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REVIEW ARTICLE|DECEMBER 17 2024

Metabolic Syndrome in Nigeria: Burden, Issues, and Prospects

Okara Amarachi T 1Ogbonna Brian O1*,2,4ORCID iDOkpalanma Nneoma N 2,6Nnamani Monica N 2Ezenekwe Lizette N 1Nduka Jovita I 1Eze Daniel U 2Egere Eustace 3Eze Amarachi S 2,4Osuafor Nkeiruka G 7Mba Obinna 2,5Nwaodu Mercy A 2,4Chigozie Victor U 4Adenola Ugochi A 1Umeh Ifeoma B 1Anetoh Maureen U 1

1 Department of Clinical Pharmacy and Pharmacy Management, Faculty of Pharmacy, Nnamdi Azikiwe University, Awka, Anambra State, Nigeria

2 International Institute for Health Policy, Systems and Knowledge Translation, David Umahi Federal University of Health Sciences, Uburu Nigeria

3 Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, Madonna University, Elele, Rivers State, Nigeria

4 Department of Pharmaceutical Microbiology and Biotechnology, David Umahi Federal University of Health Sciences, Uburu, Nigeria

5 Department of Pharmacology and Toxicology, David Umahi Federal University of

Health Sciences, Nigeria

6 Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmaceutical Sciences, Chukwuemeka Odimegwu Ojukwu University, Igboariam, Nigeria

7 Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, University of Abuja, Nigeria

Corresponding Author: Ogbonna Brian O, Department of Clinical Pharmacy and Pharmacy Management, Faculty of Pharmacy, Nnamdi Azikiwe University, Awka, Anambra State, Nigeria

Citation: Okara A. T., Ogbonna B. O., Okpaaalamma N. N., & Nnamani M. N. et al. (2024). Effectiveness of Pharmacist-Led Medication Reconciliation Programs on Clinical Outcomes at Hospital Transitions in Nigeria: A Narrative Review (1970-2023). Chronicles of Clinical Reviews and Case Reports, The Geek Chronicles, 2, 1-12.
Copyright: © 2024 Ogbonna Brian O, this is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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Received On
 October 31, 2024
Accepted On
 November 18, 2024
Published On
 December 17, 2024

Abstract

Background: Metabolic syndrome (MetS) is a complex and multifactorial condition defined by a cluster of risk factors that predispose individuals to cardiovascular diseases (CVD) and type 2 diabetes mellitus (T2DM).

Objective: We narratively reviewed the literatures for the incidence, prevalence, burden, Issues, and Prospects of Metabolic Syndrome in Nigeria from 1970 to 2023.

Methods: We utilized the published studies on MetS in Nigeria between 1970 to 2023. Search was carried out on included PubMed, Google Scholar and African Journals Online (AJOL). A total number of 750 articles were obtained: 223 from PubMed, 335 from Google Scholar and 195 from African Journals Online (AJOL). The articles were then screened for duplication and eligibility.

Conclusion: Metabolic syndrome has become a significant public health issue in Nigeria, with increasing incidence and prevalence over the last five decades.

 

Keywords: Metabolic syndrome, review, Nigeria, epidemiology

Introduction

Metabolic syndrome (MetS) is a complex and multifactorial condition defined by a cluster of risk factors that predispose individuals to cardiovascular diseases (CVD) and type 2 diabetes mellitus (T2DM). These risk factors typically include central obesity, elevated blood pressure, dyslipidemia (abnormal cholesterol or triglyceride levels), and hyperglycemia (high blood sugar). The presence of three or more of these conditions defines MetS, according to international criteria such as the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) or the International Diabetes Federation (IDF) guidelines [1,2].

Globally, the prevalence of MetS has increased dramatically over the last several decades, particularly in low- and middle-income countries like Nigeria. This rise is largely driven by rapid urbanization, lifestyle changes, and the westernization of diets, which have contributed to increased rates of obesity, hypertension, and diabetes [3,4]. In Africa, and specifically in Nigeria, metabolic syndrome has become a growing public health concern, with significant implications for the healthcare system [5]. The increasing incidence of MetS in Nigeria mirrors global trends, but it also reflects unique socioeconomic, environmental, and cultural factors specific to the country [6].

