Diabetes in Ethiopia: A systematic review of prevalence, risk factors, complications, and cost

Abstract Aims Diabetes is disproportionately increasing in low- and middle-income countries due partly to rapid urbanization, lifestyle changes, and limited resources. This is the first comprehensive review of prevalence, risk factors, complications and costs related to diabetes in Ethiopia. Methods We searched PubMed, MEDLINE, EMBASE, African MEDICUS, and IEEE Xplorer for studies on prevalence, risk factors, outcomes, treatments or cost of diabetes published in English from 1984 to 2019. Other sources such as Google Scholar were hand-searched for additional studies and we included 39 studies for our analysis. Results The review shows the prevalence of diabetes in Ethiopia ranged 2.0%–6.5% with the low 2% in smaller rural areas. Oral hypoglycemics and insulin were most common treatments. The most frequently reported diabetes-associated problems included retinopathy (2.7%–25%), neuropathy (4.8%–35.0%), depression (13.0%–61.0%), kidney diseases (18.2%–23.8%), hypertension (23.0%–54.82%), anemia (19.0%), and associated costs. Conclusions Diabetes and associated complications in Ethiopia are major causes of morbidity and mortality with consequential economic impact. Tailored strategies towards prevention and management of modifiable risk factors for diabetes are needed to reduce the burden. Resource reallocation for epidemiological surveillance, tailored prevention of modifiable risk factors and research are needed.