Ekpenyong et al, Department of Physiology, College of Health Sciences, University of Uyo, Akwa Ibom State, Nigeria study published in European Journal of Sustainable Development (2012), suggest that “The overall prevalence of NCDs was 32.8%. Disease specific prevalence was as follows: 25%, 14.4%, 12.7%, 20.1% and 10% for obesity, hypertension, diabetes mellitus, musculoskeletal disorders and respiratory disorders respectively. Males’ vs females’ prevalence were: 20.7% vs 29.5%; 12.6% vs 12.2%; 9.7% vs 16.0%; 14.0% vs 26.5% and 8.6% vs 7.6% for obesity, hypertension, diabetes mellitus, musculoskeletal disorders and respiratory disorders respectively. Risk factors with increase odds for NCDs were: age, area of residence, work stress, triglyceride levels and positive family history. Physical inactivity, high total cholesterol level, high general adiposity, high central adiposity and poor dietary habits were equally significantly associated. The high prevalence of NCDs in Nigeria was precipitated by modifiable and un-modifiable life style factors. Intervention programmes should focus on these factors to reverse the trend”. The researchers concluded that “The prevalence of NCDs was high and was influenced by several modifiable and un-modifiable risk factors. Intervention programmes should focus on these factors to put a halt and reverse the trend”.

London School of Hygiene and Tropical Medicines stated that “The rapidly rising epidemic of non-communicable diseases (NCDs) in sub-Saharan Africa, in the presence of the long-standing burden of infectious diseases and constrained health care resources, represents an enormous challenge to the region. The causes, determinants and potential trajectory of the NCD epidemic are poorly understood. There is an urgent need for local research to inform an effective response to these changing health needs”.

The Lancet stated that “Burden of non-communicable diseases in sub-Saharan Africa In 2010, is more than 2·06 million deaths due to NCDs occurred in SSAF, a 46% (95% CI 41–59) increase from 1990. The risk in terms of age-standardised death rate has declined by about 12% (95% CI 8–14) from 1990 to 2010, with a negligible decline in central SSAF. The total burden of NCDs in terms of disability-adjusted life-years (DALYs) showed a similar pattern, with an increase of 45% (95% CI 41–52) in DALYs and a decrease of 9% (7–12) in standardised DALYs per capita. The fraction of burden of cancers remained at 8% in 2010, while cardiovascular and respiratory diseases decreased slightly from 16% and 12% in 1990 to 15% and 10% in 2010, respectively. Mental and behavioural disorders, musculoskeletal diseases, and diabetes and endocrine diseases increased by 3%, 2%, and 1% in 2010, respectively (from 12%, 9%, and 11% in 1990). In southern SSAF, the proportion of DALYs due to infectious diseases increased by 17% between 1990 and 2010, while the proportion of DALYs due to NCDs and injuries declined by about 20% and 15%, respectively. The decline in the burden of NCDs may be due to the pressure of competing infectious disease risks over this period.

Interpretation

An increasing burden of NCDs in Africa shows a growing health iceberg hidden under epidemics of infectious diseases. The NCDs with an increasing burden of disease in SSAF are mental and behavioural conditions and musculoskeletal diseases.

Holmes et al, Non-Communicable Diseases in Sub-Saharan Africa: The Case for Cohort Studies, believe there is an urgent need for longitudinal cohorts based in sub-Saharan Africa (SSA). This conclusion is drawn from the fact that non-communicable diseases (NCDs) cause a large and growing disease burden.

Selected Statistics on Non-Communicable Disease Burden in Sub-Saharan Africa

Non-communicable disease (NCD) burden

• Over 80% of deaths from non-communicable diseases worldwide are estimated to occur in low- and middle-income countries

Cardiac diseases

• The World Health Organization projects that the number of deaths from ischaemic heart disease in the African region will double by 2030

Stroke

• In 2004 stroke was estimated to cause 3% of all deaths in Africa and 52% of vascular deaths

Diabetes Mellitus

• The prevalence of diabetes mellitus in Africa is predicted to increase by 80% in 20 y [5].

Cancer

• One in five deaths from NCDs in adults over 45 y in Africa is estimated to be caused by cancer.

Delta Diabetes Research Initiaitive is a Federal Government of Nigeria NON GOVERNMENTAL ORGANISATION (Charity) with a focus to reduce the burden of non-communicable diseases (NCDs) in Nigerian communities through NCDs risk factors screening, prevention, treatment, management for patients and patient carers benefits.