scispace - formally typeset
Search or ask a question
Author

J. O. M. Pobee

Other affiliations: University of Zambia
Bio: J. O. M. Pobee is an academic researcher from University of Ghana. The author has contributed to research in topics: Population & Rural area. The author has an hindex of 7, co-authored 10 publications receiving 190 citations. Previous affiliations of J. O. M. Pobee include University of Zambia.

Papers
More filters
Journal ArticleDOI
TL;DR: It is concluded that hypertension is not a significant health problem in rural Ghanaians and that large-scale hypertension case-finding and intervention programmes should be confined to urban populations.
Abstract: Hypertension and related complications appear, from clinical impression, to be increasing problems in urban Ghanaians. In early 1973 we conducted a blood pressure survey in 20 rural Ghanaian villages to determine the prevalence of hypertension, in comparison with studies done in Accra residents and black Americans. Rural Ghanaians had mean systolic and diastolic blood pressures which were lower at all ages than the urban groups. 2·5% of the subjects aged 16 to 54 years had diastolic blood pressures of 95 or higher mm Hg. These findings are discussed in view of the proposed hypertension control programme in Accra. We conclude that hypertension is not a significant health problem in rural Ghanaians and that large-scale hypertension case-finding and intervention programmes should be confined to urban populations.

87 citations

Journal Article
TL;DR: Evaluated residents of urban and rural areas of Ghana from 1972 through 1987 to evaluate the health burden of cardiovascular diseases, especially high blood pressure, in these African communities found rates were higher among men than among women.
Abstract: We studied residents of urban and rural areas of Ghana from 1972 through 1987 to evaluate the health burden of cardiovascular diseases, especially high blood pressure, in these African communities. Among urban adults, the prevalence of hypertension was 8% to 13%, compared to only 4.5% among rural adults. Overall, rates were higher among men than among women. However, the rate of hypertension was the same for men and women over 40 years old. The prevalence of hypertension was 29% for persons aged 35 and older, compared to 3.9% for persons under 35 years of age. Of the 24% of the study participants who were aware of their hypertension status, only a third were undergoing treatment, and only half of those were receiving adequate treatment. The determinants of hypertension include age, family history, body mass index, parity, and alcohol use. On a continent where over 80% of the health budget is spent on communicable diseases such as malaria, this study represents one of the few early attempts to understand the magnitude of the health burden of noncommunicable diseases in Africa.

46 citations

Journal Article
TL;DR: In a medical survey of an urban population in Ghana, abnormal cardiovascular findings were present in 25% of the population aged from 15 to 64 years, largely due to hypertension and to cardiomegaly of obscure origin.
Abstract: In a medical survey of an urban population in Ghana, abnormal cardiovascular findings were present in 25% of the population aged from 15 to 64 years. This was largely due to hypertension and to cardiomegaly of obscure origin. The prevalence of valvular heart disease was comparatively low. Abnormal cardiovascular findings were commonest in the lowest third of the socio-economic stratum and next most frequent in the highest third. Abnormal findings were not related to smoking or drinking habits; these seem to be only marginally important in the population at present.

14 citations

Journal ArticleDOI
TL;DR: In a poll carried out by a unit among over 100 doctors practising in Ghana, it has been found that systemic hypertension was diagnosed in 1.3-22.20 of adult out-patients in all types of hospital general, private general and specialist practice.
Abstract: Medical Reports of the Gold Coast, now Ghana, stretch back to 1898 but they were official annual medical reports of the expatriate colonial officers. From the point of view of the Africans, reports of the important role of hypertension began to appear in 1953 and 1961, from the ophthalmological and pathological services (Sarkies 1953; Edington 1954; Binder 1961). In the late sixties and early seventies medical clinicians joined pathologists in drawing attention to the increasing role of systemic hypertension in the causation of morbidity and mortality in Ghana (Amanor and Martinson 1969; Haddock et al. 1972; Pobee et al. 1975). All these reports have emanated from Accra. The 1967 Medical Statistical Report ofthe Ministry of Health, Ghana, stated that hypertension and hypertensive heart disease caused 12 deaths per 1,000 certified deaths. In a poll carried out by our unit among over 100 doctors practising in Ghana, it has been found that systemic hypertension was diagnosed in 1.3-22.20 () of adult out-patients in all types of hospital general, private general and specialist practice. The incidence was higher in the southern half of the country. Fifty-six per cent of the doctors who trained overseas did not think at the time they were abroad that hypertension would be a problem. But is it, in fact, a problem? All the experience so far has been clinical, with its attendant bias which make generalizations difficult.

