Non-communicable Diseases In Nigeria Research Articles

Validity and Reproducibility of a Semiquantitative Food Frequency Questionnaire and Food Picture Book in Nigeria

BackgroundIncreasing noncommunicable diseases in Nigeria are partly related to dietary factors. However, the lack of validated nutrition assessment tools hinders the conduct of nutritional epidemiology research in this population. ObjectivesTo develop a Food Frequency Questionnaire (FFQ) and Food Picture Book (FPB) for Nigerian adults, and to assess its reproducibility and validity compared with 24-h dietary recalls (24DRs) during different seasons in the year. MethodsWe compiled 202 foods for the FFQ through focus groups and consultations with local dietitians. We created an FPB with standardized food portion images to enhance the accuracy of reports of dietary intakes. We administered the FFQs to 205 randomly selected adults in Ibadan, Nigeria at ∼6 monthly intervals between November 2018 and October 2020. We evaluated the FFQ’s reproducibility and validity compared with 24DR across the dry and rainy seasons by examining the consumption of common food and mixed dishes. We computed the Spearman’s correlation coefficients (SCC), intraclass correlation coefficients (ICC), and Wilcoxon signed-rank tests, and generated Bland and Altman plots. ResultsOverall, we studied 110 women (53.7%) and 95 men (46.3%) with a mean age of 45.0 ± 13.4 y (mean ± SD). The reproducibility tests showed a mean ± SD SCC of 0.39 ± 0.14 and mean ± SD ICC of 0.32 ± 0.12. Higher mean ± SD SCC values were noted for cereal products (0.43 ± 0.09), starchy roots and tubers (0.45 ± 0.17), and soups (0.44 ± 0.20). Conversely, lower mean ± SD SCC values were observed for milk products (0.29 ± 0.02), solid fats (0.29 ± 0.26), and fish (0.22 ± 0.19). Regarding validity tests, the overall mean ± SD SCC was 0.27 ± 0.16 and mean ± SD ICC was 0.26 ± 0.16. We observed seasonal variations in intakes of fruits, cassava flour-based products, and nuts, although most foods did not show significant differences in intakes between seasons. ConclusionsOur FFQ and FPB demonstrated moderate correlations and seasonal variations in intakes of certain foods, emphasizing the need to account for seasonality in dietary intakes in nutritional studies in Nigeria and similar countries.

Economic burden of non-communicable diseases on households in Nigeria: evidence from the Nigeria living standard survey 2018-19.

The importance of non-communicable diseases (NCDs) in Nigeria is reflected in their growing burden that is fast overtaking that of infectious diseases. As most NCD care is paid for through out-of-pocket (OOP) expenses, and NCDs tend to cause substantial income losses through chronic disabilities, the rising NCD-related health burden may also be economically detrimental. Given the lack of updated national-level evidence on the economic burden of NCDs in Nigeria, this study aims to produce new evidence on the extent of financial hardship experienced by households with NCDs in Nigeria due to OOP expenditure and productivity loss. This study analysed cross-sectional data from the most recent round (2018-19) of the Nigeria Living Standard Survey (NLSS). Household-level health and consumption data were used to estimate catastrophic health expenditure (CHE) and impoverishing effects due to OOP health spending, using a more equitable method recently developed by the World Health Organization European region in 2018. The productivity loss by individuals with NCDs was also estimated from income and work-time loss data, applying the input-based human capital approach. On average, a household with NCDs spent ₦ 122,313.60 or $ 398.52 per year on NCD care, representing 24% of household food expenditure. The study found that OOP on cancer treatment, mental problems, and renal diseases significantly contribute to the cost of NCD care. The OOP expenditure led to catastrophic and impoverishing outcomes for households. The estimations showed that about 30% of households with NCDs experienced CHE in 2018, using the WHO Europe method at the 40% threshold. The study also found that the cost of NCD medications was a significant driver of CHE among NCD-affected households. The results showed heterogeneity in CHE and impoverishment across states and geographical regions in Nigeria, with a higher concentration in rural and North East geopolitical locations. The study also found that 20% of NCD-affected households were impoverished or further impoverished by OOP payment, and another 10% were on the verge of impoverishment. The results showed a negligible rate of unmet needs among households with NCDs. The study highlights the significant effect of NCDs on Nigerian households and the need for effective policy interventions to address this challenge, particularly among the poor and vulnerable.

