KNOWLEDGE, teachers in Benghazi, Libya involved age, BMI,

KNOWLEDGE, ATTITUDE AND PRACTICE FOR RISK FACTORS FOR CARDIOVASCULAR
DISEASES AMONG BOTH GOVT AND PRIVATE PRIMARY SCHOOL TEACHERS IN BELAGAVI CITY –
A CROSS SECTIONAL STUDY

REVIEW LITRETURE

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1.     
The cross-sectional study was conducted when
the?
school
?year? 2004-05,
in Benghazi, Libya. The prevalence for hypertension and also IHD were 15.1% and
2.7% respectively while not signal cases of stroke could be detected on the
study-sample. The selected CVD should be independently predicted by age,
gender, family history of hypertension, BMI, smoking index, fasting blood sugar
level, and HDL (CI 95%). Risk factors for hypertension & IHD among school teachers
in Benghazi, Libya involved age, BMI, fasting blood sugar, gender, smoking
index, HDL, & family history of hypertension.(1)

2.     
A cross-sectional, hospital-based study
was carried out from May 20, 2013 to July 4, 2013 at Suhrawardy Cardiovascular
Institute Dhaka in Bangladesh. The mean KAP score were 21.45±5.83 with a total
possible score being 40. Only 5.86% of the samples were able to shows a increased
level of proficiency. Most of men had more knowledge (t (1.962) = 1.334, P = 0.051),
also women shows more health-seeking behaviours with powerful statistical
significance (t (-2.135) = -0.407, P = 0.034). Most significant chi-square
relationships were identified between socioeconomic status (SES) and KAP
scores.(2)

3.     
 The
cross-sectional survey study was conducted from November 2010 to January 2011 teacher
training in Hong Kong. Total, 130 pre-service teachers (70.6%) and 54 in-service
teachers (29.4%) included in the study. Many of the teachers were below 25
years old (61.4%). In that most of them female (n = 100; 54.3%) and male
teachers (n = 84; 45.7%). The majority of in-service teachers were subject
teachers (70.4%) and they had less than 5 years’ teaching experience (74.1%).
The teachers’ knowledge regarding hypertension was too low. Many teachers did
not answered that “increasing of systolic or diastolic blood pressure can
represent hypertension” (75.5%), “Hereditary plays a major part in the
developing of hypertension” (76.6%), and “Hypertension are associated with Type
II diabetes” (65.2%). Regarding the knowledge of hypertension and stroke, the
correct measure were only 48% and 53% respectively.(3)

4.     
The prospective study were conducted Multispecialty
Hospital at Coimbatore. Participants who all are aware regarding risk factors
were 48% and 52% were unaware. Among the risk factors, over weight was the most
common, as compared by high cholesterol level (98%), increased blood pressure
(94%) and Smoking (92%). The participants are also aware about regular physical
activity and exercise to lower risk factors for heart disease.(4)

5.     
A prospective questionnaire based survey
was administered from October 2014 to March 2015 at Basaveshwara Medical
College Hospital and Research Centre, Chitradurga, Karnataka, India. The most
of the participants who all are aware regarding the risk factors are 82% and
unaware were 15%. Among the all risk factors, increased blood pressure and
diabetes (93.3%) first ranked the most, followed by smoking (85.7%), overweight
(60%), and age (56.2%). In that most of the participants are aware of the risk
factors and majority of risk factor in the survey was high blood pressure. The study
also found that the participants were unaware of comorbid conditions like
diabetes and hyper-lipidemia.(6)

