Sodium, potassium food intake and global cardiovascular risks in Togo.

Objectives: To assess urinary sodium/potassium intake and identify its links with global cardiovascular risk (GCVR) according to the WHOPEN approach to WHO/ISH (International High Blood Pressure Society). Methods: It was a cross-sectional and analytical study that took place from July 6, 2020, to September 17, 2021, in Togo, in the Aneho, Notse and Dapaong localities. It focused on 400 adults selected by sampling. The analysis of two urine samples was done. Cardiovascular risk scores were determined from specific graphs that take into account age, gender, systolic blood pressure, diabetes status, and smoking behavior. Results: Among the 400 respondents, 49% lived in rural areas. The average age was 41 (30; 51) years. The average sodium and potassium intakes were respectively 3.2 g (1.04-5.99) or 7.95 g of salt and 1.4 g (1.89-5.62) per day. The risk of excessive sodium intake was 2.39 times higher in urban areas than in rural ones (P=0.049). Residing in rural areas was associated with high potassium intakes compared to urban ones [OR=3,2 IC (1.89-5.62)]. Thirteen percent (13%) of respondents were likely to develop at least a deadly or non-deadly cardiovascular disease in the next 10 years 'time, of whom 5% present a high risk. Excessive sodium intake increases by 2.10 times the risk of a deadly cardiovascular disease occurrence. Conclusions: Sodium intakes are high while potassium intakes are low with a subsequent GCVR in the three cities. Sodium intakes were associated with GCVR. It is necessary to take steps to reduce excessive sodium intake and improve potassium intake.

Sodium, potassium food intake and global cardiovascular risks in Togo

Objectives. To assess urinary sodium/potassium intake and identify its links with global cardiovascular risk (RCVG) according to the WHOPEN approach to WHO/ISH (International High Blood Pressure Society). Methods. It was a cross-sectional and analytical study that took place from July 6, 2020, to September 17, 2021, in Togo, in the Aneho, Notse and Dapaong localities. It focused on 400 adults selected by sampling. The analysis of two urine samples was done. Cardiovascular risk scores were determined from specific graphs that take into account age, gender, systolic blood pressure, diabetes status and smoking behavior. Results. Among the 400 respondents, 49% lived in rural areas. The average age was 41 (30; 51) years. The average sodium and potassium intakes were respectively 3.2 g (1.04-5.99) or 7.95 g of salt and 1.4 g (1.89-5.62) per day. The risk of excessive sodium intake was 2.39 times higher in urban areas than in rural ones (p=0.049). Residing in rural areas was associated with high potassium intakes compared to urban ones (OR=3,2 IC [1.89-5.62]). Thirteen percent (13%) of respondents were likely to develop at least a deadly or non-deadly cardiovascular disease in the next 10 years 'time, of whom 5% present a high risk. Excessive sodium intake increases by 2.10 times the risk of a deadly cardiovascular disease occurrence. Conclusions. Sodium intakes are high while potassium intakes are low with a subsequent global cardiovascular risk (GCVR) in the three cities. Sodium intakes were associated with VCVR. It is necessary to take steps to reduce excessive sodium intake and improve potassium intake.

Assessment of the nutritional status and dietary intake of women of childbearing age in the city of Comè, Benin.

Introduction: over nutrition and undernutrition problems affect many women of childbearing age in Benin. The inadequacy of the diet is the major reason. The objective of this study is to assess their nutritional status and diet in Comè, a city with the highest proportions of adverse neonatal outcomes in the Mono regional department of Benin in 2015. Methods: data were collected in June 2017 in a cross-sectional survey with a two-stage random sampling of non-pregnant or lactating women aged 15-49 years. Their sociodemographic characteristics, diet and nutritional status were reported and explored through descriptive and bivariate analysis. Results: the prevalence of underweight was 9.5% and overweight (overweight and obese) was 31.7%. The dietary diversity score was low for 47.9% of them. Compared to the Recommended Dietary Allowances, the energy and protein intakes were insufficient for 78.7% and 11.8% respectively. None of them had an energy-balanced diet according to the energy distribution between macronutrients after normalization of intakes. The contribution of carbohydrates was high in 99.1%, low in 96.2% for fats and adequate in 60.2% for proteins. Conclusion: these results reiterate the importance of developing nutritional interventions to improve the nutritional status and the diet of women of childbearing age in Benin. Periodically national food surveys must be conducted to evaluate their real nutritional intakes and promote better nutrition.

