Prevalence of hypertension and associated cardiovascular risk factors among adults aged 18-69 years in Juba city, South Sudan.

Abstract

Background: The prevalence of hypertension in Africa (46%) is now the highest in the world. This increased burden of hypertension and other NCDs is partly due to the accelerated epidemiological transition driven by drastic changes in lifestyle. There is paucity of data on the burden of hypertension and associated risk factors in South Sudan. This study, therefore, set out to determine the prevalence of hypertension and associated risk factors among adults (18-69 years) in Juba city. Methods: This was a community based cross-sectional survey among adults (18-69 years) who were residents of Juba city South Sudan. Trained Interviewers collected primary data on socio-demographic and self-reported health behaviors, using a structured questionnaire adapted from the validated WHO Stepwise instrument for surveillance of chronic disease risk factors(STEPS). Anthropometry and blood pressure measurements were taken per the standards in the STEPs Manual. Multiple Logistic Regression was used for analysis and both Crude and adjusted odds ratio with 95% confidence interval was used to identify behavioral risk factors associated with hypertension Results: A total of 830 participants were enrolled in the study, of which 464(55%) were females and 366(45%) were males. The age-standardized prevalence of hypertension was 34.7% [95% CI 31.1-38.3] similar among men and women. The prevalence of hypertension increased with age (p= <0.001). The level of awareness of hypertension status was 27.9% [95% CI, 22.3-34.2]. More females (48.4%) were aware of their status than men (18.5%).. In a multivariate logistic regression model, age 50-69 years [AOR = 2.10; (95 % CI, 1.1– 4.11)], female sex [AOR = 2.14; (95 % CI, 1.36– 3.36)] , obesity [AOR = 2.25; 95 % CI, 1.3– 3.8)] , light cigarette use(1-9sticks/day) [AOR=19.63, (95 % CI, 9.6-40.1)] moderate cigarette use (10-19sticks/day) [AOR=36.6;(95 % CI, 16.9-79.6)] and heavy cigarette use(>20 sticks/day) [AOR=36.34, (95 % CI, 12.7-104.1)]were associated with hypertension. Conclusion: The prevalence of hypertension and associated risk factors is high in Juba city with very low levels of hypertension status awareness. There is need to scale up health promotion, diagnosis, treatment and control of hypertension in this low-income setting. Given the nascent status of the health system of South Sudan, behavior change interventions targeting lifestyle modification should be prioritized to minimize the upsurge of hypertension at the community level.