Risk factors and morbidities associated with childhood obesity in sub-Saharan Africa: a systematic scoping review

Abstract

Background: The rising burden of childhood obesity is a major public health concern, particularly in sub-Saharan Africa (SSA), where most health systems are weak and least prepared for complications that may arise. While the need for preventive action is increasingly recognized, policy implementation within the sub-region has often been inadequate, non-systematic, and ad hoc. This study described evidence on the risk factors and morbidities associated with childhood obesity in SSA. Methods: Guided by the Arksey and O'Malley framework incorporating the Levac et al. recommendations, and the Joanna Briggs Institute guidelines, we conducted a scoping study to address the research question. Thorough keywords systematic search was conducted for potentially eligible articles in PubMed, Google Scholar, Web of Science, and CINAHL published between 2009 and June 2019. Articles obtained were screened independently by two investigators at the abstract and full text phases using the eligibility criteria. All relevant data were extracted by two investigators in parallel and thematic analysis conducted. Results: A total of 337,229 articles were obtained from the database search of which 68 satisfied the inclusion criteria and were included for data extraction. These 68 included studies were conducted in 19 countries with the majority, 27.9% (19/68) from South Africa followed by Nigeria with 20.6% (14/68). Six of the included studies were conducted in Ethiopia, 5 studies in Kenya, 4 studies each in Tanzania and Cameroon, and 2 studies each in Ghana, Uganda, and Sudan. Of the 68 included studies, one each was conducted in Botswana, Gambia, Lesotho, Mauritius, Mozambique, Seychelles, Togo, and Zimbabwe. Most (80.9%) of the included studies were cross-sectional, and only one was an intervention trial. Of the 68 included studies, 53 reported on risk factors, 12 reported on morbidities, and 3 reported both risk factors and morbidities. We found no evidence in almost 60% (28/47) of countries included in the World Health Organisation Africa region.

Global Trends in Child Obesity: Are Figures Converging?

“…Usually, higher human capital is associated with lower overweight problems [ 25 ]. However, some studies in developing countries find that a higher level of parental education is associated with a greater risk of children becoming overweight or obese [ 14 ]. In our case, a non-linear relationship is observed in which higher levels of human capital are associated with a greater risk of obesity, but this relationship is reversed at a point where obesity begins to decline.…”

“…Club 3 is formed mainly by Asian and Latin American countries, but it has a more heterogeneous composition with the presence of countries from Africa, Oceania, Europe and North America. Europe predominates in Club 4 (with a BMI value of 18.67), but also includes countries from Asia (14) and Africa (13). The most important region in Club 5 is Africa (35), followed by Asia (24) and Europe (16).…”

“…Childhood obesity could potentially result in the current generation of children having a shorter life expectancy than their parents because of its implications for adult mortality and morbidity [ 9 , 10 , 11 , 12 ]. Moreover, obese and overweight individuals have been reported to face higher levels of stigmatization, low self-esteem and a reduced health-related quality of life [ 13 , 14 ].…”

“…Substantial data have been collected in many countries allowing for the examination of time trends in obesity in adults and young people [ 2 ]. However, most international comparisons focus on the adult population [ 15 , 16 , 17 ], while studies of childhood obesity are often limited to individual country case studies [ 14 , 18 , 19 , 20 , 21 , 22 ]. This paper tries to fill this gap by analyzing convergence between a large set of countries, to determine whether there is indeed a closing of the gap between childhood obesity rates in industrialized and developing countries.…”

Double Burden of Poverty and Cardiovascular Disease Risk among Low-Resource Communities in South Africa

“…Obesity is considered a multi-factorial condition [20, 53,54] associated with an increased risk for comorbidities such as type 2 diabetes, insulin resistance, cancer, stroke, [53] hypertension, dyslipidaemia, [53,55] and hypertriglyceridaemia. [55] Obesity is also considered an independent risk factor for CVD.…”