title: Hypertension, a Neglected Disease in Rural and Urban Areas in Moramanga, Madagascar.
abstract: BACKGROUND
  Hypertension is one of the main risk factors of cardiovascular diseases. In Madagascar, studies on hypertension in urban and rural communities are scarce.
  
  
  OBJECTIVE
  The aim of this study was to determine the prevalence of hypertension and identify associated risk factors in adults living in a health and demographic system in Moramanga, Madagascar.
  
  
  METHODS
  The study included people aged 15 years old and above living in a health and demographic system in Moramanga. A household census was performed in 2012 to enumerate the population in 3 communities in Moramanga. In addition to the questionnaire used in the initial census, a standardized questionnaire and blood pressure were taken twice after 5 and 10 minutes of rest. In urban areas, heights and weights were also measured to calculate the body mass index.
  
  
  RESULTS
  There were 3621 and 4010 participants respectively in rural and urban areas. Prevalence of hypertension in rural population was 27.0% (IC95% [25.6-28.5]) and 29.7% (IC95% [28.3-31.1]) in urban population. Among hypertensive subjects, 1.7% (17/979) and 5.3% (64/1191) were on antihypertensive treatment for at least 1 month before the survey in rural and urban population, respectively. In rural areas, increasing age (65 years and older vs 18-25 years OR = 11.81, IC95% [7.79-18.07]), giving more than 3 positive responses to the usual risks factors of hypertension (OR = 1.67, IC95% [1.14-2.42]) and singles in comparison with married people (OR = 1.61, IC95% [1.20-2.17]) were associated to hypertension in a logistic regression model. In urban areas, increasing age (65 years and older vs 18-25 years OR = 37.54, IC95% [24.81-57.92]), more than 3 positive responses to the usual risks of hypertension (OR = 3.47, IC95% [2.58-4.67]) and obesity (OR = 2.45, IC95% [1.56-3.87]) were found as risk factors.
  
  
  CONCLUSIONS
  Hypertension is highly prevalent in rural areas although it is significantly less treated. As a result, a major epidemic of cardiovascular diseases is at risk in Madagascar's progressively aging society.
authors.affiliation: Pasteur Institute of Madagascar, PO Box: 1274 Ambatofotsikely, Antananarivo, Madagascar.
authors.forename: Rila
authors.initials: R
authors.lastname: Ratovoson
authors.affiliation: Faculty of Medicine, Antananarivo University, Antananarivo, Madagascar.
authors.forename: Ony Rabarisoa
authors.initials: OR
authors.lastname: Rasetarinera
authors.affiliation: Pasteur Institute of Madagascar, PO Box: 1274 Ambatofotsikely, Antananarivo, Madagascar.
authors.forename: Ionimalala
authors.initials: I
authors.lastname: Andrianantenaina
authors.affiliation: Pasteur Institute of Madagascar, PO Box: 1274 Ambatofotsikely, Antananarivo, Madagascar; Unité de Recherche sur les Maladies Infectieuses et Tropicales Émergentes (URMITE), UMR 6236, 27 boulevard Jean Moulin, 13385, Marseille Cedex 05, France; Institute for Biomedical Research of the French Armed Forces (IRBA), BP 73, 91223, Brétigny-Sur-Orge Cedex, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Rogier
authors.affiliation: Pasteur Institute of Madagascar, PO Box: 1274 Ambatofotsikely, Antananarivo, Madagascar.
authors.forename: Patrice
authors.initials: P
authors.lastname: Piola
authors.affiliation: Inserm, UMR_S1087, University of Nantes, CHU Nantes, l'Institut du thorax, Nantes, F-44000, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Pacaud
mesh_terms: D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use; D003710:Demography; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000453:epidemiology*; D008270:Madagascar / Q000453:epidemiology; D008297:Male; D058069:Neglected Diseases / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data*; D014505:Urban Population / Q000706:statistics & numerical data*
chemical_list: D000959:Antihypertensive Agents