Academic journal article Journal of Health Population and Nutrition

Epidemiology of Major Non-Communicable Diseases in Ethiopia: A Systematic Review

Academic journal article Journal of Health Population and Nutrition

Epidemiology of Major Non-Communicable Diseases in Ethiopia: A Systematic Review

Article excerpt

INTRODUCTION

Non-communicable diseases are the leading causes of death globally, killing more people each year than all other causes combined. Contrary to popular opinion, available data demonstrate that nearly 80% of deaths due to non-communicable diseases occur in low- and middle-income countries (1). Of the 57 million deaths that occurred globally in 2008, thirty-six million were due to non-communicable diseases comprising mainly cardiovascular diseases, cancers, diabetes, and chronic lung diseases. The combined burden of these diseases is rising fastest among the lower-income countries, populations, and communities (2).

World Health Organization (WHO) estimated in 2011 that 34% of Ethiopian population is dying from non-communicable diseases, with a national cardiovascular disease prevalence of 15%, cancer and chronic obstructive pulmonary disease prevalence of 4% each, and diabetes mellitus prevalence of 2%. Communicable maternal, perinatal and nutritional conditions accounted for 57% of the deaths. This WHO estimation is comparable with East African countries, such as Kenya, Uganda, and Eritrea (3). The resulting double burden of non-communicable diseases, with higher prevalence of pre-existing communicable, maternal, perinatal and nutritional conditions, constrains the already-meagre health resources and hinders economic development in Ethiopia (4) .

Similarly, Global Burden of Disease (GBD) studies estimated age-standardized death rates of 800 per 100,000 population for non-communicable diseases in Ethiopia, of which higher death rates (approximately 450 per 100,000) were attributed to cardiovascular disease and diabetes, 150 per 100,000 attributed to cancer, and 100 per 100,000 to chronic obstructive pulmonary disease (5). These estimations were much higher than in many developed countries. Although these estimates of cardiovascular disease, cancer, diabetes mellitus, and chronic obstructive pulmonary disease look higher in Ethiopia, estimations by WHO and GBD studies are highly uncertain because the causes of deaths were predicted using cause-of-death models due to lack of information on the level of mortality or cause of death at the country level, which should be substantiated by national evidences (6).

Despite the above estimations for global prevalence of the four major non-communicable diseases, cardiovascular disease, cancer, diabetes mellitus, and chronic obstructive pulmonary disease were not well-documented in Ethiopia. On the other hand, accurate information on the prevalence of major public-health importance is required to have informed health policy decision (7,8). Therefore, it is crucial to document prevalence estimations for the major non-communicable diseases for the purposes of research and interventions. We reviewed published and grey literature aiming to document the prevalence and mortality associated with the four major non-communicable diseases in Ethiopia: cardiovascular disease, cancer, diabetes, and chronic obstructive pulmonary disease and the associated risk factors, such as hypertension, tobacco-use, harmful use of alcohol, overweight/obesity, and khat-chewing.

MATERIALS AND METHODS

Search strategy

A systematic review of peer-reviewed and grey literature was undertaken to identify studies that estimated the prevalence of cardiovascular diseases, cancer, diabetes mellitus, and chronic obstructive pulmonary disease in Ethiopia between 1960 and 2011. We used MeSH of PubMed search engines, using the medical subject titles 'cardiovascular diseases', 'stroke', 'hypertension', 'myocardial infarction, 'heart disease', 'diabetes mellitus', 'neoplasm', 'cancer', 'asthma', 'burden of disease', 'non communicable diseases', combined with the term 'smoking', 'tobacco', 'alcohol', 'khat chewing', 'risk factors', 'physical exercise', 'diet', and 'Ethiopia'. The references of included articles were scanned to identify additional articles of interest and used websites of the HINARI and Google Scholar, World Bank, and World Health Organization to access articles. …

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