Urbanization in Sub‐Saharan Africa: Declining Rates of Chronic and Recurrent Infection and Their Possible Role in the Origins of Non‐communicable Diseases

Bickler, Stephen W.; Wang, Andrew; Amin, Said; Halbach, Jonathan; Lizardo, Radhames E.; Cauvi, David M.; Maio, Antonio De

doi:10.1007/s00268-017-4389-5

Cited by 28 publications

(18 citation statements)

References 61 publications

(82 reference statements)

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“…Although, the prevalence of diabetes in Sub-Sahara Africa was reported to be lower (3%) as compared to the global prevalence (8.5%) in 2016, there is a rising trend in the past few decades due to the effects of rapid urbanization, globalization and life style changes [5]. Moreover, it is alarming that more than two thirds of the diabetes mellitus cases were undiagnosed in the Sub-Sahara Africa [3,4,[6][7][8][9].…”

Section: Introductionmentioning

confidence: 98%

Prevalence and Associated Factors of Diabetes Mellitus in Hosanna Town, Southern Ethiopia

Dereje¹,

Earsido²,

Temam

et al. 2020

Annals of Global Health

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Background/Objectives: Diabetes is a global public health problem, and its burden is rising, particularly in developing countries. However, limited data is available from sub-Sahara African communities to assess and monitor the disease burden. The study aimed to determine the prevalence and associated factors of diabetes in Hosanna, Ethiopia. Methods: A community-based cross-sectional study was conducted among 634 randomly selected adults in Hosanna. The study participants were recruited by multi-stage stratified sampling. A face-to-face interview using a structured questionnaire was administered by trained nurses. Anthropometry, blood pressure and fasting blood glucose levels were measured. Diabetes mellitus was considered when the fasting blood glucose level was ≥126 mg/dl on two separate measurements or when the participant self-reported a previous diagnosis of diabetes by healthcare providers or when the participant was currently receiving treatment for diabetes. Multi-variable binary logistic regression was used to identify factors associated with diabetes mellitus. Findings: The overall prevalence of diabetes was found to be 5.7% (95% CI; 4.0-7.7), out of which more than one third (36%) were not aware of it prior to the survey. Nearly two thirds (61.1%) of the diabetic participants were also found to be hypertensive. In the multi-variable analysis, diabetes was associated with current alcohol use, sitting on average of more than 8 hours/day, abnormal BMI and being hypertensive. Conclusion: The prevalence of diabetes among the adult population in the town is alarming. If appropriate measures to address the burden are not emplaced, it might result in serious complications to the patients and unnecessarily high costs to the health system of the country. Active screening for raised blood glucose level should be given due consideration, particularly in the community setting. Designing health education programs on the importance of physical activity and the risks of alcohol use should also be considered.

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Section: Introductionmentioning

confidence: 98%

Prevalence and Associated Factors of Diabetes Mellitus in Hosanna Town, Southern Ethiopia

Dereje¹,

Earsido²,

Temam

et al. 2020

Annals of Global Health

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“…Rapid urbanisation and international migration have been associated with increased risk of cardiovascular diseases (CVD) in sub‐Saharan Africa (SSA) . Much of this emerging CVD risk has been attributed to changes in lifestyle factors such as alcohol consumption, smoking, physical inactivity and poor diet .…”

Section: Introductionmentioning

confidence: 99%

Hyperuricaemia and its association with 10‐year risk of cardiovascular disease among migrant and non‐migrant African populations: the RODAM study

Chilunga

Henneman

Requena‐Méndez

et al. 2020

Tropical Med Int Health

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objective In the advent of rapid urbanisation, migration and epidemiological transition, the extent to which serum uric acid (sUA) affects cardiovascular disease (CVD) risk among Africans is not well understood. We assessed differences in sUA levels and associations with CVD risk among migrant Ghanaians in Europe and non-migrant Ghanaians in rural and urban Ghana.methods Baseline data from 633 rural, 916 urban and 2315 migrant participants (40-70 years) from the cross-sectional RODAM study were analysed. Hyperuricaemia was defined as sUA >7 mg/dl in men and >6 mg/dl in women. The 10-year risk of atherosclerotic cardiovascular disease (ASCVD) was calculated using the American College of Cardiology (ACC)/American Heart Association (AHA) risk score which takes into account ethnic minority populations. High CVD risk was defined as ASCVD risk scores ≥7.5%. Logistic regressions were used to assess associations between hyperuricaemia and CVD risk.results Prevalence for hyperuricaemia in rural, urban and migrant participants was 17.4%, 19.1% and 31.7% for men, and 15.9%, 18.2% and 33.2% for women, respectively. Hyperuricaemia was positively associated with elevated CVD risk among rural residents (adjusted OR for men 3.28, 95% CI: 1.21-8.96, 6.36, 95% CI: 2.98-13.56 for women), urban residents (1.12, 95% CI: 0.45-2.81 for men, 2.11, 95% CI: 1.26-3.52 for women) and migrants (1.73, 95% CI: 1.01-2.96 for men, 4.61, 95% CI: 3.05-6.97 for women).conclusion Our study shows variations of sUA levels in different African contexts. Hyperuricaemia is associated with elevated 10-year CVD risk in both migrants and non-migrants. Further studies should identify factors driving associations between sUA and CVD risk in Africans.keywords serum uric acid, cardiovascular disease risk, sub-Saharan Africans, migrants, Europe, RODAM study Sustainable Development Goals (SDGs): SDG 3 (good health and well-being), SDG 10 (reduced inequalities), SDG 17 (partnerships for the goals)

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“…Urbanization is shaping epidemiological and demographic transition in sub-Saharan Africa (SSA) 1 . In Malawi, one of the poorest countries in SSA, 84% of the 18 million population live in rural areas, yet internal net rural-to-urban migration, predominantly for economic reasons, has been increasing steadily at 4.1% per annum 2 , 3 .…”

Section: Introductionmentioning

confidence: 99%

Investigating associations between rural-to-urban migration and cardiometabolic disease in Malawi: a population-level study

Chilunga

Musicha

Tafatatha

et al. 2019

International Journal of Epidemiology

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BackgroundThe 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.MethodsIn 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.ResultsIn 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.ConclusionsRural-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.

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Urbanization in Sub‐Saharan Africa: Declining Rates of Chronic and Recurrent Infection and Their Possible Role in the Origins of Non‐communicable Diseases

Cited by 28 publications

References 61 publications

Prevalence and Associated Factors of Diabetes Mellitus in Hosanna Town, Southern Ethiopia

Prevalence and Associated Factors of Diabetes Mellitus in Hosanna Town, Southern Ethiopia

Hyperuricaemia and its association with 10‐year risk of cardiovascular disease among migrant and non‐migrant African populations: the RODAM study

Investigating associations between rural-to-urban migration and cardiometabolic disease in Malawi: a population-level study

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