Hypertension, diabetes mellitus, overweight and obesity in employees under health transition at the railways company in Congo-Brazzaville


Background and Aim: Cardiovascular risk (CVR) factors, namely hypertension (HT), diabetes mellitus and obesity, are a public health problem in sub-Saharan Africa because of health transition. The additional effect of the social gradient within the railway companies in Congo-Brazzaville on high CVR is not yet established. The aim of this study was to determine the extent of hypertension, diabetes mellitus, overweight, and obesity and to identify the contributing factors of fatness and hypertension. Methods: This was a cross-sectional study conducted in April 2013. A simple random sample of 255 out of all 2550 workers from the railway companies of Congo was examined for epidemiological, clinical and biological variables. Results: Out of the study sample, 231 (90.6%), 79 (31%), and 52 (20.4%) were men, rural dwellers, and senior executives, respectively. The mean age was 45 ± 13 years (range 19 to 63 years). The rates of overweight, hypertension, obesity, and diabetes mellitus were 40.3% (n = 103), 29.4% (n = 75), 7.5% (n = 19), and 3.5% (n = 9), respectively. In univariate analysis, female sex (OR 2.7, 95% CI 1.13 - 6.45, p = 0.01), senior executive (OR 2.4; 95% CI: 1.3 - 4.5; p = 0.003) and physical inactivity (OR 2.5; 95% CI: 1.5 - 4.2; p < 0.001) were significantly associated with overweight. Female sex (OR 7.5, 95% CI: 2.6 - 21; p < 0.001) and senior executive (OR 3.17; 95% CI:

1.2 - 8.3) were also significantly associated with obesity. In logistic regression, overweight (OR = 4.8, 95% CI 2.8 - 11, p < 0.0001), and obesity (OR = 6.8, 95%CI 2.1 - 22, p = 0.01) were identified as the most important and independent determinants of hypertension. Conclusions: Fatness is emerging and it is the most contributing factor of hypertension among workers at the Congolese railway companies. There is also a significant interaction between non-modifiable factors (genetic: females and family history) and modifiable factors (inactivity, fatness) for higher risk of hypertension. Health promotion should be emphasized by physical activity programs.

Share and Cite:

