Danquah Frederick Inkum, Ansu-Mensah Monica, Bawontuo Vitalis, Yeboah Matilda, Udoh Roseline H, Tahiru Mohammed, Kuupiel Desmond
Department of Public Health, Faculty of Health and Allied Sciences, Catholic University College of Ghana, Fiapre, Sunyani, Ghana.
Research for Sustainable Development Consult, Sunyani, Ghana.
BMC Nutr. 2020 Sep 1;6:37. doi: 10.1186/s40795-020-00364-5. eCollection 2020.
The rising burden of childhood obesity is a major public health concern, particularly in sub-Saharan Africa (SSA), where most health systems are weak and least prepared for complications that may arise. While the need for preventive action is increasingly recognized, policy implementation within the sub-region has often been inadequate, non-systematic, and ad hoc. This study described evidence on the risk factors and morbidities associated with childhood obesity in SSA.
Guided by the Arksey and O'Malley framework incorporating the Levac et al. recommendations, and the Joanna Briggs Institute guidelines, we conducted a scoping study to address the research question. Thorough keywords systematic search was conducted for potentially eligible articles in PubMed, Google Scholar, Web of Science, and CINAHL published between 2009 and June 2019. Articles obtained were screened independently by two investigators at the abstract and full text phases using the eligibility criteria. All relevant data were extracted by two investigators in parallel and thematic analysis conducted.
A total of 337,229 articles were obtained from the database search of which 68 satisfied the inclusion criteria and were included for data extraction. These 68 included studies were conducted in 19 countries with the majority, 27.9% (19/68) from South Africa followed by Nigeria with 20.6% (14/68). Six of the included studies were conducted in Ethiopia, 5 studies in Kenya, 4 studies each in Tanzania and Cameroon, and 2 studies each in Ghana, Uganda, and Sudan. Of the 68 included studies, one each was conducted in Botswana, Gambia, Lesotho, Mauritius, Mozambique, Seychelles, Togo, and Zimbabwe. Most (80.9%) of the included studies were cross-sectional, and only one was an intervention trial. Of the 68 included studies, 53 reported on risk factors, 12 reported on morbidities, and 3 reported both risk factors and morbidities. We found no evidence in almost 60% (28/47) of countries included in the World Health Organisation Africa region.
This review findings suggest a paucity of literature on the risk factors of childhood obesity and morbidities in most SSA countries. Hence, there is the need to intensify research efforts, especially experimental study designs using innovative strategies to promote healthy lifestyle choices that will prevent or minimize the risks and health consequences of childhood obesity in SSA.
儿童肥胖负担日益加重，这是一个重大的公共卫生问题，在撒哈拉以南非洲地区（SSA）尤为如此，该地区大多数卫生系统薄弱，对可能出现的并发症准备不足。虽然人们越来越认识到采取预防行动的必要性，但该次区域内的政策实施往往不够充分、缺乏系统性且具有临时性。本研究描述了与SSA地区儿童肥胖相关的风险因素和发病率的证据。
在纳入莱瓦克等人建议的阿克西和奥马利框架以及乔安娜·布里格斯研究所指南的指导下，我们开展了一项范围界定研究以解决该研究问题。在PubMed、谷歌学术、科学网和护理学与健康领域数据库（CINAHL）中，对2009年至2019年6月期间发表的潜在符合条件的文章进行了全面的关键词系统检索。两名研究人员在摘要和全文阶段使用纳入标准对获取的文章进行独立筛选。两名研究人员并行提取所有相关数据并进行主题分析。
通过数据库检索共获得337,229篇文章，其中68篇符合纳入标准并被纳入数据提取。这68篇纳入研究在19个国家开展，其中大多数（27.9%，19/68）来自南非，其次是尼日利亚，占20.6%（14/68）。纳入研究中有6项在埃塞俄比亚开展，5项在肯尼亚开展，坦桑尼亚和喀麦隆各开展4项，加纳、乌干达和苏丹各开展2项。在这68篇纳入研究中，博茨瓦纳、冈比亚、莱索托、毛里求斯、莫桑比克、塞舌尔、多哥和津巴布韦各开展了1项。纳入研究中大多数（80.9%）为横断面研究，只有1项是干预试验。在这68篇纳入研究中，53篇报告了风险因素，12篇报告了发病率，3篇既报告了风险因素又报告了发病率。在世界卫生组织非洲区域纳入的近60%（28/47）国家中，我们未发现相关证据。
本次综述结果表明，大多数SSA国家关于儿童肥胖风险因素和发病率的文献匮乏。因此，有必要加强研究力度，尤其是采用创新策略促进健康生活方式选择的实验性研究设计，以预防或最小化SSA地区儿童肥胖的风险和健康后果。
