Aim: To establish the prevalence and risk factors for hypertension, diabetes and obesity among teaching and non-teaching staff of Bishop Stuart University , Mbarara-Uganda. Background: None communicable diseases (NCDs) are projected to exceed communicable diseases as the most common causes of death by 2030 in Africa. Most sub-Saharan African countries however lack detailed countrywide data on hypertension and other NCDs risk factors. Cognizant of Uganda’s recent inclusion of Hypertension and diabetes in the health policy agenda, this study was conducted among the university staff in a rural setting to provide benchmark information for design of appropriate interventions. Study Design: This was a descriptive cross-sectional, institutional based survey design. Place and duration of the study: This study was conducted among the teaching and none teaching staff of Bishop Stuart University Mbarara, Uganda from 18th April - 6th June 2017 . Methodology: A structured questionnaire was used to gather social demographic and risk factors data from the university workers at their work stations. Blood pressure of each participant was measured and Hypertension was defined as systolic BP > 140 and/or diastolic (BP) > 90 mmHg. Anthropometric measurements : Body Mass index (BMI) was done by weight in (Kg) and Height in (M2) to establish weight levels. Obesity was considered at BMI > 40. A random Blood Sugar (RBS) > 200 mg/dl was considered as diabetic. Epi-info version 7 was used to enter data, analyzed using SPSS version 19. Results: A total of 156 University staff aged 25 - 75 years of both sexes, mean age 42 ± 8 were interviewed of whom 51% were males. About 15% were administrative staff, 55% teaching staff, 3% senior lecturers and professors and 25% non-teaching staff. The prevalence s of Hypertension, Diabetes, and obesity w ere 7.7%, 16%, and 28% respectively. But also majority (60.2%) were found at risk of developing both hypertension and diabetes. Less than 20% of the participants were knowledgeable on causes, signs and symptoms and preventive measures for Hypertension but had moderate knowledgeable of the risk factors, the most frequently mentioned risk by 71% was lack of exercise. Despite the awareness of risk factors, majority (61.3%) had not done any form of exercise and 64.1% had not had regular Blood pressure check ups. The study also demonstrated a statistically significant relationship between those aged more than 40 years and having hypertension (X2 = 5.82, P = 0.015, OR = 4.2). Likewise the risk of Diabetes increased with increasing age. Lecturers aged 40 years and above were 5.6 times likely to have diabetes compared to those aged less than 40 years (OR = 5.6, X2 = 16 , P = 0.0005). A significant number of respondents 57/156 (36.5%) reported history of HPT among their family members. Prevalence of obesity and overweight was observed higher in senior administrative staff and lecturers than in lower cadre staff 49% and 34% ( p < 0.01). Conclusion: Hypertension, Diabetes and obesity are conditions prevalent among the teaching and none teaching staff of BSU, but knowledge on risk factors, clinical presentation and preventive strategies is limited. Routine physical exercises...
Diabetes, hypertension and obesity are among the Non-Communicable Diseases (NCDs) affecting the developed and the developing world. These conditions are often associated with older age groups, but evidence shows that 15 million of all deaths attributed to NCDs which occur between the ages of 30 and 69 years. Of these “premature” deaths, over 80% are estimated to occur in low- and middle-income countries [
In Sub Saharan Africa, NCDs are on rather an alarmingly increasing rate. WHO estimates that by the year 2025, about 1.56 billion people will have increased blood pressure [
Currently in Uganda, there are no Ministry of Health targeted health education programs or interventions for institutions of higher learning on NCDs prevention and control. This is on the assumption that individuals in such institutions are highly knowledgeable of these conditions and their risk factors. Besides, there is scarcity of studies on hypertension and diabetes in tertiary institutions in Uganda. Based on this background, the study was undertaken to find out the prevalence of hypertension, diabetes, obesity and their risk factors if any among the teaching and non-teaching staff of Bishop Stuart University, Mbarara Uganda.
An institutional based, epidemiological study with cross-sectional design was conducted among 156 teaching and non-teaching staff of Bishop Stuart University from 18th April-6th May 2017. Participants were drawn from the three major components of the university staffing i.e., the academic staff, the administration and the non-teaching staff.
Bishop Stuart University had a total of 260 teaching and non-teaching staff by March 2017 according to the Human resource report for the beginning of semester 11 of 2016/2017 academic year. Aware of the target population, Krejcie and Morgan table 1970 [
Stratified sampling was used to categories the study population into 3 components i.e. teaching staff, administrative staff, and support staff. Teaching staff members were drawn from all the departments and a total of 85 staffs (teaching Assistants, lecturers, senior lecturers and professors) were by simple random sampling identified. Being a small population, all the administrative staffs (25) in number were incorporated in the study except those on leave. The non-teaching staff included compound working staff, security department staff and drivers, a total of 42 non-teaching staff were randomly selected and incorporated in the study.
