Abstract Background/Introduction Abdominal obesity is a growing public health concern in Africa, disproportionately affecting women and urban populations, and significantly contributing to the burden of non-communicable diseases (NCDs). However, data on the burden and risk factors of abdominal obesity in the Africa region remain limited. Understanding its key drivers is crucial for developing targeted, gender and context-specific interventions. Knowledge on time trends is also important to evaluate and potentially adapt ongoing interventions. Purpose This study aims to quantify the prevalence of abdominal obesity, identify associated sociodemographic and behavioral factors, and examine time trends over two decades across the WHO African Region. Methods This is a cross-sectional analysis of pooled data from WHO STEPS Surveys (2003- 2022) in 36 countries in the WHO African region representing 156 million people. Participants were nonpregnant adults aged 18-69 years. Abdominal obesity was defined as a measured waist circumference of more than 80 cm in women and more than 94 cm in men. Hierarchical multilevel models were used to identify key determinants of abdominal obesity. Trends in abdominal obesity over the 20-year period were estimated using a spatiotemporal Bayesian model. The study also estimated the Population Attributable Fraction (PAF) of abdominal obesity (exposure) for adverse blood pressure and type 2 diabetes (outcomes). Results The study population included 196,865 participants with 50·1% being females. Abdominal obesity affected 47.2% of adult women and 12.3% of adult men. Key risk factors were female sex, older age, higher education, marital status, employment status, physical inactivity, suboptimal diet, smoking and alcohol consumption status (Table 1). The overall prevalence of abdominal obesity increased from 37.8% in 2003 to 49.1% in 2022, with consistent trend in both sexes; prevalence of abdominal obesity increased from 59·51% in 2003 to 69·46% in 2022 in women (p for trend 0·001), and 13·82% in 2003 to 19·56% in 2022 in men (p for trend 0·001). The weighted and age-standardized mean waist circumference increased significantly from 83.94 cm (95% CI: 84.40-85.90) in 2003 to 88.22 cm (95% CI: 87.80-92.36) in 2022 (p for trend 0.001). The PAF of abdominal obesity for hypertension and for diabetes was 42.7% and 37.3% respectively. Conclusion(s) This study highlights the high prevalence of abdominal obesity in the WHO Africa region, especially among females, identifies individual key drivers and the continuous increasing trend over the last 20 years.
Agboyibor et al. (Sat,) studied this question.