- Title
- Screening for cardiometabolic risk factors among commercial drivers in Buffalo City Metropolitan Municipality, Eastern Cape, South Africa
- Creator
- Adedokun, Aanuoluwa Odunayo
- Subject
- Diabetes -- South Africa -- Eastern Cape Obesity -- South Africa -- Eastern Cape Commercial vehicles
- Date
- 2018
- Type
- Thesis
- Type
- Masters
- Type
- Nursing Science
- Identifier
- http://hdl.handle.net/10353/10431
- Identifier
- vital:35463
- Description
- Cardio-metabolic risk factors are the aggregates of conditions that increase the susceptibility of developing cardio-metabolic diseases such as cardiovascular diseases (CVD) and diabetes. This includes insulin resistance, obesity, hyperglyceamia, dyslipoproteinemia, hyperinsulinemia and hypertension. This condition are worsen by smoking and physical inactivity as they mostlyare not easily detected. This was a cross-sectional survey of 403 commercial taxi drivers at ten different taxi ranks in BCMM. The study utilized a convenient sampling technique for the participants of the study. The WHO STEPwise approach was used for data collection. The WHO STEPwise questionnaire was used for a face-to-face interview. Socio-demographic (sex, age, marital status, driving experience, income) and behavioural characteristics (smoking, alcohol consumption, consumption of sweet drinks, physical activity, and dietary intake) of participants were obtained. Also, objective reports concerning anthropometric measurements (weight, height, waist and hip circumference), blood pressure and biochemical measurement that is the blood glucose measurement. All anthropometric measurements were taken following a standard procedure using a Lufkin nonextensible flexible anthropometric tape (W606PM), Rosscraft, Canada and a SECA weighing scale and stadiometer (Hamburg, Germany). Blood pressure was checked also in accordance with standard protocols using a Medic+ Digital Blood Pressure Monitor Model 1219 (Hamburg, Germany). A validated ACCU-CHEK glucose monitoring apparatus (Mannheim, Germany) wasused for blood glucose measurement. Overweight and obesity was defined as a body mass index (BMI) of 25.0 kg/m2 –29.9 kg/m2 and≥ 30 kg/m2, respectively. Pre-hypertension was defined according JNC-8 criteria a systolic blood pressure of 120- 139 mmHg and diastolic of BP 80-89 mmHg while hypertension was defined as an average of two systolic BP ≥140mmHg and/or diastolic BP of ≥90mmHg or a history of hypertension or anti hypertensive medication use. Diabetes status was determined using the fasting blood glucose (FBG) test and defined as a FBG ≥ 7.0mmol/L or self-reports of history or current diabetes medication use (treatment), while pre-diabetes was defined as a FBG of 5.6-6.9mmol/L. Awareness of diabetes was defined as self-reported history of diabetes among the people with diabetes. Metabolic syndrome status was determined according to the National agreement among makers of abdominal obesity. Statistical Package for Social Sciences (SPSS) was used for data analysis. The mean age of the participants was 43.3 (SD12.5) years. The prevalence of overweight and obesity was 34.0 percent and 38.0 percent, respectively. Age, marital status, period of driving, not-smoking, hypertension and diabetes were significantly associated with obesity. In logistic regression analysis, after adjusting for confounding factors, only age (OR 1.6, CI 1.0-2.7), hypertension (OR 3.6, CI 2.3-5.7) and non-smoking (OR 2.0, CI 1.3-3.1) were the independent and significant determinants of obesity. The prevalence rates of abdominal obesity by waist circumference (WC), waist-hip-ratio (WHR), waist-to-height ratio (WHtR) and neck circumference (NC) were 61.5 percent, 67.5 percent, 80.1 percent and 65.3 percent, respectively. A strong correlations exists between WHR and WC (>0.64); and WHtR and WC (>0.62). There exists a good agreement between WC and WHR. Also, a moderate agreement exists between WC and WHtR, WC and NC, WHR and WHtR, and WHtR and NC. The prevalence of above normal body composition for participants with hypertension was 71.0 percent, 65.9 percent, 63.2 percent and 66.5 percent by WC, WHR, WHtR and NC, respectively. For diabetes, the prevalence was 20.6 percent, 19.4 percent, 17.0 percent and 18.6 percent by WC, WHR, WHtR and NC, respectively. Waist circumference was a stronger predictor of hypertension and diabetics, with odds ratio of 3.7 (95 percent CI: 2.3-6.1 and 3.1 (95 percent CI: 1.6-6.0), compared to NC, with odds ratio of 1.7 (95 percent CI: 1.1-2.8). The prevalence of pre-hypertension was 33.7 percent and hypertension was 57.0 percent. Age, marital status, level of education, period of driving, obesity, alcohol, sweet drinks consumption and diabetes were significantly associated with hypertension. After adjusting for confounders, age >35 years (P=0.004), obesity and alcohol use (P<0.001), period of driving >5years (p=0.028) and diabetes (P=0.003) were significant predictors of hypertension. Prevalence of pre-diabetes and diabetes was 17 percent and 16 percent, respectively. Of those who were diabetic (n=63), the majority were aware of their diabetes status (n=43) and were on treatment (n=30). Age, marital status, level of education, period of driving, obesity, sweet drinks consumption, physical activities and hypertension were significantly associated with diabetes. Only age >35 (AOR= 3.6, CI 1.2-11.1), ever married (AOR= 3.3, CI 1.5-7.0) and hypertension (AOR= 3.4, CI 1.7-6.8) were the independent predictors of diabetes after adjusting for confounders. The prevalence of metabolic syndrome was 22 percent. Age, marital status, level of education, physical inactivity and period of driving were significantly associated with metabolic syndrome. After adjusting for confounders, only age above 35 years (Adjusted Odd Ratio [AOR] =3.8, CI=1.4- 9.5), ever married (AOR=3.0, CI=1.6-5.3) and period of driving above five years (AOR= 2.4, CI=1.2-4.7) were the significant and independent predictors of metabolic syndrome. About 30 percent of the participants were daily smokers, 37 percent consume alcohol regularly and only 18 percent were physically active, while 82 percent were physically inactive. In conclusion, there was a high prevalence of obesity, hypertension and diabetes among the commercial drivers in this setting, which is associated with unhealthy lifestyles (smoking, excessive alcohol consumption, physical inactivity). Interventions aimed at promoting cardiovascular health of commercial drivers such as health education and workplace screening, should prioritize weight reduction, healthy eating and physical activity in this population.
- Format
- 161 leaves
- Format
- Publisher
- University of Fort Hare
- Publisher
- Faculty of Health Sciences
- Language
- English
- Rights
- University of Fort Hare
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