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Cross-sectional study of association between psychosocial stressors with chronic kidney disease among migrant and non-migrant Ghanaians living in Europe and Ghana: the RODAM study.
BMJ Open. 2019 08 01; 9(8):e027931.BO

Abstract

OBJECTIVES

The association between psychosocial stressors (PS) and chronic kidney disease (CKD) among sub-Saharan African (SSA) populations is unknown. We examined the association between PS and CKD prevalence among rural and urban Ghanaians and Ghanaian migrants living in three European cities. We also assessed if the influence of PS on CKD is partially mediated by primary risk factors (hypertension and diabetes) of CKD.

DESIGN

A multi-centred cross sectional data from the Research on Obesity and Diabetes among African Migrants study.

SETTING

Rural and urban Ghana and three European cities (Amsterdam, Berlin and London).

PARTICIPANTS

A random sample of 5659 adults (Europe 3167, rural Ghana 1043 and urban Ghana 1449) aged 25-70 years.

EXPLANATORY MEASURES

PS defined by negative life events, perceived discrimination, perceived stress at work/home and depressive symptoms. Three CKD outcomes were considered using the 2012 Kidney Disease: Improving Global Outcomes severity of CKD classification. Comparisons between PS and CKD outcomes were made using logistic regression analyses across all sites.

RESULTS

We observed higher proportion of negative life events (68.7%) and perceived permanent stress (15.9%) among Ghanaians living in Ghana than Ghanaians living in Europe. Depressive symptoms (7.5%) and perceived discrimination (29.7%) were more common among Ghanaians living in Europe than Ghanaians living in Ghana. No significant association was observed between any of the PS constructs and CKD outcomes across sites except for positive association between stress at work/home and albuminuria (2.81, 95% CI 1.46 to 5.40) and CKD risk (2.78, 95% CI 1.43 to 5.43) among Ghanaians living in Berlin.

CONCLUSION

Our study found a positive association between stress at work/home and albuminuria and CKD risk. There was no convincing evidence of associations between the other PS constructs and the prevalence of CKD risk. Further studies are needed to identify potential factors driving the high prevalence of CKD among these populations.

Links

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Authors+Show Affiliations

Adjei DN
Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands. Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Accra, Ghana.
Stronks K
Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
Adu D
Department of Medicine, School of Medicine and Dentistry, University of Ghana and Korle-Bu Teaching Hospital, Accra, Ghana.
Beune E
Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
Meeks K
Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
Smeeth L
Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom.
Addo J
Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom.
Owusu-Dabo E
Kumasi Centre for Collaborative Research, KNUST, Kumasi, Ghana.
Klipstein-Grobusch K
Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Centre, Utrecht University, Utrecht, The Netherlands. Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Mockenhaupt F
Institute of Tropical Medicine and International Health, Charité-University Medicine Berlin, Berlin, Germany.
Schulze M
Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany.
Danquah I
Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany. Institute for Social Medicine, Epidemiology and Health Economics, Charité-Universitaetsmedizin Berlin, Berlin, Germany.
Spranger J
Department of Endocrinology and Metabolism, Charité-University Medicine Berlin, Berlin, Germany. German Centre for Cardiovascular Research (DZHK), Berlin, Germany. Center for Cardiovascular Research (CCR), Charité-University, Medicine, Berlin, Germany.
Bahendeka SK
MKPGMS, Uganda Martyrs University, Kampala, Uganda.
Agyemang C
Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.

MeSH

AdultAgedBerlinBlack PeopleCross-Sectional StudiesFemaleGhanaHumansLogistic ModelsLondonMaleMiddle AgedNetherlandsPrevalenceRenal Insufficiency, ChronicRisk FactorsRural PopulationStress, PsychologicalTransients and MigrantsUrban Population

