BackgroundStudies on alcohol consumption in rural areas in sub-Saharan Africa are scarce. This study aimed to determine the prevalence and determinants of alcohol consumption in rural western Kenya. The study was conducted as a preliminary stage of a community-based intervention to reduce hazardous alcohol consumption.MethodsA cross-sectional survey of 478 participants aged 18–65 years residing in Ikolomani Sub-county, Kakamega County was conducted in April 2015. Data were collected using an interviewer-administered questionnaire. We defined current drinkers as participants who consumed any alcoholic product in the preceding one month, and hazardous/high-risk drinkers as participants with an Alcohol Use Disorders Identification Test (AUDIT) score of 8 and above. We summarised data using descriptive statistics and used logistic regression to explore for the correlates of each of current alcohol consumption and hazardous/high-risk alcohol consumption.ResultsThe sex-standardized prevalence of current alcohol drinkers was 31.7% (95% confidence interval (CI): 26.8%–37.2%). The prevalence was higher in men (54.6%) than in women (8.9%). The mean AUDIT score among current drinkers was 16.9 (SD 8.2) and the sex-standardized prevalence of hazardous/high-risk alcohol drinking was 28.7% (95% CI: 24.1%–34.0%). Traditional brews were the most commonly consumed types of alcohol and most drinkers took alcohol in the homes of alcohol sellers/brewers. In multivariate analyses, the number of drinkers in the family, the number of friends who are drinkers and the attitude towards alcohol intake were positively associated with current alcohol drinking status, and with hazardous/high-risk alcohol consumption. Women were less likely to be current drinkers and hazardous/high-risk drinkers than were men. Other socio-demographic factors were not significantly associated with alcohol consumption.ConclusionsThe prevalence of alcohol consumption in the study area was higher than the national level estimate of 13.3%. The results suggest that the social environment is the main determinant of alcohol consumption in this setting. These findings imply that interventions to mitigate alcohol consumption in this area will have to target the social networks of the alcohol consumers, change the drinkers’ attitude towards alcohol, and tackle the issue of availability of unlicensed homemade brews.Electronic supplementary materialThe online version of this article (doi:10.1186/s12888-017-1344-9) contains supplementary material, which is available to authorized users.

Community-based alcohol brief interventions implemented by community-health workers accompanied by motivational talks by former drinkers were associated with reduced hazardous and harmful alcohol consumption in a rural setting in western Kenya.

Background. The dual burden of cardiovascular diseases and Human Immunodeficiency Virus (HIV) in sub-Saharan Africa is of public health concern. Persons living with HIV are 1.5–2 times more likely to develop CVD risk factors compared to the noninfected individuals. Hypertension is a major risk factor leading to the rising CVD epidemic in SSA. However, the burden of hypertension among HIV patients in Kenya is not well documented. Objective. This study determined the prevalence and the associated factors of hypertension among HIV patients receiving regular care at Thika Level 5 Hospital Comprehensive Care Clinic (CCC), within metropolitan Nairobi, Kenya. Methods. The current cross-sectional study involved review of patients’ records/charts. Charts for adult patients seen in the last 6 months at Thika Level 5 Hospital CCC were included in the study. Hypertension was defined as systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg on two different readings one month apart, while overweight/obesity was defined as body mass index (BMI) ≥ 25 kg/m2. Results. In a sample of 939 HIV patients, the majority, 68.8% (646), were female. The patients’ ages ranged from 18 to 84 years with a median age of 44 (IQR 37–51) years. The mean BMI was higher for females (25.8 kg/m2) compared to that of males (23.1 kg/m2). However, the prevalence of hypertension was higher among males (25.3%) compared to females (16.9%). Age >40 years (AOR = 2.80, p ≤ 0.001 ), male sex (AOR = 2.10; p = 0.04 ), history of alcohol consumption (AOR = 2.56, p ≤ 0.001 ), and being overweight/obese (AOR = 2.77 p ≤ 0.001 ) were significantly associated with hypertension. The antiretroviral (ARV) regimen and, additionally, the duration of antiretroviral therapy had no association with being hypertensive. Conclusion. The prevalence of hypertension is high among HIV patients. Traditional cardiovascular risk factors were associated with hypertension, but no association was observed with ART regime or duration of ARV use. There is a need to integrate hypertension management into regular HIV care.

Aim To investigate effect of <10 min moderate intensity exercise on cardiovascular function and maximal oxygen consumption ( V O 2 max) among sedentary adults.Methods We studied 53 sedentary urbanites aged ≥50 years, randomised into: (1) male (M S ) and (2) female (F S ) undertaking three short-duration exercise (5-10 min) daily, and (3) male (M L ) and (4) female (F L ) exercising 30-60 min 3-5 days weekly. Resting systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate and V O 2 max were measured at baseline and 8 weekly for 24 weeks.

ObjectivesTo critically appraise the scope, content and outcomes of community health worker (CHW) interventions designed to reduce blood pressure (BP) in low-income and middle-income countries (LMICs).MethodWe performed a database search (PUBMED, EMBASE, CINAHL, PsycINFO, OpenGrey, Cochrane Central Trials Register and Cochrane Database of Systematic Reviews) to identify studies in LMICs from 2000 to 2020. Eligible studies were interventional studies published in English and reporting CHW interventions for management of BP in LMICs. Two independent reviewers screened the titles, abstracts and full texts of publications for eligibility and inclusion. Relevant information was extracted from these studies using a tailored template. Risk of bias was assessed using the Cochrane collaboration risk of bias tool. Qualitative synthesis of results was done through general summary of the characteristics and findings of each study. We also analysed the patterns of interventions and their outcomes across the studies. Results were presented in form of narrative and tables.ResultsOf the 1557 articles identified, 14 met the predefined criteria. Of these, 12 were cluster randomised trials whereas two were pretest/post-test studies. The CHW interventions were mainly community-based and focused on behaviour change for promoting BP control among hypertensive patients as well as healthy individuals. The interventions had positive effects in the BP reduction, linkage to care, treatment adherence and in reducing cardivascular-disease risk level.Discussion and conclusionThe current review is limited in that, a meta-analysis to show the overall effect of CHW interventions in the management of hypertension was not possible due to the diversity of the interventions, and outcomes of the studies included in the review. Summarised outcomes of individual studies showed CHW enhanced the control and management of hypertension. Further studies are needed to indicate the impact and cost-effectiveness of CHW-led interventions in the control and management of hypertension in LMICs.