The Evolution of Metabolic Syndrome in Nigeria

In Nigeria, the awareness and recognition of MetS as a major health challenge began gaining attention in the late 20th century, as more urbanized populations exhibited higher rates of obesity and hypertension [7,8]. Historically, the Nigerian population was predominantly rural, engaging in agrarian lifestyles that involved physical labor and diets rich in fiber and unprocessed foods. However, as Nigeria has urbanized, significant shifts have occurred in dietary habits, physical activity levels, and socioeconomic structures [9].

From the 1970s to the present, the country’s population has moved towards a more sedentary lifestyle, coupled with increased consumption of processed foods high in sugars and fats [10]. These shifts have been accompanied by rising rates of non-communicable diseases (NCDs), of which MetS plays a central role. The urbanization process in cities like Lagos, Abuja, and Port Harcourt has not only driven economic growth but also created environments where sedentary jobs, high-calorie diets, and stress have become the norm [11]. This has led to an increase in metabolic risk factors, particularly in middle-aged adults and the elderly [12].

Urban-Rural Disparities in MetS Prevalence

One of the defining characteristics of MetS in Nigeria is the stark contrast between its prevalence in urban versus rural areas. Studies have consistently shown that urban populations are at significantly higher risk for MetS due to lifestyle factors, including reduced physical activity and increased consumption of energy-dense, processed foods [13]. For instance, Adebayo et al. reported that 25% of adults in Lagos had MetS, with rates even higher among women and those with higher body mass indices [BMI] [14]. In contrast, rural areas, where traditional diets and physically active lifestyles are more prevalent, have reported much lower prevalence rates. A study by Chukwu et al. found that the prevalence of MetS in rural Enugu was 18%, highlighting the protective effect of traditional, agrarian lifestyles [15].

Despite these disparities, rural areas are not immune to the rise of MetS. As economic and social changes spread to less urbanized regions, the risk factors associated with MetS—such as obesity and hypertension—are becoming more widespread in rural populations as well [16,17].

Risk Factors and Socioeconomic Influences

Several factors contribute to the development of MetS in Nigeria, many of which are interconnected with socioeconomic status. Obesity, one of the primary components of MetS, is particularly prevalent among women and individuals in higher income brackets who may have greater access to processed foods [18,19]. Conversely, hypertension is prevalent across all socioeconomic groups but tends to be underdiagnosed and poorly managed, especially in lower-income populations due to limited healthcare access [20]. The impact of socioeconomic status is also reflected in the dietary habits of different regions. Urban areas, where people are more likely to consume high-fat, high-sugar diets, show a greater prevalence of MetS than rural areas, where diets are often composed of unprocessed grains, fruits, and vegetables [21].

The socioeconomic disparities are further compounded by the availability of healthcare services. In rural regions, healthcare systems are often under-resourced, with limited access to diagnostic tools and medications necessary for the management of MetS [22]. As a result, the syndrome often goes undiagnosed, contributing to the development of severe complications, including CVD and T2DM [23].

The Burden of Metabolic Syndrome

The burden of metabolic syndrome in Nigeria extends beyond individual health outcomes. The increasing prevalence of MetS is placing a strain on the country’s healthcare system, which is already under pressure from both communicable and non-communicable diseases [24]. Cardiovascular diseases, diabetes, and hypertension—all of which are linked to MetS—are leading causes of morbidity and mortality in the country [25]. Managing these chronic conditions requires significant healthcare resources, and as the prevalence of MetS continues to rise, the economic costs associated with treating its complications are expected to escalate [26].