[Evaluation of the performance of the logistics management system of malaria control resources in the Littoral Department, Benin, in 2017]. / Evaluation de la performance du système de gestion logistique des intrants de lutte contre le paludisme dans le Département du Littoral, au Bénin, en 2017.

INTRODUCTION: This study aimed to evaluate the performance of the logistics management system (LMS) of malaria control (MC) resources in the Littoral Department, Benin, in 2017. METHODS: In June 2017, we conducted a cross-sectional evaluative study focusing on the structures for the storage and the disposal of MC resources as well as on staff involved in their management. The performance of the the logistics management system was evaluated on the basis of the observed compliance of the components and sub-components of the "Structure", the "Process" and the "Results" with the norms and standards defined by the Ministry of Health. RESULTS: A total of 36 structures were investigated and secondary target was surveyed. It followed that 52,78% of the structures for the storage and the disposal of MC resources met the requirements for resources storage while only 33.33% of MC resources management staff were trained in logistics management. The performance of the logistics management system of MC resources was inadequate (compliance 59,13 % compared to the expected score). The structure, as well as the process were non-compliant with the standards ( 60,20% and 73.22% compared to the expected score respectively), leading to negative results (41.53% compared to the expected score). The most inadequate sub-component was the logistics management information system (LMIS). CONCLUSION: This study highlights the role of LMS for better performance of MC resources management. Particular attention should be given to this component.

[Factors associated with the strength of organizational culture in a Beninese hospital]. / Facteurs associés à la force de la culture organisationnelle dans un hôpital du Bénin.

INTRODUCTION: Organizational culture, a frequently ignored concept, affects job satisfaction and productivity in organizations. OBJECTIVE: To determine the factors associated with the strength of organizational culture (OC) in Mono / Couffo regional hospital in Lokossa in Benin. METHODS: This cross-sectional and analytical study involved 121 workers of Mono/Couffo hospital in March 2015. Data on the strength of OC was collected using a questionnaire based on the validated tool proposed by Cameron and Quinn (2006). Logistic regression was performed to explore the nature of the relationship between the independent variables and OC using Odds ratios. RESULTS: 62% of the surveyed subjects had a positive perception of organizational culture. This perception was statistically associated with managerial factors (moral support of workers and type of relationship with the executive staff). The risk of perceiving a low strength of OC was sixfold higher OR = 3.78, 95% CI (1.08 - 13.22) among subjects who felt they did not have moral support from executive staff than in those who perceived this moral support. The risk of perceiving a weak OC was higher among subjects who considered relations with the staff to be uncordial [OR = 14.32, 95% CI (4.35 - 47.11)] compared to those who considered these relations to be cordial. CONCLUSION: Human resource management factors were more closely associated with the strength of organizational culture. Hospital managers should pay more attention to these factors in their hospitals to promote better institutional performance.

Evaluation of the international standardized 24-h dietary recall methodology (GloboDiet) for potential application in research and surveillance within African settings.

BACKGROUND: Collection of reliable and comparable individual food consumption data is of primary importance to better understand, control and monitor malnutrition and its related comorbidities in low- and middle-income countries (LMICs), including in Africa. The lack of standardised dietary tools and their related research support infrastructure remains a major obstacle to implement concerted and region-specific research and action plans worldwide. Citing the magnitude and importance of this challenge, the International Agency for Research on Cancer (IARC/WHO) launched the "Global Nutrition Surveillance initiative" to pilot test the use of a standardized 24-h dietary recall research tool (GloboDiet), validated in Europe, in other regions. In this regard, the development of the GloboDiet-Africa can be optimised by better understanding of the local specific methodological needs, barriers and opportunities. The study aimed to evaluate the standardized 24-h dietary recall research tool (GloboDiet) as a possible common methodology for research and surveillance across Africa. METHODS: A consultative panel of African and international experts in dietary assessment participated in six e-workshop sessions. They completed an in-depth e-questionnaire to evaluate the GloboDiet dietary methodology before and after participating in the e-workshop. RESULTS: The 29 experts expressed their satisfaction on the potential of the software to address local specific needs when evaluating the main structure of the software, the stepwise approach for data collection and standardisation concept. Nevertheless, additional information to better describe local foods and recipes, as well as particular culinary patterns (e.g. mortar pounding), were proposed. Furthermore, food quantification in shared-plates and -bowls eating situations and interviewing of populations with low literacy skills, especially in rural settings, were acknowledged as requiring further specific considerations and appropriate solutions. CONCLUSIONS: An overall positive evaluation of the GloboDiet methodology by both African and international experts, supports the flexibility and potential applicability of this tool in diverse African settings and sets a positive platform for improved dietary monitoring and surveillance. Following this evaluation, prerequisite for future implementation and/or adaptation of GloboDiet in Africa, rigorous and robust capacity building as well as knowledge transfer will be required to roadmap a stepwise approach to implement this methodology across pilot African countries/regions.

