Evidence-based guidelines for hypertension and diabetes in sub-Saharan Africa: a scoping review

Abstract

ObjectiveThe Collaboration for Evidence-Based Healthcare and Public Health in sub-Saharan Africa (CEBHA+), a research network, aims to build capacities for evidence-based healthcare. Hypertension (HTN) and diabetes mellitus (DM) are two priority areas of the network, both are major causes of burden of disease in this region. This review aimed to: (1) identify existing evidence-based guidelines for HTN and DM, (2) map their recommendations and (3) assess their quality.SettingSub-Saharan Africa.DesignScoping review.MethodsSystematic searches for evidence-based guidelines, developed with systematic review of evidence and certainty of evidence assessment, were undertaken in electronic databases and grey literature, and ministries of health of all countries in this region were contacted. Included guidelines were assessed with the Appraisal of Guidelines for research and evaluation II (AGREE-II) tool. Searches were conducted between 7 December 2021 and 14 January 2022. Results are presented descriptively.Results66 potentially relevant guidelines were identified, developed in 23, out of 49 sub-Saharan African countries. Of these, only two guidelines (on DM) reported the use of systematic review of evidence and certainty of evidence assessment. Their quality appraisal showed that both have relatively similar scores on domains of AGREE-II, with higher scores on Scope and Purpose and Clarity and Presentation domains, and lower on Stakeholder Involvement, Applicability, Rigour of Development and Editorial independence domains. The overall scores of both guidelines were 50% and 58%, respectively.ConclusionsLess than half of the countries in sub-Saharan Africa developed and published their own guidelines for HTN or DM. The quality appraisal showed that the two included guidelines scored relatively low in several crucial domains of AGREE-II. Countries in this region could consider adopting or adapting already published high-quality recommendations, in order to facilitate a more efficient and faster development of much needed trustworthy evidence-based guidance.

Protocol for scoping review to identify current paediatric hypertension surveillance techniques in the sub-Saharan African region

“…Rapid and consistent increases in the prevalence of paediatric hypertension have been documented irrespective of the varying global classi cation guidelines. Several classi cation guidelines have been published in the SSA countries published, however methodological shortcomings hampered the acceptability and usability (Nagavci et al, 2022). The most widely adopted and generally accepted classi cation guidelines for paediatric hypertension worldwide, Including the SSA are those endorsed by the 2016 European Society of Hypertension (Lurbe et al, 2016), the 2017 American Academy of Paediatrics (Flynn et al, 2017.…”