title: Prevalence and time trends in diabetes and physical inactivity among adult West African populations: the epidemic has arrived.
abstract: OBJECTIVE
  To determine the prevalence and distribution of, and trends in, physical inactivity and diabetes in adult West African populations.
  
  
  METHODS
  Systematic review and meta-analysis.
  
  
  METHODS
  Literature searches were conducted using four electronic databases. Journal hand searches and examination of citations of relevant articles were also undertaken. To be included, studies had to be population based, use clearly defined criteria for measuring diabetes and physical inactivity, present data that allowed calculation of the prevalence of diabetes or physical inactivity, and sample adult participants. Studies retrieved were appraised critically. Meta-analysis was performed using the DerSimonian-Laird random effect model.
  
  
  RESULTS
  Twenty-one reports were retrieved for diabetes and 15 reports were retrieved for physical in/activity. Most studies (10 for diabetes and six for physical activity) were conducted solely among urban populations. The prevalence of diabetes in West Africa was approximately 4.0% [95% confidence interval (CI) 2.0-9.0] in urban adults and 2.6% (95%CI 1.5-4.4) in rural adults, and was similar in men and women [prevalence ratio (PR) 1.36, 95%CI 0.96-1.92]. Cumulative time trend analyses suggested an increase in the prevalence of diabetes among adults in urban West Africa, from approximately 3.0% (95%CI 1.0-7.0) to 4.0% (95%CI 2.0-9.0) in the past 10 years. The prevalence of inactivity in West Africa was 13% (95%CI 9.0-18.0). An association was found between physical inactivity and being older (> or = 50 years) (PR 1.82, 95%CI 1.36-2.44), female gender (PR 1.62, 95%CI 1.41-1.87) and urban residence (PR 2.04, 95%CI 1.58-2.63).
  
  
  CONCLUSIONS
  Diabetes and physical inactivity are important public health issues in urban West Africa, with similar prevalences to wealthy industrialized countries. There is an urgent need for policy makers, politicians and health promotion experts to put measures in place to encourage active lifestyles and control diabetes in urban West Africa.
authors.affiliation: School of Nursing & Midwifery, University of Dundee, Dundee DD1 4HJ, UK. a.abubakari@dundee.ac.uk
authors.forename: A R
authors.initials: AR
authors.lastname: Abubakari
authors.forename: W
authors.initials: W
authors.lastname: Lauder
authors.forename: M C
authors.initials: MC
authors.lastname: Jones
authors.forename: A
authors.initials: A
authors.lastname: Kirk
authors.forename: C
authors.initials: C
authors.lastname: Agyemang
authors.forename: R S
authors.initials: RS
authors.lastname: Bhopal
mesh_terms: D000354:Africa, Western / Q000453:epidemiology; D044383:Black People; D003920:Diabetes Mellitus / Q000453:epidemiology* / Q000208:ethnology; D004196:Disease Outbreaks / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D009043:Motor Activity; D015995:Prevalence; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data / Q000639:trends; D057185:Sedentary Behavior; D014505:Urban Population / Q000706:statistics & numerical data / Q000639:trends