dc.description.abstract
For the last 25 years, an epidemiologic transition has taken place in sub-Saharan Africa.
While infectious diseases and malnutrition slowly decline and thus, still constitute main
public health threats, cardio-metabolic diseases are on the rise as major contributors to
the burden of disease.
In Ghana, both groups of diseases co-occur at the country level, within households and
at the individual level. However, among adolescents as one of the largest population
groups in this region, the occurrence of such entities has hardly been described.
Therefore, the present study aimed at investigating the proportions of infectious
diseases, malnutrition and cardio-metabolic risk factors (CRFs) among teenagers in
Ghana, and at evaluating demographic, socio-economic and medical risk factors for
these conditions.
In a cross-sectional analysis including 188 adolescents in rural Ghana, the single
proportions (95% confidence interval, CI) and the co-occurrence of infectious diseases
(malaria, other common diseases), malnutrition (underweight, stunting, iron deficiency,
vitamin A deficiency), and CRFs (overweight, obesity, impaired fasting glucose,
hypertension) were determined. In questionnaire-based interviews, we collected socioeconomic
data and self-reported health status. Body weight, -height, -temperature and
blood pressure were measured for each individual. From venous blood samples
Plasmodium species, plasma concentrations of ferritin, C-reactive protein, retinol, and
fasting plasma glucose were analyzed. Anthropometric measures and blood pressure
values were compared to age- and sex-specific reference data to detect underweight,
stunting, overweight, obesity as well as hypertension, respectively. In logistic regression
models, odds ratios (OR) and 95% CIs were calculated for the associations of sociodemographic
and medical factors with disease status.
In this Ghanaian population (age range, 14.4-15.5 years; males, 50%), the proportions
were for infectious diseases 45% (95% CI: 38-52%), for malnutrition 50% (43-57%) and
for CRFs 16% (11-21%). Infectious diseases and malnutrition frequently coexisted
(28%; 21-34%). Overlap of CRFs with infectious diseases (6%; 2-9%) or with
malnutrition (7%; 3-11%) was also present. The former mainly comprised hypertension
plus malarial infection (n=8/11), while the
latter was largely attributable to overweight or obesity plus vitamin A deficiency (n=7/13). Male gender and low socio-economic status increased the odds of infectious
diseases and malnutrition, respectively.
Malarial infection, chronic malnutrition and VAD remain the predominant health
problems among these Ghanaian adolescents. Regarding CRFs, already at this young
age, obesity and hypertension evolve. Investigating the interrelations of infection,
malnutrition, and CRFs is warranted.
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dc.description.abstract
In Subsahara-Afrika vollzieht sich in den letzten 25 Jahren ein epidemiologischer Wandel. Während Infektionskrankheiten und Mangelernährung weiterhin die vorrangigen Gesundheitsprobleme bilden und ihr Anteil in der Public Health-Belastung nur langsam abnimmt, steigt die Belastung durch kardio-metabolische Erkrankungen rapide. Demnach liegt in Ghana eine Doppelbelastung durch beide Erkrankungsgruppen vor, die sich auf Bevölkerungsebene, innerhalb einer Familie und bei Einzelpersonen zeigt. Jedoch ist dieses Phänomen kaum erforscht für Jugendliche – eine der größten Bevölkerungsgruppen in dieser Region. Daher hatte die vorliegende Studie die Ziele, die Häufigkeit von Infektionskrankheiten, Mangelernährung und kardio-metabolischen Risikofaktoren unter Jugendlichen in Ghana zu bestimmen sowie demografische, sozioökonomische und klinische Risikofaktoren für deren Auftreten zu analysieren.
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