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Diabetes and endocrinology
Research
Prevalence of type 2 diabetes mellitus in women of childbearing age in Africa during 2000–2016: a systematic review and meta-analysis
  1. Tawanda Chivese1,2,3,
  2. Mahmoud M Werfalli1,
  3. Itai Magodoro4,
  4. Rekai Lionel Chinhoyi5,
  5. A P Kengne6,
  6. Shane A Norris3,
  7. Naomi S Levitt1,5
  1. 1 Chronic Disease Initiative for Africa, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
  2. 2 Biostatistics Unit, Division of Epidemiology and Biostatistics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
  3. 3 SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
  4. 4 Division of Epidemiology and Biostatistics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
  5. 5 Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
  6. 6 Non-communicable Disease Research Unit, South African Medical Research Council, Cape Town, South Africa
  1. Correspondence to Mr. Tawanda Chivese; tchivese{at}gmail.com

Abstract

Objectives The aim of this research was to estimate the prevalence of type 2 diabetes mellitus (T2DM), impaired fasting glucose (IFG) and impaired glucose tolerance (IGT), in African women of childbearing age.

Study design Systematic review and meta-analysis of relevant African studies published from January 2000 to December 2016.

Data sources We searched several databases, including EMBASE, MEDLINE, CINAHL, grey literature and references of included studies.

Setting Studies carried out in African communities or any population-based studies were included.

Participants We included studies, carried out in Africa, with non-pregnant women of childbearing age. Studies must have been published between the years 2000 and 2016.

Outcomes The primary outcome was prevalent T2DM. The secondary outcomes were IFG and IGT.

Data extraction and synthesis Two reviewers independently extracted data and, using the adapted Hoy risk of bias tool, independently assessed for risk of bias. We used random-effects meta-analysis models to pool prevalence estimates across studies. We used Cochran’s Q statistic and the I2 statistic to assess heterogeneity.

Results A total of 39 studies from 27 countries were included, totaling 52 075 participants, of which 3813 had T2DM. The pooled prevalence of T2DM was 7.2% (95% CI 5.6% to 8.9%) overall and increased with age. The pooled prevalence was 6.0% (95% CI 4.2% to 8.2%) for impaired fasting glycemia while the prevalence of IGT ranged from 0.9% to 37.0% in women aged 15–24 and 45–54 years, respectively. Substantial heterogeneity across studies was not explained by major studies characteristics such as period of publication, rural/urban setting or whether a study was nationally representative or not.

Conclusion This review highlights the need for interventions to prevent and control diabetes in African women of childbearing age, in view of the significant prevalence of T2DM and prediabetes.

PROSPERO registration number CRD42015027635

  • type 2 diabetes mellitus
  • impaired fasting glucose
  • impaired glucose tolerance
  • women of childbearing age
  • prevalence
  • 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-2018-024345

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    Footnotes

    • Contributors TC: conception of, drafting and revision of manuscript, data extraction and data analysis. Guarantor of review. IM: revision of manuscript and data extraction, and approval for final submission. RLC and MW: revision of manuscript, data extraction and risk of bias assessment and approval for final submission. APK: conception of, drafting and revision of manuscript, data analysis and approval for final submission. SAN: conception of, revision of manuscript and approval for final submission. NL: conception of, revision of and approval for final submission.

    • Disclaimer The depiction of boundaries on the map(s) in this article do not imply the expression of any opinion what so ever on the part of BMJ (or any member of its group) concerning the legal status of any country, territory, jurisdiction or area or of its authorities. The map(s) are provided without any warranty of any kind, either express or implied.

    • Competing interests None declared.

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

    • Data sharing statement All data relevant to the study are included in the article or uploaded as supplementary information. This is a systematic review and meta-analysis of published data. The data may be available in the primary studies.

    • Patient consent for publication Not required.