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Dessie G, Mulugeta H, Amare D, Negesse A, Wagnew F, Getaneh T, Endalamew A, Adamu YW, Tadesse G, Workineh A, Lebu S. A systematic analysis on prevalence and sub-regional distribution of undiagnosed diabetes mellitus among adults in African countries. J Diabetes Metab Disord 2020; 19:1931-1941. [PMID: 33553047 PMCID: PMC7843872 DOI: 10.1007/s40200-020-00635-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 09/13/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Despite the high prevalence of diabetes in Africa, the extent of undiagnosed diabetes in the region is still poorly understood. This systematic review and meta-analysis was designed to determine the pooled prevalence of undiagnosed diabetes mellitus among adults in Africa. METHODS We conducted a systematic desk review and electronic web-based search of PubMed, Google Scholar, EMBASE, and the World Health Organization's Hinari portal (which includes the SCOPUS, African Index Medicus, and African Journals Online databases), identifying peer-reviewed research studies on the prevalence of undiagnosed diabetes among adult individuals using pre-defined quality and inclusion criteria. We ran our search from June 1, 2018 to Jun 14, 2020. We extracted relevant data and presented descriptive summaries of the studies in tabular form. The I2 test was used to assess heterogeneity across studies. A random effects model was used to estimate the pooled prevalence of undiagnosed diabetes mellitus at a 95% confidence interval (CI). Funnel plot asymmetry and Egger's tests were used to check for publication bias. The final effect size was determined by applying a trim and fill analysis in a random-effects model. RESULTS Our search identified 1442 studies amongst which 23 articles were eligible for inclusion in the final meta-analysis. The average pooled prevalence of undiagnosed diabetes mellitus among adults was 3.85 (95% CI: 3.10-4.60). The pooled prevalence of undiagnosed diabetes mellitus based on geographic location was 4.43 (95% CI: 3.12-5.74) in Eastern Africa; 4.72 (95% CI: 2.64-6.80) in Western Africa; 4.27 (95% CI: 1.77-6.76) in Northern Africa and 1.46 (95%CI: 0.57-2.34) in southern Africa respectively. CONCLUSION Our findings indicate a high prevalence of undiagnosed diabetes in Africa and suggest that it may be more prevalent in Western Africa than the rest of the regions. Given the high levels of undiagnosed diabetes in the Africa region, more attention should be paid to incorporating diabetes screening and treatment services into existing diabetes related programs to reduce the prevalence of undiagnosed cases.
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Affiliation(s)
- Getenet Dessie
- Department of Nursing, School of Health Science, College of Medicine and Health Science, Bahr Dar University, Bahr Dar, Ethiopia
| | - Henok Mulugeta
- grid.449044.90000 0004 0480 6730Department of Nursing, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Desalegne Amare
- Department of Nursing, School of Health Science, College of Medicine and Health Science, Bahr Dar University, Bahr Dar, Ethiopia
| | - Ayenew Negesse
- grid.449044.90000 0004 0480 6730Department of Human Nutrition and Food Science, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Fasil Wagnew
- grid.449044.90000 0004 0480 6730Department of Nursing, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Temsgen Getaneh
- grid.449044.90000 0004 0480 6730Department of Midwifery, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Akililu Endalamew
- Department of Nursing, School of Health Science, College of Medicine and Health Science, Bahr Dar University, Bahr Dar, Ethiopia
| | - Yibeltal Wubale Adamu
- Department of Biomedical Science, College of Medicine and Health Science, Bahr Dar University, Bahr Dar, Ethiopia
| | - Gizachew Tadesse
- Department of Biostatics and Epidemiology, School of public health, College of Medicine and Health Science, Bahr Dar University, Bahr Dar, Ethiopia
| | - Aster Workineh
- grid.47840.3f0000 0001 2181 7878School of Public Health, University of California, Berkeley, Berkeley, CA USA
| | - Sarah Lebu
- grid.47840.3f0000 0001 2181 7878School of Public Health, University of California, Berkeley, Berkeley, CA USA
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