| 1. |
- Berhane, Yemane, et al.
(författare)
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A rural Ethiopian population undergoing epidemiological transition over a generation : Butajira from 1987 to 2004
- 2008
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 36:4, s. 436-441
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To describe the epidemiological development of a rural Ethiopian population from 1987 to 2004 in terms of mortality and associated sociodemographic factors. Methods: A rural population comprising 10 communities was defined in 1987 and has since been followed by means of regular household visits. After an initial census, births, deaths and migration events were recorded, together with key background factors, on an open cohort basis. Over 97,000 individuals were observed during a total of over 700,000 person years. Results: The initial population of 28,614 increased by an average of 3.64% annually to 54,426 from 1987 to 2004, and also grew older on average. Birth and mortality rates fell, but were still subject to short-term variation due to external factors. Overall mortality was 13.5 per 1000 person years. Increasing mortality in some adult age groups was consistent with increasing AIDS-related deaths, but a new local hospital in 2002 may have contributed to later falls in overall mortality. Sex, age group, time period, literacy, water source, house ownership and distance to town were all significantly associated with mortality differentials. Conclusions: This population has undergone a complex epidemiological transition during a generation. Detailed long-term surveillance of this kind is essential for describing such processes. Many factors that significantly affect mortality cannot be directly controlled by the health sector and will only improve with general development.
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| 2. |
- Ng, Nawi, et al.
(författare)
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Combining risk factors and demographic surveillance : potentials of WHO STEPS and INDEPTH methodologies for assessing epidemiological transition.
- 2006
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 34:2, s. 199-208
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: Demographic surveillance systems (DSSs) create platforms to monitor population dynamics. This paper discusses the potential of combining the WHO STEPwise approach to Surveillance (STEPS) within ongoing DSSs, to assess changes in non-communicable disease (NCD) risk factors. METHODS: Three DSSs in Ethiopia, Vietnam, and Indonesia have collected NCD risk factors using WHO STEPS, focusing on self-reported lifestyle risk factors (Step 1) and measurement of blood pressure and anthropometric parameters (Step 2). RESULTS: DSSs provide sampling frames for NCD risk factor surveillance, which reveals the distribution of risk factors and their dynamics at the population level. The WHO STEPS approach with its add-on modules is feasible and adaptable in DSS settings. Available mortality data in the DSSs enable mortality assessment by cause of death using verbal autopsy, which is relevant in estimating the impact of NCDs. DSSs as well as risk factor surveillance data may potentially be a lever for hypothesis-driven research to address specific a priori hypotheses or research questions. CONCLUSION: Combining DSSs with the WHO STEPS approach can potentially address basic epidemiological questions on NCDs, which can be used as a powerful advocacy tool in public health decision-making for NCD prevention.
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| 4. |
- Tesfaye, Fikru, et al.
(författare)
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Association of Smoking and Khat (Catha edulis Forsk) Use With High Blood Pressure Among Adults in Addis Ababa, Ethiopia, 2006
- 2008
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Ingår i: Preventing Chronic Disease. - : National Center for Chronic Disease Prevention and Health Promotion. - 1545-1151. ; 5:3
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Tidskriftsartikel (refereegranskat)abstract
- Introduction We assessed the prevalence of substance use and its association with high blood pressure among adults in Addis Ababa, Ethiopia.Methods We employed a cross-sectional descriptive study design. The World Health Organization instrument for stepwise surveillance of risk factors for chronic diseases was applied on a probabilistic sample of 4001 men and women aged 25 to 64 years in Addis Ababa. We determined the prevalence of cigarette smoking, alcohol drinking, and khat (Catha edulis Forsk) chewing. We measured blood pressure by using a digital device and determined mean levels of systolic and diastolic blood pressure.Results Smoking cigarettes, drinking alcohol, and chewing khat were widely prevalent among men. Among men, the prevalence of current daily smoking was 11.0% (95% confidence interval [CI], 9.5%–12.5%). Binge drinking of alcohol was reported by 10.4% (95% CI, 9.0%–11.9%) of men. Similarly, 15.9% (95% CI, 14.1%–17.6%) of men regularly chewed khat. Consequently, 26.6% of men and 2.4% of women reported practicing one or more of the behaviors. Current daily smoking and regular khat chewing were significantly associated with elevated mean diastolic blood pressure (β = 2.1, P = .03 and β = 1.9, P = .02, respectively).Conclusion Cigarette smoking and khat chewing among men in Addis Ababa were associated with high blood pressure, an established risk factor for cardiovascular disease. Health promotion interventions should aim to prevent proliferation of such behaviors among young people and adoption by women. Surveillance for risk factors for cardiovascular disease should be implemented nationwide to provide information for policy decisions and to guide prevention and control programs.