In this study, pre-designed and pre-tested, interviewer-administered structured questionnaire with open-ended and closed questions was used. The first part of our study tool focused on respondents’ demographic, socioeconomic, and knowledge while the second part of the tool focused on respondents’ physical body measurements (anthropometry). Three (3) research assistants were trained to administer the questionnaires and take anthropometric measurements. Training was done by the principle investigator for a period of 2 days a laboratory Technician was co-opted on the team to collect and process the collected samples.
Study subjects were interviewed in their work place setting after explaining the academic nature of this research and they were assured that information collected would be kept confidential. Two (2) attempts were made to interview a particular individual if the person could not be accessed the first time or (s)he was suffering from any acute illness on the day of the first visit. Blood pressure was measured on the upper left arm after at least 10 minutes of rest using a mercury sphygmomanometer in millimeters of mercury (mmHg). During the study, individuals with blood pressure level more than or equal to 140/90 mmHg were advised to visit the University Clinic for further treatment.
Weight was measured in kilograms (kg) using calibrated weighing scales with participants lightly clothed. Height was measured in meters using standard height meter by participants standing upright on the height meter, BMI was computed using a Reference Scale BMI: Below 16 = severe malnutrition, 16 - 16.99 = moderate malnutrition, 17 - 18.4 = mild malnutrition, Normal weight = 18.5 - 25, 25 - 29.99 = overweight grade 1.30 - 39.99 = overweight grade 2 (obesity), above 40 = overweight grade 3 (severe obesity).
Random blood sugar sample was drawn from every participant and measured using glucometer strips following the Reference Scale for Normal Random Blood Sugar as equal or less than 200 mg/dl. Any participant without history of diabetes presenting with random blood sugar of >200 mg/dl was identified as having diabetes.
Data were entered, cleaned and edited for inconsistencies in Epi-info version 7. There after a Statistical Package for Social Scientists (SPSS) version 19 was used for analysis. Descriptive and analytical statistics were used to summarize the data. Descriptive statistics involved the use of frequencies, proportions and tables. Analytical statistics through bivariate analysis and multivariate logistic regression were performed to identify factors associated with the occurrence of hypertension, overweight and obesity. The chi square test was used in determining statistically significant associations while factors with p-values < 0.05 were included in the logistic regression model. Adjusted odds ratios (AORs) were determined with 95% confidence interval (CI) to identify independent factors.
Guidance to do research was sought from the Institutional Review Committee that reviewed all the protocols. Informed consent was sought from the respondents before taking their blood pressure, weight, height and getting blood samples from them. Respondents consented to the data collection process. Standard Operating Procedures (SOPs) for checking blood pressure, Weight, Height, blood sugar were considered.
This study set out to find the prevalence of hypertension, diabetes and obesity among staff of Bishop Stuart University, proportion of staff at a risk of developing hypertension, diabetes and obesity and also to examine the university staff’s knowledge on risk factors, complications and preventive measures for the mentioned three conditions.
