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

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RESEARCH ARTICLE SA JOURNAL OF DIABETES & VASCULAR DISEASE
16 VOLUME 16 NUMBER 1 • JULY 2019
CKD was present in 4.9% of the participants.42 In a similar study
from Cameroun, the prevalence of CKD ranged from 11.0 to
14.2%, depending on the prediction equation used.43 In a study
that evaluated 402 private sector IT workers in Dakar, Senegal in
late 2010, 22.4% had CKD.35 The prevalence of CKD in Nigeria
in various subsets of the population has been reported to range
from 7.8% among public sector employees,44 to 11.4% in the
community45 and 43.5% among retirees,46 depending on the
criteria used.
The prevalence of DM in this study parallels the estimated global
prevalence of 9%, the WHO estimated prevalence of 7.9% in
Nigeria in 2014,1 and the 9.7% recently reported from Senegal.35 It
is however slightly lower than the 11% obtained among university
employees in south-western Nigeria.8 However, our study differed
from theirs as they relied on selfreported diagnosis, which is subject
to recall bias. Oluyombo and associates37 recently reported that
6.8% of 750 respondents had DM. Our finding together with the
foregoing support the assertion that the prevalence of DM is on
the increase in Nigeria. However, the prevalence of DM in our study
was higher than the 2.5% reported by Oladapo and co-workers47
in south-west Nigeria, and the 3.6% by Okpechi and colleagues21
in southeastern Nigeria.
That sociodemographic characteristics impact on NCDs and their
risk factors was confirmed by the findings of our study. The prevalence
of hypertension, CKD and DM rose with increasing age, as expected.
Their prevalence also increased with increasing income, as a result of
the concomitant rise in the prevalence of some of the risk factors with
increasing income. It is noteworthy that hypertension decreased with
increasing educational level. This confirms the results of prior studies
that reported an inverse relationship between educational level and
hypertension.19,48 This provides an opportunity for intervention in
order to halt the rising trends in NCD.
Together with the existing literature, our study has implications
for the subset of employees at this university and the general
population at large, as large numbers of these individuals are at an
elevated risk of NCD-related events. In a recent review of national
policies addressing NCDs in low- and middle-income countries,
Lachat and colleagues22 demonstrated the disconnect that exists
between the burden of NCDs and the response of the respective
governments, including Nigeria. Concerted efforts are needed to
stem the high prevalence of NCDs and their risk factors in our
environment, so as to achieve the 2025 voluntary global targets of
the Global NCD Action Plan.1
Limitations
The findings of this study must be interpreted within the limitations
inherent in the study design. We studied only employees of the
university hence the generalisability of the findings is limited.
The purposive sampling process used may also have introduced
selection bias in the study. A stratified systematic sampling would
have yielded a more representative sample. However we invited all
the staff members of the university to participate in the study.
We were unable to measure triglyceride levels so we used non-
fasting blood samples for the determination of lipid levels. At first
glance, one may assume that assessing lipid abnormalities using
casual plasma samples (and not in the fasted state) as we did in
this study would constitute a limitation. However, the lack of effect
of fasting on levels of serum total cholesterol and reduced high-
density lipoprotein cholesterol has been documented and therefore
casual plasma sampling is used in field studies.49,50
We were also unable to repeat proteinuria assessments or eGFR
after three months and therefore the prevalence of CKD may have
been spuriously high. Finally, we could not establish causality as our
study was cross-sectional in design. Despite these limitations, we
have studied the largest sample of university employees in Nigeria
to date. Our study therefore provides the fulcrum for further studies
of this nature to elucidate the burden of NCDs in this category of
workers.
Conclusion
This study identified that the most prevalent NCD risk factors
among employees of a university are behavioural and therefore
modifiable. We also demonstrated that the NCDs and their risk
factors are impacted upon by sociodemographic characteristics.
Given the burden of NCDs and their risk factors among this subset
of the general population, there is a need for workplace policies
aimed at health promotion to be put in place in order to stem the
rising trend of NCDs. Multicentre studies addressing the burden of
NCDs among university employees are imperative.
This study was funded in part by the Tertiary Education Trust Fund
of the Federal Government of Nigeria. The authors acknowledge
the contribution of the management of the University health centre
and the leaders and members of the various associations at the
University of Jos for participating in the study. We also appreciate
the efforts of the physicians who participated in data collection, and
Mr Chime of the Jos University Teaching Hospital for data entry.
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