Ellenga Mbolla, B. , Alexis Gombet, T. , Monabeka, H. , Ossou-Nguiet, P. , Mongo-Ngamami, S. , Kouala Landa, C. , Kimbally-Kaky, S. and Longo-Mbenza, B. (2014) Hypertension, diabetes mellitus, overweight and obesity in employees under health transition at the railways company in Congo-Brazzaville. World Journal of Cardiovascular Diseases, 4, 45-49. doi: 10.4236/wjcd.2014.42008.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Araújo, F., Gouvinhas, C., Fontes, F., La Vecchia, C., Azevedo, A. and Lunet, N. (2013) Trends in cardiovascular diseases and cancer mortality in 45 countries from five continents (1980-2010). European Journal of Preventive Cardiology.
[2] Rapport sur la Santé dans le Monde 2013. (2013) La recherche pour la couverture sanitaire universelle. OMS, 79.
[3] Mbanya, J.C., Motala, A.A., Sobngwi, E., Assah, F.K. and Enoru, S.T. (2010) Diabetes in sub-Saharan Africa. Lancet, 375, 2254-2266.
[4] Lim, S.S., Vos, T., Flaxman, A.D., Danaei, G., Shibuya K., Adair-Rohani, H., AlMazroa, M.A., Amann, M., Ross Anderson, H., Andrews, K.G., Aryee, M., Atkinson, C., et al. (2012) A comparative risk assessment to 67 risk factors and risk factor clusters in 21 regions, 1999-2010: A systematic analysis for the Global Burden of Disease Study. Lancet, 380, 2224-2260.
[5] Twagirumukiza, M., De Backar, C., Kips, J.G., de Backer, G., Vander Stichele, R. and Van Bortel L.M. (2011) Current and projected prevalence of arterial hypertension in sub-Saharan africa by sex, age and habitat: An estimate from population studies. Journal of Hypertension, 29, 1243-1252. http://dx.doi.org/10.1097/HJH.0b013e328346995d
[6] Danaei, G., Finucane, M.M., Lu, Y., Singh, G.M., Cowan, M.J., Paciorek, C.J., Lin, J.K.,, Farzadfar, F., et al. (2011) National, regional, and global trends in fasting plasma glucose and diabetes prevalence since 1980: Sytematic analysis of health examination surveys and epidemiological studies with 370 country-years and 2.7 million participants. Lancet, 378, 31-40.
[7] Rapport sur la Situation Mondiale des Maladies Non Transmissibles en 2010 (2011) Résumé d’Orientation. OMS 2011, ISBN 978 92 4 156422 9, 38-45.
[8] Ibrahim, M.M. and Damasceno, A. (2012) Hypertension in developing countries. Lancet, 380, 611-619.
[9] Kimbally-Kaky, G. (2004) Hypertension artérielle et les autres facteurs de risque cardiovasculaires à Brazzaville. Ministère de la santé et de la population—OMS. Rapport d’enquête. Brazzaville.
[10] Levisse, P., Mughnetsyan, V. and Kessy, G.S. (2009) Epidemiological study based on mass screening for diabetes, hypertension and android obesity in Brazzaville (Congo), 2008. Médecine et Maladies Métaboliques, 3, 438-441. http://dx.doi.org/10.1016/S1957-2557(09)72413-7
[11] Gombet, T., Longo-Mbenza, B., Ellenga Mbolla, B., Ikama, M.S., Mokondjimobe, E. and Nkoua, J.L. (2012) Aging, female sex, migration, elevated HDL-C and inflammation are associated with prevalence of metabolic syndrome among African bank employees. International Journal of General Medecine, 5, 495-503.
[12] Gombet, Th., Kimbally-Kaky, G., Ikama, M.S. and Ellenga Mbolla, B.F. (2007) Hypertension artérielle et autres facteurs de risque cardiovasculaires en milieu professionnel Brazzavillois. Médecine d’Afrique Noire, 54, 545-548.
[13] Koffi, N.M., Sally, S.J., Kouame, P., Silue, K. and Nama, A.J. (2001) Facies de l’hypertension artérielle en milieu professionnel à Abidjan. Médecine d’Afrique Noire, 48, 257-260.
[14] Bita Fouda, A.A., Lemogoum, D., Owona Manga, J., Dissongo, J., Tobbit, R., Ngounou Moyo, D.F., Etapelong Sume, G. and Kollo, B. (2012) Epidemiologie de l’obésité en milieu du travail à Douala, Cameroun. Revue Médicale de Bruxelles, 33, 131-137
[15] Mbaye, A., Ndiaye, M.B., Kane, A.D., Ndoume, F., Diop, S., Yaméogo, N.V. and Kane, A. (2011) Screening of cardiovascular risk factors among workers of a private telecommunication company in Senegal. Archives de Maladies Professionnelles et de l’Environnement, 72, 96-99.
[16] Assah, F.K., Ekelund, U., Brage, S., Mbanya, J.C. and Wareham, N.J. (2011) Urbanization, physical activity, and metabolic health in sub-Saharan Africa. Diabetes Care, 34, 491-496.
[17] Cappuccio, F.P., Kerry, S.M., Adeyemo, A., Luke, A., Amoah, A.G., Bovet, P., Connor, M.D., Forrester, T., Gervasoni, J.P., Kimbally Kaki, G, Plange-Rhule, J., Thorogood, M. and Cooper, R.S. (2008) Body size and blood pressure. An analysis of Africans and the African diaspora. Epidemiology, 19. 38-46.
[18] Mina, R. and Casolin, A. (2007) National standard for health assessment of rail workers: The first year. Medical Journal of Australia, 187, 394-397.
[19] Finucane, M.M., Stevens, G.A., Cowan, M.J., Danaie, G., Lin, J.K., Paciorek, C., Sing, G.M., et al. (2011) National, regional, and global trends in body-mass index since 1980: Systematic analysis of health examination surveys and epidemiological studies with 960 country-years and 9.1 milion participants. Lancet, 377, 557-567.
[20] Yayehd, K., Damorou, F., Akakpo, R., Tchérou, T., N’da, N.W., Pessinaba, S., Belle, L. and Johnson, A. (2013) Prevalence and determinants of hypertension in Lomé (Togo): Results of a screening in May 2011. Annales de Cardiologie et d’Angeiologie, 62, 43-50.
[21] Harada, K., Karube, Y., Saruhara, H., Takeda, K. and Kuwajima, I. (2006) Workplace hypertension is associated with obesity and family history of hypertension. Hypertension Research, 29, 969-976.
[22] Mina, R. and Casolin, A. (2012) The australian standard for rail workers five years on. Occupationnal Medecine, 62, 642-647.
[23] Ng, K.L., Quinn, S., Gill, T.K., Hill, C. and Shanahan, E.M. (2013) Impact of the new national health standard for rail safety workers on ischaemic heart disease risk factors in train drivers. Internal Medicine Journal, 43, 650-655. http://dx.doi.org/10.1111/j.1445-5994.2012.02923.x
[24] Ghiasvand, M., Heshmat, R., Golpira, R., Haghpanah, V., Soleimani, A., Shoushtarizadeh, P., Tavangar, S.M. and Larijani, B. (2006) Shift working and risk of lipid dis-orders: A cross-sectional study. Lipids Health Diseases, 5, 9.

Copyright © 2020 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.