Hypertension and associated cardiovascular risk factors among urban slum dwellers in Egypt: a population-based survey.

BACKGROUND: The economic deprivation of most slum inhabitants, and the lack of services and facilities may increase their vulnerability to unhealthy lifestyles and cardiovascular diseases. AIMS: This study aimed to determine the prevalence of modifiable risk factors for cardiovascular diseases in slum residents in Cairo, Egypt and evaluate their association with hypertension. METHODS: A household cluster survey was conducted in Mansheiet Nasser, a large slum area in Cairo. The study included 984 adult participants. The World Health Organization STEPS instrument for noncommunicable disease risk factor surveillance was used to determine the prevalence of smoking, fruit/vegetable consumption, overweight/obesity, physical activity, diabetes and hypertension. RESULTS: Smoking, insufficient fruit/vegetable consumption, low physical activity and diabetes were reported by 43.4%, 92.2%, 98.4% and 8.7% of the sample respectively. The prevalence of hypertension and overweight/obesity were 31.2% and 73.0% respectively. Most of the participants (83.8%) had ≥ 3 cardiovascular risk factors. A significantly higher proportion of men smoked, engaged in less physical activity, had diabetes and had multiple risk factors. Hypertension was significantly associated with age 30-< 50 years (OR = 3.04, 95% CI: 1.66-5.58), age ≥ 50 years (OR = 12.5, 95% CI: 6.71-23.26), overweight (OR = 1.58, 95% CI: 1.0-62.35), obesity (OR = 2.23, 95% CI: 1.49-3.35), low fruit/vegetable consumption (OR = 1.88, 95% CI: 1.02-3.48), and diabetes (OR = 1.77, 95% CI: 1.08-2.92). CONCLUSIONS: Urban slum dwellers in Mansheiet Nasser have an increased vulnerability to cardiovascular diseases compared with the Egyptian population. Measures are needed to improve their lifestyles and reduce their risk of cardiovascular diseases.

The application of Urban Health Equity Assessment and Response Tool to assess health inequity among dwellers of an urban slum area in Giza Governorate, Egypt.

BACKGROUND: The WHO in 2008 developed the Urban Health Equity Assessment and Response Tool. It is a user-friendly guide for stakeholders and decision makers at national and local levels to identify health inequities. Moreover, using such tool will facilitate decisions on viable and effective strategies, interventions, and actions that should be used to reduce health inequities. AIM: To assess the health equity in a disadvantaged district (Gezerit El Warak) located in Giza province, Egypt. MATERIALS AND METHODS: A population-based survey was conducted in the study district. A total of 643 heads of households were interviewed using Urban Health Equity Assessment and Response developed by WHO. Indicators of key health outcomes and major social determinants were calculated and then compared with the corresponding national indicators. RESULTS: The results of social determinants of health showed lower performance than national figures in the core indicators illiteracy (42.5%) and male tobacco smoking (56.0%), whereas good performance was reported for unemployment among adults (2.0%), fully immunized infants (95.1%), and females' overweight (34.5%)/obesity (38.0%). The main problem encountered was the inadequate physical infrastructure, mainly safe drinking water and sewage disposal system. The health outcome indicators revealed higher prevalence of hypertension among both males (20.7%) and females (19.2%). History of diabetes mellitus was markedly higher than the national figures among both males (11.5%) or females (9.6%). CONCLUSION: Compared with the national indicators, the main health determinants with low performance encountered in the study area included the physical infrastructure and high prevalence of male tobacco smoking. Health outcome indicators with low performance were diabetes and hypertension. The response of stakeholders was positive and immediate actions were taken to tackle some of the low-performance indicators.