Abstract
We conducted a large population-based survey among adults measuring weight, height, and blood pressure nested within an HIV survey in rural KwaZulu-Natal, South Africa, to identify and characterize clusters of overweight and hypertension in a typical rural African population and to explore whether geographic clusters can be accounted for by established individual-level risk factors. 58.4% of the participants were overweight and 22.6% were hypertensive. One cluster of high prevalence of overweight (RR=1.50, p<0.001) was identified using Kulldorff spatial scan statistic as the most likely cluster, whereas a low-risk cluster was identified in the nearby high-density settlement area (RR=0.62, p<0.05). No geographic clusters of hypertension were identified. After controlling for age, sex, educational attainment, household wealth, marital status, place of residence, and HIV status, no spatial clustering of overweight remained. The results provided clear evidence for the localized clustering of overweight. Identification of clustering of chronic disease could provide additional insights into the prevention and control for the rural South African population.
Highlights
Once considered a health burden confined to high income countries, the prevalence of overweight and obesity is increasing in low- and middle-income countries (WHO, 2000)
Non-communicable diseases related to overweight and obesity, such as heart disease, diabetes, and stroke, together constitute the second most common cause of death among adult South Africans (Bradshaw et al, 2003)
Hypertension has been found to be associated with some modifiable socioeconomic determinants, such as education and occupation (Grotto et al, 2008), it is less studied at the population level
Summary
Once considered a health burden confined to high income countries, the prevalence of overweight and obesity is increasing in low- and middle-income countries (WHO, 2000). The prevalence of obesity (body mass index (BMI)Z30) in adult men and adult women (over the age of 15 years), respectively, is 9% and 27%, according to the South African Demographic and Health Survey conducted in 2003 (Department of Health, 2007). Some researchers, mostly from developed countries, have started studying the wider neighborhoodlevel characteristics of body weight, hoping to discover new approaches to better understand and curb the continuing obesity epidemic (Black and Macinko, 2008; Yancey et al, 2004). Studies from developed countries have suggested that low communitylevel socioeconomic resources are related to high prevalence of obesity (Black and Macinko, 2008). Hypertension has been found to be associated with some modifiable socioeconomic determinants, such as education and occupation (Grotto et al, 2008), it is less studied at the population level
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
