RT Journal Article
SR Electronic
T1 Epidemiological transition in morbidity: 10-year data from emergency consultations in Dakar, Senegal
JF BMJ Global Health
JO BMJ Global Health
FD BMJ Publishing Group Ltd
SP e001396
DO 10.1136/bmjgh-2019-001396
VO 4
IS 4
A1 Bamba Gaye
A1 Massamba Diop
A1 Kumar Narayanan
A1 Lucile Offredo
A1 Peter Reese
A1 Marie Antignac
A1 Vasenta Diop
A1 Ahmadoul Badaviyou Mbacké
A1 Louise Boyer Chatenet
A1 Eloi Marijon
A1 Archana Singh-Manoux
A1 Ibrahima Bara Diop
A1 Xavier Jouven
YR 2019
UL http://gh.bmj.com/content/4/4/e001396.abstract
AB 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.