lydia kaduka (phd) centre for public health research kenya medical research institute
TRANSCRIPT
Lydia Kaduka (PhD)Centre for Public Health ResearchKenya Medical Research Institute
In Kenya, NCD accounts for >50% of total hospital admissions and over 55% of hospital deaths (MOH SP, 2014)
Overall, CVDs, diabetes, cancer and chronic lung disease contribute to over two thirds of morbidity & mortality from NCDs in Kenya (WHO 2010).
Leading CVDs RFs◦ Conventional - high blood pressure, dyslipideamia, tobacco and alcohol use,
physical inactivity, obesity, unhealthy diets and raised blood glucose◦ Novel – homocysteine, CRP
Obesity - associated with CVDs, diabetes and cancers → ↑risk of premature death and disabilities → reduced quality of life.
(Narkiewicz, 2006)
To assess the relationship between obesity and conventional and novel metabolic risk markers in an urban population in Kenya
Study site – Kibra and Karen Constituency of Nairobi County – hosts all the five SEC (Upper, Lower Upper, Middle, Lower Middle and Lower class).
Study design: Cross sectional design based on a three-stage cluster sampling methodology – selection of clusters, households and respondents.
Sample size – 536 (Fisher et al., 1983)
Sampling – 30 clusters sampled using the systematic Probability Proportional to Size (PPS) sampling method
Inclusion – adults aged >18yrs, absence of debilitating disease, residence>2years
Kibra and Karen Constituencies
Upper Upper Middle Middle Upper Lower Lower
Quick Count of EA
Select one Segment
Identify Eligible Respondents
Select one Respondent from the Eligibles per Household
Interview and testing
Sampling Procedure
Socio-economic and demographic assessments
Anthropometric assessments – weight, height (BMI), WC
Clinical examination- blood pressure
Biochemical assessments – fasting blood glucose, lipid profile, homocysteine and CRP
Permission – Ethical (KEMRI SERU) and informed consent
Total n = 539 (m: 50.5%; w: 49.5%); mean age 38.09 + 13.4 years.
Prevalence of overweight (BMI 25.0-29.99) ◦ m: 29.6%; w: 5.9%
Prevalence of obesity (BMI>30) ◦ m: 30.3%; w: 27.3%
Men Women
Increased blood pressure
P=0.003 P=0.010
Fasting blood glucose P<0.001 P=0.010
C-reactive protein P>0.05 P=0.002
Homocysteine P>0.05 P=0.003
Total cholesterol P=0.002 P>0.05
LDLC P<0.001 P=0.003
HDLC P<0.001 P<0.001
TAG P<0.001 P<0.001
SES P<0.001 P>0.05
Increasing age P<0.001 P<0.001
Men(WC>95cm)
WomenWC (80cm)
Increased blood pressure
P<0.001 P=0.010
Fasting blood glucose P<0.001 P=0.036
C-reactive protein P>0.05 P=0.032
Homocysteine P=0.021 P=0.025
Total cholesterol P<0.001 p= 0.004
LDLC P<0.001 P<0.001
HDLC P<0.001 P=0.002
TAG P<0.001 P<0.001
SES P<0.001 P>0.05
Increasing age P<0.001 P<0.001
Prevalence of CVD risk factors is high - consequence of components associated with urbanization
Components • More than an economic issue• Changes in lifestyle related factors, living conditions,
social structures etc, associated with and induced by urbanization as probable contributing factors
• Accelerated effects of cultural and behavioral shifts in transitional societies
Lifestyle management focusing on diet and physical activity.
Gender disparities → Patient-physician discussions of individual risks are paramount
Simple measures should be adapted as clinical components in the routine assessment and management of metabolic and cardiovascular risks
Risk factors operate in continuum - follow up longitudinal studies and prospective validation of the risk factors.
KEMRI
Kenya National Bureau of Statistics
Administration-Karen and Kibra Constituencies
University of Southampton
Coca-Cola Company