Metabolic syndrome among type 2 diabetic patients in Sub-Saharan African countries: a systematic review and meta-analysis
Background: Metabolic syndrome is one of the serious public health problems among type 2 diabetic patients. Despite a number of studies have been conducted there is no overall estimation on the prevalence of metabolic syndrome among type 2 diabetic patients in Sub-Saharan African countries. Therefore this study aimed to estimate the pooled prevalence of metabolic syndrome in patients with type 2 diabetes mellitus in Sub Saharan African countries. Methods: PubMed Web of Science African Journals Online Google Scholar Scopus, and Wiley Online Library databases from inception to April 27 2020 were searched to identify relevant studies. The I2 statistic was used to check heterogeneity across the included studies. DerSimonian and Laird random-effects model was applied to estimate pooled effect size and 95% confidence interval across studies. A funnel plot and Egger regression test were used to determine the presence of publication bias. Sensitivity analysis was deployed to determine the effect of a single study on the overall estimation. All statistical analyses were done using STATA Version 14 software. Result: In this meta-analysis a total of 23 studies with 6482 study participants were included. The estimated prevalence of metabolic syndrome in Sub-Saharan African countries was 59.62% (95% CI: 52.20 67.03). Based on the subgroup analysis, the highest prevalence of metabolic syndrome (61.14%, 95% CI: 51.74 70.53) was reported in Ethiopia. . Additionally the highest prevalence of metabolic syndrome was reported across studies using the diagnostic criteria of National Cholesterol Education Program Adult Treatment Panel III 64.8% (95% CI: 54.74 74.86), followed by International Diabetic Federation (57.15%) and World health Organization (53.12%) definitions. Conclusion: Almost two out of three type 2 diabetic patients in Sub-Saharan African countries have metabolic syndrome, which implies that its prevalence is high in patients with T2DM. Therefore Policymakers (FMoH) need to design efficient strategies and guideline to reduce and control the burden of metabolic syndrome and its impact among diabetic population.