Globally, the proportion of non-communicable diseases (NCDs) deaths is predicted to rise from 59% in 2002 to 69% of all deaths by 2030 (1). The NCDs profile has been suggested to be changing rapidly globally. For example, the growing patterns of the elderly, economic growth, and rapid urbanization, which characterized a shift in dietary patterns and a lack of physical activity, resulted in an increase in NCD morbidity and mortality worldwide [2-4]. Furthermore, the interconnected risk factors resulting from lifestyle, such as elevated blood pressure (BP), waist circumference (WC), blood sugar, and low high-density lipoprotein (HDL) cholesterol, are among the leading risk factors for NCDs in Africa. In addition, insulin resistance (IR) and high levels of leptin are said to be underlying markers of metabolic syndrome risk factors in the African population [5]. However, such evidence is limited in the rural South African population, of which the majority of the population labels death from the NCDs as witchcraft.
 
The rapid changes of the NCDs risk factor profiles were also evident in Ellisras rural community over time in the past. For example, undernutrition amongst Ellisras children was over 50% in the period 1996 to 2003, with most children categorized in the ectomorphic mesomorph category [6,7]. The prevalence of Type 2 diabetes mellitus (T2DM) was non-existent in the same population during the same period. However, the level of physical fitness and physical activity was extremely low for girls when compared to boys and other children of the same age studied in urban areas [8]. It was clear from previous analysis of this population that the prevalence of hypertension was emerging [4;8;9]. At present, the same group of young adults exhibits a high prevalence of hypertension. Furthermore, Metabolic syndrome seems to be already entrenched even in the rural communities in Ellisras community with females being the most vulnerable population group [10].

The concepts of relying on indigenous knowledge systems to combat NCDs amongst rural South African populations will be replaced by well-researched concepts. The SANDP vision for 2030 (11) highlights key recommendations for reducing the prevalence of NCD by 28% in 2030, which are all mirrored in the World Heart Federation, though they focus on reducing the NCDs prevalence by 25% in 2025 (12). The targeted diseases include, among others, cardiovascular diseases, diabetes, cancer, and chronic respiratory diseases. The risk factors to be targeted include tobacco smoking, physical inactivity, raised blood pressure, raised blood glucose, obesity, and raised cholesterol.
  

The community must make strides to shift from the traditional knowledge and medication, and seek new innovative ways of addressing issues facing the population concerning obesity, overweight, hypertension, health, smoking cessation, alcohol abuse, and low physical activity in line with a healthy living lifestyle. Changing lifestyle away from unhealthy risk behaviors should be encouraged in individuals, which will ultimately affect community members. Several quality study design results should be made available to provide evidence in combating these NCDs in the South African population.
To that effect, the 4th Ellisras Longitudinal Study and other non-communicable Diseases studies International Conference (ELSONCDSIC) is scheduled for the 25 to 27 November 2025 at the University of Limpopo and Kauletsi Village, Lephalale. The 4th ELSONCDIC will provide a unique inclusive platform for discussion by ordinary members of the Ellisras community, expert scholars, students, and experienced professionals from places all over the world, offering a truly, special international networking experience. A comprehensive and interactive programme in which participants can cultivate their cross-cultural and communication skills while shining a light on different topics related to poverty and cardiovascular diseases. To let the programme have a long-lasting effect on the conference participants as well as the Ellisras/Lephalale communities, as the knowledge gained will be taken back to our respective communities and families.

References

1. Mathers CD, Loncar D (2006) Projection of global mortality and burden of diseases from 2002 to 2030. PLos Med 3:e442
2. NCD Risk factor Collaboration (NCD-RisC)- Africa Working group. (2017). Trends in obesity and diabetes across regions in Africa from 1980 to 2014: an analysis of pooled population-bases studies. International Journal of Epidemiology, doi.10.1093/ije/dys078
3. Miranda JJ, Kinra S, Casas JP, Smith GD, Ebrahim S. (2009) Non-communicable diseases in low and middle-income countries: context determinants and health policy. Trop Med Int Health 13 (10):1225-1234
4. Monyeki, K.D. and Kemper, H.C. 2008. The risk factors for elevated blood pressure and how to address cardiovascular risk factors: A review in paediatric populations. Journal of Human Hypertension, 22:450–459.
5. De Gusmao Correia ML, Haynes WG. (2004). Leptin, obesity and cardiovascular diseases. Current Opinion in Nephrology and Hypertension, 13:215−223.
6. Monyeki, K.D., Toriola, A.L., De Ridder, J.D., Kemper, H.C., Steyn, N.P., Nthangeni, M.E., Twisk, J.W. and Lenthe, F.V. 2002. Stability of somatotypes in 4 to 10 year-old rural South African girls. Annals of Human Biology, 29:37–49.
7. Makgae, P.J., Monyeki, K.D., Brits, S.J., Kemper, H.C. and Mashita, J. 2007. Somatotype and blood pressure of rural South African children aged 6–13 years: Ellisras Longitudinal Growth and health study. Annals of Human Biology, 34:240–251.
8. Matshipi, M., Monyeki, K.D. and Kemper, H. 2017. The Relationship between physical activity and plasma glucose level amongst Ellisras Rural young adult males and females: Ellisras Longitudinal Study. International Journal of Environmental Research and Public Health, 14:198. [doi: 10.3390/ijerph14020198].
9. Sekgala, M.D., Monyeki, K.D., Mogale, M.A. and Ramoshaba, N.E. 2017. Performance of blood pressure to height ratio as a screening tool for elevated blood pressure in rural children: Ellisras Longitudinal Study. Journal of Human Hypertension. [doi: 10.1038/jhh.2017.25]
10. Sekgala MD, Mchiza ZJ , Parker W, Monyeki KD Dietary Fiber Intake and Metabolic Syndrome Risk Factors among Young South African Adults Nutrients 2018, 10, 504; doi:10.3390/nu10040504
11. National Development plan vision for 2030. National Planning Commission: National Development plan. Republic of South Africa: Pretoria 2011
12. WHO. Cardiovascular Diseases [Internet]. 2017. Available from: https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)