Factors associated with post-cesarean stillbirth in 12 hospitals in Benin: a cross-sectional.

INTRODUCTION: In spite of free caesarean section applied in Benin since 2009, high rates of stillborn babies continue to be recorded. This study aimed to determine the factors associated with post-caesarean stillborn in Benin. METHODS: Cross-sectional study that covered all women who have delivered by caesarean from December 2013 to February 2014 in twelve hospitals chosen by simple random selection in each of the twelve departments of Benin. Data collected by chart review have been analyzed using the statistical software Epi info 3.5.1. Univariate analysis and multivariable logistic regression were used to identify factors associated with post-caesarean stillbirth at the significance threshold of 5%. RESULTS: There were 66 stillborn per 1,000 births of which 58% died before admission to hospital. The risk factors identified were the reference (p = 0.0011), general anesthesia (p = 0.0371), the low birth weight (p = 0.0001), the retro-placental hematoma (p = 0.0083), and the umbilical cord prolapse (p = 0.0229). Acute fetal distress (p = 0.0308) and anesthesia administered by an anesthetist nurse or midwife (p = 0.0337) were protective factors. CONCLUSION: The majority of cases, in utero death occurred before admission to hospital. Strengthening antenatal refocused consultation, a better access to quality obstetric care and the grant of all obstetric care could reduce stillbirths from caesarean sections in Benin.

Contribution to the development of a food guide in Benin: linear programming for the optimization of local diets.

OBJECTIVE: Food guides are important tools for nutrition education. While developing a food guide in Benin, the objective was to determine the daily number of servings per food group and the portion sizes of common foods to be recommended. DESIGN: Linear programming (LP) was used to determine, for each predefined food group, the optimal number and size of servings of commonly consumed foods. Two types of constraints were introduced into the LP models: (i) WHO/FAO Recommended Nutrient Intakes and dietary guidelines for the prevention of chronic diseases; and (ii) dietary patterns based on local food consumption data recently collected in southern Benin in 541 adults. Dietary intakes of the upper tertile of participants for diet quality based on prevention and micronutrient adequacy scores were used in the LP algorithms. SETTING: Southern area of the Republic of Benin. SUBJECTS: Local key-players in nutrition (n 30) from the government, academic institutions, international organizations and civil society were partners in the development of the food guide directed at the population. RESULTS: The number of servings per food group and the portion size for eight age-sex groups were determined. For four limiting micronutrients (Fe, Ca, folate and Zn), local diets could be optimized to meet only 70 % of the Recommended Nutrient Intakes, not 100 %. CONCLUSIONS: It was possible to determine the daily number of servings and the portion sizes of common foods that can be recommended in Benin with the help of LP to optimize local diets, although Recommended Nutrient Intakes were not fully met for a few critical micronutrients.

Pilot project of the Nutrition-Friendly School Initiative (NFSI) in Ouagadougou, Burkina Faso and Cotonou, Benin, in West Africa.

This paper describes the first African experience with the Nutrition-Friendly School Initiative (NFSI) in two large West African cities: Ouagadougou, Burkina Faso and Cotonou, Benin. NFSI was launched by the World Health Organization (WHO) and its partners in 2006, as a means of preventing the double burden of malnutrition: the coexistence of undernutrition and overnutrition among school-children. NFSI pilot-testing is one component of the Partnership Project on the Double Burden of Malnutrition, funded by the Canadian International Development Agency for 6 years (2008-2014). The Project assisted the government in the selection of pilot schools, fostered the installation of health and nutrition committees in selected schools, and helped with the initial school self-assessments. In accordance with the empowering philosophy of health promotion, pilot schools did not follow a pre-defined schedule of interventions, except for the training of teachers in nutrition education and the nutritional (anthropometric) surveillance of schoolchildren. For the latter activities, technical assistance and seminal funds were provided. Yearly planning workshops were held for school committees, with WHO support. In both settings, training was given to street vendors in order to improve the hygiene and nutritional value of food sold to schoolchildren. Other activities included special nutrition events and sanitation measures. In both cities, NFSI showed promising results in terms of school and community mobilization towards improved nutrition and health; however, NFSI must be better understood as an endogenous and self-sustaining approach. Furthermore, household poverty and scarce school resources appear as major barriers to gaining full impact of NFSI in low-income populations.

