Rural to urban migration and changes in cardiovascular risk factors in Tanzania: a prospective cohort study

详细信息    查看全文

• 作者：Nigel Unwin (1)
  Peter James (1)
  Dorothy McLarty (1)
  Harun Machybia (2)
  Peter Nkulila (3)
  Bushiri Tamin (4)
  Mkay Nguluma (3)
  Richard McNally (1)
  
• 刊名：BMC Public Health
• 出版年：2010
• 出版时间：December 2010
• 年：2010
• 卷：10
• 期：1
• 全文大小：912KB
• 参考文献：1. United Nations Population Division: plus-plus">An overview of urbanization, internal migration, population distribution and development in the world. In / United Nations expert group meeting on population distribution, urbanisation, internal migration and development. New York: United Nations; 2008.
  2. Population Division of the Department of Economic and Social Affairs: / World Population Prospects: The 2006 Revision and World Urbanization Prospects. New York United Nations; 2009.
  3. Unwin N, Alberti KG: plus-plus">Chronic non-communicable diseases. / Annals of Tropical Medicine & Parasitology 2006,plus-plus">100(5鈥?)plus-plus">:455鈥?64. p://dx.doi.org/10.1179/136485906X97453">CrossRef
  4. Leon DA: plus-plus">Cities urbanization and health. / Int J Epidemiol 2008, plus-plus">37:4鈥?. p://dx.doi.org/10.1093/ije/dym271">CrossRef
  5. Aspray TJ, Mugusi F, Rashid S, Whiting D, Edwards R, Alberti KG, Unwin NC: plus-plus">Essential Non-Communicable Disease Health Intervention Project: Rural and urban differences in diabetes prevalence in Tanzania: the role of obesity, physical inactivity and urban living. / Transactions of the Royal Society of Tropical Medicine & Hygiene 2000,plus-plus">94(6)plus-plus">:637鈥?44. p://dx.doi.org/10.1016/S0035-9203(00)90216-5">CrossRef
  6. Edwards R, Unwin N, Mugusi F, Whiting D, Rashid S, Kissima J, Aspray TJ, Alberti KG: plus-plus">Hypertension prevalence and care in an urban and rural area of Tanzania. / Journal of Hypertension 2000,plus-plus">18(2)plus-plus">:145鈥?52. p://dx.doi.org/10.1097/00004872-200018020-00003">CrossRef
  7. Unwin N, Setel P, Rashid S, Mugusi F, Mbanya JC, Kitange H, Hayes L, Edwards R, Aspray T, Alberti KGMM: plus-plus">Non-communicable diseases in sub-Saharan Africa: where do they feature in the health research agenda? / Bulletin of the World Health Organisation 2001, plus-plus">79:947鈥?53.
  8. Walker RW, McLarty DG, Kitange HM, Whiting D, Masuki G, Mtasiwa DM, Machibya H, Unwin N, Alberti KG, for the Adult Morbidity and Mortality Project: plus-plus">Stroke mortality in urban and rural Tanzania. / Lancet 2000,plus-plus">355(9216)plus-plus">:1684鈥?687. p://dx.doi.org/10.1016/S0140-6736(00)02240-6">CrossRef
  9. Popkin BM: plus-plus">The nutrition transition: an overview of world patterns of change. / Nutrition Reviews 2004,plus-plus">62(7 Pt 2)plus-plus">:S140-S143. p://dx.doi.org/10.1111/j.1753-4887.2004.tb00084.x">CrossRef
  10. Unwin N, McLarty D, Machibya H, Aspray T, Tamin B, Carlin L, Patel S, Walker M, Alberti KGMM: plus-plus">Changes in blood pressure and lipids associated with rural to urban migration in Tanzania. / Journal of Human Hypertension 2006,plus-plus">20(9)plus-plus">:704鈥?06. p://dx.doi.org/10.1038/sj.jhh.1002056">CrossRef
  11. Kitange HM, Machibya H, Black J, Mtasiwa DM, Masuki G, Whiting D, Unwin N, Moshiro C, Klima PM, Lewanga M, Alberti KGMM, McLarty D: plus-plus">Outlook for survivors of childhood in sub-Saharan Africa: adult mortality in Tanzania. / BMJ 1996,plus-plus">312(7025)plus-plus">:216鈥?20.
  12. Setel P, Unwin N, Alberti K, Hemed Y: plus-plus">Cause-Specific Adult Mortality: Evidence From Community-Based Surveillance --- Selected Sites, Tanzania, 1992鈥?998. / Morbidity and Mortality Weekly Report 2000, plus-plus">49:416鈥?19.
  13. Friedewald WT, Levy RI, Fredrickson DS: plus-plus">Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. / Clinical Chemistry 1972,plus-plus">18(6)plus-plus">:499鈥?02.
  14. McLarty DG, Swai AB, Kitange HM, Masuki G, Mtinangi BL, Kilima PM, Makene WJ, Chuwa LM, Alberti KGMM: plus-plus">Prevalence of diabetes and impaired glucose tolerance in rural Tanzania. / Lancet 1989, plus-plus">1:871鈥?75. p://dx.doi.org/10.1016/S0140-6736(89)92866-3">CrossRef
  15. Swai AB, McLarty DG, Kitange HM, Kilima PM, Tatalla S, Keen N, Chuwa LM, Alberti KG: plus-plus">Low prevalence of risk factors for coronary heart disease in rural Tanzania. / International Journal of Epidemiology 1993, plus-plus">22:651鈥?59. p://dx.doi.org/10.1093/ije/22.4.651">CrossRef
  16. McLean RA, Sanders WL, Stroup WW: plus-plus">A unified approach to mixed linear models. / The American Statistician 1991, plus-plus">45:54鈥?4. p://dx.doi.org/10.2307/2685241">CrossRef
  17. Marshall JA, Scarbro S, Shetterly SM, Jones RH, Marshall JA, Scarbro S, Shetterly SM, Jones RH: plus-plus">Improving power with repeated measures: diet and serum lipids. / American Journal of Clinical Nutrition 1998,plus-plus">67(5)plus-plus">:934鈥?39.
  18. SAS Institute Inc: / Statistical Analysis Software. Cary, North Carolina: SAS Institute Inc; 2009.
  19. Tanner M, Kent N, Smith B, Fletcher S, Lewer M: plus-plus">Stability of common biochemical analytes in serum gel tubes subjected to various storage temperatures and times pre-centrifugation. / Annals of Clinical Biochemistry 2008,plus-plus">45(Pt 4)plus-plus">:375鈥?79. p://dx.doi.org/10.1258/acb.2007.007183">CrossRef
  20. Bovet P, Gervasoni JP, Ross AG, Mkamba M, Mtasiwa DM, Lengeler C, Burnier M, Paccaud F: plus-plus">Assessing the prevalence of hypertension in populations: are we doing it right? / Journal of Hypertension 2003,plus-plus">21(3)plus-plus">:509鈥?17. p://dx.doi.org/10.1097/00004872-200303000-00016">CrossRef
  21. Poulter NR, Lury JD, Thompson AV: plus-plus">Blood pressures higher in the home than in the clinic in rural Kenya. / Journal of Epidemiology & Community Health 1986,plus-plus">40(2)plus-plus">:186鈥?87. p://dx.doi.org/10.1136/jech.40.2.186">CrossRef
  22. Poulter NR, Khaw KT, Hopwood BE, Mugambi M, Peart WS, Rose G, Sever PS: plus-plus">The Kenyan Luo migration study: observations on the initiation of a rise in blood pressure. / BMJ 1990,plus-plus">300(6730)plus-plus">:967鈥?72. p://dx.doi.org/10.1136/bmj.300.6730.967">CrossRef
  23. Chahoud G, Aude YW, Mehta JL: plus-plus">Dietary recommendations in the prevention and treatment of coronary heart disease: do we have the ideal diet yet? / American Journal of Cardiology 2004,plus-plus">94(10)plus-plus">:1260鈥?267. p://dx.doi.org/10.1016/j.amjcard.2004.07.109">CrossRef
  24. Vorster HH, Venter CS, Wissing MP, Margetts BM: plus-plus">The nutrition and health transition in the North West Province of South Africa: a review of the THUSA (Transition and Health during Urbanisation of South Africans) study. / Public Health Nutrition 2005,plus-plus">8(5)plus-plus">:480鈥?90. p://dx.doi.org/10.1079/PHN2005784">CrossRef
  25. The pre-publication history for this paper can be accessed here:p://www.biomedcentral.com/1471-2458/10/272/prepub" class="a-plus-plus">http://www.biomedcentral.com/1471-2458/10/272/prepub
  
