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BMC Public Health
Published in: BMC Public Health 1/2015

Open Access 01-12-2015 | Research article

Burden attributable to Cardiometabolic Diseases in Zimbabwe: a retrospective cross-sectional study of national mortality data

Authors: Mutsa P. Mutowo, Alice J. Owen, Baki Billah, Paula K. Lorgelly, Kudzai E. Gumbie, John C. Mangwiro, Andre M. N. Renzaho

Published in: BMC Public Health | Issue 1/2015

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Abstract

Background

Cardiometabolic diseases (CMDs) are an important cause of mortality worldwide and the burden associated with them is increasing in Sub-Saharan Africa. The tracking of mortality helps support evidence based health policy and priority setting. Given the growing prevalence of non-communicable diseases in Zimbabwe, a study was designed to determine the mortality attributable to CMDs in Zimbabwe.

Methods

The study design was a retrospective cross-sectional analysis of national mortality from 1996 to 2007, collated by the Ministry of Health and Child Welfare in Zimbabwe. We employed generalized additive models to flexibly estimate the trend of the CMD mortality and a logistic regression model was used to find significant factors (cause of death according to the death certificate) of the CMD mortality and predict CMD mortality to 2040.

Results

CMDs accounted for 8.13 % (95 % CI: 8.08 % - 8.18 %) of all deaths during 1996 to 2007 (p = 0.005). During the study period CMD mortality rate increased by 29.4 % (95 % CI: 19.9 % - 41.1 %). The association between gender and CMD mortality indicated female mortality was higher for diabetes (p < 0.001), hypertensive disease (p < 0.001), CVD (p < 0.001) and pulmonary disease (p < 0.001), while male mortality was higher for ischaemic (p = 0.010) and urinary diseases (p < 0.001). There was no gender difference for endocrine disease (p = 0.893). Overall, females have 1.65 % higher mortality than males (p < 0.001). CMD mortality is predicted to increase from 9.6 % (95 % CI: 8.0 % - 11.1 %) in 2015 to 13.7 % (95 % CI: 10.2 % - 17.2 %) in 2040 for males, and from 11.6 % (95 % CI: 10.2 % - 12.9 %) in 2015 to 16.2 % (95 % CI: 13.1 % - 19.3 %) in 2040 in females.

