Nationwide Geospatial Analysis to Identify Variations in Primary Cardiovascular Risk in Ethiopia

BACKGROUND: Cardiovascular disease (CVD) varies across regions due to socioeconomic, cultural, lifestyle, healthcare access, and environmental factors.

OBJECTIVE: To find geographical variations in 10-year primary CVD risk and assess the impact of contextual factors on CVD risk.

METHOD: Data from 2658 Ethiopians aged 40 to 69 years with no previous CVD who participated in a nationally representative World Health Organization (WHO) STEPS survey in 2015 were included in the analysis. The mean 10-year CVD risk for 450 enumeration areas (EA) was used to identify spatial autocorrelation (using Global Moran's I) and CVD hot spots (using getas-Ord Gi*). Geographically Weighted Regression (GWR) analysis quantified the relationship between mean 10-year CVD risk and climate-related factors across areas.

RESULT: The spatial autocorrelation analysis identified significant spatial variation in the 10-year CVD risk at the EA level, with a global Moran's I value of 0.016. Statistically significant hot spot areas with 10-year CVD risk were identified in Addis Ababa (the capital), Benishangul Gumuz, SNNPR (Southern Nations, Nationalities, and Peoples' Region), Amhara, Afar, Oromia, and Hareri regions. In a multivariable GWR analysis, average water vapor pressure was a statistically significant explanatory variable for the geographical variations in 10-year CVD risk.

CONCLUSION: Hot spot areas for 10-year CVD risk were identified across numerous country regions rather than concentrated in a specific region. Alongside these hot spot areas, regions with a higher annual water vapor pressure (humidity) were identified as geographical targets for CVD prevention.