The study aimed to investigate the prevalence of cardiometabolic risk factors (CMRFs), target organ damage and its associated factors among adults in Freetown, Sierra Leone.

Design

This community-based cross-sectional study used a stratified multistage random sampling method to recruit adult participants. 

Setting

The health screening study was conducted between October 2019 and October 2021 in Western Area Urban, Freetown, Sierra Leone. 

Participants

A total of 2394 adults Sierra Leoneans aged 20 years, or more were enrolled.

Outcome measure

Anthropometric data, fasting lipid profiles, fasting plasma glucose, target organ damage, clinical profiles and demographic characteristic of participants were described. The cardiometabolic risks were further related to target organ damage.

Results

The prevalence of known CMRFs was 35.3% for hypertension, 8.3% for diabetes mellitus, 21.1% for dyslipidemia, 10.0% for obesity, 13.4% for smoking and 37.9% for alcohol. Additionally, 16.1% had left ventricular hypertrophy (LVH) by ECG, 14.2% had LVH by 2D-Echo while 11.4% had chronic kidney disease. Diabetes [OR = 1.176, 95% C.I. (0.759 - 1.823)] and dyslipidaemia [OR = 1.844, 95% C.I. (1.006 -3.380)] were independently associated with LVH. LVH by Echo shows an independent association with diabetes mellitus [OR =1.176, 95% C.I (0.759-1.823)] and dyslipidemia [OR = 1.844, 95% C.I (1.006-3.380)]. The odds of having CKD were associated with diabetes mellitus [OR =1.212, 95% CI (0.741-1.983)] and hypertension [OR =1.163, 95% CI (0.887-1.525)]. A low optimal cut-off points for ECG-LVH (male 24.5 vs female 27.5mm) was required to maximize sensitivity and specificity. 

Conclusions

This study provides novel data-driven information on the burden of cardiometabolic risks and its association with preclinical target organ damage in a resource limited setting. It illustrates the need for interventions in improve cardiometabolic health screening and management among adults in Sierra Leoneans. 

Procedure and data collection

All eligible potential participants in each selected community were invited to participate in the ‘awareness and screening campaign for non-communicable disease’ on a designated date at the National Victoria Park. The WHO stepwise approach questionnaire guided the process of data collection for this study. Medical students, doctors and nurses were trained on the campaign's conduct, including data collection.

Data analysis was done using IBM SPSS Statistical 2.6 and STATA 17 software