Prevalence and Risk Factors for Non-Communicable Chronic Diseases in Low and Middle-Income Countries: A Systematic Review and Meta-Analysis
Xavier, S.; Gotine, A. R. M.; Vasco, M. D.; Victor, A.
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BackgroundNon-communicable chronic diseases (NCDs) have become increasingly prominent in low- and middle-income countries (LMIC), driven by a rapid rise in their incidence. Current estimates suggest that these conditions account for approximately 80% of deaths in these regions. This study aimed to analyze the prevalence of NCDs and their associated risk factors in LMIC. MethodsElectronic searches were conducted in the PubMed, Embase, Scopus, Cochrane, and Virtual Health Library (VHL) databases between June and July 2023. Studies on the prevalence of NCDs, with or without associated risk factor analysis, were included. The quality of these studies was assessed using NIH tools, and a meta-analysis was conducted using the random-effects model. ResultsA total of 34 studies on hypertension and 22 studies on diabetes were included in the systematic review and meta-analysis. The estimated prevalence of hypertension was 24% (95% CI: 21.0; 28.0) and diabetes mellitus (DM) was 11% (95% CI: 10.0; 13.0), with future predictions for similar populations ranging from 11.0-46.0% for hypertension and 6.0-21.0% for DM. Geographic analysis revealed a lower prevalence of hypertension in Latin America and the Caribbean (7.0%) with no statistically significant differences compared to other regions (p-value = 0.101). The prevalence of DM was lower in Sub-Saharan Africa (5.0%; p-value < 0.001). The identified risk factors for hypertension included increased age, male sex, elevated BMI, alcohol consumption, excessive salt intake, and stress. For diabetes, the risk factors were increased age, lack of religious affiliation, elevated BMI, family history of DM, hypertension, high hemoglobin concentration (HbA1c), waist-to-hip ratio, smoking, and infection with Taenia spp. ConclusionNCDs such as hypertension and DM pose a growing public health challenge in low- and middle-income countries. Our findings may assist policymakers in identifying high-risk groups and recommending appropriate prevention strategies. Systematic Review RegistrationThe protocol was submitted for registration with the International Prospective Register of Systematic Reviews (PROSPERO) (registration number: CRD42024520601).
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