Andre Pascal Kengne; James Bentham; Bin Zhou; Honor Bixby; Cristina Taddei; Queenie Chan; Paul Elliott; Majid Ezzati; Nasheeta Peer; Herculina S. Kruger; Aletta E. Schutte; Tandi E. Matsha; Mariachiara Di Cesare; Kaveh Hajifathalian; Yuan Lu; Pascal Bovet; Catherine Kyobutungi; Charles Agyemang; Karien Stronks; Hajer Aounallah-Skhiri; Felix K. Assah; Amina Barkat; Habiba Ben Romdhane; Olfa Saidi; Nishi Chaturvedi; Albertino Damasceno; Hélène Delisle; Francis Delpeuch; Bernard Maire; Yves Martin-Prevel; Pierre Traissac; Kouamelan Doua; Eruke E. Egbagbe; Jalila El Ati; Reina Engle-Stone; Rajiv T. Erasmus; Heba M. Fouad; Dickman Gareta; Frank Tanser; Oye Gureje; Marleen Elisabeth Hendriks; Constance Schultsz; Leila Houti; Sounnia Mediene-Benchekor; Mohsen M. Ibrahim; Han C.G. Kemper; Japhet Killewo; Sudhir Kowlessur; Fatima Zahra Laamiri; Youcef Laid; Naomi S. Levitt; Nuno Lunet; Dianna J. Magliano; Jonathan E. Shaw; Mostafa K. Mohamed; Aya Mostafa; Charles K. Mondo; Kotsedi Daniel Monyeki; Martin Nankap; Ellis Owusu-Dabo; Tobias F.Rinke de Wit; Idowu O. Senbanjo; Liam Smeeth; Eugène Sobngwi; Jean Claude N. Mbanya; Charles Sossa Jérome; Félicité Tchibindat; Lechaba Tshepo; Fikru Tullu; Flora A.M. Ukoli; Bharathi Viswanathan; Alisha N. Wade; Goodarz Danaei; Gretchen A. Stevens; Leanne M. Riley Show More Hide
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Background: The 2016 Dar Es Salaam Call to Action on Diabetes and Other noncommunicable diseases (NCDs) advocates national multi-sectoral NCD strategies and action plans based on available data and information from countries of sub-Saharan Africa and beyond. We estimated trends from 1980 to 2014 in age-standardized mean body mass index (BMI) and diabetes prevalence in these countries, in order to assess the coprogression and assist policy formulation. Methods: We pooled data from African and worldwide population-based studies which measured height, weight and biomarkers to assess diabetes status in adults aged ≥18 years. A Bayesian hierarchical model was used to estimate trends by sex for 200 countries and territories including 53 countries across five African regions (central, eastern, northern, southern and western), in mean BMI and diabetes prevalence (defined as either fasting plasma glucose of ≥ 7.0 mmol/l, history of diabetes diagnosis, or use of insulin or oral glucose control agents). Results: African data came from 245 population-based surveys (1.2 million participants) for BMI and 76 surveys (182 000 participants) for diabetes prevalence estimates. Countries with the highest number of data sources for BMI were South Africa (n=17), Nigeria (n=15) and Egypt (n=13); and for diabetes estimates, Tanzania (n=8), Tunisia (n=7), and Cameroon, Egypt and South Africa (all n=6). The age-standardized mean BMI increased from 21.0 kg/m(95% credible interval: 20.3-21.7) to 23.0 kg/m(22.7-23.3) in men, and from 21.9 kg/m(21.3-22.5) to 24.9 kg/m(24.6-25.1) in women. The agestandardized prevalence of diabetes increased from 3.4% (1.5-6.3) to 8.5% (6.5-10.8) in men, and from 4.1% (2.0-7.5) to 8.9% (6.9-11.2) in women. Estimates in northern and southern regions were mostly higher than the global average; those in central, eastern and western regions were lower than global averages. A positive association (correlation coefficient ≃ 0.9) was observed between mean BMI and diabetes prevalence in both sexes in 1980 and 2014. Conclusions: These estimates, based on limited data sources, confirm the rapidly increasing burden of diabetes in Africa. This rise is being driven, at least in part, by increasing adiposity, with regional variations in observed trends. African countries' efforts to prevent and control diabetes and obesity should integrate the setting up of reliable monitoring systems, consistent with the World Health Organization's Global Monitoring System Framework.