Urbanization in Sub-Saharan Africa: Declining Rates of Chronic and Recurrent Infection and Their Possible Role in the Origins of Non-communicable Diseases
| Autor: | Radhames E. Lizardo, Jonathan Halbach, Antonio De Maio, Said Amin, David M. Cauvi, Stephen W. Bickler, Andrew W. Wang |
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| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
Rural Population Recurrent infections medicine.medical_specialty Sub saharan Urban Population Inflammatory response Disease epidemiology Gene Expression Infections Article 03 medical and health sciences 0302 clinical medicine Recurrence Risk Factors Environmental health Urbanization Epidemiology Medicine Humans 030212 general & internal medicine Child Noncommunicable Diseases Developing Countries Poverty Africa South of the Sahara Cause of death business.industry Incidence 030104 developmental biology Chronic Disease Surgery business |
| Zdroj: | World journal of surgery. 42(6) |
| ISSN: | 1432-2323 |
| Popis: | BACKGROUND: Non-communicable diseases (NCDs), such as atherosclerosis and cancers, are a leading cause of death worldwide. An important, yet poorly explained epidemiological feature of NCDs is their low incidence in under developed areas of low-income countries and rising rates in urban areas. METHODS: With the goal of better understanding how urbanization increases the incidence of NCDs we provide an overview of the urbanization process in sub-Saharan Africa, discuss gene expression differences between rural and urban populations, and review the current NCD determinant model. We conclude by identifying research priorities. RESULTS: Declining rates of chronic and recurrent infection are the hallmark of urbanization in sub- Saharan Africa. Gene profiling studies show urbanization results in complex molecular changes, with almost one-third of the peripheral blood leukocyte transcriptome altered. The current NCD determinant model could be improved by including a possible effect from declining rates of infection and expanding the spectrum of diseases that increase with urbanization. CONCLUSIONS: Urbanization in sub-Saharan Africa provides a unique opportunity to investigate the mechanism by which the environment influences disease epidemiology. Research priorities include: 1) studies to define the relationship between infection and risk factors for NCDs, 2) explaining the observed differences in the inflammatory response between rural and urban populations, and 3) identification of animal models that simulate the biological changes that occurs with urbanization. A better understanding of the biological changes that occur with urbanization could lead to new prevention and treatment strategies for some of the most common surgical diseases in high-income countries. |
| Databáze: | OpenAIRE |
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