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Obesity matters but is not perceived: A cross-sectional study on cardiovascular disease risk factors among a population-based probability sample in rural Zambia.

ABSTRACT: BACKGROUND:Sub-Saharan Africa, including Zambia, has experienced an increase in overweight and obesity due to rapid lifestyle changes associated with recent economic growth. We explored the prevalence and correlates of overweight and obesity in rural Zambia. We also investigated the role of self-perception of body weight in weight control given the local socio-cultural context. METHODS:In this cross-sectional study, we recruited 690 residents of the Mumbwa district aged 25-64 years through a multistage, clustered, household random sampling. We administered a questionnaire and collected anthropometric and bio-behavioral data from May to July 2016. Factors associated with body mass index (BMI) ?25 kg/m2 and underestimation of body weight were assessed using multiple logistic regression. RESULTS:Of the weighted sample of 689 participants (335 men and 354 women), 185 (26.8%) had BMI ?25 kg/m2. In multivariate analyses, female gender, age 45-64 years, tertiary education, higher fruit and vegetable intake, high blood pressure, abnormal blood lipid profile, and Hemoglobin A1c ?5.7% were significantly associated with BMI ?25 kg/m2. Among participants with BMI ?25 kg/m2, 14.2% and 58.2% perceived themselves as being underweight and normal weight, respectively. Age 45-64 years was the only factor significantly associated with body weight underestimation. Preference for obesity was reported by 17.5% and 3.6% of respondents with BMI <25 kg/m2 and BMI?25 kg/m2, respectively; "looks attractive" and "fear of being perceived as HIV-positive" were the main reasons. CONCLUSION:In rural Zambia, overweight and obesity are prevalent and significantly associated with alterations in blood pressure, blood lipid profile, and glucose metabolism. However, most subjects with BMI ?25 kg/m2 underestimated their body weight; some preferred obesity, in part due to cultural factors and HIV-related stigma. A health promotion program that addresses such perceptions and body weight underestimation should be urgently introduced in Zambia.

SUBMITTER: Tateyama Y

PROVIDER: S-EPMC6264511 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Obesity matters but is not perceived: A cross-sectional study on cardiovascular disease risk factors among a population-based probability sample in rural Zambia.

Tateyama Yukiko Y Techasrivichien Teeranee T Musumari Patou Masika PM Suguimoto S Pilar SP Zulu Richard R Macwan'gi Mubiana M Dube Christopher C Ono-Kihara Masako M Kihara Masahiro M

PloS one 20181129 11

<h4>Background</h4>Sub-Saharan Africa, including Zambia, has experienced an increase in overweight and obesity due to rapid lifestyle changes associated with recent economic growth. We explored the prevalence and correlates of overweight and obesity in rural Zambia. We also investigated the role of self-perception of body weight in weight control given the local socio-cultural context.<h4>Methods</h4>In this cross-sectional study, we recruited 690 residents of the Mumbwa district aged 25-64 year ...[more]

PMID: 30496252

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Project description:BackgroundModern contraceptive use among adolescents is low despite the adverse effects of adolescent pregnancies. Understanding correlates of modern contraceptive use in different settings is key to the design of effective context-specific interventions. We aimed to determine factors associated with modern contraceptives use among adolescents in rural and urban settings of Zambia.MethodsWe analyzed secondary data from 2018 Zambia demographic and health survey (ZDHS) focusing on adolescent girls aged 15-19 years. We used multivariable logistic regression in SPSS version 25 to examine rural-urban variations in factors associated with modern contraceptive utilization.ResultsOverall, 12.0% (360/3000, 95% CI: 10.9-13.2) of adolescents in Zambia were using modern contraceptives. Use of modern contraceptives was higher in rural areas at 13.7% (230/1677, 95% CI: 12.1-15.3) compared to 9.8% (130/1323, 95% CI: 8.3-11.6) in urban areas. In the rural areas, having a child (aOR = 13.99; 95% CI 8.60-22.77), being married (aOR = 2.13; 95% CI 1.42-3.18), being older at 19 years (aOR = 3.90; 95% CI 1.52-10.03), having been visited by a field health worker (aOR = 1.62; 95% CI 1.01-2.64), having been exposed to family planning messages on mass media (aOR = 2.87; 95% CI 1.01-8.18) and belonging to the richest wealth quintile (aOR = 2.27; 95% CI 1.43-3.62) were associated with higher odds of contraceptive utilization. Furthermore, adolescents in the Northern (aOR = 0.29; 95% CI 0.11-0.80) and Luapula (aOR = 0.35; 95% CI 0.15-0.81) provinces were associated with less odds of utilizing contraceptives compared to those in Western province. In the urban areas, older age at 19 years (aOR = 4.80; 95% CI 1.55-14.84) and having a child (aOR = 18.52; 95% CI 9.50-36.14) were the only factors significantly associated with modern contraceptive utilization.ConclusionAge and having a child were associated with modern contraceptive use in both rural and urban areas. In rural areas (province, marital status, being visited by field health workers, family planning messages exposure and wealth index) were the only associated factors. This indicates that interventions aiming to increase contraceptive utilization should be context specific.

