Prevalencia de enfermedades no transmisibles y factores de riesgo en población rural de San Luis, Argentina

Eloy Salinas; María Cecilia De Pauw; María Fernanda Aguirre; María Jimena Marro; Christian Ballejo; Alejandro Félix Sturniolo; Alicia E.B. Lawrynowicz

doi:10.31053/1853.0605.v81.n1.42138

Authors

Eloy Salinas NATIONAL UNIVERSITY OF SAN LUIS
María Cecilia, De Pauw NATIONAL UNIVERSITY OF SAN LUIS
María Fernanda Aguirre National Institute of Epidemiology “Dr. Juan H. Jara.”
María Jimena Marro National Institute of Epidemiology “Dr. Juan H. Jara.”
Christian Ballejo National Institute of Epidemiology “Dr. Juan H. Jara.”
Alejandro Félix Sturniolo Universidad Nacional de San Luis. Facultad de Química Bioquímica y Farmacia
Alicia E.B. Lawrynowicz National Institute of Epidemiology “Dr. Juan H. Jara.”

DOI:

https://doi.org/10.31053/1853.0605.v81.n1.42138

Keywords:

rural health, epidemiology, Argentina

Abstract

The objective of this study was to estimate the prevalence of diabetes mellitus (DM) and cardiovascular risk factors in a rural population in the province of San Luis, Argentina. Cross-sectional study developed between September and November 2017 with 18-year-old inhabitants and more than four towns in the Juan Martín de Pueyrredón department, San Luis. The participants answered questions by self-report on sociodemographic aspects, habits, psychosocial and risk factors for non-communicable diseases; physical measurements, FINDIRSC questionnaire and blood sample extraction were performed. Univariate estimates stratified by sex with their 95% confidence interval (95%CI) were obtained. We worked with sample expansion factors; crude and adjusted prevalences were calculated. The population consisted of 424 men (52.5%, 95%CI: 46.0-58.9) and 384 women (47.5%, 95%CI: 41.1-54.0). The adjusted prevalences for both sexes (by self-report) were: DM 11.8% (95%CI: 8.2-15.4); arterial hypertension (AHT): 35.5% (95% CI: 31.0-40.1); high cholesterol: 20.3% (CI 16.0-24.7). Males had significantly higher desirable HDL cholesterol and elevated blood pressure than females; women abdominal obesity in greater magnitude. 16.4% (95% CI: 11.0 - 23.6) had a high-very high risk of developing type 2 DM in the next 10 years. The adjusted prevalences of DM, hypertension, and high cholesterol were lower than those of the urban population of the province of San Luis. We highlight the pioneering contribution of this work to the knowledge of the health profile of rural communities in Argentina.

Downloads

Author Biographies

Eloy Salinas, NATIONAL UNIVERSITY OF SAN LUIS

PhD in Biochemistry, National University of San Luis. Associate Professor Biology Area. Faculty of Biochemical Chemistry and Pharmacy. UNSL
Responsible Contact salinaseloy@gmail.com Fac. Qca, Bioqca and Fcia.- UNSL Tel.02664 659489 Ejército de los Andes 950 (5700) San Luis- Argentina. ORCID: https://orcid.org/0000-0002-4276-2631

