Spatial and temporal trends of overweight/obesity and tobacco use in East Africa: subnational insights into cardiovascular disease risk factors.
Level 4 - case-series / case-control
Repeated cross-sectional survey analysis (DHS data)
PubMed 37620831 · doi:10.1186/s12942-023-00342-7
What was done
Analyzed repeated cross-sectional, nationally representative Demographic and Health Surveys (DHS) conducted between 2003 and 2016 across five East African nations (Burundi, Kenya, Rwanda, Tanzania, and Uganda). The authors used adaptive kernel density estimation and logistic regression to examine subnational spatiotemporal trends and urban versus rural distributions for overweight/obesity and tobacco use.
What was found
The abstract reports no numerical estimates, percentages, or effect sizes. Overweight and obesity prevalence increased over time across most included nations, with higher rates observed in urban populations compared to rural populations. In contrast, national tobacco use prevalence generally declined, with rural residents having higher overall use; however, spatial analysis revealed that tobacco use increased in and around major cities while declining in rural areas.
Why it matters
Demonstrates that national-level aggregate statistics mask localized, subnational shifts in cardiovascular disease risk factors in East Africa, highlighting the need for geographically targeted interventions.
Limits
The abstract reports no sample sizes (n), point estimates, or confidence intervals. The design is based on repeated cross-sectional survey data, which limits causal inference, and relies on survey-level risk factor reporting across differing national time points.
Cited by
- contradicts Rural populations in specific regions of Rwanda and Kenya consume at least 65% of their total dietary calories from carbohydrates and exhibit virtually no overweight or obesity.