BackgroundDiabetes is increasingly becoming a major chronic disease burden all over the world. This requires a shift in healthcare priorities and up-to-date data on the epidemiology and impact of diabetes in all regions of the world to help plan and prioritize health programs. We systematically reviewed the literature on diabetes prevalence and its complications in the UN sub region of Northern Africa including Morocco, Algeria, Tunisia, Libya, Egypt, Sudan, South Sudan and Western Sahara.MethodsA systematic literature review of papers published on diabetes prevalence and complications in North Africa from January 1990 to July 2012. Literature searches were conducted using electronic databases.ResultsDiabetes prevalence ranged from 2.6% in rural Sudan to 20.0% in urban Egypt. Diabetes prevalence was significantly higher in urban areas than in rural areas. Undiagnosed diabetes is common in Northern Africa with a prevalence ranging from 18% to 75%. The prevalence of chronic diabetes complications ranged from 8.1% to 41.5% for retinopathy, 21% to 22% for albuminuria, 6.7% to 46.3% for nephropathy and 21.9% to 60% for neuropathy.ConclusionsDiabetes is an important and common health problem in Northern Africa. Variations in prevalence of diabetes between individual countries are observed. Chronic complications of diabetes are common. Urgent measures are needed to prevent diabetes and its related complications in Northern Africa.

PurposeRadical cystectomy currently is the treatment of choice in muscle-invasive bladder cancer. However, cystectomy is associated with considerable morbidity. Bladder sparing treatment consists of transurethral resection of the tumor (with or without partial cystectomy), external beam radiotherapy, and brachytherapy. The purpose of this study is to compare bladder preservation with brachytherapy to cystectomy by a systematic review.Material and methodsA systematic review was conducted using PubMed electronic database. Article selection was done independently by two authors. Data were extracted on cause-specific survival and overall survival at 2, 5, and 10 years. Comparison of the two treatment modalities was done by a Weibull survival analysis with metaregression analysis and estimation of Hazard Ratio's (HR's) with 95% confidence intervals (CI).ResultsLarge differences in tumor staging and tumor grading were found between cystectomy and bladder sparing series. The adjusted HR's for cause-specific survival and overall survival were 1.27 (95% CI: 1.15-1.40) and 0.85 (95% CI: 0.84-0.87), respectively for bladder sparing relative to radical cystectomy.ConclusionsRobustness of the analysis is hampered by the retrospective character of the study and differences in patient characteristics. For selected cases, bladder sparing by brachytherapy leads to at least similar overall survival compared to radical cystectomy for muscle invasive bladder cancer.