Lifestyle and dietary factors associated with the evolution of cardiometabolic risk over four years in West-African adults: the Benin study.

AIM: To assess in adults from Benin changes in cardiometabolic risk (CMR) using both the Framingham risk score (FRS) and metabolic syndrome (MetS) and to examine the effects of diet, and lifestyles, controlling for location and socioeconomic status. METHODS: Apparently healthy subjects (n = 541) aged 25-60 years and randomly selected in the largest city, a small town, and rural areas were included in the four-year longitudinal study. Along with CMR factors, socioeconomic, diet and lifestyle data were collected in individual interviews. A food score based on consumption frequency of four "sentinel" food groups (meat and poultry, dairy, eggs, and vegetables) was developed. Lifestyle included physical activity, alcohol and tobacco use. Education and income (proxy) were the socioeconomic variables. RESULTS: Among the subjects with four-year follow-up data (n = 416), 13.5% were at risk at baseline, showing MetS or FRS ≥ 10%. The incidence of MetS and FRS ≥ 10% during follow-up was 8.2% and 5%, respectively. CMR deteriorated in 21% of subjects. Diet and lifestyle mediated location and income effects on CMR evolution. Low food scores and inactivity increased the likelihood of CMR deterioration. CONCLUSION: Combining MetS and FRS might be appropriate for surveillance purposes in order to better capture CMR and inform preventive measures.

Insulin resistance status and four-year changes in other cardiometabolic risk factors in West-African adults: the Benin study.

BACKGROUND: The association of insulin resistance (IR) with other cardiometabolic risk (CMR) factors in sub-Saharan Africans is poorly documented. This study examined the links between IR and the evolution of blood pressure (BP), glycaemia, serum lipids and abdominal obesity in the population of Benin. DESIGN: Population-based longitudinal study. METHODS: This study initially included 541 apparently healthy Beninese adults (50% women) aged 25-60 years who were randomly selected in a large city, a small town and a rural area. After a baseline survey, our subjects were followed up after 2 years, and again at 4 years. IR based on homeostasis model assessment (HOMA), blood glucose, BP, waist circumference (WC), triglycerides, total cholesterol and HDL-cholesterol were measured. Complete data at the end of the follow-up periods was available for 416 subjects. RESULTS: IR was more prevalent in women than in men (33.2% versus 17.8%) and it was generally associated with more adverse values of CMR factors, excepting BP. In controlling for baseline age, sex, WC, diet, lifestyle variables and WC changes; the relative risk (RR) of hyperglycemia over 4 years was as least 3-fold in IR subjects, compared to normal subjects. The RR of abdominal obesity was 5.3 (1.04-26.93) in IR women, compared to non-IR. The association of IR with the evolution of dyslipidemia was inconsistent, but IR tended to exacerbate low HDL-cholesterol. CONCLUSION: Over 4 years, IR exacerbated hyperglycemia in both men and women, and abdominal obesity in women, but IR did not affect blood pressure. Further research on the link found between IR and dyslipidemia, particularly low HDL-C, is needed in sub-Saharan Africa.

Four-Year Trends in Cardiometabolic Risk Factors according to Baseline Abdominal Obesity Status in West-African Adults: The Benin Study.

The study examined whether abdominal obesity (AO) according to waist circumference was associated with more unfavourable changes in other cardiometabolic risk (CMR) factors in sub-Saharan Africans. The study included 541 randomly selected and apparently healthy subjects (50% women) aged 25-60 years. Complete data at baseline, 24, and 48 months later was available in 366 subjects. AO was associated with higher CMR at baseline and over the follow-up period, except for high blood pressure. A significantly higher incidence of high ratio of total cholesterol : HDL-cholesterol (TC/HDL-C) was associated with AO. Controlling for WC changes, age, baseline diet, and lifestyles, the relative risk (RR) of low HDL-C and high TC/HDL-C was 3.2 (95% CI 1.06-9.61) and 7.4 (95% CI 2.01-25.79), respectively, in AO men; the RR was not significant in women. Over a four-year period, AO therefore appeared associated with an adverse evolution of cholesterolemia in the study population.

