Prevalence of Gestational Diabetes Mellitus in Sub-Saharan Africa in 2000 and Beyond: A Systematic Review

Abstract

Introduction: Gestational diabetes mellitus (GDM) is the common cause of hyperglycaemia in pregnancy, accounting for about 90% of all diabetes during pregnancy. A diabetic pregnant woman and her unborn child are at increased risk of pregnancy complications. Gestational diabetes mellitus has long-term public health significance, contributing to the escalating type 2 diabetes epidemic. Understanding the magnitude of gestational diabetes mellitus in Africa may provide evidence on how interventions should be targeted to reduce the magnitude of the problem, to improve maternal and child health and to reduce the burden of type 2 diabetes in the region. Objective: The aim of this systematic review was to assess the prevalence of Gestational diabetes mellitus in Sub-Saharan AfricaMethods: A systematic computer based literature search was conducted for published papers on gestational diabetes in sub-Saharan Africa in 2000 and beyond. The PRISMA guidelines (Checklist, Moher D. et al 2009 ) for the reporting of systematic reviews were followed. A comprehensive key word search strategy was done in Google scholar and PubMed for terms associated with diabetes and pregnancy and sub-Saharan Africa. Articles Published in English language were included. Data were then extracted regarding country, residence (rural/urban), population group, sample size, age of pregnant women in the cohort, gestational age, how they tested for GDM and what GDM prevalence was reportedResult: We identified 7 studies conducted in five of (about 10% of) the 47 sub-Saharan African countries. Most of the studies conducted in West Africa. It needs more effort to work in the area of GDM in Sub-Saharan Africa since only about 10% of the countries had studies on GDM in the year 2000-2016.  The most commonly employed method for GDM screening in Sub-Saharan Africa is the two hour 75 g OGTT with glucose reference ranges as set by the WHO 1985 or 1999 diagnostic criteria. The percentage of women affected with GDM in this review was as low as 4.8% in Nigeria and as high as 11.6% amongst urban Kenyan women. This review  has  found  some  evidence  of  an  increase  in  the  prevalence  of  GDM in Sub-Saharan Africa. Conclusion: There are few studies on prevalence GDM in sub-Saharan Africa. The most commonly employed method for GDM screening in Sub-Saharan Africa is the two hour 75 g OGTT with glucose reference ranges as set by WHO diagnostic criteria.  The prevalence was high and needs preventive measures to reduce maternal and child complications related to GDM in sub-Saharan Africa.

Keywords: Gestational Diabetes Mellitus, Sub-Saharan Africa