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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*     
0.04¥
  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