Abstract
Background The prevalence of diabetes is rapidly increasing in Africa. Type two diabetes may remain undetected for many years, leading to severe complications and healthcare costs. This underlines the importance of understanding the magnitude of undiagnosed diabetes in different populations of Africa. This study is intended to summarize and pool the results of community-based studies to provide a continental level estimate of the undiagnosed diabetes mellitus. Methods We searched MEDLINE/PubMed, HINARI, Cochrane Library, and Google Scholar for community-based studies on diabetes mellitus in Africa. Descriptive information for the original studies was presented in a table, and the quantitative results were presented in forest plots. The Cochran's Q test and I2 test statistic were used to test heterogeneity across studies. The pooled prevalence of undiagnosed diabetes and subgroup analyses within urban and rural population and diagnostic methods were computed by a random effects model from 2011 to 2017. Results One hundred fifty-seven articles were identified through electronic searching using keywords. Of these, seventeen studies, with a total population of 20,350, met the inclusion criteria. A random effects meta-analysis showed that the pooled prevalence of undiagnosed diabetes mellitus in African population was 5.37% (95% CI: 4.57, 6.81). The pooled prevalence from subgroup analyses indicated that undiagnosed diabetes mellitus in the urban population (8.68%, 95% CI: 5.33, 12.03) is twice higher than that in the rural population (3.93%, 95% CI: 2.91, 4.95). The prevalence of UDM by OGTT (8.84%, 95% CI: 1.95, 15.73) was higher than that by the FPG diagnostic method (4.54%, 95% CI: 3.59, 5.49). Conclusion This study found high proportions of undiagnosed diabetes mellitus in different communities of the African countries. Policy makers must consider diagnostic strategies to improve screening for the undiagnosed diabetes mellitus cases for effective care, which can bring about a substantial reduction in diabetes-related complications and mortality. This review is registered with PROSPERO registration number CRD42018092637.
Highlights
Diabetes mellitus (DM) with other noncommunicable diseases is responsible for an increasing burden of diseases in developing countries
We identified one hundred fifty-seven articles by the electronic search in MEDLINE/PubMed, Google Scholar, HINARI, and Cochrane Library
The study populations varied from 382 studies done in Tanzania [16] to 4371 in Ethiopia [21], and these studies were conducted between the years 2011 and 2017
Summary
Diabetes mellitus (DM) with other noncommunicable diseases is responsible for an increasing burden of diseases in developing countries. 45.8% of all diabetes cases, or 174.8 million people, are estimated to have undiagnosed diabetes mellitus (UDM) in 2013 [4]. Type two diabetes may remain undetected for many years, leading to severe complications and healthcare costs This underlines the importance of understanding the magnitude of undiagnosed diabetes in different populations of Africa. This study is intended to summarize and pool the results of community-based studies to provide a continental level estimate of the undiagnosed diabetes mellitus. The pooled prevalence of undiagnosed diabetes and subgroup analyses within urban and rural population and diagnostic methods were computed by a random effects model from 2011 to 2017. A random effects metaanalysis showed that the pooled prevalence of undiagnosed diabetes mellitus in African population was 5.37% (95% CI: 4.57, 6.81).
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