Keep it in the family - preventing cardiovascular disease in The Gambia

Non-communicable diseases (NCDs) are an increasingly important cause of disease and death in sub-Saharan Africa. Studies in industrialised countries show that relatives of people with NCDs are more likely to suffer from these conditions themselves. Is this also true in developing countries? Family ties are traditionally strong in many African societies. Does this provide useful opportunities for disease prevention?

Researchers from the Medical Research Council Laboratories in The Gambia collected data from 2166 adults in urban Banjul and 3223 adults in 20 villages in the rural Farafenni area. Participants completed a questionnaire, underwent a medical examination and gave blood samples for laboratory testing.

Results showed that:

• Overall, 7.1 percent of subjects have high blood pressure (greater than 160/95 mmHg), four percent are overweight (body mass index of 30 or higher) and 3.4 percent have diabetes.
• Nearly 15 percent of subjects have a family history of the NCDs studied. The individual proportions are eight percent for high blood pressure, 5.4 percent for obesity, 3.3 percent for diabetes and 1.4 percent for stroke.
• Compared with the general population, people with a family history of NCDs have higher blood pressure and lipid levels, and are more likely to be overweight.
• A family history of NCDs is more common among urban than rural participants.

This study identified a population at high risk from NCDs, particularly in urban areas. Regardless of the cause of the disease, a healthier lifestyle can help to reduce the risks. Changes in diet and physical activity could be highly effective.

Family histories of disease are relatively easy to obtain and can help to identify those at risk. In countries such as The Gambia, traditionally strong community and family ties can influence the acceptance or rejection of lifestyle changes. A behavioural change might be impossible to implement if it is not accepted as a family commitment. Health professionals dealing with NCD patients should use every opportunity to involve families in patient care and health education, promoting changes in their diet and physical activity. This would be beneficial both for the patient and for family members who are at increased risk of becoming patients themselves.

Source(s):
'Family history: an opportunity for early interventions and improved control of hypertension, obesity and diabetes' by M. van der Sande et al., Bulletin of the World Health Organization 79 (2001)

Funded by: UK Medical Research Council

id21 Research Highlight: 11 December 2001

Further Information:
Marianne van der Sande
Epidemiologist
Medical Research Council Laboratories
Fajara
PO Box 273
Banjul
The Gambia

Tel: +220 49 59 16
Fax: +220 49 59 19
Contact the contributor: mvdsande@mrc.gm

Other related links:
PROCOR is an on-line forum addressing the issue of NCDs in developing countries.

The WHO is a good starting point for information on non-communicable diseases.

The Health of Populations in Transition site has details of this NCD research programme.

The WHO has resources and links relating to diabetes.

Search the International Diabetes Foundation site for more information.