Assessment of hypertension service availability in some primary health centres in Nigeria: a mixed-methods study

ObjectiveStrengthening primary health centre (PHC) systems is a potentially effective strategy to reduce the burden of non-communicable diseases in Nigeria, a low/middle-income country with limited resources. The aim of this...

Exploring community reintegration among Nigerian stroke survivors.

Community reintegration is one of the ultimate goals of stroke rehabilitation. The increasing burden of stroke morbidity by other non-communicable diseases in Nigeria indicated the need for our study. The authors explored the factors contributing to successful community reintegration among Nigerian stroke survivors. We conducted an explorative qualitative study design to achieve this aim using in-depth semi-structured interviews with 12-purposively sampled stroke survivors. Three overarching themes emerged: restriction of participation experienced by stroke survivors, activity limitation as pointers to the quality-of-life experience of stroke survivors and enablers or barriers to community reintegration for stroke survivors. Among the core, sub-themes included incapability of returning to work, difficulty performing domestic activities, social isolation or separation, recreation and leisure time. Enablers of community reintegration included creating a positive mindset, encouragement and social support, while barriers included mobility and speech or language challenges. Stroke survivors have challenges in returning to work and experience varying levels of activity limitation, which affects their quality of life with identifiable enablers or barriers to community reintegration. Stroke survivors with severe functional deficits should be monitored closely and given further rehabilitative assistance to aid functional recovery, thereby facilitating community reintegration.

Barriers to health in women of reproductive age living with or at risk of non-communicable diseases in Nigeria: a Photovoice study

BackgroundNigeria has one of the highest maternal mortality ratios (MMR) globally with an MMR of 512 (per 100,000 live births) and the proportion of maternal deaths due to non-communicable diseases (NCDs) is increasing. While evidence shows that many of these deaths are preventable, limited attention is being paid to the unique vulnerabilities and experiences of women of reproductive age (WRA) with NCDs and their risk factors, as well as the barriers to the screening, diagnosis, and management of these diseases in Nigeria.MethodsThis study explored the lives of WRA in Lagos and Federal Capital Territory in Nigeria from May to June 2019 using a community-based participatory research (CBPR) methodology called Photovoice which is aligned with CBPR as it includes procedures such as the identification of important community issues, discussion of photo assignments and data analysis. Twenty-four women of reproductive age were provided with digital cameras and trained on how to capture photos that conveyed their current health, healthcare utilization and engagement, and experience journeys. Individual interviews with the women were held for an in-depth exploration of the photographs. The data was then analysed thematically.ResultsSix distinct themes were identified across the barriers highlighted by the women: food and nutrition, home and family, neighborhood-built environment, economic instability, religion and spirituality and low prioritization of self-care. These themes captured the challenge of reduced agency, limited contribution and participation, and a complex relationship between visible and invisible illness.ConclusionThe perspectives of WRA in Nigeria obtained through this qualitative research provided a strong substratum for understanding the environmental barriers that predispose WRA to NCDs in Nigeria. The results of the study are useful for the improvement of woman-centred services of prevention, diagnosis, and management of NCD risk factors across the maternal and reproductive health care continuum in Nigeria.