Project description:OBJECTIVE:Zambia is among the world's top 10 countries with higher fertility rate (5.5 births/woman); unmet family planning need for births spacing (14%) and limiting births (7%). Women in rural Zambia (24%) are reported to have unmet need for family planning than those in urban areas (17%). This study was conducted to ascertain factors associated with modern contraceptive use among rural Zambian women. DESIGN:Cross-sectional study. SETTING:Rural Zambia. PARTICIPANTS:Secondary data of 4903 married or cohabiting rural women (15-49 years) after filtering out the pregnant, urban based and unmarried women from 2013 to 2014 Zambian Demographic and Health Survey (ZDHS) were analysed using SPSS V.22. Multiple logistic regression, Pearson's ?2 and descriptive statistics were performed to examine factors associated with modern contraceptive use. RESULTS:Factors that were positively associated with contraceptive use were respondent's education (secondary adjusted ORs (AOR?=?1.61, p?0.002); higher (AOR?=?2.39, p?0.050)), wealth index (middle class, (AOR?=?1.35, p?0.005); rich (AOR?=?2.04, p?0.001) and richest (AOR?=?1.95, p?0.034)), high parity (1-2 (AOR?=?5.31, p?0.001); 3-4 (AOR?=?7.06, p?0.001); 5+ (AOR?=?8.02, p?0.001)), men older than women by <10 years (AOR?=?1.50, p?0.026) and women sensitised about family planning at health facility (AOR?=?1.73, p?0.001). However, old age (40-49 years (AOR?=?0.49, p?0.001)), other religions (Protestants, African traditionalists and Muslims) (AOR?=?0.77, p?0.007), ever had pregnancy miscarried, aborted or stillbirth (AOR?=?0.78, p?0.026) and women without knowledge of number of children husband desires (AOR?=?0.71, p?0.001) were negatively associated with contraceptive use. CONCLUSION:Modern contraceptive use in rural Zambia among currently married women of reproductive age group is relatively low (43%). We recommend that appropriate interventions are instituted to increase contraceptive access and use especially among uneducated older rural Zambian women.

Project description:BACKGROUND:Sex-based differences in cardiovascular disease (CVD) burden are widely acknowledged, with male sex considered a risk factor in high-income settings. However, these relationships have not been examined in sub-Saharan Africa (SSA). We aimed to apply the American Heart Association (AHA) ideal cardiovascular health (CVH) tool modified by the addition of C-reactive protein (CRP) to examine potential sex-based differences in the prevalence of CVD risk in rural Uganda. METHODS:In a cross-sectional study nested within a population-wide census, 857 community-living adults completed physical and laboratory-based assessments to calculate individual ideal CVH metrics including an eight category for CRP levels. We summarized sex-specific ideal CVH indices, fitting ordinal logistic regression models to identify correlates of improving CVH. As secondary outcomes, we assessed subscales of ideal CVH behaviours and factors. Models included inverse probability of sampling weights to determine population-level estimates. RESULTS:The weighted-population mean age was 39.2 (1.2) years with 52.0 (3.7) % females. Women had ideal scores in smoking (80.4% vs. 68.0%; p < 0.001) and dietary intake (26.7% vs. 16.8%; p = 0.037) versus men, but the opposite in body mass index (47.3% vs. 84.4%; p < 0.001), glycated hemoglobin (87.4% vs. 95.2%; p = 0.001), total cholesterol (80.2% vs. 85.0%; p = 0.039) and CRP (30.8% vs. 49.7%; p = 0.009). Overall, significantly more men than women were classified as having optimal cardiovascular health (6-8 metrics attaining ideal level) (39.7% vs. 29.0%; p = 0.025). In adjusted models, female sex was correlated with lower CVH health factors sub-scales but higher ideal CVH behaviors. CONCLUSIONS:Contrary to findings in much of the world, female sex in rural SSA is associated with worse ideal CVH profiles, despite women having better indices for ideal CVH behaviors. Future work should assess the potential role of socio-behavioural sex-specific risk factors for ideal CVH in SSA, and better define the downstream consequences of these differences.