Conclusion

The findings of this study indicate a growing prevalence of CMDs and related mortality in Zimbabwe. Health policy decisions and cost-effective preventive strategies to reduce the burden of CMDs are urgently required.
Literature
1.
Alberti KG, Zimmet PZ. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet Med. 1998;15(7):539–53.CrossRefPubMed
2.
3.
Executive Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults. Executive summary of the third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). JAMA. 2001;285(19):2486-2497.
4.
Sattar N. The metabolic syndrome: Setting the scene: The cons. Diabetes Vasc Dis Res. 2007;4 suppl 2:S4–6.
5.
Bruno G, Merletti F, Biggeri A, Bargero G, Ferrero S, Runzo C. Metabolic syndrome as a predictor of all-cause and cardiovascular mortality in type 2 diabetes: The Casale Monferrato study. Diabetes Care. 2004;27:2689–94.CrossRefPubMed
6.
Ogbera A. Prevalence and gender distribution of the metabolic syndrome. Diabetol Metab Syndrome. 2010;2:1.CrossRef
7.
Isezuo SA, Ezunu E. Demographic and clinical correlates of metabolic syndrome in native African type 2 diabetic patients. J Natl Med Assoc. 2005;97:557–63.PubMedPubMedCentral
8.
Fezeu L, Balkau B, Kengne A, Sobngwi E, Mbanya JC. Metabolic syndrome in a Sub-Saharan African setting: Central obesity may be the key determinant. Atherosclerosis. 2007;193:70–6.CrossRefPubMed
9.
10.
Ministry of Health and Child Welfare. Zimbabwe National Health Strategy for Zimbabwe 2009-2013: Equity and Quality in Health: A People’s Right. Zimbabwe: MOHCW; 2009.
11.
12.
Chapman G, Hansen KS, Jelsma J, Ndhlovu C, Piotti B, Byskov J, et al. as measured by disability-adjusted life years lost. Trop Med Int Health. 1997;2006(11):660–71.
13.
14.
Mutowo MP, Mangwiro JC, Lorgelly PK, Owen AJ, Renzaho AMN. Hypertension in Zimbabwe: a meta-analysis to quantify its burden and policy implications. World J Meta-Anal. 2015;3(1):54–60 15. February 26.CrossRef
15.
ICD9. International Classification of Diseases, vol. 1. Geneva: World Health Organization; 1975.
16.
World Health Organization. International classification of diseases and related health problems, Tenth Revision. Geneva: World Health Organization; 1992.
17.
18.
19.
20.
Norheim, OF, Jha, P, Admasu, K, Godal T, Hum RJ, Kruk ME, et al. Avoiding 40% of the premature deaths in each country, 2010–30: review of national mortality trends to help quantify the UN Sustainable Development Goal for health. Lancet. 2015;385(9964):239-252.
21.
22.
Shlipak MG, Fried LF, Cushman M, Manolio TA, Peterson D, Stehman-Breen C, et al. Cardiovascular mortality risk in chronic kidney disease: comparison of traditional and novel risk factors. JAMA. 2005;293:1737–45.CrossRefPubMed
23.
24.
25.
Nyanga T, Mpala C, Chifamba E. Brain Drain: implications for sustainable development in Zimbabwe. J Sustainable Dev Afr. 2012;14(8):141–153.
26.
Silva GAR, Andrade MCT, Sugui DAS, Nunes RF, Pinto JFC, et al. Association between antiretrovirals and thyroid diseases: a cross-sectional study. Arch Endocrinol Metab. 2015;59(2):116–22.CrossRefPubMed
27.
Bricaire F, Marche C, Zoubi D, et al. Adrenal lesions in AIDS: anatomopathological study. Ann Med Interne (Paris). 1987;138:607–9.
28.
29.
Mathers CD, Fat DM, Inoue M, Rao C, Lopez AD. Counting the dead and what they died from: an assessment of the global status of cause of death data. Bull World Health Organ. 2005;83:171–7.PubMedPubMedCentral
30.
Kim AS, Johnston SC. Global variation in the relative burden of stroke and ischemic heart disease. Circulation. 2011;124:314–23.CrossRefPubMed
31.
Ogeng'o JA, Olabu BO, Ong'era D, Sinkeet SR. Pattern of acute myocardial infarction in an African country. Acta Cardiol. 2010;65:613–8.PubMed
32.
Mendis S, Puska P, Norrving B. Global Atlas on Cardiovascular Disease Prevention and Control. Geneva: World Health Organization; 2011.
33.
Blair Research Institute, Oxford University. The early socio‐demographic impact of the HIV‐1 epidemic in rural Zimbabwe. Harare Zimbabwe: Blair Research Institute; 1996.
34.
