Sociodemographic distribution of non-communicable disease risk factors in rural Uganda: a cross-sectional study
Identifieur interne : 001C01 ( Pmc/Corpus ); précédent : 001C00; suivant : 001C02Sociodemographic distribution of non-communicable disease risk factors in rural Uganda: a cross-sectional study
Auteurs : Georgina A V. Murphy ; Gershim Asiki ; Kenneth Ekoru ; Rebecca N. Nsubuga ; Jessica Nakiyingi-Miiro ; Elizabeth H. Young ; Janet Seeley ; Manjinder S. Sandhu ; Anatoli KamaliSource :
- International journal of epidemiology [ 0300-5771 ] ; 2013.
Abstract
Non-communicable diseases (NCDs) are rapidly becoming leading causes of morbidity and mortality in low and middle-income countries, including those in sub-Saharan Africa. By contrast to high-income countries, the sociodemographic distribution, including socioeconomic inequalities, of NCDs and their risk factors is unclear in sub-Saharan Africa, particularly among rural populations.
We undertook a cross-sectional population-based survey of 7809 residents 13 years or older in the General Population Cohort in south-western rural Uganda. Information on behavioural, physiological, and biochemical risk factors was obtained using standardised methods as recommended by the WHO STEPwise Approach to Surveillance. Socioeconomic status (SES) was determined by principal component analysis including household features, ownership, and occupation and education of the head of household.
SES was found to be associated with NCD risk factors in this rural population. Smoking, alcohol consumption (men only), and low HDL-cholesterol were more common among those of lower SES. For example, the prevalence of smoking decreased fourfold from the lowest to highest SES groups, from 22.0% to 5.7% for men and 2.2% to 0.4% for women. By contrast, overweight, raised blood pressure, raised HbA1c (women only), and raised cholesterol were more common among those of higher SES. For example the prevalence of overweight increased fivefold from 2.1% to 10.1% for men and twofold from 12.0% to 23.4% for women from the lowest to highest SES groups. However, neither low physical activity nor fruit, vegetable, or staples consumption was associated with SES. Furthermore, associations between NCD risk factors and SES were modified by age and sex.
Within this rural population NCD risk factors are common and vary both inversely and positively across the socioeconomic status gradient. A better understanding of the determinants of the sociodemographic distribution of NCDs and their risk factors in rural sub-Saharan African populations will help identify populations at most risk of developing NCDs and help plan interventions to reduce their burden.
Url:
DOI: 10.1093/ije/dyt184
PubMed: 24191304
PubMed Central: 4234905
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PMC:4234905Le document en format XML
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<author><name sortKey="Murphy, Georgina A V" sort="Murphy, Georgina A V" uniqKey="Murphy G" first="Georgina A V" last="Murphy">Georgina A V. Murphy</name>
<affiliation><nlm:aff id="A1">Department of Public Health & Primary Care, University of Cambridge, Cambridge, United Kingdom</nlm:aff>
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<affiliation><nlm:aff id="A2">Wellcome Trust Sanger Institute, Hinxton, United Kingdom</nlm:aff>
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<author><name sortKey="Asiki, Gershim" sort="Asiki, Gershim" uniqKey="Asiki G" first="Gershim" last="Asiki">Gershim Asiki</name>
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<author><name sortKey="Ekoru, Kenneth" sort="Ekoru, Kenneth" uniqKey="Ekoru K" first="Kenneth" last="Ekoru">Kenneth Ekoru</name>
<affiliation><nlm:aff id="A1">Department of Public Health & Primary Care, University of Cambridge, Cambridge, United Kingdom</nlm:aff>
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<affiliation><nlm:aff id="A2">Wellcome Trust Sanger Institute, Hinxton, United Kingdom</nlm:aff>
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<affiliation><nlm:aff id="A3">Medical Research Council/Uganda Virus Research Institute (MRC/UVRI), Uganda Research Unit on AIDS, Entebbe, Uganda</nlm:aff>
