Burden of cardiometabolic risk factors and preclinical target organ damage among adults in Freetown, Sierra Leone: a community-based health-screening survey

• Published in: BMJ open Vol. 13; no. 5; p. e067643
• Main Authors: Russell, James Baligeh Walter, Koroma, Theresa Ruba, Sesay, Santigie, Samura, Sallieu Kabay, Lakoh, Sulaiman, Bockarie, Ansumana, Abir, Onome Thomas, Kanu, Joseph Sam, Coker, Joshua, Jalloh, Abdul, Conteh, Victor, Conteh, Sorie, Smith, Mohamed, Mahdi, Othman Z, Lisk, Durodami R
• Format: Journal Article
• Language: English
• Published: England British Medical Journal Publishing Group 16-05-2023; BMJ Publishing Group LTD; BMJ Publishing Group
• Series: Original research
• Subjects: Adult; Adults; Alcohol; Blood pressure; Cardiology; Cardiometabolic Risk Factors; Cardiovascular Medicine; Cross-Sectional Studies; Data collection; Demographics; Developing countries; Diabetes; Diabetes Mellitus - epidemiology; Female; Humans; Hypertension; Hypertension - complications; Hypertrophy, Left Ventricular; LDCs; Lipid disorders; Male; Medical screening; Metabolic disorders; Population; Prevalence; Renal Insufficiency, Chronic - complications; Risk Factors; Sample size; Sierra Leone - epidemiology; Smoking; Sierra Leone; Freetown Sierra Leone; Africa; Hypertension; Lipid disorders; Cardiology
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2022-067643

ObjectiveTo investigate the prevalence of cardiometabolic risk factors (CMRFs), target organ damage (TOD) and its associated factors among adults in Freetown, Sierra Leone.DesignThis community-based cross-sectional study used a stratified multistage random sampling method to recruit adult participants.SettingThe health screening study was conducted between October 2019 and October 2021 in Western Area Urban, Sierra Leone.ParticipantsA total of 2394 adult Sierra Leoneans aged 20 years or older were enrolled.Outcome measureAnthropometric data, fasting lipid profiles, fasting plasma glucose, TOD, clinical profiles and demographic characteristics of participants were described. The cardiometabolic risks were further related to TOD.ResultsThe prevalence of known CMRFs was 35.3% for hypertension, 8.3% for diabetes mellitus, 21.1% for dyslipidaemia, 10.0% for obesity, 13.4% for smoking and 37.9% for alcohol. Additionally, 16.1% had left ventricular hypertrophy (LVH) by ECG, 14.2% had LVH by two-dimensional echo and 11.4% had chronic kidney disease (CKD). The odds of developing ECG-LVH were higher with diabetes (OR=1.255, 95% CI (0.822 to 1.916) and dyslipidaemia (OR=1.449, 95% CI (0.834 to 2.518). Associated factors for higher odds of Left Ventricular Mass Index by echo were dyslipidaemia (OR=1.844, 95% CI (1.006 to 3.380)) and diabetes mellitus (OR=1.176, 95% CI (0.759 to 1.823)). The odds of having CKD were associated with diabetes mellitus (OR=1.212, 95% CI (0.741 to 1.983)) and hypertension (OR=1.163, 95% CI (0.887 to 1.525)). A low optimal cut-off point for ECG-LVH (male 24.5 mm vs female 27.5 mm) was required to maximise sensitivity and specificity by a receiver operating characteristics curve since the odds for LVH by ECG were low.ConclusionsThis study provides novel data-driven information on the burden of CMRF and its association with preclinical TOD in a resource-limited setting. It illustrates the need for interventions in improving cardiometabolic health screening and management in Sierra Leonean.