13 citations

Journal ArticleDOI
J. Blankson1, E.B. Larbi1, J. O. M. Pobee1, D. J. Pole1, A. C. Ikeme1 
TL;DR: Blood pressures in African children in this study are significantly lower than those of American children of comparable age and there is no significant correlation between socio-economic status and the arterial pressure.

11 citations


Cited by
More filters
Journal ArticleDOI
TL;DR: The prevalence of hypertension varied extensively between and within studies, and was higher in urban than rural studies in all studies that covered both types of area, and also increased with increasing age in most studies.
Abstract: Hypertension is an important public health challenge worldwide. Information on the burden of disease from hypertension is essential in developing effective prevention and control strategies. An up-to-date and comprehensive assessment of the evidence concerning hypertension in sub-Saharan Africa is lacking. A literature search of the PUBMED database was conducted and supplemented by a manual search of bibliographies of retrieved articles. The search was restricted to population based studies on hypertension in sub-Saharan Africa published between January 1975 and May 2006. Data were extracted after a standard protocol and using standard data collection forms. Thirty-seven publications met the inclusion criteria. The prevalence of hypertension varied extensively between and within studies. Prevalence of hypertension was higher in urban than rural studies in all studies that covered both types of area, and also increased with increasing age in most studies. In most studies less than 40% of people with blood pressure above the defined normal range had been previously detected as hypertensive. Of people with previously diagnosed hypertension, less than 30% were on drug treatment in most studies, and less than 20% had blood pressure within the defined normal range. Hypertension is of public health importance in sub-Saharan Africa, particularly in urban areas, with evidence of considerable under-diagnosis, treatment, and control. There is an urgent need to develop strategies to prevent, detect, treat, and control hypertension effectively in the African region.

626 citations

Journal ArticleDOI
TL;DR: With the lack of vital statistics systems, epidemiologic studies with a variety of designs capable of in-depth analyses of risk factors could provide a better understanding of NCDs in SSA, and inform health-care policy to mitigate the oncoming NCD epidemic.
Abstract: BACKGROUND Sub-Saharan Africa (SSA) has a disproportionate burden of both infectious and chronic diseases compared with other world regions. Current disease estimates for SSA are based on sparse data, but projections indicate increases in non-communicable diseases (NCDs) caused by demographic and epidemiologic transitions. We review the literature on NCDs in SSA and summarize data from the World Health Organization and International Agency for Research on Cancer on the prevalence and incidence of cardiovascular diseases, diabetes mellitus Type 2, cancer and their risk factors. METHODS We searched the PubMed database for studies on each condition, and included those that were community based, conducted in any SSA country and reported on disease or risk factor prevalence, incidence or mortality. RESULTS We found few community-based studies and some countries (such as South Africa) were over-represented. The prevalence of NCDs and risk factors varied considerably between countries, urban/rural location and other sub-populations. The prevalence of stroke ranged from 0.07 to 0.3%, diabetes mellitus from 0 to 16%, hypertension from 6 to 48%, obesity from 0.4 to 43% and current smoking from 0.4 to 71%. Hypertension prevalence was consistently similar among men and women, whereas women were more frequently obese and men were more frequently current smokers. CONCLUSIONS The prevalence of NCDs and their risk factors is high in some SSA settings. With the lack of vital statistics systems, epidemiologic studies with a variety of designs (cross-sectional, longitudinal and interventional) capable of in-depth analyses of risk factors could provide a better understanding of NCDs in SSA, and inform health-care policy to mitigate the oncoming NCD epidemic.

