Social determinants and exposure to risk factors for chronic non-communicable diseases in a peri-urban setting of Maputo City, Mozambique

Macicame, Ivalda Benigna (2021): Social determinants and exposure to risk factors for chronic non-communicable diseases in a peri-urban setting of Maputo City, Mozambique. Dissertation, LMU München: Medizinische Fakultät

Abstract

Background: Chronic non-communicable diseases (NCDs) are responsible for almost three quarters of all deaths globally. The prevalence of NCDs and its behavioral and metabolic risk factors are increasing rapidly in African urban areas. Identifying the behavioral and metabolic risk factors for NCDs present in the Mozambican capital and its associated social determinants may guide health policies for the prevention and control of NCDs. Methods: A cross-sectional study where quantitative data regarding socioeconomic status and risk factors for NCDs was collected in individuals aged 15-64 years was conducted in the Health and Demographic Surveillance System (HDSS) in Maputo city. STEPwise Approach-based procedures were used to collect physical measures (weight, height, abdominal circumference and blood pressure). Capillary blood samples were collected to measure glucose and lipid profile. Physical activity was measured using pedometers. Results: Overall, 963 individuals from 367 households consented to participate in the study. The percentage of sedentary subjects was 20.8% while the percentage who were physically inactive was 64.8%. The prevalence of overweight (BMI ≥25 kg/m²) and obesity (BMI≥30 kg/m²) was 30.9% (95% CI: 28.0, 33.9) and 12.6% (95% CI: 10.4, 14.7), respectively. The overall prevalence of metabolic syndrome (MS) was 5.6% (95%CI: 4.1, 7.1). In general, women were more sedentary and inactive and showed a significantly higher prevalence of overweight, obesity and MS compared to men. Social determinants such as wealth, education and occupation were not associated with measured behavioral and metabolic risk factors for NCDs. Conclusion: Both behavioral and metabolic risk factors for NCDs are highly prevalent in this peri-urban part of the Mozambican capital where underweight and infectious diseases are also present, which confirms that the country is facing a double burden of disease. The fact that behavioral and metabolic risk factors for NCDs are not associated with specific socioeconomic and environmental factors may relate to the homogenicity of the evaluated cohort. However, this finding also indicates that prevention programs should not be restricted to certain population subgroups but should target the general population.

• Dokumententyp: Dissertationen (Dissertation, LMU München)
• Keywords: Non-communicable diseases, Risk factors, Social determinants, Urbanization, Mozambique
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften ; 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• Fakultäten: Medizinische Fakultät
• Sprache der Hochschulschrift: Englisch
• Datum der mündlichen Prüfung: 8. November 2021
• 1. Bericht­erstatter:in: Parhofer, Klaus