A.M. Adebayo, O.K. Ige, O.S. Ilesanmi, T.B. Ogunniyan, and T. Ojo
Department of Community Medicine, University College Hospital, Ibadan.
Abstract
Background: Currently, population based medical check up is yet to be explored as a veritable tool for assessing the burden of non-communicable diseases in Nigeria.
Objectives: This study aimed to assess the prevalence of selected lifestyle related diseases during a free medical rally in an urban community.
Methods: General medical examinations of all participants at a free medical rally in a middle class community in Ibadan, Oyo State was conducted. Body Mass Index (BMI), blood pressure and random blood sugar measurements were done using standardised instruments. BMI classification for children was done using the CDC guidelines for males and females aged 2-20 years.
Results: Of the 302 participants examined, 33.1% were males and 32.1% were less than 18 years. Of those aged 2 to 20 years, 22.9% were underweight, while 5.2% were overweight/ obese. In adults 3.6% were underweight and 43.2% were overweight/ obese. Adults were significantly more likely to be overweight/obese (P<0.001). Prevalence of high blood pressure was 29.3% and 9.4% of adults had elevated random blood glucose levels. A higher proportion of obese people (P=0.259), males (P= 0.327) and those older than 40 years (P<0.001) had elevated blood pressure. A weak correlation (spearman rho= 0.3) was found between blood pressure and BMI (P<0.001) and also between BMI and blood sugar level (spearman rho= 0.2) P=0.05.
Conclusion: There is a need for greater emphasis on community based screening programmes to aid early diagnosis and treatment of non communicable diseases in the country.
Correspondence:
Dr O.K Ige
Department of Community Medicine,
University College Hospital,
Ibadan.
E-mail: drsimbo@yahoo.co.uk
Introduction
Non-communicable diseases (NCD) are a major health burden in the industrialized countries, and are increasing rapidly in the developing countries owing to demographic transitions and changing lifestyles.1 Although these lifestyle diseases have become important threats to the health of adults in sub-Saharan Africa, efforts to detect these diseases are haphazard and prevention targets are largely inexistent.2
Most people tend to take good health for granted. It is a known fact that almost every major ailment first manifests itself as minor symptoms, which are often not noticed and hence, neglected. As such, proper preventive health check- ups are necessary for early detection and diagnoses of these health conditions.3 Carefully planned screening programmes are an important component of the strategy to help solve this problem. A major role of community-based projects is to demonstrate and stimulate a national NCD prevention policy. However one of the first, essential elements for a successful community intervention programme is a good understanding of the prevalent health problems.2
There have been arguments for and against most community based screening programmes especially about their effectiveness in detecting disease.4 However generally the consensus is that usually by the time most NCD are clinically obvious, all therapeutic endeavours and changes in habits will, at best, produce only slight improvement in the prognosis. 3 It is therefore imperative that our efforts should be directed increasingly towards the prevention rather than the cure of the NCD processes. This can be done only by increasing public awareness of the multiple risk factors involved and, in addition, screening communities in an attempt to identify individuals who are particularly at risk. This study therefore aimed to assess the prevalence of selected lifestyle related diseases in an urban community in Ibadan.
MATERIALS AND METHODS
This was a cross sectional survey conducted at Mokola, a lower class urban community in Ibadan North local government area, Oyo State. Ibadan is the capital of Oyo State, south west Nigeria. The findings obtained from the general medical examinations of all the 302 participants at a free medical rally were documented. An initial awareness campaign was conducted to sensitise the community about the medical rally. Participants included adults and children who were serially recruited as they came to the medical rally following the local publicity.
Weight, height, blood pressure and random blood sugar measurements were carried out using standardised instruments. A stadiometer was used to measure height with the respondent standing upright without shoes and against the wall, feet together and gazing forward. Height was measured to the nearest 0.5 cm. Weight was measured with a manual Seca 761 scale (Vogel & Halke, Germany) which was calibrated to zero each time weight was measured. Blood pressure for adults was measured in a sitting position using an Accoson sphygmomanometer and random blood sugar levels with Accucheck glucometer.
Hypertension was defined according to the JNC 7 criteria5 as average blood pressure of >140/90 mm Hg after two readings. Body mass index (BMI) was calculated as weight (kg)/height (m2). For adults BMI was categorised thus: underweight as BMI < 18,normal weight as BMI 18-24, overweight as BMI 25-29 and obesity as BMI > 30. BMI classification for children was done using the CDC guidelines for males and females aged 2-18 years. Underweight as <5th percentile, normal weight 5th percentile to less than the 85th percentile, overweight as 85th to less than the 95th percentile and obese as equal to or greater than the 95th percentile.6 WHO diagnostic criteria (1999) was used as the cut-off for diabetes i.e. random plasma glucose > 11.1 mmol/L (200 mg/dL). Data were analyzed using SPSS version 15. Associations were explored with the Chi-square test at 5% level of significance.