552 citations

Journal ArticleDOI
TL;DR: Differences from whites in etiology and therapeutic responses in sub-Saharan African populations are graded and overlapping rather than absolute, and two lifestyle changes that are feasible and should help to stem the epidemic of hypertension in Africa are a decreased salt intake and decreased obesity.
Abstract: Background— Hypertension in sub-Saharan Africa is a widespread problem of immense economic importance because of its high prevalence in urban areas, its frequent underdiagnosis, and the severity of its complications. Methods and Results— We searched PubMed and relevant journals for words in the title of this article. Among the major problems in making headway toward better detection and treatment are the limited resources of many African countries. Relatively recent environmental changes seem to be adverse. Mass migration from rural to periurban and urban areas probably accounts, at least in part, for the high incidence of hypertension in urban black Africans. In the remaining semirural areas, inroads in lifestyle changes associated with “civilization” may explain the apparently rising prevalence of hypertension. Overall, significant segments of the African population are still afflicted by severe poverty, famine, and civil strife, making the overall prevalence of hypertension difficult to determine. Blac...

502 citations

Journal ArticleDOI
TL;DR: There is an urgent need for preventive strategies on hypertension control in Ghana, particularly in urban areas, and detection rates are suboptimal in both men and women, especially in rural areas.
Abstract: Hypertension and stroke are important threats to the health of adults in sub-Saharan Africa. Nevertheless, detection of hypertension is haphazard and stroke prevention targets are currently unattainable. Prevalence, detection, management, and control of hypertension were assessed in 1013 men (n=385) and women (n=628), both aged 55 [SD 11] years, living in 12 villages in Ashanti, Ghana. Five hundred thirty two lived in semi-urban and 481 in rural villages. The participants underwent measurements of height, weight, and blood pressure (BP) and answered a detailed questionnaire. Hypertension was defined as BP ≥140 and/or ≥90 mm Hg or being on drug therapy. Women were heavier than men. Participants in semi-urban areas were heavier and had higher BP (129/76 [26/14] versus 121/72 [25/13] mm Hg; P P =0.007). Treatment and control rates were low in both groups (7.8% and 4.4% versus 13.6% and 1.7%). Detection, treatment, and control rates were higher in semi-urban (25.7%, 14.3%, and 3.4%) than in rural villages (16.4%, 6.9%, and 1.7%). Hypertension is common in adults in central Ghana, particularly in urban areas. Detection rates are suboptimal in both men and women, especially in rural areas. Adequate treatment of high BP is at a very low level. There is an urgent need for preventive strategies on hypertension control in Ghana.

317 citations

Journal ArticleDOI
TL;DR: This editorial reviews eight original papers submitted to a Globalization and Health special issue themed: "Africa's chronic disease burden: local and global perspectives", which offer new empirical evidence and comprehensive reviews on diabetes in Tanzania, sickle cell disease in Nigeria, chronic mental illness in rural Ghana and HIV/AIDS care-giving among children in Kenya.
Abstract: Africa faces a double burden of infectious and chronic diseases. While infectious diseases still account for at least 69% of deaths on the continent, age specific mortality rates from chronic diseases as a whole are actually higher in sub Saharan Africa than in virtually all other regions of the world, in both men and women. Over the next ten years the continent is projected to experience the largest increase in death rates from cardiovascular disease, cancer, respiratory disease and diabetes. African health systems are weak and national investments in healthcare training and service delivery continue to prioritise infectious and parasitic diseases. There is a strong consensus that Africa faces significant challenges in chronic disease research, practice and policy. This editorial reviews eight original papers submitted to a Globalization and Health special issue themed: "Africa's chronic disease burden: local and global perspectives". The papers offer new empirical evidence and comprehensive reviews on diabetes in Tanzania, sickle cell disease in Nigeria, chronic mental illness in rural Ghana, HIV/AIDS care-giving among children in Kenya and chronic disease interventions in Ghana and Cameroon. Regional and international reviews are offered on cardiovascular risk in Africa, comorbidity between infectious and chronic diseases and cardiovascular disease, diabetes and established risk factors among populations of sub-Saharan African descent in Europe. We discuss insights from these papers within the contexts of medical, psychological, community and policy dimensions of chronic disease. There is an urgent need for primary and secondary interventions and for African health policymakers and governments to prioritise the development and implementation of chronic disease policies. Two gaps need critical attention. The first gap concerns the need for multidisciplinary models of research to properly inform the design of interventions. The second gap concerns understanding the processes and political economies of policy making in sub Saharan Africa. The economic impact of chronic diseases for families, health systems and governments and the relationships between national policy making and international economic and political pressures have a huge impact on the risk of chronic diseases and the ability of countries to respond to them.

296 citations