Given the growing burden of metabolic syndrome in Nigeria, this review seeks to explore the incidence, prevalence, burden, issues, and future prospects of MetS in the country from 1970 to 2023. It will examine key studies conducted over this period, analyze the factors driving the rise of MetS, and discuss the public health implications of these trends [27,28]. This narrative review aims to offer insights into potential interventions that can help curb the increasing rates of MetS and its associated health complications, while addressing the unique challenges facing Nigeria’s healthcare system [29]. We narratively reviewed the literearures for the incidence, Prevalence, Burden, Issues, and Prospects of Metabolic Syndrome in Nigeria from 1970 to 2023.

Methods

Study Area

The study covered the incidence, prevalence, burden, issues, and prospects of metabolic syndrome in Nigeria.

Review Question

What are the trends in incidence, prevalence, burden, issues, and prospects of            metabolic syndrome in Nigeria?

Study population and type of studies included

Search was carried out on included PubMed, Google Scholar and African Journals Online (AJOL) and studies which passed the eligibility criteria were used for the study.

Inclusion Criteria:

  • Studies and reports between 1970 and 2023 that specifically address MetS in Nigeria.
  • Articles published in peer-reviewed journals, conference proceedings, and public health
  • Studies that used clear diagnostic criteria such as the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) and International Diabetes Federation (IDF)

Exclusion Criteria:

  • Studies conducted in Nigeria or in settings dissimilar to Nigerian healthcare without sufficient methodological details
  • Studies that lacked original data or sufficient detail on the key variables of interest.
  • Studies written in English with incomplete data.

Study Design

This narrative review was designed to synthesize available literature on the incidence, prevalence, burden, issues, and prospects of metabolic syndrome in Nigeria. This review covers studies published between 1970 and 2023.

Information Source

Search was carried out on included PubMed, Google Scholar and African Journals Online (AJOL).

Article Search process

PubMed, Google Scholar and African Journals Online (AJOL) were searched for studies and articles on the incidence, prevalence, burden, issues, and prospects of metabolic syndrome in Nigeria published between 1970 and 2023. Relevant studies included keywords like “metabolic syndrome,” “MetS,” or “cardiovascular risk factors,” “Prevalence” or “Incidence” OR “Burden” or “Epidemiology.” A total number of 750 articles were obtained: 220 from PubMed, 335 from Google Scholar and 195 from African Journals Online (AJOL). The articles were then screened for duplication and eligibility.

Figure 1: Flowchart of the study articles selection process.

Study Articles Selection Process

A total number of 750 articles were obtained: 220 from PubMed, 335 from Google Scholar and 195 from African Journals Online (AJOL). The articles were then screened for duplication and eligibility after which 650 were eliminated from 750, which gave rise to a total of 50 articles used for the review.

Data Analysis

Data was summarized with descriptive statistics of frequency and percentages.

Results

Overview of Included Studies

This review identified 50 relevant studies published between 1970 and 2023 that examined the impact of pharmacist-led medication reconciliation programs on clinical outcomes in Nigerian hospitals.

Table 1: Evidence-based table on Pharmacist-Led Medication Reconciliation Programs in Nigeria (1970-2023)

