Public Health
Volume 123, Issue 9 , Pages 602-614, September 2009

Prevalence and time trends in diabetes and physical inactivity among adult West African populations: The epidemic has arrived

  • A.R. Abubakari

      Affiliations

    • School of Nursing & Midwifery, 11 Airlie Place, University of Dundee, Dundee DD1 4HJ, UK
    • Corresponding Author InformationCorresponding author. Tel.: +44 1382 388 503; fax: +44 1382 388 533.
    • ,
  • W. Lauder

      Affiliations

    • School of Nursing & Midwifery, 11 Airlie Place, University of Dundee, Dundee DD1 4HJ, UK
    • ,
  • M.C. Jones

      Affiliations

    • School of Nursing & Midwifery, 11 Airlie Place, University of Dundee, Dundee DD1 4HJ, UK
    • ,
  • A. Kirk

      Affiliations

    • Institute of Sports and Exercise, University of Dundee, Dundee, UK
    • ,
  • C. Agyemang

      Affiliations

    • Department of Social Medicine, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
    • ,
  • R.S. Bhopal

      Affiliations

    • Public Health Sciences Section, Division of Community Health Sciences, University of Edinburgh, Edinburgh, UK

Received 6 August 2008; received in revised form 5 June 2009; accepted 24 July 2009. published online 14 September 2009.

Summary 

Objective

To determine the prevalence and distribution of, and trends in, physical inactivity and diabetes in adult West African populations.

Design

Systematic review and meta-analysis.

Methods

Literature searches were conducted using four electronic databases. Journal hand searches and examination of citations of relevant articles were also undertaken. To be included, studies had to be population based, use clearly defined criteria for measuring diabetes and physical inactivity, present data that allowed calculation of the prevalence of diabetes or physical inactivity, and sample adult participants. Studies retrieved were appraised critically. Meta-analysis was performed using the DerSimonian-Laird random effect model.

Results

Twenty-one reports were retrieved for diabetes and 15 reports were retrieved for physical in/activity. Most studies (10 for diabetes and six for physical activity) were conducted solely among urban populations. The prevalence of diabetes in West Africa was approximately 4.0% [95% confidence interval (CI) 2.0–9.0] in urban adults and 2.6% (95%CI 1.5–4.4) in rural adults, and was similar in men and women [prevalence ratio (PR) 1.36, 95%CI 0.96–1.92]. Cumulative time trend analyses suggested an increase in the prevalence of diabetes among adults in urban West Africa, from approximately 3.0% (95%CI 1.0–7.0) to 4.0% (95%CI 2.0–9.0) in the past 10 years. The prevalence of inactivity in West Africa was 13% (95%CI 9.0–18.0). An association was found between physical inactivity and being older (≥50 years) (PR 1.82, 95%CI 1.36–2.44), female gender (PR 1.62, 95%CI 1.41–1.87) and urban residence (PR 2.04, 95%CI 1.58–2.63).

Conclusions

Diabetes and physical inactivity are important public health issues in urban West Africa, with similar prevalences to wealthy industrialized countries. There is an urgent need for policy makers, politicians and health promotion experts to put measures in place to encourage active lifestyles and control diabetes in urban West Africa.

Keywords: Diabetes, Physical inactivity, West Africans, Systematic review, Meta-analysis

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PII: S0033-3506(09)00200-5

doi:10.1016/j.puhe.2009.07.009

Public Health
Volume 123, Issue 9 , Pages 602-614, September 2009

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