Diabetes complications in Sudanese individuals with type 2 diabetes: Overlooked problems in sub-Saharan Africa?

Awadalla, Heitham; Noor, Sufian K.; Elmadhoun, Wadie M; Almobarak, Ahmed O.; Elmak, Nehad Elsheikh; Abdelaziz, Sulaf Ibrahim; Sulaiman, Amel A.; Ahmed, Mohamed H.

doi:10.1016/j.dsx.2017.07.039

Cited by 51 publications

(47 citation statements)

References 24 publications

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“…In most of SSA and other countries in the LMIC in general, varying incidence of diabetic foot, ranging between 10.2% and 38.9%, has been reported [19–24]. Our study showing a mean diabetic foot incidence of 8.3% is lower than previous findings from LMICs.…”

Section: Discussioncontrasting

confidence: 76%

Diabetes-related foot disorders among adult Ghanaians

Sarfo‐Kantanka

Kyei

Mbanya

et al. 2018

Diabetic Foot & Ankle

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Background: Diabetic foot remains a challenge in most low-middle-income countries (LMICs). A severe deficit in data exists on them in sub-Saharan Africa (SSA). Up-to-date data on the longitudinal trajectories and determinants can provide a benchmark for reducing diabetic foot complications in SSA. Objective: The primary objective of this study was to estimate trends in the incidence of diabetic foot and determine predictors in an adult Ghanaian diabetes cohort. Design: The study is a retrospective longitudinal study over a 12 year period. Methods: We applied Poisson regression analysis and Cox proportional hazard models to demographic and clinical information obtained from patients who enrolled in a diabetes specialist clinic in Ghana from 2005 to 2016 to identify longitudinal trends in incidence and predictors of diabetic foot. Results: The study comprised 7383 patients (63.8% female, mean follow-up duration: 8.6 years). The mean incidence of foot disorders was 8.39% (5.27% males and 3.12% females). An increase in the incidence of diabetic foot ranging from 3.25% in 2005 to 12.57% in 2016, p < 0.001, was determined. Diabetic foot, with adjusted hazard ratio (HR; 95% confidence interval (CI)), was predicted by disease duration, that is, for every 5-year increase in diabetes duration: 2.56 (1.41–3.06); male gender: 3.51 (1.41–3.06); increased body mass index (BMI), that is, for every 5 kg/m2: 3.20 (2.51–7.52); poor glycaemic control, that is, for every percentage increase in HbA1c: 1.11 (1.05–2.25), hypertension: 1.14 (1.12–3.21); nephropathy: 1.15 (1.12–3.21); and previous foot disorders: 3.24 (2.12–7.21). Conclusions: We have found a trend towards an increased incidence of diabetic foot in an outpatient tertiary diabetes setting in Ghana. Systemic and individual-level factors aimed at preventive foot screening as well as vascular risk factor control should be intensified in diabetic patients in Ghana and other LMICs. Abbreviations: BMI: Body Mass Index, BP: Blood Pressure, CI: Confidence Interval, HR: Hazard Ratio, HbA1c: Glycated Hemoglobin, PAD: Peripheral Arterial Disease, NCDs: Non Communicable Disease, SSA: Sub Saharan Africa.

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Section: Discussioncontrasting

confidence: 76%

Diabetes-related foot disorders among adult Ghanaians

Sarfo‐Kantanka

Kyei

Mbanya

et al. 2018

Diabetic Foot & Ankle

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“…Totally, 1,278 studies were retrieved, of which, 1,261 studies were found from six international databases and the remaining 17 were through manual search. Databases includes; PubMed 161 [44,45], 2 research paper from Egypt [46,47],the remaining was from Ghana [15],Uganda [48],and Tanzania [49]. The highest prevalence of diabetic peripheral neuropathy (83.4%) and the lowest (7.5%) were reported from Nigeria.…”

Section: Search Resultsmentioning

confidence: 99%

Prevalence of diabetic peripheral neuropathy in Africa: A systematic review and meta-analysis

