title: The prevalence of type 2 diabetes among older people in Africa: a systematic review.
abstract: Little information is available on the prevalence of diabetes in people aged 55 years or older living on the African continent. We did a systematic review of the prevalence of type 2 diabetes in studies reported from Jan 1, 2000, to June 30, 2015, to provide accurate data for monitoring future trends. We did a comprehensive literature search using an African search filter and extracted and synthesised data from full papers. Among 1473 identified citations, 41 studies providing 49 separate data contributions involving 16 086 individuals met the inclusion criteria. The overall prevalence of diabetes was 13·7% (95% CI 11·3-16·3) and was higher in studies based on the oral glucose tolerance test (23·9%, 17·7-30·7, 12 contributions with 3415 participants) than fasting blood glucose criteria (10·9%, 8·9-13·0, 37 contributions with 12 671 participants; p<0·001). Prevalence was also higher in non-STEPS than in STEPS studies (17·1%, 95% CI 13·6-20·9) vs 9·6%, 6·6-13·0, p=0·003) and in urban than in rural settings (19·7%, 15·0-24·9 vs 7·9%, 4·6-12·0, p=0·0002), but did not differ significantly across age groups, sex, sample size, year of publication, region, or population coverage. These data highlight the need to reduce diabetes risk factors and implement adequate management strategies. In addition, they suggest that uniform diagnostic methods should be used across African countries and elsewhere to enable assessment of trends in diabetes prevalence and the success of diabetes prevention strategies. A collaborative initiative is required between key international and national diabetes and geriatric organisations to improve diabetes care for the older population in Africa and worldwide.
authors.affiliation: Chronic Disease Initiative for Africa (CDIA), University of Cape Town, Cape Town, South Africa; Division of Diabetic Medicine and Endocrinology, University of Cape Town, Cape Town, South Africa.
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Werfalli
authors.affiliation: Department of Medicine, University of Cape Town, Cape Town, South Africa.
authors.forename: Mark E
authors.initials: ME
authors.lastname: Engel
authors.affiliation: Faculty of Medicine and Health Sciences, Centre for Evidence Based Health Care, Stellenbosch University, Cape Town, South Africa.
authors.forename: Alfred
authors.initials: A
authors.lastname: Musekiwa
authors.affiliation: Non-Communicable Diseases Research Unit, University of Cape Town, Cape Town, South Africa.
authors.forename: Andre P
authors.initials: AP
authors.lastname: Kengne
authors.affiliation: Chronic Disease Initiative for Africa (CDIA), University of Cape Town, Cape Town, South Africa; Division of Diabetic Medicine and Endocrinology, University of Cape Town, Cape Town, South Africa. Electronic address: naomi.levitt@uct.ac.za.
authors.forename: Naomi S
authors.initials: NS
authors.lastname: Levitt
mesh_terms: D000349:Africa / Q000453:epidemiology; D000368:Aged; D000369:Aged, 80 and over; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors