Estimating the prevalence, hospitalisation and mortality from type 2 diabetes mellitus in Nigeria: A systematic review and meta-analysis

Aderemi, Adewale V.; Amoo, Emmanuel O.; Oni, Gbolahan; Ige, Janet; Adeloye, Davies; Adeleye, Ngozi; Auta, Asa

Abstract

© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. Background: There is not yet a comprehensive evidence-based epidemiological report on type 2 diabetes mellitus (T2DM) in Nigeria. We aimed to estimate country-wide and zonal prevalence, hospitalisation and mortality rates of T2DM in Nigeria. Methods: We searched MEDLINE, EMBASE, Global Health, Africa Journals Online (AJOL) and Google Scholar for population and hospital-based studies on T2DM in Nigeria. We conducted a random-effects meta-analysis on extracted crude estimates, and applied a meta-regression epidemiological model, using the United Nations demographics for Nigeria in 1990 and 2015 to determine estimates of diabetes in Nigeria for the two years. Results: 42 studies, with a total population of 91 320, met our selection criteria. Most of the studies selected were of medium quality (90.5%). The age-adjusted prevalence rates of T2DM in Nigeria among persons aged 20-79 years increased from 2.0% (95% CI 1.9% to 2.1%) in 1990 to 5.7% (95% CI 5.5% to 5.8%) in 2015, accounting for over 874 000 and 4.7 million cases, respectively. The pooled prevalence rate of impaired glucose tolerance was 10.0% (95% CI 4.5% to 15.6%), while impaired fasting glucose was 5.8% (95% CI 3.8% to 7.8%). Hospital admission rate for T2DM was 222.6 (95% CI 133.1 to 312.1) per 100 000 population with hyperglycaemic emergencies, diabetic foot and cardiovascular diseases being most common complications. The overall mortality rate was 30.2 (95% CI 14.6 to 45.8) per 100 000 population, with a case fatality rate of 22.0% (95% CI 8.0% to 36.0%). Conclusion: Our findings suggest an increasing burden of T2DM in Nigeria with many persons currently undiagnosed, and few known cases on treatment.

• Journal Article Type: Article
• Acceptance Date: Mar 30, 2017
• Publication Date: May 1, 2017
• Deposit Date: May 26, 2017
• Publicly Available Date: May 26, 2017
• Journal: BMJ Open
• Electronic ISSN: 2044-6055
• Publisher: BMJ Publishing Group
• Peer Reviewed: Peer Reviewed
• Volume: 7
• Issue: 5
• Pages: e015424
• DOI: https://doi.org/10.1136/bmjopen-2016-015424
• Keywords: Nigera, diabetes
• Public URL: https://uwe-repository.worktribe.com/output/888165
• Publisher URL: http://dx.doi.org/10.1136/bmjopen-2016-015424
• Contract Date: May 26, 2017