Prevalence and Predictors of Gestational Diabetes Mellitus in Sub-Saharan Africa: A 10-Year Systematic Review

BACKGROUND

Gestational diabetes mellitus (GDM) remains a global public health problem, which affects the well-being of mothers and their children in sub-Saharan Africa (SSA). Studies conducted in different geographical areas provide varied results on its prevalence and predictors. Understanding the extent and predictors of GDM in SSA is important for developing effective interventions and policies. Thus, this review aimed to investigate the prevalence of GDM and its predictive factors in sub-Saharan Africa.

METHODS

We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards in this review. An extensive search of the PubMed, Web of Sciences and EMBASE databases was carried out covering papers from 2012 to 2022 to assess the prevalence and predictors of GDM. Microsoft Excel 2019 was utilised for study management. GraphPad Prism Version 8.0 and the MedCalc statistical software were employed for data analysis. The findings were analysed using textual descriptions, tables, forest plots and heat maps.

RESULTS

Using 30 studies with 23,760 participants that satisfied the inclusion criteria, the review found the overall prevalence of GDM in SSA to be 3.05% (1.85%-4.54%). History of preterm delivery, alcohol consumption, family history of diabetes, history of stillbirths, history of macrosomia, overweight or obesity and advanced mother age were all significant predictors of gestational diabetes. Additionally, various biomarkers such as haemoglobin, adiponectin, leptin, resistin, visfatin, vitamin D, triglycerides and dietary intake type were identified as significant predictors of GDM.

CONCLUSION

In sub-Saharan Africa, there is a high pooled prevalence of gestational diabetes mellitus. In the light of the predictors of GDM identified in this review, it is strongly recommended to implement early screening for women at risk of developing gestational diabetes during their pregnancy. This proactive approach is essential for enhancing the overall well-being of both mothers and children.

Soluble fluoride levels in drinking water-a major risk factor of dental fluorosis among children in Bongo community of Ghana

BACKGROUND

The purpose of the study was to investigate the relationship between fluoride ions in drinking water and the incidence of dental fluorosis in some endemic areas of Bongo District, Ghana.

METHOD

Two hundred children were randomly selected from various homes and taken through a questionnaire. Their teeth were examined for the detection of dental fluorosis using the Dean's specific index. Samples of their permanent sources of water were taken for the determination of soluble fluoride levels by SPADNS spectrophotometric method.

RESULTS

The study revealed that the incidence of dental fluorosis among the children in the main Bongo township was 63.0%, whereas villages outside the township recorded less than 10.0%. The respondents from the various communities had similar age group, educational background, sources of drinking water, oral hygiene habits and usage of oral health products, p-value > 0.05. However, there were statistically significant differences in the cases of dental fluorosis and fluoride ions among the communities, p-value < 0.05. The fluoride ion concentration in the Bongo township was above the WHO requirement of 1.50 ppm, whereas the nearby villages showed acceptable fluoride levels. Statistically, there was no significant relationship between the presence of dental fluorosis and the other characteristics, except the age group and fluoride ion concentration of the area.

CONCLUSION

These findings strongly support the association between the dental fluorosis and the high fluoride levels in the underground water of Bongo community. Therefore, policy makers need to consider an alternative source of drinking water for the area.