ABSTRACT
BACKGROUND: Hypertension remains the major risk factor for cardiovascular diseases (CVDs) worldwide with a prevalence and mortality in low- and middle-income countries (LMICs) among the highest. The early detection of hypertension risk factors is a crucial pillar for CVD prevention. DESIGN AND METHOD: This cross-sectional study included 4284 subjects, mean age 46 ± 16SD, 56.4% females and mean BMI 26.6 ± 3.7 SD. Data were collected through a screening campaign in rural area of Kirehe District, Eastern of Rwanda, with the objective to characterize and examine the prevalence of elevated blood pressure (BP) and other CVD risk factors. An adapted tool from the World Health Organization STEPwise Approach was used for data collection. Elevated BP was defined as ≥ 140/90 mm/Hg and elevated blood glucose as blood glucose ≥ 100 mg/dL after a 6-h fast. RESULTS: Of the sampled population, 21.2% (n = 910) had an elevated BP at screening; BP was elevated among individuals not previously known to have HTN in 18.7% (n = 752). Among individuals with a prior diagnosis of HTN, 62.2% (n = 158 of 254) BP was uncontrolled. Age, weight, smoking, alcohol history and waist circumference were associated with BP in both univariate analyses and multivariate analysis. CONCLUSION: High rates of elevated BP identified through a health screening campaign in this Rwandan district were surprising given the rural characteristics of the district and relatively low population age. These data highlight the need to implement an adequate strategy for the prevention, diagnosis, and control of HTN that includes rural areas of Rwanda as part of a multicomponent strategy for CVD prevention.
Subject(s)
Autonomic Nervous System Diseases , Cardiovascular Diseases , Hypertension , Adult , Blood Glucose , Cross-Sectional Studies , Female , Humans , Hypertension/diagnosis , Hypertension/epidemiology , Male , Middle Aged , Rwanda/epidemiologyABSTRACT
Chronic disease morbidity is a concern for cancer research. Contradictory results have been reported concerning adherence to breast cancer screening among patients with chronic diseases. The study was conducted to assess the adherence to breast cancer screening among women with chronic diseases in Korea. It was a cross sectional and population based study; the data came from the Korean National Health and Nutrition Examination Survey (KNHANES) 2012. Participation in breast cancer screening was analyzed among women who had at least one of eight chronic diseases (hypertension, diabetes, cancer, dyslipidemia, stroke, depression, osteoarthritis and asthma). Pearson's chi-squared test and multiple logistic regression analysis were performed using STATA version 14. A total 2,404 women aged 40 years or older were included in analysis. Among them, 77.3% had experienced breast cancer screening. In logistic regression model, adherence to breast cancer screening was lower in women who have ever been diagnosed as diabetes mellitus (odds ratio (OR)= 0.47, 95% confidence interval (95%CI) = 0.31-0.72), asthma (OR=0.44, 95%CI=0.24-0.82) and higher in women who have ever been diagnosed as dyslipidemia (OR= 1.85, 95%CI= 1.27-2.69), osteoarthritis (OR= 1.42, 95%CI= 1.31-2.06) and cancers (OR= 2.70, 95%CI= 1.26-5.79) compared to women without those chronic diseases. Based on treatment of chronic diseases, lower participation in breast cancer screening was observed in women who were on treatment of diabetes mellitus (OR= 0.48, 95%CI= 0.31-0.74), asthma (OR= 0.41, 95%CI= 0.15-0.92) and stroke (OR= 0.37, 95%CI= 0.14-0.97), and higher in women who were on treatment of dyslipidemia (OR= 1.37, 95%CI=1.42-2.14). In conclusion, low participation rate in breast cancer screening in women with some chronic diseases was identified. The results from this study may provide an important contribution for helping to maintain and increase participation in cancer screening of patients with chronic diseases.
