Surveillance of Cardiovascular Risk Factors in the Fifth Military Sector Health Center, Ngaoundéré, Cameroon: Observational Study

Williams Bell Ngan, Lawrence Essama Eno Belinga, Alain Serges Patrick Essam Nlo'o, Frederic Roche, Luc Goethals, Samuel Honoré Mandengue, Bienvenu Bongue, Williams Bell Ngan, Lawrence Essama Eno Belinga, Alain Serges Patrick Essam Nlo'o, Frederic Roche, Luc Goethals, Samuel Honoré Mandengue, Bienvenu Bongue

Abstract

Background: Noncommunicable diseases (NCDs) are the leading causes of death worldwide. They were responsible for 40 million of the 57 million deaths recorded worldwide in 2016. In Cameroon, epidemiological studies have been devoted to NCDs and their risk factors. However, none provides specific information on their extent or the distribution of their risk factors within the Cameroonian defense forces.

Objective: The objective of our study was to assess the cardiovascular risk of a Cameroonian military population compared with that of its neighboring civilian population.

Methods: We conducted a cross-sectional study that involved subjects aged 18 to 58 years, recruited from October 2017 to November 2018 at the Fifth Military Sector Health Center in Ngaoundéré, Cameroon. Data collection and assessment were done according to the World Health Organization (WHO)'s STEPS manual for surveillance of risk factors for chronic NCDs and the Alcohol Use Disorders Identification Test. Five cardiovascular risk factors were assessed: smoking, harmful alcohol consumption, obesity/overweight, hypertension, and diabetes. The risk was considered high in subjects with 3 or more of the factors. Univariate analysis and multivariate logistic regression were carried out according to their indications.

Results: Our study sample of 566 participants included 295 soldiers and 271 civilians of the same age group (median age 32 years versus 33 years, respectively; P=.57). The military sample consisted of 31 officers and 264 noncommissioned officers (NCOs). Soldiers were more exposed to behavioral risk factors than civilians, with a prevalence of smoking of 13.9% versus 4.4% (P<.001) and excessive alcohol consumption of 61.7% versus 14.8% (P<.001). They also presented with a higher cardiovascular risk than civilians (odds ratio 2.7, 95% CI 1.50-4.81; P<.001), and among the military participants, the cardiovascular risk was higher for officers than for NCOs (51.6% versus 14.0%, respectively; P<.001).

Conclusions: Cameroonian soldiers are particularly exposed to cardiovascular behavioral risk factors and consequently are at higher risk of NCDs.

Trial registration: ClinicalTrials.gov NCT04315441; https://ichgcp.net/clinical-trials-registry/NCT04315441.

Keywords: cardiovascular diseases; cardiovascular risk; noncommunicable disease; prevention; soldiers.

Conflict of interest statement

Conflicts of Interest: None declared.

©Williams Bell Ngan, Lawrence Essama Eno Belinga, Alain Serges Patrick Essam Nlo'o, Frederic Roche, Luc Goethals, Samuel Honoré Mandengue, Bienvenu Bongue. Originally published in JMIR Formative Research (http://formative.jmir.org), 26.11.2020.

