title: Blood pressure in primary school children in Uganda: a cross-sectional survey.
abstract: BACKGROUND
  Non-communicable diseases are an emerging concern in sub-Saharan Africa, and risks for these conditions are often based on exposures in early life, with premonitory signs developing during childhood. The prevalence of hypertension has been reported to be high in African adults, but little is known about blood pressure in African children. We studied prevalence and risk factors for high blood pressure (HBP) among school children in central Uganda.
  
  
  METHODS
  Two urban and five rural schools were randomly selected from government schools in Wakiso district, Uganda. Questionnaires were administered and anthropometric measures taken. Blood pressure (BP) was measured three times in one sitting (on day 1) and the average compared to internationally-used normograms. Children with BP >95th percentile were re-tested at two additional sittings (day 2 and day 3) within one week, and at two further follow up visits over a period of six months. Those with sustained HBP were referred for further investigation.
  
  
  RESULTS
  Of 552 students included, 539 completed the initial assessments (days 1-3) of whom 92 (17.1%) had HBP at the initial sitting. Age (adjusted odds ratio (aOR) 1.29 (95% confidence interval 1.14, 1.47), p< 0.001), body mass index (1.70 (1.25-2.31) p = 0.001) and soil-transmitted helminths (2.52 (1.04-6.11), 0.04) were associated with increased prevalence of HBP at the initial sitting. After further investigation, sustained HBP was seen in 14 children, yielding an estimated prevalence of 3.8% allowing for losses to follow up. Four children required treatment.
  
  
  CONCLUSIONS
  It is feasible to measure blood pressure accurately in the school setting. A high HBP prevalence on initial readings gave cause for concern, but follow up suggested a true HBP prevalence commensurate with international normograms. Extended follow up is important for accurate assessment of blood pressure among African children.
authors.forename: Farah
authors.initials: F
authors.lastname: Kidy
authors.forename: Diana
authors.initials: D
authors.lastname: Rutebarika
authors.forename: Swaib A
authors.initials: SA
authors.lastname: Lule
authors.forename: Moses
authors.initials: M
authors.lastname: Kizza
authors.forename: Amos
authors.initials: A
authors.lastname: Odiit
authors.forename: Emily L
authors.initials: EL
authors.lastname: Webb
authors.affiliation: London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK. alison.elliott@lshtm.ac.uk.
authors.forename: Alison M
authors.initials: AM
authors.lastname: Elliott
mesh_terms: D000293:Adolescent; D001794:Blood Pressure; D001795:Blood Pressure Determination; D015992:Body Mass Index; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D008297:Male; D016017:Odds Ratio; D015995:Prevalence; D012307:Risk Factors; D012424:Rural Population; D012574:Schools; D013334:Students; D011795:Surveys and Questionnaires; D014454:Uganda