Changes in ideal cardiovascular health among Malawian adults from 2009 to 2017.

Ideal Cardiovascular Health (CVH) is a concept defined by the American Heart Association (AHA) as part of its 2020 Impact Goals. Until now, changes in ideal CVH have been poorly evaluated in Sub-Saharan African populations. We aimed to investigate changes in the prevalence of ideal CVH and its components in a population of Malawian adults. Secondary analysis was done on cross-sectional data from 2009 to 2017, obtained from the Malawi STEPS surveys which included 5730 participants aged 25-64 years. CVH metrics categorized into "ideal (6-7 ideal metrics)", "intermediate (3-5 ideal metrics)" and "poor (0-2 ideal metrics)" were computed using blood pressure, body mass index (BMI), fasting glycaemia, fruit and vegetable intake, physical activity, smoking, and total cholesterol. Sampling weights were used to account for the sampling design, and all estimates were standardised by age and sex using the direct method. The mean participant age across both periods was 40.1 ± 12.4 years. The prevalence of meeting ≥ 6 ideal CVH metrics increased substantially from 9.4% in 2009 to 33.3% in 2017, whereas having ≤ 2 ideal CVH metrics decreased from 7.6% to 0.5% over this time. For the individual metrics, desirable levels of smoking, fruit and vegetable intake, physical activity, blood pressure (BP), total cholesterol and fasting glucose all increased during the study period whilst achievable levels of BMI (< 25 kg/m2) declined. From 2009 to 2017, the mean number of ideal CVH metrics was higher in women compared to men (from 2.1% to 5.1% vs 2.0% to 5.0%). However, poor levels of smoking and fruit and vegetable intake were higher in men compared to women (from 27.9% to 23.6% vs. 7.4%% to 1.9% ,and from 33.7% to 42.9% vs 30.8% to 34.6%, respectively). Also, whilst achievable levels of BMI rose in men (from 84.4% to 86.2%) the proportion reduced in women (from 72.1% to 67.5% ). Overall, CVH improved in Malawian adults from 2009 to 2017 and was highest in women. However, the prevalence of poor fruit and vegetable intake, and poor smoking remained high in men whilst optimal levels of BMI was declined in women. To improve this situation, individual and population-based strategies that address body mass, smoking and fruit and vegetable intake are warranted for maximal health gains in stemming the development of cardiovascular events.info:eu-repo/semantics/publishe

High Urban-Rural Inequities of Abdominal Obesity in Malawi: Insights from the 2009 and 2017 Malawi Noncommunicable Disease Risk Factors Surveys

Geographical disparities in abdominal obesity (AO) exist in low-income countries due to major demographic and structural changes in urban and rural areas. We aimed to investigate differences in the urban&ndash;rural prevalence of AO in the Malawi population between 2009 and 2017. We conducted a secondary analysis of data from the Malawi 2009 and 2017 STEPS surveys. AO (primary outcome) and very high waist circumference (secondary outcome) were defined using WHO criteria. Prevalence estimates of AO and very high waist circumference (WC) were standardized by age and sex using the age and sex structure of the adult population in Malawi provided by the 2018 census. A modified Poisson regression analysis adjusted for sociodemographic covariates was performed to compare the outcomes between the two groups (urban versus rural). In total, 4708 adults in 2009 and 3054 adults in 2017 aged 25&ndash;64 were included in the study. In 2009, the age&ndash;sex standardized prevalence of AO was higher in urban than rural areas (40.9% vs 22.0%; adjusted prevalence ratio [aPR], 1.51; 95% confidence interval [CI], 1.36&ndash;1.67; p &lt; 0.001). There was no significant trend for closing this gap in 2017 (urban 37.0% and rural 21.4%; aPR, 1.48; 95% CI, 1.23&ndash;1.77; p &lt; 0.001). This urban&ndash;rural gap remained and was slightly wider when considering the &lsquo;very high WC&rsquo; threshold in 2009 (17.0% vs. 7.1%; aPR, 1.98; 95%CI, 1.58&ndash;2.47; p &lt; 0.001); and in 2017 (21.4% vs. 8.3%; aPR, 2.03; 95%CI, 1.56&ndash;2.62; p &lt; 0.001). Significant urban&ndash;rural differences exist in the prevalence of AO and very high WC in Malawi, and the gap has not improved over the last eight years. More effective weight management strategies should be promoted to reduce health care disparities in Malawi, particularly in urban areas

First Report on the Co-Occurrence and Clustering Profiles of Cardiovascular Lifestyle Risk Factors among Adults in Burkina Faso.