Project description:BackgroundBetween March and December, 2020, more than 20 000 laboratory-confirmed cases of SARS-CoV-2 infection were reported in Zambia. However, the number of SARS-CoV-2 infections is likely to be higher than the confirmed case counts because many infected people have mild or no symptoms, and limitations exist with regard to testing capacity and surveillance systems in Zambia. We aimed to estimate SARS-CoV-2 prevalence in six districts of Zambia in July, 2020, using a population-based household survey.MethodsBetween July 4 and July 27, 2020, we did a cross-sectional cluster-sample survey of households in six districts of Zambia. Within each district, 16 standardised enumeration areas were randomly selected as primary sampling units using probability proportional to size. 20 households from each standardised enumeration area were selected using simple random sampling. All members of selected households were eligible to participate. Consenting participants completed a questionnaire and were tested for SARS-CoV-2 infection using real-time PCR (rtPCR) and anti-SARS-CoV-2 antibodies using ELISA. Prevalence estimates, adjusted for the survey design, were calculated for each diagnostic test separately, and combined. We applied the prevalence estimates to census population projections for each district to derive the estimated number of SARS-CoV-2 infections.FindingsOverall, 4258 people from 1866 households participated in the study. The median age of participants was 18·2 years (IQR 7·7-31·4) and 50·6% of participants were female. SARS-CoV-2 prevalence for the combined measure was 10·6% (95% CI 7·3-13·9). The rtPCR-positive prevalence was 7·6% (4·7-10·6) and ELISA-positive prevalence was 2·1% (1·1-3·1). An estimated 454 708 SARS-CoV-2 infections (95% CI 312 705-596 713) occurred in the six districts between March and July, 2020, compared with 4917 laboratory-confirmed cases reported in official statistics from the Zambia National Public Health Institute.InterpretationThe estimated number of SARS-CoV-2 infections was much higher than the number of reported cases in six districts in Zambia. The high rtPCR-positive SARS-CoV-2 prevalence was consistent with observed community transmission during the study period. The low ELISA-positive SARS-CoV-2 prevalence might be associated with mitigation measures instituted after initial cases were reported in March, 2020. Zambia should monitor patterns of SARS-CoV-2 prevalence and promote measures that can reduce transmission.FundingUS Centers for Disease Control and Prevention.

Project description:ObjectivesThis study aimed to investigate perceived impacts, ways of communication with professionals and information sources related to COVID-19, and explore whether these impacts or information sources were associated with ethnicity that is, language spoken at home.DesignA cross-sectional study.SettingSydney, Australia during the period from March to October 2020.ParticipantsMothers of young children participating in an existing trial.Outcome measuresMothers were asked to respond to a set of survey questions related to COVID-19 via telephone. The questions included a mental health scale, and how they communicated with health professionals and their information sources related to COVID-19 during the COVID-19 pandemic.ResultsOf 537 mothers who completed the survey (81% response rate), 45% reported they spoke a language other than English at home. Overall, 136 (26%) reported experiencing mental distress. 234 (44%) reported that COVID-19 affected the way they receive and communicate health-related information with health professionals, especially for those from non-English speaking backgrounds with an adjusted odds ratio (AOR) 1.58 (95% CI 1.10 to 2.27). They were less likely to use a face-to-face service (AOR 0.55, 95% CI 0.37 to 0.80) and more likely to use social media (AOR 2.11, 95% CI 1.40 to 3.17) for health-related information. Regarding sources of COVID-19-related information, mothers from non-English-speaking backgrounds were more likely to rely on family members (AOR 1.49, 95% CI 1.01 to 2.19) and social media (AOR 3.34, 95% CI 2.05 to 5.43).ConclusionsCOVID-19 has significantly impacted mothers with young children in regard to their mental health, means of communication with health professionals and sources of health information. Mothers from non-English-speaking communities were less likely to use a face-to-face service, and more likely to seek information from family members and social media. Appropriate health support for non-English-speaking community needs to take these factors into account.Trial registration numberANZCTR:12618001571268.they.

Dataset Information

Obesity matters but is not perceived: A cross-sectional study on cardiovascular disease risk factors among a population-based probability sample in rural Zambia.

Publications

Obesity matters but is not perceived: A cross-sectional study on cardiovascular disease risk factors among a population-based probability sample in rural Zambia.

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