Socio-economic factors associated with hypertension in adults aged 45 and below in Malawi- a cross sectional study
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Date
2020-11-11
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Kamuzu University of Health Sciences
Abstract
Type of study: Quantitative cross-sectional Study
Problem: Despite the high rates of mortality and morbidity due to NCDs, attention to this
group of diseases is arguably insufficient both at global, regional and country level.
Hypertension is the leading cause of cardiovascular disease and its prevalence continue to
escalate in the least developed parts. Hypertension is responsible for at least 45% of deaths due
to heart disease and 51% of deaths due to stroke. The highest prevalence of hypertension is
documented in the African region at an estimated 46% in 2013. Studies initially identified
hypertension to be a disease of the affluent. However emerging evidence suggests that the
condition also affects those from underserved and socially disadvantaged communities like
Malawi, where 65% of the population is reported to be poor and resides in rural areas. Most
studies establishing this association used income and expenditure as economic indicators.
These indicators may not depict the economic status of rural Malawians as most are not
formally employed nor do they document household expenditure. In addition, globally
reported hypertension risk factors such as obesity and physical inactivity in Malawi are
uncommon. It is reported that most hypertensives in Malawian are lean, young and highly
physically active. Establishing context specific factors associated with hypertension, may
improve its management and assist in the attainment of the WHO target to reduce hypertension
by 25%. This study therefore aims to determine the socioeconomic factors associated with
hypertension in rural Malawi using the wealth index as an economic indicator. This study also
aims at determining the mechanism through which low socioeconomic status leads to
hypertension.
Methodology: This will be a population-based study using secondary data from the Malawi
Longitudinal Study of Families and Health (MLSFH), a long-standing publicly-available
longitudinal cohort study that documents more than two decades of demographic,
socioeconomic and health conditions in three districts in Malawi.In particular, this analysis will
focus on cross-sectional survey data for 2019; focusing on Education levels, stress and
household wealth as potential socioeconomic correlates for hypertension. This study aims to
determine the association of household wealth, stress and hypertension. Ethical issues
including seeking permission to access, use and protect the data will be followed.
Expected findings and dissemination: The investigator will determine the socioeconomic
factors associated with hypertension in a low socioeconomic setting, in rural Malawi. The
findings will be presented to COMREC and the research dissemination organized by the
college, the department for viva and publishing findings in a recognized health peer-reviewed
journal once accepted