The co-occurrence of cardiovascular risk factors is usually associated with a higher risk of cardiovascular disease (CVD) or cancer. This study aimed to determine the prevalence of the co-occurrence and its determinants and to identify the clustering profiles of lifestyle risk factors among the adult population in Burkina Faso. Among 4692 participants, 4377 adults from the first STEPS survey conducted in Burkina Faso were considered in this analysis. Four lifestyle risk factors (smoking, alcohol consumption, inadequate fruit and vegetable intake and low physical activity) were analysed. The clustering was evaluated using the observed/expected (O/E) ratio approach. To identify the determinants of co-occurrence, we performed a modified Poisson regression. The prevalence of the co-occurrence of two or more cardiovascular lifestyle risk factors was 46.4% (95% CI: 43.1-49.7). The main determinants of the co-occurrence were being male (adjusted prevalence ratio (aPR): 1.27 (95% CI: 1.16-1.38)), advanced age (55-64 years old: aPR: 1.45 (95% CI: 1.31-1.60)) and a high level of education (aPR: 1.29 (95% CI: 1.09-1.52)). The clustering profile for lifestyle risk factors was tobacco consumption combined with alcohol consumption (O/E: 2.77 (95% CI: 2.12-3.56)), and concurrent involvement in all four lifestyle risk factors (O/E = 1.51 (95% CI: 1.19-1.89)). This first population-based report on the co-occurrence of lifestyle risk factors calls for action to tailor health-promoting interventions to increase healthy lifestyle behaviors. The identified CVD-risk clustering should be considered as an important step in this strategy development in Burkina Faso.info:eu-repo/semantics/publishe

National levels, changes and correlates of ideal cardiovascular health among Beninese adults: evidence from the 2008 to 2015 STEPS surveys.

A higher number of ideal cardiovascular health (CVH) metrics is associated with a lower risk of cardiovascular-related and all-cause mortality. However, the change in CVH metrics has rarely been studied in sub-Saharan Africa. We investigated the level and changes of CVH metrics and their correlates among Beninese adults between 2008 and 2015.info:eu-repo/semantics/publishe

Predictors of severe hypoxemia among COVID-19 patients in Burkina Faso (West Africa): Findings from hospital based cross-sectional study

Introduction: COVID-19 is one of the world’s major health crises. The objective of this study was to determine the predictive factors of severe hypoxemia in patients hospitalized in COVID-19 health facilities in Burkina Faso. Patients and method: This study was a hospital-based cross-sectional study. The data collected relate to the period of the first wave of the epidemic (March 9 to June 30, 2020). All patients hospitalized for COVID-19 in the requisitioned health facilities of Ouagadougou were included in this study. Predictors of severe hypoxemia were identified using a multivariate logistic regression model. Results: During the study period, 442 patients were included, representing 45.7% of the total number of positive patients in the entire country. The most common co-morbidities were diabetes (55; 12.4%) and arterial hypertension (97; 21.9%). Severe hypoxemia (SpO2 < 90%) was observed in 64 patients (14.5%). Age over 65 years (OR = 8.24; 95% CI: 2.83–24.01) and diabetes (OR = 2.43; 95% CI: 1.17–5.06) were the predictors for occurrence of severe hypoxemia in multivariate analysis. Conclusion: The predictive factors of COVID-19 are similar in African and Caucasian populations. The surveillance of COVID-19 in risk groups should be strengthened to reduce their morbidity and mortality

Le Mali contemporain

Le Mali contemporain ? Il est bien différent des images que les médias diffusent ! La société malienne a considérablement évolué depuis l'indépendance, les jeunes y sont beaucoup plus nombreux et mieux informés, les femmes plus actives. Mais les changements qui ont marqué notamment la gouvernance et la situation économique paraissent décalés au regard des nouvelles contraintes, attentes et exigences liées à ces mutations. Comment cette société, dans sa diversité, pense-t-elle et s'engage-t-elle dans la modernité ? Voilà le sujet de ce livre. Une cinquantaine de chercheurs en sciences sociales, dans le cadre d'une collaboration franco-malienne, ont travaillé sur le Mali contemporain dans la période qui a immédiatement précédé la crise (2007-2012). Ils se sont principalement intéressés à la vie politique dans les communes et quartiers, à la réalité de la décentralisation, à l'image que l'Etat en action donne de lui, au fait religieux dans ses manifestations et ses tendances lourdes, mais aussi aux divers aspects de la migration, et enfin et surtout à la place des jeunes dans la société. Le tableau qui se dégage de leurs observations est sans complaisance : faire évoluer positivement la situation actuelle de la société malienne est un défi pour les décideurs et l'ensemble de la population ; et pour y parvenir, il est impérieux d'ébranler les pesanteurs, blocages, et faux-fuyants qui ont conduit le pays au bord du gouffre