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Objective: To examine whether childbearing before age 18 in Sub-Saharan Africa is associated with increased risk of maternal and child complications through a systematic literature review and meta-analysis. Methods: The literature on adolescent pregnancy and associated complications in Sub-Saharan Africa was reviewed. A systematic electronic database search in Medline and Embase identified relevant papers. Studies were eligible for inclusion if they had numeric data on maternal mortality, pre-eclampsia, eclampsia, preterm birth, low birth weight, small for gestational age, stillbirth, neonatal death or perinatal death. We included studies on adolescents aged 17 years or younger, and with a comparison group of adult women aged between 20 and 35 years. The quality of the articles was assessed. Meta-analyses were conducted when there were at least three included studies with minor clinical heterogeneity in population and outcome measures. Results: Eighteen studies met our inclusion criteria. There were many studies from Sub-Saharan Africa with data on the age group 15–19 years old, but few studies had separate data on adolescents <18 years old. All included studies were of either moderate or low quality. Adolescents had an increased risk of low birth weight, pre-eclampsia/eclampsia, preterm birth and maternal and perinatal mortality. We found a lower, nonsignificant risk of stillbirth and for small for gestational age babies among the young mothers. Conclusion: In this systematic review, the findings indicate that young maternal age is associated with some unfavorable outcomes in Sub-Saharan Africa. High quality observational studies that adjust for sociodemographic factors are lacking. [ABSTRACT FROM AUTHOR]

Adult women are disproportionately affected by overweight and obesity in Sub-Saharan African (SSA) countries. Existing evidence on the sociocultural context remains unconsolidated. In this qualitative research synthesis, we aggregate research literature on contextual factors that potentially predispose adult women and adolescent girls to overweight and obesity to inform research, policies and programs over the life course. PubMed, CINAHL, PsychInfo, ProQuest Central, EMBASE, and Web of Science were searched to locate qualitative research articles conducted in SSA countries beginning in the year 2000. After assessment for eligibility and critical appraisal, 17 studies were included in the synthesis. Textual data and quotes were synthesized using meta-aggregation methods proposed by the Joanna Briggs Institute. The synthesized studies were conducted in South Africa, Ghana, Kenya and Botswana. The three overarching themes across these studies were body size and shape ideals, barriers to healthy eating, and barriers to physical activity, with cultural and social factors as cross-cutting influences within the major themes. Culturally, the supposedly ideal African woman was expected to be overweight or obese, and voluptuous, and this was associated with their identity. Although being overweight or obese was not acceptable to adolescent girls, they desired to be voluptuous. Healthy food choices among women and adolescent girls were hampered by several factors including affordability of nutritious foods and peer victimization. Both adult women and adolescent girls experienced ageism as a barrier to physical activity. This is the first qualitative research synthesis to amplify the voices of women and girls in SSA countries highlighting the challenges they face in maintaining a healthy body weight. Sociocultural, institutional and peer-related factors were powerful forces shaping body size preferences, food choices and participation in physical activity. Our study findings provide insights for the design of contextually appropriate obesity prevention interventions and lay the foundation for further research studies. [ABSTRACT FROM AUTHOR]

Background: Non-communicable diseases (NCDs) have become a global public health problem, which threatens Sub-Sahara Africa (SSA) including Nigeria. Civil servants are at risk of NCDs because of the stressful and sedentary nature of their work. The study aimed to determine the prevalence and associated factors of the major risk factors of NCDs among civil servants in Ibadan, Nigeria. Methods: A cross-sectional study was conducted among 606 civil servants in Oyo State using a two-stage cluster sampling technique. The WHO Stepwise approach was used to assess the behavioural and metabolic risk factors. Anthropometric (weight, height, waist and hip circumferences), blood pressure and biochemical measurements (fasting blood sugar) were obtained. Prevalence rates and 95% confidence intervals were calculated. Multivariate logistic models with adjusted odds ratios and their 95% confidence intervals were used to assess the associated factors of NCD risk factors. Multiple Poisson regression was also performed to determine the effects of certain socio-demographic factors on the clustering of NCD risk factors. Results: The mean age of the civil servants was 43.0±10.3 and 53.8% were males. The prevalence estimates and 95% confidence intervals of the risk factors were 6.5% (95% CI:4.5–8.5) for current smoking, 7.8% (95% CI:5.1–10.5) for harmful use of alcohol, 62.2% (95% CI:58.2–66.2) for low physical activity, 69.7% (95% CI:66.0–73.4) for insufficient fruit and vegetable intake, 37.1% (95% CI:33.2–41.0) for abdominal obesity, 57.3% (95% CI:53.3–61.3) for overweight and obesity, 33.1% (95% CI:29.3–36.8) for raised blood pressure and 7.1% (95% CI:5.0–9.1) for raised blood sugar. Over 75% of the population had at least two NCD risk factors and the study participants had an average of 3 NCD risk factors 3.01 (95% CI: 2.88–3.14) The female gender was significantly associated with an increased risk for abdominal obesity (AOR 27.9; 95% CI: 12.09–64.6) and being overweight or obese (AOR 6.78; 95% CI: 3.53–13.01), but was protective of smoking (AOR 0.21; 95% CI: 0.07–0.61) and binge drinking (AOR 0.04; 95% CI: 0.01–0.45). Also, the risk of hypertension increased with age– 30–39 years (AOR 12.29; 95% CI: 1.06–141.8), 40–49 years (AOR 14.28; 95% CI: 1.10–181.4) and 50 years and above (AOR 32.43; 95% CI: 2.44–413.7). Raised blood pressure was a strong correlate for having raised blood sugar (AOR 5.63; 95% CI: 1.48–21.3). Increasing age (IRR 1.02; 95% CI: 1.01–1.02) and being female (IRR 1.36; 95% CI: 1.23–1.49) were also important predictors of the clustering of risk factors. Conclusion: The feminization (i.e. the preponderance of risk factors among the females) and clustering of non-communicable disease risk factors were observed among Oyo State civil servants. Our findings highlight the high prevalence of cardio-metabolic risk factors among the working class. Hence the need for targeted preventive and therapeutic interventions among this population. [ABSTRACT FROM AUTHOR]