BEHAVIOURAL MEDICINE: A KEY TO THE MANAGEMENT OF NON-COMMUNICABLE DISEASES IN NIGERIA

Urbanisation and advances in health technology have led to a reduction in communicable diseases. However, poverty, population growth, and the globalisation of unhealthy diets have resulted in a global upsurge of non-communicable diseases (NCD) like cancers, cardiovascular diseases, nutritional and metabolic diseases, endocrine disorders and respiratory diseases. Healthcare for NCDs remains a significant public health challenge. The primary management in Nigeria is currently pharmacological. However, non-pharmacological measures that are cost-effective and safe, with minimal side effects, are available for the prevention (primary and secondary) and treatment of NCDs. The impact of behavioural medicine in Nigeria remains limited despite the potential to significantly reduce the burden of NCDs and improve health and clinical outcomes. This is mainly due to insufficient investment in behavioural medicine research, inferior quality evaluation methods, lack of implementation of research outcomes, and poor interdisciplinary collaboration. Based on insights from the literature, this article discusses the need for behavioural medicine interventions and examines their application, effectiveness, and potential impact on NCDs. It also recommends more consideration of behavioural medicine in preventing and managing NCDs in Nigeria.

Consensus NHF-CAFSANI Summit on Food, Drinks and Cardiovascular Health: A Multisectoral Approach to Reducing NCDs in Nigeria.

The increasing prevalence of non-communicable diseases (NCDs) in Nigeria, like many other developing countries, has become worrisome. With the pre-existing health burden due to malnutrition, the challenges of low productivity, poverty, reduced economic growth and development are exacerbated. It is also a significant threat to the attainment of the Sustainable Development Goals (SDGs) in Nigeria. Several risk factors have been associated with this increased burden, including genetic, environmental, and behavioural. The rise in urbanization and globalization has undoubtedly had a significant influence on consumer food and drink preferences and choices. Many of the risk factors are preventable with changes in diet, lifestyle, alcohol, and drug use, among other measures. However, to prevent the growing occurrence of NCDs in Nigeria, critical and relevant stakeholders must work together with a definite agenda and concerted efforts to combat this challenge. This paper examines the roles of stakeholders, including global and national governments, industry, and consumers, and advocates a holistic and genuine commitment to measures that will fast-track the implementation of various recommendations such as WHO SHAKE and use of Front of Pack Labelling.

The organisation of primary health care service delivery for non-communicable diseases in Nigeria: A case-study analysis.

As chronic diseases, non-communicable diseases (NCDs) require sustained person-centred and community-based care. Given its direct link to communities and households, Primary Health Care (PHC) is well positioned to achieve such care. In Nigeria, the national government has prioritized PHC system strengthening as a means of achieving national NCD targets. However, strengthening PHC systems for NCDs require re-organization of PHC service delivery, based on contextual understanding of existing facilitators and barriers to PHC service delivery for NCDs. We conducted a mixed method case study to explore NCD service delivery with 13 PHC facilities serving as the cases of interest. The study was conducted in two northern and two southern states in Nigeria-and included qualitative interviews with 25 participants, 13 focus group discussion among 107 participants and direct observation at the 13 PHCs. We found that interprofessional role conflict among healthcare workers, perverse incentives to sustain the functioning of PHC facilities in the face of government under-investment, and the perception of PHC as an inferior health system were major barriers to improved organisation of NCD management. Conversely, the presence of physicians at PHC facilities and involvement of civil society organizations in aiding community linkage were key enablers. These marked differences in performance and capacity between PHC facilities in northern compared to southern states, with those in the south better organised to deliver NCD services. PHC reforms that are tailored to the socio-political and economic variations across Nigeria are needed to improve capacity to address NCDs.

Impact of Guided Nutrition Intervention on the Anthropometric and Biochemical Profile of Non-Communicable Disease Patients in Nigeria; A Multi Facility Based Study

