Modifiable Socio-Behavioural Factors Associated with Overweight and Hypertension among Persons Aged 35 to 60 Years in Eastern Uganda

Roy William Mayega,Fredrick Makumbi,Elizeus Rutebemberwa,David Guwatudde,Claes-Göran Östenson,Göran Tomson,Stefan Peterson,Wang Guoying

doi:10.1371/journal.pone.0047632

Roy William Mayega, Fredrick Makumbi + Show 6 more

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https://doi.org/10.1371/journal.pone.0047632

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Abstract

BackgroundFew studies have examined the behavioural correlates of non-communicable, chronic disease risk in low-income countries. The objective of this study was to identify socio-behavioural characteristics associated with being overweight or being hypertensive in a low-income setting, so as to highlight possible interventions and target groups.MethodsA population based survey was conducted in a Health and Demographic Surveillance Site (HDSS) in eastern Uganda. 1656 individuals aged 35 to 60 years had their Body Mass Index (BMI) and blood pressure (BP) assessed. Seven lifestyle factors were also assessed, using a validated questionnaire. Logistic regression was used to identify socio-behavioural factors associated with being overweight or being hypertensive.ResultsPrevalence of overweight was found to be 18% (25.2% of women; 9.7% of men; p<0.001) while prevalence of obesity was 5.3% (8.3% of women; 2.2% of men). The prevalence of hypertension was 20.5%. Factors associated with being overweight included being female (OR 3.7; 95% CI 2.69–5.08), peri-urban residence (OR 2.5; 95% CI 1.46–3.01), higher socio-economic status (OR 4.1; 95% CI 2.40–6.98), and increasing age (OR 1.8; 95% CI 1.12–2.79). Those who met the recommended minimum physical activity level, and those with moderate dietary diversity were less likely to be overweight (OR 0.5; 95% CI 0.35–0.65 and OR 0.7; 95% CI 0.49–3.01). Factors associated with being hypertensive included peri-urban residence (OR 2.4; 95%CI 1.60–3.66), increasing age (OR 4.5; 95% CI 2.94–6.96) and being over-weight (OR 2.8; 95% CI 1.98–3.98). Overweight persons in rural areas were significantly more likely to be hypertensive than those in peri-urban areas (p = 0.013).ConclusionsBeing overweight in low-income settings is associated with sex, physical activity and dietary diversity and being hypertensive is associated with being overweight; these factors are modifiable. There is need for context-specific health education addressing disparities in lifestyles at community levels in rural Africa.

Highlights

Non-communicable diseases (NCDs), such as cardiovascular disease (CVD), are the leading causes of adult mortality globally [1,2]
We report crude odds ratios (COR), adjusted odds ratios (AOR), and their respective 95% confidence intervals (CI) and p-values, as the measure of association
A family history of diabetes was reported in 12.4% of participants (Table 1)

Summary

Introduction

Non-communicable diseases (NCDs), such as cardiovascular disease (CVD), are the leading causes of adult mortality globally [1,2]. The increasing incidence of chronic diseases in low-income countries of sub-Sarahan Africa (SSA) poses a growing challenge to their national health systems [3], given that infectious diseases are still highly prevalent in these settings. Propelling the upsurge of CVD in Africa is the growing prevalence of risk factors, including obesity and hypertension among others [6,7]. In some countries (e.g. Ghana, South Africa and Cameroon) CVD risk factors have increased to epidemic proportions [8,9,10]. Few studies have examined the behavioural correlates of non-communicable, chronic disease risk in lowincome countries. The objective of this study was to identify socio-behavioural characteristics associated with being overweight or being hypertensive in a low-income setting, so as to highlight possible interventions and target groups

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