Prevalence of pressure ulcers in africa: A systematic review and meta-analysis

Abstract

BackgroundA recent global review of pressure ulcers contained no studies from Africa. ObjectiveTo identify the prevalence and incidence of pressure ulcers in Africa. Data sourcesBibliographic databases, African specific databases, grey literature. Study eligibility criteriaStudies with prevalence or incidence data of pressure ulcers from Africa since the year 2000. ParticipantsAny age, including children, in any setting, specifically including hospital patients from any clinical area but not restricted to hospital settings. Study appraisal and synthesis methodsHoy score for bias, Joanna Briggs Institute Critical Appraisal Instrument. MethodWe followed the PRISMA guideline for systematic reviews. We searched Embase, Medline, Scopus, CINHAL, Google Scholar, specialist African databases and grey literature for studies reporting incidence or prevalence data. ResultsNineteen studies met the inclusion criteria and were included in the study. Point prevalence rates varied from 3.4% to 18.6% for medical/surgical and other general hospital units with a pooled prevalence of 11%, for grades II-IV 5%. For spinal injury units the pooled prevalence was 44%. Limitationsrestricted to English, French and Arabic. ConclusionPrevalence of pressure ulcers in Africa reported here is similar to figures from a recent review of prevalence in Europe and two recent global reviews of hospitalised patients. Prevalence of pressure ulcers in spinal cord injury patients is similar to figures from a review of developing countries. The reporting of prevalence is lacking in detail in some studies. Studies using an observational design employing physical examination of patients showed higher prevalence than those relying on other methods such as medical notes or databases. Implications of key findingsFurther prevalence and incidence studies are needed in Africa. Reporting of such studies should ensure items in the “Checklist for Prevalence Studies” from Joanna Briggs Institute (or similar well regarded resources) are addressed and the PICOS model and PRISMA guidelines are employed. Systematic review registration numberProspero registration number CRD42020180093