References

    1. World Health Organization Global Health Estimates: Deaths by Cause, Age, Sex and Country, 2000-2016. World Health Organization. 2018. Mar 15, [2020-06-15]. .
    1. World Health Organization Global status report on non-communicable diseases 2018 Internet. 2020. [2020-06-15]. .
    1. Smoley BA, Smith NL, Runkle GP. Hypertension in a population of active duty service members. J Am Board Fam Med. 2008;21(6):504–11. doi: 10.3122/jabfm.2008.06.070182.
    1. Aziz NA, Mohamed SS, Badara TA, Boubacar G, Gallo SP, Awa G, Anta T. [Chronic noncommunicable diseases in Senegalese soldiers: cross-sectional study in 2013] Pan Afr Med J. 2015;22:59. doi: 10.11604/pamj.2015.22.59.4777.
    1. Chellak S, Bigaillon C, El Jahiri Y, Garcia C, Ceppa F, Mayaudon H, Dupuy O, Garcin J, Baigts F, Bauduceau B, Burnat P. Immuno-analyse & Biologie Spécialisée. Netherlands: Elsevier; 2005. Jun, Homocystéine et paramètres du syndrome métabolique et du risque cardiovasculaire chez 2045 militaires : étude EPIMIL; pp. 169–172.
    1. Armed Forces Health Surveillance Center (AFHSC) Incidence and prevalence of select cardiovascular risk factors and conditions, active component, U.S. Armed Forces, 2003-2012. MSMR. 2013 Dec;20(12):16–9.
    1. Heydari S, Khoshdel A, Sabayan B, Abtahi F, Zamirian M, Sedaghat S. Prevalence of Cardiovascular Risk Factors Among Military Personnel in Southern Iran. Iranian Cardiovascular Research Journal. ? 2010;4(1):7.
    1. Bin Horaib G, Al-Khashan HI, Mishriky AM, Selim MA, Alnowaiser N, Binsaeed AA, Alawad AD, Al-Asmari AK, Alqumaizi K. Prevalence of obesity among military personnel in Saudi Arabia and associated risk factors. Saudi Med J. 2013 Apr;34(4):401–7.
    1. Fezeu L, Kengne AP, Balkau B, Awah PK, Mbanya JC. Ten-year change in blood pressure levels and prevalence of hypertension in urban and rural Cameroon. J Epidemiol Community Health. 2010 Apr;64(4):360–5. doi: 10.1136/jech.2008.086355.
    1. Katte J, Dzudie A, Sobngwi E, Mbong EN, Fetse GT, Kouam CK, Kengne A. Coincidence of diabetes mellitus and hypertension in a semi-urban Cameroonian population: a cross-sectional study. BMC Public Health. 2014 Jul 08;14:696. doi: 10.1186/1471-2458-14-696.
    1. Kingue S, Ngoe CN, Menanga AP, Jingi AM, Noubiap JJN, Fesuh B, Nouedoui C, Andze G, Muna WFT. Prevalence and Risk Factors of Hypertension in Urban Areas of Cameroon: A Nationwide Population-Based Cross-Sectional Study. J Clin Hypertens (Greenwich) 2015 Oct;17(10):819–24. doi: 10.1111/jch.12604. doi: 10.1111/jch.12604.
    1. Pancha MO, Ngoufack J, Koona KA, Maha F, Kingue S. Épidémiologie des maladies cardiovasculaires en milieu hospitalier nord camerounais. Health Sci Dis. 2015
    1. Pefura-Yone E, Balkissou A, Mbele-Onana C, Boulleys-Nana J, Ndjeutcheu-Moualeu P, Afane-Ze E, Kuaban C. Facteurs atopiques non polliniques associés à l’asthme et à la rhinite à Yaoundé, Cameroun : étude cas-témoin. Revue des Maladies Respiratoires. 2015 Jan;32:A52–A53. doi: 10.1016/j.rmr.2014.10.404.
    1. Bigna JJ, Nansseu JR, Katte J, Noubiap JJ. Prevalence of prediabetes and diabetes mellitus among adults residing in Cameroon: A systematic review and meta-analysis. Diabetes Res Clin Pract. 2018 Mar;137:109–118. doi: 10.1016/j.diabres.2017.12.005.
    1. Pancha Mbouemboue O, Derew D, Tsougmo JON, Tangyi Tamanji M. A Community-Based Assessment of Hypertension and Some Other Cardiovascular Disease Risk Factors in Ngaoundéré, Cameroon. Int J Hypertens. 2016;2016:4754636. doi: 10.1155/2016/4754636. doi: 10.1155/2016/4754636.
    1. World Health Organization . The Alcohol Use Disorders Identification Test: Guidelines for Use in Primary Care, 2nd edition. Geneva: World Health Organization; 2001. .
    1. Kuate Defo B, Mbanya JC, Kingue S, Tardif J, Choukem SP, Perreault S, Fournier P, Ekundayo O, Potvin L, D'Antono B, Emami E, Cote R, Aubin M, Bouchard M, Khairy P, Rey E, Richard L, Zarowsky C, Mampuya WM, Mbanya D, Sauvé Sébastien, Ndom P, Silva RBD, Assah F, Roy I, Dubois C. Blood pressure and burden of hypertension in Cameroon, a microcosm of Africa: a systematic review and meta-analysis of population-based studies. J Hypertens. 2019 Nov;37(11):2190–2199. doi: 10.1097/HJH.0000000000002165.
    1. Bah AO, Bah MF, Fofana FB, Beavogui M. Soldiers’ Hypertension Prevalence in Military Garrisons in the City of Conakry. OJNeph. 2016;06(04):132–137. doi: 10.4236/ojneph.2016.64016.
    1. Hussain NAA, Akande TM, Adebayo O. Prevalence of cigarette smoking and the knowledge of its health implications among Nigerian soldiers. East Afr J Public Health. 2009 Aug;6(2):168–70. doi: 10.4314/eajph.v6i2.51754.
    1. Basaza R, Otieno E, Musinguzi A, Mugyenyi P, Haddock CK. Factors influencing cigarette smoking among soldiers and costs of soldier smoking in the work place at Kakiri Barracks, Uganda. Tob Control. 2017 May;26(3):330–333. doi: 10.1136/tobaccocontrol-2015-052878.
    1. Godé C, Kouassi B, Horo K, Ahui-Brou J, Samaké K, Koné A, Koffi M, Aka-Dangui E. Tabagisme et armée en Côte d’Ivoire. Revue des Maladies Respiratoires. 2015 Jan;32:A137. doi: 10.1016/j.rmr.2014.10.687.
    1. Chu N, Lin F, Wu Y. Prevalence and Trends of Cigarette Smoking Among Military Personnel in Taiwan: Results of 10-Year Anti-Smoking Health Promotion Programs in Military. Mil Med. 2017 Jul;182(7):e1933–e1937. doi: 10.7205/MILMED-D-16-00361.
    1. Gaziano TA, Young CR, Fitzmaurice G, Atwood S, Gaziano JM. Laboratory-based versus non-laboratory-based method for assessment of cardiovascular disease risk: the NHANES I Follow-up Study cohort. The Lancet. 2008 Mar 15;371(9616):923–931. doi: 10.1016/S0140-6736(08)60418-3.
    1. D'Agostino RB, Vasan RS, Pencina MJ, Wolf PA, Cobain M, Massaro JM, Kannel WB. General cardiovascular risk profile for use in primary care: the Framingham Heart Study. Circulation. 2008 Feb 12;117(6):743–53. doi: 10.1161/CIRCULATIONAHA.107.699579.
    1. World Health Organization . Guidelines for assessment and management of total cardiovascular risk. Geneva: World Health Organization; 2007. Prevention of Cardiovascular Disease. .
    1. Mendis S, Lindholm LH, Mancia G, Whitworth J, Alderman M, Lim S, Heagerty T. World Health Organization (WHO) and International Society of Hypertension (ISH) risk prediction charts: assessment of cardiovascular risk for prevention and control of cardiovascular disease in low and middle-income countries. Journal of Hypertension. 2007;25(8):1578–1582. doi: 10.1097/hjh.0b013e3282861fd3.

Source: PubMed

赞助者和合作者

医疗条件

药物干预

3
订阅