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<author><name sortKey="Nsubuga, Rebecca N" sort="Nsubuga, Rebecca N" uniqKey="Nsubuga R" first="Rebecca N" last="Nsubuga">Rebecca N. Nsubuga</name>
<affiliation><nlm:aff id="A3">Medical Research Council/Uganda Virus Research Institute (MRC/UVRI), Uganda Research Unit on AIDS, Entebbe, Uganda</nlm:aff>
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<author><name sortKey="Nakiyingi Miiro, Jessica" sort="Nakiyingi Miiro, Jessica" uniqKey="Nakiyingi Miiro J" first="Jessica" last="Nakiyingi-Miiro">Jessica Nakiyingi-Miiro</name>
<affiliation><nlm:aff id="A3">Medical Research Council/Uganda Virus Research Institute (MRC/UVRI), Uganda Research Unit on AIDS, Entebbe, Uganda</nlm:aff>
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<author><name sortKey="Young, Elizabeth H" sort="Young, Elizabeth H" uniqKey="Young E" first="Elizabeth H" last="Young">Elizabeth H. Young</name>
<affiliation><nlm:aff id="A1">Department of Public Health & Primary Care, University of Cambridge, Cambridge, United Kingdom</nlm:aff>
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<author><name sortKey="Seeley, Janet" sort="Seeley, Janet" uniqKey="Seeley J" first="Janet" last="Seeley">Janet Seeley</name>
<affiliation><nlm:aff id="A3">Medical Research Council/Uganda Virus Research Institute (MRC/UVRI), Uganda Research Unit on AIDS, Entebbe, Uganda</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A4">London School of Hygiene and Tropical Medicine, London, United Kingdom</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A5">School of International Development, University of East Anglia, Norwich, United Kingdom</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Sandhu, Manjinder S" sort="Sandhu, Manjinder S" uniqKey="Sandhu M" first="Manjinder S" last="Sandhu">Manjinder S. Sandhu</name>
<affiliation><nlm:aff id="A1">Department of Public Health & Primary Care, University of Cambridge, Cambridge, United Kingdom</nlm:aff>
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<affiliation><nlm:aff id="A2">Wellcome Trust Sanger Institute, Hinxton, United Kingdom</nlm:aff>
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<author><name sortKey="Kamali, Anatoli" sort="Kamali, Anatoli" uniqKey="Kamali A" first="Anatoli" last="Kamali">Anatoli Kamali</name>
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<affiliation><nlm:aff id="A4">London School of Hygiene and Tropical Medicine, London, United Kingdom</nlm:aff>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Sociodemographic distribution of non-communicable disease risk factors in rural Uganda: a cross-sectional study</title>
<author><name sortKey="Murphy, Georgina A V" sort="Murphy, Georgina A V" uniqKey="Murphy G" first="Georgina A V" last="Murphy">Georgina A V. Murphy</name>
<affiliation><nlm:aff id="A1">Department of Public Health & Primary Care, University of Cambridge, Cambridge, United Kingdom</nlm:aff>
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<affiliation><nlm:aff id="A2">Wellcome Trust Sanger Institute, Hinxton, United Kingdom</nlm:aff>
</affiliation>
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<author><name sortKey="Asiki, Gershim" sort="Asiki, Gershim" uniqKey="Asiki G" first="Gershim" last="Asiki">Gershim Asiki</name>
<affiliation><nlm:aff id="A3">Medical Research Council/Uganda Virus Research Institute (MRC/UVRI), Uganda Research Unit on AIDS, Entebbe, Uganda</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Ekoru, Kenneth" sort="Ekoru, Kenneth" uniqKey="Ekoru K" first="Kenneth" last="Ekoru">Kenneth Ekoru</name>
<affiliation><nlm:aff id="A1">Department of Public Health & Primary Care, University of Cambridge, Cambridge, United Kingdom</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A2">Wellcome Trust Sanger Institute, Hinxton, United Kingdom</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A3">Medical Research Council/Uganda Virus Research Institute (MRC/UVRI), Uganda Research Unit on AIDS, Entebbe, Uganda</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Nsubuga, Rebecca N" sort="Nsubuga, Rebecca N" uniqKey="Nsubuga R" first="Rebecca N" last="Nsubuga">Rebecca N. Nsubuga</name>
