A comparison of health complaints of settled and nomadic Turkana men.

This article examines the health complaints of settled and nomadic Ngisonyoka Turkana of northwest Kenya. Samples of 152 nomadic and 124 settled men, aged 14 and over, were surveyed about their health status. The general pattern of disease reported concurs with previous studies of health among Turkana; that is, the primary complaints are respiratory tract infections and eye infections. The settled Turkana reported more severe complaints and higher rates of infectious disease than the nomads, including a significantly higher frequency of cold with cough, eye infection, and chest infection. Although the settled males as a group had slightly higher body mass index and other measures of body fat than the nomadic group, none of these indicators of body composition were predictive of health complaints. Observed differences in health patterns are possibly related to differences in dietary composition, exposure to pathogens associated with population density and environmental pollution, physical activity patterns, and psychosocial stress.

Spectrum of hypertensive target organ damage in Africa: a review of published studies.

This paper reviews the evidence of hypertensive target organ damage (HTOD) in Africa, and the difficulties of its assessment, with a focus on implications for further research and prevention. Specific examples of HTOD reviewed include left ventricular hypertrophy, heart failure, ischaemic heart disease, arrhythmias and sudden death, kidney failure, cerebrovascular accidents, retinopathy and central as well as peripheral vascular disease. There is evidence that the prevalence of hypertension is increasing in some parts of Africa, thus increasing the number of people who suffer from fatal and nonfatal complications. Analysis of the type, frequency and distribution of HTOD is critical to the design of interventions to prevent and manage hypertension, and in the design of future clinical research. As would be expected, the frequency of atherosclerotic complications, particularly involving the heart, is lower in Africa than in developed countries. Stroke, renal failure and heart failure appear to be the principal adverse outcomes and are likely to be associated with a high case fatality rate. Community-based data on these issues are limited, however, and hospital series cannot estimate the population burden and may be unreliable in describing the case mix. Improved data on HTOD will more accurately reflect the health impact of hypertension, provide the basis for aggressive efforts at prevention, detection and control of high BP and establish their relevance in the overall scheme of resource allocation during fiscal austerity and limited healthcare spending. Additionally, knowledge of the prevalence and relative frequencies of HTOD has direct and important implications for clinical outcomes research in hypertension.