BackgroundSedentary lifestyles and related morbidities are rising among adults despite existing exercise recommendations. Appealing exercise regimes yielding similar/better body composition should be sought.ObjectiveWe investigated the effect of moderate-intensity exercise bouts of <10 min on body composition in previously sedentary adults.MethodsThis unblinded study enrolled 53 healthy sedentary volunteers aged ≥50 years, randomised into one of two gender-balanced exercise interventions: (1) male and (2) female short-duration bouts (MS, n=14; FS, n = 13), and (3) male and (4) female long-duration bouts (ML, n=13; FL, n=13). Short-duration bouts entailed 5–10 min of jogging thrice daily; long-duration bouts, 30–60 min 3–5 days weekly. Body composition was determined at recruitment and 8-weekly thereafter, for 24 weeks.ResultsAt baseline, 14.3% of MS, 38.5% of ML, 92.3% of FS and 69.2% of FL were obese, dropping to 7.1%, 15.4%, 61.5% and 30.8%, respectively. For waist:height ratio, 64.3 % of MS, 76.9% of ML, 100% of FS and 84.6.3% of FL had ratios >0.5, dropping to 42.9%, 30.8%, 92.9% and 26.2%, respectively. While baseline MS and ML waist:hip ratio (WHR) ≥0.9 were 64.3% and 69.2%, respectively, they correspondingly dropped to 23.1% and 21.4%. The FS and FL with WHR ≥0.85 dropped from 46.2% to 15.4% and from 30.8% to 7.7%, respectively. Body composition variables improved for both sexes (all p <0.05) and mean change between exercise regimes was comparable for both sexes.ConclusionIn equal cumulative times, moderate-intensity exercise bouts lasting <10 min are comparable with current 30–60 min bouts in body composition modification for adults of ≥50 years.

ObjectivesWe compared effects of shorter moderate-intensity exercise time (<10 min bouts) on cardiometabolic parameters with the current recommendations among elderly adults.MethodsFifty-three sedentary individuals aged ≥50 years were divided into exercise groups1: male and2 female short-duration bouts (MS and FS, respectively), and3 male and4 female long-duration bouts (ML and FL, respectively). Short-duration bouts consisted three 5–10 min moderate-intensity jogging sessions daily, and long-duration bouts consisted 30–60 min sessions 3–5 days weekly. Cumulative exercise times were equivalent. Physical activity (PA) was measured by log and activity monitors. Fasting venous blood at baseline and 8 weekly intervals was used for blood chemistry.ResultsAfter 24 weeks, MS and FS with total cholesterol (TC) of >5.2 mmol/L and >5.3 mmol/L decreased from 22.2% to 14.8% and from 30.9% to 11.5%, respectively. For ML, this decreased from 25.9% to 3.7%, while FL had 0% change. In MS and ML, TC/high-density lipoproteins (HDLs) of >5.0 mmol/L dropped from 22.2% to 7.4% and from 22.2% to 15.4%, respectively. In FS and FL, TC/HDL of >4.5 mmol/L declined from 19.2% to 7.7% and from 19.2% to 3.8%, respectively. MS and ML with fasting blood glucose of ≥5.5 mmol/L declined from 40.7% to 11.1% and from 33.3% to 3.7%, respectively. Similarly, it declined from 46.2% to 0% and 42.3% to 11.5% for FS and FL, respectively. There were no differences in the changes between regimes throughout the study.ConclusionBouts lasting <10 min per session are as good as those lasting;≥30 min in improving cardiometabolic profiles of sedentary adults aged ≥50 years.

Aim: To assess Cardio-respiratory fitness (CF) markers among university students using a 20m shuttle run test (SRT). Methods: Markers of CF were assessed in 80 males aged 21.4±1.8 years, randomly selected from Moi University, Kenya. Assessed at different stages of SRT protocol included heart rate (HR), systolic and diastolic blood pressure (SBP & DBP). VO 2max was also determined. Data were analyzed using Stata v10. Comparisons were based on subjects exercise regimes. Results: Subjects with either regular or irregular regimes attained lower HR in 4 th minute of SRT compared to non-exercise group (174.5±11.6 and 172.2±10.8 vs 182.8±6.8 b/m; p=0.04 and p=0.01 respectively). Lower HRs were maintained among irregularly exercising after 5 th minute (176.5±10.1 vs 186.7±6.3 b/m; p=0.02). Regularly exercising subjects obtained lowest DBP at exhaustion compared to irregular and non-exercising (58.58±15.0, 62.43±12.9 and 64.1±8.8 mmhg respectively). VO 2max predictors included year of study (r=-0.40), age (r=-0.41) and weight (r=-0.23). The regularly exercising had higher VO 2max than irregular (p<0.01) and non-exercising (p<0.001). No demonstrable difference in VO 2max existed between irregular and non-exercise subjects. Conclusion: Exercise regimes should be emphasized amongst university students, albeit with less regard to regularity, which should be encouraged for those in higher study years and those with higher DBP at exhaustion.