Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Jul 19;4(4):e001396.
doi: 10.1136/bmjgh-2019-001396. eCollection 2019.

Epidemiological transition in morbidity: 10-year data from emergency consultations in Dakar, Senegal

Bamba Gaye #  1   2   3 , Massamba Diop #  4 , Kumar Narayanan  5 , Lucile Offredo  1 , Peter Reese  6 , Marie Antignac  1 , Vasenta Diop  4 , Ahmadoul Badaviyou Mbacké  3 , Louise Boyer Chatenet  1 , Eloi Marijon  1   2 , Archana Singh-Manoux  7 , Ibrahima Bara Diop  8 , Xavier Jouven  1   2
Affiliations

Epidemiological transition in morbidity: 10-year data from emergency consultations in Dakar, Senegal

Bamba Gaye et al. BMJ Glob Health. .

Abstract

Background: It is thought that low-income countries are undergoing an epidemiological transition from infectious to non-communicable diseases; however, this phenomenon is yet to be examined with long-term data on morbidity.

Methods: We performed a prospective evaluation of all emergency medical consultations at a major emergency service provider in Dakar, Senegal from 2005 to 2014. Using standardised definitions, the primary diagnosis for each consultation was classified using the International Classification of Diseases-10 and then broadly categorised as 'infectious', 'non-communicable' and 'other' diseases. Morbidity rates for each year in the 10-year observation period were plotted to depict the epidemiological transition over time. To quantify the yearly rate ratios of non-communicable over infectious diagnosis, we used a generalised Poisson mixed model.

Results: Complete data were obtained from 49 702 visits by African patients. The mean age was 36.5±23.2 and 34.8±24.3 years for women and men, respectively. Overall, infections accounted for 46.3% and 42.9% and non-communicable conditions 32.2% and 40.1% of consultations in women and men, respectively. Consultation for non-communicable compared with infectious conditions increased by 7% every year (95% CI: 5% to 9%; p<0.0001) over the 10 years. Consultations for non-communicable condition were more likely in women compared with men (RR=1.29, 95% CI: 1.18, 1.40) and at older ages (RR=1.27; 95% CI 1.25, 1.29 for 10-year increase in age).

Conclusion: Using high-quality disease morbidity data over a decade, we provide novel data showing the epidemiological transition of diseases as manifested in emergency service consultations in a large Sub-Saharan African city. These results can help reorientation of healthcare policy in Sub-Saharan Africa.

Keywords: Sub-Saharan Africa; epidemiological transition; morbidity; urban city.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Broad diagnostic categories of emergency medical consultations by age-group in African women (PANEL A) and men (PANEL B). *Data on 27,529 consultations in African women and 22,173 consultations in African men over a 10-year period.
Figure 2
Figure 2
Broad diagnostic categories of emergency medical consultations in African women (PANEL A) and men (PANEL B) over 10 years in Dakar, Senegal. *Data on 27,529 consultations in African women and in 22,173 African men over a 10-year period.
See this image and copyright information in PMC

References

    1. Global, regional, and national age–sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013: a systematic analysis for the global burden of disease study 2013. The Lancet 2015;385:117–71. 10.1016/S0140-6736(14)61682-2 - DOI - PMC - PubMed
    1. Murray CJL, Barber RM, Foreman KJ, et al. . Global, regional, and national disability-adjusted life years (DALYs) for 306 diseases and injuries and healthy life expectancy (HALE) for 188 countries. The Lancet 2015;386:e45:2117–226. - PMC - PubMed
    1. Yayehd K, Damorou F, N'Da NW, et al. . [Evolution of cardiovascular diseases' admissions in cardiology departments of Lomé hospitals: a cross-sectional study on 7959 patients from June 2004 to May 2009]. Rev Epidemiol Sante Publique 2012;60:205–11. 10.1016/j.respe.2012.02.002 - DOI - PubMed
    1. Soliman EZ, Juma H. Cardiac disease patterns in northern Malawi: epidemiologic transition perspective. J Epidemiol 2008;18:204–8. 10.2188/jea.JE2008006 - DOI - PMC - PubMed
    1. Erete EI, Ogun OG, Oladapo OO, et al. . Prevalence and severity of atherosclerosis in extra cranial carotid arteries in Nigeria: an autopsy study. BMC Cardiovasc Disord 2012;12:106 10.1186/1471-2261-12-106 - DOI - PMC - PubMed

LinkOut - more resources