Abstract P384: Gender Disparities in the Co-Existence of Hypertension and Diabetes in South Africa: Results From the Nationwide Demographic and Health Household Survey Data
Bibliographic record
Abstract
Introduction: The rapidly growing public health burden of cardiovascular disease and diabetes in low- and middle-income countries threatens the progress expected by many countries’ effort to combat endemic infectious diseases and achieve good health and wellbeing (SDG3). Specifically, in South Africa the burden of hypertension and diabetes is a preventable but still neglected public health issue, causing a large number of premature deaths among men and women. There are very few population-based studies examining the distribution of risk factors and the combined burden of hypertension and diabetes prevalence in South Africa to inform an effective public health response. Objectives: This study investigates potential gender disparities in the co-existence of hypertension and diabetes prevalence and provincial variation in South Africa in 2016, adjusting for individual level demographic, behavioural and socio-economic variables, while allowing for spatial autocorrelation and adjusting simultaneously for the hierarchical data structure and risk factors. Methods: The study sample was based on participants aged ≥15 years from the 2016 South Africa DHS. Hypertension was defined as blood pressure ≥ 140/90 mmHg or self-reported health professional diagnosis or on antihypertensive medication and diabetes was defined as self-reported health professional diagnosis or on diabetic medication. Bayesian geo-additive regression modelling investigated the association of various socio-economic factors on the prevalence of both hypertension and diabetes across SA’s nine provinces while controlling for the latent effects of geographical location. Results: The prevalence of hypertension, diabetes, and combined hypertension and diabetes were 48.2% (4212 of 8679), 4.5% (458 of 10255) and 3.8% (314 of 8195) successively in the DHS in 2016. The prevalence of hypertension increased with age and was significantly higher in male, in people of coloured ethnic group, in overweight and obese, in people with high blood cholesterol and varied with geographical location. Diabetes prevalence increased with age and was significantly higher in male, in overweight and obese and in people with high blood cholesterol. The co-existence of the prevalence of both combined hypertension and diabetes was significantly higher in male, in overweight and obese and in people with high blood cholesterol, in people with heart attack/angina and increased with age. Conclusions: The findings can inform public health policy and decision making regarding the allocation of public resources to tackle the growing burden of hypertension and diabetes in South Africa, particularly in the most affected areas and subgroups of the population. Public health education aiming at the prevention of CVDs should target both ailments at the same time as cost-effective measure to achieve SDG3.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.006 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".