Urbanisation, nutrition transition and cardiometabolic risk: the Benin study.

A rising prevalence of CVD and diabetes has been observed in sub-Saharan Africa, particularly in cities. The aim of the present study conducted in Benin was to examine the mediating role of nutrition transition in the relationship of urbanisation level and socio-economic status (SES) to cardiometabolic risk markers. A total of 541 subjects in apparent good health were randomly selected from the main city of Cotonou, a small town and its surrounding rural areas. SES was assessed based on a proxy for income and on education. Dietary intake and physical activity were assessed with at least two non-consecutive 24 h recalls. Scores for micronutrient adequacy and preventive diet were used as indicators of diet quality. Cardiometabolic risk markers were BMI, waist circumference (WC), blood pressure, serum cholesterol and insulin resistance according to homeostasis model assessment. A more advanced stage of nutrition transition, which correlated with lower diet quality scores and less physical activity, was observed in the large city compared with less urbanised locations. More obesity and more adverse cholesterol profiles, but also lower blood pressure, were present in the large city. Urbanisation, income, sedentary lifestyle and alcohol consumption, but not diet quality, independently contributed to higher BMI and WC. Higher micronutrient adequacy was independently associated with a better cholesterol profile. The study confirmed the positive rural-urban gradient in nutrition transition and cardiometabolic risk, except for blood pressure. This risk could be mitigated by a more adequate diet, particularly micronutrient intake, and a more active lifestyle.

Partnership research on nutrition transition and chronic diseases in West Africa - trends, outcomes and impacts.

BACKGROUND: Nutrition-related chronic diseases (NRCD) are rising quickly in developing countries, and the nutrition transition is a major contributor. Low-income countries have not been spared. Health issues related to nutritional deficiencies also persist, creating a double burden of malnutrition (DBM). There is still a major shortage of data on NRCD and DBM in Sub-Saharan Africa. A research program has been designed and conducted in partnership with West African institutions since 2003 to determine how the nutrition transition relates to NRCD and the DBM in order to support prevention efforts. METHODS: In Benin, cross-sectional studies among apparently healthy adults (n=540) from urban, semi-urban and rural areas have examined cardiometabolic risk (hypertension, obesity, dyslipidemia, insulin resistance) in relation to diet and lifestyle, also factoring in socio-economic status (SES). Those studies were followed by a longitudinal study on how risk evolves, opening the way for mutual aid groups to develop a prevention strategy within an action research framework. In Burkina Faso, a cross-sectional study on the nutritional status and dietary patterns of urban school-age children (n=650) represented the initial stages of an action research project to prevent DBM in schools. A cross-sectional study among adults (n=330) from the capital of Burkina Faso explored the coexistence, within these individuals, of cardiometabolic risk factors and nutritional deficiencies (anemia, vitamin A deficiency, chronic energy deficiency), as they relate to diet, lifestyle and SES. RESULTS: The studies have shown that the prevalence of NRCD is high among the poor, thereby exacerbating social inequalities. The hypothesis of a positive socio-economic (and rural-urban) gradient was confirmed only for obesity, whereas the prevalence of hypertension, insulin resistance and dyslipidemia did not prove to be higher among affluent city dwellers. Women were particularly affected by abdominal obesity, at 48% compared to 6% of men. Protective factors against the risk of NRCD were physical activity and adequate micronutrient intake. The research also showed that nutritional deficiencies were not restricted to schoolchildren in rural areas because in the capital of Ouagadougou, for example, 40% of schoolchildren were anaemic and 40% were vitamin A deficient. Partnership research has expanded to include advocacy and human resources training. CONCLUSION: These initial studies on NRCD in West Africa indicate the relevance and urgency of prevention, even among low-income groups and countries. They show that the fight against NRCD as well as nutritional deficiencies should focus on women. Seeing how researchers from the African partner institutions have connections with decision-making authorities, the research findings could have an impact on prevention policies and programs in communities and schools alike. Greater support must nevertheless be provided to lobbying and advocacy work for an even greater impact. As well, the sustainability of the research program remains a challenge that requires resource mobilization and training for the purpose.

