Prevalence and associated factors of self-reported ischaemic heart disease and/or stroke: a cross-sectional nationally representative community-based study of adults in Malawi in 2017

Abstract

Objective This study aimed to assess the prevalence and associated factors of self-reported ischaemic heart disease (IHD) and/or stroke among adults in Malawi.Design Population-based cross-sectional study.Setting Nationally representative sample of general adult population in Malawi.Participants The sample included 4187 persons aged 18–69 years (32 years of median age) that participated in the ‘2017 Malawi STEPwise Approach to Non-Communicable Disease Risk-Factor Surveillance survey.’Primary and secondary outcome measures Self-reported history of IHD and/or stroke, along with biological, behavioural, psychosocial stress and sociodemographic covariates. Multivariable logistic regression calculated OR with 95% CI for IHD and/or stroke.Results The prevalence of IHD and/or stroke was 6.5%, 4.4% among men and 8.4% among women. In adjusted logistic regression analysis, older age (50–69 years) (adjusted OR (AOR) 3.49, 95% CI 1.75 to 6.94), female sex (AOR 2.09, 95% CI 1.45 to 3.01), Chewa speaking (AOR 4.62, 95% CI 1.32 to 16.22), English speaking (AOR 5.63, 95% CI 1.43 to 22.19), suicidal ideation, plan and/or attempt (AOR 1.87, 95% CI 1.11 to 3.13) and sedentary behaviour (AOR 2.00, 95% CI 1.12 to 3.59) were associated with IHD and/or stroke. In addition, in unadjusted analysis, non-paid or unemployed, urban residence, overweight, obesity and having hypertension were associated with IHD and/or stroke.Conclusions Almost 1 in 10 women and 1 in 20 men aged 18–69 years had IHD and/or stroke in Malawi. Several risk and protective factors were found that can be targeted in population health interventions.