Limited resources and access to healthcare in sub-Saharan Africa are associated with high rates of malnourished children, although many countries globally are demonstrating increasing childhood obesity. This study evaluated how well current age- or height-based formulae estimate the weight of children undergoing surgery in Zambia. All children under 14 years of age presenting for elective surgery at the University Teaching Hospital, Lusaka, had both height and weight measured. Their actual weight was compared against estimated weight from various formulae. The Broselow tape outperformed all the age-based formulae, demonstrating the lowest median percentage error of -5.8%, with 46.0% of estimates falling within 10% of the actual measured weight (p < 0.001). Of the 1111 children who were eligible for World Health Organization growth standard appraisal, 88 (8%) met the weight criteria for severe acute malnutrition. Our results are consistent with other studies in finding that the Broselow tape is the best estimator of weight in a lower middle-income country, followed by the original Advanced Paediatric Life Support formula if the Broselow tape is unavailable. [ABSTRACT FROM AUTHOR]

Background: Nutritional research in sub-Saharan Africa has primarily focused on under-nutrition. However, there is evidence of an ongoing nutritional transition in these settings. This study aimed to examine the geographic variation of overweight and obesity prevalence at the state-level among women in Nigeria, while accounting for individual-level risk factors. Methods: The analysis was based on the 2008 Nigerian Demographic and Health Survey (NDHS), including 27,967 women aged 15–49 years. Individual data were collected on socio-demographics, but were aggregated to the country's states. We used a Bayesian geo-additive mixed model to map the geographic distribution of overweight and obesity at the state-level, accounting for individual-level risk factors. Results: The overall prevalence of combined overweight and obesity (body mass index ≥25) was 20.9%. In multivariate Bayesian geo-additive models, higher education [odds ratio (OR) & 95% Credible Region (CR): 1.68 (1.38, 2.00)], higher wealth index [3.45 (2.98, 4.05)], living in urban settings [1.24 (1.14, 1.36)] and increasing age were all significantly associated with a higher prevalence of overweight/obesity. There was also a striking variation in overweight/obesity prevalence across ethnic groups and state of residence, the highest being in Cross River State, in south-eastern Nigeria [2.32 (1.62, 3.40)], the lowest in Osun State in south-western Nigeria [0.48 (0.36, 0.61)]. Conclusions: This study suggests distinct geographic patterns in the combined prevalence of overweight and obesity among Nigerian women, as well as the role of demographic, socio-economic and environmental factors in the ongoing nutritional transition in these settings. [ABSTRACT FROM AUTHOR]

Background: Prevalence of childhood overweight/obesity has increased considerably in recent years. The transition to higher rates of overweight/obesity has been well documented in high income countries; however, consistent or representative data from lower income countries is scarce. It is therefore pertinent to assess if rates of overweight/obesity are also increasing in lower income countries, to inform public health efforts. Objective: This systematic review aimed to investigate the evidence for an overweight/obesity transition occurring in school-aged children and youth in Sub Saharan Africa. Methods: Studies were identified by searching the MEDLINE, Embase, Africa Index Medicus, Global Health, Geobase, and EPPI-Centre electronic databases. Studies that used subjective or objective metrics to assess body composition in apparently healthy or population-based samples of children and youth aged 5 to 17 years were included. Results: A total of 283 articles met the inclusion criteria, and of these, 68 were used for quantitative synthesis. The four regions (West, Central, East, and South) of Sub Saharan Africa were well represented, though only 11 (3.9%) studies were nationally representative. Quantitative synthesis revealed a trend towards increasing proportions of overweight/obesity over time in school-aged children in this region, as well as a persistent problem of underweight. Weighted averages of overweight/obesity and obesity for the entire time period captured were 10.6% and 2.5% respectively. Body composition measures were found to be higher in girls than boys, and higher in urban living and higher socioeconomic status children compared to rural populations or those of lower socioeconomic status. Conclusions: This review provides evidence for an overweight/obesity transition in school-aged children in Sub Saharan Africa. The findings of this review serve to describe the region with respect to the growing concern of childhood overweight/obesity, highlight research gaps, and inform interventions. PROSPERO Registration Number: CRD42013004399 [ABSTRACT FROM AUTHOR]