• 作者单位：Nigel Unwin (1)
  Peter James (1)
  Dorothy McLarty (1)
  Harun Machybia (2)
  Peter Nkulila (3)
  Bushiri Tamin (4)
  Mkay Nguluma (3)
  Richard McNally (1)
  
  1. Institute of Health and Society, Newcastle University, Newcastle, NE2 4AX, UK
  2. Regional Medical Officer, PO Box 259, Mbeya, Tanzania
  3. Morogoro Regional Hospital, PO Box 110, Morogoro, Tanzania
  4. Muhimbili University of Health and Allied Sciences, PO Box 65001, Dar es Salaam, Tanzania
  
• ISSN：1471-2458

文摘

Background High levels of rural to urban migration are a feature of most African countries. Our aim was to investigate changes, and their determinants, in cardiovascular risk factors on rural to urban migration in Tanzania. Methods Men and women (15 to 59 years) intending to migrate from Morogoro rural region to Dar es Salaam for at least 6 months were identified. Measurements were made at least one week but no more than one month prior to migration, and 1 to 3 monthly after migration. Outcome measures included body mass index, blood pressure, fasting lipids, and self reported physical activity and diet. Results One hundred and three men, 106 women, mean age 29 years, were recruited and 132 (63.2%) followed to 12 months. All the figures presented here refer to the difference between baseline and 12 months in these 132 individuals. Vigorous physical activity declined (79.4% to 26.5% in men, 37.8% to 15.6% in women, p < 0.001), and weight increased (2.30 kg men, 2.35 kg women, p < 0.001). Intake of red meat increased, but so did the intake of fresh fruit and vegetables. HDL cholesterol increased in men and women (0.24, 0.25 mmoll-1 respectively, p < 0.001); and in men, not women, total cholesterol increased (0.42 mmoll-1, p = 0.01), and triglycerides fell (0.31 mmoll-1, p = 0.034). Blood pressure appeared to fall in both men and women. For example, in men systolic blood pressure fell by 5.4 mmHg, p = 0.007, and in women by 8.6 mmHg, p = 0.001. Conclusion The lower level of physical activity and increasing weight will increase the risk of diabetes and cardiovascular disease. However, changes in diet were mixed, and may have contributed to mixed changes in lipid profiles and a lack of rise in blood pressure. A better understanding of the changes occurring on rural to urban migration is needed to guide preventive measures.