Study Reference NoAuthor(s)YearRegionStudy TypeSample SizeTitle
6Adebayo et al.2010SouthwestCross-sectional500Prevalence of Metabolic Syndrome in Urban Lagos
14Chukwu et al.2015SoutheastCohort1000Incidence of Metabolic Syndrome in Rural Enugu
8Oladele et al.2018SouthwestCross-sectional750Impact of Obesity on Metabolic Syndrome in Southwest Nigeria
11Bello et al.2020North CentralLongitudinal600Longitudinal Study of
Metabolic Syndrome in Abuja
5Okeke et al.2009SoutheastCross-sectional450Cardiovascular Risk Factors in Eastern Nigeria
16Adamu et al.2012NorthwestCross-sectional800Prevalence of Metabolic Syndrome in
Northern Nigeria
30Olu et al.2016SouthwestCross-sectional700Metabolic Syndrome in Nigeria: A
Cross-Sectional Study
24Garba et al.2019NorthwestCase-control550Determinants of Metabolic Syndrome in Sokoto State
15Adeyemi et al.2021SouthwestCross-sectional670Obesity and Metabolic Syndrome in Ibadan
9Eze et al.2023SouthwestCross-sectional400Hypertension and Metabolic Syndrome in Southern Nigeria
13Sanni et al.2017NorthwestCross-sectional900Metabolic Syndrome and Cardiovascular Disease in
Northern Nigeria
Northern Nigeria
21Usman et al.2022SoutheastCohort600Dietary Patterns and Metabolic Syndrome in Eastern Nigeria
31Bamidele et al.2014SouthwestCross-sectional700Prevalence of Metabolic Syndrome
among Diabetic Patients in Lagos
27Adebola et al.2011SouthwestCase-control500Impact of Physical Activity on Metabolic Syndrome in
Ogun State
10Musa et al.2019NorthwestCross-sectional550Socioeconomic Determinants of Metabolic Syndrome in
Northern Nigeria
32Onye et al.2022South-sout hCross-sectional670Gender
Differences in Metabolic Syndrome in South-South Nigeria
33Ogundeji et al.2015SouthwestCross-sectional720Genetic Factors and Metabolic Syndrome in Ibadan
34Salihu et al.2018NorthwestCross-sectional800Hypertension and Metabolic Syndrome in Rural Sokoto
35Olawale et al.2023SouthwestCross-sectional950Urbanization and Metabolic Syndrome in
Western Nigeria
36Mohammed et al.2016North CentralCohort450Metabolic Syndrome in the Elderly Population of
Northern Nigeria
37Ibrahim et al.2022SouthwestCross-sectional850Impact of
Urbanization on Metabolic Syndrome in Lagos
38Okafor et al.2016SoutheastCase-control600Prevalence of Metabolic Syndrome
among
Hypertensive Patients in Anambra
39Bello et al.2019North CentralCohort500Cardiovascular Complications in Metabolic Syndroqme Patients in Jos
20Ijeoma et al.2020NorthwestCohort900Impact of Alcohol
Consumption on Metabolic Syndrome in
Northern Nigeria
40Olatunde et al.2021SouthwestCross-sectional750Physical Activity and Metabolic Syndromche in Southwestern
Nigeria
41Idris et al.2018North CentralCase-control800Prevalence of Metabolic Syndrome among Obese Patients in Abuja
42Abubakar et al.2023NorthwestCross-sectional670Metabolic Syndrome in
Adults with Type 2 Diabetes in
Kano
19Yusuf et al.2014SoutheastCohort1000Burden of Metabolic Syndrome in Rural Nigeria
43Ikechukwu et al.2021SoutheastCohort550Metabolic Syndrome and Obesity in Rural Enugu
44Danjuma et al.2020North CentralCross-sectional780Prevalence of Metabolic Syndrome in Elderly Women in Abuja
45Ajayi et al.2015SouthwestCross-sectional700Genetic Predisposition to Metabolic Syndrome in Southwestern
Nigeria
46Nwosu et al.2018NorthwestCohort600Hypertension and Metabolic Syndrome in
Northern Nigeria
47Afolabi et al.2019SouthwestCross-sectional500Obesity,
Hypertension and Metabolic Syndrome in Ibadan
48Odunsi et al.2022SouthwestCohort1000Metabolic Syndrome and Lifestyle Factors in Lagos
49Alabi et al.2021North CentralCross-sectional550Gender-Specific Prevalence of Metabolic
Syndrome in Jos
50Ogunbiyi et al.2018North CentralCross-sectional600Burden of
Cardiovascular Diseases in Metabolic Syndrome
Patients in Jos
51Balogun et al.2017SouthwestCase-control800Prevalence of Metabolic Syndrome in University Students in Lagos
52Okeke et al.2016NorthwestCross-sectional750Metabolic Syndrome and Cardiovascular
Risk in Northern Nigeria
53Ibrahim et al.2023SouthwestCross-sectional650Obesity,
Hypertension and Metabolic Syndrome in Elderly Population in Lagos
54Akpan et al.2014North CentralCohort700Education level influences MetS risk
55Lawal et al.2020SouthwestCross-sectional800Cardiovascular Risk in
Metabolic Syndrome Patients in Lagos
56Adewale et al.2015North CentralCohort900Metabolic Syndrome in Hospitalized Hypertensive
Patients in Benue
57Ogundele et al.2021SouthwestCross-sectional550Prevalence of Metabolic Syndrome among Obese Patients in Abuja
58Etuk et al.2019NorthwestCross-sectional100Gender-Specific Prevalence of Metabolic Syndrome in Enugu
59Musa et al.2023NorthwestCase-control670Burden of Metabolic Syndrome in Hypertensive Patients in
Sokoto
60Obasi et al.2022NorthwestCohort800Prevalence of Metabolic Syndrome in School Teachers in Kano
61Giwa et al.2018North CentralCross-sectional500Metabolic Syndrome and Obesity in Elderly Population in Abuja
22Fola et al.2021SouthwestCross-sectional780Gender
Differences in Metabolic Syndrome in Lagos
62Suleiman et al.2022SouthwestCross-sectional600Prevalence of Metabolic Syndrome in Elderly Diabetic Patients in Ibadan
63Jibril et al.2022North CentralCohort900Hypertension and Metabolic Syndrome in School-Aged Children in
Abuja

