Burden of cardiometabolic risk factors and preclinical target organ damage among adults in Freetown, Sierra Leone: a community-based health-screening survey

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.