Sustaining Increase in Life Expectancy in Africa Requires Active Preventive Measures against Non-Communicable Diseases

Efosa K. Oghagbon, Lydia Giménez-Llort

Department of Chemical Pathology, College of Health Sciences, Benue State University, Makurdi, Nigeria.
Institute of Neurosciences, Autonomous University of Barcelona, Cerdanyola del Vallès, Barcelona, Spain.

DOI: 10.4236/ojpm.2014.45035                

Abstract

It is projected that aged population (≥60 years) will continue to increase globally, including in Africa. This is due to reduced population growth, decreased fecundity and improved medical interventions; factors which increase life expectancy. While this is typical for developed countries, it is not the same for Africa and similar developing regions. In these regions, a significant proportion of death is due to non-communicable diseases (NCD’s) such as hypertension, cerebrovascular accident, coronary heart disease, diabetes mellitus, chronic renal disease and cancer, among others. Rising prevalence of NCD’s due mainly to western style diets and sedentary living is made worse by inadequate nutrition education, high prevalence of low birth weight, poor health services, lack of efficient tobacco control and deficient planning of built environment. In order to halt the possible reduction in life expectancy occasioned by NCD’s, efforts by the community, health planners and governments in Africa to address relevant NCD’s, must be put in place. Suggested measures are: nutrition education, regular community directed physical exercise, improved environmental planning and development. Others are review of present health service model, early detection, prevention and treatment of NCD’s, including improved antenatal care to reduce low birth weights, and establishment of policies and measures that decreased access to tobacco especially by women of childbearing age. Africa and similar developing regions cannot fund the health bill due to NCD’s and their complications; hence it is important that this scourge is attended to with all seriousness.

Keywords

Life Expectancy, Developing Countries, Non-Communicable Diseases, Prevention, Community Role and Health System Review

