Table 3.
Factors associated with hypertension and diabetes mellitus among patients at a rural and an urban clinic in Zomba District
| Hypertension | Diabetes Mellitus | |||||||
|---|---|---|---|---|---|---|---|---|
| Characteristic | n (%) HTN | Crude OR (95% CI) | Adjusted OR (95% CI) | P-value* | n (%) DM | Crude OR (95% CI) | Adjusted OR (95% CI) | P-value* |
| Study site (N = 952) | ||||||||
| Rural | 99 (21.0) | 1 | 1 | 0.66 | 16 (3.4) | 1 | 1 | 0.40 |
| Urban | 127 (26.5) | 1.36 (1.00, 1.83) | 1.09 (0.74, 1.60) | 23 (4.8) | 1.43 (0.75, 2.75) | 1.38 (0.65, 2.92) | ||
| Gender (N = 952) | ||||||||
| Female | 160 (23.4) | 1 | 1 | 0.94 | 29 (4.3) | 1 | 1 | 0.32 |
| Male | 66 (24.5) | 1.06 (0.76–1.48) | 0.98 (0.65, 1.49) | 10 (3.7) | 0.87 (0.42–1.81) | 0.63 (0.26, 1.55) | ||
| Age in years (N = 952) | <0.01* | <0.12* | ||||||
| <0.01 ¥ | 0.02 ¥ | |||||||
| 18–34 | 22 (10.5) | 1 | 1 | 5 (2.4) | 1 | 1 | ||
| 35–44 | 47 (13.0) | 1.28 (0.75, 2.19) | 1.09 (0.61, 1.96) | 13 (3.6) | 1.53 (0.54, 4.36) | 1.51 (0.47, 4.91) | ||
| 45–54 | 87 (36.6) | 4.92 (2.94, 8.24) | 4.50 (2.55, 7.95) | 11 (4.6) | 1.99 (0.68, 5.81) | 2.16 (0.64, 7.27) | ||
| ≥ 55 | 70 (49.0) | 8.19 (4.72, 14.20) | 7.46 (4.02, 13.84) | 10 (7.0) | 3.08 (1.03, 9.22) | 3.91 (1.12, 13.62) | ||
| Education level (N = 952) | 0.37 | 0.85 | ||||||
| None | 62 (30.4) | 1 | 1 | 8 (3.9) | 1 | 1 | ||
| Standard 1–8 | 122 (21.2) | 0.62 (0.43–0.88) | 0.73 (0.48, 1.13) | 25 (4.3) | 1.11 (0.49–2.51) | 1.23 (0.51, 2.98) | ||
| Secondary & above | 42 (24.6) | 0.75 (0.47–1.18) | 0.83 (0.46, 1.49) | 6 (3.5) | 0.89 (0.30–2.62) | 1.01 (0.31, 3.30) | ||
| Household size (N = 951) | ||||||||
| ≤ 3 | 180 (22.9) | 1 | 35 (4.5) | 1 | ||||
| > 3 | 46 (27.9) | 1.30 (0.89, 1.90) | 4 (2.4) | 0.53 (0.19, 1.52) | ||||
| Employment status (N = 952) | ||||||||
| Employed | 30 (26.8) | 1 | 6 (5.4) | 1 | ||||
| Unemployed | 58 (22.8) | 0.80 (0.48–1.34) | 9 (3.5) | 0.65 (0.22–1.86) | ||||
| Self Employed | 138 (23.6) | 0.84 (0.53–1.34) | 24 (4.1) | 0.76 (0.30–1.89) | ||||
| Physical activity (N = 952) | 0.51 | |||||||
| Less active | 33 (33.7) | 1 | 1 | 0.56 | 6 (6.1) | 1 | 1 | |
| Active | 193 (22.6) | 0.58 (0.37–0.90) | 0.85 (0.49, 1.48) | 33 (3.9) | 0.62 (0.25, 1.51) | 0.72 (0.27, 1.91) | ||
| Fruit servings/ day (N = 906) | ||||||||
| ≤ 1 | 147 (22.8) | 1 | 30 (4.7) | 1 | ||||
| > 1 | 64 (24.5) | 1.10 (0.79. 1.54) | 9 (3.5) | 0.73 (0.34, 1.56) | ||||
| Vegetables servings/day (N = 951) | ||||||||
| ≤ 1 | 45 (22.8) | 1 | 10 (5.1) | 1 | ||||
| > 1 | 181 (24,0) | 1.07 (0.74, 1.55) | 29 (3.9) | 0.75 (0.36, 1.56) | ||||
| Current smokers (N = 952) | ||||||||
| No | 219 (23.9) | 1 | 36 (3.9) | 1 | ||||
| Yes | 7 (20.6) | 0.83 (0.36–1.93) | 3 (8.8) | 2.37 (0.69–8.12) | ||||
| Alcohol use in the past 12 months (N = 952) | ||||||||
| No | 206 (24.1) | 1 | 37 (4.3) | 1 | ||||
| Yes | 20 (20.6) | 0.82 (0.49–1.37) | 2 (2.1) | 0.47 (0.11–1.96) | ||||
