Prevalence of cardiometabolic diseases in Sub-Saharan Africa: a systematic review and meta-analysis

TL;DR

This study finds that cardiometabolic diseases like hypertension and diabetes are highly prevalent in Sub-Saharan Africa, emphasizing the need for better public health strategies.

Contribution

The study provides the first comprehensive meta-analysis of cardiometabolic disease prevalence across Sub-Saharan Africa using PRISMA 2020 guidelines.

Findings

Hypertension prevalence is 27.1% and type 2 diabetes is 6.1% in Sub-Saharan Africa.

Most studies were conducted in Ethiopia, Nigeria, and Ghana, highlighting a research gap in other countries.

Stroke prevalence showed a statistically significant decline after 2010.

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.

Main findings: This systematic review highlights the substantial prevalence of cardiometabolic diseases (CMDs) such as hypertension (27.1%) and type 2 diabetes (6.1%) across Sub-Saharan Africa.Added knowledge: Across 266 studies, the majority of these studies were primarily in Ethiopia, Nigeria, and Ghana, emphasising a need for CMD research in underrepresented countries within the region.Global health impact for policy and action: This study highlights the need for targeted preventative care strategies to comprehensively address the region’s public health burden.

Main findings: This systematic review highlights the substantial prevalence of cardiometabolic diseases (CMDs) such as hypertension (27.1%) and type 2 diabetes (6.1%) across Sub-Saharan Africa.

Added knowledge: Across 266 studies, the majority of these studies were primarily in Ethiopia, Nigeria, and Ghana, emphasising a need for CMD research in underrepresented countries within the region.

Global health impact for policy and action: This study highlights the need for targeted preventative care strategies to comprehensively address the region’s public health burden.

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