ObjectivesThis study was designed to assess the impact on guided nutrition intervention on the anthropometry and biochemical profile control of patients with non-communicable diseases in Nigeria. MethodsNinety-two in-patients suffering from non-communicable diseases with metabolic complications were recruited from six Nigerian tertiary health care institutions using a quasi-experimental design and purposive sampling technique. Informed consent and ethical approval were obtained. The respondents were subjected to six months of guided/individualised nutrition interventions which comprised; nutrition counselling, formulation/administration of disease appropriate therapeutic diets and close monitoring/follow up. Descriptive statistics were computed for the continuous variables, paired t-test was used to evaluate the impact of the intervention. ResultsResults showed a significant (p < 0.05) reduction in respondents’ weight (78.07 to 76.05 kg) and Body Mass Index (28.68–27.82 kg/m2) status. Mean systolic (135.41 to 129.52 mmHg) and diastolic (84.17 to 78.05 mmHg) blood pressure values dropped significantly after the intervention. Fasting blood sugar of the subjects significantly (t = 4.84; p = 0.00) declined (136.19 to 120.82 mg/dl), while a significant (t = –2.48; p = 0.02) elevation in mean packed cell volume of the patients was recorded. There was no significant (p < 0.05) effect of the intervention on the serum electrolytes except chloride (101.66 to 95.24 mmol/l) which recorded a significant (t = 2.16; p = 0.42) reduction. ConclusionsAppropriate nutrition/dietary interventions significantly improved the health and nutritional status of the patients. Longitudinal studies and clinical trials that will validate the impact of nutrition interventions on the health outcomes of NCD patients in sub-Saharan Africa should be conducted. Funding SourcesNone

Aligning policymaking in decentralized health systems: Evaluation of strategies to prevent and control non-communicable diseases in Nigeria.

Noncommunicable diseases (NCDs) are leading causes of death globally and in Nigeria they account for 29% of total deaths. Nigeria's health system is decentralized. Fragmentation in governance in federalised countries with decentralised health systems is a well-recognised challenge to coherent national health policymaking. The policy response to the rising NCD burden therefore requires strategic intent by national and sub-national governments. This study aimed to understand the implementation of NCD policies in Nigeria, the role of decentralisation of those policies, and to consider the implications for achieving national NCD targets. We conducted a policy analysis combined with key informant interviews to determine to what extent NCD policies and strategies align with Nigeria's decentralised health system; and the structure and process within which implementation occurs across the various tiers of government. Four inter-related findings emerged: NCD national policies are 'top down' in focus and lack attention to decentralisation to subnational and frontline care delivery levels of the health system; there are defective coordination mechanisms for NCD programmes which are underpinned by weak regional organisational structures; financing for NCDs are administratively burdensome and fragmented; and frontline NCD service delivery for NCDs are not effectively being integrated with other essential PHC services. Despite considerable progress being made with development of national NCD policies, greater attention on their implementation at subnational levels is needed to achieve more effective service delivery and progress against national NCD targets. We recommend strengthening subnational coordination mechanisms, greater accountability frameworks, increased and more efficient funding, and greater attention to integrated PHC service delivery models. The use of an effective bottom-up approach, with consideration for decentralization, should also be engaged at all stages of policy formulation.

Perception and Determinants of Uptake of Preventive Health Services among the Staff of Obafemi Awolowo University, Ile-Ife, Osun State

Background: The rising burden of chronic non-communicable diseases in Nigeria makes the need for preventive health services (PHS) imperative. Thus, this study assessed the perception and determinants of uptake of preventive health services among the staff of Obafemi Awolowo University, Ile-Ife, Osun State.Methods: A cross-sectional analytical study was employed. Two hundred and ninety academic and non-academic staff of the university were enrolled in the study, using a stratified random sampling technique. The sample size was proportionally allocated to various subunits in the institution. Data were collected using a self-administered questionnaire. Determinants of uptake of PHS were assessed using binary logistic regression. A p-value of &lt; 0.05 was considered to be statistically significant.Results: The majority of the respondents, 280 (96.6%) had good perceptions of PHS, and 176 (60.7%) reported barriers in access to PHS. Although a majority of the respondents, 268 (92.4%) had positive attitudes towards PHS, most of the respondents 196 (67.6%) had poor uptake. Common barriers to uptake of PHS were availability and affordability of the services, time constraints, and interference with other activities. Being an academic staff (p = 0.001) and presence of chronic illness (p = 0.043) were significant determinants of PHS uptake.Conclusion: Uptake of PHS was poor among majority of the respondents despite their good perception of the services. This may be linked to the perceived barriers to access. Thus, there is a need for policy formulation and provision of an enabling environment by the University’s authority for ease of access to PHS.

