Research reveals alarming findings on diabetes, hypertension in Gambia

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A press release from the Medical Research Council has revealed very high levels of hypertension, and concerning levels of obesity, diabetes, and multimorbidity in both men and women.

The full text of the press release is as follows:

High levels of NCDs [non communicable diseases] and associated risk factors in Gambian adults present major

stress on the country’s fragile health system, according to new research published in

The Lancet Global Health.

Researchers at the MRC Unit The Gambia at LSHTM, in collaboration with Gambia

Government partners and institutions including the International Centre for Eye Health

(ICEH) at the London School of Hygiene & Tropical Medicine analysed the 2019 Gambia

National Eye Health Survey of adults aged 35 years or older to better understand the

prevalence of Non-Communicable Diseases (NCDs), multimorbidity and related risk factors

in adults in The Gambia.

The study provides the latest data on hypertension, diabetes, obesity and related risk

factors, which are leading causes of other conditions such as, ischaemic heart disease,

stroke, chronic kidney diseases, and cancers among middle-aged and older adults.

The nationally representative survey included 9188 participants, 54.8% of whom were from

urban areas and 70.5% were women. The survey shows very high levels of hypertension,

and concerning levels of obesity, diabetes, and multimorbidity in both men and women.

Overall, the data shows a higher prevalence of NCDs in The Gambia in women compared to

men. The prevalence of hypertension was 47.0%, affecting 49.3% of women and 44.7% of

men. This prevalence increased with age, rising from 30% in those aged 35–45 years to

over 75% in those aged 75 years and older. Obesity increased the odds of hypertension and

underweight reduced the odds. The prevalence of diabetes was 6.3%, affecting 7.0% of

women and 5.6% of men. The prevalence of obesity was 12.0% and was notably higher in

women (20.2%) than men (3.9%).

However, the nationwide prevalence of smoking was 9.7%. However, this was almost

exclusively in men (19.3%) compared to women (0.1%).

“The findings in this study are quite alarming and show an increasing trend of non-

communicable diseases compared to earlier studies in The Gambia. This possibly reflects

the effect of rapid urbanisation, and the pace at which dietary patterns and other behavioural

risk factors are changing in The Gambia. The good news is that all these factors are

amenable to a comprehensive and coordinated multisectoral intervention”, Dr. Modou Jobe,

lead author of this study, MRC Unit The Gambia at LSHTM.

“A surprising aspect of the prevalence data is that contrary to the case for diabetes,

hypertension is equally common in people living in rural areas. Deciphering this anomaly

should help in the design of preventative measures”, said Prof Andrew Prentice, Theme

Leader, Nutrition and Planetary Health at MRC Unit The Gambia at LSHTM.

Multimorbidity or the coexistence of two or more chronic conditions in the same individual

was more common in women than men (15·9 vs 5·5), thus contributing to health inequalities.

“The integration of this survey work on NCDs with data on ocular disease, mental health and

musculoskeletal impairments in the 2019 Gambia National Eye Health Survey has

highlighted the frequent intersection of different chronic conditions and the impact of this

multimorbidity for The Gambia, providing a template for other countries,” Prof Matthew

Burton, Director of ICEH at LSHTM said.

“These data are concerning but also timely as the government of The Gambia implements its

recently launched NCD multisectoral strategic plan. We call on all stakeholders, both locally

and internationally, to continue to support us in this endeavour.” Mr Omar Badjie, NCD

Programme Manager at the Ministry of Health Gambia Government contributor/national

stakeholder.

In May 2022, The Gambia launched a 5-year National Multi-sectoral strategy and costed

action plan for non-communicable disease prevention and control. The overarching goal of

this plan is to reduce premature deaths from NCDs in The Gambia by one-third by 2027.

Like many other developing countries within the subregion, The Gambia has made progress

in reducing the prevalence of many infectious diseases and is on track to meet several

health targets of the Sustainable Development Goals (SDGs). However, this research

presents new challenges for the country’s already fragile health system which requires a

collaborative national response to prioritise non-communicable diseases. MRCG and its

partners remain committed to supporting and working together with national institutions to

ease the burden of disease in The Gambia.

—ENDS—

Notes to Editors

Publication embargo: December 12122023

https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(23)00508-9/fulltext

About Medical Research Council Unit The Gambia (MRCG) at LSHTM

MRC Unit The Gambia is a centre of excellence for scientific research and innovation, with a

vision to lead health research to save lives in Africa and improve health across the world.

With more than 75 years’ experience in sub-Saharan Africa delivering research aimed at

reducing the burden of illness and death in low- and middle-income countries, MRCG brings

world class research technology to The Gambia, invests in life-changing disease

surveillance and preparedness, and is training the next generation of researchers. Over this

period, the Unit has conducted its research covering 3 broad themes – Disease Control and

Elimination, Nutrition and Planetary Health and Vaccines and Immunity.