Prevalence and risk factors for diabetes mellitus in Nigeria: a systematic review and meta – analysis
Andrew Uloko Enemako1,&, Musa Baba Maiyaki1, Ramalan Mansur Aliyu1, Ibrahim Danjummai Gezawa1, Mohammed Borodo Musa1, Fabian Homsuk Puepet2, Augustine Efedaye Ohwovoriole1
1Department of Medicine, Bayero University Kano & Aminu Kano Teaching Hospital Kano, Nigeria, 2Department of Medicine, University of Jos & Jos University Teaching Hospital Jos, Nigeria
Andrew Uloko Enemako, Department of Medicine, Bayero University Kano & Aminu Kano Teaching Hospital Kano, Nigeria
there has not been any recent nationwide health (diabetes) survey in Nigeria ever since the last one conducted in 1992 which reported a diabetes mellitus (DM) prevalence of 2.2%. We aimed to determine the prevalence and risk factors of DM in Nigeria using a systematic review and meta-analysis.
we searched Medline, EMBASE, PubMed, Papers First, the Cochrane Library, Scopus, Bioline, African Journal Online, Institute of Science Information, and Google Scholar from year 1990 to 2016. Using MeSH headings, text words and word variations of diabetes mellitus, risk factors, prevalence and Nigeria was searched. The last search was performed on the 26th November 2016. We included only studies utilizing OGTT, random plasma glucose, fasting plasma glucose or HbA1c for diagnosis of DM. We included 23 studies (n = 14,650 persons). A random effect modeling was used to determine the pooled estimate of DM. We estimated overall pooled prevalence estimates of DM and sub group specific prevalence accounting for inter-study and intra-study variability/heterogeneity.
the overall pooled prevalence of DM was 5.77% (95% CI; 4.3 - 7.1). The pooled prevalence of DM according to the six geopolitical zones of Nigeria showed North-west 3.0% (95%CI; 1.7 – 4.3), North-East 5.9% (95%CI; 2.4 – 9.4), North-Central 3.8% (95%CI; 2.9 – 4.7), South-West 5.5% (95%CI; 4.0 – 7.1), South-East 4.6% (95%CI; 3.4 – 5.9), and South-South 9.8% (95%CI; 7.2 – 12.4). The pooled prevalence of DM among individuals with family history of DM was 4.6% (95%CI; 3.5 – 5.6); urban dwellers 6.0% (95%CI; 4.3 – 7.8); unhealthy dietary habits 8.0% (95%CI; 5.4 – 10.5); cigarette smokers 4.4% (95%CI; 1.3 – 10.2); older age 6.6% (95%CI; 4.5 – 8.7); the physically inactive 4.8% (95%CI; 3.2 – 6.4); and obese individuals 5.3% (95%CI; 3.8 – 6.9).
there is an increase in the prevalence of DM in Nigeria affecting all regions of the country with the highest prevalence in the south-south geopolitical zone. Urban dwelling, physical inactivity, advancing age and unhealthy diet are important risk factors for DM among Nigerians. A national diabetes care and prevention policy is highly recommended.