Epidemiologic transition and the double burden of disease in Ghana: What do we know at the neighborhood level?

Abstract

Many developing countries including Ghana are currently experiencing dual disease burdens emerging from an unprecedented risk overlap that drive their epidemiological transitions. Yet, siloed and disintegrated approaches continue to take precedence in health research and policy programs that drive competition for limited resources to address competing health problems. The objective of this study was to offer empirical evidence in support of a cogent argument for an integrated framework for the study and management of infectious and chronic health conditions in Ghana. We did so by examining the prevalence, determinants, and neighborhoods trajectories of the double burden of disease using data from a cross-sectional neighborhood-based study in Ghana. We fitted multinomial multilevel multivariate models to a sample of 1377 individual surveys and the results presented as odds ratios. Findings show that amidst a rising burden of NCDs, infectious diseases remain the most common health condition and participants in deprived neighborhoods were significantly more likely to report poor health outcomes. Risk factors such as tobacco and alcohol consumption were significantly associated with NCDs and infectious diseases and respondents who reported being diagnosed with NCDs and infectious diseases in the past year were likely to engage in leisure time physical activities and eat healthy. Based on our findings, we recommend health reforms in Ghana and argue for the design and implementation of an integrated framework for the study and management of the double burden of disease in Ghana and similar developing country settings.

The burden and treatment of non-communicable diseases among healthcare workers in sub-Saharan Africa: a multi-country cross-sectional study

“…Our study adds evidence to the broader discourse on the dual burden of communicable and non-communicable diseases in low-income countries. In addition to studies from Ghana, Mozambique, and Zimbabwe, we found a considerable prevalence of NCDs in four other sub-Saharan Africa countries underlining the current epidemiological transition and the need to encompass NCDs in these settings (15)(16)(17).…”

“…These behavioral risk factors in higher socioeconomic groups can translate in less physically activity and increased consumption of fat, salt and processed food (46). A study from Ghana confirms tertiary education and private employment as risk factors for NCDs (15). However, evidence was not conclusive, as lower socioeconomic status was also associated with higher prevalence of tobacco and alcohol use (46).…”

“…Across sub-Saharan Africa many NCDs are rising ( 14 ), but data are hardly available on country level ( 3 ). Recent studies from Ghana, Mozambique, and Zimbabwe reported a double burden of NCDs and infectious diseases in the general population ( 15–17 ). A scoping review from 2019 found hypertension as the most commonly reported NCD followed by obesity and diabetes ( 18 ) with a prevalence range from 17.5 to 37.5% among HCWs ( 19 ).…”

Exposure to mass media chronic health campaign messages and the uptake of non-communicable disease screening in Ghana

“…The study further demonstrates the need to consciously address neighborhood disparities in the Ghanaian context. High unemployment rate coupled with high cost of living in many Ghanaian cities have led to the emergence of deplorable settlements and the expansion of existing slums which produce conditions for poor health outcomes [34]. Importantly, residents of such spaces do not often have the financial resources to access health service and mostly do not even consider voluntary screening a priority until they are too sick to go about their daily activities.…”

Exploring the prevalence and predictors of overweight and obesity in second cycle schools in Ghana

“…Ghana, like many developing nations, has experienced a rapid epidemiological transition marked by shifts in lifestyle, dietary habits, and physical activity levels. [22][23][24] These changes, coupled with the increasing availability of high-calorie foods and sedentary lifestyles, contribute significantly to the rise in overweight and obesity among adolescents. 25 The consequences of these conditions are far-reaching, affecting not only the immediate health of the students but also their long-term well-being as they transition into adulthood.…”