Burden of disease attributable to suboptimal diet, metabolic risks and low physical activity in Ethiopia and comparison with Eastern sub-Saharan African countries, 1990-2015: findings from the Global Burden of Disease Study 2015

• Published in: BMC public health 2018-04, Vol.18 (1), p.552-552, Article 552
• Main Authors: Melaku, Yohannes Adama, Wassie, Molla Mesele, Gill, Tiffany K, Zhou, Shao Jia, Tessema, Gizachew Assefa, Amare, Azmeraw T, Lakew, Yihunie, Hiruye, Abiy, Bekele, Tesfaye Hailu, Worku, Amare, Seid, Oumer, Endris, Kedir, Lemma, Ferew, Tesfay, Fisaha Haile, Yirsaw, Biruck Desalegn, Deribe, Kebede, Adams, Robert, Shi, Zumin, Misganaw, Awoke, Deribew, Amare
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Adults; Africa South of the Sahara - epidemiology; Aged; Aged, 80 and over; Analysis; Bayesian analysis; Breastfeeding & lactation; Child; Child and maternal undernutrition; Child Nutrition Disorders - epidemiology; Cost of Illness; Diabetes; Diet; Diet - standards; Dietary risks; Disabled Persons - statistics & numerical data; Disease; Disease control; Estimates; Ethiopia; Ethiopia - epidemiology; Exercise; Famine; Fatty acids; Female; Gaussian process; Global Burden of Disease; Health aspects; Health risk assessment; Humans; Hypertension; Life expectancy; Male; Malnutrition; Malnutrition - epidemiology; Mathematical models; Metabolic diseases; Metabolic Diseases - epidemiology; Metabolic risks; Metabolic syndrome; Middle Aged; Mortality; Mortality - trends; Noncommunicable Diseases - epidemiology; Nutrient deficiency; Nutrition; Overnutrition; Physical activity; Public health; Quality-Adjusted Life Years; Regression analysis; Regression models; Risk analysis; Risk assessment; Risk Factors; Risk taking; Sedentary Behavior; Sub-Saharan Africa; Sustainable development; Undernutrition; Young Adult
• ISSN: 1471-2458; 1471-2458
• DOI: 10.1186/s12889-018-5438-1

Twelve of the 17 Sustainable Development Goals (SDGs) are related to malnutrition (both under- and overnutrition), other behavioral, and metabolic risk factors. However, comparative evidence on the impact of behavioral and metabolic risk factors on disease burden is limited in sub-Saharan Africa (SSA), including Ethiopia. Using data from the Global Burden of Disease (GBD) Study, we assessed mortality and disability-adjusted life years (DALYs) attributable to child and maternal undernutrition (CMU), dietary risks, metabolic risks and low physical activity for Ethiopia. The results were compared with 14 other Eastern SSA countries. Databases from GBD 2015, that consist of data from 1990 to 2015, were used. A comparative risk assessment approach was utilized to estimate the burden of disease attributable to CMU, dietary risks, metabolic risks and low physical activity. Exposure levels of the risk factors were estimated using spatiotemporal Gaussian process regression (ST-GPR) and Bayesian meta-regression models. In 2015, there were 58,783 [95% uncertainty interval (UI): 43,653-76,020] or 8.9% [95% UI: 6.1-12.5] estimated all-cause deaths attributable to CMU, 66,269 [95% UI: 39,367-106,512] or 9.7% [95% UI: 7.4-12.3] to dietary risks, 105,057 [95% UI: 66,167-157,071] or 15.4% [95% UI: 12.8-17.6] to metabolic risks and 5808 [95% UI: 3449-9359] or 0.9% [95% UI: 0.6-1.1] to low physical activity in Ethiopia. While the age-adjusted proportion of all-cause mortality attributable to CMU decreased significantly between 1990 and 2015, it increased from 10.8% [95% UI: 8.8-13.3] to 14.5% [95% UI: 11.7-18.0] for dietary risks and from 17.0% [95% UI: 15.4-18.7] to 24.2% [95% UI: 22.2-26.1] for metabolic risks. In 2015, Ethiopia ranked among the top four countries (of 15 Eastern SSA countries) in terms of mortality and DALYs based on the age-standardized proportion of disease attributable to dietary and metabolic risks. In Ethiopia, while there was a decline in mortality and DALYs attributable to CMU over the last two and half decades, the burden attributable to dietary and metabolic risks have increased during the same period. Lifestyle and metabolic risks of NCDs require more attention by the primary health care system of the country.