Cardiovascular disease prevalence and associated factors in a low-resource setting: A multilevel analysis from Somalia's first demographic health survey

Abstract

Background

Cardiovascular diseases (CVDs) are a leading cause of death globally, with low- and middle-income countries disproportionately affected. Somalia, a nation grappling with persistent humanitarian crises and a rising burden of non-communicable diseases, has limited data on CVD prevalence and its risk factors. This study, the first of its kind in Somalia, leverages data from the inaugural nationally representative demographic health survey to examine the prevalence and associated factors of CVD among Somali adults.

Methods

A cross-sectional analysis was conducted using data from the 2020 Somali Demographic Health Survey, encompassing 5062 participants aged 35 years and older. Multilevel logistic regression was utilized to explore associations between individual-level and community-level factors and CVD prevalence. Individual-level factors included age, sex, marital status, education, wealth, smoking, and khat chewing. Community-level factors encompassed region and type of residence.

Results

The prevalence of CVD in Somalia was found to be 7.1%. Community-level factors were significantly associated with CVD prevalence. Residents of Sool region exhibited higher odds of CVD, while those in Banadir region had lower odds. Nomadic communities demonstrated lower CVD risk compared to urban areas. School attendance was marginally associated with CVD risk. After controlling for other factors, sex of the household head remained significant, with females having slightly lower odds of CVD.

Conclusion

This study underscores the critical influence of community-level factors, particularly region and type of residence, on CVD prevalence in Somalia. The findings highlight the need for targeted interventions that address geographic disparities and promote healthy lifestyles within communities. Future research should delve deeper into the underlying mechanisms of these associations and explore the impact of individual-level factors like school attendance and sex on CVD risk.