Global Health, Epidemiology and Genomics

An exciting new development from Cambridge Journals

Global Health, Epidemiology and Genomics

Understanding the diabetes burden in sub-Saharan Africa

Home / Non-communicable Diseases / Understanding the diabetes burden in sub-Saharan Africa

Understanding the diabetes burden in sub-Saharan Africa

Posted on
14 November 2016
by Ayesha Motala

Sub-Saharan Africa (SSA) has the dubious privilege of being a fertile ground for a diabetes epidemic. It has a population of over 1 billion and one of the fastest rates of urbanization in the world, with countries at varying stages of the epidemiological transition. The WHO global action plan for the prevention and control of NCDs 2013-2020 set out the target for a 0% increase in diabetes by 2020 (1). However, achieving this will remain a pipe-dream unless large-scale population studies are employed to understand the distribution and determinants of diabetes in SSA.

Although data on the epidemiology of diabetes in Africa has increased over the last two decades, it is still limited. Diabetes prevalence is variable, but contrary to previous notions, it is not rare. Although the prevalence is still low in some rural African populations, moderate and even high rates have been reported in some countries and there is now evidence that the prevalence is increasing. The International Diabetes Federation estimates that the number of people with diabetes will increase globally by 55% by 2040, with the greatest increase (140%) expected for the Africa region (2). The moderate-to-high frequency of intermediate hyperglycaemia found in many African populations may also indicate that we are in the early stages of a diabetes epidemic.

The wide variability in the prevalence of diabetes and its associated risk factors, suggests that in SSA, diabetes is due to a complex interaction of environmental and genetic factors, which might differ between populations. We know from studies in other settings that overweight and obesity, an unhealthy diet, physical inactivity, high blood pressure, ethnicity, history of gestational diabetes and poor nutrition during pregnancy are associated with increased risk of developing type 2 diabetes (T2D). However, there is currently a dearth of data on these risk factors as well as the impact of HIV/AIDS, and other potential psycho-social, environmental and genetic risk factors in African populations. There is a clear need for comparable and large-scale epidemiological studies to reliably assess the burden of T2D in SSA (2-4).

To this end, the Human Heredity and Health in Africa (H3A) diabetes study was conceived – it is a multi-country epidemiological study of the prevalence and determinants of T2D in SSA, using an approach that spans public health, epidemiology and genomics (5). The primary study aims to assess the burden and spectrum of T2D in adults across SSA and investigate the environmental and genetic determinants of the disease in these populations. It is currently recruiting participants from 11 sites across 8 countries, with recruitment at hospitals and clinics (cases) and through population based cross-sectional surveys (potential controls). The secondary study, conducted in four of the 11 sites, aims to assess and characterize the presence and severity of diabetic eye disease. Data on lifestyle and behavioral risk factors, anthropometry, glucose levels, serology biomarkers and DNA will be taken from all participants. So far, close to 40% of the 12,000 target sample have been recruited. The results of the study will hopefully provide important insights into the known and potentially novel determinants of T2D in SSA and inform prevention and therapeutic strategies to work towards the WHO target of a 0% increase in diabetes prevalence.

 
References

  1. WHO. Global action plan for the prevention and control of noncommunicable diseases 2013–2020. Geneva, Switzerland: World Health Organization, 2013.
  2. International Diabetes Federation. IDF Diabetes Atlas 7th Edition. Brussels, Belgium, 2015. Available from: http://www.idf.org/diabetesatlas
  3. Mbanya JC, Motala AA, Sobngwi E, Assah FK, Enoru ST. Diabetes in sub-Saharan Africa. Lancet. 2010;375(9733):2254-66.
  4. Peer N, Kengne AP, Motala AA, Mbanya JC. Diabetes in the Africa Region: an update. Diabetes research and clinical practice 2014; 103(2): 197-205
  5. Ekoru K, Young EH, Adebamowo C, Balde N, Hennig BJ, Kaleebu P, Kapiga S, Levitt NS, Mayige M, Mbanya JC, McCarthy MI, Nyan O, Nyirenda M, Oli J, Ramaiya K, Smeeth L, Sobngwi E, Rotimi CN, Sandhu MS, Motala AA. H3Africa Multi-Centre Study of the Prevalence and Environmental and Genetic Determinants of Type 2 Diabetes in Sub-Saharan Africa. Global Health, Epidemiology and Genomics / Volume 1 / January 2016, e5. DOI: http://dx.doi.org/10.1017/gheg.2015.6
Non-communicable Diseases tags: Africa / diabetes / H3A / sub-saharan Africa / World Diabetes Day

Leave a Reply Cancel reply

Recent Posts

  • Eight Years & Five Countries Later: PRIME shows integration of mental healthcare into primary care is feasible
  • Promoting dental leadership to transform child oral health
  • Working towards gender equity in health: experiences from rural Nepal
  • Global aspects of change in diabetes burden
  • Developing standards for African genomics research and biobanking

Archives

  • February 2019
  • January 2019
  • December 2018
  • November 2018
  • October 2018
  • September 2018
  • August 2018
  • July 2018
  • June 2018
  • May 2018
  • April 2018
  • March 2018
  • February 2018
  • January 2018
  • December 2017
  • November 2017
  • October 2017
  • September 2017
  • August 2017
  • July 2017
  • May 2017
  • April 2017
  • March 2017
  • February 2017
  • January 2017
  • December 2016
  • November 2016
  • October 2016
  • September 2016
  • August 2016
  • July 2016
  • June 2016
  • May 2016
  • April 2016
  • March 2016
  • February 2016
  • January 2016
  • December 2015
  • November 2015
  • October 2015
  • September 2015
  • August 2015
  • July 2015
  • June 2015
  • May 2015

Categories

  • Capacity Building
  • Genetics
  • Global Health
  • Indigenous People
  • Infectious Diseases
  • Journal
  • Non-communicable Diseases
  • Technological advances

Tags

Africa antiretrovirals APCDR blood pressure Brown Capacity building Child health CRONICAS diabetes Ebola Electronic health records epidemiology genetic diversity genetics genomics GHEG global health H3Africa H3Africa network and genomics in Africa HIV HIV/AIDS human health hypertension India infectious diseases intervention journal LMICs Longitudinal Population-Based studies Low- and middle-income countries Malaria Mental Health NCDs PacBio Peru populations Pregnancy Sandhu Sierra Leone South Africa sub-saharan Africa Women in Global Health World AIDS Day Zoonoses zoonotic
© Copyright 2015 Cambridge University Press
Cambridge University Press