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Table 3 Factors associated with hypertension and diabetes mellitus among patients at a rural and an urban clinic in Zomba District

From: The burden of hypertension, diabetes mellitus, and cardiovascular risk factors among adult Malawians in HIV care: consequences for integrated services

 

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*

    

0.04Â¥

  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)

  
  1. Age, sex, study site and educational status kept in the model as a priori confounder regardless of degree of association in univariable analysis
  2. HTN hypertension, DM diabetes mellitus, OR odds ratio, CI confidence interval, ART antiretroviral therapy, WHO World Health Organization, BMI body mass index
  3. *LHR test
  4. ¥Ptrend = p-value for trend
  5. ** Proteinuria omitted from diabetes final model due to insufficient numbers
  6. Statistically significant findings are indicated in bold font