[Factors associated with the quality of well water and the prevalence of waterborne diseases in the municipality of Abomey-Calavi in Benin]. / Facteurs associés à la qualité de l'eau de puits et prévalence des maladies hydriques dans la commune d'Abomey-Calavi (Bénin).

The objective of this work is to assess the factors associated with the water quality of household wells, suggest solutions to improve it, and study the prevalence of water-borne diseases in this community. The quality of well water and the prevalence of waterborne diseases in the municipality were studied by analysis of the microbiological indicators currently used to assess drinking-water quality and the retrospective study of waterborne diseases treated in the local health centres. The wells surveyed were contaminated by Escherichia coli, Klebsiella pneumonia, Staphylococcus aureus, Salmonella spp, Clostridium perfringens and fecal streptococci, at prevalences of 12.5, 12.2, 12.2, 12.1, 12 and 11.1%, respectively. The high rates of diarrhea, urinary infections, typhoid fever and abdominal pain found in the retrospective study were consistent with the results of the well-water quality assessment. These results showed that human activity has strongly influenced water quality, especially the lack of sanitation in the different districts and neighbourhoods. Other factors affecting the vulnerability of well water include poor waste management by households, the low depth of the water table, the nature of the soil, and the permeability of the aquifer used. Improvement in water quality, sanitation, and personal hygiene will make it possible to reduce considerably the propagation of these diseases and several others. It is therefore important to provide these populations with the necessary equipment for an adequate drinking water supply, but also to promote health education to avoid water pollution. The search for solutions to these problems will lead to a plan for future action.

[Determinants and relationship of homocysteinemia with cardiometabolic risk factors. A study in Benin, West Africa]. / Homocystéinémie: déterminants et relation avec les facteurs de risque cardiométabolique au Bénin (Afrique de l'Ouest).

INTRODUCTION: Elevated circulating homocysteine (Hcy) is considered as an independent cardiovascular disease risk factor. Hyperhomocysteinaemia (HHcy) is influenced by nutritional, genetic, and environmental factors. The purpose of the study was to assess HHcy prevalence in Benin, its association with intakes of B-vitamins (B2, B6, B9, B12), alcohol intake, and socio-economic status (SES), and its links with other factors of cardio-metabolic risk. METHODS: The cross-sectional study included 541 apparently healthy subjects, aged 25 to 65 years, from three sites: the main city, a small city and a rural area. Hcy was measured with an ELISA test kit. The HHcy cut-off was 12 µmol/L. Dietary intake was assessed with three 24-hour recalls. We used a structured questionnaire to assess alcohol consumption, demographics, and SES according to education and an amenity score as income proxy. Criteria for obesity, hypertension, dyslipidemia and hyperglycemia were primarily those of World Health Organization (WHO) and the International Diabetes Federation. RESULTS: Mean age was 38.1 ± 10.1 years. The prevalence of HHcy was 52.2% in men and 24.7% in women. In multiple linear regression models, Hcy in men was positively associated with alcohol intake, but only alcohol in beer. In women, Hcy was negatively related to vitamin B12 intake. According to multivariate models of cardio-metabolic risk factors, HHcy was associated in women with more than twice the odds of hypertension and with high TC/HDL-c ratio. In men, Hcy was positively and independently associated with diastolic blood pressure and with LDL-cholesterol and total cholesterol in linear regression models. DISCUSSION: The prevalence of HHcy is high in Benin, when compared with other studies, and it was as expected higher in men than in women. Elevated Hcy was associated with inadequate intake of vitamin B12 in women, whereas alcohol consumption and its negative correlation with B12 intake was also involved in men. Although HHcy was independently associated with hypertension (in women) and more adverse cholesterol profile, no inference can be made because of the cross-sectional design of the study.

Validation of the use of historical events to estimate the age of subjects aged 65 years and over in Cotonou (Benin).