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Report of the Second World Assembly on Ageing (United Nations Publication A/CONF.197/9, Sales No.02.IV.4).
[2]	Bongaarts, J. (2004) Long Range Trends in Adult Mortality Trends: Models and Projection Methods. Population Council Working Paper, 192.
[3]	Cutler, D. and Meara, E. (2003) Changes in the Age Distribution of Mortality over the 20th Century. In: Wise, D., Ed., Perspectives on the Economics of Aging, University of Chicago Press, Chicago.
[4]	Ferrucci, L., Giallaura, F. and Guralnik, J.M. (2008) Epidemiology of Aging. Radiologic Clinics of North America, 46, 643-652. http://dx.doi.org/10.1016/j.rcl.2008.07.005
[5]	Marcoux, A. (2000) Changing Age Structure and Population Distribution in the 21st Century: Implications for Development and Programming. Working Paper I, 2000-2050.
[6]	Velkoff, V.A. and Paul, R.K. (2007) Population Aging in Sub-Saharan Africa: Demographic Dimensions 2006. Current Population Reports, P95/07-1, US Government Printing Office, Washington DC.
[7]	Sembajwe, I. and Kalasa, B. (1999) Ageing in Africa: The Foreseen Situation and Its Security, Health, Social and Economic Implications. UNFPA/CST, Addis Ababa.
[8]	Mathers, C.D. and Loncar, D. (2006) Projections of Global Mortality and Burden of Disease from 2002 to 2030. PLoS Medicine, 3, e442. http://dx.doi.org/10.1371/journal.pmed.0030442
[9]	World Health Organization (2004) Global Burden of Disease. Part 2.
[10]	Murray, C.J.L. and Loped, A.D. (1997) Mortality by Cause for Eight Regions of the World: Global Burden of Disease Study. The Lancet, 349, 1269-1276. http://dx.doi.org/10.1016/S0140-6736(96)07493-4
[11]	IDF (International Diabetes Federation) (2003) Diabetes Atlas. 2nd Edition, IDF, Brussels.
[12]	Aspray, T.J., Mugusi, F.J., Rashid, D.S., et al. (2000) Rural and Urban Differences in Diabetes Prevalence in Tanzania: The Role of Obesity, Physical Inactivity and Urban Living. Transaction of the Royal Society of Tropical Medicine, 94, 637-644. http://dx.doi.org/10.1016/S0035-9203(00)90216-5
[13]	Edwards, R., Unwin, N., Mugusi, F., et al. (2001) Hypertension Prevalence and Care in an Urban and Rural Area of Tanzania. Journal of Hypertension, 18, 145-152. http://dx.doi.org/10.1097/00004872-200018020-00003
[14]	Mollentze, W.F., Moore, A.J., Steyn, A.F., et al. (1995) Coronary Heart Disease Risk Factors in a Rural and Urban Orange Free State Black Population. South African Medical Journal, 85, 90-96.
[15]	Kruger, H.S., Venter, C.S., Vorster, H. and Margetts, B.M. (2002) Physical Inactivity Is the Major Determinant of Obesity in Black Women in the North West Province, South Africa: The THUSA Study. Nutrition, 18, 422-427. http://dx.doi.org/10.1016/S0899-9007(01)00751-1
[16]	Cooper, R., Rotimi, C., Ataman, S., et al. (1997) The Prevalence of Hypertension in Seven Populations of West African Origin. American Journal of Public Health, 87, 160-168. http://dx.doi.org/10.2105/AJPH.87.2.160
[17]	Reddy, K.S. (2002) Cardiovascular Diseases in the Developing Countries: Dimensions, Determinants, Dynamics and Directions for Public Health Action. Public Health Nutrition, 5, 231-237. http://dx.doi.org/10.1079/PHN2001298
[18]	Chinenye, S., Uloko, A.E., Ogbera, A.O., Ofoegbu, E.N., Fasanmade, O.A., Fasanmade, A.A. and Ogbu, O.O. (2012) Profile of Nigerians with Diabetes Mellitus—Diabcare Nigeria Study Group 2008: Results of a Multicenter Study. Indian Journal of Endocrinology and Metabolism, 16, 558-564. http://dx.doi.org/10.4103/2230-8210.98011
[19]	Gill, G.V. (1997) Outcome of Diabetes in Africa. In: Gill, G.V., Mbanya, J.C. and Alberti, K.G.M.M., Eds., Diabetes in Africa, FSG Communication, Cambridge, 65-71.
[20]	McLarty, D.G., Kinabo, L. and Swaim, A.B.M. (1990) Diabetes in Tropical Africa: A Prospective Study, 1981-7. II. Course and Prognosis. British Medical Journal, 300, 1107-1110. http://dx.doi.org/10.1136/bmj.300.6732.1107
[21]	Boutayeb, A. (2006) The Double Burden of Communicable and Non-Communicable Diseases in Developing Countries. Transactions of the Royal Society of Tropical Medicine & Hygiene, 100, 191-199. http://dx.doi.org/10.1016/j.trstmh.2005.07.021
[22]	World Health Organisation (2002) Reducing Risk: Promoting Health Life. World Health Organization, Geneva, Annual Report.
[23]	Nissinen, A., Berrios, X. and Puska, P. (2001) Community-Based Communicable Disease Interventions: Lessons from Developed Countries for Developing Ones. Bulletin of the World Health Organization, 79, 963-970.
[24]	Oghagbon, K.E., Odili, V.U., Nwangwa, E.K. and Pender, K.E. (2009) Body Mass Index and Blood Pressure. Pattern of Students in a Nigerian University. International Journal of Health Research, 2, 177-182.
[25]	Interhealth Steering Committee (1991) Demonstration Projects for the Integrated Prevention and Control of Communicable Diseases (Interhealth Programme): Epidemiological Background and Rationale. World Health Statistics Quarterly, 44, 48-54.
[26]	Puska, P., Koskela, K., McAlister, A., et al. (1986) Use of Lay Opinion Leaders to Promote Diffusion of Health Innovations in a Community Programme: Lessons Learned from the North Karelia Project. Bulletin of the World Health Organization, 64, 437-446.