Degree in biochemistry. UNSL 1987. Doctor in Biochemistry. UNSL 2005. Associate Professor, Biology Area. Faculty of Biochemical Chemistry and Pharmacy. RESPONSIBLE for dictating the Workshop "Public Health and Epidemiology from Clinical Biochemistry for the Bachelor's Degree in Biochemistry (Ord. 11/10 CD). From 2015 to date. He has collaborated in numerous courses of PROFESSIONAL UPDATE Given in the field of the Faculty of Chemistry, Biochemistry, and Pharmacy of the UNSL by professors of the Department of Research and Teaching National Institute of Epidemiology "Dr. Juan H. Jara”. -“Epidemiology, Evolution and Challenges in the XXI century, from the miasma paradigm to Ecoepidemiology and Collective Health” 2012- “Introduction to Epidemiological Study Designs and their critical reading” 2013. “Epidemiological Surveillance and Health Surveillance” 2014 "Application of Epidemiology in the Health Planning and Programming Process" 2014 "Bioethical Aspects of Health Research" 2014. "Notions of Probability" 2015. "Epidemiology Course: Intermediate Level" 2015. ": Statistical Inference" 2016. “Introduction to Multivariate Descriptive Analysis”. 2016. Director of the research project of the National University of San Luis (PROIPRO 02-2616) "Social determinants, lifestyles, metabolic syndrome and cardiovascular risk factors in the province of San Luis. -2016-2017. Director of the research project of the National University of San Luis (PROICO 02-3618) "Social determinants, lifestyles, metabolic syndrome, and cardiovascular risk factors in rural populations of the province of San Luis.- 2018-2022
María Cecilia, De Pauw, NATIONAL UNIVERSITY OF SAN LUIS

Magister in Pharmaceutical Chemical Sciences, Adjunct Professor. National University of San Luis. mcdepauw4@gmail.com ORCID: https://orcid.org/0000-0002-1264-5653
National Pharmaceutical. UNSL 1993. 1.2. Graduate in Biochemistry. UNSL 2002.. Master in Pharmaceutical Chemical Sciences. UNSL 2010. 33 postgraduate courses (2500 hours). Internship with topics related to Pharmacoepidemiology, FQByF 2004. Internship in the Epidemiological Research Department of the National Institute of Epidemiology “Dr. Juan H. Jara”, with topics related to the design and validation of databases. 2017. Adjunct professor -interim-, with functions in area 9 Basic Training in the Biological Chemistry subject and area 10 Professional Training in the course/workshop of Final Integrative Work of the Department of Kinesiology and Physiatry of the Bachelor's degree in Kinesiology and Physiatry, since June 18, 2015 and continues. Collaborator in the dictation of the Public Health Workshop of the first year of the Nursing career, of the National University of San Luis. Member of the research project of the National University of San Luis (PROIPRO 02-2616) "Social determinants, lifestyles, metabolic syndrome and cardiovascular risk factors in the province of San Luis. -2016-2017. Member of the research project of the National University of San Luis (PROICO 02-3618) "Social determinants, lifestyles, metabolic syndrome and cardiovascular risk factors in rural populations of the province of San Luis.- 2018-2022
María Fernanda Aguirre, National Institute of Epidemiology “Dr. Juan H. Jara.”

Teacher in Mathematics. National Institute of Epidemiology “Dr. Juan H. Jara”. fernandaaguirre64@gmail.com
ORCID: https://orcid.org/0000-0002-3979-865X

Professor of Mathematics and Cosmography. Superior Institute of Western Teachers. Hummock. Buenos Aires province. 1988. University Diploma in Teacher Training in Health awarded by the Undersecretary of Knowledge Management and Comptroller, Health Networks and Technology – Ministry of Health of the Province of Buenos Aires – National University of Tres de Febrero. 2017. He works as head of the Department of Exact and Natural Sciences - General Directorate of Schools and Culture of Pica. of Buenos Aires-1999. Statistical Technician – Computing and Statistics Service – Department of Epidemiological Research. - National Institute of Epidemiology “Dr. Juan H. Jara”- National Administration of Laboratories and Health Institutes “Dr. Carlos G. Malbrán”. Ministry of Health of the Nation. - 1994-1995. Hardware and Software Specialist – Information Technology and Statistics Service – Department of Epidemiological Research - National Institute of Epidemiology “Dr. Juan H. Jara” – ANLIS “Dr. Carlos G. Malbrán” – Ministry of Health of the Nation- 1995 – continues.
-Marro, Maria Jimena. Master in Epidemiology, Management and Health Policies. Lanús National University. National Institute of Epidemiology “Dr. Juan H. Jara”. jimenamarro@gmail.com ORCID: https://orcid.org/0000-0002-9483-2304
Medical. Faculty of Medical Sciences of the National University of Rosario (U.N.R. – Argentina). Pediatrician. Awarded by the Argentine Society of Pediatrics. November 2004. Specialist in Pediatrics. Granted by the National University of Rosario. September 2006. December 2006.
Master in Epidemiology, Management and Health Policies. National University of Lanús. March 2009 to August 2011. Thesis title: Inequality trends in the maternal and child health situation in Argentina during the period 1990-2010. Current job performance National Institute of Epidemiology “Dr. Juan H. Jara”. Department of Investigation. line of research: epidemiology of diabetes mellitus. Silver Sea. April 2013 to present.
Member of Doctors of the World. Member of the national executive board. in charge of vice presidency 2º. Argentine representative in the International MDM Network.
María Jimena Marro, National Institute of Epidemiology “Dr. Juan H. Jara.”