6.       
A descriptive, community based,
cross-sectional study from September to November 2011 in the Jhaukhel-Duwakot
Health Demographic Surveillance Site, Bhaktapur district in the Kathmandu. 70%
of all those participants are women and 26.9% formal education. The burdens of
cardiovascular risk factors were high, 20.1% were current smokers, 43.3% show low
physical activity and 21.6% were hypertensive. Participants showed only less knowledge
of cardiac disease cause, 29.7% found hypertension and 11% found over weight and
physical activity as causes, whereas very less, 2.2% found high blood sugar as causative.
Around 60% of participants did not know any heart attack symptoms compared with
20% who knew 2–4 symptoms. Median percentage scores for knowledge, attitude and
practice/behaviour are 79.3, 74.3 and 48, respectively. Closely 44% of
respondents have insufficient knowledge and less than 20% had more satisfactory
knowledge. Among them with highly satisfactory knowledge, only 14.7% have a
more satisfactory attitude and 19.5% and 13.9% have satisfactory and more satisfactory
practices, respectively.(10)

7.       
The Cross-sectional study was
conducted 78 primary schools 400 teachers in Belgaum city during month of March
to December 2009. Overall, prevalence of any other form of tobacco use among
primary school teachers was 14.50%. Only male teachers 46.03% used tobacco.
37.93% are using smoking type of tobacco, 46.56% used smokeless & 15.51% are
using both types of tobacco products. Most of the users initiated tobacco use
by 16 to 20 years of age. A substantial number of teachers initiated tobacco
use for fun, imitation and peer pressure. 58.33% of the teachers are using
tobacco due to dis-satisfaction from job, 37.50% due to family problems.11

8.     
The descriptive analytic study was conducted
from the year 2012 in Fariden and Chadegan health centres, located in the
Isfahan province. Total mean percentage of knowledge, attitude and practice numbers
of health services staff  are  56.48 ± 9.89, 67.01 ± 5.46 and 37.56 ± 20.30,
respectively. Regarding the risk factors of cardiovascular disease 2.7% of the
subjects have well and 36.2 % had less knowledge. Furthermore, 4.9% have good
attitude, 0.5% have less attitude, 82.2% have less practice, and only 1.1% have
good practice.(13)

9.     
A cross-sectional survey was performed
from February 2009 to December 2010 in Luanda, Angola. The prevalence rates
for cardiovascular risk factors was as followed by hypertension 45.2%,
hypercholesterolemia 11.1%, less high-density lipoprotein (HDL) cholesterol
50.1%, hypertriglyceridemia 10.6% , smoking 7.2%,  diabetes 5.7%,  overweight 29.3%, obesity 19.6%,  sedentary lifestyle 87.2%, and left
ventricular hypertrophy 20%. At least one risk factors were present in 27.7% of
a sample; 15.2% have two risk factors, and 31.4% have three or more risk
factors. Among them individuals with low socioeconomic status, 41.0% have three
or more risk factors.(19)

 

10.  The
cross-sectional survey performed from September to December 2011 in Southern
Nevada. Total Samples of 300 Filipino Americans subjects were participated in
our study. Participants had an average knowledge score of 82.81% in that
maximum correct score of 100%. The risk factors prevalence among them including
the hypertension (47.7%), diabetes (14%), dyslipidemia (27.7%), overweight
(36.7%), abdominal obesity (80.6%), smoking (11.7%), and lack of exercise
(48%). Filipino Americans have sufficient knowledge of heart disease in that
many of reported having risk factors. Understanding the behavioral basis of
cardiac disease knowledge and specific risk factors are helpful in providing
effective health prevention strategies. Early screening targeting to the
younger generation are also important for detect the risk factors in the beginning
stages.(20)

11.  The
cross-sectional survey was done from June 2012 to December 2012 in the
government and private school in Delhi. The prevalence of overweight and
obesity were respectively 9.5% and 11.5%. The percentage of prehypertension, grade
1 hypertension and grade-2 hypertension were 12.4%, 6.8% and 1.4% respectively.
Of the total, 43.8% was physically active 1 hour per day on all 7 days of the
previous week. Daily consumption of vegetables and fruits were reported by 76% and
42% of the school children respectively. Report says that 5% of school children
are used any form of tobacco. 1/5 of the school children had a family history
of CVD. Of the total, 25.4% had adequate knowledge regarding cardiovascular risk
factors.(21)

