Older people in Sierra Leone face ‘ticking time bomb’ says health study report

Sierra Leone Telegraph: 17 September 2020:

Three-quarters of people over-40 in Sierra Leone have at least one health factor that could contribute to cardiovascular disease – creating a ‘ticking time bomb’ of death and disability in one of the world’s poorest counties, a new study reveals.

Researchers found that cardiovascular disease risk factors (CVDRFs) such as hypertension, diabetes and obesity are much more common in Sierra Leone than expected, whilst access to health care for these conditions is low.

The experts also warn that older people with such multi-morbidity are more likely to contract COVID-19, making getting on top of these conditions useful in reducing the impact of current and future pandemics.

Led by researchers at the University of Birmingham and funded by the Wellcome Trust, the group includes experts in Sierra Leone, USA and UK – publishing its findings in BMJ Open and noting that in the over 40s:

Hypertension was seen in over 50% of the population; Smoking is very common (around 25%), especially among younger men; Some 25% of people are obese or overweight; Access to care for individuals with diabetes and hypertension is low – fewer than 10% of sufferers are being adequately treated for these conditions.

They also discovered that CVDRFs are more prevalent among people living in urban areas, women, educated, unmarried, and relatively wealthier individuals – all of whom are more likely to receive care for these health conditions.

Dr. Maria Lisa Odland, from the University of Birmingham’s Institute of Applied Health Research, commented: “Hypertension, diabetes and obesity are much more common than expected and access to care for these conditions is low. This is likely to result in premature death and disability and needs urgent attention from health authorities and policy makers.

“Over half of Sierra Leone’s over-40s have high blood pressure and most are not receiving any treatment for this. This alone is a health disaster in the making – a ticking time bomb of death and disability given the strong associations between stroke and high blood pressure.”

Much of Sierra Leone’s health funding comes from overseas aid. In 2017, Sierra Leone received $30 million in aid to tackle HIV/AIDS, yet by comparison received $510,000 for non-communicable diseases, including CVDRFs. Attention has been recently focussed on maternal and new-born health and infectious diseases, such as Ebola.

Professor Justine Davies, also from the University’s Institute of Applied Health Research, commented: “Our research has already informed a national non-communicable disease plan in Sierra Leone, but health system funders need to recognise the extent of the problem with CVDRFs in order to save lives and promote economic wealth.

“With its under-developed health system and high levels of poverty, Sierra Leone can ill-afford to be surprised by an epidemic of non-infectious diseases. We hope our research will help the Ministry of Health and external funders acknowledge what major issues CVDRFs, lifestyle changes and lack of access to care are in Sierra Leone.”

Professor Davies added that the group’s findings highlighted that forthcoming policies in Sierra Leone would need to consider nutritional strategies to prevent CVDRF and try to reduce impacts on the health services of treating these diseases. Future interventions should consider how to develop and enhance awareness about CVDRFs and their consequences.

Non-communicable diseases (NCDs) such as cardiovascular disease and its risk factors are major global health problems. Reduction in deaths from infections has led to an aging population moving towards a high-calorie, low-activity, urban lifestyle – causing a rising prevalence of NCDs in lower and middle income countries (LMICs).

High blood pressure has become the world’s largest contributor to early death, and cardiovascular diseases such as coronary heart disease and stroke are the most common NCDs, globally responsible for an estimated 17.8 million deaths in 2017. More than three quarters of these deaths were in LMICs.

About the study

‘Prevalence and access to care for cardiovascular risk factors in older people in Sierra Leone: A cross-sectional survey’ – Maria Lisa Odland, Tahir Bockarie, Haja Wurie, Rashid Ansumana, Joseph Lamin, Rachel Nugent, Ioannis Bakolis, Miles Witham and Justine Davies is published by BMJ Open.

Participating research partners include: University of Sierra Leone; Mercy Hospital Research Laboratory, Freetown, Sierra Leone; RTI International, Seattle, USA; University of Warwick, UK; King’s College London, UK; Newcastle University, UK; and Newcastle Upon Tyne Hospitals NHS Foundation Trust, UK.

The University of Birmingham is ranked amongst the world’s top 100 institutions. Its work brings people from across the world to Birmingham, including researchers, teachers and more than 6,500 international students from over 150 countries.


  1. Life expentacy in Sierra Leone in 1969 was almost 36 years. As of 2018 that figure have gradually jumped to 54 years. A Japanese national will live twenty to thirty years more than the average Sierra Leonean. This report that highlights the curable cardiovascular diseases that affect the average Sierra Leonean like diabetes, high blood pressure and obesity are all due to poverty and lack of critical care in our health service. Our health and social care is one of the worst in the region. Now if you ever wonder why our politicians seek medical treatment abroad, look no further.

    Thousands of Sierra Leoneans die needlessly both old and young, each year because, let us face it, our politicians only care about their own well-being rather the health of the nation. It seems like in every human index survey, our country is always posting records as one of the least performing countries in the world. Our corrupt politicians have always made sure our country is always competing for the last place. These life and death issues affect every Sierra Leonean family. Instead of tackling corruption and debating how to address these critical issues, we spend more time debating endlessly, about who is up or down in the two major political parties – APC and SLPP.

    In the process we lose focus on what really matters to us. Partisan politics, regionalism and tribalism and ignoring the real issues affecting our country is what we as Sierra Leoneans are good at. Maybe it is about time we start debating about the real issues in our country.The best way to start a conversation with a Sierra Leonean is POLITICS. Tribal politices have brought us nothing but misery and war. Now you can add disease as well. May God bless Sierra Leone.

  2. These health research findings are heart rending and troubling as most of those afflicted are not even aware of these disease and ailments. This also requires a holistic approach especially in our tertiary institutions with emphases in the studies of the Allied Health sciences especially in the Nutritional sciences and Sports and Exercises sciences/Exercise Physiology sciences. These studies require an extensive restructuring within our tertiary institutions with availability of the necessary laboratory facilities and lecturers for these courses and encouraging students to study these courses. I am a graduate since 2009/10 of the Bachelor of Sports and Exercise Science from the Southern Cross UNIVERSITY, AUSTRALIA and I know what I am saying.

    These silent killer diseases are real and killing people all over the world and we need our leaders and educational authorities to take these findings very seriously and try to find solutions including educating about lifestyle changes within the populace of Mama salone. May God almighty help us to find practical solutions TO these findings/research.

    • Mr Senessie Junior Bioma you are right. There are lot of diseases that can be avoided by good nutrition and exercise. If anything the COVID19 pandemic has proved one thing. To be in a sedentary position and eating unhealthy foods is one of the main causes of obesity. The primary effects of that is breathing problems, high blood pressure, diabetes, cancers and mental health issues. Yes research should be carried out as to why our population are susceptible to all these diseases. My own point is clear, you can’t rule out poverty and lack of investment to communities affected.

      Take the Aboriginal communities in Australia. Why are they susceptible to diseases that are clearly not rampant amongst the white Australian population? Poverty and neglect. Take a trip to Alice Spring in the outback of Australia and see how the Aboriginal population lives. In the UK and USA people of ethnic minorities died more per share of the population in this COVID19 pandemic. So I was horrified not so long ago when the APC government wanted to ban group RUNNING. EXERCISE IS THE BEST. So government investment is crucial in preventing some of these diseases. But what do we know; when our country is in the hands of corrupt leaders.

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