Prevalence and Determinants of Adult Obesity in a Low-Income Population of Western Africa: Results from a Nationwide Cross-Sectional Survey

Ouédraogo³

et al. 2021

BMJ Open

ObjectiveThe objective of this study is to determine the prevalence of abdominal obesity, its predictors and its association with cardiovascular risk among adults in Burkina Faso.DesignWe performed a secondary analysis of data from a national cross-sectional study, using WHO STEPwise approach.SettingThe study was conducted in Burkina Faso, in all the 13 regions of the country.ParticipantsOur study involved 4308 adults of both sexes, aged between 25 and 64 years.Primary and secondary outcomesOur primary outcome was abdominal obesity, which was defined using a cut-off point of waist circumference (WC) of ≥94 cm for men and ≥80 cm for women. The secondary outcome was very high WC (≥102 cm for men and ≥88 cm for women) (for whom weight management is required).ResultsThe mean age of participants was 38.5±11.1 years. The age-standardised prevalence of abdominal obesity was 22.5% (95% CI 21.3% to 23.7%). This prevalence was 35.9% (95% CI 33.9% to 37.9%) among women and 5.2% (95% CI 4.3% to 6.2%) among men. In urban areas, the age-standardised prevalence of abdominal obesity was 42.8% (95% CI 39.9% to 45.7%) and 17.0% (95% CI 15.7% to 18.2%) in rural areas. The age-standardised prevalence of very high WC was 10.2% (95% CI 9.3% to 11.1%). The main predictors of abdominal obesity were being female, increased age, married status, high level of education and living in urban areas. Abdominal obesity was also significantly associated with high blood pressure (adjusted prevalence ratio (aPR): 1.30; 95% CI 1.14 to 1.47) and hypercholesterolaemia (aPR: 1.52; 95% CI 1.18 to 1.94). According to the combination matrix between body mass index and WC, 14.6% of the adult population in Burkina Faso had an increased cardiometabolic risk.ConclusionOur study showed a high prevalence of abdominal obesity and a high proportion of adults who require weight management strategies to prevent cardiometabolic complications. Strategies to reduce the burden of abdominal obesity and very high WC should be considered by Burkina Faso’s policy-makers.

Section: Discussionmentioning

confidence: 99%

Prevalence of abdominal obesity and its association with cardiovascular risk among the adult population in Burkina Faso: findings from a nationwide cross-sectional study

Ouédraogo³

et al. 2021

BMJ Open

“…Yayehd et al . [43] noted that the prevalence of abdominal obesity was 48.8% in semi-urban areas in Togo. Using the cut-off point for WC of ≥102 cm for men and ≥88 cm for women, Kabwama et al .…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Abdominal Obesity and Its Association With Cardiovascular Risk Among the Adult Population in Burkina Faso

Ouédraogo

et al. 2021

Preprint

ObjectiveThe objective of this study is to determine the prevalence of abdominal obesity and its associated factors in Burkina Faso. We hypothesize that there is a high burden of abdominal obesity and it is significantly associated with sociodemographic and cardiovascular risk factors.DesignWe performed secondary analysis of the survey conducted in Burkina Faso using the World Health Organization (WHO) STEPwise approach.SettingThe study was conducted in Burkina Faso with all 13 regions of the country included.ParticipantsOur study involved 4308 adults of both sexes aged 25 to 64 years.Main outcomeOur primary outcome was the abdominal obesity which was could defined using a cut-off point of waist circumference (WC) of ≥94 cm for men and ≥80 cm for women.ResultsThe overall age-standardized prevalence of abdominal obesity was 22.5% (95% CI: 21.3–23.7). This age-standardized prevalence was 35.9% (95% CI: 33.9–37.9) among women and 5.2% (95% CI: 4.3–6.2) among men (p < 0.001). In urban areas, the age-standardized prevalence of abdominal obesity was 42.8% (95% CI: 39.9–45.7) and 17.0% (95%CI: 15.7–18.2) in rural areas (p < 0.001). The overall age-standardized prevalence of very high WC (WC ≥102 cm for men and ≥88 cm for women) was 10.2% (95%CI: 9.3–11.1). According to the National Institute for Health and Clinical Excellence (NICE) BMI–WC matrix, which combines the body mass index (BMI) and WC to define different levels of cardiovascular health risk, 14.6% of adult Burkinabè had an increased cardiovascular health risk.ConclusionOur study shows a high prevalence of abdominal obesity among the adult population in Burkina Faso. These findings suggest that the measurement of WC should be systematically incorporated in Burkina Faso primary healthcare centers for the early detection of high cardiovascular risk in order to reduce levels of premature death.STRENGTHS AND LIMITATIONS OF THIS STUDY➢This is the first national representative study on abdominal obesity in the context of an emerging epidemiological transition in Burkina Faso.➢A recommended cut-off point was used to define abdominal obesity among the adult population in Burkina Faso, which we found to be associated with “intermediate” cardiovascular risk factors.➢The waist circumference and risk factors used in this study were measured using the standard approach proposed by the WHO [1]. However, some risk factors such as physical inactivity, alcohol consumption, and type of fat were self-reported and may therefore be affected by information bias.➢This study was a cross-sectional study and must not be considered to make causal inference.Target journalhttps://bmjopen.bmj.com/

