PREVALENCE AND RISK FACTORS OF GESTATIONAL DIABETES MELLITUS IN SUB-SAHARAN AFRICA: A SYSTEMATIC REVIEW

Abstract

Background: Gestational Diabetes Mellitus (GDM) is a major public health concern globally, which carries a double burden for the mother and the fetus.
Objectives: This systematic review aimed to investigate the prevalence and risk factors of GDM in Sub-Saharan Africa (SSA).
Methods: Researchers systematically searched five databases: PubMed, PubMed Central, ProQuest Central, Cochrane, and Articles from the reference lists and grey literature. The review included studies conducted (2012 - 2024) and published (2017 - 2024). Eligibility criteria included studies that reported prevalence or risk factors of GDM, conducted in SSA, published in English, provided full-text access, and employed a cross-sectional, cohort, or interventional study design. Studies were required to use oral glucose tolerance tests as the diagnostic standard. The risk of
bias was assessed using the ROBIS Tool. A total of 47 articles met the inclusion criteria.
Results: Out of 55 countries in SSA, only 11 conducted studies meeting the criteria, resulting in 47 relevant studies on GDM risk factors and prevalence. Ethiopia had the highest number of studies (eight), while Gabon had the fewest (one). Kenya had no studies reporting the prevalence rate. The mean prevalence of GDM across the 47 studies was 14%, with individual study prevalence rates ranging from 3% to
a high level of 39%. Among the included studies, 16 were hospital-based cross-sectional studies, while 11 were population-based studies. Collectively, the studies' total sample size is 42,952 participants. 

Conclusion: The study revealed an increasing trend in the prevalence of GDM in SSA. The identified risk factors are largely modifiable and therefore present opportunities for prevention. The researcher recommends targeted intervention to address these risk factors and reduce the prevalence of GDM. Lack of similar evidence in many SSA Countries suggests that existing practices and guidelines may not be based on the most current relevant data.