Prevalence of obesity, tobacco use, and alcohol consumption by socioeconomic status among six communities in Nicaragua.

OBJECTIVE: To describe the prevalence of noncommunicable disease (NCD) risk factors (overweight/obesity, tobacco smoking, and alcohol consumption) and identify correlations between these and sociodemographic characteristics in western and central Nicaragua. METHODS: This was a cross-sectional study of 1 355 participants from six communities in Nicaragua conducted in September 2007-July 2009. Demographic and NCD risk-related health behavior information was collected from each individual, and their body mass index (BMI), blood pressure, diabetes status, and renal function were assessed. Data were analyzed using descriptive statistics, bivariate analyses, and (non-stratified and stratified) logistic regression models. RESULTS: Of the 1 355 study participants, 22.0% were obese and 55.1% were overweight/obese. Female sex, higher income, and increasing age were significantly associated with obesity. Among men, lifelong urban living correlated with obesity (Odds Ratio [OR] = 4.39, 1.18-16.31). Of the total participants, 31.3% reported ever smoking tobacco and 47.7% reported ever drinking alcohol. Both tobacco smoking and alcohol consumption were strikingly more common among men (OR = 13.0, 8.8-19.3 and 15.6, 10.7-22.6, respectively) and lifelong urban residents (OR = 2.42, 1.31-4.47 and 4.10, 2.33-7.21, respectively). CONCLUSIONS: There was a high prevalence of obesity/overweight across all income levels. Women were much more likely to be obese, but men had higher rates of tobacco and alcohol use. The rising prevalence of NCD risk factors among even the poorest subjects suggests that an epidemiologic transition in underway in western and central Nicaragua whereby NCD prevalence is shifting to all segments of society. Raising awareness that health clinics can be used for chronic conditions needs to be priority.

Prevalence of obesity, tobacco use, and alcohol consumption by socioeconomic status among six communities in Nicaragua / Prevalencia de la obesidad, el tabaquismo y el consumo de alcohol según la condición socioeconómica en seis comunidades de Nicaragua

Objective. To describe the prevalence of noncommunicable disease (NCD) risk factors(overweight/obesity, tobacco smoking, and alcohol consumption) and identify correlationsbetween these and sociodemographic characteristics in western and central Nicaragua.Methods. This was a cross-sectional study of 1 355 participants from six communitiesin Nicaragua conducted in September 2007–July 2009. Demographic and NCD risk-relatedhealth behavior information was collected from each individual, and their body mass index(BMI), blood pressure, diabetes status, and renal function were assessed. Data were analyzedusing descriptive statistics, bivariate analyses, and (non-stratified and stratified) logisticregression models.Results. Of the 1 355 study participants, 22.0% were obese and 55.1% were overweight/obese. Female sex, higher income, and increasing age were significantly associated with obesity.Among men, lifelong urban living correlated with obesity (Odds Ratio [OR] = 4.39,1.18–16.31). Of the total participants, 31.3% reported ever smoking tobacco and 47.7%reported ever drinking alcohol. Both tobacco smoking and alcohol consumption were strikinglymore common among men (OR = 13.0, 8.8–19.3 and 15.6, 10.7–22.6, respectively) andlifelong urban residents (OR = 2.42, 1.31–4.47 and 4.10, 2.33–7.21, respectively).Conclusions. There was a high prevalence of obesity/overweight across all income levels.Women were much more likely to be obese, but men had higher rates of tobacco and alcoholuse. The rising prevalence of NCD risk factors among even the poorest subjects suggests thatan epidemiologic transition in underway in western and central Nicaragua whereby NCDprevalence is shifting to all segments of society. Raising awareness that health clinics can beused for chronic conditions needs to be priority.