| ART Status (N = 952) | ||||||||
| On ART | 216 (23.7) | 1 | 38 (4.2) | 1 | ||||
| Pre-ART | 10 (25.6) | 1.11 (0.53–2.32) | 1 (2.6) | 0.61 (0.08–4.53) | ||||
| ART duration, months (N = 913) | ||||||||
| ≤ 24 | 40 (17.5) | 1 | 1 | 0.77 | 5 (2.2) | 1 | 1 | 0.18 |
| > 24 | 176 (25.7) | 1.64 (1.12, 2.40) | 1.07 (0.66, 1.73) | 33 (4.8) | 2.27 (0.88, 5.89) | 2.17 (0.70, 6.70) | ||
| CD4 count at ART initiation (N = 632) | ||||||||
| ≤ 250 | 104 (25.2) | 1 | 17 (4.1) | 1 | ||||
| > 250 | 47 (21.4) | 0.80 (0.54, 1.19) | 9 (4.1) | 0.99 (0.43, 2.26) | ||||
| WHO stage at ART initiation (N = 914) | 0.01 | |||||||
| WHO Stage 1 | 49 (17.8) | 1 | 1 | 8 (2.9) | 1 | 1 | 0.99 | |
| WHO Stage 2 | 81 (26.5) | 1.66 (1.11–2.48) | 1.23 (0.76, 1.99) | 13 (4.3) | 1.48 (0.60–3.63) | 1.10 (0.42, 2.85) | ||
| WHO Stage 3 | 77 (28.5) | 1.84 (1.22–2.76) | 1.13 (0.68, 1.87) | 14 (5.2) | 1.83 (0.75–4.42) | 1.01 (0.38, 2.68) | ||
| WHO Stage 4 | 10 (15.9) | 0.87 (0.41–1.83) | 0.31 (0.13, 0.76) | 3 (4.8) | 1.67 (0.43–6.48) | 1.11 (0.27, 4.62) | ||
| Current ART regimen (N = 913) | <0.01 | |||||||
| 5A | 157 (20.3) | 1 | 1 | 30 (3.9) | 1 | 1 | 0.01 | |
| 2A | 49 (45.8) | 3.33 (2.19, 5.05) | 2.80 (1.71, 4.61) | 3 (2.8) | 0.72 (0.21, 2.39) | 0.46 (0.13, 1.58) | ||
| Other | 10 (32.3) | 1.87 (0.86–4.06) | 1.96 (0.82, 4.71) | 5 (16.1) | 4.78 (1.71–13.30) | 4.75 (1.60, 14.11) | ||
| BMI categories (N = 952) | <0.01* | 0.73* | ||||||
| <0.01 ¥ | 0.37 ¥ | |||||||
| Underweight | 145 (21.3) | 1 | 1 | 25 (3.7) | 1 | 1 | ||
| Normal | 21 (20.6) | 0.96 (0.57, 1.61) | 0.76 (0.43, 1.35) | 6 (5.9) | 1.64 (0.66, 4.11) | 1.65 (0.63, 4.33) | ||
| Overweight | 40 (30.0) | 1.61 (1.06–2.44) | 1.47 (0.90, 2.41) | 6 (4.6) | 1.25 (0.50–3.11) | 1.33 (0.51, 3.46) | ||
| Obesity | 20 (55.6) | 4.63 (2.34–9.16) | 3.67 (1.56, 8.64) | 2 (5.6) | 1.54 (0.35–6.80) | 1.55 (0.33, 7.39) | ||
| Waist-to-hip ratio (N = 927) | 0.56 | 0.85 | ||||||
| Normal | 157 (23.2) | 1 | 1 | 26 (3.8) | 1 | 1 | ||
| Elevated | 67 (26.9) | 1.22 (0.88–1.70) | 1.13 (0.75, 1.71) | 12 (4.8) | 1.27 (0.63–2.56) | 1.08 (0.50, 2.31) | ||
| Proteinuria (N = 948)** | 0.08* | |||||||
| 0.04¥ | ||||||||
| Normal | 218 (23.5) | 1 | 1 | 38 (4.1) | 1 | |||
| 1+ | 2 (15.4) | 0.59 (0.13–2.69) | 0.92 (0.16, 5.25) | 0 (0.0) | - | |||
| 2+ | 5 (71.4) | 8.14 (1.57–42.26) | 8.25 (1.25, 54.44) | 1 (14.3) | 3.90 (0.46–33.24) | |||
Age, sex, study site and educational status kept in the model as a priori confounder regardless of degree of association in univariable analysis
HTN hypertension, DM diabetes mellitus, OR odds ratio, CI confidence interval, ART antiretroviral therapy, WHO World Health Organization, BMI body mass index
*LHR test
¥Ptrend = p-value for trend
** Proteinuria omitted from diabetes final model due to insufficient numbers
Statistically significant findings are indicated in bold font