A systematic review of diabetes risk assessment tools in sub-Saharan Africa

Abstract

Objectives To systematically review all current studies on diabetes risk assessment tools used in SSA to diagnose diabetes in symptomatic and asymptomatic patients. Methods Tools were identified through a systematic search of PubMed, Ovid, Google Scholar, and the Cochrane Library for articles published from January 2010 to January 2020. The search included articles reporting the use of diabetes risk assessment tool to detect individuals with type 2 diabetes in SSA. A standardized protocol was used for data extraction (registry #177726). Results Of the 825 articles identified, 39 articles met the inclusion criteria, and three articles reported tools used in SSA population but developed for the Western population. None was validated in SSA population. All but three articles were observational studies (136 and 58,657 study participants aged between the ages of 15 and 85 years). The Finnish Medical Association risk tool, World Health Organization (WHO) STEPS instrument, General Practice Physical Activity Questionnaire (GPPAQ), Rapid Eating and Activity Assessment for Patients (REAP), and an anthropometric tool were the most frequently used non-invasive tools in SSA. The accuracy of the tools was measured using sensitivity, specificity, or area under the receiver operating curve. The anthropometric predictor variables identified included age, body mass index, waist circumference, positive family of diabetes, and activity levels. Conclusions This systematic review demonstrated a paucity of validated diabetes risk assessment tools for SSA. There remains a need for the development and validation of a tool for the rapid identification of diabetes for targeted interventions.

Development and validation of a risk assessment tool for uncontrolled type 2 diabetes among patients in South Karnataka, India

“…7 To lessen this impact, India needs an effective, noninvasive screening tool for DM such as the diabetes risk assessment tools, which are convenient and practical for early screening and detection of diabetes to prevent diabetes-related morbidity, lower the cost of healthcare and enhance the quality of life. 8 In recent years, multivariate risk scores have been developed to predict the risk of developing diabetes in healthy individuals. These risk scores are recommended in the most recent practice guidelines for preventing diabetes and are used in prevention programmes in some Western nations.…”

Validation of prevalent diabetes risk scores based on non-invasively measured predictors in Ghanaian migrant and non-migrant populations – The RODAM study

“…Available diabetes risk scores mostly originate from non-African populations and have rarely been validated in people of African ancestry [ 12 , 13 ]. The few validation studies conducted have reported varying predictive performance for different noninvasive diabetes models in sub-Saharan African populations [ 9 , 14 ].…”