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

Tawanda Chivese; Mahmoud M Werfalli; Itai Magodoro; Rekai Lionel Chinhoyi; A P Kengne; Shane A Norris; Naomi S Levitt

doi:10.1136/bmjopen-2018-024345

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

BMJ Open. 2019 May 22;9(5):e024345. doi: 10.1136/bmjopen-2018-024345.

Authors

Tawanda Chivese^{1

2

3}, Mahmoud M Werfalli¹, Itai Magodoro⁴, Rekai Lionel Chinhoyi⁵, A P Kengne⁶, Shane A Norris³, Naomi S Levitt^{1

5}

Affiliations

¹ Chronic Disease Initiative for Africa, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
² Biostatistics Unit, Division of Epidemiology and Biostatistics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
³ SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
⁴ Division of Epidemiology and Biostatistics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
⁵ Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
⁶ Non-communicable Disease Research Unit, South African Medical Research Council, Cape Town, South Africa.

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.

Keywords: Africa; impaired fasting glucose; impaired glucose tolerance; prevalence; type 2 diabetes mellitus; women of childbearing age.

Publication types

Meta-Analysis
Systematic Review

MeSH terms

Adolescent
Adult
Africa / epidemiology
Diabetes Mellitus, Type 2 / epidemiology*
Female
Glucose Tolerance Test
Humans
Middle Aged
Prevalence
Young Adult