Master in Epidemiology, Management, and Health Policies. Lanús National University. National Institute of Epidemiology “Dr. Juan H. Jara”. jimenamarro@gmail.com ORCID: https://orcid.org/0000-0002-9483-2304
Medical. Faculty of Medical Sciences of the National University of Rosario (U.N.R. – Argentina). Pediatrician. Awarded by the Argentine Society of Pediatrics. November 2004. Specialist in Pediatrics. Granted by the National University of Rosario. September 2006. December 2006.
Master in Epidemiology, Management, and Health Policies. National University of Lanús. March 2009 to August 2011. Thesis title: Inequality trends in the maternal and child health situation in Argentina during the period 1990-2010. Current job performance National Institute of Epidemiology “Dr. Juan H. Jara”. Department of Investigation. line of research: epidemiology of diabetes mellitus. Silver Sea. April 2013 to present.
Member of Doctors of the World. Member of the national executive board. in charge of vice presidency 2º. Argentine representative in the International MDM Network.
Christian Ballejo, National Institute of Epidemiology “Dr. Juan H. Jara.”

Systems Specialist. National Institute of Epidemiology “Dr. Juan H. Jara” christiaBallejo, nballejo@yahoo.com.ar ORCID: https://orcid.org/0000-0002-7346-5701

Systems specialist. - Awarded by the Institute of Systems - IBM Mar del Plata 1996. He works for the Information Technology and Statistics Service, Department of Epidemiological Research - National Institute of Epidemiology "Dr. Juan H. Jara”. Administration of Laboratories and Institutes of Health “Dr. Carlos G. Malbrán” as Computer Technician from March 1997 to September 2002 and Hardware and Software Specialist September 2002 to date.
Alejandro Félix Sturniolo, Universidad Nacional de San Luis. Facultad de Química Bioquímica y Farmacia

Graduate in Biochemistry, National University of San Luis. Adjunct Professor of the Clinical Analysis Chair of the Faculty of Chemistry, Biochemistry, and Pharmacy asturni@gmail.com
ORCID: https://orcid.org/0000-0001-6006-2869
Degree in biochemistry. UNSL 1989. Adjunct Professor of the Clinical Analysis Area. Faculty of Biochemical Chemistry and Pharmacy. Microbiology specialist. He has worked in private activity at the Clinical Analysis Laboratory, Sanatorio Rivadavia de San Luis. Member of the research project of the National University of San Luis (PROIPRO 02-2616) "Social determinants, lifestyles, metabolic syndrome and cardiovascular risk factors in the province of San Luis. -2016-2017. Member of the research project of the National University of San Luis (PROICO 02-3618) "Social determinants, lifestyles, metabolic syndrome and cardiovascular risk factors in rural populations of the province of San Luis.- 2018-2022.
Alicia E.B. Lawrynowicz, National Institute of Epidemiology “Dr. Juan H. Jara.”

