RESUMO
BACKGROUND: Understanding the differences in care-seeking pattern is key in designing interventions aimed at improving health-care service delivery, including prevention and control of noncommunicable diseases. The aim of this study was to identify the differences and determinants of care-seeking patterns of urban and rural residents in Abia State in southeast Nigeria. METHODS: This was a cross-sectional, community-based, study involving 2999 respondents aged 18 years and above. Data were collected using the modified World Health Organization's STEPS questionnaire, including data on care seeking following the onset of illness. Descriptive statistics and logistic regressions were used to analyze care-seeking behavior and to identify differences among those seeking care in urban and rural areas. RESULTS: In both urban and rural areas, patent medicine vendors (73.0%) were the most common sources of primary care following the onset of illness, while only 20.0% of the participants used formal care. Significant predictors of difference in care-seeking practices between residents in urban and rural communities were educational status, income, occupation, and body mass index. CONCLUSIONS: Efforts should be made to reduce barriers to formal health-care service utilization in the state by increasing health insurance coverage, strengthening the health-care system, and increasing the role of patent medicine vendors in the formal health-care delivery system.
RESUMO
OBJECTIVE: Hypertension is the most common non-communicable disease and risk factor for heart failure, stroke, chronic kidney disease and ischemic heart disease in sub-Saharan Africa. Few population-based studies have been conducted recently in Nigeria and, in Abia State, no previous study has been conducted on the prevalence and correlates of hypertension among the populace. The purpose of our study was, therefore, to determine the prevalence and determinants of high blood pressure in Abia State, southeastern Nigeria. We hypothesise that high blood pressure burden is high in Abia State. DESIGN: The study was a community based cross-sectional house-to-house survey aimed at ascertaining the burden/prevalence of hypertension in the state as well as identifying related risk factors associated with them. SETTING: The study was conducted in rural and urban communities in Abia State, Nigeria. PARTICIPANTS: Participants in the study were men and women aged > or =15 years and were recruited from the three senatorial zones in the state. MAIN OUTCOMES: A total of 2,999 respondents were selected for the survey and, 2,983 consented to be interviewed giving a response rate of 99.5%. The data for 2,928 participants were suitable for analysis. Of these, 1,399 (47.8%) were men. The mean age of the population was 41.7 +/- 18.5 years (range 18-96 years). About 54% of the population were < or =40 years. Ninety percent had at least primary education with about 47% having completed secondary education. Expectedly, 96% of the respondents were Ibos, the predominant tribe in the southeastern part of the country. Women had significantly higher BMI than the men. Similarly, waist circumference was also larger in women but waist-to-hip ratio was only significantly higher in women in the urban areas compared to those in rural areas. Thirty-one percent of all participants had systolic hypertension (33.5% in men and 30.5% in women). This sex difference was statistically different in the urban area. On the other hand, diastolic hypertension was 22.5% in all the population (23.4% in men and 25.4% in women). Age and indices of obesity were the strongest predictors of blood pressure. CONCLUSION: The prevalence of hypertension was high in our study both in rural and urban settings. The major determinants of blood pressure in our participants included age, sex, indices of obesity and pulse rate.
