title: Growing burden of diabetes in sub-saharan Africa: contribution of pesticides ?
abstract: The diabetes burden is growing in Sub-Saharan Africa (SSA). The low overall access to health care has been documented to contribute to the high diabetes-related mortality. Due to economic, demographic, epidemiological and nutrition transitions in SSA, the growing prevalence of diabetes appears to be related to obesogenic lifestyles and the intergenerational impact of malnutrition in women of childbearing age. Both overnutrition and undernutrition have been associated with the development of diabetes and other chronic diseases. Africans are also suspected of being genetically predisposed to diabetes. According to existing data in developed countries, exposure to pesticides, particularly organochlorines and metabolites, is associated with a higher risk of developing type 2 diabetes and its comorbidities. In African countries, pesticide exposure levels often appear much higher than in developed countries. Furthermore, undernutrition, which is still highly prevalent in SSA, could increase susceptibility to the adverse effects of organic pollutants. Therefore, the growing and inadequate use of pesticides may well represent an additional risk factor for diabetes in SSA. Additionally, high exposure to pesticides in African infants in utero and during the perinatal period may increase the intergenerational risk of developing diabetes in SSA.
authors.affiliation: TRANSNUT, WHO Collaborating Centre on Nutrition Changes and Development, Department of Nutrition, Faculty of Medicine, University of Montreal, PO Box 6128, Downtown Station, Montreal (Qc) Canada H3C 3J7. helene.delisle@umontreal.ca.
authors.forename: Colette Sylvie
authors.initials: CS
authors.lastname: Azandjeme
authors.forename: Michèle
authors.initials: M
authors.lastname: Bouchard
authors.forename: Benjamin
authors.initials: B
authors.lastname: Fayomi
authors.forename: Francois
authors.initials: F
authors.lastname: Djrolo
authors.forename: Dismand
authors.initials: D
authors.lastname: Houinato
authors.forename: Hélène
authors.initials: H
authors.lastname: Delisle
mesh_terms: D000293:Adolescent; D000328:Adult; D017954:Africa South of the Sahara / Q000453:epidemiology; D000368:Aged; D002648:Child; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000139:chemically induced* / Q000453:epidemiology*; D004784:Environmental Monitoring; D004785:Environmental Pollutants / Q000009:adverse effects* / Q000097:blood; D005260:Female; D020022:Genetic Predisposition to Disease; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D009765:Obesity / Q000150:complications / Q000453:epidemiology; D010575:Pesticides / Q000009:adverse effects* / Q000097:blood; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000097:blood / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D014507:Urbanization
chemical_list: D004785:Environmental Pollutants; D010575:Pesticides