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| 5. |
- Tesfaye, Fikru, et al.
(författare)
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Concurrent comparison of energy intake and expenditure among adults in Butajira District, Ethiopia
- 2008
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Ingår i: Public Health Nutrition. - 1368-9800 .- 1475-2727. ; 11:7, s. 675-683
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To estimate and compare dietary energy intake (DEI) and total energy expenditure (TEE) among adults, using questionnaires. DESIGN: Comparative, cross-sectional study. SETTING: Community-based, at the demographic surveillance site (DSS) in Butajira District of Ethiopia. SUBJECTS: A total of 619 adults, 18-64 years of age, were randomly selected from among the urban and rural population of Butajira using the DSS sampling frame. Habitual dietary intake and physical activity were assessed using questionnaires. BMR was estimated using a regression equation, and TEE was calculated from BMR and the metabolic energy equivalent task (MET) and duration of reported activities. Physical activity level (PAL) was calculated as TEE/BMR, while food intake level (FIL) was calculated as DEI/BMR. The mean DEI:TEE ratio was used to evaluate reported DEI at the population level, while individual misreporters were identified by applying the Goldberg cut-off points at three levels of PAL. RESULTS: Based on the Goldberg method, 57% of the study participants were identified as acceptable reporters of DEI, among whom mean TEE was 8.21 (95% CI 8.01, 8.42) MJ (1963 (95% CI 1914, 2012) kcal), mean DEI was 8.13 (95% CI 7.93, 8.34) MJ (1944 (95% CI 1895, 1993) kcal) and mean DEI:TEE was 1.01 (95% CI 0.99, 1.04). CONCLUSION: The dietary history and physical activity questionnaires provide comparable estimates of mean energy intake and expenditure at a population level. Acceptable reporters have to be identified in order to obtain better estimates. Questionnaire-based estimates of energy intake should not be interpreted without an inherent system of comparison or validation.
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| 6. |
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| 7. |
- Tesfaye, Fikru, et al.
(författare)
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Population based prevalence of high blood pressure among adults in Addis Ababa : uncovering a silent epidemic
- 2009
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Ingår i: BMC Cardiovascular Disorders. - : BioMed Central. - 1471-2261 .- 1471-2261. ; 9, s. Article nr 39-
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The prevention and control of high blood pressure or other cardiovascular diseases has not received due attention in many developing countries. This study aims to describe the epidemiology of high blood pressure among adults in Addis Ababa, so as to inform policy and lay the ground for surveillance interventions.METHODS: Addis Ababa is the largest urban centre and national capital of Ethiopia, hosting about 25% of the urban population in the country. A probabilistic sample of adult males and females, 25-64 years of age residing in Addis Ababa city participated in structured interviews and physical measurements. We employed a population based, cross sectional survey, using the World Health Organization instrument for stepwise surveillance (STEPS) of chronic disease risk factors. Data on selected socio-demographic characteristics and lifestyle behaviours, including physical activity, as well as physical measurements such as weight, height, waist and hip circumference, and blood pressure were collected through standardized procedures. Multiple linear regression analysis was performed to estimate the coefficient of variability of blood pressure due to selected socio-demographic and behavioural characteristics, and physical measurements.RESULTS: A total of 3713 adults participated in the study. About 20% of males and 38% of females were overweight (body-mass-index > or = 25 kg/m2), with 10.8 (9.49, 12.11)% of the females being obese (body-mass-index > or = 30 kg/m2). Similarly, 17% of the males and 31% of the females were classified as having low level of total physical activity. The age-adjusted prevalence (95% confidence interval) of high blood pressure, defined as systolic blood pressure (SBP) > or = 140 mmHg (millimetres of mercury) or diastolic blood pressure (DBP) > or = 90 mmHg or reported use of anti-hypertensive medication, was 31.5% (29.0, 33.9) among males and 28.9% (26.8, 30.9) among females.CONCLUSION: High blood pressure is widely prevalent in Addis Ababa and may represent a silent epidemic in this population. Overweight, obesity and physical inactivity are important determinants of high blood pressure. There is an urgent need for strategies and programmes to prevent and control high blood pressure, and promote healthy lifestyle behaviours primarily among the urban populations of Ethiopia.
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