Research Article: Non-Communicable Diseases in Sub-Saharan Africa: The Case for Cohort Studies

Date Published: May 11, 2010

Publisher: Public Library of Science

Author(s): Michelle D. Holmes, Shona Dalal, Jimmy Volmink, Clement A. Adebamowo, Marina Njelekela, Wafaie W. Fawzi, Walter C. Willett, Hans-Olov Adami

Abstract: Michelle Holmes and colleagues argue that there is an urgent need for longitudinal cohorts based in sub-Saharan Africa to address the growing burden of noncommunicable diseases in the region.

Partial Text: We believe there is an urgent need for longitudinal cohorts based in sub-Saharan Africa (SSA). This conclusion is drawn from the fact that non-communicable diseases (NCDs) cause a large and growing disease burden (please see Box 1) [1]–[6].

In 2001, Pettiti prepared a list of 55 important findings from epidemiological studies for the Epidemiology Monitor [9]. This list, reproduced and recently revised by Dr. Pettiti (personal communication, D. Pettiti) in Table 1, represents only a partial inventory of epidemiological discoveries and does not refer exclusively to cohorts but all epidemiological designs.

There is no reason to doubt that smoking, obesity, high salt intake, sedentary lifestyle and pollution will have adverse health effects in Africa as in other places.

We propose cohort studies of 50,000 to 100,000 people in three or four countries covering west, east, and southern Africa. The higher number would increase enrollment of Africans to 532 per million, still only 5% compared to the US.

Yach defined the following obstacles impeding attention to NCDs in developing countries: policy makers lack evidence of disease burden, beliefs that NCDs affect only the wealthy and elderly, that they arise only from freely acquired risks, and that their control is expensive, ineffective, and a lower priority than infectious diseases [7].



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