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Blood lead concentrations in sub-Saharan African children below 6 years: systematic review
1Population Health and Optimal Health Practices Research Unit, CHUQ Research Center, Laval University, Quebec, QC, Canada; Department of Social and Preventive Medicine, Faculty of Medicine, Laval University, Quebec, QC, Canada.
Insights
Blood lead levels in sub-Saharan African children are high, exceeding US standards. Urgent prevention programs and research are needed to address this public health concern.
Area of Science:
- Environmental Health
- Pediatric Health
- Public Health
Background:
- Elevated blood lead levels (BLLs) pose significant health risks to children.
- Sub-Saharan Africa (SSA) faces a critical need to assess and mitigate lead exposure in young populations.
Purpose of the Study:
- To determine the geometric mean of blood lead levels in children under six years old residing in sub-Saharan Africa.
- To compare BLLs in SSA children with established international standards.
Main Methods:
- A systematic literature search was conducted across MEDLINE, Web of Science, and Google Scholar.
- Included studies focused on children under six years in SSA, with rigorous quality assessment of methods.
- Data were extracted and synthesized using weighted means based on sample size.
Main Results:
- Nine relevant studies from 11,148 identified papers reported a weighted mean BLL of 13.1 μg/dl.
- Studies with higher methodological quality (venipuncture, quality control) showed a weighted mean BLL of 16.2 μg/dl.
- Prevalence of BLLs ≥10 μg/dl ranged from 7.0% to 70.9% in six studies.
Conclusions:
- Blood lead levels in SSA children remain significantly elevated compared to US children.
- The current US CDC standard of 5 μg/dl highlights the urgent need for enhanced prevention programs and research in SSA.
- Targeted interventions are crucial to reduce lead exposure and protect child health in the region.
Objective:
To assess the geometric mean of blood lead levels in children aged below 6 years living in sub-Saharan Africa.
Methods:
Search strategies were developed in MEDLINE, Web of Science and Google scholar system, supplemented by screening of references from included papers and review articles. Studies including children younger than 6 years residing in sub-Saharan Africa (SSA) were eligible. The studies were assessed for quality of methods for blood collection, for participants' recruitment and for quality control for lead analyses. Data were extracted and synthetised by estimating the mean weighted by sample size.
Results:
A total of 11 148 published papers were identified with only 16 studies conducted in SSA. Only nine of them were relevant of inclusion criteria. The weighted mean of blood lead levels was 13.1 μg/dl. Five of included studies were classified as being less likely to present selection bias, having performed venipuncture and adequate quality control for lead analyses. The weighted mean from analyses involving only these studies was 16.2 μg/dl. Six of the included studies reported the prevalence of blood lead levels ≥10 μg/dl; levels ranged from 7.0% to 70.9%. Only one study reported the prevalence of blood lead levels ≥5 μg/dl (50%).
Conclusions:
The geometric mean of blood lead levels in sub-Saharan African children is still elevated relative to the US children. The new standard from the Centers for Disease Control and Prevention (5 μg/dl) implies that important efforts should be directed towards the initiation (or reinforcement) of prevention programmes and thorough research studies in sub-Saharan Africa.
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