Cardiometabolic disease risk and HIV status in rural South Africa: establishing a baseline
Samuel J. Clark,F. Xavier Gómez-Olivé,Brian Houle,Brian Houle,Brian Houle,Margaret Thorogood,Margaret Thorogood,Kerstin Klipstein-Grobusch,Kerstin Klipstein-Grobusch,Nicole Angotti,Chodziwadziwa W. Kabudula,Jill Williams,Jill Williams,Jane Menken,Jane Menken,Stephen Tollman +15 more
Reads0
Chats0
TLDR
Sub-Saharan Africa is facing intersecting epidemics of HIV and hypertension, and around half the adult population require long-term care for at least one of HIV, hypertension or diabetes, which may have serious implications for the South African health care system.Abstract:
Background: To inform health care and training, resource and research priorities, it is essential to establish how non-communicable disease risk factors vary by HIV-status in high HIV burden areas; and whether long-term anti-retroviral therapy (ART) plays a modifying role. Methods: As part of a cohort initiation, we conducted a baseline HIV/cardiometabolic risk factor survey in 2010–2011 using an age-sex stratified random sample of ages 15+ in rural South Africa. We modelled cardiometabolic risk factors and their associations by HIV-status and self-reported ART status for ages 18+ using sex-stratified logistic regression models. Results: Age-standardised HIV prevalence in women was 26% (95% CI 24-28%) and 19% (95% CI 17–21) in men. People with untreated HIV were less likely to have a high waist circumference in both women (OR 0.67; 95% CI 0.52-0.86) and men (OR 0.42; 95% CI 0.22-0.82). Untreated women were more likely to have low HDL and LDL, and treated women high triglycerides. Cardiometabolic risk factors increased with age except low HDL. The prevalence of hypertension was high (40% in women; 30% in men). Conclusions: Sub-Saharan Africa is facing intersecting epidemics of HIV and hypertension. In this setting, around half the adult population require long-term care for at least one of HIV, hypertension or diabetes. Together with the adverse effects that HIV and its treatment have on lipids, this may have serious implications for the South African health care system. Monitoring of the interaction of HIV, ART use, and cardiometabolic disease is needed at both individual and population levels.read more
Citations
More filters
Journal ArticleDOI
Cardiometabolic risk in a population of older adults with multiple co-morbidities in rural south africa: the HAALSI (Health and Aging in Africa: longitudinal studies of INDEPTH communities) study
Thomas A. Gaziano,Thomas A. Gaziano,Shafika Abrahams-Gessel,F. Xavier Gómez-Olivé,Alisha N. Wade,Nigel J. Crowther,Sartaj Alam,Jennifer Manne-Goehler,Jennifer Manne-Goehler,Chodziwadziwa W. Kabudula,Ryan G. Wagner,Julia Rohr,Livia Montana,Kathleen Kahn,Till Bärnighausen,Till Bärnighausen,Lisa F. Berkman,Stephen Tollman +17 more
TL;DR: This cohort has high CMD risk based on both traditional risk factors and novel markers like hsCRP, with HIV+ persons having a consistently lower prevalence of co-morbidities compared to those without HIV.
Journal ArticleDOI
Genomic and environmental risk factors for cardiometabolic diseases in Africa: methods used for Phase 1 of the AWI-Gen population cross-sectional study
Stuart A. Ali,Cassandra Soo,Godfred Agongo,Marianne Alberts,Lucas Amenga-Etego,Romuald P. Boua,Ananyo Choudhury,Nigel J. Crowther,Depuur C,Francesc Xavier Gómez-Olivé,Issa Guiraud,Tilahun Nigatu Haregu,Scott Hazelhurst,Kathleen Kahn,Christopher Khayeka-Wandabwa,Catherine Kyobutungi,Zané Lombard,Felistas Mashinya,Lisa K. Micklesfield,Shukri F. Mohamed,Freedom Mukomana,Seydou Nakanabo-Diallo,Hamtandi Magloire Natama,Nicholas Ngomi,Engelbert A. Nonterah,Shane A. Norris,Abraham Oduro,Athanase M Some,H. Sorgho,Paulina Tindana,Halidou Tinto,Stephen Tollman,Rhian Twine,Alisha N. Wade,Osman Sankoh,Michèle Ramsay +35 more
TL;DR: Detailed methods for Phase 1 of the AWI-Gen study are described that were used to capture phenotype data and assess the associated risk factors and end points for CMD in persons over the age of 40 years in sub-Saharan Africa (SSA).
Journal ArticleDOI
Progression of the epidemiological transition in a rural South African setting: findings from population surveillance in Agincourt, 1993–2013
Chodziwadziwa W. Kabudula,Chodziwadziwa W. Kabudula,Brian Houle,Brian Houle,Brian Houle,Mark A. Collinson,Mark A. Collinson,Kathleen Kahn,Kathleen Kahn,Francesc Xavier Gómez-Olivé,Samuel J. Clark,Stephen Tollman,Stephen Tollman +12 more
TL;DR: This typical rural South African population is experiencing a protracted epidemiological transition, characterized by persistent gender differences with more rapid positive progression in females than males, which will impact on continued progress in reducing preventable mortality and improving health across the life course.