Addressing the high burden of noncommunicable diseases in Nigeria: a commentary

PurposeThe purpose of this study describes how individuals; healthcare providers and the government can reduce the burden of noncommunicable diseases (NCDs) in Nigeria.Design/methodology/approachThis commentary paper combines extensive literature searches and experience from public health physicians.FindingsNoncommunicable diseases are chronic diseases. They result from a combination of genetic, physiological, environmental and behavioral factors. NCDs are divided into four classes: cardiovascular diseases, cancers, chronic respiratory diseases and diabetes.Practical implicationsNoncommunicable diseases are responsible for about a quarter of total deaths in Nigeria. These deaths are unnecessary as most NCDs can be prevented if the risk factors are dealt with. Dealing with these risk factors involves everyone (Individuals, government, interdisciplinary and multidisciplinary researchers, policymakers, government, etc.).Originality/valueMajor risk factors for NCDs are tobacco use, harmful use of alcohol, unhealthy diet and physical inactivity. The solution to NCDs, therefore, lies in dealing with these factors, which, fortunately, are modifiable since they have to do with lifestyle practices. There is evidence to support the claim that a reduction of the risks of NCDs can be achieved by engaging in healthy lifestyle practices.

Physical Activity Intervention: A Tool to Forestall Endemic Prevalence of Noncommunicable Diseases in Nigeria

Paradigm shift in the promotion of health in Nigerian through physical activity remain unaddressed. Lower respiratory infections, ischemic heart disease, liver cirrhosis, stroke being among the top 10 causes of death in Nigeria are tied to physical inactivity among others. It is on this ground that this paper seeks to examine the risk of inactive interventions towards physical activity. Through reviews of related literature this article explored strategies for physical activity intervention by creating active society, active people, active environment and active system. It is therefore recommended that the government, institution and all relevant agencies implement all strategies of intervention through multi-sectoral approach for impactful delivery.

Knowledge, Attitudes, and the Practice of Health Promotion among Physiotherapists in Nigeria.

Purpose: In spite of the growing epidemic of non-communicable diseases in Nigeria and the compelling need for the active participation of physiotherapists in health promotion activities around the world, there is no evidence that physiotherapists in Nigeria are engaged in health promotion activities. This study aimed to investigate the knowledge of, attitudes toward, and practice of health promotion among physiotherapists practising in Nigeria. Method: This was a cross-sectional study. We contacted members of the Nigeria Society of Physiotherapy (n = 368) by email; the message contained a link to an online questionnaire. Results: A total of 229 (62%) physiotherapists responded. Most demonstrated a good knowledge of health promotion (approximately 70%) and indicated that they often incorporated aspects of health promotion into their patients' treatment (63%). However, fewer than one-fifth strongly agreed that health promotion was taught in their entry-level programme and had equipped them with the necessary health promotion skills. Conclusions: The majority of the physiotherapists surveyed demonstrated good knowledge and often incorporated health promotion into their routine daily practice. Nevertheless, the respondents stated that their entry-level physiotherapy education had not sufficiently equipped them for health promotion practice. These findings provide a baseline reference that can be used to track capacity building for health promotion practices. The results also highlight important gaps in the physiotherapy entry-level curriculum and the health promotion training needs of physiotherapists in Nigeria.