Master of Public Health. National Institute of Epidemiology “Dr. Juan H. Jara” alawryno@gmail.com ORCID: https://orcid.org/0000-0001-9803-0387

Physician: Awarded by the "Nicolas Copernicus" Academy of Medicine. Jagiellonian University. Krakow, Poland. Year 1982. Master in Public Health (The Johns Hopkins University School of Hygiene and Public Health,) Final work: Population and Coverage Adjustment. In Search of the Real Target Population of the Expanded Program on Immunization. Argentina 1995. Head in charge of the Department of Epidemiological Research, since December 31, 2014 National Institute of Epidemiology “Dr. Juan H. Jara”. Free teacher. Epidemiology Chair. Resolution Act No. 240. Faculty of Medical Sciences. National University of La Plata. 2011, March 1, 2011. Responsible for the Public Health and Epidemiology Module. Postgraduate in Epidemiology. School of Public Health. National University of Cordoba. Ministry of Health of the Argentine Republic. September 2010 and continuing. Academic Manager for Epidemiology and Health Surveillance course. Virtual Educational Platform. Ministry of Health of the Province of Buenos Aires. April 2010 and continuing. Head of the Chair of Community Health and Medicine, Mar del Plata Branch, Faculty of Medical Sciences - National University of La Plata. July 2004 and continuing.

References

1. World Health Organization. Noncommunicable Diseases Progress Monitor 2020. Genebra: World Health Organization; 2022. Disponible en: https://apps.who.int/iris/bitstream/handle/10665/353048/9789240047761-eng.pdf

2. Organización Panamericana de la Salud. La carga de las enfermedades no transmisibles en la Región de las Américas, 2000-2019. Washington D.C.: Organización Panamericana de la Salud; 2021. Disponible en: https://www.paho.org/es/temas/enfermedades-no-transmisibles

3. Secretaría de Gobierno de Salud de la Nación. Instituto Nacional de Estadística y Censo (Argentina). 4ta encuesta Nacional de Factores de Riesgo. Resultados definitivos. La secretaría, 2019. Disponible en: https://biblioteca.indec.gob.ar/bases/minde/enfr_2018_resultados_definitivos.pdf.

4. Franco CM, Lima JG, Giovanella L. Primary healthcare in rural areas: access, organization, and health workforce in an integrative literature review. Cad Saude Publica. 2021 Jul 7;37(7):e00310520. English. doi: 10.1590/0102-311X00310520.

5. Zapata ME, Rovirosa A, Carmuega E. Urbano y rural: diferencias en la alimentación de los hogares argentinos según nivel de ingreso y área de residencia. Salud Colect. 2019 Jul 29;15:e2201. doi: 10.18294/sc.2019.2201.

6. Salinas E, De Pauw MC, Sturniolo A, Aguirre MF, Marro MJ, Ballejo C, Lawrynowicz AEB. Estudio epidemiológico sobre enfermedades no transmisibles en población rural de San Luis, Argentina. Aspectos metodológicos. Rev Fac Cien Med Univ Nac Cordoba. 2021 Jun 28;78(2):118-124. doi: 10.31053/1853.0605.v78.n2.31304.

7. Lindström J, Tuomilehto J. The diabetes risk score: a practical tool to predict type 2 diabetes risk. Diabetes Care. 2003 Mar;26(3):725-31. doi: 10.2337/diacare.26.3.725.

8. Instituto Nacional de Estadísticas y Censos. Base de datos REDATAM. Cuestionario Básico. Disponible en: https://redatam.indec.gob.ar/argbin/RpWebEngine.exe/PortalAction?&MODE=MAIN&BASE=CPV2010B&MAIN=WebServerMain.inl&_ga=2.210626645.1366130706.1675863233-1261307949.1631734968

9. Rao, JNK, Scott, AJ. On Chi-squared Tests For Multiway Contigency Tables with Proportions Estimated From Survey Data. Annals of Statistics 1984; 12:46-60. doi: 10.1214/aos/1176346391.

10. Instituto Nacional de Estadísticas y Censos. Proyecciones nacionales. https://www.indec.gob.ar/indec/web/Nivel4-Tema-2-24-84.