A total of 156 study respondents participated in the study mean age 42.4 SD ± 9 years. Eighty percent of the samples were males and 48% were females. Overall prevalence of hypertension in the study subjects was 7.1%. But 9.6% had systolic and diastolic blood pressure of 140 mm Hg and 90 mmHg respectively with high likely hood of being hypertensive if the blood pressure persisted. The Diabetic status of the staffs was established based on random blood sugar. About 16.7% of respondents were diabetic with high blood glucose > 7 mmol/dl, majority 83.3% were not diabetic. About a third (27.6%) of the respondents had family members with diabetes, a risk factor for the study subjects to develop diabetes. The overall prevalence of obesity in the study was 28% (44/156) (
About three quarters (74%) of the staff were not aware of Visual Problems as Sign of Diabetes, 69% not aware of Excess thirst as a Sign of Diabetes and 68% were not aware of the need for regular blood glucose checkups as a preventive strategy (
This cross-sectional study being the first of its kind to explore the knowledge and prevalence of hypertension, diabetes and obesity among the staff of Bishop Stuart University in western Uganda, one most important finding of the study is
Characteristics | Hypertension n (%) | Non-Hypertension n (%) | Total n (%) | Chi-square and p-value |
---|---|---|---|---|
Age ≥ 40 years <40 years Total | 6 (16%) 5 (4%) 11 (7%) | 32 (84%) 113 (96%) 145 (93%) | 38 (25%) 118 (75%) | 0R = 4.23, X2 = 5.82 RR = 0.07, *p = 0.015 |
Religion Protestant Other religions Total | 7 (5.6%) 4 (11.1) 11 (7.1%) | 118 (94.4%) 32 (89%) 145 (92.9%) | 120 (64%) 36 (36%) | 0R = 0.5, X2 = 1.3 RR =0.5, p = 0.248 |
Gender: Male Female | 8 (10%) 3 (4%) | 72 (90%) 73 (96%) | 80 (52%) 76 (48%) | 0R = 2.7, X2 = 0.14 RR =2.53, p = 0.14 |
Role: Technical staff support staff Total | 10 (8.8%) 1 (2.3%) 11 (7.1%) | 103 (91.2%) 42 (97.6%) 145 (92.9%) | 113 (72%) 43 (28%) | 0R = 4.0, X2 = 2.02 RR = 3.80, p = 0.15 |
Technical staff ≥Master’s degree Total | 5 (5.8%) 6 (8.57%) 11 (7.1%) | 81 (92.2%) 64 (91.4%) 145 (92.9%) | 86 (73%) 70 (27%) | 0R = 0.65, X2 = 0.44 RR = 0.67, p = 0.50 |
Characteristics | Diabetic n (%) | Non-diabetic n (%) | Total n (%) | Chi-square, p-value, RR,& OR |
---|---|---|---|---|
Age ≥ 40 years <40 years Total | 14 (36.8) 11 (9.4) 25 (16%) | 24 (64%) 107 (90.6 %) 131 (83%) | 38 (25%) 118 (75%) | 0R = 5.6, X2 = 16, *p = 0.0005 |
Religion Protestant Other religions Total | 20 (16.6%) 5 (13.8%) 25 (16%) | 100 (83.4%) 31 (86.2%) 131 (83%) | 120 (64%) 36 (36%) | OR = 1.24, X2 = 0.158 P = 0.690 |
Gender: Male Female Total | 16 (20%) 9 (11.8%) 25 (16%) | 64 (80%) 67 (88.2%) 131 (83%) | 80 (52%) 76 (48) | 0R = 1.86, X2 = 1.942 *p = 0.0167 |
Role: Technical staff support staff Total | 22 (19.4%) 2 (4.3%) 25 (16%) | 91 (80%) 41 (95.7%) 131 (83%) | 113 (72%) 43 (28%) | QR = 5.31, X2 = 5.832 RR = 3.939, *p = 0.0157 |
Technical staff < Mst degree ≥Master’s degree Total | 10 (11.6%) 15 (21.3%) 25 (16%) | 76 (88.4 %) 55 (78.6 %) 131 (83%) | 86 (73%) 70 (27%) | 0R = 0.491, X2 = 2.621 *p = 0.096 |
Characteristics | Obese n (%) | Non-Obese n (%) | Total n (%) | Chi-square and p-value |
---|---|---|---|---|
Age ≥ 40 years <40 years Total | 18 (42%) 24 (20%) 42 (27%) | 20 (53%) 94 (79%) 114 (79%) | 118 (75%) 38 (25%) | QR: 3.5, X2 = 10.6 RR = 2.25, *p = 0.0011 |
Religion: Protestant Other Religions Total | 30 (25%) 14 (38%) 44 (28%) | 90 (75%) 22 (61%) 112 (72%) | 120 (64%) 36 (36%) | QR: 0.5, X2 = 2.63 RR = 0.62, p = 0.104 |
Gender: Male Female Total | 32 (40%) 12 (15.8%) 44 (28%) | 48 (60%) 64 (84.2%) 112 (72%) | 80(52%) 76 (48) | QR: 3.5, X2 = 11.2 RR = 2.5, *p = 0.0078 |
Role: Technical staff support staff Total | 38 (33.6%) 6 (13.9%) 44 (28%) | 75 (66.4% 37 (88.1%) 112 (72%) | 113(72%) 43 (28%) | QR: 3.1, X2 = 5.9 RR = 2.4, *p = 0.014 |
Technical staff ≥Master’s degree Total | 16 (19.5%) 28 (37.8%) 44 (28%) | 60 (80.5%) 42 (62.3%) 112 (72%) | 86 (73%) 70 (27%) | QR: 0.39, X2 = 6.45 RR = 0.62, *p = 0.011 |
that all the three conditions were prevalent among the university staff i.e. 7.1% with hypertension, 16.7% were diabetic and 28 % with obesity.
