Epidemiology and patterns of hypertension in semi-urban communities, south-western Nigeria

Prevalence of hypertension in a rural community in southeastern Nigeria; an opportunity for early intervention

Hypertension is a leading cause of non-communicable morbidity in Sub Saharan Africa. Recent studies suggest and increase in the prevalence of hypertension in rural Sub-Saharan Africa. Using a three-phase approach, a structured questionnaire was used to determine the prevalence of hypertension in a rural settlement is Enugu State, Southeast Nigeria. Blood pressure measurement was done according to the guidelines of the European Society of Hypertension. Out of 1576 participants aged 18 years and above, 1082 (68.7%) completed the full survey, their blood pressure was measured, and data analyzed. The prevalence of hypertension in this study was 27.6%, (95%CI 25-30.4), similar in males 29.2, (95%CI 24.7-30.4) and females 26.8%, (95%CI 23.5-30.2). p = 0.39. The prevalence of hypertension increased with age reaching a peak of 32.8% (95%CI 26.2-40) in the 40-49 age group, however this was not statistically significant P = 0.22. This age-related increase in the prevalence of hypertension tended towards significance in males (p = 0.05) but not in females (p = 0.44). Awareness of hypertension was 7.2%. Systolic blood pressure positively correlated with older age, higher blood glucose levels and waist-hip ratio. Diastolic blood pressure correlated with the type of work the patients is involved in and blood glucose levels. In conclusion, the prevalence of hypertension in a rural southeastern Nigeria community was 27.6%, however awareness was very low (7.9%). Most participants had mild hypertension thus offering a window of opportunity for public health educators in preventing the complications of hypertension. There is therefore the need for awareness campaigns to be intensified in rural communities.

Estimating the prevalence of overweight and obesity in Nigeria in 2020: a systematic review and meta-analysis

BACKGROUND

Targeted public health response to obesity in Nigeria is relatively low due to limited epidemiologic understanding. We aimed to estimate nationwide and sub-national prevalence of overweight and obesity in the adult Nigerian population.

METHODS

MEDLINE, EMBASE, Global Health, and Africa Journals Online were systematically searched for relevant epidemiologic studies in Nigeria published on or after 01 January 1990. We assessed quality of studies and conducted a random-effects meta-analysis on extracted crude prevalence rates. Using a meta-regression model, we estimated the number of overweight and obese persons in Nigeria in the year 2020.

RESULTS

From 35 studies (n = 52,816), the pooled crude prevalence rates of overweight and obesity in Nigeria were 25.0% (95% confidence interval, CI: 20.4-29.6) and 14.3% (95% CI: 12.0-15.5), respectively. The prevalence in women was higher compared to men at 25.5% (95% CI: 17.1-34.0) versus 25.2% (95% CI: 18.0-32.4) for overweight, and 19.8% (95% CI: 3.9-25.6) versus 12.9% (95% CI: 9.1-16.7) for obesity, respectively. The pooled mean body mass index (BMI) and waist circumference were 25.6 kg/m2 and 86.5 cm, respectively. We estimated that there were 21 million and 12 million overweight and obese persons in the Nigerian population aged 15 years or more in 2020, accounting for an age-adjusted prevalence of 20.3% and 11.6%, respectively. The prevalence rates of overweight and obesity were consistently higher among urban dwellers (27.2% and 14.4%) compared to rural dwellers (16.4% and 12.1%).

CONCLUSIONS

Our findings suggest a high prevalence of overweight and obesity in Nigeria. This is marked in urban Nigeria and among women, which may in part be due to widespread sedentary lifestyles and a surge in processed food outlets, largely reflective of a trend across many African settings.KEY MESSAGESAbout 12 million persons in Nigeria were estimated to be obese in 2020, with prevalence considerably higher among women. Nutritional and epidemiological transitions driven by demographic changes, rising income, urbanization, unhealthy lifestyles, and consumption of highly processed diets appear to be driving an obesity epidemic in the country.