A survey of physiotherapists on physical activity promotion in northern Nigeria

Tackling the menace of non-communicable diseases (NCDs) through the promotion of population participation in health enhancing physical activities requires the engagement of healthcare experts, such as physiotherapists, to make necessary assessments and individualized recommendation. The aim of this study was to determine the knowledge of physical activity message, role perception and counselling practice, and the feasibility of, and barriers to physical activity promotion among physiotherapists in Northern Nigeria. Physiotherapists in seven hospitals in Northern Nigeria (N=94) were surveyed using a questionnaire that elicited information on socio-demographic characteristics and the participants also completed a Physical Activity Promotion Questionnaire which elicited responses on knowledge of physical activity message, feasibility of physical activity promotion, and barriers to physical activity promotion. Overall, the physiotherapists in this study reported good knowledge of physical activity promotion, perceived physical activity promotion as their role, and also reported minimal or little barrier to physical activity promotion. The physiotherapists also believed promoting physical activity was feasible for them. These findings suggest that physiotherapists in Northern Nigerian have a good disposition towards promoting a physically active lifestyle among their patients and clients and they could play an important public health role in the prevention and control of NCDs in Nigeria. Keywords: Physical activity, physical activity promotion, physiotherapists, disposition, active lifestyle

The Prevalence and Correlates of Pre-Diabetes and Diabetes Mellitus Among Public Category Workers in Akure, Nigeria

Background:Limited epidemiological data on pre-diabetes and diabetes mellitus among public service workers, considered an at-risk population, may undermine the government’s efforts toward addressing the scourge of non-communicable diseases in Nigeria. This study aimed to address this gap by determining the prevalence of pre-diabetes and diabetes mellitus (DM), and to examine their correlates.Methods:We conducted a workplace cross-sectional survey of 4828 public service workers across 47 ministries, departments and agencies in Ondo State, Nigeria. An adapted World Health Organisation (WHO) STEPwise surveillance questionnaire was utilised to obtain relevant items of demographic factors, medical history and lifestyle behaviour. Height, weight, blood pressure and fasting blood sugar were measured according to standard protocols. Pre-diabetes and DM were defined as fasting blood glucose 5.6-6.9mmol/L and greater than or equal to 7.0mmol/L, respectively. We performed univariate and multivariate model analyses to determine the associated factors of pre-diabetes and DM.Results:Overall, 2299 men and 2529 women participated in the study. The mean age of the participants was 40.4 years (SD±9.7) and the age range was 19 to 76 years. The prevalence of pre-diabetes and DM was 11.7% (n=563) and 5.3% (n=254), respectively. Women had a higher prevalence of pre-diabetes than men did (12.5% versus 10.8%). In univariate analysis, the following factors were associated with pre-diabetes and DM; aging (p&lt;0.0001), marital status (p&lt;0.0001), lower level of education (p=0.008), body mass index (BMI) (p&lt;0.0001) and hypertension (p&lt;0.0001). In multivariate model analysis, after adjusting for confounding factors, age ≥45 years (OR=1.8, 95%CI 1.3-2.4), lower level of education (OR=1.7, 95%CI 1.2-2.4), hypertension (OR=2.0, 95%CI 1.5-2.6) and overweight/obesity (OR=2.2, 95%CI 1.6-3.0) were the independent and significant determinants of DM.Conclusion:We found a high prevalence of pre-diabetes and DM in the study population. Cardio-metabolic screening of public category workers might contribute significantly towards bridging the gap of undiagnosed DM in the study setting.

Health promotion strategies for the prevention and control of non-communicable diseases in Nigeria

Health promotion strategies for the prevention and control of non-communicable diseases in Nigeria

Willingness to Pay for Clinical Preventive Services of Patients Attending the GENERAL Out-Patient Clinic of a Tertiary Hospital in South-South Nigeria