Journal ArticleDOI
The ART Advantage: Health Care Utilization for Diabetes and Hypertension in Rural South Africa
Jennifer Manne-Goehler,Livia Montana,Francesc Xavier Gómez-Olivé,Julia Rohr,Guy Harling,Ryan G. Wagner,Alisha N. Wade,Chodziwadziwa W. Kabudula,Pascal Geldsetzer,Kathleen Kahn,Stephen Tollman,Lisa F. Berkman,Till Bärnighausen,Thomas A. Gaziano +13 more
TL;DR: HIV-positive patients who use ART are more likely to have received health care services for diabetes and hypertension, and this apparent ART advantage suggests that ART programs may be a vehicle for strengthening health systems for chronic care.
Journal ArticleDOI
Assessment of cardiovascular risk factors in people with HIV infection treated with ART in rural South Africa: a cross sectional study.
TL;DR: The high proportion of participants with a moderate to high CVD risk, observed with the DAD risk equation, clearly represents a considerable health burden that can possibly be reduced by increasing educational programs on CVD prevention for people on ART.
References
More filters
Journal ArticleDOI
The burden of non-communicable diseases in South Africa.
Bongani M. Mayosi,Alan J. Flisher,Umesh G. Lalloo,Freddy Sitas,Stephen Tollman,Stephen Tollman,Debbie Bradshaw +6 more
TL;DR: The launching of a national initiative to establish sites of service excellence in urban and rural settings throughout South Africa to trial, assess, and implement integrated care interventions for chronic infectious and non-communicable diseases is urged.
Journal ArticleDOI
Health in South Africa: changes and challenges since 2009
Bongani M. Mayosi,Joy E Lawn,Ashley van Niekerk,Ashley van Niekerk,Debbie Bradshaw,Salim S. Abdool Karim,Salim S. Abdool Karim,Hoosen M. Coovadia,Hoosen M. Coovadia +8 more
TL;DR: Transformation of the health system into a national institution that is based on equity and merit and is built on an effective human-resources system could still place South Africa on track to achieve Millennium Development Goals 4, 5, and 6 and would enhance the lives of its citizens.
Journal ArticleDOI
Incidence and risk factors for new-onset diabetes in HIV-infected patients: the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study.
Stéphane De Wit,Caroline A. Sabin,Rainer Weber,Signe Westring Worm,Peter Reiss,Charles Cazanave,Wafaa El-Sadr,Antonella d'Arminio Monforte,Eric Fontas,Matthew Law,Nina Friis-Møller,Andrew N. Phillips +11 more
TL;DR: Stavudine and zidovudine are significantly associated with diabetes after adjustment for risk factors for diabetes and lipids, suggesting that the two thymidine analogs probably directly contribute to insulin resistance, potentially through mitochondrial toxicity.
Journal ArticleDOI
Hypertension among older adults in low- and middle-income countries: prevalence, awareness and control
TL;DR: The high rates of hypertension in low- and middle-income countries are striking and levels of treatment and control are inadequate despite half those sampled being aware of their condition, emphasizing the need for new approaches towards control of this major risk factor.
Related Papers (5)
Profile: Agincourt Health and Socio-demographic Surveillance System
Association of HIV and ART with cardiometabolic traits in sub-Saharan Africa: a systematic review and meta-analysis
David G. Dillon,David G. Dillon,Deepti Gurdasani,Deepti Gurdasani,Johanna Riha,Johanna Riha,Kenneth Ekoru,Kenneth Ekoru,Gershim Asiki,Billy N. Mayanja,Naomi S. Levitt,Nigel J. Crowther,Moffat J. Nyirenda,Marina Njelekela,Kaushik Ramaiya,Ousman Nyan,O O Adewole,Kathryn Anastos,Livio Azzoni,W Henry Boom,Caterina Compostella,Joel A. Dave,Halima Dawood,Christian Erikstrup,Carla M.T. Fourie,Henrik Friis,Annamarie Kruger,John A Idoko,Chris T. Longenecker,Suzanne Mbondi,Japheth E Mukaya,Eugene Mutimura,Chiratidzo E. Ndhlovu,George PrayGod,Eric Walter Pefura Yone,Mar Pujades-Rodriguez,Mar Pujades-Rodriguez,Nyagosya Range,Mahmoud U Sani,Aletta E. Schutte,Karen Sliwa,Phyllis C. Tien,Este H Vorster,Corinna M. Walsh,Rutendo Zinyama,Fredirick Mashili,Eugene Sobngwi,Eugene Sobngwi,Clement Adebamowo,Anatoli Kamali,Janet Seeley,Elizabeth H. Young,Elizabeth H. Young,Liam Smeeth,Ayesha A. Motala,Pontiano Kaleebu,Manjinder S. Sandhu,Manjinder S. Sandhu +57 more