E. Seekoe

Social epidemiology of hypertension in Buffalo City Metropolitan Municipality (BCMM): cross-sectional study of determinants of prevalence, awareness, treatment and control among South African adults

Objectives This study examined hypertension prevalence, awareness, treatment and control and their determinants among adults attending health facilities in Buffalo City Metropolitan Municipality (BCMM) in the Eastern Cape. Design A cross-sectional analytical study. Settings The three largest outpatient clinics in BCMM. Participants Ambulatory adults (aged 18 years and over) attending the study settings during the study period (n=998). Primary outcome measure The prevalence of hypertension (systolic blood pressure (BP) of ≥140 mm Hg and/or a diastolic BP of ≥90 mm Hg or current medication for hypertension), the awareness of it (prior diagnosis of it) and its treatment and control (Eighth Joint National Committee Criteria of BP <140/90/90 mm Hg). Secondary outcome measure Associated factors of hypertension, hypertension unawareness and uncontrolled hypertension. Results Of the 998 participants included, the prevalence of hypertension was 49.2%. Hypertension unawareness was reported by 152 participants (23.1%) with significant gender difference (p=0.005). Male sex, age <45 years, higher level of education, single status, current employment, higher monthly income, current smoking, alcohol usage, absence of diabetes and non-obese were significantly associated (p<0.05) with hypertension unawareness. Of the participants who were aware of having hypertension (n=339), nearly all (91.7%, n=311) were on antihypertensive medication and only 121 participants (38.9%) achieved the BP treatment target. In the multivariate logistic regression model analysis, ageing (95% CI 1.9 to 4.4), being married (95% CI 1.0 to 2.0), male sex (95% CI 1.2 to 2.3), concomitant diabetes (95% CI 1.9 to 3.9), lower monthly income (95% CI 1.2 to 2.2), being unemployed (95% CI 1.0 to 1.9) and central obesity (95% CI 1.5 to 2.8) were the significant and independent determinants of prevalent hypertension. Conclusion The prevalence and awareness of hypertension was high in the study population. In addition, the suboptimal control of BP among treated individuals, as well as the significant cardiovascular risk factors, warrant the attention of health authorities of BCMM and the country.

Prevalence and Correlates of Metabolic Syndrome Among Adults Attending Healthcare Facilities in Eastern Cape, South Africa

RESEARCH ARTICLE Prevalence and Correlates of Metabolic Syndrome Among Adults Attending Healthcare Facilities in Eastern Cape, South Africa Eyitayo Omolara Owolabi, Daniel Ter Goon, Oladele Vincent Adeniyi, Aanuoluwa O. Adedokun and Eunice Seekoe Department of Nursing Science, Faculty of Health Sciences, University of Fort Hare, East London, South Africa Department of Family Medicine, Faculty of Health Sciences, Walter Sisulu University, Cecilia Makiwane Hospital, East London Hospital Complex, East London, South Africa

Prevalence and factors associated with tobacco use among adults attending selected healthcare facilities in Buffalo City Metropolitan Municipality, South Africa

Aim: Tobacco use increases the risk of cardiovascular disease, premature death and certain cancers. This study investigated the prevalence and determinants of tobacco use among adults in Buffalo City Metropolitan Municipality (BCMM), South Africa. Methods: This study forms part of the cardio-metabolic risk survey carried out at the three largest outpatient clinics in BCMM. This multi-centre cross-sectional survey utilised the relevant items of the WHO STEPwise questionnaire to obtain information on demographic and behavioural characteristics of 1 107 participants. A total of 109 participants were excluded as a result of incomplete data. Thus, 998 participants (male = 327; female = 671) were included in the analysis. Self-reported, current use of any tobacco product was defined as tobacco use while secondary smoking was defined as exposure of non-smokers to environmental tobacco smoke, either at home or in the workplace. Results: Of all the study participants, 150 (15%) were current tobacco users and 335 (39.5%) of the non-smoking participants were exposed to secondary smoking. The majority of the tobacco users were males (70.7%) compared with females (29.3%). The commonest form of tobacco use was the manufactured cigarette. The mean age at initiation of smoking was 18.3 ± 5.1 and 22.6 ± 8.0 years for men and women, respectively. Only male sex (p = 0.000), single status (p = 0.003), no formal education (p = 0.007) and self-employment (p = 0.043) were significantly associated with tobacco use. Conclusion: High prevalence of tobacco use, especially cigarette smoking, in BCMM is worrisome given its strong association with cardiovascular events and cancers. The district health authorities should prioritise smoking cessation measures at the primary health care level.

