Prevalence of hypertension, diabetes mellitus, and their risk factors in an informal settlement in Freetown, Sierra Leone: a cross-sectional study

Background: Noncommunicable diseases (NCDs), especially hypertension and diabetes mellitus are on the increase in sub-Saharan Africa (SSA). Informal settlement dwellers exhibit a high prevalence of behavioural risk factors and are highly vulnerable to hypertension and diabetes. However, no study has assessed the prevalence of hypertension, diabetes, and NCDrisk factors among informal settlement dwellers in Sierra Leone. We conducted a study in June 2019 to determine the prevalence of hypertension, diabetes, and NCD risk factors among adults living in the largest Sierra Leonean informal settlement (KrooBay). Methods and materials: We conducted a community-based cross-sectional survey among adults aged ≥ 35 years in the KrooBay community. Trained healthcare workers collected data on socio-demographic characteristics and self-reported health behaviours using the World Health Organization STEPwise surveillance questionnaire for chronic disease risk factors. Anthropometric, blood glucose, and blood pressure measurements were performed following standard procedures. Logistics regression was used for analysis and adjusted odd ratios with 95% confidence intervals were calculated to identify risk factors associated with hypertension. Results: Of the 418 participants, 242 (57%) were females and those below the age of 45 years accounted for over half (55.3%) of the participants. The prevalence of smoking was 18.2%, alcohol consumption was 18.8%, overweight was 28.2%, obesity was 17.9%, physical inactivity was 81.5%, and inadequate consumption of fruits and vegetables was 99%. The overall prevalence of hypertension was 45.7% (95% CI 41.0-50.5%), systolic hypertension was 34.2% (95% CI 29.6–38.8%), diastolic blood pressure was 39.9% (95% CI 35.2–44.6), and participants with diabetes were 2.2% (95% CI 0.7–3.6%). Being aged ≥ 55 years (AOR = 7.35, 95% CI 1.49–36.39) and > 60 years (AOR 8.05; 95% CI 2.22–29.12), separated (AOR = 1.34; 95% 1.02–7.00), cohabitating (AOR = 6.68; 95% CL1.03-14.35), vocational (AOR = 3.65; 95% CI 1.81–7.39 ) and having a university education (AOR = 4.62; 95% CI 3.09–6.91) were found to be independently associated with hypertension. Conclusion: The prevalence of hypertension,and NCD risk factors was high among the residents of the Kroobay informal settlement. We also noted a low prevalence of diabetes. There is an urgent need for the implementation of health education, promotion, and screening initiatives to reduce health risks so that these conditions will not overwhelm health services

Canopy composition and drought shape understorey plant assemblages in a young tree diversity experiment

Questions Tree diversity is key to the functioning of forest ecosystems. However, which components of tree diversity are responsible for tree diversity effects on associated organisms, and in which context, is poorly understood. Location ORPHEE Experimental site, Cestas-Pierroton in the southwest of France. Methods We used a large-scale tree diversity experiment in which we controlled water availability by an irrigation treatment to address tree diversity and water stress effects on the diversity and height of forest understorey vegetation. We assessed the species richness and height of understorey vegetation in irrigated and non-irrigated 20 m x 20 m plots, either being monocultures ofPinus pinaster,Betula pendulaorQuercus robur, or either mixtures of two to five species amongPinus pinaster,Betula pendula,Quercus robur,Quercus ilexandQuercus pyrenaica. Results Tree species composition, i.e. the proportion of birch or pine, had a significant effect on understorey plant assemblage, species richness and diversity. The proportion of the fast-growing deciduous angiospermBetula pendulawas negatively correlated to understorey plant richness and diversity, and positively correlated with understorey vegetation height. Understorey vegetation was higher in irrigated plots than in non-irrigated plots, but irrigation had no clear effect on the species richness, diversity or composition of understorey plant assemblages. Conclusions Forest tree species composition and in particular the relative proportions of different tree species had stronger effects on understorey plants than tree species richness per se. These effects were consistent across irrigation treatments. Even in young forest plantations, effects of tree mixture on understorey vegetation may be observed and seem mainly driven by the functional type of tree in the canopy and initial dynamics of plant regeneration in planted forests.Plateforme d'Innovation " Forêt-Bois-Fibre-Biomasse du Futur