Date of Award

5-30-2015

Document Type

Dissertation

Degree Name

Master of Medicine (MMed)

First Supervisor/Advisor

Prof. Gerald O. Yonga

Second Supervisor/Advisor

Dr. Alice Musibi

Department

Internal Medicine (East Africa)

Abstract

Background: Non-Communicable Diseases (NCDs) are fast becoming the leading causes of morbidity and mortality in Low and Middle-income countries (LMIC) with cancers and cardiovascular diseases (CVDs) becoming the most prominent. CVD can be prevented if appropriate measures of screening and treatment of modifiable risk factors are addressed. This may translate to reduced risk of CVDs and some cancers in the long term. Increasing evidence exhibits common risk factors for both CVDs and cancer and that CVDs and their risk factors when present in cancer patients may worsen the overall outcome.

Objectives: The primary objective was to determine and compare the prevalence of hypertension, diabetes, obesity and dyslipidaemia amongst newly diagnosed cancer patients and non-cancer patients (elective surgical patients). Secondary objectives were to estimate and compare the 10yrs predicted occurrence of major cardiovascular events using WHO Afri-E risk score and prevalence of metabolic syndrome in the two populations.

Methodology: a Cross-sectional survey of newly diagnosed cancer patients and non-cancer patients in the same institution.

Results: The prevalence of hypertension was 23.4 and 31.58% in the cancer and non-cancer group respectively (p-value = 0.62). Diabetes was more prevalent in the cancer group, but this was not statistically different (7.89% vs. 1.32% with a P-value of 0.05). Obesity was more prevalent in the non-cancer group than the cancer group (58% vs. 54%), but this was not statistically significant (p- value = 0.85). The prevalence of total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides were higher in the cancer group (76.3%) than the non-cancer group (67.1%), but this difference was not significant (p-value =0.21) .The prevalence of metabolic syndrome was similar in both groups with the cancer group having a prevalence of 30.26% and the non-cancer group 31.58% (p-value=0.86). The AFRI-E CV risk estimations were similar across the various risk stratifications (p-values ranging from 0.32 – 1)

Conclusion: There is no significant difference in prevalence of hypertension, diabetes, obesity, but there was a significant difference in the HDL levels (p=0.009), with the cancer group with lower HDL levels, amongst newly diagnosed cancer patients and non-cancer patients at AKUHN. Despite this the prevalence of CVR is appreciable and warrants screening. Similarly, the CV risk scores and prevalence of metabolic syndrome were not significantly different.

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