“…In Nigeria, Olatunbosum et al estimated the prevalence of abdominal obesity at 30.1% in urban areas [34]. According to the International Diabetes Federation threshold, the prevalence of abdominal obesity in Togo was 48.8% [35], 52% in Kenya [29], and 67% in South Africa [36]. The prevalence of very high abdominal obesity (persons requiring a weight loss plan) was 10.2% in Burkina Faso [37], 11.8% in Uganda [38], and 33.7% in Togo [35].…”

Section: Trend In Urban and Rural Disparities Of Abdominal Obesitymentioning

confidence: 99%

“…According to the International Diabetes Federation threshold, the prevalence of abdominal obesity in Togo was 48.8% [35], 52% in Kenya [29], and 67% in South Africa [36]. The prevalence of very high abdominal obesity (persons requiring a weight loss plan) was 10.2% in Burkina Faso [37], 11.8% in Uganda [38], and 33.7% in Togo [35]. While the prevalence in Burkina Faso and Uganda is on par with our findings, there is a difference with the estimates from Togo.…”

Section: Trend In Urban and Rural Disparities Of Abdominal Obesitymentioning

confidence: 99%

“…In general, the prevalence of abdominal obesity in SSA is gradually approaching that of high-income countries because most of these countries, including Malawi, are undergoing a rapid epidemiological, nutrition, and economic transition. This is likely to exacerbate health deficits in these countries [35]. Indeed, they will have to deal with an expanding double burden of communicable and noncommunicable diseases.…”

Section: Trend In Urban and Rural Disparities Of Abdominal Obesitymentioning

confidence: 99%

See 1 more Smart Citation

High Urban-Rural Inequities of Abdominal Obesity in Malawi: Insights from the 2009 and 2017 Malawi Noncommunicable Disease Risk Factors Surveys

Diallo

et al. 2022

IJERPH

Geographical disparities in abdominal obesity (AO) exist in low-income countries due to major demographic and structural changes in urban and rural areas. We aimed to investigate differences in the urban–rural prevalence of AO in the Malawi population between 2009 and 2017. We conducted a secondary analysis of data from the Malawi 2009 and 2017 STEPS surveys. AO (primary outcome) and very high waist circumference (secondary outcome) were defined using WHO criteria. Prevalence estimates of AO and very high waist circumference (WC) were standardized by age and sex using the age and sex structure of the adult population in Malawi provided by the 2018 census. A modified Poisson regression analysis adjusted for sociodemographic covariates was performed to compare the outcomes between the two groups (urban versus rural). In total, 4708 adults in 2009 and 3054 adults in 2017 aged 25–64 were included in the study. In 2009, the age–sex standardized prevalence of AO was higher in urban than rural areas (40.9% vs 22.0%; adjusted prevalence ratio [aPR], 1.51; 95% confidence interval [CI], 1.36–1.67; p < 0.001). There was no significant trend for closing this gap in 2017 (urban 37.0% and rural 21.4%; aPR, 1.48; 95% CI, 1.23–1.77; p < 0.001). This urban–rural gap remained and was slightly wider when considering the ‘very high WC’ threshold in 2009 (17.0% vs. 7.1%; aPR, 1.98; 95%CI, 1.58–2.47; p < 0.001); and in 2017 (21.4% vs. 8.3%; aPR, 2.03; 95%CI, 1.56–2.62; p < 0.001). Significant urban–rural differences exist in the prevalence of AO and very high WC in Malawi, and the gap has not improved over the last eight years. More effective weight management strategies should be promoted to reduce health care disparities in Malawi, particularly in urban areas.