Obesity Epidemic in Urban Tanzania: A Public Health Calamity in an already Overwhelmed and Fragmented Health System.

Abstract

Background Worldwide, the epidemiological and demographic transitions have resulted in nutrition shift characterized by an increased consumption of sugar-sweetened beverages and energy-dense fast food products. In just over 3 decades, overweight and obesity rates have nearly tripled to currently affecting over a third of the global population. Notwithstanding the ever present under-nutrition burden, sub Saharan Africa (SSA) is witnessing a drastic escalation of overweight and obesity. We aimed to explore the prevalence and associated factors for obesity among residents of Dar es Salaam city in Tanzania.Methods Participants from this study were recruited during a community screening conducted in Dar es Salaam. Sociodemographic and clinical data were gathered using a structured questionnaire during enrollment. Dietary habits, anthropometric measurements and blood pressure were assessed. All statistical analyses utilized STATA v11.0 software. Pearson Chi square and Student’s T-test were used to compare categorical and continuous variables respectively. Linear logistic regression analyses were used to assess for factors associated with BMI≥25. All tests were 2-sided and p<0.05 was used to denote a statistical significance.Results A total of 6691 participants were enrolled. The mean age was 43.1 years and males constituted 54.2% of all participants. Over two-thirds of participants were alcohol consumers and 6.9% had a positive smoking history. Eighty eight point three percent of participants were underactive, 4.7% had a history of diabetes mellitus and 18.1% were known to have elevated blood pressure. Overweight and obesity were observed in 34.8% and 32.4% of participants respectively. Among overweight and obese participants, 32.8% had a misperception of having a healthy weight. Age≥40, female sex, a current working status, habitual breakfast skipping, poor water intake, high soft drink consumption, regular fast food intake, low vegetable and fruit consumption, alcohol consumption and elevated blood pressure were found to be independent associated factors for obesity.Conclusion A sizeable proportion of participants were overweight or obese. Concomitantly, the rates of physical inactivity and unhealthy eating are disproportionately high. In view of this, community-based and multilevel public health strategies to promote and maintain healthy eating and physical activity require an urgent step-up in urban Tanzania.

Day case laparoscopic cholecystectomy at Kilimanjaro Christian Medical Centre, Tanzania

“…This is likely to be due to a multifactorial causality. Nutrition plays a major role in wound healing and Tanzania suffers a double burden of rising obesity rates in a population where undernutrition still prevails [22,23]. Compromised immune systems also contribute to SSI rates.…”