TY - JOUR T1 - Epidemiological transition in morbidity: 10-year data from emergency consultations in Dakar, Senegal JF - BMJ Global Health JO - BMJ Global Health DO - 10.1136/bmjgh-2019-001396 VL - 4 IS - 4 SP - e001396 AU - Bamba Gaye AU - Massamba Diop AU - Kumar Narayanan AU - Lucile Offredo AU - Peter Reese AU - Marie Antignac AU - Vasenta Diop AU - Ahmadoul Badaviyou Mbacké AU - Louise Boyer Chatenet AU - Eloi Marijon AU - Archana Singh-Manoux AU - Ibrahima Bara Diop AU - Xavier Jouven Y1 - 2019/07/01 UR - http://gh.bmj.com/content/4/4/e001396.abstract N2 - 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. ER -