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Health services research
Protocol
Integrated management of type 2 diabetes and gestational diabetes within multi-morbidity conditions in Africa: a systematic review protocol
  1. Jean Claude Mutabazi1,2,
  2. Mahmoud M Werfalli3,
  3. Angeli Rawat4,
  4. Ezekiel Musa3,5,
  5. Shane A Norris5,6,
  6. Katherine Murphy3,5,
  7. Helen Trottier7,8,
  8. Naomi Levitt3,5,
  9. Christina Zarowsky2,7
  1. 1 Département de Médecine Sociale et Préventive - Santé Mondiale, École de Santé Publique, Université de Montréal, Montréal, Quebec, Canada
  2. 2 École de santé publique, Université de Montréal, Institut de Recherche en Santé Publique de l’Université de Montréal (IRSPUM), Montreal, Quebec, Canada
  3. 3 Department of Medicine, Faculty of Health Science, University of Cape Town, Chronic Disease Initiative for Africa, Cape Town, South Africa
  4. 4 School of Population and Public Health, University of British Colombia, Vancouver, British Columbia, Canada
  5. 5 Department of Medicine, Faculty of Health Science, University of Cape Town, Integrated Intervention for DIAbetes risks after GestatiOnal diabetes (IINDIAGO), Cape Town, South Africa
  6. 6 Paediatrics and Child Health, University of Witwatersrand, Johannesburg, South Africa
  7. 7 Médecine Sociale et Préventive, École de Santé Publique, Université de Montréal, Montréal, Quebec, Canada
  8. 8 Centre de Recherche du Centre Hospitalier Universitaire Sainte Justine, Montréal, Quebec, Canada
  1. Correspondence to Jean Claude Mutabazi; mutajeanc{at}yahoo.fr

Abstract

Introduction Multi-morbidity, defined as the co-existence of more than one chronic condition in one person, has been increasing due to comorbid non-communicable and infectious chronic diseases (CNCICDs). Type 2 diabetes (T2D) and gestational diabetes mellitus (GDM) incidences within the CNCICDs conditions are increasing and overwhelming already weak and under-resourced healthcare systems in Africa. There is then an urgent need for the integrated management of CNCICDs. We aim to review the integrated management of T2D and GDM within multi-morbidity conditions in Africa.

Methods Studies that have assessed the integrated management of T2D and GDM within multi-morbidity conditions in Africa will be considered based on the Population, Intervention, Comparator and Outcome method: population (adult diagnosed with T2D and GDM, who also have other diseases, non-communicable diseases (NCDs) and infectious, in public primary and secondary healthcare facilities in Africa); Intervention (integrated management of T2D and GDM, also suffering from other diseases in Africa), Comparator (Unintegrated management of T2D and GDM in Africa) and Outcomes (integrated management of T2D and GDM in Africa). The following databases Cochrane Library, MEDLINE, PubMed and SCOPUS, the WHO International Clinical Trials Registry Platform, among others will be searched. Two reviewers (JCM and MW) will independently screen, select eligible studies and extract data. Discrepancies will be resolved by consensus or by a discussion with the third author (AR). Quality of included studies will be assessed using both the newly developed tool, ‘the Cochrane Collaboration Risk of Bias Tool’ and ‘Risk Of Bias In Non-randomised Studies - of Interventions (ROBINS-I)”. A narrative synthesis of extracted data and meta-analysis, if necessary will be conducted and then reported according to the preferred reporting items for systematic review and meta-analysis.

Ethics consideration and dissemination By only using the published data, there is no ethics approval required for this study. This systematic review will be included in JCM’s PhD thesis and its findings will also be disseminated through peer-reviewed publication and conference presentation.

PROSPERO registration number CRD42016046630.

  • type 2 diabetes
  • gestational diabetes
  • multi-morbidity
  • integrated care
  • Africa

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjopen-2018-023684

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    Footnotes

    • Contributors JCM and MW designed the study. JCM wrote the first manuscript of the review. JCM, MW, AR, EM, KM, NS, HT, NL and CZ critically revised the review. All authors read and approved the final manuscript. JCM is an MHA, MSc, MA, MPhil and PhD candidate in Public Health-Global Health. MW is an MD, MPH and PhD candidate in Public Health. AR is an MPH and PhD in Healthcare and Epidemiology-Global Health. EM is an MBBS and Fellow of West African College of Physicians (FWACP) in Internal Medicine-Endocrinology. KM is a BA, HDE, PGDip. in Health Promotion and PhD in Public Health. NS is a BSc, BSc (Hon.) and PhD in Health Sciences. HT is an MSc and PhD in Epidemiology. NL is an MBChB, MD and Fellow of College Physicians of South Africa (FCP-SA)-Endocrinology/Diabetology. CZ is an MD, MPH and PhD in Medical Anthropology.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Ethics approval Given that this is a protocol for a systematic review only using the published data, there is no ethics approval required for this study.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Patient consent for publication Not required.