropometric, and clinical data using standard STEPS questionnaires. RESULTS Out of all participants, women were 71% and mean age was 47±12.6 years. The overall prevalence of hypertension was 38.9% (95% CI: 36-41.7) while age and sex adjusted prevalence was 40.6%. The hypertension was present in 48.1% (95% CI: 45.2-50.9) of men and 35.2% (95% CI: 32.4-37.9)] of women. Male gender (OR = 1.49), older age (OR = 1.04 per year), Dalit caste (OR = 1.71), past history of cigarettes smoking (OR = 2.78), current alcohol consumption (OR = 1.75), and raised body mass index (OR = 1.17 per unit) were identified as significant factors associated with hypertension. Of total hypertensive respondents, 53.4% (95% CI: 48.7-58) were aware, 29% (95% CI: 24.8-33.1) were receiving treatment for high blood pressure, and 8.2% (95% CI: 5.6-10.7) had controlled blood pressure. The awareness, treatment, and control status were worse in younger participants. CONCLUSIONS The study revealed high prevalence with low awareness, treatment, and control of hypertension in Nepal. Gender, age, ethnicity, smoking, drinking alcohol, and body mass index were associated with hypertension. Immediate public health and individual measures are warranted to reduce future burden of cardiovascular diseases. TRIAL REGISTRATION ClinicalTrial.gov (NCT02981251).
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Affiliation(s)
| | | | | | - Yadav Gurung
- Population Services International Nepal, Lalitpur, Nepal
| | - K. N. Paudel
- Ministry of Health, Mid-western Regional Hospital, Surkhet, Nepal
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Hypertension, an Emerging Problem in Rural Cameroon: Prevalence, Risk Factors, and Control. Int J Hypertens 2016; 2016:5639146. [PMID: 28053779 PMCID: PMC5178358 DOI: 10.1155/2016/5639146] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2016] [Accepted: 11/15/2016] [Indexed: 11/18/2022] Open
Abstract
Background. Despite the increasing trends suggesting that hypertension is a growing public health problem in developing countries, studies on its prevalence, associated risk factors, and extent of blood pressure control have been inequitably done in urban and rural communities in these countries. We therefore aimed to determine the prevalence of hypertension and extent of blood pressure control in rural Cameroon. Methods. This was a community-based cross-sectional study conducted in rural Cameroon (the Moliwe Health Area). Participants aged 21 years and above were recruited by a probability proportional to size multistage sampling method, using systematic sampling for household selection and random sampling for participant selection. Blood pressure, weight, and height were measured by standard methods. Hypertension was defined as BP ≥ 140/90 mmHg. Results. The prevalence of hypertension among the 733 participants recruited was 31.1% (95% CI: 27.8-34.6) and 71% (95% CI: 58.7-81.7) of these hypertensive patients were newly diagnosed. Only 21.2% (95% CI: 12.1-33.3) of known hypertensives had a well controlled BP. Age, obesity, low educational status, and being married were associated with HTN after adjusting for confounders. Conclusions. The high prevalence of hypertension and inadequate BP control among known hypertensives in rural Cameroon warrants greater sensitization and regular screening to reduce hypertension-related morbidity and mortality.
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Dhungana RR, Pandey AR, Bista B, Joshi S, Devkota S. Prevalence and Associated Factors of Hypertension: A Community-Based Cross-Sectional Study in Municipalities of Kathmandu, Nepal. Int J Hypertens 2016; 2016:1656938. [PMID: 27293880 PMCID: PMC4880705 DOI: 10.1155/2016/1656938] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 04/24/2016] [Indexed: 11/17/2022] Open
Abstract
Objective. This study aimed to assess the prevalence and associated factors of hypertension in newly declared municipalities of Kathmandu, Nepal. Design, Settings, and Participants. This was a community-based cross-sectional study conducted in the municipalities of Kathmandu District, Nepal, between January and July 2015. Study participants were aged 18 to 70 years, residing permanently in the study sites. Municipalities, Wards, households, and respondents were selected randomly. Results. Of the 587 participants, 58.8% were females, mean (SD) age was 42.3 (13.5) years, 29.3% had no formal education, 35.1% were Brahmins, and 41.2% were homemakers. Prevalence of hypertension was 32.5% (95% CI: 28.7-36.3). Age, gender, education, ethnicity, occupation, smoking, alcohol consumption, physical activity, diabetes, menopausal history, and family history of cardiovascular disease (CVD) and hypertension were significantly associated with hypertension. In multivariable analysis, smoking, alcohol consumption, physical activity, body mass index, and diabetes were identified as significant explanatory variables for hypertension. Conclusion. This study demonstrated that the people living in newly established municipalities of Kathmandu, Nepal, have a high burden of hypertension as well as its associated factors. Therefore, community-based preventive approaches like lifestyle modification and early detection and treatment of hypertension might bring a substantial change in tackling the burden effectively.