Prevalence, awareness, treatment, and control of hypertension in Nigeria in 1995 and 2020: A systematic analysis of current evidence

Improved understanding of the current burden of hypertension, including awareness, treatment, and control, is needed to guide relevant preventative measures in Nigeria. A systematic search of studies on the epidemiology of hypertension in Nigeria, published on or after January 1990, was conducted. The authors employed random‐effects meta‐analysis on extracted crude hypertension prevalence, and awareness, treatment, and control rates. Using a meta‐regression model, overall hypertension cases in Nigeria in 1995 and 2020 were estimated. Fifty‐three studies (n = 78 949) met our selection criteria. Estimated crude prevalence of pre‐hypertension (120‐139/80‐89 mmHg) in Nigeria was 30.9% (95% confidence interval [CI]: 22.0%‐39.7%), and the crude prevalence of hypertension (≥140/90 mmHg) was 30.6% (95% CI: 27.3%‐34.0%). When adjusted for age, study period, and sample, absolute cases of hypertension increased by 540% among individuals aged ≥20 years from approximately 4.3 million individuals in 1995 (age‐adjusted prevalence 8.6%, 95% CI: 6.5‐10.7) to 27.5 million individuals with hypertension in 2020 (age‐adjusted prevalence 32.5%, 95% CI: 29.8‐35.3). The age‐adjusted prevalence was only significantly higher among men in 1995, with the gap between both sexes considerably narrowed in 2020. Only 29.0% of cases (95% CI: 19.7‐38.3) were aware of their hypertension, 12.0% (95% CI: 2.7‐21.2) were on treatment, and 2.8% (95% CI: 0.1‐5.7) had at‐goal blood pressure in 2020. Our study suggests that hypertension prevalence has substantially increased in Nigeria over the last two decades. Although more persons are aware of their hypertension status, clinical treatment and control rates, however, remain low. These estimates are relevant for clinical care, population, and policy response in Nigeria and across Africa.

Socio-demographic factors associated with overweight and obesity among primary school children in semi-urban areas of mid-western Nigeria

BACKGROUND

Many developing countries are in a state of nutritional transition from prevalent under-nutrition to the emergent problem of over-nutrition (overweight and obesity), which is associated with increased morbidity and mortality, and whose complications can persist into adulthood with long-term consequences. However, data are limited on the risk factors for overweight and obesity (O&O) among primary school children, particularly those in rural and semi-urban areas in these countries.

AIM AND OBJECTIVES

To determine the socio-demographic factors associated with overweight and obesity among primary school children in semi-urban areas.

SUBJECTS AND METHODS

1187 school pupils aged 6-11 years recruited from semi-urban areas using multistage sampling were interviewed for risk factors of overweight and obesity using a structured questionnaire. Nutritional status was assessed using body mass index and this was classified using a standard method. The proportions were compared using Pearson's chi-squared. Multivariate logistic regression analysis was also carried out with overweight and obesity as the dependent variable and socio demographic factors as independent variables. The level of statistical significance was set at p <0.05 in all the statistical analyses.

RESULTS

Fifty-eight pupils (4.9%) had overweight and obesity while 1129 (95.1%) were either of normal nutritional status (1088, 91.6%) or were thin/severely thin (41, 3.5%). Among those with overweight and obesity, 41 (3.5%) were overweight and 17 (1.4%) obese. A higher prevalence of overweight and obesity was significantly associated (in unadjusted analysis) with female gender [unadjusted Odds Ratio, OR (95% CI) = 2.42 (1.37, 4.28)], attendance at private schools [OR (95% CI) = 3.34 (1.86, 6.00)], higher socio-economic status families [OR (95% CI) = 2.32 (1.65, 5.80)] and presence of a television in the pupil's bedrooms [OR (95% CI) = 2.22 (1.02, 4.82)] on bivariate analyses. However, only gender, school type and family socioeconomic status were independently associated with overweight and obesity on multivariate logistic regression analysis.

CONCLUSION

We conclude that overweight and obesity among primary school pupils in semi-urban areas is associated with female gender, attendance at private schools and higher socioeconomic status families. Preventive programmes should accordingly be more directed at children from affluent families; particularly those who are females and those attending private schools.