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Africa has higher risk of non-communicable diseases, research finds


ncd-health• WHO urges countries to trace causes

With predictions that millions of people in Africa will die from non-communicable diseases (NCDs) by 2020, the World Health Organisation (WHO), African region, is calling on countries to carry out surveys to identify the main causes of this rising trend.

According to a report released and published online by the organisation, which consolidates available data, these impending threats can be predicted because most adults in Africa have at least one risk factor that increases their chances of developing a life-threatening NCD, including heart disease, cancer, type-2 diabetes and chronic obstructive lung disease.

The burden of illness, which has been gradually increasing over the past decade, will likely surpass the toll of sickness and death from infectious diseases by 2030. Worldwide, deaths from NCDs will reach an estimated 44 million within the next four years, an increase of 15 per cent from WHO’s 2010 estimate. 

“In recent years, much of the world’s attention and resources have – deservedly been directed toward the immediate threat posed by emerging viruses, including Zika and Ebola,” said WHO’s Regional Director for Africa, Dr. Matshidiso Moeti. “What this reports serves to highlight, however, is that amidst these emergencies we cannot lose sight of the enormous health dangers posed by NCD especially since many of these can be prevented through changes in behavior and lifestyle.’’

High prevalence of major risk factors
Prevention of NCDs relies heavily on avoidance of four major behavioral risk factors: tobacco use, harmful use of alcohol, a poor diet (not consuming five servings of fruits and vegetables daily), and low levels of physical activity. In half of the African countries surveyed, one-quarter of adults had at least three of these risk factors, raising the probability that they will become ill with one or more of these conditions during the course of their lives. Most of these adults were likely to be female between the ages of 45-64.

“These are diseases that can be life-threatening as well as debilitating, and they place a significant hardship on the region, robbing people and families of those who otherwise should be enjoying their most productive years,’’Dr. Moeti said. “We must do everything we can to reverse these disturbing trends.’’

The prevalence of hypertension, or high blood pressure, in the African region is the highest worldwide, affecting an estimated 46% of adults, the report said. In half of the countries in the African region, at least one in three adults was found to be hypertensive.

“The high rates of hypertension are particularly worrisome, as hypertension is a silent killer, with most people unaware of their condition until it is too late,’’ said Dr. Abdikamal Alisalad, acting Director of WHO’s NCD cluster. “High blood pressure can damage the heart, leading to heart attacks, congestive heart failure, and fatty buildup in the arteries, causing them to harden. It also can contribute to stroke, kidney damage and vision loss, among other things.’’ At the same time, hypertension can be successfully treated through lifestyle changes and medication, Dr. Alisalad added.

Other key findings from the report indicate:
Tobacco use is one of the most serious health risks globally, causing more than 70% of lung cancers, 40% of chronic lung diseases, and 10% cardiovascular diseases. In the African region, the prevalence of daily tobacco use among adults ranged from 5% to 26% (12% across the region).

Globally, people fail to eat enough fruits and vegetables which accounts for about 14% of deaths from gastrointestinal cancer and about 10% of deaths from ischemic heart disease and stroke. While the consequences of such unhealthy diets are greatest in other WHO regions, Sub-Saharan Africa paradoxically is the only WHO region suffering from the double burden of under nutrition and obesity.

The prevalence of people who are overweight ranged from 12% in Madagascar to 60% in Seychelles, with a median of 35%. Adult females are more likely to be overweight than their male counterparts. Obesity followed similar patterns.

While alcohol consumption in the region generally is low – an estimated two-thirds of adults abstain – the prevalence of heavy episodic drinking among males who do drink ranged from almost 1% in Gambia to as high as 69% in Chad, with a median of 31%. Among schoolchildren, alcohol use was as low as 3% in Senegal and as high as 62% in Seychelles, with a median of 16%.

Among 32 countries surveyed, the average time spent in moderate or high intensity physical activity ranged from 21 minutes per day in Mauritania to 386 minutes per day in Mozambique, with a median of 116 minutes on a typical day. Adult males spend more time being physically active than females.

The report primarily is based on data from WHO STEPwise surveys from 33 countries in the region and global school-based student health surveys (GSHS) from 19 countries. WHO developed the former in 2002 in order to collect, analyse and disseminate population-based information from nationally representative samples on major risk factors for NCDs.

The GSHS was developed through collaborative efforts between WHO, the U.S. Centers for Disease Control and Prevention (CDC), and other partners to collect similar information from schoolchildren and students. The school surveys collect information mainly from students aged 13-15 years through a self-administered questionnaire on alcohol use, dietary habits, drug use, hygiene, mental health, physical activity, protective factors; sexual activities, tobacco use; and violence and unintentional injury. 

“These surveys have provided us with an extremely valuable – albeit alarming – picture of the health risks that confront the region. Now it is up to public health officials, government leaders and the people themselves to take action, ‘’ Dr. Moeti said.Much can be achieved through lifestyle changes – quitting smoking, drinking in moderation, increasing fruit and vegetable intake, and becoming more physically active.

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