Systematic review finds sparse, heterogeneous evidence on hypertension’s economic burden in Sub-Saharan Africa

A systematic literature review found that evidence on the economic burden of hypertension in Sub-Saharan Africa remains sparse and highly heterogeneous. Researchers identified 22 studies published between 2021 and 2024, including 21 studies not included in a previous review, and reported costs ranging widely according to the perspective, time horizon and categories examined. The review was published in BMC Public Health.

The analysis focused on peer-reviewed cost-of-illness estimates for hypertension in adults aged 18 years or older in Sub-Saharan Africa. Investigators searched Medline, Embase and the Global Health database for English-language studies published from 2021 through 2024, using a PICOS framework and economic and hypertension-related search terms. The authors converted reported costs to 2024 international dollars using purchasing power parities and assessed study quality. The review is an update to the first systematic review of hypertension’s economic burden in the region, which had included 33 studies.

Among the included studies, more than half were conducted in East Africa, while no studies were identified from Central Africa. Four studies reported monthly direct medical costs from a patient perspective; those estimates ranged from $1.39 to $179.52. Another four reported annual mean costs per patient per year, ranging from $154.00 to $1,010.27. The review also summarized costs reported from provider, health-system and societal perspectives, expressed as per-visit, lifetime or aggregate national costs. Differences in study time horizons, costing perspectives and cost categories contributed to substantial variation across the evidence base.

The findings indicate that available cost estimates are not directly uniform, limiting comparisons between studies and countries. The review’s geographic coverage was also uneven, with no identified studies from Central Africa and a concentration of research in East Africa. Because the authors identified relatively few studies and observed marked heterogeneity in costs and study methods, the reported ranges should be interpreted within the specific perspectives and populations used in the underlying studies. The authors concluded that more standardized and comprehensive cost-of-illness studies are needed to support decision-making, budget allocation and comparisons within and across countries, and to allow best practices to be shared where applicable.

Subject of Research: Cost-of-illness evidence for hypertension in Sub-Saharan Africa

Article Title: The economic burden of hypertension in Sub-Saharan Africa: a systematic literature review

Article References: Muchenje, W., Stokes, E. A., Ek Wild, C., & Luengo-Fernandez, R. (2026). The economic burden of hypertension in Sub-Saharan Africa: a systematic literature review. BMC Public Health. https://doi.org/10.1186/s12889-026-29671-5

Image Credits: AI Generated

DOI: 10.1186/s12889-026-29671-5

Keywords: hypertension, Sub-Saharan Africa, economic burden, cost of illness, systematic review, health economics, noncommunicable diseases, health systems, economic, burden, Sub-Saharan, Africa