Larsson R, Capili B, Eckert-Norton M, Colagreco JP, Anastasi JK. Disorders of glucose metabolism in the context of human immunodeficiency virus infection. J AANP. 2006;18:92–103.
35.
Sliwa K, Carrington MJ, Becker A, Thienemann F, Ntsekhe M, Stewart S. Contribution of the human immunodeficiency virus/acquired immunodeficiency syndrome epidemic to de novo presentations of heart disease in the heart of SOWETO study cohort. Eur Heart J. 2012;33:866–74.CrossRefPubMed
36.
Ntsekhe M, Hakim J. Impact of human immunodeficiency virus infection on cardiovascular disease in Africa. Circulation. 2005;112:3602–7.CrossRefPubMed
37.
38.
Basu S, McKee M, Galea G, Stuckler D. Relationship of soft drink consumption to global overweight, obesity, and diabetes: a cross-national analysis of 75 countries. Am J Public Health. 2013;103(11):2071–7.CrossRefPubMedPubMedCentral
39.
Taylor FC, Satija A, Khurana S, Singh G, Ebrahim S. Pepsi and Coca Cola in Delhi, India: availability, price and sales. Public Health Nutr. 2011;14(4):653–60.CrossRefPubMed
40.
Srinath Reddy K, Katan MB. Diet, nutrition and the prevention of hypertension and cardiovascular diseases. Public Health Nutr. 2004;7(1A):167–86.PubMed
41.
Steyn NP, Mann J, Bennett PH, Temple N, Zimmet P, Tuomilehto J, et al. Diet, nutrition and the prevention of type 2 diabetes. Public Health Nutr. 2004;7(1A):147–65.CrossRefPubMed
42.
Renzaho AMN. Fat, rich and beautiful: changing socio-cultural paradigms associated with obesity risk, nutritional status and refugee children from sub-Saharan Africa. Health Place. 2004;10(1):105–13.CrossRefPubMed
43.
Abubakari AR, Lauder W, Jones MC, Kirk A, Agyemang C, Bhopal RS. Prevalence and time trends in diabetes and physical inactivity among adult West African populations: the epidemic has arrived. Public Health. 2009;123(9):602–14.CrossRefPubMed
44.
Tuei VC, Maiyoh GK, Ha CE. Type 2 diabetes mellitus and obesity in sub-Saharan Africa. Diabetes Metab Res Rev. 2010;26(6):433–45.CrossRefPubMed
45.
Unwin N, James P, McLarty D, Machybia H, Nkulila P, Tamin B, et al. Rural to urban migration and changes in cardiovascular risk factors in Tanzania: a prospective cohort study. BMC Public Health. 2010;10:272.CrossRefPubMedPubMedCentral
46.
Vorster HH. The emergence of cardiovascular disease during urbanization of Africans. Public Health Nutr. 2002;5:239–43.PubMed
47.
48.
Newschaffer CJ, Longjian L, Sim A. Cardiovascular diseases. In: Remington PL, Brownson RC, Wegner MV, editors. Chronic disease epidemiology and control. Washington: American Public Health Association; 2010. p. 383–428.
49.
Mirzaei M, Truswell R, Taylor R, Leeder SR. Coronary heart disease epidemics: not all the same. Heart. 2009;95(9):740–6.CrossRefPubMed
50.
O’Malley KJ, Cook KF, Price MD, Wildes KR, Hurdle JF, Ashton CM. Measuring diagnoses: ICD code accuracy. Health Serv Res. 2005;13(5 Pt 2):1620–39.CrossRef
51.
52.
Khaw K-T, Wareham N, Bingham S, Welch A, Luben R, Day N. Combined impact of health behaviours and mortality in men and women: the EPIC-Norfolk prospective population study. PLoS Med. 2008;5(1):e12.CrossRefPubMedPubMedCentral
53.
54.
Fuller JH. Mortality trends and causes of death in diabetic patients. Diabetes Metab. 1993;19:96–9.
55.
Gu K, Cowie CC, Harris MI. Mortality in adults with and without diabetes in a national cohort of the U.S. population, 1971–1993. Diabetes Care. 1998;21:1138–45.CrossRefPubMed
56.
Butler R, Bonazelli J. Converting MS-DRGs to ICD-10-CM/PCS. Methods used, lessons learned. J Ahima. 2009;80(11):40–3.PubMed
57.
Anderson RN, Miniño MM, Hoyert DL, Rosenberg HM. Comparability of cause of death between ICD-9 and ICD-10: Preliminary Estimates. Natl Vital Stat Rep. 2001;49(2):1–32.
Metadata
Title
Burden attributable to Cardiometabolic Diseases in Zimbabwe: a retrospective cross-sectional study of national mortality data
Authors
Mutsa P. Mutowo
Alice J. Owen
Baki Billah
Paula K. Lorgelly
Kudzai E. Gumbie
John C. Mangwiro
Andre M. N. Renzaho
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2015
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-015-2554-z

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