Browsing by Author "Lisa K Micklesfield"

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    Body composition and physical activity as mediators in the relationship between socioeconomic status and blood pressure in young South African women: a structural equation model analysis
    (2018-11-11) Richard J Munthali; Mercy Manyema; Rihlat Said-Mohamed; Juliana Kagura; Stephen Tollman; Kathleen Kahn; F Xavier Gómez-Olivé; Lisa K Micklesfield; David Dunger; Shane A Norris
    Objectives Varying hypertension prevalence across different socioeconomic strata within a population has been well reported. However, the causal factors and pathways across different settings are less clear, especially in sub-Saharan Africa. Therefore, this study aimed to compare blood pressure (BP) levels and investigate the extent to which socioeconomic status (SES) is associated with BP, in rural and urban South Africa women. Setting Rural and urban South Africa. Design Cross-sectional. Participants Cross-sectional data on SES, total moderate and vigorous physical activity (MVPA), anthropometric and BP were collected on rural (n=509) and urban (n=510) young black women (18–23 years age). Pregnant and mentally or physically disabled women were excluded from the study. Results The prevalence of combined overweight and obesity (46.5% vs 38.8%) and elevated BP (27.0% vs 9.3%) was higher in urban than rural women, respectively. Results from the structural equation modelling showed significant direct positive effects of body mass index (BMI) on systolic BP (SBP) in rural, urban and pooled datasets. Negative direct effects of SES on SBP and positive total effects of SES on SBP were observed in the rural and pooled datasets, respectively. In rural young women, SES had direct positive effects on BMI and was negatively associated with MVPA in urban and pooled analyses. BMI mediated the positive total effects association between SES and SBP in pooled analyses (ß 0.46; 95% CI 0.15 to 0.76). Conclusions Though South Africa is undergoing nutritional and epidemiological transitions, the prevalence of elevated BP still varies between rural and urban young women. The association between SES and SBP varies considerably in economically diverse populations with BMI being the most significant mediator. There is a need to tailor prevention strategies to take into account optimizing BMI when designing strategies to reduce future risk of hypertension in young women. This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the license is given, and indication of whether changes were made.
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    Identifying the prevalence and correlates of multimorbidity in middle-aged men and women: a cross-sectional populationbased study in four African countries
    (2023-02-15) Lisa K Micklesfield; Richard Munthali; Godfred Agongo; Gershim Asiki; Palwende Boua; Solomon SR Choma; Nigel J Crowther; June Fabian; Francesc Xavier Gómez-Olivé; Chodziwadziwa Kabudula; Eric Maimela; Shukri F Mohamed; Engelbert A Nonterah; Frederick J Raal; Hermann Sorgho; Furahini D Tluway; Alisha N Wade; Shane A Norris; Michele Ramsay
    Objectives To determine the prevalence of multimorbidity, to identify which chronic conditions cluster together and to identify factors associated with a greater risk for multimorbidity in sub-Saharan Africa (SSA). Design Cross-sectional, multicentre, population-based study. Setting Six urban and rural communities in four subSaharan African countries. Participants Men (n=4808) and women (n=5892) between the ages of 40 and 60 years from the AWI-Gen study. Measures Sociodemographic and anthropometric data, and multimorbidity as defined by the presence of two or more of the following conditions: HIV infection, cardiovascular disease, chronic kidney disease, asthma, diabetes, dyslipidaemia, hypertension. Results Multimorbidity prevalence was higher in women compared with men (47.2% vs 35%), and higher in South African men and women compared with their East and West African counterparts. The most common disease combination at all sites was dyslipidaemia and hypertension, with this combination being more prevalent in South African women than any single disease (25% vs 21.6%). Age and body mass index were associated with a higher risk of multimorbidity in men and women; however, lifestyle correlates such as smoking and physical activity were different between the sexes. Conclusions The high prevalence of multimorbidity in middle-aged adults in SSA is of concern, with women currently at higher risk. This prevalence is expected to increase in men, as well as in the East and West African region with the ongoing epidemiological transition. Identifying common disease clusters and correlates of multimorbidity is critical to providing effective interventions.