Prevalence of hypertension in children aged 5 – 20 Years in four districts of jimma zone

Abstract

Background: Unarguably hypertension is a major contributor to morbidity and mortality in adults not to mention the huge health care cost it poses to the economy. It is thought that adult hypertension might have its origin early in childhood and went undetected. Childhood blood pressure screening, particularly at schools is believed to fill this gap as also been recommended by the American heart association. Objective: This study aimed at finding the prevalence of high blood pressure in apparently healthy school children and looking for the risk factors. Subjects and Methods: A cross-sectional study design was conducted based on a secondary data collected primarily for the purpose of studying the prevalence of rheumatic heart disease in apparently healthy 2,000 school children and adolescents in four districts of Jimma zone. This current study addressed 1067 children sampled from the source population using a computer generated simple random sampling method after constructing sampling frame. The data for the study participants were retrieved from the data base by a trained research assistant and data was checked for completeness and consistency. Each variable in the data such as blood pressure, and body mass index was categorized based on the standard charts recommended by the world health organization. Data analysis was done by using SPSS for windows, version 16. The research undertaking was funded by Jimma University student research program. Results: The prevalence of high blood pressure in the study population is 17.4%; whereas children with pre – hypertension accounted for 15.2% of the population studied. With regard to nutritional status, the prevalence of overweight and obesity are 2.4 % and 1%, respectively. The remaining children are either under-weight (15.3%) or normal (81.3%). Bivariable logistic regression analysis was done and all the background variables have a statistically significant association with the outcome variable, hypertension (Systolic, diastolic, or overall hypertension). Females and those in the age group 10-20 years are more likely to develop overall hypertension (AOR=1.53 and 1.68, p=0.010 and 0.006 & 95% CI of 1.11 – 2.11 and 1.16-2.43, respectively), and therefore sex and age group are the variables independently associated with the development of overall hypertension according to this study. Conclusion: The prevalence of hypertension in these apparently healthy school children is significantly high. There is a statistically significant positive association between all the independent variables with the presence of systolic, diastolic or overall hypertension. The fact that this blood pressure measurement was done once might give an impression that the actual prevalence will be low; even then this figure is so high that it is recommended to periodically screen school children for high blood pressure as that will open a window of opportunity to intervene before it is late. A more practical and achievable first step would be to at least conduct a routine blood pressure measurement for all children visiting pediatric outpatient and inpatient facilities, which is not happening at the moment; and it is the recommendation of this study to implement this strategy as it will pave the way for a more wider look in to the case