[27]	Popkin, B.M. (2001) The Nutrition Transition and Obesity in the Developing World. Journal of Nutrition, 131, 8715-8735.
[28]	Yang, G., Kong, L., Zhao, W., et al. (2008) Emergence of Chronic Non-Communicable Diseases in China. The Lancet, 372, 1697-1705. www.thelancet.com
[29]	Sobngwi, E.J., Mbanya, J.C.N., Unwin, N.C., et al. (2002) Physical Activity and Its Relationship with Obesity, Hypertension and Diabetes in Urban and Rural Cameroon. International Journal of Obesity and Related Metabolic Disorder, 26, 1009-1016.
[30]	Forrest, K.Y.C., Bunker, C.H., Kriska, A.M., Ukoli, F.A., Huston, S.L. and Markavic, N. (2001) Physical Activity and Cardiovascular Risk Factors in a Developing Population. Medicine and Science in Sports and Exercise, 33, 1598-1604. http://dx.doi.org/10.1097/00005768-200109000-00025
[31]	Ross, N.A., Tremblay, S., Khan, S., Crouse, D., Tremblay, M. and Berthelot, J.M. (2007) Body Mass Index in Urban Canada: Neighborhood and Metropolitan Area Effects. American Journal of Public Health, 97, 500-508. http://dx.doi.org/10.2105/AJPH.2004.060954
[32]	Rosen, G. (1993) A History of Public Health. John Hopkins University Press, Baltimore, 177-178.
[33]	Perdue, W.C., Stone, L.A. and Gostin, L.O. (2003) The Built Environment and Its Relationship to the Public Health: The Legal Framework. American Journal of Public Health, 93, 1390-1394. http://dx.doi.org/10.2105/AJPH.93.9.1390
[34]	Lord, C.P. (1995) Community Initiatives: Environmental Justice Law and the Challenge Facing Urban Communities. Virginia Environmental Law Journal, 14, 721-733.
[35]	Steyn, K. and Damasceno, A. (2006) Lifestyle and Related Risk Factors for Chronic Diseases. In: Jamison, D.T., Feachem, R.G., Makgoba, M.W., Bos, E.R., Baingana, F.K., Hofman, K.J. and Rogo, K.O., Eds., Disease and Mortality in Sub-Saharan Africa, The International Bank for Reconstruction and Development, The World Bank, Washington DC.
[36]	Global Youth Tobacco Survey Collaboration Group (2002) Tobacco Use among Youth: A Cross Country Comparison. Tobacco Control, 11, 252-270. http://dx.doi.org/10.1136/tc.11.3.252
[37]	Mark, A.S., Steyn, K. and Ratheb, E. (2001) Tobacco Use by Black Women in Cape Town. MRC Policy Brief 3. Medical Research Council, Parowvallei.
[38]	Saloojee, Y. (1995) Price and Income Elasticity of Demand of Cigarettes in South Africa. In: Shlama, K., Ed., Tobacco and Health, Plenum Press, New York, 235-239. http://dx.doi.org/10.1007/978-1-4615-1907-2_51
[39]	Steyn, K., Bradshaw, D., Norman, R., Laubscher, R. and Saloojee, Y. (2002) Tobacco Use in South Africans during 1998: The First Demographic and Health Survey. Journal of Cardiovascular Risk, 9, 161-170. http://dx.doi.org/10.1097/00043798-200206000-00005
[40]	WHO (2003) Framework Convention on Tobacco Control. World Health Organization.
[41]	Piekarz, A. and Ozanne, S.E. (2009) Fetal Programming of Type 2 Diabetes. In: Newnham, J.P. and Ross, M.G., Eds., Early Origin of Human Health and Disease, Karger, Basel, 164-173.
[42]	Barker, D.J.P. (1994) Mothers, Babies and Diseases in Later Life. London: British Medical Journal Publishing Group.
[43]	Lucas, A. (1991) Programming by Early Nutrition in Man. Ciba Foundation Symposium, 156, 38-50.
[44]	Hales, C.N., Barker, D.J., Clark, P.M., et al. (1991) Fetal and Infant Growth and Impaired Glucose Tolerance at Age 64. British Medical Journal, 303, 1019-1022. http://dx.doi.org/10.1136/bmj.303.6809.1019
[45]	Kinabo, J.L., Kissakwe, K. and Msuya, J. (1997) Factors Influencing Birth Weight in Morogoro Municipality, Tanzania. South African Journal Food Science and Nutrition, 9, 3-8.
[46]	Cessay, S.M., Prentice, A.M., Cole, T.J., et al. (1997) Effects of Birth Weight and Perinatal Mortality of Maternal Dietary Supplements in Rural Gambia: 5 Years Randomized Controlled Trial. British Medical Journal, 315, 786-790. http://dx.doi.org/10.1136/bmj.315.7111.786
[47]	Homan, H. and Lorig, K. (2000) Patients as Partners in Managing Chronic Disease. British Medical Journal, 320, 526-527. http://dx.doi.org/10.1136/bmj.320.7234.526
[48]	World Health Organization (2008) Action Plan for the Global Strategy for the Prevention and Control of Noncommunicable Diseases 2008-2013.
[49]	Swartz, L. and Dick, J. (2000) Managing Chronic Conditions in Less Developed Countries. British Medical Journal, 325, 914-915. http://dx.doi.org/10.1136/bmj.325.7370.914
[50]	Chopra, M., Lawn, J.E., Sanders, D., et al. (2009) Achieving the Health Millennium Development Goals for South Africa: Challenges and Priorities. Health in South Africa 6. Lancet. www.lancet.com
[51]	The World Bank (2007) World Development Report: Development and the Next Generation, World Bank, Washington DC.
[52]	Oghagbon, E.K. and Giménez-Llort, L. (2010) Preventable Non-Communicable Disease and Its Relation to Life Expectancy in Developing Countries. The 1st International Congress on Controversies in Longevity, Health and Aging (Colongy), Barcelona, 24-27 June 2010.
[53]	Al-Lawati, J.A., Mabry, R. and Mohammed, A.J. (2008) Addressing the Threat of Chronic Diseases in Oman. Preventing Chronic Disease, 5, Published Online. http://www.cdc.gov/pcd/issues/2008/jul/07_0086.htm