Estimating the burden of disease attributable to high cholesterol in South Africa in 2000.

Burden of Disease Research Unit, South African Medical Research Council, Tygerberg, Cape Town.
South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde (Impact Factor: 1.71). 08/2007; 97(8 Pt 2):708-15.
Source: PubMed

ABSTRACT To estimate the burden of disease attributable to high cholesterol in adults aged 30 years and older in South Africa in 2000.
World Health Organization comparative risk assessment (CRA) methodology was followed. Small community studies were used to derive the prevalence by population group. Population-attributable fractions were calculated and applied to revised burden of disease estimates for the relevant disease categories for each population group. The total attributable burden for South Africa in 2000 was obtained by adding the burden attributed to high cholesterol for the four population groups. Monte Carlo simulation-modelling techniques were used for uncertainty analysis.
South Africa.
Black African, coloured, white and Indian adults aged 30 years and older.
Mortality and disability-adjusted life years (DALYs) from ischaemic heart disease (IHD) and ischaemic stroke.
Overall, about 59% of IHD and 29% of ischaemic stroke burden in adult males and females (30+ years) were attributable to high cholesterol (>or= 3.8 mmol/l), with marked variation by population group. High cholesterol was estimated to have caused 24,144 deaths (95% uncertainty interval 22,404 - 25,286) or 4.6% (95% uncertainty interval 4.3 - 4.9%) of all deaths in South Africa in 2000. Since most cholesterol-related cardiovascular disease events occurred in middle or old age, the loss of life years comprised a smaller proportion of the total: 222,923 DALYs (95% uncertainty interval 206,712 - 233,460) or 1.4% of all DALYs (95% uncertainty interval 1.3 - 1.4%) in South Africa in 2000.
High cholesterol is an important cardiovascular risk factor in all population groups in South Africa.

  • [Show abstract] [Hide abstract]
    ABSTRACT: As part of justifiable nutrition promotion, this study aimed to determine internal consistency of a dietary fat screener and to compare self-assessment to maternal assessment of fat intake of grade six (about 12 years old) learners in a South African public primary school. The children completed in school a pictorial, quantitative food frequency-type screener consisting of 10 high-fat food categories; mothers individually completed a text version. Internal consistency was measured with item-total correlations, Cronbach's alpha and the split-half method. Child–mother comparison was based on kappa (κ) statistics, McNemar's tests, Wilcoxon signed-rank test and the Bland–Altman method. In total, 101 (93.5%) children and 78 (72.2%) mothers responded. The screener was internally consistent, regardless of data source and statistical technique. For portion sizes and frequency of intake, children consistently reported higher intake than mothers. This resulted in systematic error, also evidenced by a significant difference from zero for the difference between child's and mother's final test scores for the whole group, and for boys and girls separately (always P < 0.001). In 76% of the pairs, classification into high fat or prudent intake was identical, yet the chance-corrected agreement was poor (κ = 0.16) and non-agreement was non-symmetrical (P = 0.001). Children and mothers reported high fat intakes (93% and 75%, respectively). It was concluded that the dietary fat screener was internally consistent, yet children and mothers did not agree in their assessment. The high fat intakes reported by children and mothers warrant measurement refinement and implementation of primary prevention programmes.
    Maternal and Child Nutrition 10/2012; · 2.97 Impact Factor
  • Official journal of the South African Academy of Family Practice/Primary Care 08/2014; 50(4):6-12.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Hypercholesterolemia is a major cardiovascular risk factor that increases the incidence of atherosclerotic diseases in adults, although the association is less well established in the elderly. The role of statins is well characterized for the reduction of myocardial infarction incidence or death in individuals with a history or high risk of cardiovascular diseases, regardless of age. Therapeutic measures recommended to prevent cardiovascular diseases and to reduce cholesterol levels in the elderly, such as lifestyle changes and lipid-lowering drugs, particularly statins, are based on studies conducted in younger adults. This narrative review aims to summarize the main observational studies and randomized clinical trials that have studied the relationship between cholesterol and cardiovascular diseases and the potential benefits and drawbacks of statins use in elderly patients.
    Aging and disease. 06/2013; 4(3):154-69.

Full-text (2 Sources)

Available from
Jun 2, 2014