BACKGROUND The extent to which rural-to-urban migration affects risk for cardiometabolic diseases (CMD) in Africa is not well understood. We investigated prevalence and risk for obesity, diabetes, hypertension and precursor conditions by migration status. METHODS In a cross-sectional survey in Malawi (February 2013-March 2017), 13 903 rural, 9929 rural-to-urban migrant and 6741 urban residents (≥18 years old) participated. We interviewed participants, measured blood pressure and collected anthropometric data and fasting blood samples to estimate population prevalences and odds ratios, using negative binomial regression, for CMD, by migration status. In a sub-cohort of 131 rural-urban siblings-sets, migration-associated CMD risk was explored using conditional Poisson regression. RESULTS In rural, rural-to-urban migrant and urban residents, prevalence estimates were; 8.9, 20.9 and 15.2% in men and 25.4, 43.9 and 39.3% in women for overweight/obesity; 1.4, 2.9 and 1.9% in men and 1.5, 2.8 and 1.7% in women for diabetes; and 13.4, 18.8 and 12.2% in men and 13.7, 15.8 and 10.2% in women for hypertension. Rural-to-urban migrants had the greatest risk for hypertension (adjusted relative risk for men 1.18; 95% confidence interval 1.04-1.34 and women 1.17: 95% confidence interval 1.05-1.29) and were the most screened, diagnosed and treated for CMD, compared with urban residents. Within sibling sets, rural-to-urban migrant siblings had a higher risk for overweight and pre-hypertension, with no evidence for differences by duration of stay. CONCLUSIONS Rural-to-urban migration is associated with increased CMD risk in Malawi. In a poor country experiencing rapid urbanization, interventions for the prevention and management of CMD, which reach migrant populations, are needed.

中文翻译：

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在马拉维调查从农村到城市的迁徙与心脏代谢疾病之间的关联：一项人口水平的研究。

背景技术从农村到城市的迁移对非洲心脏代谢疾病（CMD）风险的影响程度尚不十分清楚。我们通过迁移状态调查了肥胖，糖尿病，高血压和前体疾病的患病率和风险。方法在马拉维（2013年2月至2017年3月）的横断面调查中，有13903名农村居民，9929名农村到城市移民和6741名城市居民（≥18岁）参加了调查。我们采访了参与者，测量了血压，并收集了人体测量学数据和空腹血液样本，使用负二项式回归（针对CMD）通过迁移状态估算了人口患病率和比值比。在131个农村-城市同胞组合的子队列中，使用条件Poisson回归研究了与移民相关的CMD风险。结果在农村，从农村到城市的移民和城市居民中，患病率估计为：超重/肥胖症的男性分别为8.9％，20.9％和15.2％，女性为25.4％，43.9％和39.3％；男性患糖尿病的比例分别为1.4％，2.9％和1.9％，女性1.5％，2.8％和1.7％；男性中高血压的比例分别为13.4％，18.8％和12.2％，女性为13.7％，15.8％和10.2％。从农村到城市的移民患高血压的风险最高（男性相对危险度经调整为1.18； 95％的置信区间为1.04-1.34；女性为1.17：95％的置信区间为1.05-1.29），并且他们是接受CMD筛查，诊断和治疗最多的人群，与城市居民相比。在同胞组合中，从农村到城市的移民同胞具有超重和高血压前期的较高风险，没有证据表明停留时间存在差异。结论在马拉维，从农村向城市的迁徙与CMD风险增加有关。在一个经历快速城市化的贫穷国家，