Prevalence of Type 2 Diabetes in South Africa: A Systematic Review and Meta-Analysis.

Carmen Pheiffer,Debbie Bradshaw,Eunice Turawa,Victoria Pillay-Van Wyk,Andre P Kengne,Naomi Levitt

doi:10.3390/ijerph18115868

Abstract

Synthesis of existing prevalence data using rigorous systematic review methods is considered an effective strategy to generate representative and robust prevalence figures to inform health planning and policy. The purpose of this systematic review was to identify, collate, and synthesise all studies reporting the prevalence of total and newly diagnosed type 2 diabetes (T2DM), impaired glucose tolerance (IGT), and impaired fasting glucose (IFG) in South Africa. Four databases, PubMed, Scopus, Web of Science, and African Index Medicus were searched for articles published between January 1997 and June 2020. A total of 1886 articles were identified, of which 11 were included in the meta-analysis. The pooled prevalence in individuals 25 years and older was 15.25% (11.07–19.95%) for T2DM, 9.59% (5.82–14.17%) for IGT, 3.55% (0.38–9.61%) for IFG, and 8.29% (4.97–12.34%) for newly diagnosed T2DM. Although our pooled estimate may be imprecise due to significant heterogeneity across studies with regard to population group, age, gender, setting, diagnostic test, and study design, we provide evidence that the burden of glucose intolerance in South Africa is high. These factors contribute to the paucity of representative T2DM prevalence data. There is a need for well-designed epidemiological studies that use best-practice and standardised methods to assess prevalence.

Highlights

Diabetes mellitus is an escalating public health crisis and among the top ten leading causes of death worldwide [1]
Africa is already grappling with high rates of communicable diseases such as human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) and tuberculosis (TB) [3], diabetes poses a serious health and economic burden to these already overburdened and under-resourced health systems
SANHANES and SADHS were conducted across different provinces, geographical locations, and population groups as defined by South African birth and death notification registries [29]

Summary

Introduction

Diabetes mellitus is an escalating public health crisis and among the top ten leading causes of death worldwide [1]. The condition affects approximately 451 million adults worldwide, with projections of 693 million cases by 2045 [2]. The largest relative increase is predicted for Africa, where in 2017, 15.5 million adults had diabetes, with 69.2% of people unaware of their diabetic status. Africa is already grappling with high rates of communicable diseases such as human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) and tuberculosis (TB) [3], diabetes poses a serious health and economic burden to these already overburdened and under-resourced health systems. To achieve the United Nations’ Sustainable Development Goal 3.4, which aims to reduce premature mortality from non-communicable diseases (NCDs) by a third by 4.0/).

Results

Discussion

Conclusion