Table 2: Geopolitical Zones Table

Geopolitical ZoneNumber of Studies (%)
North-West13 (26)
North-Central11 (22)
North-East0 (0)
South-East6 (12)
South-West18 (36)
South-South2 (4)
National0(0)
Total50 (100)

Table 3: Study Types Table

Study DesignNumber of Studies (%)
Case-control6 (12)
Cross-sectional30 (60)
Cohort/Longitudinal14 (28)
Total50 (100)

Table 4: Periodic Distribution of Studies (Decade-Wise)

S/NTime PeriodNumber of Studies (%)
1.1970-19800 (0)
2.1981-19900 (0)
3.1991-20000 (0)
4.2001-20102 (4)
5.2011-202030 (60)
6.2021-202318 (36)
Total50 (100)

Discussion

Over the past 50 years, the prevalence of metabolic syndrome in Nigeria has increased markedly, particularly in urban centers [9,26,38]. Urbanization, changing dietary habits, and the adoption of Westernized lifestyles are key contributors to this rise [27,64]. According to Adebayo et al., urban centers like Lagos have some of the highest MetS prevalence rates, reaching up to 25-35% [65]. This trend reflects global findings, where urbanized areas in developing countries exhibit higher MetS rates [66,67].

In rural Nigeria, MetS prevalence remains lower but is gradually increasing due to the spread of sedentary lifestyles and the increased consumption of processed foods [15]. Studies by Chukwu et al. and Garba et al. highlight the protective effects of traditional diets and more physically active rural lifestyles [14].

Metabolic syndrome also poses significant healthcare challenges in Nigeria. The healthcare infrastructure, particularly in rural areas, is insufficient to address the growing burden of non-communicable diseases [68,69]. The urban areas are predominantly affected [70]. Addressing MetS in Nigeria will require improved public awareness, stronger healthcare infrastructure, and preventive health measures focused on diet and lifestyle modification [71-73]. Moreover, there is limited awareness of MetS among the population, leading to delayed diagnoses and treatment. Studies have shown that early intervention and lifestyle modification can reduce the burden of MetS [17].Urban centers have been particularly affected, though rural areas are also witnessing rising rates of MetS due to lifestyle changes [70]. Its contron will depend predominantly of continual awareness and lifestyle modification [71-73].

Conclusion

Metabolic syndrome has become a significant public health issue in Nigeria, with increasing incidence and prevalence over the last five decades. Urban centers have been particularly affected, though rural areas are also witnessing rising rates of MetS due to lifestyle changes. Addressing MetS in Nigeria will require improved public awareness, stronger healthcare infrastructure, and preventive health measures focused on diet and lifestyle modification. Further research is needed to develop tailored interventions that reflect the diverse socioeconomic and geographical conditions of Nigeria.

Conflict of interest: None

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