Prevalence and factors associated with abdominal obesity among primary health care professional nurses in Eastern Cape, South Africa

Background: Nurses are key stakeholders in health promotion and obesity management, yet a high-risk group for obesity development. This study examined the prevalence and correlates of abdominal obesity among primary health care professional nurses (PHCPNs) in Eastern Cape, South Africa. Methods: This cross-sectional study involved 203 PHCPNs conveniently selected across 41 primary health care facilities in Eastern Cape, South Africa. The WHO STEPwise questionnaire was used for data collection. Abdominal obesity was defined according to the WHO criteria as a waist circumference ≥ 94 cm for men and ≥ 80 cm for women or waist-to-hip ratio ≥ 0.90 in men and ≥ 0.85 in women; and a waist-to-height ratio of > 0.50. Results: The prevalence of abdominal obesity ranged from 50%, to 87% to 90%, using waist-to-hip ratio, waist circumference and waist-to-height ratio, respectively. Age, gender and duration of practice were significantly associated with abdominal obesity. After adjusting for potential confounders, only age > 30 years (OR = 6.7; 95% CI = 2.4–18.7; p < 0.001) and female sex (AOR = 7.9; 95% CI = 2.4–18.7; p < 0.001) were independent predictors of obesity. Conclusion: There is a high prevalence of abdominal obesity among PHCPNs in Eastern Cape, South Africa, which was associated with female sex and ageing. This constitutes a potential risk for the healthcare workforce of the province and might be an impediment to adequate conveyance to patients of health education on healthy weight management by the affected nurses. There is an urgent need for appropriate workplace health policies targeted towards the promotion of physical activities, healthy lifestyle and ultimately weight reduction among this group.

Adult binge drinking: rate, frequency and intensity in Buffalo City Metropolitan Municipality, South Africa

Abstract Background: Binge drinking (BD) is a significant risk factor for several acute and chronic illnesses, including injuries. This study examines the rate, frequency and intensity of BD in Buffalo City Metropolitan Municipality (BCMM), South Africa. Methods: This was a cross-sectional survey of 998 adults attending the three largest outpatient clinics in BCMM. Rate, frequency and intensity of BD were assessed using the WHO STEPwise questionnaire. Descriptive and inferential statistics were carried out to determine the rate and determinants of binge drinking. Results: The overall rate of BD was 15.0%. Frequency and intensity of BD were 5.4 episodes per month and 13.4 drinks on one occasion, respectively. The study data showed that BD was commoner in males than females (24.0% vs. 10.8%). Smokers engage more in BD than non-smokers (44.0% vs. 9.9%). In the analysis of socio-demographic variables, BD was commonest among students, age group 18–25 years, those never married and those on incomes between 2001 and 5000 Rand per month. In the multivariate logistic regression, after adjusting for confounders, only age less than 25 years (p < 0.001) and male gender (p < 0.001) were significant predictors of binge drinking. Also, male gender (p = 0.002) was significantly associated with frequency of BD. There was no significant gender variation in the intensity of BD. Only age and smoking were significantly associated with the intensity of BD. Conclusion: The rate of binge drinking was high among the study participants, and those who binge drink tend to do so frequently and at a high intensity. Women who binge drink also do so at a high intensity. There is a need for sensitisation campaigns and health advocacy talks on the dangers associated with binge drinking among young adults in this setting.

Attitude To, and Knowledge and Practice of Family Planning Among Women of Child-Bearing Age Attending Selected Hospitals in Osogbo, Nigeria

Unplanned child birth generates serious health and financial problems for families, and results in a population explosion in the presence of inadequate infrastructure. In spite of the various awareness creation campaigns on family planning, many women are still ignorant of its importance; some believe that children are gifts from God and women should bear children without any restrictions. This study therefore sought to assess the knowledge, attitude and practice of family planning among women of child-bearing age attending selected hospitals in Osogbo, Osun State, Nigeria. A structured questionnaire was administered to 200 purposively selected women of child-bearing age attending the two largest infant welfare clinics in Osogbo. The mean age of the participants was 26.23 (SD ± 1.23) years. The majority (170; 85%) were married, had 3-4 children (114; 57%) and were Muslim (118; 59%). Most (130; 65%) of the participants had secondary level education. Almost all the participants (194; 97%) were knowledgeable about family planning and contraception and all of them practised it. About 70% of the women had a good attitude to family planning. There was a significant relationship between education qualification (p < 0.000) and parity (p < 0.000) and women’s attitude to family planning. Likewise, there was a significant relationship between the family planning knowledge of women of child-bearing age as well as their practice of family planning (p < 0.000). The study showed that these women in the selected hospitals had good knowledge of and attitudes to family planning and applied good practices.