<affiliation><nlm:aff id="A3">Medical Research Council/Uganda Virus Research Institute (MRC/UVRI), Uganda Research Unit on AIDS, Entebbe, Uganda</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Nakiyingi Miiro, Jessica" sort="Nakiyingi Miiro, Jessica" uniqKey="Nakiyingi Miiro J" first="Jessica" last="Nakiyingi-Miiro">Jessica Nakiyingi-Miiro</name>
<affiliation><nlm:aff id="A3">Medical Research Council/Uganda Virus Research Institute (MRC/UVRI), Uganda Research Unit on AIDS, Entebbe, Uganda</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Young, Elizabeth H" sort="Young, Elizabeth H" uniqKey="Young E" first="Elizabeth H" last="Young">Elizabeth H. Young</name>
<affiliation><nlm:aff id="A1">Department of Public Health & Primary Care, University of Cambridge, Cambridge, United Kingdom</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A2">Wellcome Trust Sanger Institute, Hinxton, United Kingdom</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Seeley, Janet" sort="Seeley, Janet" uniqKey="Seeley J" first="Janet" last="Seeley">Janet Seeley</name>
<affiliation><nlm:aff id="A3">Medical Research Council/Uganda Virus Research Institute (MRC/UVRI), Uganda Research Unit on AIDS, Entebbe, Uganda</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A4">London School of Hygiene and Tropical Medicine, London, United Kingdom</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A5">School of International Development, University of East Anglia, Norwich, United Kingdom</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Sandhu, Manjinder S" sort="Sandhu, Manjinder S" uniqKey="Sandhu M" first="Manjinder S" last="Sandhu">Manjinder S. Sandhu</name>
<affiliation><nlm:aff id="A1">Department of Public Health & Primary Care, University of Cambridge, Cambridge, United Kingdom</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A2">Wellcome Trust Sanger Institute, Hinxton, United Kingdom</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Kamali, Anatoli" sort="Kamali, Anatoli" uniqKey="Kamali A" first="Anatoli" last="Kamali">Anatoli Kamali</name>
<affiliation><nlm:aff id="A3">Medical Research Council/Uganda Virus Research Institute (MRC/UVRI), Uganda Research Unit on AIDS, Entebbe, Uganda</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A4">London School of Hygiene and Tropical Medicine, London, United Kingdom</nlm:aff>
</affiliation>
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<series><title level="j">International journal of epidemiology</title>
<idno type="ISSN">0300-5771</idno>
<idno type="eISSN">1464-3685</idno>
<imprint><date when="2013">2013</date>
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<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Background</title>
<p id="P2">Non-communicable diseases (NCDs) are rapidly becoming leading causes of morbidity and mortality in low and middle-income countries, including those in sub-Saharan Africa. By contrast to high-income countries, the sociodemographic distribution, including socioeconomic inequalities, of NCDs and their risk factors is unclear in sub-Saharan Africa, particularly among rural populations.</p>
</sec>
<sec id="S2"><title>Methods</title>
<p id="P3">We undertook a cross-sectional population-based survey of 7809 residents 13 years or older in the General Population Cohort in south-western rural Uganda. Information on behavioural, physiological, and biochemical risk factors was obtained using standardised methods as recommended by the WHO STEPwise Approach to Surveillance. Socioeconomic status (SES) was determined by principal component analysis including household features, ownership, and occupation and education of the head of household.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P4">SES was found to be associated with NCD risk factors in this rural population. Smoking, alcohol consumption (men only), and low HDL-cholesterol were more common among those of lower SES. For example, the prevalence of smoking decreased fourfold from the lowest to highest SES groups, from 22.0% to 5.7% for men and 2.2% to 0.4% for women. By contrast, overweight, raised blood pressure, raised HbA1c (women only), and raised cholesterol were more common among those of higher SES. For example the prevalence of overweight increased fivefold from 2.1% to 10.1% for men and twofold from 12.0% to 23.4% for women from the lowest to highest SES groups. However, neither low physical activity nor fruit, vegetable, or staples consumption was associated with SES. Furthermore, associations between NCD risk factors and SES were modified by age and sex.</p>