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Affiliation(s)
| | | | | | - Suira Joshi
- Ministry of Health and Population, Kathmandu, Nepal
| | - Surya Devkota
- Manmohan Cardiothoracic, Vascular and Transplant Centre, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
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Mishra SR, Neupane D, Bhandari PM, Khanal V, Kallestrup P. Burgeoning burden of non-communicable diseases in Nepal: a scoping review. Global Health 2015; 11:32. [PMID: 26178459 PMCID: PMC4504073 DOI: 10.1186/s12992-015-0119-7] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Accepted: 07/01/2015] [Indexed: 11/23/2022] Open
Abstract
In the last decades, prevalence of non-communicable diseases (NCDs) has escalated in Nepal. This study reviews existing evidence on the burden of non-communicable diseases in Nepal using the framework developed by Arksey and O'Malley for scoping reviews. A total of 110 articles were identified from database searches, and four from additional searches. The titles and abstracts were reviewed using predetermined screening criteria. We limited our search to existing literature in English language and included all studies regardless of year of study. Both observational and interventional studies were included. Studies conducted outside Nepal and studies not reporting prevalence of NCDs were excluded. Additionally, we searched reference lists of included publications. All previous reports of Step Wise Surveillance to NCDs (STEPS Surveys) were included in the review. Finally, a total of 60 articles were included in this review. Limited studies on population-based prevalence of mental illness, chronic respiratory diseases, cardiovascular diseases, and road traffic accidents were found. There were limitations in the studies related to generalizability due to small sample sizes, non-random sampling and lack of studies from certain region of country. Nevertheless, high prevalence of hypertension and diabetes was found. Similarly, hospital-based studies reported high burden of cardiovascular diseases among outpatient contacts. Population-based cancer registries do not exist in Nepal. However, existing studies report 8,000-10,000 cancer deaths annually in Nepal. The most common cancer site in males was the lung, followed by the oral cavity and gastric, while the first three in females were cervix uteri, breast and lung. Prevalence of psychiatric morbidity was also high. Despite alarming burden of NCDs, the country's response is weak. Nepal needs to build non-communicable disease programmes with focus on disease prevention and management as well as awareness activities in urban and rural settings at community level.
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Affiliation(s)
- Shiva Raj Mishra
- Nepal Development Society (NEDS), Bharatpur-10, Chitwan, Nepal.
- School of Population Health, University of Western Australia, Crawley, Australia.
| | - Dinesh Neupane
- Nepal Development Society (NEDS), Bharatpur-10, Chitwan, Nepal.
- Center for Global Health, Department of Public Health, Aarhus University, Aarhus, Denmark.
| | | | - Vishnu Khanal
- Nepal Development Society (NEDS), Bharatpur-10, Chitwan, Nepal.
- School of Public Health, Curtin University, Bentley, Australia.
| | - Per Kallestrup
- Center for Global Health, Department of Public Health, Aarhus University, Aarhus, Denmark.
