Abstract
BackgroundDespite 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.MethodsWe 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.ResultsOur 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.ConclusionOur 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.
Highlights
Diabetes mellitus (DM) is a broad term used to describe chronic metabolic disorders leading to prolonged hyperglycemia
J Diabetes Metab Disord (2020) 19:1931–1941 should be paid to incorporating diabetes screening and treatment services into existing diabetes related programs to reduce the prevalence of undiagnosed cases
The electronic databases searched were PubMed, Google Scholar, Embase, and World Health Organization (WHO) database portal for LMICs that includes the Web of Science, SCOPUS, African Index Medicus (AIM), Cumulative Index to Nursing and Allied Health Literature (CINAHL), WHO’s Institutional Repository for Information Sharing (IRIS) and African Journals Online databases
Summary
Diabetes mellitus (DM) is a broad term used to describe chronic metabolic disorders leading to prolonged hyperglycemia It is generally classified into 2 main types depending on disease development mechanism [1]. Type 1 DM is not fully understood but is generally due to environmental and genetic factors triggering an autoimmune destruction of β-cells that leads to absolute insulin deficiency. It usually develops during childhood and adolescence. Type 2 DM is characterized by insufficient insulin production as well as insulin resistance with the body unable to effectively use the insulin it produces It is normally diagnosed after the fourth decade of life due to its slow progression and accounts for 90% of all diabetes worldwide [1, 2].
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