Spearman C Wendy, Abdo Abdelmounem, Ambali Aggrey, Awuku Yaw A, Kassianides Chris, Lesi Olufunmilayo A, Ndomondo-Sigonda Margareth, Onyekwere Charles A, Rwegasha John, Shewaye Abate B, Sonderup Mark W
Division of Hepatology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
National Centre for Gastrointestinal and Liver Disease, Ibn Sina Hospital, Khartoum, Sudan.
Lancet Gastroenterol Hepatol. 2021 Dec;6(12):1047-1056. doi: 10.1016/S2468-1253(21)00296-X. Epub 2021 Sep 9.
Sub-Saharan Africa, which has a population of more than 1 billion people, carries 24% of the global burden of disease and spends the least on health care of any region, relying heavily on international development assistance to deliver health care for HIV, tuberculosis, and malaria. The demographic and epidemiological transitions occurring in sub-Saharan Africa, with rising prevalences of obesity and diabetes, enhance the risk of non-alcoholic fatty liver disease (NAFLD), yet this remains an unrecognised complication of metabolic syndrome. There are no guidance documents on NAFLD from sub-Saharan Africa, and non-communicable disease (NCD) guidance documents do not include the associated burden of fatty liver disease. Combating the health and socioeconomic burden of NAFLD requires an integrated liver health approach, with task-shifting to primary health care. Using clear guidance documents to link education and management of HIV, viral hepatitis, NAFLD, and associated NCDs is also crucial to an integrated approach to infectious diseases and NCDs, which requires targeted funding from both governments and international development agencies.
撒哈拉以南非洲地区拥有超过10亿人口，承担着全球24%的疾病负担，且在医疗保健方面的支出是所有地区中最少的，严重依赖国际发展援助来提供针对艾滋病毒、结核病和疟疾的医疗服务。撒哈拉以南非洲地区正在经历人口结构和流行病学转变，肥胖和糖尿病患病率不断上升，这增加了非酒精性脂肪性肝病（NAFLD）的风险，但这仍是代谢综合征一种未被认识到的并发症。撒哈拉以南非洲地区没有关于NAFLD的指导文件，非传染性疾病（NCD）指导文件也未包括脂肪肝疾病的相关负担。应对NAFLD的健康和社会经济负担需要采取综合肝脏健康方法，并将任务转移到初级卫生保健。使用明确的指导文件将艾滋病毒、病毒性肝炎、NAFLD及相关非传染性疾病的教育和管理联系起来，对于传染病和非传染性疾病的综合方法也至关重要，而这需要政府和国际发展机构提供有针对性的资金。
