Understanding and acting on the developmental origins of health and disease in Africa would improve health across generations

Shane A Norris^{1

2}, Abdallah Daar^{1

3}, Dorairajan Balasubramanian^{1

4}, Peter Byass^{1

5}, Elizabeth Kimani-Murage^{1

6}, Andrew Macnab^{1

7}, Christoff Pauw¹, Atul Singhal^{1

8}, Chittaranjan Yajnik^{1

9}, James Akazili¹⁰, Naomi Levitt¹¹, Jihene Maatoug¹², Nolwazi Mkhwanazi¹³, Sophie E Moore¹⁴, Moffat Nyirenda¹⁵, Juliet R C Pulliam¹⁶, Tamsen Rochat^{2

17}, Rihlat Said-Mohamed², Soraya Seedat¹⁸, Eugene Sobngwi¹⁹, Mark Tomlinson²⁰, Elona Toska²¹, Cari van Schalkwyk¹⁶

Affiliations

¹ a Stellenbosch Institute for Advanced Study (STIAS) , Wallenberg Research Centre at Stellenbosch University , Stellenbosch , South Africa.
² b MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa.
³ c Dalla Lana School of Public Health and Department of Surgery , University of Toronto , Toronto , Canada.
⁴ d L V Prasad Eye Institute , Hyderabad , India.
⁵ e Department of Public Health and Clinical Medicine , Umeå University , Umea , Sweden.
⁶ f African Population and Health Research Center , Kenya.
⁷ g Department of Pediatrics , University of British Columbia , Vancouver , Canada.
⁸ h Institute of Child Health , University College London , London , UK.
⁹ i King Edward Memorial Hospital Research Centre , Pune , India.
¹⁰ j INDEPTH Network , Ghana.
¹¹ k Department of Diabetic Medicine and Endocrinology , University of Cape Town , Cape Town , South Africa.
¹² l Department of Epidemiology , Hospital Farhat Hached, Sousse , Tunisia.
¹³ m Department of Anthropology , University of the Witwatersrand , Johannesburg , South Africa.
¹⁴ n Division of Women's Health , King's College London , London , UK.
¹⁵ o College of Medicine , University of Malawi , Zomba , Malawi.
¹⁶ p DST-NRF Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA) , University of Stellenbosch , Stellenbosch , South Africa.
¹⁷ q Human and Social Development Research Programme , Human Sciences Research Council , Durban , South Africa.
¹⁸ r Department of Psychiatry , Stellenbosch University , Stellenbosch , South Africa.
¹⁹ s Department of Applied Epidemiology , University of Yaoundé , Yaounde , Cameroon.
²⁰ t Department of Psychology , Stellenbosch University , Stellenbosch , South Africa.
²¹ u Department of Social Policy and Intervention , University of Oxford , Oxford , UK.

PMID: 28715931
PMCID: PMC5533158
DOI: 10.1080/16549716.2017.1334985

Understanding and acting on the developmental origins of health and disease in Africa would improve health across generations

Shane A Norris et al. Glob Health Action. 2017.

. 2017;10(1):1334985.

doi: 10.1080/16549716.2017.1334985.

Authors

Affiliations

¹ a Stellenbosch Institute for Advanced Study (STIAS) , Wallenberg Research Centre at Stellenbosch University , Stellenbosch , South Africa.
² b MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa.
³ c Dalla Lana School of Public Health and Department of Surgery , University of Toronto , Toronto , Canada.
⁴ d L V Prasad Eye Institute , Hyderabad , India.
⁵ e Department of Public Health and Clinical Medicine , Umeå University , Umea , Sweden.
⁶ f African Population and Health Research Center , Kenya.
⁷ g Department of Pediatrics , University of British Columbia , Vancouver , Canada.
⁸ h Institute of Child Health , University College London , London , UK.
⁹ i King Edward Memorial Hospital Research Centre , Pune , India.
¹⁰ j INDEPTH Network , Ghana.
¹¹ k Department of Diabetic Medicine and Endocrinology , University of Cape Town , Cape Town , South Africa.
¹² l Department of Epidemiology , Hospital Farhat Hached, Sousse , Tunisia.
¹³ m Department of Anthropology , University of the Witwatersrand , Johannesburg , South Africa.
¹⁴ n Division of Women's Health , King's College London , London , UK.
¹⁵ o College of Medicine , University of Malawi , Zomba , Malawi.
¹⁶ p DST-NRF Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA) , University of Stellenbosch , Stellenbosch , South Africa.
¹⁷ q Human and Social Development Research Programme , Human Sciences Research Council , Durban , South Africa.
¹⁸ r Department of Psychiatry , Stellenbosch University , Stellenbosch , South Africa.
¹⁹ s Department of Applied Epidemiology , University of Yaoundé , Yaounde , Cameroon.
²⁰ t Department of Psychology , Stellenbosch University , Stellenbosch , South Africa.
²¹ u Department of Social Policy and Intervention , University of Oxford , Oxford , UK.

PMID: 28715931
PMCID: PMC5533158
DOI: 10.1080/16549716.2017.1334985

Abstract

Data from many high- and low- or middle-income countries have linked exposures during key developmental periods (in particular pregnancy and infancy) to later health and disease. Africa faces substantial challenges with persisting infectious disease and now burgeoning non-communicable disease.This paper opens the debate to the value of strengthening the developmental origins of health and disease (DOHaD) research focus in Africa to tackle critical public health challenges across the life-course. We argue that the application of DOHaD science in Africa to advance life-course prevention programmes can aid the achievement of the Sustainable Development Goals, and assist in improving health across generations. To increase DOHaD research and its application in Africa, we need to mobilise multisectoral partners, utilise existing data and expertise on the continent, and foster a new generation of young African scientists engrossed in DOHaD.

Keywords: Africa; Sustainable Development Goals (SDGs); developmental origins of health and disease (DOHaD); life course epidemiology; non-communicable disease; policy.

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Conflict of interest statement

PB is Deputy Editor of Global Health Action but was not involved in the editorial handling of this article.

Figures

**Figure 1.**
The DOHaD intergenerational cycle, annotated with examples of relevant stresses and exposures and indicating (in italic text boxes) examples of recommended interventions.

See this image and copyright information in PMC

References

1. International Society for Developmental Origins of Health and Disease 2015. The Cape Town manifesto – November 2015. Cape Town: International Society for Developmental Origins of Health and Disease; [cited 2016 September 26]. Available from: https://dohadsoc.org/wp-content/uploads/2015/11/DOHaD-Society-Manifesto-...
1. Heindel JJ, Balbus J, Birnbaum L, et al. Developmental origins of health and disease: integrating environmental influences. Endocrinology. 2015;156:3416–4. - PMC - PubMed
1. Ferraro AA, Fernandes MTB, Vieira SE.. New challenges beyond nutrition: c-section, air pollution and domestic violence. J Dev Orig Health Dis. 2016;7:253–256. - PubMed
1. Naghavi M, Forouzanfar MH. Burden of non-communicable diseases in sub-Saharan Africa in 1990 and 2010: global burden of diseases, injuries, and risk factors study 2010. Lancet. 2013;381:S95.
1. Moore SE. Early life nutritional programming of health and disease in The Gambia. J Dev Orig Health Dis. 2016;7:123–131. - PMC - PubMed

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Understanding and acting on the developmental origins of health and disease in Africa would improve health across generations

Affiliations

Understanding and acting on the developmental origins of health and disease in Africa would improve health across generations

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Other Literature Sources