Indicators of optimal diabetes care and burden of diabetes complications in Africa: a systematic review and meta-analysis

Kibirige, Davis; Chamba, Nyasatu; Andia-Biraro, Irene; Kilonzo, Kajiru; Laizer, Sweetness; Sekitoleko, Isaac; Kyazze, Andrew Peter; Ninsiima, Sandra; Ssekamatte, Phillip; Bongomin, Felix; Mrema, Lucy Elauteri; Olomi, Willyhelmina; Mbunda, Theodora D; Ntinginya, Nyanda Elias; Sabi, Issa; Sharples, Katrina; Hill, Philip C.; Brake, Lindsey te; VandeMaat, Josephine; vanCrevel, Reinout; Critchley, Julia

doi:10.1136/bmjopen-2022-060786

Cited by 9 publications

(5 citation statements)

References 130 publications

(292 reference statements)

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“…Using the quality assessment tools for RCTs and observational studies of the National Health Institute/National Heart, Lung, and Blood Institute; five of the RCTs [18][19][20][21][22] were deemed to be of 'good quality' (score of 10-14 in quality assessment tool), 12 of the RCTs [23][24][25][26][27][28][29][30][31][32][33][34] were 'fair quality' (score of 7-9 in quality assessment tool) and the remaining four studies [35][36][37][38] were 'low quality'. Six of the observational studies [39][40][41][42][43][44] were of 'good quality' (score of [10][11][12][13][14], 15 [45][46][47][48][49][50][51][52][53][54][55][56][57][58][59] were of 'fair quality' (score of…”

Section: Resultsmentioning

confidence: 99%

“…The prevalence of diabetes in Sub‐Saharan Africa (hereafter referred to as Africa) has risen rapidly [ 6 , 7 , 8 ], now standing between 3% and 10%, and the largest global increase in prevalence in the next two decades is expected to occur on this continent [ 3 , 9 ]. Diabetes is affecting a younger and a poorer population in Africa than is the case in high‐income countries, with almost 80% of all diabetes‐related deaths occurring before people reach the age of 60 years, and high levels of morbidity from diabetes‐related complications [ 9 , 10 ]. The effective control of diabetes is therefore a major challenge facing health services.…”

Section: Introductionmentioning

confidence: 99%

“…This is difficult in Africa, where health systems have typically focussed on acute management of infectious diseases and are ill‐prepared and ill‐resourced to respond to the chronic nature of care required for diabetes [ 11 , 12 , 13 , 14 ]. The impact of this is seen in the low achievement of optimal diabetes treatment goals in the region [ 10 ]. For patients, the costs of transport and other related expenses can be catastrophic and accessing care regularly for diabetes presents a huge problem [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

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Retention in care for type 2 diabetes management in Sub‐Saharan Africa: A systematic review

Garrib

Njim

Adeyemi

et al. 2023

Tropical Med Int Health

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Objective: Diabetes prevalence has risen rapidly in Sub-Saharan Africa, but rates of retention in diabetes care are poorly understood. We conducted a systematic review and meta-analysis to determine rates of retention in care of persons with type 2 diabetes. Methods: We searched MEDLINE, Global Health and CINAHL online databases for cohort studies and randomised control trials (RCTs) published up to 12 October 2021, that reported retention in or attrition from care for patients with type 2 diabetes in Sub-Saharan Africa. Retention was defined as persons diagnosed with diabetes who were alive and in care or with a known outcome, while attrition was defined as loss from care. Results: From 6559 articles identified, after title and abstract screening, 209 articles underwent full text review. Forty six papers met the inclusion criteria, comprising 22,610 participants. Twenty one articles were of RCTs of which 8 trials had 1 year or more of follow-up and 25 articles were of non-randomised studies of which 19 had 12 months or more of follow-up. A total of 11 studies (5 RCTs and 6 non-randomised) were assessed to be of good quality. Sixteen RCTs were done in secondary or tertiary care settings. Their pooled retention rate (95% CI) was 80% (77%, 84%) in the control arm. Four RCTs had been done in primary care settings and their pooled retention rate (95% CI) was 53% (45%, 62%) in the control arm. The setting of one trial was unclear. For non-randomised studies, retention rates (95% CI) were 68% (62%, 75%) among 19 studies done in secondary and tertiary care settings, and 40% (33%, 49%) among the 6 studies done in primary care settings. Conclusion: Rates of retention in care of people living with diabetes are poor in primary care research settings.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Retention in care for type 2 diabetes management in Sub‐Saharan Africa: A systematic review

Garrib

Njim

Adeyemi

et al. 2023

Tropical Med Int Health

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“…Worldwide, the prevalence of DR and STDR in patients with diabetes was 22.27% and 6.17%, respectively 6. A meta-analysis based on a clinical survey in Africa found that the prevalence of DR ranged from 7.0% to 62.4%, that of proliferative DR from 0% to 6.9% and that of diabetic maculopathy from 1.2% to 31.1% 7 8. Furthermore, the national prevalence of DR in Ethiopia was 19.48% 9…”

