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Department of Community Medicine, College of Health Sciences, Usmanu Danfodiyo University, Sokoto.
2
Department of Internal Medicine, College of Health Sciences, Usmanu Danfodiyo
University, Sokoto.
3
Department of Chemical Pathology, Specialist Hospital, Sokoto.
*Corresponding author. E-mail: awosankj1@yahoo.com
Abstract
Coronary heart disease (CHD) was previously considered to be rare in sub-Saharan Africa, but its
prevalence is on the increase mainly because of the increasing prevalence of its risk factors, linked to
trends in urbanization and changes in lifestyle. This study sought to assess the awareness and
prevalence of risk factors of coronary heart disease in Sokoto, Nigeria. A comparative cross sectional
study was conducted among 110 bankers and 110 secondary school teachers selected by multistage
sampling technique in August 2011. Anthropometric measurements, blood pressure measurement,
and estimation of fasting blood sugar and cholesterol were done for the participants, together with
questionnaire administration. Up to 50% awareness was reported in only 4 of 7 and 1 of 7 CHD risk
factors among bankers and teachers respectively. Prevalence of CHD risk factors was high in both
groups as follows; hypertension (teachers 33.3%, bankers 22.9%), diabetes mellitus (teachers 9.5%,
bankers 8.5%), obesity (teachers 30.5%, bankers 20%), hypercholesterolemia (teachers 37.1%, bankers
41.9%), sedentary lifestyle (teachers 5.7%, bankers 33.3%) and smoking (teachers 4.8%, bankers 7.6%).
This study demonstrated poor awareness and high prevalence of CHD risk factors among bankers and
teachers in Sokoto. Public health education and promotion of healthy lifestyles are suggested to
reduce this burden.
Keywords: Coronary heart disease, risk factors, awareness, prevalence, health education
INTRODUCTION
Coronary heart disease (CHD) was previously considered
to be rare in sub-Saharan Africa, but its prevalence is on
the increase and now ranks 8th among the leading
causes of deaths in men and women in the region (Steyn
et al., 2005). While communicable diseases account for
the highest proportion of deaths in all persons and in
those aged 15 to 59 years, importantly, in people aged 60
years and above, CHD is already the leading cause of
deaths in men and the second leading cause of deaths in
women in the African region (Dean et al., 2006). The
World Health Organization (WHO) estimated that in 2005,
CHD caused approximately 361,000 deaths in the African
region, and current projections suggest that this number
Rayto
RT-9200
semi-auto
chemistry
analyzer
(spectrophotometer) was used for analysis of fasting
serum total cholesterol.
Three medical officers, two nurses and two laboratory
scientists assisted in data collection after pre-training on
the objectives, selection of participants and use of survey
instruments. Ethical permission to carry out the study was
obtained from the Ethical committee of the Usmanu
Danfodiyo University Teaching Hospital Sokoto.
Permission to carry out the study in the schools was
sought and obtained from Sokoto State Ministry of
Education and Ministry of Science and Technology;
likewise the Management of the banks. Informed written
consent was obtained from the participants before data
collection.
Operational definition of terms
Body mass index (BMI) was calculated as weight (kg)
divided by height2 (m2) and used as marker for
overweight and obesity (Tsigos et al., 2008). Underweight
was defined as BMI less than 18.5kg/m2, normal weight
was defined as BMI of 18.5 to 24.9kg/m2, overweight was
defined as BMI of 25.0 to 29.9kg/m2, while obesity was
defined as BMI of 30.0kg/m2 and above. Diabetes
mellitus was defined using the WHO criteria (WHO, 1999)
as fasting plasma whole glucose > 6.1mmol/l (110mg/dl).
Hypercholesterolaemia was defined using the American
Heart Association criteria (AHA, 2002) as fasting serum
Total cholesterol (Tc) > 5.2mmol/l (200mg/dl).
Hypertension was defined using the World Health
Organization and International Society of Hypertension
criteria (WHO and ISH, 2003) as systolic blood pressure
(SBP) > 140mmHg and/or diastolic blood pressure (DBP)
> 90mmHg or both or self reported antihypertensive
medication during the past 1 week.
