Inter-arm difference in systolic blood pressure: Prevalence and associated factors in an African population.

OBJECTIVES: Inter-arm blood pressure difference (IABPD) can lead to underdiagnosis and poor management of hypertension, when not recognized and are associated with increased cardiovascular mortality and morbidity. However, the prevalence and associated risk factors of IABPD in sub-Saharan Africa are unknown. This study aims to determine the prevalence and associated risk factors of IABPD among Tanve Health Study (TAHES) participants, a cohort about cardiovascular diseases in a rural area in Benin. METHODS: The cohort was conducted since 2015 among adults aged 25 years and over in Tanve village. Data were collected from February to March, 2020. Brachial blood pressure were recorded at rest on both arm with an electronic device. Systolic IABPD (sIABPD) was defined as the absolute value of the difference in systolic blood pressure between left and right arms ≥ 10 mmHg. A multivariate logistic regression models identified factors associated with sIABPD. RESULTS: A total of 1,505 participants (women 59%) were included. The mean age was 45.08 ±15.65 years. The prevalence of sIABPD ≥ 10 mmHg was 19% (95%CI: 17-21). It was 19% (95%CI: 16-22) in men and 20% (95%CI: 17-22) in women. In final multivariable model, the probability of sIABPD ≥ 10 mmHg increased significantly with age (adjusted OR (aOR) = 1.1; 95%CI: 1.02-1.20 per 10-years), hypertension (aOR = 2.33; 95%CI: 1.77-3.07) and diabetes (aOR = 1.96; 95%CI: 1.09-3.53). CONCLUSION: Almost quarter of sample have a sIABPD ≥ 10 mmHg, with an increased risk with older age and hypertension and diabetes.

Prevalence of abnormal kidney function in a rural population of Benin and associated risk factors.

BACKGROUND: The global burden of kidney disease has increased in recent years worldwide. Risk factors for kidney disease are common in Africa, but data on their prevalence are lacking. This study aims to determine the prevalence of abnormal kidney function and associated factors among participants included in the TAnve HEalth Study (TAHES) cohort in Benin. METHODS: This was a cross-sectional study nested within the TAHES cohort. It was carried out in 2019, among TAHES participants aged 25 years and above, living in Tanvè and Dékanmè, two villages located in southwestern Benin. Data on risk factors were collected using the World Health Organization's STEPS questionnaire. Anthropometric measurements and capillary creatinine measurements were performed. Abnormal kidney function was defined as a low glomerular filtration rate (< 60 mL/min/1.73 m2). RESULTS: Creatinine was measured among 1360 out of the 1583 participants in the cohort in 2019. The median age was 39 [32-53]. The prevalence of abnormal kidney function was 16.10%; 95%CI = [14.15-18.05]. The results of the multivariate logistic regression showed that the probability of abnormal kidney function increased significantly with age (adjusted OR (aOR) = 2.75; 95%CI = [1.83-4.14]), female gender (aOR = 2; 95%CI = [1.37-2.91]), hypertension (aOR = 1.54; 95%CI = [1.12-2.13]), high body mass index (aOR = 1, 56; 95%CI = [1.12-2.17]) and hyperglycemia (aOR = 2.86; 95%CI = [1.68-4.88]). CONCLUSION: The prevalence of abnormal kidney function was high. These data should guide national authorities and help to raise community awareness of the benefits of early detection of this condition.

Systematic review of observational studies of the impact of cardiovascular risk factors on preeclampsia in sub-saharan Africa.

BACKGROUND: Maternal mortality is a public health issue, particularly in low- and middle-income countries (LMIC). Sub-Saharan Africa (SSA) is the region most affected worldwide by maternal mortality, and preeclampsia is one of the main causes. We performed a systematic review of observational studies to identify the impact of cardiovascular risk factors on preeclampsia in SSA with a more representative sample. METHODS: Databases: PubMed and Google Scholar were searched to identify published studies. Studies were included if they reported results on the link between at least one cardiovascular risk factor and preeclampsia. Relevant studies quality was assessed with the Newcastle-Ottawa Scale (NOS). Odds ratios and relative risk (RR) were reported with their confidence intervals. RESULTS: Twelve articles (8 case-controls, 3 cohorts, 1 cross-sectional) were included in this review, with a total of 24,369 pregnant women. Cardiovascular risk factors such as chronic hypertension, overweight, obesity, diabetes and alcohol were significantly associated with a high risk of preeclampsia. Very few data were available concerning some risk factors. None of the articles reported tobacco consumption as a preeclampsia risk factor. There is a lack of data from French-speaking SSA countries. CONCLUSION: Cardiovascular risk factors increase the risk of preeclampsia. Our results suggest the need for prospective cohort studies to ascertain this association in order to reduce maternal mortality due to preeclampsia.

