title: Multiple cardiovascular risk factors in Kenya: evidence from a health and demographic surveillance system using the WHO STEPwise approach to chronic disease risk factor surveillance.
abstract: OBJECTIVE
  To describe the distribution of cardiovascular risk factors in western Kenya using a Health and Demographic Surveillance System (HDSS).
  
  
  METHODS
  Population based survey of residents in an HDSS.
  
  
  METHODS
  Webuye Division in Bungoma East District, Western Province of Kenya.
  
  
  METHODS
  4037 adults ≥ 18 years of age.
  
  
  METHODS
  Home based survey using the WHO STEPwise approach to chronic disease risk factor surveillance.
  
  
  METHODS
  Self-report of high blood pressure, high blood sugar, tobacco use, alcohol use, physical activity, and fruit/vegetable intake.
  
  
  RESULTS
  The median age of the population was 35 years (IQR 26-50). Less than 6% of the population reported high blood pressure or blood sugar. Tobacco and alcohol use were reported in 7% and 16% of the population, respectively. The majority of the population (93%) was physically active. The average number of days per week that participants reported intake of fruits (3.1 ± 0.1) or vegetables (1.6 ± 0.1) was low. In multiple logistic regression analyses, women were more likely to report a history of high blood pressure (OR 2.72, 95% CI 1.9 to 3.9), less likely to report using tobacco (OR 0.08, 95% CI 0.06 to 0.11), less likely to report alcohol use (OR 0.18, 95% CI 0.15 to 0.21) or eat ≥ 5 servings per day of fruits or vegetables (OR 0.87, 95% CI 0.76 to 0.99) compared to men.
  
  
  CONCLUSIONS
  The most common cardiovascular risk factors in peri-urban western Kenya are tobacco use, alcohol use, and inadequate intake of fruits and vegetables. Our data reveal locally relevant subgroup differences that could inform future prevention efforts.
authors.affiliation: Division of Cardiology, Duke Clinical Research Institute, Duke University, Durham, North Carolina, USA. gerald.bloomfield@duke.edu
authors.forename: Gerald S
authors.initials: GS
authors.lastname: Bloomfield
authors.forename: Ann
authors.initials: A
authors.lastname: Mwangi
authors.forename: Patrick
authors.initials: P
authors.lastname: Chege
authors.forename: Chrispinus J
authors.initials: CJ
authors.lastname: Simiyu
authors.forename: Daniel F
authors.initials: DF
authors.lastname: Aswa
authors.forename: David
authors.initials: D
authors.lastname: Odhiambo
authors.forename: Andrew A
authors.initials: AA
authors.lastname: Obala
authors.forename: Paul
authors.initials: P
authors.lastname: Ayuo
authors.forename: Barasa O
authors.initials: BO
authors.lastname: Khwa-Otsyula
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D004032:Diet; D005260:Female; D015438:Health Behavior; D006801:Humans; D007630:Kenya / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance / Q000379:methods*; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D014944:World Health Organization; D055815:Young Adult