Non-Communicable Disease Mortality and Risk Factors in Formal and Informal Neighborhoods, Ouagadougou, Burkina Faso: Evidence from a Health and Demographic Surveillance System

Abstract

The expected growth in NCDs in cities is one of the most important health challenges of the coming decades in Sub-Saharan countries. This paper aims to fill the gap in our understanding of socio-economic differentials in NCD mortality and risk in low and middle income neighborhoods in urban Africa. We use data collected in the Ouagadougou Health and Demographic Surveillance System. 409 deaths were recorded between 2009–2011 among 20,836 individuals aged 35 years and older; verbal autopsies and the InterVA program were used to determine the probable cause of death. A random survey asked in 2011 1,039 adults aged 35 and over about tobacco use, heavy alcohol consumption, lack of physical activity and measured their weight, height, and blood pressure. These data reveal a high level of premature mortality due to NCDs in all neighborhoods: NCD mortality increases substantially by age 50. NCD mortality is greater in formal neighborhoods, while adult communicable disease mortality remains high, especially in informal neighborhoods. There is a high prevalence of risk factors for NCDs in the studied neighborhoods, with over one-fourth of the adults being overweight and over one-fourth having hypertension. Better-off residents are more prone to physical inactivity and excessive weight, while vulnerable populations such as widows/divorced individuals and migrants suffer more from higher blood pressure. Females have a significantly lower risk of being smokers or heavy drinkers, while they are more likely to be physically inactive or overweight, especially when married. Muslim individuals are less likely to be smokers or heavy drinkers, but have a higher blood pressure. Everything else being constant, individuals living in formal neighborhoods are more often overweight. The data presented make clear the pressing need to develop effective programs to reduce NCD risk across all types of neighborhoods in African cities, and suggest several entry points for community-based prevention programs.

Prevalence and correlates of adult overweight in the Muslim world: analysis of 46 countries

“…Preferences were given for microdata over macrodata and directly measured over self‐reported height and weight. I found prevalence data for both genders for 15 countries and either no data or data for females only for the remaining five countries. For these I used recent prevalence estimates based on statistical modelling .…”

A comparison of all-cause and cause-specific mortality by household socioeconomic status across seven INDEPTH network health and demographic surveillance systems in sub-Saharan Africa

“…Studies from LLMICs have shown socioeconomic disparities in all-cause mortality across the age spectrum, but these data are mostly based on cross-sectional population surveys and more commonly describe inequalities in child and neonatal mortality [5][6][7]. Evidence from studies investigating disparities in SES and cause-specific death patterns and rates in these populations is limited, particularly across multiple causes and age groups [8][9][10].…”

“…Studies examining household-level or individual-level socioeconomic factors and cause-specific death rates have often been limited to single sites and particular health conditions. Such studies have often shown higher death rates from some causes, including HIV, malaria, tuberculosis, maternal conditions, childhood infection, and noncommunicable diseases (NCDs) associated with lower attainment on certain SES indicators [9,10,[20][21][22][23][24]. Nonetheless, other studies report conflicting or inconclusive evidence about the same causes [8,25,26].…”

Chronic kidney disease in low-middle income populations: a call to action for screening and prevention

“…The incidence and the prevalence of chronic kidney disease (CKD) are increasing worldwide. The true burden of kidney disease should be better assessed and prevented; in fact this worldwide health problem is probably underestimated, because of the relative lack of epidemiological data, the poor awareness of the problem, and the limited access to laboratory examinations for most of the general population in low-middle income countries [1][2][3][4]. A recent analysis of all the available studies published between 2008 and 2014, reporting the prevalence of CKD in Nigeria, finds a high prevalence of CKD in the country, ranging from 2.5 to 26%, with a high variability according to the examined population, but probably also influenced by the equation used to estimate the glomerular filtration rate (GFR) [5].…”

“…Several areas in the developing world are experiencing the deleterious effects of noncommunicable diseases with an increase in morbidity and mortality from stroke, coronary artery disease and end-stage renal disease. Obesity, diabetes mellitus and hypertension are becoming a significant public health concern especially in urban residents [3,7] where a higher prevalence of cardiovascular diseases [8], diabetes [9,10] and kidney diseases [4,11,12] in foreign-born populations in most migrants' destination countries have been described.…”