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

31375611

Citation

Adjei, David Nana, et al. "Cross-sectional Study of Association Between Psychosocial Stressors With Chronic Kidney Disease Among Migrant and Non-migrant Ghanaians Living in Europe and Ghana: the RODAM Study." BMJ Open, vol. 9, no. 8, 2019, pp. e027931.
Adjei DN, Stronks K, Adu D, et al. Cross-sectional study of association between psychosocial stressors with chronic kidney disease among migrant and non-migrant Ghanaians living in Europe and Ghana: the RODAM study. BMJ Open. 2019;9(8):e027931.
Adjei, D. N., Stronks, K., Adu, D., Beune, E., Meeks, K., Smeeth, L., Addo, J., Owusu-Dabo, E., Klipstein-Grobusch, K., Mockenhaupt, F., Schulze, M., Danquah, I., Spranger, J., Bahendeka, S. K., & Agyemang, C. (2019). Cross-sectional study of association between psychosocial stressors with chronic kidney disease among migrant and non-migrant Ghanaians living in Europe and Ghana: the RODAM study. BMJ Open, 9(8), e027931. https://doi.org/10.1136/bmjopen-2018-027931
Adjei DN, et al. Cross-sectional Study of Association Between Psychosocial Stressors With Chronic Kidney Disease Among Migrant and Non-migrant Ghanaians Living in Europe and Ghana: the RODAM Study. BMJ Open. 2019 08 1;9(8):e027931. PubMed PMID: 31375611.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cross-sectional study of association between psychosocial stressors with chronic kidney disease among migrant and non-migrant Ghanaians living in Europe and Ghana: the RODAM study. AU - Adjei,David Nana, AU - Stronks,Karien, AU - Adu,Dwomoa, AU - Beune,Erik, AU - Meeks,Karlijn, AU - Smeeth,Liam, AU - Addo,Juliet, AU - Owusu-Dabo,Ellis, AU - Klipstein-Grobusch,Kerstin, AU - Mockenhaupt,Frank, AU - Schulze,Matthias, AU - Danquah,Ina, AU - Spranger,Joachim, AU - Bahendeka,Silver Karaireho, AU - Agyemang,Charles, Y1 - 2019/08/01/ PY - 2019/8/4/entrez PY - 2019/8/4/pubmed PY - 2020/9/15/medline KW - Europe KW - Ghana KW - chronic kidney disease KW - migrants KW - psychosocial stressors KW - rodam study SP - e027931 EP - e027931 JF - BMJ open JO - BMJ Open VL - 9 IS - 8 N2 - OBJECTIVES: The association between psychosocial stressors (PS) and chronic kidney disease (CKD) among sub-Saharan African (SSA) populations is unknown. We examined the association between PS and CKD prevalence among rural and urban Ghanaians and Ghanaian migrants living in three European cities. We also assessed if the influence of PS on CKD is partially mediated by primary risk factors (hypertension and diabetes) of CKD. DESIGN: A multi-centred cross sectional data from the Research on Obesity and Diabetes among African Migrants study. SETTING: Rural and urban Ghana and three European cities (Amsterdam, Berlin and London). PARTICIPANTS: A random sample of 5659 adults (Europe 3167, rural Ghana 1043 and urban Ghana 1449) aged 25-70 years. EXPLANATORY MEASURES: PS defined by negative life events, perceived discrimination, perceived stress at work/home and depressive symptoms. Three CKD outcomes were considered using the 2012 Kidney Disease: Improving Global Outcomes severity of CKD classification. Comparisons between PS and CKD outcomes were made using logistic regression analyses across all sites. RESULTS: We observed higher proportion of negative life events (68.7%) and perceived permanent stress (15.9%) among Ghanaians living in Ghana than Ghanaians living in Europe. Depressive symptoms (7.5%) and perceived discrimination (29.7%) were more common among Ghanaians living in Europe than Ghanaians living in Ghana. No significant association was observed between any of the PS constructs and CKD outcomes across sites except for positive association between stress at work/home and albuminuria (2.81, 95% CI 1.46 to 5.40) and CKD risk (2.78, 95% CI 1.43 to 5.43) among Ghanaians living in Berlin. CONCLUSION: Our study found a positive association between stress at work/home and albuminuria and CKD risk. There was no convincing evidence of associations between the other PS constructs and the prevalence of CKD risk. Further studies are needed to identify potential factors driving the high prevalence of CKD among these populations. SN - 2044-6055 UR - https://www.unboundmedicine.com/medline/citation/31375611/Cross_sectional_study_of_association_between_psychosocial_stressors_with_chronic_kidney_disease_among_migrant_and_non_migrant_Ghanaians_living_in_Europe_and_Ghana:_the_RODAM_study_ DB - PRIME DP - Unbound Medicine ER -