Jean Jacques Noubiap¹, Mickael Essouma^2, Jean Joel Bigna^3,4, Ahmadou M Jingi², Léopold N Aminde⁶, Jobert Richie Nansseu⁷

Authors’ affiliations:

1. Department of Medicine, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa
2. Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
3. Department of Epidemiology and Public Health, Centre Pasteur of Cameroon, Yaoundé, Cameroon
4. Faculty of Medicine, University of Paris Sud XI, Le Kremlin Bicêtre, France
5. School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
6. Department of Public Health, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon

Corresponding author : Dr Essouma Mickael, Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon. E-mail : Cette adresse e-mail est protégée contre les robots spammeurs. Vous devez activer le JavaScript pour la visualiser. Tél : (237) 676541328

Objectives : Despite constant update on the burden of high blood pressure (BP) in children and adolescents in high-income countries and in adult populations in Africa, the magnitude of  high BP among children and adolescents in Africa remains to be ascertained. Accordingly, we did a systematic review and meta-analysis providing estimates of the prevalence of elevated BP among children and adolescents in Africa, and assessing associated factors.

Methods : We searched Embase, PubMed, African Journals Online, and African Index Medicus to identify articles published from Jan 1, 1996, to Feb 2, 2017, and searched the reference list of retrieved articles. Each study was independently reviewed for methodological quality. We used a random-effects model to estimate the prevalence of elevated BP across studies and heterogeneity (I²) was assessed via the χ² test on Cochran’s Q statistic.

Results : We included 51 studies in qualitative synthesis and 25 in the meta-analysis reporting data of a pooled sample of 54 196 participants aged 2–19 years. Study quality was high with only four medium-quality studies and no low-quality studies. Prevalence of elevated BP varied widely across studies (range 0·2–24·8%). The pooled prevalence of elevated BP (systolic or diastolic BP ≥95th percentile) was 5·5% (95% CI 4·2–6·9), whereas that of slightly elevated BP (systolic or diastolic BP ≥90th percentile and <95th percentile) was 12·7% (2·1–30·4). The prevalence of elevated BP was largely associated with body mass index, with a prevalence of elevated BP six times higher in obese (30·8%, 95% CI 20·1–42·6) versus normal-weight children (5·5%, 3·1–8·4; p<0·0001).

Conclusion : The prevalence of elevated BP is high among children and adolescents in Africa ; overweight and obesity being potential main risk factors. Efforts to address this burden of elevated BP in children and adolescents in Africa should mainly focus on primary prevention at the community level, targeting weight control measures along with healthy lifestyles.

Key-words : Elevated blood pressure ; children ; adolescents ; Africa