High prevalence of dyslipidaemia among persons with diabetes mellitus and hypertension at a tertiary hospital in Blantyre, Malawi

Abstract

Background Dyslipidaemia drives the process of atherosclerosis, and hence a significant modifiable risk factor complicating hypertension and diabetes. In Malawi, the prevalence, screening and management of dyslipidaemia among persons with diabetes mellitus have not been reported. This study aimed to investigate the prevalence, biochemical characteristics, screening and management practices for dyslipidaemia among persons with diabetes mellitus, hypertension, and diabetes mellitus and hypertension comorbidity at Queen Elizabeth Central hospital in Blantyre, Malawi. Methods This was a cross-sectional study conducted in 2021. A total of 256 adult participants (diabetes mellitus = 100); hypertension = 100; both conditions = 56) were included. Medical data and anthropometric measurements were recorded. Blood samples were analysed for HbA1C and serum lipids. Associated risk factors for dyslipidaemia were also assessed. Results Dyslipidaemia was prevalent in 58%, 55%, and 70% of participants with diabetes mellitus, hypertension, and both conditions. Low-density lipoprotein cholesterol (LDL-C) dyslipidaemia was the most common in all participant groups. Participants with both diabetes and hypertension had 2.4 times (95% CI 1.2–4.6) increased risk of LDL-C dyslipidaemia than those with diabetes alone (p < 0.02). Being overweight or obese and age over 30 years were risk factors for dyslipidaemia in patients with diabetes mellitus alone (OR 1.3 (95% CI 1.1–1.6), p < 0.04, and OR 2.2 (95% CI 1.2–4.7) (p < 0.01), respectively. Overweight and obesity predicted LDL-C dyslipidaemia in hypertensive patients (OR 3.5 (95% CI 1.2–9.9) p < 0.001). Poorly controlled hypertension was associated with a 1.8 times risk (95% CI 1.1–2.7) of dyslipidaemia in patients with both diabetes mellitus and hypertension (p < 0.01). Less than 1% of the participants had a lipogram performed before the study and on lipid-lowering therapy. Conclusions Dyslipidaemia with LDL-C derangement was highly prevalent, especially in individuals with both diabetes mellitus and hypertension, and there was absent use of lipid-lowering therapy. Screening and managing dyslipidaemia should be reinforced to reduce the risk of cardiovascular complications in this population at increased risk.

Willingness to pay for agricultural mechanization services by smallholder farmers in Malawi

“…Recently, NGOs have promoted small‐scale machines to smallholder farmers through different projects and programs. For example, drip irrigation lines, V‐tractors, walk‐behind tractors, grain storage facilities, central pivotal irrigation, and groundnut strippers and shellers have been promoted (Kumwenda et al, 2020; Tsusaka et al, 2017). Moreover, 2WT and rippers are being promoted as a complement to conservation agriculture practices to reduce drudgery from the preparation of planting basins, one of the components of conservation agriculture practices (Jaleta et al, 2014; Sims & Heney, 2017).…”