Adolescent health in rural Ghana: A cross-sectional study on the co-occurrence of infectious diseases, malnutrition and cardio-metabolic risk factors

• Published in: PloS one 2017-07, Vol.12 (7), p.e0180436-e0180436
• Main Authors: Alicke, Marie, Boakye-Appiah, Justice K, Abdul-Jalil, Inusah, Henze, Andrea, van der Giet, Markus, Schulze, Matthias B, Schweigert, Florian J, Mockenhaupt, Frank P, Bedu-Addo, George, Danquah, Ina
• Format: Article
• Language: English
• Subjects: Adolescent; Adolescent Health; Adolescents; Adults; Age; Biology and Life Sciences; Blood Glucose; Blood pressure; Blood Pressure - physiology; Body mass; Body Mass Index; Body weight; C-reactive protein; Children; Childrens health; Chronic infection; Communicable diseases; Communicable Diseases - epidemiology; Comorbidity; Confidence intervals; Cross-Sectional Studies; Data processing; Demographic aspects; Demographics; Epidemiology; Fasting; Female; Ferritin; Ghana - epidemiology; Glucose; Health aspects; Health problems; Health risks; Humans; Hypertension; Hypertension - epidemiology; Infectious diseases; Iron; Iron deficiency; Malaria; Male; Males; Malnutrition; Malnutrition - epidemiology; Medical examination; Medicine and Health Sciences; Nutrient deficiency; Nutrition; Obesity; Overweight; Overweight - epidemiology; People and Places; Physical sciences; Prevalence; Regression analysis; Risk analysis; Risk Factors; Rural Population; Sex Factors; Socioeconomic Factors; Teenagers; Underweight; Vector-borne diseases; Vitamin A; Youth
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0180436

In sub-Saharan Africa, infectious diseases and malnutrition constitute the main health problems in children, while adolescents and adults are increasingly facing cardio-metabolic conditions. Among adolescents as the largest population group in this region, we investigated the co-occurrence of infectious diseases, malnutrition and cardio-metabolic risk factors (CRFs), and evaluated demographic, socio-economic and medical risk factors for these entities. In a cross-sectional study among 188 adolescents in rural Ghana, malarial infection, common infectious diseases and Body Mass Index were assessed. We measured ferritin, C-reactive protein, retinol, fasting glucose and blood pressure. Socio-demographic data were documented. We analyzed the proportions (95% confidence interval, CI) and the co-occurrence of infectious diseases (malaria, other common diseases), malnutrition (underweight, stunting, iron deficiency, vitamin A deficiency [VAD]), and CRFs (overweight, obesity, impaired fasting glucose, hypertension). In logistic regression, odds ratios (OR) and 95% CIs were calculated for the associations with socio-demographic factors. In this Ghanaian population (age range, 14.4-15.5 years; males, 50%), the proportions were for infectious diseases 45% (95% CI: 38-52%), for malnutrition 50% (43-57%) and for CRFs 16% (11-21%). Infectious diseases and malnutrition frequently co-existed (28%; 21-34%). Specifically, VAD increased the odds of non-malarial infectious diseases 3-fold (95% CI: 1.03, 10.19). Overlap of CRFs with infectious diseases (6%; 2-9%) or with malnutrition (7%; 3-11%) was also present. Male gender and low socio-economic status increased the odds of infectious diseases and malnutrition, respectively. Malarial infection, chronic malnutrition and VAD remain the predominant health problems among these Ghanaian adolescents. Investigating the relationships with evolving CRFs is warranted.