The SA Journal Diabetes & Vascular Disease Vol 16 No 1 (July 2019)

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RESEARCH ARTICLE SA JOURNAL OF DIABETES & VASCULAR DISEASE
12 VOLUME 16 NUMBER 1 • JULY 2019
Sensitisation of the university staff members was carried out
using invitation letters through the various directorate heads,
announcements on the university FM radio station, and banners
placed at strategic places such as the entrances and exits of the
university and the health clinic two months prior to and during the
study period.
All employees of the university who subsequently presented to
the university health clinic during the study period were recruited
into the study. Pregnant and menstruating women were excluded
from the study as anthropometric measurements and urine testing
for abnormalities would not be useable.
The Human Research and Ethics Committee of the Jos University
Teaching Hospital approved the study. All participants gave written
informed consent before participation.
All participants had the opportunity to be counselled on healthy
lifestyles, and participants found to have NCDs were referred
for appropriate care. All the participants were evaluated using a
modified version of the World Health Organisation (WHO) STEPwise
approach to non-communicable disease.12
STEP 1 entailed history taking, looking particularly for risk factors
for NCDs and the lifestyle of the subjects.
STEP 2 involved a physical examination in which the height and
weightweremeasuredusinganelectronicweighingscale, stadiometer
and non-stretch tape measure, respectively. The body mass index
(BMI) was calculated from the Quetelet index.13 Blood pressure was
measured using the OMRON digital sphygmomanometer.
STEP 3 involved obtaining blood samples for casual plasma
glucose, serum creatinine, total cholesterol and high-density
lipoprotein cholesterol levels, and urine testing for proteinuria and
haematuria. Casual plasma glucose (CPG) level was estimated using
the glucose oxidase method. Serum creatinine was assayed using
the kinetic enzymatic method, and estimated glomerular filtration
rate (eGFR) from the measured serum creatinine level using the
CKD-EPI calculator.14 The laboratory analyses of the tests were
carried out at the commercial laboratory of APIN, Jos University
Teaching Hospital, Jos.
Generalised obesity, hypertension, diabetes mellitus and
dyslipidaemia were defined according to internationally accepted
guidelines.13,15-17 Chronic kidney disease (CKD) was regarded as the
presence of proteinuria using urine dipsticks and/or eGFR < 60 ml/
min/1.73 m2.18
Statistical analysis
Data obtained were analysed using the Epi Info 7 statistical software
(CDC, Atlanta, GA). Means ± SD were used to describe normally
distributed continuous variables, and proportions for categorical
variables. Median with range was used to describe non-normally
distributed continuous variables. The Student’s t-test was used
to compare group means and the chi-squared test to compare
proportions. The Fisher exact test was used when cells contained
less than five observations. The non-parametric Mann–Whitney
U-test was used to compare non-normally distributed continuous
variables. A p-value < 0.05 was considered significant.
Results
A total of 883 (521; 59.0% males) employees with a slight
predominance of junior-cadre workers participated in the study
(Table 1). The majority were between 31 and 60 years old with
a mean age of 44 ± 10 years. Women were older than the men
and half had completed tertiary level education. The majority
(80.5%) were married, with a median monthly household income
of US$400 equivalent (US$1:00 exchanged for N150:00 as at the
time of the study).
The median (IQR) number of NCD risk factors was three (two
to three) per participant. The most common NCD risk factors
were inadequate intake of fruit and vegetables (94.6%; 95% CI:
92.8–95.9), physical inactivity (77.8%; 95% CI: 74.9– 80.5%) and
dyslipidaemia (51.8%; 95% CI: 48.4–51.6%). Details of NCD risk
factors by sociodemographic variables are shown in Table 2.
No participant admitted to passive (second-hand) smoking
at home or in the work environment and none used smokeless
tobacco. As shown in Fig. 1, tobacco use (Fig. 1A), obesity and
dyslipidaemia (Fig. 1B) increased with age.
A low intake of fruit and vegetables was common in participants
with a formal education (Fig. 1C), as were physical inactivity, obesity
and dyslipidaemia (Fig. 1D), compared to those without formal
education. Fig. 1F shows that physical inactivity and dyslipidaemia
increased with increasing household income.
Hypertension was the most common NCD, being present in
nearly half the participants (48.5%; 95% CI: 45.1–51.8%), as
Table 1. Characteristics of 883 staff members of the University of Jos
evaluated for select non-communicable diseases between February
and June 2014
Total Males Females
Variable (n = 883) (n = 521) (n = 362) p-value
Mean age, years 44 ± 10 43 ± 10 45 ± 9 0.002
Age group, years, n (%)*
< 20 3 (0.3) 2 (0.4) 1 (0.3) < 0.0001
21–30 83 (9.4) 61 (11.7) 22 (6.1)
31–40 257 (29.1) 166 (31.9) 91 (25.1)
41–50 294 (33.3) 155 (29.8) 139 (38.4)
51–60 215 (24.3) 115 (22.1) 100 (27.6)
> 60 31 (3.5) 22 (4.2) 9 (2.5)
Married (n = 878);
n (%) 707 (80.5) 437 (84.2) 270 (75.2) < 0.0001
Tertiary education
completed 440 (50.2) 243 (46.9) 197 (55.0) 0.02
(n = 876); n (%)
Junior staff (n = 843);
n (%) 466 (55.3) 319 (63.0) 147 (43.6) < 0.0001
Monthly income, USD,
median 400 333.33 466.66 < 0.0001
BMI (kg/m2) 27.2 ± 5.1 25.1 ± 3.5 30.2 ± 5.7 < 0.0001
SBP (mmHg) 129 ± 19 130 ± 19 127 ± 20 0.06
DBP (mmHg) 79 ± 12 79 ± 12 80 ± 11 0.4
CPG, median (mg/dl) 85.0 85.0 86.0 0.10
[mmol/l] [4.72] [4.72] [4.77]
Proteinuria
(n = 883) (%) 116 (13.2) 72 (13.8) 44 (12.2) 1.15
Serum creatinine
(mmol/l) 74.5 ± 19.3 81.8 ± 19.7 64.0 ± 13.1 < 0.0001
eGFR (ml/min/1.73m 2) 114.2 ± 20.5 115.1 ± 20.7 113.1 ± 20.2 0.15
Reduced eGFR 4 (0.4) 2 (0.4) 2 (0.5) 0.69
TC (mg/dl) 193.4 ± 43.9 201.4 ± 46.2 187.9 ± 41.4 < 0.0001
[mmol/l] [5.01 ± 1.14] [5.22 ± 1.20] [4.87 ± 1.07]
HDL-C (mg/dl) 56.6 ± 16.4 60.7 ± 16.5 53.8 ± 15.7 < 0.0001
[mmol/l] [1.47 ± 0.42] [1.57 ± 0.43] [1.39 ± 0.41]
*Fisher exact test; USD: United States Dollars; BMI: body mass index; SBP:
systolic blood pressure; DBP: diastolic blood pressure; CPG: casual plasma
glucose; eGFR: estimated glomerular filtration rate; TC: total cholesterol;
HDL-C: high-density lipoprotein cholesterol.