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  • Multiple cardiovascular risk factors in Kenya: evidence from a health and demographic surveillance system using the WHO STEPwise approach to chronic disease risk factor surveillance

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Global burden of cardiovascular disease
Original article
Multiple cardiovascular risk factors in Kenya: evidence from a health and demographic surveillance system using the WHO STEPwise approach to chronic disease risk factor surveillance
  1. Gerald S Bloomfield1,
  2. Ann Mwangi2,
  3. Patrick Chege3,
  4. Chrispinus J Simiyu4,
  5. Daniel F Aswa4,
  6. David Odhiambo4,
  7. Andrew A Obala5,
  8. Paul Ayuo6,
  9. Barasa O Khwa-Otsyula7
  1. 1Division of Cardiology, Duke Clinical Research Institute, Duke University, Durham, North Carolina, USA
  2. 2Department of Behavioral Sciences, School of Medicine, College of Health Sciences, Moi University, Eldoret, Kenya
  3. 3Department of Family Medicine, School of Medicine, College of Health Sciences, Moi University, Eldoret, Kenya
  4. 4Webuye Demographic Surveillance System Project, College of Health Sciences, Moi University, Eldoret, Kenya
  5. 5Department of Medical Microbiology and Parasitology, School of Medicine, College of Health Sciences, Moi University, Eldoret, Kenya
  6. 6Department of Medicine, School of Medicine, College of Health Sciences, Moi University, Eldoret, Kenya
  7. 7Department of Surgery and Anesthesiology, School of Medicine, College of Health Sciences, Moi University, Eldoret, Kenya
  1. Correspondence to Dr Gerald S Bloomfield, Division of Cardiology, Duke Clinical Research Institute, Duke University, 2400 Pratt Street, DUMC Box 3850, Durham, NC 7705, USA; gerald.bloomfield{at}duke.edu

Abstract

Objective To describe the distribution of cardiovascular risk factors in western Kenya using a Health and Demographic Surveillance System (HDSS).

Design Population based survey of residents in an HDSS.

Setting Webuye Division in Bungoma East District, Western Province of Kenya.

Patients 4037 adults ≥18 years of age.

Interventions Home based survey using the WHO STEPwise approach to chronic disease risk factor surveillance.

Main outcome measures Self-report of high blood pressure, high blood sugar, tobacco use, alcohol use, physical activity, and fruit/vegetable intake.

Results The median age of the population was 35 years (IQR 26–50). Less than 6% of the population reported high blood pressure or blood sugar. Tobacco and alcohol use were reported in 7% and 16% of the population, respectively. The majority of the population (93%) was physically active. The average number of days per week that participants reported intake of fruits (3.1 ± 0.1) or vegetables (1.6 ± 0.1) was low. In multiple logistic regression analyses, women were more likely to report a history of high blood pressure (OR 2.72, 95% CI 1.9 to 3.9), less likely to report using tobacco (OR 0.08, 95% CI 0.06 to 0.11), less likely to report alcohol use (OR 0.18, 95% CI 0.15 to 0.21) or eat ≥5 servings per day of fruits or vegetables (OR 0.87, 95% CI 0.76 to 0.99) compared to men.

Conclusions The most common cardiovascular risk factors in peri-urban western Kenya are tobacco use, alcohol use, and inadequate intake of fruits and vegetables. Our data reveal locally relevant subgroup differences that could inform future prevention efforts.

https://doi.org/10.1136/heartjnl-2013-303913

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