Prevalence and Determinants of Elevated Blood Pressure among Children in Rural Kayonza District, Rwanda
DOI:
https://doi.org/10.53819/81018102t2157Abstract
Childhood elevated blood pressure (BP) has emerged as a concern for global public health. In Sub-Saharan African countries, where Rwanda is located, there is a scarcity of BP data for both children and adolescents. Elevated blood pressure (EBP) is a neglected issue in children, it can develop in young age and can last into adulthood. This community-based cross-sectional study in rural Kayonza, Rwanda investigated the prevalence and determinants of elevated blood pressure (EBP) in children aged 36 months. Measurements of blood pressure and height were converted to percentiles using World Health Organization standards. Data collection involved face-to-face interviews with a digital questionnaire. OMRON HBP-1320 blood pressure monitor and SECA 213 stadiometer were used. The mean systolic blood pressure was 90.60 mmHg and 58.75 mmHg and standard deviation of 7.60mHg for diastolic blood pressure. Most child's mothers (76%) were farmers, more than half (62.7%) of child mothers attended primary school, and 36.60% were between the ages of 31 and 35. (Mean age: 30.4 years, Stand. Dev.: 4.4, Minimum age: 21 years and Maximum age: 39 years), (53%) of children were males, 38 % were 36 months old (Mean age: 36.9 months, Stand. Dev.: 1.0, Minimum age: 35 months, and Maximum age: 39 months). Elevated BP for children is defined as being prehypertensive and hypertensive; all children with systolic or diastolic blood pressure percentiles of ≥90th to <95th were prehypertensive, while those with systolic or diastolic blood pressure percentiles of ≥95th to 99th and above were hypertensive. The prevalence of elevated BP was 40.4% with 18.6% being prehypertension and 21.8% being hypertension among 3-year-old children in the rural Kayonza district. Of them 72 (97%) children who had elevated blood pressure, their family were using biomass fuel and 71(36.60%) of study children were below the 5th percentile of height which an indicator of short stature, 27(40.91%) among them had elevated blood pressure. Factors like difficulty getting food on daily basis (food insecurity) (AOR=3.75; 95% CI: [1.70-8.27]; p=0.001) and medium monthly family income (AOR= 2.38; 95% CI: [1.07-5.31]; p=0.033) were associated with increased prevalence of elevated BP. No statistically significant was found between elevated blood pressure and prenatal factors. Mobilization and increase community’s awareness on the procedure for measuring children’s BP during routine health visits from 3 years old should be done to prevent this increasingly common health condition which is ignored and in asymptomatic nature.
Keywords: Elevated Blood Pressure, Prehypertension, Hypertension, Prenatal Factors, Environmental Factors, Behavioural Factors, Kayonza District, Rwanda.
References
Astria Hannah, R., Sekarwana, N., & Effendi, S. I. (2017). Prevalence of Moderate Malnutrition in School-age Children and Its Association with Hypertension and Microalbuminuria. American Journal of Clinical Medicine Research, 5(1), 6–9. https://doi.org/10.12691/ajcmr-5-1-2
Berkowitz, S. A., Baggett, T. P., Wexler, D. J., Huskey, K. W., & Wee, C. C. (2013). Food insecurity and metabolic control among U.S. Adults with diabetes. Diabetes Care, 36(10), 3093–3099. https://doi.org/10.2337/dc13-0570
Blood Pressure Levels for Boys by Age and Height Percentile. Nhlbi.nih.gov. 2019. Available from: https: www.nhlbi.nih.gov/files/docs/guidelines/child_tbl.pdf. (2001). Blood Pressure Levels for Boys by Age and Height Percentile. Journal of Clinical Gastroenterology., 33(4), 289–294.
Choi, Y. J., Kim, S. H., Kang, S. H., Kim, S. Y., Kim, O. J., Yoon, C. H., Lee, H. Y., Youn, T. J., Chae, I. H., & Kim, C. H. (2019). Short-term effects of air pollution on blood pressure. Scientific Reports, 9(1), 1–8. https://doi.org/10.1038/s41598-019-56413-y
Farzan, S. F., Howe, C. G., Chen, Y., Gilbert-Diamond, D., Cottingham, K. L., Jackson, B. P., Weinstein, A. R., & Karagas, M. R. (2018). Prenatal lead exposure and elevated blood pressure in children. Environment International, June, 1289–1296. https://doi.org/10.1016/j.envint.2018.10.049
Fiedorowicz, H., Bartnik, A., Glazyrin, I., Diyankov, O., Jarocki, R., Krasnogorov, I., Koshelev, S., Kostecki, J., Loboda, P., & Szczurek, M. (2000). Generation of a laser plasma in result of interaction of a nanosecond laser pulse with a gas puff target. Proceedings of SPIE - The International Society for Optical Engineering, 3935(May), 2–5.