The prevalence, awareness, management and control of hypertension in men and women in Benin, West Africa: the TAHES study.

BACKGROUND: Due to epidemiological transitions, Sub-Saharan Africa is facing a growing burden of non-communicable diseases, including cardiovascular diseases (CVDs). Among their risk factors, hypertension is a major determinant of CVDs, but the prevalence and level of awareness and management of this condition are poorly studied in African populations. The aim of this study was to determine the prevalence of hypertension and identify its associated risk factors as well as the awareness and management of this condition in a community-dwelling cohort in Benin. METHODS: A cross-sectional door-to-door study was conducted in the population over the age of 25 years in Tanve, a rural setting in Benin. The questionnaire and anthropometric measurements of the World Health Organization STEPWISE survey were used. Blood pressure was measured using standard procedures. RESULTS: The sample included 1777 subjects (60.9% females, mean age was 42.5 ± 16.5 years). The prevalence of hypertension was 32.9%, similar in men (32.8%) and women (33.0%, p = 0.9342). Age and obesity were significantly associated with hypertension. Less than half (42%) of hypertensive people were aware about their condition and only 46.3% of them were treated. Awareness ratios differed between men and women (respectively 32.9% vs. 47.5%; p = 0.0039) and was not influenced by age, education, occupation, marital status or income. Female sex was the only factor associated with better controlled HTN, independent of socio-economic parameters. CONCLUSION: This large population-based study confirms the high prevalence, low awareness, and low control of hypertension in men and women in sub-Saharan Africa. Only half of the populations with hypertension are aware of their hypertension, indicating a high burden of undiagnosed and un-controlled high blood pressure in these populations.

Prévalence de la somnolence diurne excessive chez les conducteurs de véhicules poids lourds à Parakou en 2014

Introduction : La somnolence diurne excessive (SDE) est responsable d'environ 10 à 20% des acci-dents routiers dans le monde. Sa prévalence est mal connue dans la population béninoise. Objectif : Étudier la SDE chez les conducteurs professionnels de véhicules poids lourds sur longue distance ou « routiers » stationnant dans la ville de Parakou en 2014. Méthodes: Il s'est agi d'une étude transversale qui a porté sur les routiers, en transit dans la ville deParakou. Un questionnaire standardisé a été administré au cours d'entretiens individuels en face-à-face enquêteur-enquêté en septembre 2014. La SDE a été définie par un score d'Epworth ≥ 10. Résultats :Un total de 316 routiers a été inclus sur 374 recensés. L'âge moyen était de 32,5 ans ± 9 ans. La plupart d'entre eux avait un niveau d'instruction faible (67,7%) et une ancienneté ≥ 5 ans (63,9%). La prévalence de la SDE était de 23,4%. Elle était positivement associée à la pratique de la sieste (p<0,001). Elle était inversement associée à la durée de sommeil ≥ 6h par nuit (p=0,026), à la pratique régulière d'activité physique (p=0,039) et à la prise de médicaments (p=0,013).Conclusion : La prévalence de la SDE est importante dans la population étudiée. Des mesures de prévention ciblées tenant compte des facteurs associés s'imposent pour sa prévention chez les rou-tiers au Bénin

[Impact of HIV status on the overall prevalence of chronic hepatitis B infection in Parakou, Benin]. / Prévalence de l'hépatite B chronique selon le statut sérologique VIH à Parakou au Bénin.

INTRODUCTION: The prevalence of hepatitis B is very variable across geographic areas and seems to be influenced by HIV infection. This study aims to evaluate the impact of serologic HIV status on the overall prevalence of hepatitis B in a Hospital in Parakou, Benin. METHODS: We conducted a cross-sectional study of adults aged 18 years old and over hospitalized in the Departmental University Hospital Center in Parakou between May 2011 and June 2012. The diagnosis of hepatitis B was made on the basis of rapid HBsAg tests while the diagnosis of HIV was made on the basis of rapid HIV tests using venous blood samples. Data were analyzed using EpiInfo software. Multivariate logistic regression model was implemented to investigate factors associated with hepatitis B. RESULTS: Out of 1516 subjects included, 744 were HIV seropositive. The average age was 31.3 + 11.1 years and 65.1% were women. The prevalence rate of hepatitis B in the whole sample was 13.9% [CI95:12.2%-15.7%]. This prevalence was higher in HIV seropositive subjects (16.9% vs 10.9%; p < 0.0006), however there was not a more significant difference in multivariate analysis, except for the group of subjects from Borgou/Alibori (p < 0.02). A consistent association was observed between age group 24-44 years (p < 0.03), male sex (p < 0.01), primary school education (p < 0.02) and a high prevalence of hepatitis B. CONCLUSION: The prevalence of hepatitis B was higher in HIV seropositive subjects. This was influenced by age, sex, education level and geographical origin.