 

12.     
A cross-sectional study was conducted
in Rukmini nagar and Ramnagar urban area in Belagavi From August 2012 to
February 2014. Total sample 119 teachers, 83(70%) teachers age group of 34-53
years  86(72.3%) was female. 109(92%)
were married. 87(73.1%) had high waist-hip ratio,15(12.6%) was diabetics,
23(19.3%) had systolic Blood pressure (BP), 47(39.5%) had diastolic BP,
54(45.4%) was overwight,31(26.1%) was obese and 42(35.3%) was doing regularly
physical exercises 85(71.4%) consumed fruits and 31(26.1%) consumed vegetables
per week smoking and alcohol consumption habits were to be less then1%.(23)

 

13.     
A cross sectional survey were conducted
in Maralur area of Tumkur town from July to September, 2013.  Blood pressure were measured among 70 teachers
in the 5 schools of which 19 (27.14%) were males and 51 (72.86%) were females.
20 teachers (28.57%) was diagnosed with hypertension (HTN). 65% of hypertensive
teachers has positive family history of hypertension in this study. 15% of
teachers with hypertension have smoking habit and 10% of teachers have the
habit of alcohol consumption. 25% of hypertensive had less than 6 hours of sleep
daily. 65% of hypertensive do not practice yoga and 75% of hypertensive do not
practice meditation.24

 

14.  A
descriptive, cross-sectional survey done at SRM Medical College, Hospital, and
Research Centre, Kattankulathur, Tamil Nadu, India in the month of August 2015. Risk factors for CVD disease as shows by students
was dyslipidemia(96.8%), obesity(94.1%), hypertensive(92.8%), smoking(84.4%), diabetes
mellitus (DM)(82.4), age(81.8%), male gender (80.4%), inactivity (73.9%), and
family history (63.6%). However, only 12.5% exactly identi?ed High density
lipoprotein (HDL) is the good cholesterol. Comparing the mean knowledge score
for individual components, female participants have better for and lifestyle
behaviour. We could also derive statistically signi?cant differences between
students with smoking history and alcohol consumption compared with those
without, in case of total knowledge score25.

 

15.  A
cross-sectional study was carried out in Kelantan from June to December 2010. Mean
age of 39.9 years. In that, 3.1% were smokers and 41.1% were having medical
illness, the commonest are obesity (23.6%). About 87% of women know that smoking
is a risk factor. However, less than 20% knew about menopause. More than 80%
knew typical symptoms whereas less than half realised atypical symptoms. Less
than 20% of them knew the cholesterol risk target. Remaining 13% of women were exercise
as required. The mean (SD) for knowledge and practice score was 70.6 (13.76)
and 63.7(13.59) accordingly. The median for attitude score was 88.2 (14.71). The
good knowledge, attitude and practice score was 55.6%, 55.1 % and 51.1%
respectively.(26)

16.  The
cross-sectional hospital base study for patients who attending Sudan heart
centre from July to December 2011-2012. The prevalence of general obesity (body
mass index) in that CHD males patients was found to be, (overweight, 37.6%),
(obese class1, 19.5%), (obese class2, 10.5%), and (obese class3, 0.8%). On the
other side the prevalence of general obesity (body mass index) in females
patients were found to be, (overweight, 46.2%), (12% obese class1), (7.7%,
obese class2), and (2.6%, obese class3.(29)

17.  Hypertension
(HTN) screening camp was done on the world health day in 2013, for the staff of
Raichur Institute of Medical Sciences, Raichur. Out of 163
subjects, 101 (62%) were males and 62 (38%) were females. Majority, 79.1%, had
vegetarian and non-vegetarian diet, 20.9% were vegetarians, and 18.4% among
them added extra salt to the diet. Exercise were good among 27%, as they were
exercising for less than or equal 30minutes in a day. Prevalence of
hypertension were 11.7 %, and 9.2% of staff had blood pressure in pre-hypertension
range.(31)