Comparatively, the prevalence of hypertension in the current study is lower than the prevalence of hypertension (26.1%) observed in west Bengal rural community in 2017 [
Risk factor HPT, Diabetes and Obesity | Yes | Frequency | Percent |
---|---|---|---|
Doing some form of exercises | Yes | 76 | 48.7% |
No | 80 | 51.3% | |
Regular Blood pressure check up | Yes | 56 | 35.9% |
No | 100 | 64.1% | |
History of Hypertension in a family | Yes | 57 | 33.1% |
No | 99 | 63.4% | |
Respondent smoking status | Yes | 21 | 13.5% |
No | 135 | 86.5% | |
Alcohol consumption status | Yes | 22 | 14.1% |
No | 134 | 85.9% | |
Total cholesterol levels above range (200 - 260) | Yes | 4 | 2.6% |
No | 152 | 97.4% |
Respondents knowledge and awareness of Features of Diabetes | ||
---|---|---|
Awareness of Passing a lot of Urine as a Sign of Diabetes | Frequency | Percent |
Yes | 84 | 53.8 |
No | 72 | 46.2 |
Awareness of Visual Problems as Sign of Diabetes | ||
Aware | 40 | 26% |
Not aware | 116 | 74% |
Awareness of Excess Thirst as a Sign of Diabetes | ||
Aware | 48 | 31% |
Not aware | 108 | 69% |
Respondents awareness of Healthy Checks to Prevent Future Diabetes | ||
49 | 31% | |
107 | 68% |
and 32% in Ghana [
This study established the prevalence of diabetes among university staff as 16.1%, this finding is not much different from 15% prevalence in Nepal among people aged 20 years and above according to Nepal Diabetes Association (NDA) [
Risk factors for Diabetes among the study subjects included, age, sex, obesity, and family History. In this study, lecturers aged 40 years and above were 5.6 times likely to have diabetes compared to those aged less than 40 years (OR = 5.6, X2 = 16 , P = 0.0005). The strong association between advancing age and diabetic condition was consistent with other studies [
The overall prevalence of obesity in this study was 28% and overweight at 32.15% (BMI (25 < 30 kg/ m2). This is slightly higher than 25% among Civil Servants in Nepal. In this study 32.7% had practiced physical exercise to prevent future diabetes while majority (67.3%) did not. This finding is in contrast with findings of William K.M (2010) in the Kenyan study where a relatively bigger percent of respondents (72%) had not participated in regular physical exercise. Studies done elsewhere have also demonstrated that physical inactivity is a major risk factor diabetes and Hypertension.
In this study, the prevalence of Hypertension among the staff was 7.1%; diabetes was 16% and obesity 28%. Only 16% of respondents were knowledgeable about cause, signs and symptoms and risk factors for Hypertension. Notwithstanding society perception of university lecturers as highly knowledgeable and aware group of most social issues as well as health matters, the prevalence of the three non-communicable conditions studied was high amidst limited knowledge. This therefore demonstrates a need for high level awareness campaigns to the university staff about non-communicable diseases and the need for regular health checkups. Routine physical exercises and controlled diet are public health interventions recommended for control of none communicable diseases among the university staff.
These findings are based on the survey data collected from staff from one university in Uganda. Findings from more than one university could have demonstrated a different picture. Much as the risk and associated factors to Hypertension, Diabetes and Obesity were identified, detailed analysis on the confounding factors like smoking and excessive alcoholism was not done. The researcher was establishing the diabetic status of the participant basing on random blood sugar only. Other studies have demonstrated diabetic status of participants by doing both random blood sugar and fasting blood sugar to get conclusive results.
Mixed data collection techniques (quantitative and qualitative) could have been used, i.e. in depth interviews or FGDs could have helped to explore the participant’s knowledge of the three conditions studied and their risk factors. Only structured (quantitative) data collection tool was used.
We thank the three research assistants and laboratory technician who collected data and processed it. This study was funded by University (BSU) Research and Grants Committee.
There are no competing interests.
Amanyire, J., Tumwebaze, M., Mugisha, M.K. and Bright, L.W. (2019) Prevalence and Risk Factors for Hypertension, Diabetes and Obesity among Lecturers and Support Staff of Bishop Stuart University in Mbarara, Uganda. Open Journal of Applied Sciences, 9, 126-137. https://doi.org/10.4236/ojapps.2019.93012