As the burden of non-communicable diseases increases in Africa, it is important to generate locally relevant knowledge with regard to the burden, risk factors and management of these illnesses. Researchers at the KWTRP are on the frontline in providing answers to important research questions on NCDs in sub-Saharan Africa.
Kilifi is unique in having linked demographic and clinical surveillance data. This enables the estimation of burden of disease affecting the population with a high level of accuracy. Using these data we have been able to show that although infectious diseases are a major cause of admission and death, non-communicable diseases such as stroke, heart failure and injuries are important contributors to disability adjusted life years lost in the KHDSS.
These results are similar to those we have found in verbal autopsy (VA) studies that aim to determine the causes of death in the community. VA results indicate that nearly half of deaths in adults in Kilifi are due to non-communicable diseases. We are also measuring the prevalence of hypertension, one of the major risk factors for stroke and heart failure. These studies utilize ambulatory blood pressure monitoring to determine the true prevalence of the condition. Results indicate that hypertension in Kilifi is just as common as it is in urban parts of Kenya, but that the prevalence is considerably overestimated when traditional methods of diagnosis are used.
The coexistence of a dual burden of infectious and non-communicable disease naturally leads to the question of whether the two could be related. Future work will involve examining the possible relationship between childhood infectious disease and adult non-communicable disease. Using robust clinical, demographic and laboratory data that has been accumulated over a period of more than 20 years, we aim to examine whether malaria in childhood leads to hypertension in adulthood. Results of this project have the potential to influence the prevention and treatment of both infectious and non-communicable diseases.
Investigators : Investigators: Anthony Etyang, Anthony Scott, Evasius Bauni, Thomas Williams, Liam Smeeth (LSHTM), Kennedy Cruickshank (Kings College)