Background Despite the high prevalence of diabetes in Africa, the extent of undiagnosed diabetes in the region is still poorly understood. This systematic review and meta-analysis was designed to determine the pooled prevalence of undiagnosed diabetes mellitus among adults in Africa. Methods We conducted a systematic desk review and electronic web-based search of PubMed, Google Scholar, EMBASE, and the World Health Organization’s Hinari portal (which includes the SCOPUS, African Index Medicus, and African Journals Online databases), identifying peer-reviewed research studies on the prevalence of undiagnosed diabetes among adult individuals using pre-defined quality and inclusion criteria. We ran our search from June 1, 2018 to Jun 14, 2020. We extracted relevant data and presented descriptive summaries of the studies in tabular form. The I2 test was used to assess heterogeneity across studies. A random effects model was used to estimate the pooled prevalence of undiagnosed diabetes mellitus at a 95% confidence interval (CI). Funnel plot asymmetry and Egger’s tests were used to check for publication bias. The final effect size was determined by applying a trim and fill analysis in a random-effects model. Results Our search identified 1442 studies amongst which 23 articles were eligible for inclusion in the final meta-analysis. The average pooled prevalence of undiagnosed diabetes mellitus among adults was 3.85 (95% CI: 3.10–4.60). The pooled prevalence of undiagnosed diabetes mellitus based on geographic location was 4.43 (95% CI: 3.12–5.74) in Eastern Africa; 4.72 (95% CI: 2.64–6.80) in Western Africa; 4.27 (95% CI: 1.77–6.76) in Northern Africa and 1.46 (95%CI: 0.57–2.34) in southern Africa respectively. Conclusion Our findings indicate a high prevalence of undiagnosed diabetes in Africa and suggest that it may be more prevalent in Western Africa than the rest of the regions. Given the high levels of undiagnosed diabetes in the Africa region, more attention should be paid to incorporating diabetes screening and treatment services into existing diabetes related programs to reduce the prevalence of undiagnosed cases.

Defects in T cell immunity to SARS-CoV-2 have been linked to an increased risk of severe COVID-19 disease (even after vaccination), persistent viral shedding and the emergence of more virulent viral variants. To address this T cell deficit, we sought to prepare and cryopreserve banks of virus-specific T cells (VSTs), which would be available as a partially HLAmatched off-the-shelf product for immediate therapeutic use. By interrogating the peripheral blood of healthy convalescent donors, we identified immunodominant and protective T cell target antigens, and generated and characterized polyclonal VST lines with activity against multiple clinically important SARS-CoV-2 variants (including ‘delta’ and ‘omicron’). The feasibility of making and safely utilizing such VSTs clinically was assessed by administering partially HLAmatched, third-party, cryopreserved SARS-CoV-2-specific T cells (ALVR109) in combination with other antiviral agents to 4 individuals who were hospitalized with COVID-19. In conclusion, this study establishes the feasibility of preparing and delivering off-the-shelf SARS-CoV-2-directed VSTs to patients with COVID-19 and supports the clinical use of VSTs outside of the profoundly immune compromised setting (ClinicalTrials.gov number, NCT04401410).