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SA JOURNAL OF DIABETES & VASCULAR DISEASE
RESEARCH ARTICLE
VOLUME 14 NUMBER 2 • DECEMBER 2017
53
in Nigeria (62.1%), then Cameroon (45.2%), DRC (31.9%), and
the lowest in Madagascar (27.7%).
IFG was most prevalent in Cameroon (15.3%), followed by
Madagascar (10.4%), DRC (8.3%) and Nigeria (4.0%). Nigeria had
the highest prevalence of diabetes (25.0%), then Cameroon (15.6%),
DRC (15.0%) and finally Madagascar (8.7%). Both the MS and IFG
weremore prevalent inhypertensive patients than innon-hypertensive
subjects (47.8 vs 8.3% and 10.1 vs 6.2%, respectively).
Comparing gender, the MS was more prevalent in females (44.7
vs 32.1%), but incidence of IFG and diabetes was higher in males
(13.6and17.2%) compared to females (6.2and12.7%), respectively.
With regard to urban and rural status, the MS and diabetes were
more prevalent in semi-urban dwellers (57 and 24.1%), opposed to
urban dwellers (34.3 and 12.3%, respectively).
Discussion
In this self-selected group of participant in a hospital-based study of
cardiometabolic risk factors among adults in four SSA countries, we
found a high prevalence of the MS, IFG and diabetes mellitus in all
countries. In spite of the differences observed between countries,
which may reflect differences in healthcare access and resources,
and possibly selection bias, these findings clearly signify the rapid
growth of cardiovascular risk factors in a region of the world that
has traditionally been known as the hotspot of nutritional and
infectious diseases. This study is therefore relevant for understanding
the epidemiology of cardiovascular and metabolic risk profiles of
adults in the region, a pivotal step in the control of the incidence
of CVDs.
The overall prevalence of the MS in our study population was
39.4% and ranged from 62.1% in Nigeria to 27.7% in Madagascar.
This was particularly for hypertensive subjects, female participants
and semi-urban dwellers. The overall prevalence of the MS was
lower than reported in Ghana among hypertensive patients. It was
however similarly observed that the MS was more prevalent among
women than men (OR: 4.88,
p
= 0.027) in this study.
17
Another
study among newly diagnosed type 2 diabetes subjects revealed
higher prevalences of the MS of 68 and 81%, using IDF and WHO
criteria, respectively. Again, as in our study, the MS was common in
women and was driven essentially by female gender, family history
of diabetes, overweight and obesity.
18
IFG overall prevalence was 9.3% and ranged from 15.3% in
Cameroon to 4.0% in Nigeria. Our findings are however higher
than reported in a community-based study in South Africa,
19
Table 2.
Prevalence of selected risk factors across participating countries
Cameroon
Nigeria
DRC
Madagascar
Total
Risk factor
n
(%)
n
(%)
n
(%)
n
(%)
n
(%)
p
-value
Hypertension (
n
= 844)
Yes
141 (91.5)
141 (66.8)
237 (99.1)
108 (45.0)
630 (74.1)
0.000
No
13 (8.5)
70 (33.2)
02 (0.9)
132 (55.0)
220 (25.9)
Diabetes (
n
n = 839)
Yes
24 (15.6)
51 (24.8)
36 (15.0)
21 (8.7)
132 (15.7)
0.000
No
130 (84.4)
154 (75.2)
204 (85.0)
219 (91.3)
707 (84.3)
Alcohol consumption (
n
= 309)
Low–moderate
71 (63.4)
03 (100.0)
98 (79.0)
58 (82.8)
230 (74.4)
0.007
Excessive
41 (36.6)
00 (0.0)
26 (21.0)
12 (17.2)
79 (25.6)
Smoking (
n
= 844)
Current
10 (6.5)
04 (1.8)
11 (4.6)
48 (20.0)
73 (8.6)
0.000
Former
10 (6.5)
18 (8.5)
15 (6.3)
31 (12.9)
74 (8.7)
Never
133 (87.0)
190 (89.7)
213 (89.1)
161 (67.1)
697 (82.7)
Obesity (
n
= 844)
Normal
28 (18.2)
53 (25.1)
64 (26.7)
122 (50.8)
267 (31.6)
Overweight
45 (29.2)
60 (28.4)
76 (31.6)
94 (39.2)
275 (32.6)
0.000
Obese
69 (44.8)
85 (40.3)
88 (36.7)
24 (10.0)
266 (31.5)
Morbidly obese
12 (8.8)
13 (6.2)
11 (5.0)
00 (0.0)
36 (4.3)
p
-values = comparison of variables across countries.
Table 3.
Risk factors according to hypertension status in the study par-
ticipants
Hyper- Non-hyper-
Total
tensives tensives (
n
= 844)
Variable
n
(%)
n
(%)
n
(%)
p
-value
Tobacco smoking (
n
= 844)
Current
42 (6.7)
31 (14.1)
73 (8.6)
0.002
Former
52 (8.3)
22 (10.0)
74 (8.8)
Never
530 (85.0) 167 (75.9) 697 (82.6)
Alcohol consumption (
n
= 309)
Low to moderate
195 (73.6) 35 (79.5) 230 (74.4) 0.460
Excessive
70 (26.4)
09 (20.5)
79 (25.6)
Obesity (
n
= 844)
Normal
152 (24.3) 115 (52.7) 267 (31.5)
Overweight
208 (33.2) 67 (30.5) 275 (32.5) 0.000
Obese
232 (37.1) 34 (15.9) 266 (31.5)
Morbidly obese
34 (5.4)
02 (0.9)
36 (4.5)
Waist circumference (
n
= 486)
Men (> 102 cm)
76 (31.9)
86 (34.7) 162 (33.3) 0.564
Women (> 88 cm)
189 (79.4) 168 (67.7) 357 (73.4) 0.004
Diabetes mellitus (
n
= 839)
Yes
110 (17.7) 22 (10.0) 132 (15.7) 0.007
No
509 (82.3) 198 (90.0) 707 (84.3)
Hypercholesterolaemia (
n
= 811)
Yes
102 (25.8) 75 (18.0) 177 (21.8) 0.008
No
293 (74.2) 341 (82.0) 634 (78.2)
p
-value = comparison of variables between the two groups.