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

Lay summary of the article published under the DOI: https: 10.1186/s12902-020-0534-5

Published onMar 13, 2023
Prevalence of diabetic peripheral neuropathy in Africa: a systematic review and meta-analysis
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The prevalence of diabetic peripheral neuropathy

There is an alarmingly high prevalence of nerve damage in diabetic patients in Africa, much higher than anywhere else in the world. Researchers say African nations must commit more resources and attention to this debilitating disease.

Diabetic peripheral neuropathy (DPN) is weakness, numbness, and pain caused by nerve damage due to diabetes mellitus (DM), a disease in which a person’s body can not regulate their blood sugar levels properly. 

Many studies have looked into the prevalence of diabetic peripheral neuropathy but the results vary widely, with 8.4% reported in China, 48.1% in Sri Lanka, and 29.2% in India, as examples. In Africa reports have also differed vastly, for instance  71.1% reported neuropathy in Nigeria, 16.6% in Ghana, and 29.5% in Ethiopia.

In this study, researchers analysed such reports from Africa to get a better idea of the true prevalence.

The researchers searched through the digital libraries of PubMed, Scopus, Google Scholar, African Journals OnLine, WHO African Library, and the Cochrane Review to find the relevant research articles. The study used the The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines to carefully compare all the studies using many statistical techniques.

They chose 23 studies that included a combined total of 269 691 participants. The researchers used 10 studies from Nigeria, 4 from Ethiopia, 2 from Cameroon, 2 from Sudan, 2 from Egypt, and 1 each from Ghana, Uganda, and Tanzania.

Overall, they found that the prevalence of diabetic peripheral neuropathy in diabetes patients was 46% for the whole African continent, with the highest prevalence found in West Africa at 49.4%.

This finding was in line with another developing country analysis conducted in Iran, which showed a prevalence of 53%. In contrast, an analsisconducted in developed countriesreported a prevalence of only 35.78%, suggesting that developing countries should provide more services to help diabetics manage their blood sugars to prevent nerve damage

Researchers admit they only looked atEnglish language articles, so they may have missed reports from patients in other languages such as Spanish, French, or Portuguese. Another study limitation is that the researchers only used hospital-based data, which leaves out a large amount of communities of diabetes patients.

This study revealed that the many diabetic patients in Africa suffer from nerve damage related to their disease.. With this result, the researchers recommend that African nations implement situation-based interventions and preventive strategies to assist diabetic patients.

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Abstract

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 (I2). 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.


Disclaimer

This summary is a free resource intended to make African research and research that affects Africa, more accessible to non-expert global audiences. It was compiled by ScienceLink's team of professional African science communicators as part of the Masakhane MT: Decolonise Science project. ScienceLink has taken every precaution possible during the writing, editing, and fact-checking process to ensure that this summary is easy to read and understand, while accurately reporting on the facts presented in the original research paper. Note, however, that this summary has not been fact-checked or approved by the authors of the original research paper, so this summary should be used as a secondary resource. Therefore, before using, citing or republishing this summary, please verify the information presented with the original authors of the research paper, or email info@sciencelink.co.za for more information.

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

Abstract 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 (I2). 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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