Health-care provision and policy for non-alcoholic fatty liver disease in sub-Saharan Africa

Lancet Gastroenterol Hepatol. 2021 Dec;6(12):1047-1056. doi: 10.1016/S2468-1253(21)00296-X. Epub 2021 Sep 9.

Abstract

Sub-Saharan Africa, which has a population of more than 1 billion people, carries 24% of the global burden of disease and spends the least on health care of any region, relying heavily on international development assistance to deliver health care for HIV, tuberculosis, and malaria. The demographic and epidemiological transitions occurring in sub-Saharan Africa, with rising prevalences of obesity and diabetes, enhance the risk of non-alcoholic fatty liver disease (NAFLD), yet this remains an unrecognised complication of metabolic syndrome. There are no guidance documents on NAFLD from sub-Saharan Africa, and non-communicable disease (NCD) guidance documents do not include the associated burden of fatty liver disease. Combating the health and socioeconomic burden of NAFLD requires an integrated liver health approach, with task-shifting to primary health care. Using clear guidance documents to link education and management of HIV, viral hepatitis, NAFLD, and associated NCDs is also crucial to an integrated approach to infectious diseases and NCDs, which requires targeted funding from both governments and international development agencies.

Publication types

  • Review

MeSH terms

  • Africa South of the Sahara / epidemiology
  • Aged
  • COVID-19 / complications
  • COVID-19 / diagnosis
  • COVID-19 / epidemiology
  • COVID-19 / virology
  • Delivery of Health Care / economics
  • Delivery of Health Care / legislation & jurisprudence*
  • Diabetes Mellitus / epidemiology
  • Global Burden of Disease / economics*
  • Health Policy / trends
  • Health Services Accessibility / statistics & numerical data
  • Humans
  • Metabolic Syndrome / complications
  • Metabolic Syndrome / epidemiology
  • Middle Aged
  • Non-alcoholic Fatty Liver Disease / epidemiology*
  • Non-alcoholic Fatty Liver Disease / therapy*
  • Noncommunicable Diseases / epidemiology
  • Obesity / complications
  • Obesity / epidemiology
  • Patient Education as Topic
  • Prevalence
  • Primary Health Care / methods
  • Risk Factors
  • Risk Reduction Behavior
  • SARS-CoV-2 / genetics
  • Social Class