Epidemiology of lower extremity artery disease in a rural setting in Benin, West Africa: The TAHES study.

BACKGROUND: Data on epidemiology of lower extremity artery disease (LEAD) in general population in Sub-Saharan Africa are sparse. This study aims to estimate the prevalence of LEAD among participants of Tanve Health Study (TAHES), a cohort about cardiovascular diseases (CVD) in a rural setting in Benin. METHODS: The cohort was launched since 2015 among adults aged over 25 years in Tanve, a village in Benin. Ankle-brachial index (ABI) was measured for the first time during the third annual visit of the cohort in 2017. Risk factors data were collected using the WHO STEPS adapted questionnaire in a systematic door-to-door survey. The LEAD was defined as ABI ≤ 0.90. RESULTS: We recorded ABI among 1003 out of 1407 TAHES' participants. A predominance of females (61.4%) was observed. The mean age was 44.4 ±â€¯15.7 years and 49.9% were under 40 years. Regarding CVD risk factors, prevalences were estimated for sedentary behavior (68.2%), harmful use of alcohol (3.9%), fruit and vegetable low intake (96.0%), tobacco smoking (5.2%), Overweight or obesity (Body mass index > 25) (27.7%), raised blood pressure (36.8%) and raised blood glucose (5.4%). Prevalence of LEAD was 5.5% (95%CI: 4.2%­7.1%) in the sample, 7.0% (95%CI: 5.1%­9.4%) in women and 3.1% (95%CI: 1.7%­5.5%) in men. Five individuals (0.5%; 95%CI: 0.2%­1.2%) had incompressible arteries (ABI ≥ 1.40), including four men. In multivariate analysis, LEAD was significantly associated with age ≥ 55 years (OR: 2.17; 95%CI: 1.20­3.92; p = 0.009) and female gender (OR: 2.27; 95%CI: 1.17­4.40; p = 0.014). CONCLUSION: Prevalence of LEAD is high in rural Benin and predominates among women and people over 55 years old.

Feasibility of a cardiovascular cohort in a Sub-Saharan Africa community: preliminary report of the pilot project TAHES (Tanvè Health Study) in Benin.

BACKGROUND: Faced with the growing burden of cardiovascular disease (CVD) including atherosclerotic in Sub-Saharan Africa (SSA), the development of appropriate prediction tools, based on large cohorts, appears useful for prevention. OBJECTIVE: The objective of the pilot project TAHES (Tanvè Health Study) was to explore the feasibility of a large cohort study focused on CVD and risk factors in Benin. METHODS: We implemented a prospective cohort over 2 years. The sample consisted of all people aged 25 years or older who had lived for at least the previous 6 months in the villages of Tanvè or Dékanmè. At baseline in February 2015, behaviours and medical histories were recorded using a standardized questionnaire adapted from the WHO Steps instrument; screening questionnaires for angina, claudication, congestive heart failure, and stroke were applied; anthropometric measures and fasting capillary blood glucose were taken. All participants were included in the follow-up phase. Surveillance of target CVD and deaths was implemented through a medical and a community network. RESULTS: A total of 1,195 participants were enrolled at baseline; women represented 65.5% and the median age was 39 years. The high participation rate (91.4%), the quality of baseline data, and the functionality of the events surveillance network over 8 months indicated good perspective for the feasibility of a large cohort. We recorded a 3.8% prevalence of daily smoking, 3.6% of harmful use of alcohol, 10.7% of obesity, 25.5% of high blood pressure, and 3.5% of diabetes. Prevalence of angina pectoris (2.7%), intermittent claudication (2.0%), congestive heart failure (0.9%), and stroke survival with motor impairment (3‰) were also recorded. Ten deaths occurred during the first 8 months, all within households; a cardiovascular cause was suspected in four cases. CONCLUSION: These preliminary results support the feasibility of establishing a cohort in Benin. It would require technical and resource support.