Metabolic risk factors for non-communicable diseases in Ethiopia: a systematic review and meta-analysis

Abstract

ObjectivesNon-communicable diseases (NCDs) are causing a new and yetsignificant health challenge in low-income countries. In Ethiopia, although 39% of deaths are NCD related, the health system remains underprepared, highlighting the clear need for evidence on risk factor distributions to inform resource planning and the health response. Therefore, this review investigates prevalence distributions and sex and age variations of metabolic risk factors among Ethiopian adults.Research design and methodsThis systematic review used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies published until 6 January 2021 were searched from PubMed, Scopus, ProQuest and Web of Science databases, reference lists of selected studies and grey literature. Studies reporting prevalence of metabolic risk factors: overweight/obesity, hypertension, impaired glucose homoeostasis and metabolic syndrome among Ethiopian adults were eligible for this systematic review and meta-analysis. Two authors independently extracted data and used the Joanna Briggs Institute tool for quality appraisal. The random effects model was used to conduct meta-analysis using Stata V.16. Subgroup analyses examined prevalence differences by region, study year, sample size and settings.ResultsFrom 6087 records, 74 studies including 104 382 participants were included. Most showed high prevalence of metabolic risk factors. Meta-analysis revealed pooled prevalence of metabolic risk factors from 12% to 24% with the highest prevalence observed for overweight/obesity (23.9%, 95% CI 19.9% to 28.0%) and hypertension (21.1%, 95% CI 18.7% to 23.5%), followed by metabolic syndrome (14.7%, 95% CI 9.8% to 19.6%) and impaired glucose tolerance (12.4%, 95% CI 8.7% to 16.1%). The prevalence of overweight/obesity was higher in women. All metabolic risk factors were higher among people aged above 45 years.ConclusionsA signficant proportion of Ethiopian adults have at least one metabolic risk factor for NCDs. Despite heterogeneity of studies limiting the certainty of evidence, the result suggests the need for coordinated effort among policymakers, healthcare providers, non-governmental stakeholders and the community to implement appropriate preventive measures to reduce these factors.

Dietary patterns and associations with metabolic risk factors for non-communicable disease

“…The prevalence of hypertension has been increasing in developing countries, particularly in sub-Saharan Africa, partly attributed to unhealthy dietary habits: high dietary salt intake, and inadequate intakes of fruit and vegetable 3 . In Ethiopia, although some studies reported up to a 40% prevalence of hypertension, a recent systematic review of metabolic risk factors and the current study reveals that one in five (21%) adults are hypertensive 21 . Hypertension increases the incidence of chronic diseases unless prevention and control programs such as screening, identification, and treatment of cases and lifestyle interventions are strengthened 50 , 51 .…”

“…In developing countries like Ethiopia, suboptimal dietary consumptions, early-age chronic undernutrition caused by dietary insufficiency, and the growing burden of overweight/obesity in adults are overwhelming the national healthcare response 19 , 20 . Previous studies in Ethiopia identified several sociodemographic predictors of metabolic risk factors, including gender, marital status, residence, occupational status, income, and with individual risk factors such as inadequate fruit/vegetables intake, salt intake, physical inactivity, alcohol consumption, tobacco use, and khat chewing 21 – 25 . However, little is known about the association between dietary patterns and metabolic risk factors in the population.…”

Patterns of Non-Communicable Disease, Multimorbidity, and Population Awareness in Bahir Dar, Northwest Ethiopia: A Cross-Sectional Study

“… 7 , 68 The chance of exposure to behavioral risk factors that are attributable to cause NCD, like alcohol consumption and physical inactivity, 69 and metabolic risks such as overweight/obesity and hypertension are also directly associated with the age of participants. 70 Our exploratory analysis presented in Supplementary Tables 1 and 2 shows that the age of adults is associated with employment status, family history of NCD, salt intake, alcohol consumption, khat use, and overweight and obesity; and with cardiovascular health concerns, cancer knowledge, physical activity, all which could augment the influence of age on the prevalence of NCD.…”