Flynn, J. T., Kaelber, D. C., Baker-Smith, C. M., Blowey, D., Carroll, A. E., Daniels, S. R., De Ferranti, S. D., Dionne, J. M., Falkner, B., Flinn, S. K., Gidding, S. S., Goodwin, C., Leu, M. G., Powers, M. E., Rea, C., Samuels, J., Simase, M., Thaker, V. V., Urbina, E. M., … Okechukwu, K. (2017). Clinical practice guideline for screening and management of high blood pressure in children and adolescents. Pediatrics, 140(3). https://doi.org/10.1542/peds.2017-1904
Fujii, H. (2013). Advanced material designs using friction stir welding technique. Progress in Advanced Structural and Functional Materials Design, 59–68. https://doi.org/10.1007/978-4-431-54064-9_5
Kaczmarek, M., Stawińska-Witoszyńska, B., Krzyżaniak, A., Krzywińska-Wiewiorowska, M., & Siwińska, A. (2015). Who is at higher risk of hypertension? Socioeconomic status differences in blood pressure among Polish adolescents: a population-based ADOPOLNOR study. European Journal of Pediatrics, 174(11), 1461–1473. https://doi.org/10.1007/s00431-015-2554-0
Khang, Y. H., & Lynch, J. W. (2011). Exploring determinants of secular decreases in childhood blood pressure and hypertension. Circulation, 124(4), 397–405. https://doi.org/10.1161/CIRCULATIONAHA.110.014399
Kidy, F., Rutebarika, D., Lule, S. A., Kizza, M., Odiit, A., Webb, E. L., & Elliott, A. M. (2014). Blood pressure in primary school children in Uganda: A cross-sectional survey. BMC Public Health, 14(1), 1–9. https://doi.org/10.1186/1471-2458-14-1223
Kilombero District. (2013). District Profile. 20–58.
Lazarou, C., Panagiotakos, D. B., & Matalas, A. L. (2009). Lifestyle factors are determinants of children’s blood pressure levels: The CYKIDS study. Journal of Human Hypertension, 23(7), 456–463. https://doi.org/10.1038/jhh.2008.151
Liang, X., Xiao, L., Luo, Y., & Xu, J. (2020). Prevalence and Risk Factors of Childhood Hypertension in Urban-Rural Areas of China: A Cross-Sectional Study. International Journal of Hypertension, 2020. https://doi.org/10.1155/2020/2374231
Muhihi, A. J., Njelekela, M. A., Mpembeni, R. N. M., Muhihi, B. G., Anaeli, A., Chillo, O., Kubhoja, S., Lujani, B., Maghembe, M., & Ngarashi, D. (2018). Muhihi-2018-Elevated blood pressure among prim.pdf. 1–8.
Noubiap, J. J. (2020). Hypertension in children in sub-Saharan Africa: primordial prevention is crucial. The Pan African Medical Journal, 37(341), 341. https://doi.org/10.11604/pamj.2020.37.341.27387
Placide Kambola, K., Emmanuel Kiyana, M., Clarence Kaut, M., Jaques Mbaz, M., Jeef Paul, B., Christian Ngama, K., Dophra Ngoy, N., & Olivier, M. (2021). Prevalence and associated factors of elevated blood pressure in adolescents in schools in Lubumbashi, Democratic Republic of Congo. Archives of Clinical Hypertension, 7, 001–006. https://doi.org/10.17352/ach.000029
Review, A. S. (2021). Effects of Ambient Air Pollution on Blood Pressure Among Children and Adolescents : https://doi.org/10.1161/JAHA.120.017734
Rindfleisch, A., Malter, A. J., Ganesan, S., & Moorman, C. (2008). Cross-sectional versus longitudinal survey research: Concepts, findings, and guidelines. Journal of Marketing Research, 45(3), 261–279. https://doi.org/10.1509/jmkr.45.3.261
Roccella, E. J. (1996). Update on the 1987 task force report on high blood pressure in children and adolescents: A working group report from the national high blood pressure education program. Pediatrics, 98(4 PART 1), 649–658.
Sesso, R., Barreto, P., Neves, J., & Sawaya, L. (2004). Malnutrition Is Associated with Increased Blood Pressure in Childhood. 900, 61–67. https://doi.org/10.1159/000078402
Simonetti, G. D., Schwertz, R., Klett, M., Hoffmann, G. F., Schaefer, F., & Wühl, E. (2011). Determinants of blood pressure in preschool children: The role of parental smoking. Circulation, 123(3), 292–298. https://doi.org/10.1161/CIRCULATIONAHA.110.958769
Size, D. S. (n.d.). Using Published Tables Using Formulas To Calculate A Sample Size Using A Census For Small Populations.