Hypertension, urbanization, social and spatial disparities: a cross-sectional population-based survey in a West African urban environment (Ouagadougou, Burkina Faso).

Data show that hypertension has become a public health problem in developing countries. Many studies have reported social disparities among the affected populations, but few of them pointed out spatial disparities within towns. We aimed to show that hypertension could be a good indicator of the medical change that occurs unequally in towns. A cross-sectional survey was done in April and October 2004 in Ouagadougou, Burkina Faso, among 2087 adults over 35 years old in different kinds of urban areas. Social and demographic data were collected and blood pressure was measured. Prevalence of hypertension was 40.2%. Age, body mass index, level of equipment, absence of community integration, absence of occupation, duration of residence over 20 years, protein-rich diet and absence of physical activity were identified as risk factors, but there were social and spatial disparities according to location of housing (parcelled-out or non-parcelled-out areas) and to integration within the town. The high rate of hypertension found in Ouagadougou and the heterogeneity of the risk within the population highlights that social and spatial risk factors have to be taken into account for the prevention of the non-transmissible diseases in countries in full process of urbanization and medical change.

Illness-related behaviour and utilization of oral health services among adult city-dwellers in Burkina Faso: evidence from a household survey.

BACKGROUND: In sub-Saharan Africa, the availability and accessibility of oral health services are seriously constrained and the provision of essential oral care is limited. Reports from the region show a very low utilization of oral health care services, and visits to dental-care facilities are mostly undertaken for symptomatic reasons. The objectives of the present study were to describe the prevalence of oral symptoms among adults in Ouagadougou, capital city of Burkina Faso and the use of oral health services and self-medication in response to these symptoms and to measure the associations between predisposing, enabling and needs factors and decisions to seek oral health care. METHODS: The conceptual design of the study was derived from both the Andersen-Newman model of health care utilization and the conceptual framework of the WHO International Collaborative Study of Oral Health Outcomes. Data were obtained by two-stage stratified sampling through four areas representative of different stages of urbanization of Ouagadougou. The final study population comprised 3030 adults aged 15 years or over and the response rate was 65%. RESULTS: Overall, 28% of the respondents had experienced an oral health problem during the past 12 months; a high proportion (62%) reported pain or acute discomfort affecting daily life. In response to symptoms, only 28% used oral health facilities, 48% used self-medication and 24% sought no treatment at all. Multivariate analyses revealed that several socio-economic and socio-cultural factors such as religious affiliation, material living conditions and participation in a social network were significantly associated with the use of oral health care services by adults who had experienced oral health problems during the previous year. CONCLUSION: The proportion of people who have obtained oral health care is alarmingly low in Ouagadougou and self-medication appears to be an important alternative source of care for adult city-dwellers. Decision-makers in sub-Saharan countries must seek to ensure that access to essential oral health care is improved.