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Mohamed Yahaya NF, Rahman MA, Abdullah N. Therapeutic potential of mushrooms in preventing and ameliorating hypertension. Trends Food Sci Technol 2014. [DOI: 10.1016/j.tifs.2014.06.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Thapa SS, Thapa R, Paudyal I, Khanal S, Aujla J, Paudyal G, Rens GV. Prevalence and pattern of vitreo-retinal diseases in Nepal: the Bhaktapur glaucoma study. BMC Ophthalmol 2013; 13:9. [PMID: 23537395 PMCID: PMC3616998 DOI: 10.1186/1471-2415-13-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2012] [Accepted: 03/07/2013] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Vitreo-retinal diseases are among the leading causes of visual impairment and blindness worldwide. This study reports the prevalence and pattern of vitreo-retinal diseases in the Bhaktapur Glaucoma Study (BGS), a population based study conducted in Nepal. METHODS BGS was a population based cross-sectional study involving 4800 subjects aged 40 years and over from Bhaktapur district. Subjects were selected using a cluster sampling methodology and a door-to-door enumeration. All subjects underwent a detailed ocular examination at the base hospital which included log MAR visual acuity, refraction, applanation tonometry and a dilated fundus examination. Fundus photography, optical coherence tomography and fundus fluorescein angiography were performed where indicated. RESULTS Complete data was available for 3966 (82.62%) out of the total of 4800 enumerated subjects. The mean age was 55.08 years (SD 11.51). The overall prevalence of vitreo-retinal disorders was 5.35% (95% CI, 4.67 - 6.09). Increasing age was associated with a higher prevalence of vitreo-retinal disorders (P < 0.001). The prevalence of diabetes mellitus was 7.69% (95% CI, 6.88 - 8.56). Age-related macular degeneration (AMD) was the most common vitreo-retinal disorder with a prevalence of 1.50% (95% CI, 1.15 - 1.94), increasing significantly with age. The prevalence of diabetic retinopathy among the study population was 0.78% (95% CI, 0.53 - 1.11) and among the diabetic population 10.16% (95% CI, 7.01 - 14.12). The population prevalence of other retinal disorders were hypertensive retinopathy 0.88%, macular scar 0.37%, retinal vein occlusion 0.50%, macular hole 0.20%, retinitis pigmentosa 0.12%. and retinal detachment 0.10%.The prevalence of low vision and blindness due to vitreo-retinal disorders was 1.53% (95% CI, 1.18 - 1.97) and 0.65% (95% CI, 0.43 - 0.96), respectively. The prevalence of low vision and blindness was 28.77% (95% CI, 22.78-35.37) and 12.26% (95% CI, 8.17-17.45), respectively among cases with vitreo-retinal disorders. Blindness was observed to be unilateral in 19 cases (73%), and bilateral in 7 cases (27%). CONCLUSIONS The prevalence of vitreo-retinal disorders in this Nepalese population was 5.35%, which increased significantly with age. AMD was the predominant retinal condition followed by diabetic retinopathy. One fourth of the subjects with vitreo-retinal disorder had low vision. Taking into consideration the aging population and emerging systemic diseases such as diabetes mellitus and hypertension, vitreo-retinal disorders could be of future public health importance.
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Affiliation(s)
- Suman S Thapa
- Nepal Glaucoma Eye Clinic, Tilganga Institute of Ophthalmology, Kathmandu, Nepal
| | - Raba Thapa
- Nepal Glaucoma Eye Clinic, Tilganga Institute of Ophthalmology, Kathmandu, Nepal
| | - Indira Paudyal
- Nepal Glaucoma Eye Clinic, Tilganga Institute of Ophthalmology, Kathmandu, Nepal
| | - Shankar Khanal
- Nepal Glaucoma Eye Clinic, Tilganga Institute of Ophthalmology, Kathmandu, Nepal
| | - Jaskirat Aujla
- Nepal Glaucoma Eye Clinic, Tilganga Institute of Ophthalmology, Kathmandu, Nepal
| | - Govinda Paudyal
- Nepal Glaucoma Eye Clinic, Tilganga Institute of Ophthalmology, Kathmandu, Nepal
| | - Ger van Rens
- Nepal Glaucoma Eye Clinic, Tilganga Institute of Ophthalmology, Kathmandu, Nepal
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