The prevalences of non-communicable diseases in Nigeria are currently close to those of the developed countries, but the uptake of clinical preventive services (CPS) has been very poor. This study assessed the willingness of respondents to pay (WTP) for a packaged CPS, delivered in one service point. The study was conducted among patients attending the general out-patient clinic of a tertiary hospital in Port Harcourt, south-south Nigeria, using a descriptive cross-sectional study design. Data was collected using a semi-structured interviewer-administered questionnaire, and assessed the respondents’ attitude towards CPS and their WTP for the services, which was determined using the contingent valuation method. A total of 422 questionnaires were administered and analyzed. The respondents had an average age of 36.04 ±1.99 years; majority had at least secondary school education (90.05%), were Christians of Pentecostal denomination (50.95%), self employed (52.13%), with an monthly average income of more than $300 (56.64%). Most (89.57%) of the respondents were willing to pay for CPS; more than a quarter (25.93%) of them were willing to pay the prevailing cost of assessing the services, 33.84% were willing to pay less, while 34.28% were willing to pay more. The monthly income of the respondents significantly affected their willingness to pay for the services (p-value = 0.000).The respondents showed a willingness to pay for packaged CPS, the uptake of the services can therefore be improved, if the cost of the service is subsidized.

The burden of hypertension and diabetes mellitus in rural communities in southern Nigeria.

IntroductionThe African region of the world is experiencing a double epidemic of both communicable and non-communicable diseases. The objective of the study was to determine the prevalence of hypertension and diabetes mellitus among adult residents of rural communities in southern Nigeria.MethodsA community based descriptive cross-sectional study. Adults aged 18 years and above residing in the rural communities who attended a free medical outreach programme were screened for hypertension and diabetes mellitus. Data were collected using a structured interviewer-administered questionnaire.ResultsOf the 845 participants, 349 (41.3%) were aged 50-69 years, 263 (31.1%) were males, and 305 (36.1%) were farmers. Overweight and obesity were found in 184 (21.8%) and 90 (10.6%) of them respectively. The overall prevalence of hypertension was 37.6% (males 43.7%, females 35.1%, p = 0.018) while that of diabetes mellitus was 4.6% (males 1.9%, females 5.8%, p = 0.012). Predictors of hypertension were age ≥ 40 years (OR = 5.04, CI: 2.99 - 8.48), overweight/obesity (OR = 1.56, CI: 1.15 - 2.13) while females are less likely to develop hypertension (OR = 0.72, CI: 0.53 - 0.98). The significant predictor of diabetes mellitus was overweight/obesity (OR = 3.53, CI: 1.78 - 6.98).ConclusionThe rising prevalence of hypertension and diabetes mellitus is assuming an epidemic level in rural communities in southern Nigeria. There is an urgent need for intensive health education and community surveillance programmes targeted at rural communities in order to achieve prevention and control of these non-communicable diseases in Nigeria.

Perception and practice of lifestyle modification in the management of hypertension among hypertensives in south-east Nigeria

Background : Hypertension ranks first among the non-communicable diseases in Nigeria and globally. Interventions like lifestyle modifications, with its advantages, are often overlooked. Awareness and practice of these measures will aid in blood pressure control. Aim : To assess the level of awareness and practice of lifestyle modification among hypertensive adults in a semi-urban community of Olokoro in Umuahia South local government area of Abia state, Nigeria. Methods : A crosssectional study involving adult hypertensive patients who presented during a medical screening exercise. Structured pre-tested researcher administered questionnaire was used for data collection. Results : A total of 101 individuals were recruited; 58 (57.4%) males and 43 (42.6%) females. Mean age was 56.7±12 years with a range of 27 to 84 years. Mean systolic and diastolic BP were 143±17mmHg and 80±12mmHg respectively. Up to 87.1% were unaware that regular exercise is part of lifestyle modification while 60% are unaware of the need for moderation of alcohol intake. More than 80% are unaware of the roles of vegetables, fruits, unsaturated oil and reduction in diary food intake in the control of BP. Among 88 participants with some knowledge of salt restriction, 68.2% practiced it. This also applied to 8.6%, 7.5%, 32.3%, 12.9% and 6.5% of those with knowledge of regular exercise, weight reduction, alcohol moderation, fruit intake and cigarette smoking respectively. There was a negative correlation between the level of practice and both systolic and diastolic blood pressures. Conclusion : Awareness level and practice of lifestyle modification in blood pressure control among the studied cohort is poor. Concerted strategies need to be taken to improve these. Key Words : Perception; practice; lifestyle modification; hypertension; Nigeria