BACKGROUND: Our aim was to validate the use of historical events as tools for estimating the age of people > or = 65 years in Cotonou (Benin). METHODS: The survey was conducted in Cotonou, the economic capital of Benin. We included people aged > or = 65 years, with at least a primary education level and an administrative document certifying their date of birth. The historical events were the solar eclipse of 1946 covering the national territory and the date of independence (1st August 1960) of Dahomey (Benin). Agreement between estimated and actual age was assessed by the intraclass correlation coefficient and the Bland and Altman graphical representation. RESULTS: We included 112 subjects. The intraclass correlation coefficient between actual and estimated age by the use of historical landmarks was 0.87 (95% CI = 0.81-0.91), i.e. an excellent concordance. The graph of Bland and Altman did not demonstrate any systematic error of estimation. CONCLUSION: The development of similar tools in other parts of Africa and developing countries may improve the quality of information collected in epidemiological studies and thereby enhance the accuracy of the results of studies conducted on age-related disorders such as dementia.

Abdominal obesity explains the positive rural-urban gradient in the prevalence of the metabolic syndrome in Benin, West Africa.

This cross-sectional study was designed to verify the hypothesis that there is a positive rural-urban gradient in the overall prevalence of the metabolic syndrome (MetS) and its components and that the differences are associated with socioeconomic status, a sedentary lifestyle, and poor diet quality. A sample of 541 Beninese adults apparently healthy was randomly selected from rural (n = 170), semi-urban (n = 171), and urban (n = 200) areas. The MetS was defined according to the International Diabetes Federation. Diet and physical activity were assessed with a 3-day recall. Socioeconomic and additional lifestyle information was obtained during personal interviews. A positive rural-urban gradient (rural to semi-urban to urban) was observed for the overall prevalence of the MetS (4.1%, 6.4%, and 11%, respectively; P = .035), which reflected that of abdominal obesity (28.2%, 41.5%, 52.5%; P < .001) but not for the other prominent features of the MetS, that is, high blood pressure (HBP; 24.1%, 21.6%, and 26.5%; P > .05) and reduced high-density lipoprotein cholesterol (HDL-C; 25.3%, 18.1%, 37.5%; P < .001). Diet quality and physical activity were higher in rural and semi-urban compared to urban subjects. Physical activity appeared protective for obesity, HBP, and low HDL-C. Micronutrient adequacy was an independent predictor of HDL-C and was associated with a lower likelihood of HBP. Socioeconomic status was positively associated with abdominal obesity only, which was more widespread in women than in men. This study shows that the nutrition transition is ongoing in Benin and suggests that cardiovascular disease risk could be reduced substantially by promoting physical activity and a more adequate diet.

Obesity and cardio-metabolic risk factors in urban adults of Benin: relationship with socio-economic status, urbanisation, and lifestyle patterns.

BACKGROUND: There is a dearth of information on diet-related chronic diseases in West Africa. This cross-sectional study assessed the rate of obesity and other cardiovascular disease (CVD) risk factors in a random sample of 200 urban adults in Benin and explored the associations between these factors and socio-economic status (SES), urbanisation as well as lifestyle patterns. METHODS: Anthropometric parameters (height, weight and waist circumference), blood pressure, fasting plasma glucose, and serum lipids (HDL-cholesterol and triglycerides) were measured. WHO cut-offs were used to define CVD risk factors. Food intake and physical activity were assessed with three non-consecutive 24-hour recalls. Information on tobacco use and alcohol consumption was collected using a questionnaire. An overall lifestyle score (OLS) was created based on diet quality, alcohol consumption, smoking, and physical activity. A SES score was computed based on education, main occupation and household amenities (as proxy for income). RESULTS: The most prevalent CVD risk factors were overall obesity (18%), abdominal obesity (32%), hypertension (23%), and low HDL-cholesterol (13%). Diabetes and hypertriglyceridemia were uncommon. The prevalence of overall obesity was roughly four times higher in women than in men (28 vs. 8%). After controlling for age and sex, the odds of obesity increased significantly with SES, while a longer exposure to the urban environment was associated with higher odds of hypertension. Of the single lifestyle factors examined, physical activity was the most strongly associated with several CVD risk factors. Logistic regression analyses revealed that the likelihood of obesity and hypertension decreased significantly as the OLS improved, while controlling for potential confounding factors. CONCLUSION: Our data show that obesity and cardio-metabolic risk factors are highly prevalent among urban adults in Benin, which calls for urgent measures to avert the rise of diet-related chronic diseases. People with higher SES and those with a longer exposure to the urban environment are priority target groups for interventions focusing on environmental risk factors that are amenable to change in this population. Lifestyle interventions would appear appropriate, with particular emphasis on physical activity.