Prevalence of major noncommunicable diseases and their associated risk factors in Afghanistan

OBJECTIVE: Afghanistan is dealing with a double burden of diseases and yet there has been no evidence synthesis of the scientific literature on noncommunicable disease (NCDs), thus this study fills the gap by systematically analysing the prevalence of four major NCDs and the associated risk factors. METHODS: We performed a systematic review and meta-analysis of the studies published since 2000, reporting the prevalence of diabetes, chronic respiratory diseases (CRDs), cardiovascular disease (CVDs) or cancer, and their risk factors in Afghanistan. Four online databases (PubMed, Web of Science, Cochrane, and Google Scholar) and two local peer reviewed journals in Afghanistan were systematically searched using the predefined keywords. Two reviewers independently screened and appraised the quality of the papers. Data extraction and data synthesis were carried out using tabulated template. Stata 13 was used to perform the meta-analysis. RESULTS: 58 articles included in this review of which 13 focused on cancer, 10 on diabetes, 7 on CVDs, 5 on CRDs, and 23 on any of the risk factors as primary outcome. Very few articles reported the prevalence of 4 NCDs in general population where cancer was reported 0.15%, asthma ranged between 12.5% to 17.3% and no evidence on CVDs. The pooled prevalence for diabetes, hypertension, and overweight were 12%, 31%, and 35% respectively. Central obesity was almost twice prevalent in females (76% vs 40%). Similarly, the pooled prevalence of smoking and snuff use were 14% and 25% in males, and 2% and 3% in females respectively. CONCLUSIONS: Less evidence is available on the prevalence of major NCDs in Afghanistan, however, the risk factors for NCDs are prevalent across the country. The quality of the available data specially those of the local resources are poor, therefore, further research should be conducted to generate reliable evidences to inform the policy makers on prioritization of the interventions for the control of NCDs in Afghanistan. KEY MESSAGES: • The prevalence of NCDs is escalating in Afghanistan, and the local data show higher estimates of NCDs and their associated risk factors. • Prevalence of NCD risk factors is relatively high in Afghanistan, and considering the political emergency situation, if preventive measures are not taken properly, the burden of NCDs may increase.