Shiferaw

Akalu

Work

et al. 2019

Preprint

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Introduction: Diabetes mellitus is a global health care problem and financially costly. Diabetic peripheral neuropathy is common and frequent cause of morbidity and disability. Despite its serious complications,limited evidence is available on the magnitude of diabetic peripheral neuropathy among patient with diabetes mellitus. Hence the objective of this systematic review and meta-analysis was to estimate the pooled prevalence of diabetic peripheral neuropathy among patients with diabetes mellitus in Africa. Methods: PubMed Scopus Google Scholar Africa journal online WHO afro library and Cochrane review were systematically searched online to retrieve related articles. The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guideline was followed. Heterogeneity across the included studies was evaluated by inconsistency index (I2). Publication bias was examined by funnel plot and Egger regression test. The random-effect model was fitted to estimate the pooled prevalence of diabetic peripheral neuropathy among diabetes mellitus patients. All statistical analysis was done using STATA version 14 software for windows. Results: Twenty-three studies which comprises of 269 691 participants were included in the meta-analysis. The overall pooled prevalence of diabetic peripheral neuropathy was 46% (95% CI:36.21-55.78%). Based on the subgroup analysis the highest magnitude of diabetic peripheral neuropathy was reported in West Africa 49.4% (95% CI: 32.74, 66.06). Conclusion: This study revealed that the overall prevalence of diabetic peripheral neuropathy is relatively high in Africa. Hence, diabetic peripheral neuropathy needs situation based intervention and preventive strategy depending on their country context. Furthermore further meta-analysis study is needed to identify associated factors for the occurrence of diabetic peripheral neuropathy. Key word: diabetic peripheral neuropathy diabetes mellitus Systematic review Meta-analysis Ethiopia.

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“…A total of 23 studies with 269,691 study participants were included in this meta-analysis. Overall information regarding the prevalence of DPN in DM patients was obtained from various countries across Africa including 10 studies from Nigeria [14, 18-20, 22, 37-41], four from Ethiopia [16,24,42,43], two from Cameroon [23,44], two from Sudan [45,46], two from Egypt [47,48], and one each from Ghana [15], Uganda [49], and Tanzania [50]. The highest and lowest prevalence of DPN was 83.4% [22] and 7.5% [41] respectively, which were reported from Nigeria.…”

Section: Baseline Characteristics Of the Included Studiesmentioning

confidence: 99%

Prevalence of diabetic peripheral neuropathy in Africa: a systematic review and meta-analysis

et al. 2020

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Background: Diabetes mellitus (DM) is a global health care problem that can impose a substantial economic burden. Diabetic peripheral neuropathy (DPN) is a common microvascular complication of DM that increases the potential for morbidity and disability due to ulceration and amputation. Though there is a significant amount of variation in the primary studies on DM regarding the prevalence of DPN in Africa. Hence, this study was aimed to estimate the overall prevalence of DPN in DM patients in Africa. Methods: PubMed, Scopus, Google Scholar, African Journals OnLine, WHO African Library, and the Cochrane Review were systematically searched online to retrieve related articles. The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines was followed. Heterogeneity across the included studies was evaluated by the inconsistency index (I 2 ). Publication bias was examined by funnel plot and Egger's regression test.The random-effect model was fitted to estimate the pooled prevalence of diabetic peripheral neuropathy among patients in Africa. The meta-analysis was performed using the STATA™ Version 14 software. Results: Twenty-three studies which includes 269,691 participants were included in the meta-analysis. The overall pooled prevalence of diabetic peripheral neuropathy was 46% (95% CI:36.21-55.78%). Based on the subgroup analysis, the highest prevalence of diabetic peripheral neuropathy in DM patients was reported in West Africa at 49.4% (95% CI: 32.74, 66.06). Conclusion: This study revealed that the overall prevalence of diabetic peripheral neuropathy is relatively high in Africa. Hence, DPN needs situation-based interventions and preventive strategies, which are specific to the country. Further meta-analysis is needed to identify associated factors for the occurrence of diabetic peripheral neuropathy.

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Diabetes complications in Sudanese individuals with type 2 diabetes: Overlooked problems in sub-Saharan Africa?

Cited by 51 publications

References 24 publications

Diabetes-related foot disorders among adult Ghanaians

Diabetes-related foot disorders among adult Ghanaians

Prevalence of diabetic peripheral neuropathy in Africa: A systematic review and meta-analysis

Prevalence of diabetic peripheral neuropathy in Africa: a systematic review and meta-analysis

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