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Prevalence of cardiometabolic diseases in Sub-Saharan Africa: a systematic review and meta-analysis
Shabana Cassambai1, John Tetteh2,3, Patrick Highton1
1Diabetes Research Centre, University of Leicester, Leicester, UK.
Insights
Cardiometabolic diseases (CMDs) pose a significant public health challenge in Sub-Saharan Africa. This review highlights high prevalences of conditions like hypertension and type 2 diabetes, stressing the need for targeted prevention strategies.
Area of Science:
- Public Health
- Epidemiology
- Cardiology
Background:
- Cardiometabolic diseases (CMDs) are a growing concern in Sub-Saharan Africa (SSA).
- Understanding the prevalence of CMDs is crucial for developing effective public health policies and interventions in SSA.
- Existing data on CMDs prevalence in SSA requires a comprehensive synthesis to inform targeted strategies.
Purpose of the Study:
- To conduct a systematic review and meta-analysis of population-based studies to determine the prevalence of cardiometabolic diseases in Sub-Saharan Africa.
- To analyze temporal trends in the prevalence of key CMDs within the region.
- To identify research gaps and guide future public health initiatives for CMDs in SSA.
Main Methods:
- A PRISMA 2020 compliant systematic literature search was performed in MEDLINE and The Cochrane Library up to December 2024.
- Included studies were population-based, with ≥100 participants aged ≥15 years, reporting CMDs prevalence in SSA.
- Random effects meta-analyses were used for prevalence estimation, and meta-regression for temporal trend analysis.
Main Results:
- The review included 266 studies encompassing 846,511 participants, with Ethiopia, Nigeria, and Ghana contributing the most studies.
- Prevalence estimates included: type 2 diabetes (T2D) at 6.1%, hypertension at 27.1%, stroke at 1.4%, hypercholesterolemia at 11.3%, and cardiovascular diseases at 4.8%.
- No significant temporal trends were found for hypertension or T2D between 2006-2014, but a significant decline in stroke prevalence was observed from 2010 onwards.
Conclusions:
- Cardiometabolic diseases represent a substantial public health burden across Sub-Saharan Africa.
- The high prevalence rates necessitate the urgent implementation of targeted preventative care strategies for CMDs in the region.
- Further research is needed in underrepresented SSA countries to achieve a comprehensive understanding of the CMDs landscape.
Abstract:
Cardiometabolic diseases (CMDs) are increasingly prevalent in Sub-Saharan Africa (SSA), underscoring the need to understand the existing public health burden. This would guide future policy strategies and interventions to mitigate the challenges posed. The aim of this systematic review was to provide a comprehensive overview of CMDs prevalence in SSA. A PRISMA 2020 compliant systematic literature search was conducted using MEDLINE and The Cochrane Library up to December 2024, including population-based studies with ≥100 participants, aged ≥15 years, and reporting CMDs prevalence in SSA. Random effects meta-analyses were conducted for prevalence, and meta-regression, for temporal trends, evaluated using the median data collection year. Overall, 266 unique studies of 846,511 participants were included; Ethiopia (n = 53), Nigeria (n = 36) and Ghana (n = 20) represented the most studies. Prevalences for the most widely studied condition included type 2 diabetes (T2D) (6.1%; 95% CI = 5.3-7.0), hypertension (27.1%; 95% CI = 25.5-28.8), stroke (1.4%; 95% CI = 1.0-2.0), hypercholesterolemia (11.3%; 95% CI = 7.4-17.0) and cardiovascular diseases (4.8%; 95% CI = 2.5-8.9). The temporal prevalence of hypertension and T2D between 2006 and 2014 showed no statistical significance (β = -0.0289 per year; p = 0.11) and (β = 0.0131 per year; p = 0.49), respectively. For stroke, a statistically significant temporal decline was observed beginning 2010 (β = b-0.1244 per year; p < 0.001). This systematic review reveals a substantial public health burden of CMDs in SSA. The high prevalence emphasises the need for targeted CMDs preventative care strategies in SSA. Notably, most studies were from Ethiopia and Nigeria, indicating the need for more research in other SSA countries for a comprehensive understanding of CMDs in the region.
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