Prevalence of type 2 diabetes mellitus in women of childbearing age in Africa during 2000-2016: a systematic review and meta-analysis.

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. Systematic review and meta-analysis of relevant African studies published from January 2000 to December 2016. We searched several databases, including EMBASE, MEDLINE, CINAHL, grey literature and references of included studies. Studies carried out in African communities or any population-based studies were included. 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. The primary outcome was prevalent T2DM. The secondary outcomes were IFG and IGT. 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. 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. 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. CRD42015027635.

Chivese T ，Werfalli MM ，Magodoro I ，Chinhoyi RL ，Kengne AP ，Norris SA ，Levitt NS ... -  《BMJ Open》

Prevalence of type 2 diabetes mellitus in women of childbearing age in Africa during 2000-2016: protocol of a systematic review and meta-analysis.

African women of childbearing age are increasingly being exposed to risk factors for type 2 diabetes mellitus (T2DM), most particularly obesity. A differentiating feature of diabetes in women of childbearing age is that the disease may affect the mother and the developing fetus. Apart from mapping the extent of the problem, understanding the prevalence of T2DM in African women of childbearing age can help to galvanise targeted interventions for reducing the burden of T2DM. This is a protocol for a systematic review aiming to assess the prevalence of and risk factors for T2DM in women of childbearing age (15-49 years) in Africa. We will carry out a comprehensive literature search among a number of databases, using appropriate adaptations of the African search filter to identify diabetes prevalence studies, published from 2000 to 2016, among African women of childbearing age (15-49 years) according to the WHO definition. Full copies of articles identified through searches and considered to meet the inclusion criteria will be obtained for data extraction and synthesis. The analysis of the primary outcome (prevalent diabetes) will include two steps: (1) identification of data sources and documenting estimates and (2) application of the random-effects meta-analysis model to aggregate prevalence estimates and account for between-study variability in calculating the overall pooled estimates and 95% CI for diabetes prevalence. We will assess heterogeneity and publication bias using established methods. This systematic review will be reported according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses Protocol (PRISMA-P) 2015. Ethical approval is not required for this study, given that this is a protocol for a systematic review, which utilises published data. The findings of this study will be widely disseminated through peer reviewed publications and conference presentations. CRD42015027635.

Chivese T ，Mahmoud W ，Magodoro I ，Kengne AP ，Norris SA ，Levitt NS ... -  《BMJ Open》

Type 2 diabetes and pre-diabetes mellitus: a systematic review and meta-analysis of prevalence studies in women of childbearing age in the Middle East and North Africa, 2000-2018.

Al-Rifai RH ，Majeed M ，Qambar MA ，Ibrahim A ，AlYammahi KM ，Aziz F ... -  《Systematic Reviews》

Incidence and prevalence of type 2 diabetes mellitus with HIV infection in Africa: a systematic review and meta-analysis.

This systematic review aims to investigate the incidence and prevalence of type 2 diabetes mellitus (T2DM) in patients with HIV infection in African populations. Only studies reporting data from Africa were included. A systematic search was conducted using four databases for articles referring to HIV infection and antiretroviral therapy, and T2DM in Africa. Articles were excluded if they reported data on children, animals or type 1 diabetes exclusively. Incidence of T2DM and prevalence of T2DM. Risk ratios were generated for pooled data using random effects models. Bias was assessed using an adapted Cochrane Collaboration bias assessment tool. Of 1056 references that were screened, only 20 were selected for inclusion. Seven reported the incidence of T2DM in patients with HIV infection, eight reported the prevalence of T2DM in HIV-infected versus uninfected individuals and five reported prevalence of T2DM in HIV-treated versus untreated patients. Incidence rates ranged from 4 to 59 per 1000 person years. Meta-analysis showed no significant differences between T2DM prevalence in HIV-infected individuals versus uninfected individuals (risk ratio (RR) =1.61, 95% CI 0.62 to 4.21, p=0.33), or between HIV-treated patients versus untreated patients (RR=1.38, 95% CI 0.66 to 2.87, p=0.39), and heterogeneity was high in both meta-analyses (I2=87% and 52%, respectively). Meta-analysis showed no association between T2DM prevalence and HIV infection or antiretroviral therapy; however, these results are limited by the high heterogeneity of the included studies and moderate-to-high risk of bias, as well as, the small number of studies included. There is a need for well-designed prospective longitudinal studies with larger population sizes to better assess incidence and prevalence of T2DM in African patients with HIV. Furthermore, screening for T2DM using gold standard methods in this population is necessary. PROSPERO42016038689.

Prioreschi A ，Munthali RJ ，Soepnel L ，Goldstein JA ，Micklesfield LK ，Aronoff DM ，Norris SA ... -  《-》

Ethnicity, obesity and the prevalence of impaired glucose tolerance and type 2 diabetes in PCOS: a systematic review and meta-regression.

Kakoly NS ，Khomami MB ，Joham AE ，Cooray SD ，Misso ML ，Norman RJ ，Harrison CL ，Ranasinha S ，Teede HJ ，Moran LJ ... -  《-》