11. The R Foundation. Core Team. R: A language and environment for statistical computing. R Foundation for Statistical Computing; 2022. Disponible en: https://www.R-project.org/.

12. Zhang J, Xiao S, Shi L, Xue Y, Zheng X, Dong F, Xue B, Zhang C. Differences in Health-Related Quality of Life and Its Associated Factors Among Older Adults in Urban and Rural Areas. Risk Manag Healthc Policy. 2022 Jul 27;15:1447-1457. doi: 10.2147/RMHP.S373077.

13. Tushi A, Rao SR, Pattabi K, Kaur P. Prevalence of risk factors for non-communicable diseases in a rural tribal population of Mokokchung, Nagaland, India. Natl Med J India. 2018 Jan-Feb;31(1):11-14. doi: 10.4103/0970-258X.243405.

14. Mota BG, Barp M, Guimarães RA, Rosso CFW, Rocha BS, Nunes CAB, Pagotto V. Prevalência de diabetes mellitus autorreferido e fatores associados em população rural e tradicional de Goiás: estudo transversal. Rev Bras Epidemiol. 2022 Jul 6;25:e220016. doi: 10.1590/1980-549720220016.2

15. Bezerra VM, Andrade AC, César CC, Caiaffa WT. Domínios de atividade física em comunidades quilombolas do sudoeste da Bahia, Brasil: estudo de base populacional. Cad Saude Publica. 2015 Jun;31(6):1213-24. Portuguese. doi: 10.1590/0102-311X00056414.

16. Yi JY, Kim H, Chi I. Urban-rural differences in multimorbidity and associated factors in China and Korea: A population-based survey study. Geriatr Gerontol Int. 2019 Nov;19(11):1157-1164. doi: 10.1111/ggi.13771.

17. Landmann Szwarcwald C, Nogueira Damacena G, Borges de Souza Júnior PR, Silva de Almeida W, Torquato Medrado de Lima L, Carvalho Malta D, Rizzato Stopa S, França Pontes Vieira ML, Azeredo Pereira C. Determinantes da autoavaliação de saúde no Brasil e a influência dos comportamentos saudáveis: resultados da Pesquisa Nacional de Saúde, 2013. Rev Bras Epidemiol, 2015. 18, (Suppl 2): 33-44. doi: 10.1590/1980-5497201500060004.

18. Jaime PC, Monteiro CA. Fruit and vegetable intake by Brazilian adults, 2003. Cad Saúde Pública 2005; 21(Suppl. 1): S19-S24. doi: 10.1590/S0102-311X2005000700003.

19. Grisa C, Schneider S. “Plantar pro gasto”: a importância do autoconsumo entre famílias de agricultores do Rio Grande do Sul. Rev Econ Sociol Rural 2008; 46(2): 481-515. doi: 10.1590/S0103-20032008000200008

20. Perestrelo JPP, Martins IS. Modernização rural: transformações econômicas e suas implicações demográficas, epidemiológicas e nutricionais nos municípios de Monteiro Lobato e Santo Antônio do Pinhal. Saúde Soc 2003; 12(2): 38-55. doi: 10.1590/S0104-12902003000200005.

21. Sposetti G, Fuentes N, Aguirre MF, Ballejo C, Marro MJ, Uez OC, López Miranda LA, Barragán A, Lawrynowicz A. Prevalencia de diabetes mellitus y factores de riesgo cardiovascular en adultos de Mar del Plata -BATÁN, 2015-2016. Rev Argent Salud Pública. 21 de diciembre de 2020;12:e26. Disponible en: https://rasp.msal.gov.ar/index.php/rasp/article/view/676

22. Azul AM, Almendra R, Quatorze M, Loureiro A, Reis F, Tavares R, Mota-Pinto A, Cunha A, Rama L, Malva JO, Santana P, Ramalho-Santos J; HeaLIQs4Cities consortium. Unhealthy lifestyles, environment, well-being and health capability in rural neighbourhoods: a community-based cross-sectional study. BMC Public Health. 2021 Sep 6;21(1):1628. doi: 10.1186/s12889-021-11661-4.