Objetivo. Describir la prevalencia de los factores de riesgo (sobrepeso/obesidad,tabaquismo y consumo de alcohol) de las enfermedades no transmisibles (ENT), ydeterminar las correlaciones entre estos y las características sociodemográficas en laszonas occidental y central de Nicaragua.Métodos. De septiembre del 2007 a julio del 2009, se llevó a cabo este estudio transversalen 1 355 participantes de seis comunidades de Nicaragua. Para cada persona,se recopiló información demográfica y sobre la conducta en materia de salud relacionadacon el riesgo de ENT, y se evaluaron el índice de masa corporal (IMC), la presiónarterial, la presencia o no de diabetes y la función renal. Se analizaron los datosmediante estadísticas descriptivas, análisis de dos variables, y modelos de regresiónlogística (análisis no estratificado y estratificado).Resultados. De los 1 355 participantes en el estudio, 22,0% eran obesos y 55,1%presentaban sobrepeso u obesidad. El sexo femenino, los ingresos más altos y la edadmás avanzada se asociaron significativamente con la obesidad. En los varones, laresidencia de por vida en un entorno urbano se correlacionó con la obesidad (razónde posibilidades [OR] = 4,39, 1,18–16,31). Del total de participantes, 31,3% habíanfumado tabaco y 47,7% habían consumido alcohol alguna vez. Tanto el tabaquismocomo el consumo de alcohol fueron considerablemente más frecuentes en los varones(OR = 13,0, 8,8–19,3 y 15,6, 10,7–22,6, respectivamente) y en los que residían de porvida en un entorno urbano (OR = 2,42, 1,31–4,47 y 4,10, 2,33–7,21, respectivamente).Conclusiones. Se observó una alta prevalencia de obesidad/sobrepeso en todos losniveles de ingresos. Las mujeres tenían muchas más probabilidades de ser obesas,pero los varones mostraban mayores tasas de tabaquismo y consumo del alcohol.

Prevalence of hypertension and associated risk factors in six Nicaraguan communities.

OBJECTIVE: Describe the prevalence of hypertension. DESIGN: Population based cross-sectional survey. SETTING: Six Nicaraguan communities with varying economies. PARTICIPANTS: 1,355 adults aged 20-60 years who completed both self-reported and quantitative measures of health. MAIN OUTCOME MEASURES: Prevalence of hypertension (systolic > or = 140 mm Hg, diastolic > or = 90 mm Hg, or self-reported medical history with diagnosis by a health care professional), uncontrolled hypertension (systolic > or = 140 mm Hg or diastolic > or = 90 mm Hg), diabetes (urinary glucose excretion > or = 100 mg/ dL or self-reported medical history diagnosed by a health care professional), and uncontrolled diabetes (urinary glucose excretion > or =100 mg/dL only). RESULTS: The prevalence of hypertension was 22.0% (19.2% in men, 24.2% in women). Blood pressure was controlled in 31.0% of male hypertensives and 55.1% of female hypertensives (odds ratio [OR] 2.86; 95% confidence interval [Cl] 1.74-4.69). Older age and higher body mass index were strongly associated with hypertension. Women who completed primary school had a lower risk of hypertension (OR .40; 95% Cl .19-.85) compared to those with no formal education. A history of living in both urban and rural settings was associated with lower prevalence of hypertension (OR .52; 95% CI .34-.79). Diabetes mellitus was found in 1.2% of men and 4.3% of women. Male sex was independently associated with decreased risk of diabetes (OR .31; 95% Cl .11-.86). CONCLUSIONS: At least one cardiovascular risk factor was found in half of this Nicaraguan sample. Cardiovascular risk factors should be the target of educational efforts, screening, and treatment.

Nicaragua revisited: evidence of lower prevalence of chronic kidney disease in a high-altitude, coffee-growing village.

BACKGROUND: Chronic kidney disease (CKD) is found at epidemic levels in certain populations of the Pacific Coast in northwestern Nicaragua especially in younger men. There are knowledge gaps concerning CKD's prevalence in regions at higher altitudes. METHODS: A cross-sectional study of adults between the ages of 20 and 60 years in 1 coffee-growing village in Nicaragua located at 1,000 m above sea level (MASL) altitude was performed. Predictors included participant sex, age, occupation, conventional CKD risk factors and other factors associated with CKD suggested by previous surveys in Central America. Outcomes included serum creatinine (SCr) values >1.2 mg/dL for men and >0.9 mg/dL for women, estimated glomerular filtration rate (GFR) <60 ml/min per 1.73 m2, dipstick proteinuria stratified as microalbuminuria (30-300 mg/dL) and macroalbuminuria (>300 mg/dL), hypertension and body mass index. RESULTS: Of 324 eligible participants, 293 were interviewed (90.4%), and 267 of those received the physical exam (82.4% overall). Of the sample, 45% were men. Prevalence rate of estimated GFR <60 ml/min per 1.73 m2 was 0 for men (0%) and 2 for women (1.4%). The prevalence of at least microalbuminuria was significantly higher among men compared with women (27.5% vs. 21.4%, respectively; p=0.02). CONCLUSIONS: The CKD prevalence in this village is comparable to a previously studied Nicaraguan coffee-farming region and much lower than previously screened portions of northwestern Nicaragua. There is heterogeneity in CKD prevalence across Nicaragua. At this time, screenings should target individuals living in previously identified, higher risk regions. More work is needed to understand determinants of CKD in this resource-poor nation.