The pattern and burden of non-communicable diseases in armed conflict-exposed populations in Northeastern Nigeria

尼日利亚东北部受武装冲突影响人群非传染性疾病的模式和负担

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Abstract

BACKGROUND: The risk of non-communicable diseases (NCDs) in conflict and post-conflict settings in Northeastern Nigeria has not been evaluated to date. As this region undergoes recovery, understanding the prevalence of NCDs, such as hypertension, diabetes, depression, and obesity, and the associated behavioral coping mechanisms, is crucial for developing tailored healthcare solutions. Therefore, this study aimed to assess the impact of conflict on the prevalence of NCDs in conflict-exposed areas in Northeastern Nigeria compared with non-conflict regions. METHODS: This study was an unmatched cross-sectional study. The participants were selected from inpatients and outpatients at general hospitals in Mubi (conflict-exposed) and Jada (non-conflict), which are local government areas in Adamawa, a state in Northeastern Nigeria. The study was conducted over four months, and data on various health indicators were collected. Multivariable binary logistic regression and complementary log regression were performed to investigate the effects of individual risk factors and regional settings on the prevalence of NCDs. FINDINGS: A sample of 463 individuals from both locations was analyzed. The prevalence of hypertension, diabetes, abdominal obesity, and depression in the entire cohort was 22.92%, 5.04%, 44.19%, and 17.94%, respectively. The rates of hypertension and abdominal obesity in the conflict-exposed Mubi were lower, and the rate of depression was higher than those recorded in Jada. Females showed higher rates of hypertension, obesity, and depression than males. The residents of Mubi had lower odds of having abdominal obesity (adjusted odds ratio (aOR) = 0.18; 95% confidence interval (CI) [0.11-0.28]) but a higher risk of depression (incidence risk ratio (IRR) = 4.78; 95% CI [2.51-9.22]) than those in Jada. However, the participants affected by insurgency showed higher odds of having both abdominal obesity (aOR = 1.95; 95% CI [1.23-3.08]) and depression (IRR = 1.76; 95% CI [1.08-2.88]) than those who were not affected by the conflict. CONCLUSIONS: The findings of this study underscore the urgent need for mental health support in conflict-affected regions and comprehensive healthcare strategies for the aging population. As adjustment of lifestyle factors is crucial for addressing NCDs, effective case management and food security are essential for reducing the risk of NCDs in conflict-exposed populations.

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