</sec>
<sec id="S4"><title>Conclusions</title>
<p id="P5">Within this rural population NCD risk factors are common and vary both inversely and positively across the socioeconomic status gradient. A better understanding of the determinants of the sociodemographic distribution of NCDs and their risk factors in rural sub-Saharan African populations will help identify populations at most risk of developing NCDs and help plan interventions to reduce their burden.</p>
</sec>
</div>
</front>
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<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">7802871</journal-id>
<journal-id journal-id-type="pubmed-jr-id">4294</journal-id>
<journal-id journal-id-type="nlm-ta">Int J Epidemiol</journal-id>
<journal-id journal-id-type="iso-abbrev">Int J Epidemiol</journal-id>
<journal-title-group><journal-title>International journal of epidemiology</journal-title>
</journal-title-group>
<issn pub-type="ppub">0300-5771</issn>
<issn pub-type="epub">1464-3685</issn>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">24191304</article-id>
<article-id pub-id-type="pmc">4234905</article-id>
<article-id pub-id-type="doi">10.1093/ije/dyt184</article-id>
<article-id pub-id-type="manuscript">EMS60913</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Sociodemographic distribution of non-communicable disease risk factors in rural Uganda: a cross-sectional study</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Murphy</surname>
<given-names>Georgina A V</given-names>
</name>
<xref ref-type="corresp" rid="CR1">*</xref>
<xref ref-type="aff" rid="A1">1</xref>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Asiki</surname>
<given-names>Gershim</given-names>
</name>
<xref ref-type="aff" rid="A3">3</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Ekoru</surname>
<given-names>Kenneth</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
<xref ref-type="aff" rid="A2">2</xref>
<xref ref-type="aff" rid="A3">3</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Nsubuga</surname>
<given-names>Rebecca N</given-names>
</name>
<xref ref-type="aff" rid="A3">3</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Nakiyingi-Miiro</surname>
<given-names>Jessica</given-names>
</name>
<xref ref-type="aff" rid="A3">3</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Young</surname>
<given-names>Elizabeth H</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Seeley</surname>
<given-names>Janet</given-names>
</name>
<xref ref-type="aff" rid="A3">3</xref>
<xref ref-type="aff" rid="A4">4</xref>
<xref ref-type="aff" rid="A5">5</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Sandhu</surname>
<given-names>Manjinder S</given-names>
</name>
<xref ref-type="corresp" rid="CR1">*</xref>
<xref ref-type="author-notes" rid="FN1">†</xref>
<xref ref-type="aff" rid="A1">1</xref>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Kamali</surname>
<given-names>Anatoli</given-names>
</name>
<xref ref-type="author-notes" rid="FN1">†</xref>
<xref ref-type="aff" rid="A3">3</xref>
<xref ref-type="aff" rid="A4">4</xref>
</contrib>
</contrib-group>
<aff id="A1"><label>1</label>
Department of Public Health & Primary Care, University of Cambridge, Cambridge, United Kingdom</aff>
<aff id="A2"><label>2</label>
Wellcome Trust Sanger Institute, Hinxton, United Kingdom</aff>
<aff id="A3"><label>3</label>
Medical Research Council/Uganda Virus Research Institute (MRC/UVRI), Uganda Research Unit on AIDS, Entebbe, Uganda</aff>
<aff id="A4"><label>4</label>
London School of Hygiene and Tropical Medicine, London, United Kingdom</aff>
<aff id="A5"><label>5</label>