18. 
A cross-sectional study carried out from
the year May 1st 2008 to May 31st 2008. Prevalence of risk factors of CHD were
as follows, hypertension 31%, diabetes 21%, high serum total cholesterol 29%,
high triglycerides 39%, high LDL cholesterol 19.3%, low HDL cholesterol 17.7%,
smoking 26%, sedentary habits 44%, positive family history of CHD 12%,
overweight (BMI >25 kg/m2) 33% and obesity 26%. In this, 55% of the study
case had at least two of these risk factors.(16)

19. 
Community based descriptive cross-sectional
study were carried out in Kathmandu. Mean age of the 196 subjects
were 51.26 (13.56) years.  The study
participants had only 22% of good knowledge about modifiable risk factors of
Coronary Atherosclerotic Heart Disease. Study shows that majority of the
respondent lack of good knowledge regarding modifiable risk factors of Coronary
Atherosclerotic Heart Disease. Correctly identified hypertension 85.2%, obesity
61.73%, cholesterol 40.31%, smoking 28.6% and diabetes mellitus17.86% respectively
as modifiable risk factor of Coronary Atherosclerotic Heart Disease.(18)

20. 
The hospital-based cross-sectional studies
were conducted from January to June 2014 in two tertiary care hospitals under a
medical college in Mangalore, Karnataka, south India. Majority of the study participants
67.3%, (404) were never smoked in their past life, 21.6% of study participants
were former smokers (130), and 11.1% of the study subject were currently
smoking (66). Nearly half of the study subjects 54.7%, (328) were currently
diabetic mellites. Most of them had abdominal obesity 78.2%, (469).
Exactly  35.3% (212) of the participants
had felt sad for 2 weeks or more in a row in the last year.(22)

21. 
The cross sectional surveys were carried
out in Maralur area in Tumkur town during July to September, 2013. Blood
pressure were measured for 70 teachers in the 5 schools of which 19 (27.14%)
were males and 51 (72.86%) were females. 20 teachers (28.57%) were detected
with hypertension. 65% of hypertensive teachers had family history of
hypertension. Teachers having with hypertension having of habit of smoking 15%,
and alcohol consumption 10% respectively. 25% of teachers with hypertensive had
less than 6 hours of sleep daily. 65% of teachers with hypertensive do not
practice yoga and 75% of hypertensive teachers do not practice meditation.(32)

22.  Comparative
cross-sectional studies were preformed among 110 bank employers and 110 high
school teachers selected in August 2011. Prevalence of risk factors for CHD
were high in two groups as follows. Hypertension in teachers 33.3%, and bankers
22.9%, diabetes mellitus in teachers 9.5%, and bankers 8.5%, obesity in
teachers 30.5%, bankers 20%, hypercholesterolemia have in teachers 37.1%,
bankers 41.9%, sedentary lifestyle teachers having 5.7%, bankers having 33.3%
and smoking (teachers 4.8%, bankers 7.6%).(33)

23.  Cross
sectional survey Were carried out in Bangalore Karnataka, India. 22% of the
population were showed no risk of CVD, and then 66% of the population showed
moderate risk and 12% of the population were under high risk. Smokers
were 29%, hypertensive  were 35%, alcoholic
are 24%, diabetic were14%, positive family history of CVD were 5.5%, 64% of the
subjects were physically inactive 64%.(35)

24.  Cross-sectional
surveys were conducted between January 1, 2013 and December 31, 2014. Departments
of Cardiology, Pulmonary Medicine, Endocrinology Internal Medicine Departments
at a tertiary care hospital at Belgaum district of Karnataka in India.
Prevalence of Diabetes mellitus, hypertension, and CVD in the 2432 Chronic
obstetric pulmonary diseases subjects were 25.94%, 37.25%, and 13.93%,
respectively.(36)