23. Piovani JI. Salvia A. Servicios de salud: cobertura, acceso y utilización. En: La Argentina del siglo XXI. Cómo somos, vivimos y convivimos en una sociedad desigual. Encuesta Nacional sobre la estructura social 2018. p. 265-290. Disponible en: https://d1wqtxts1xzle7.cloudfront.net/86666244/La_Argentina_en_el_siglo_XXI-libre.pdf?1653856491=&response-content-disposition=inline%3B+filename%3DLa_Argentina_en_el_siglo_XXI_como_somos.pdf&Expires=1708467409&Signature=S2ldledBl7nhgrnFg7xSEMVFaTu9gRXVxwPiX4g6ejbxmnZxzrrwLoo6QtkEVZUwGxQ7gKMkPJGmicXBCRo4PGUOSb3PieKC4DcfOS96MfHjtjqrdZNZPkgmNhRyygPpT6tFyy0lc27WZpSfPlA1R~7RVx0lmr5ljKtYKfxS6~ZXTWbf6vxQKitntWfC7pRye9O7KeNuYvnsdm2U1efDa7wReP54U43w6ypCBIg81h7~zLrVvAdYB7quk4K~VawK0KIcVlZSDxHF2J8FVW~VUsmTjXeoCTkQMJnRr3OG~XwMJMWGVTcrdOYRzUkVpsobEX-~IO6MyAXvHU3DduSIDA__&Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA#page=265

24. International Diabetes Federation. Atlas de la diabetes de la FID, 9a ed. Bélgica: International Diabetes Federation; 2019. Disponible en: https://www.diabetesatlas.org/upload/resources/material/20200302_133352_2406-IDF-ATLAS-SPAN-BOOK.pdf

25. Tavares NU, Bertoldi AD, Mengue SS, Arrais PS, Luiza VL, Oliveira MA, Ramos LR, Farias MR, Pizzol TD. Factors associated with low adherence to medicine treatment for chronic diseases in Brazil. Rev Saude Publica. 2016 Dec;50(suppl 2):10s. doi: 10.1590/S1518-8787.2016050006150.

26. Pan L, Yang Z, Wu Y, Yin RX, Liao Y, Wang J, Gao B, Zhang L; China National Survey of Chronic Kidney Disease Working Group. The prevalence, awareness, treatment and control of dyslipidemia among adults in China. Atherosclerosis. 2016 May;248:2-9. doi: 10.1016/j.atherosclerosis.2016.02.006.

27. Sav A, King MA, Whitty JA, Kendall E, McMillan SS, Kelly F, Hunter B, Wheeler AJ. Burden of treatment for chronic illness: a concept analysis and review of the literature. Health Expect. 2015 Jun;18(3):312-24. doi: 10.1111/hex.12046.

28. Brito Nuñez JD, Cedeño Rondón J, Pérez Arciniega E, Brito Núñez N. Riesgo de diabetes mellitus según el cuestionario Finnish Diabetes Risk Score (FINDRISC) en Indígenas Warao de Barrancas del Orinoco, Monagas, Venezuela. Rev. salud pública [Internet]. 1 de julio de 2022 [citado 20 de febrero de 2024];24(4):1-5. Disponible en: https://revistas.unal.edu.co/index.php/revsaludpublica/article/view/75956.

29. Singh KN, Sendall MC, Crane P. Understanding Sociocultural Influences on Physical Activity in Relation to Overweight and Obesity in a Rural Indigenous Community of Fiji Islands. J Racial Ethn Health Disparities. 2023 Jun;10(3):1508-1517. doi: 10.1007/s40615-022-01336-0.

30. Ministerio de Economía. Secretaría de Política Económica. Dirección Nacional de Economía, Igualdad y Género. Las brechas de Género en Argentina. Estado de situación y desafíos, 2020. Disponible en: https://www.argentina.gob.ar/sites/default/files/las_brechas_de_genero_en_la_argentina_0.pdf.