School of International Development, University of East Anglia, Norwich, United Kingdom</aff>
<author-notes><corresp id="CR1"><label>*</label>
Corresponding authors: Georgina A V Murphy, International Health Research Group, Dept of Public Health & Primary Care University of Cambridge, Strangeways Research Laboratory, Wort’s Causeway, Cambridge, CB1 8RN, UK, Tel: +44 (0)1223 740567, <email>gm7@sanger.ac.uk</email>
; Manjinder S Sandhu, International Health Research Group, Dept of Public Health & Primary Care University of Cambridge, Strangeways Research Laboratory, Wort’s Causeway, Cambridge, CB1 8RN, UK, Tel: +44 (0)1223 740567, <email>ms23@sanger.ac.uk</email>
</corresp>
<fn id="FN1"><label>†</label>
<p id="P1">These authors jointly directed this work</p>
</fn>
</author-notes>
<pub-date pub-type="nihms-submitted"><day>12</day>
<month>11</month>
<year>2014</year>
</pub-date>
<pub-date pub-type="epub"><day>04</day>
<month>11</month>
<year>2013</year>
</pub-date>
<pub-date pub-type="ppub"><month>12</month>
<year>2013</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>18</day>
<month>11</month>
<year>2014</year>
</pub-date>
<volume>42</volume>
<issue>6</issue>
<fpage>1740</fpage>
<lpage>1753</lpage>
<pmc-comment>elocation-id from pubmed: 10.1093/ije/dyt184</pmc-comment>
<abstract><sec id="S1"><title>Background</title>
<p id="P2">Non-communicable diseases (NCDs) are rapidly becoming leading causes of morbidity and mortality in low and middle-income countries, including those in sub-Saharan Africa. By contrast to high-income countries, the sociodemographic distribution, including socioeconomic inequalities, of NCDs and their risk factors is unclear in sub-Saharan Africa, particularly among rural populations.</p>
</sec>
<sec id="S2"><title>Methods</title>
<p id="P3">We undertook a cross-sectional population-based survey of 7809 residents 13 years or older in the General Population Cohort in south-western rural Uganda. Information on behavioural, physiological, and biochemical risk factors was obtained using standardised methods as recommended by the WHO STEPwise Approach to Surveillance. Socioeconomic status (SES) was determined by principal component analysis including household features, ownership, and occupation and education of the head of household.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P4">SES was found to be associated with NCD risk factors in this rural population. Smoking, alcohol consumption (men only), and low HDL-cholesterol were more common among those of lower SES. For example, the prevalence of smoking decreased fourfold from the lowest to highest SES groups, from 22.0% to 5.7% for men and 2.2% to 0.4% for women. By contrast, overweight, raised blood pressure, raised HbA1c (women only), and raised cholesterol were more common among those of higher SES. For example the prevalence of overweight increased fivefold from 2.1% to 10.1% for men and twofold from 12.0% to 23.4% for women from the lowest to highest SES groups. However, neither low physical activity nor fruit, vegetable, or staples consumption was associated with SES. Furthermore, associations between NCD risk factors and SES were modified by age and sex.</p>
</sec>
<sec id="S4"><title>Conclusions</title>
<p id="P5">Within this rural population NCD risk factors are common and vary both inversely and positively across the socioeconomic status gradient. A better understanding of the determinants of the sociodemographic distribution of NCDs and their risk factors in rural sub-Saharan African populations will help identify populations at most risk of developing NCDs and help plan interventions to reduce their burden.</p>
</sec>
</abstract>
<kwd-group><title>Medical Subject Headings</title>
<kwd>epidemiology</kwd>
<kwd>public health</kwd>
<kwd>sub-Saharan Africa</kwd>
<kwd>Africa</kwd>
<kwd>Uganda</kwd>
<kwd>sociodemographic</kwd>
<kwd>socioeconomic status</kwd>
<kwd>non-communicable diseases</kwd>
<kwd>NCDs</kwd>
<kwd>chronic diseases</kwd>
<kwd>risk factors</kwd>
<kwd>epidemiological transition</kwd>
</kwd-group>
</article-meta>
</front>
</pmc>
</record>
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