25.  A descriptive cross-sectional study were performed
in Kuwait during the year from January to June 2014. Total numbers of the
response rate were 90.7%. Participants knowledge about types of cardiovascular
diseases (CVD), heart attack or stroke symptoms were low. 60% of participants
did not know regarding CVD, and coronary artery diseases were the commonly
identified (29.0%). Two-fifths of participants were not aware of any heart
attack symptoms, and the most commonly known were chest pain (50.4%) and
shortness of breath (48.0%). Participants knowledge about CVD risk factors
were moderate. The common risk factors were
identified by over four-fifths of participants were obesity, smoking, physical
inactivity and unhealthy diet.(40)

26.  A hospital-based, cross sectional survey were carried
out at All India Institute of Medical Sciences (AIIMS), tertiary care hospital
in New Delhi, India. 41% of the sample shows a good level of knowledge. Population
identified smoking 68%, obesity 72%, hypertension 73%, and high cholesterol
correctly 57%, respectively. 30% identified diabetes mellitus as a modifiable
risk factor of coronary atherosclerotic heart disease.41

27.  Cross-sectional community-based studies were
conducted in Kerala during the period from January to June 2011. Prevalence of exact
coronary artery disease (CAD) were 3.5 %, men 4.8 %, women 2.6 %. Prevalence of
any coronary artery disease were 12.5 %, men 9.8 %, women 14.3 %. There is no
difference in CAD between rural and urban population. Physical inactivity were
reported 17.5 and 18% reported family history of CAD. Other CAD risk factors were
found in the study were overweight 59 %, abdominal obesity 57 %, high total cholesterol
52 %, hypertension 28 %, diabetes 15 %, and low level of high density
lipoprotein cholesterol 39 %. Current smoking was reported only by men (28 %).42

28.  A baseline survey and 6-month
longitudinal follow-up were conducted between January 2011 and May 2012 in the
SA pilot.
The
participation of schools was permitted by 53.2% of principals, and 489 of 1 779
teachers agreed to participate. Of teachers willing to participate in the
follow-up, 52% were retained, three-quarters by post and a quarter by email.
Their mean age was 46.3 years and 70.3% were female. The prevalence of CVD risk
factors was high and featured hypertension (48.5%), hypercholesterolemia
(20.5%), smoking (18.0%), diabetes (10.1%) and chronic kidney disease (10.4%),
while 84.7% were overweight or obese. Of the participants, 18.7% were at high
risk of a heart attack or stroke within 10 years. Establishing
a cohort study among teachers has challenges but also opportunities for
addressing CVD, which will soon impose a substantial burden on Cape Town’s
education system.43

29.  This
was a cross?sectional study done among the staff of Lautech, Ogbomoso, Nigeria
and was carried out between November 2013 and February 2014. The study
population included 96 males (46.6%) and 110 females. The mean age was 45.3 ±
7.9 years (range 27-73 years). The prevalence of CV risk factors were as
follows: Hypertension 84 (40.8%), visceral obesity 92 (44.7%), generalized
obesity 79 (38.3%), low high density lipoprotein 113 (54.9%), impaired blood
glucose 16 (7.8%), diabetes mellitus 3 (1.5%), hypercholesterolemia 102
(49.5%), left ventricular hypertrophy-ECG 24 (11.7%), elevated low density
lipoprotein-cholesterol 99 (48.1%). About – (72.3%) had two or more CV risk
factors clustered together. Females had a higher prevalence of CV risk factors
and its clusters than their male counterparts. Of those diagnosed with
hypertension in this study, more than half had never been told they were
hypertensive 48 (57.1%). This study suggests a very high prevalence of CV risk
factors among University Staff in LAUTECH, Ogbomoso, Nigeria. Clustering of CV
risk factors is more prevalent among women. Appropriate preventive strategy in
terms of education and modification of risk factors are important to reduce the
burden of CV diseases among this population.46

30.  A
cross-sectional study was carried out amongst teaching staff of IIMSR Medical
College, Badnapur, Jalna, Maharashtra during the period of August to October
2016.