Section: Introductionmentioning

confidence: 99%

Sight-threatening diabetic retinopathy and its predictors among patients with diabetes visiting Adare General Hospital in Southern Ethiopia: a hospital-based cross-sectional study

Alemayehu,

Tilahun,

Abebe

et al. 2024

BMJ Open

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ObjectiveThe study aimed to determine the prevalence of sight-threatening diabetic retinopathy and its predictors among patients with diabetes attending Adare General Hospital in Southern Ethiopia.DesignA hospital-based cross-sectional study was conducted using a systematic random sampling method.SettingThe study was conducted at the diabetic clinic of Adare General Hospital in Sidama region, Southern Ethiopia.ParticipantsThe study included 391 patients with diabetes aged ≥18 years who had attended the diabetic clinic of Adare General Hospital in Southern Ethiopia.Main outcome measuresData were collected using questionnaires completed by an interviewer, a review of medical records and eye examinations.ResultThe study included 391 patients with diabetes with a median age of 49 years. The prevalence of sight-threatening diabetic retinopathy was 10.7% (95% CI: 7.7% to 14%). Rural dwellers (adjusted OR (AOR)=2.17, 95% CI: 1.05 to 4.46), duration of diabetes ≥6 years (AOR=2.43, 95% CI: 1.06 to 5.57), poor glycaemic control (AOR=2.80, 95% CI: 1.03 to 7.64), low physical activity (AOR=2.85, 95% CI: 1.01 to 8.05), hypertension (AOR=3.25, 95% CI: 1.48 to 7.15) and diabetic peripheral neuropathy (AOR=3.32, 95% CI: 1.18 to 9.33) were significantly associated with sight-threatening diabetic retinopathy.ConclusionThis study showed a high prevalence of sight-threatening diabetic retinopathy. Sight-threatening diabetic retinopathy was significantly associated with modified factors such as glycaemic control, hypertension, physical activity and diabetic peripheral neuropathy. Therefore, all patients with diabetes were recommended to maintain normal blood glucose, avoid hypertension, exercise regularly and have regular eye examinations.

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“…A review of studies from sub-Saharan Africa reported that the pooled prevalence of patients with T2D categorised as achieving good glycaemic control was 30% (Fina Lubaki et al, 2022). Another review from Africa reported pooled prevalence estimates of 27%, 38% and 42% of optimal glycaemic, blood pressure and LDL-C control, respectively, in patients with T2D (Kibirige et al, 2022). Although these reviews are informative, and highlight the challenge of diabetes control internationally, they are region-specific, spanning 2000-2022, and are restricted to adult patients with T2D.…”

Section: Introductionmentioning

confidence: 99%

Monitoring Global Progress in Core Diabetes Control Metrics: Protocol for a Systematic Review of Prevalence (2015–2023)

McCaffrey,

Jabakhanji,

Mehta

et al. 2024

HRB Open Res

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Background The Global Diabetes Compact is a WHO-sponsored initiative that aims to improve diabetes care and prevention, and to reduce the global burden of diabetes. This includes the goal of monitoring the progress and achievement of country-level diabetes metrics and targets. The objective of this systematic review is to examine population-based studies from 2015–2023 to determine the status of core diabetes control metrics: glycaemic (HbA1c), blood pressure and lipid control (low-density lipoprotein and non-high-density lipoprotein cholesterol), and statin use. This review will describe regional and country-level variation in attainment gaps concerning these indicators. Methods This review will follow the JBI methodological approach to systematic reviews of prevalence, and will be reported using the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. We will include population-based observational studies, conducted in all geographic settings that report data on adult populations (≥18 years) with diagnosed Type 1 or Type 2 diabetes, with no language restrictions. We will search the following databases: Ovid MEDLINE, Embase, Scopus, Cochrane Library, and WHO Global Index Medicus. Using Covidence, two reviewers will independently screen titles and abstracts against eligibility criteria, review potentially relevant full-text articles, and extract data from eligible studies. A third reviewer will resolve any conflicts. Reviewers will use a standardised data extraction form to extract study population, methodological, and outcome data. Primary outcomes are levels of glycaemic, blood pressure, and lipid control, and statin use. Methodological quality of included studies will be assessed using the JBI Critical Appraisal tool for studies reporting prevalence data. Extracted data will be synthesised using descriptive statistics and summarised narratively. Dissemination Findings will be used to inform global diabetes surveillance, prevention, and treatment initiatives. The completed review will be submitted for publication in a peer-reviewed journal, and presented at national and international conferences. PROSPERO registration CRD42024505286 OSF https://doi.org/10.17605/OSF.IO/DZYJK

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Indicators of optimal diabetes care and burden of diabetes complications in Africa: a systematic review and meta-analysis

Cited by 9 publications

References 130 publications

Retention in care for type 2 diabetes management in Sub‐Saharan Africa: A systematic review

Retention in care for type 2 diabetes management in Sub‐Saharan Africa: A systematic review

Sight-threatening diabetic retinopathy and its predictors among patients with diabetes visiting Adare General Hospital in Southern Ethiopia: a hospital-based cross-sectional study

Monitoring Global Progress in Core Diabetes Control Metrics: Protocol for a Systematic Review of Prevalence (2015–2023)

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