Abstract:
BACKGROUND : The prevalence of chronic conditions such as obesity, hypertension, and diabetes is increasing in African countries.
Many chronic diseases have been linked to risk factors such as poor diet and physical inactivity. Data for these behavioral risk
factors are usually obtained from surveys, which can be delayed by years. Behavioral data from digital sources, including social
media and search engines, could be used for timely monitoring of behavioral risk factors.
OBJECTIVE : The objective of our study was to propose the use of digital data from internet sources for monitoring changes in
behavioral risk factors in Africa.
METHODS : We obtained the adjusted volume of search queries submitted to Google for 108 terms related to diet, exercise, and
disease from 2010 to 2016. We also obtained the obesity and overweight prevalence for 52 African countries from the World
Health Organization (WHO) for the same period. Machine learning algorithms (ie, random forest, support vector machine, Bayes
generalized linear model, gradient boosting, and an ensemble of the individual methods) were used to identify search terms and
patterns that correlate with changes in obesity and overweight prevalence across Africa. Out-of-sample predictions were used to
assess and validate the model performance.
RESULTS : The study included 52 African countries. In 2016, the WHO reported an overweight prevalence ranging from 20.9%
(95% credible interval [CI] 17.1%-25.0%) to 66.8% (95% CI 62.4%-71.0%) and an obesity prevalence ranging from 4.5% (95%
CI 2.9%-6.5%) to 32.5% (95% CI 27.2%-38.1%) in Africa. The highest obesity and overweight prevalence were noted in the
northern and southern regions. Google searches for diet-, exercise-, and obesity-related terms explained 97.3% (root-mean-square
error [RMSE] 1.15) of the variation in obesity prevalence across all 52 countries. Similarly, the search data explained 96.6%
(RMSE 2.26) of the variation in the overweight prevalence. The search terms yoga, exercise, and gym were most correlated with
changes in obesity and overweight prevalence in countries with the highest prevalence.
CONCLUSIONS : Information-seeking patterns for diet- and exercise-related terms could indicate changes in attitudes toward and
engagement in risk factors or healthy behaviors. These trends could capture population changes in risk factor prevalence, inform
digital and physical interventions, and supplement official data from surveys.