Data analysis
Data was analyzed using the SPSS version 17 computer
statistical software package. Frequency distribution
tables were constructed; cross tabulations were done to
examine relationship between categorical variables. The
Chi-square test was used to compare differences
between proportions. The independent students t-test
was used for comparison of mean differences between
the two groups. Logistic regression analysis was used to
determine the variables that predict the risk factors of
CHD. All statistical analysis was set at 5% level of
significance (i.e. p < 0.05).
RESULTS
Only 105 of the 110 participants in each group had
useable questionnaires. The age of the teachers ranged
TEACHERS
N= 105 (%)
BANKERS
N=105 (%)
p- value
25
56
36.58
7.70
20
49
31.31
6.18
t = 5.466
p < 0.001
22 (21.0)
48 (45.7)
29 (27.6)
6 (5.7)
49 (46.7)
46 (43.8)
10 (9.5)
0 (0)
x2= 25.567
p < 0.001
SEX
Male
Female
62 (59.0)
43 (41.0)
79 (75.2)
26 (24.8)
x2= 6.238
p= 0.013
MARITAL STATUS
Single
Married
Separated
Widowed
23 (21.9)
80 (76.2)
0 (0)
2 (1.9)
53 (50.5)
51 (48.6)
1 (0.9)
0 (0)
x2= 3.525
p= 0.060
RELIGION
Islam
Christianity
81 (77.1)
24 (22.9)
43 (41.0)
62 (59.0)
x2= 28.436
p < 0.001
EDUCATIONAL STATUS
College of Education
Polytechnic
University
26 (24.8)
8 (7.6)
71 (67.6)
2 (1.9)
42 (40.0)
61 (58.1)
x2= 44.449
p < 0.001
Response
Yes
No
Dont know
TEACHERS
N= 105 (%)
38 (36.2)
9 (8.6)
58 (55.2)
BANKERS
N= 105 (%)
36 (34.3)
19 (18.1)
50 (47.6)
As age increases
p- value
Yes
No
Dont know
44 (42.3)
8 (7.7)
52 (50.0)
61 (58.1)
3 (2.9)
41 (39)
x2= 6.322
p= 0.042
Overweight/ Obesity
Yes
No
Dont know
50 (47.6)
5 (4.8)
50 (47.6)
58 (55.2)
3 (2.9)
44 (41.9)
x2= 1.476
p= 0.478
Yes
No
Dont know
48 (45.7)
4 (3.80
53 (50.5)
55 (52.4)
8 (7.6)
42 (40.0)
x2= 3.083
p= 0.214
Hypertension
Yes
No
Dont know
53 (50.5)
2 (1.9)
50 (47.6)
62 (59.0)
3 (2.9)
40 (38.1)
x2= 2.015
p= 0.365
Diabetes mellitus
Yes
No
Dont know
33 (31.4)
6 (5.7)
66 (62.9)
45 (42.9)
3 (2.9)
57 (54.3)
x2= 3.505
p= 0.173
Yes
No
Dont know
47 (44.8)
7 (6.7)
51 (48.6)
51 (48.6)
6 (5.7)
48 (45.70
x2= 0.331
p= 0.847
x2= 1.582
p= 0.663
22.90%
33.40%
Hypertension
Alcohol consumption
27.60%
3.80%
Cigarette smoking
7.60%
4.80%
3.80%
6.70%
77.10%
61.90%
Hypercholesterolaemia
Sedentary lifestyle
Overweight
Obesity
Diabetes mellitus
33.30%
Teachers
5.70%
45.70%
22.90%
19.00%
26.70%
8.60%
10.50%
43.80%
52.40%
Psychological stress
Bankers
4.80%
8.70%
How to cite this article: Awosan, K.J., Ibrahim, M.T.O., Sabir A.A.,
Ejimodu, P. (2013). Awareness and prevalence of risk factors of
coronary heart disease among teachers and bankers in Sokoto,
Nigeria. J. Med. Med. Sci. 4(9):337-342