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META-ANALYSIS AND SYSTEMATIC REVIEW
Year : 2018  |  Volume : 2  |  Issue : 3  |  Page : 85-94

Point prevalence of painful diabetic neuropathy in the Middle East and North Africa region: A systematic review with meta-analysis


1 Centre for Pain Research; MENA Research Group, School of Clinical and Applied Sciences, Leeds Beckett University, Leeds, UK; Faculty of Medicine, University of Benghazi, Benghazi, Libya, United Kingdom
2 Centre for Pain Research; MENA Research Group, School of Clinical and Applied Sciences, Leeds Beckett University, Leeds, UK
3 Centre for Pain Research; MENA Research Group, School of Clinical and Applied Sciences, Leeds Beckett University, Leeds, UK; Faculty of Medicine, University of Benghazi, Benghazi, Libya

Correspondence Address:
Dr. Sabri Garoushi
School of Clinical and Applied Sciences, Portland Way, Leeds Beckett University, Leeds
United Kingdom
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/LJMS.LJMS_36_18

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Background/Aim: Painful diabetic neuropathy (PDN) is a common complication of diabetes. Over recent decades, there has been a rise in the prevalence of diabetes in the Middle East and North Africa (MENA) region. It is suspected that this will be accompanied by an increase in PDN. Epidemiological research on PDN is needed to inform health policy in the MENA region. The aim of this systematic review was to estimate the point prevalence of PDN in countries from the MENA region. Methods: Cross-sectional or longitudinal studies that reported the prevalence of adults with PDN in the MENA region were sought by searching three computerized databases (Medline via web of science, PubMed, and Science Direct). Titles and abstracts were reviewed and screened independently by two researchers (SG and OT). Data extracted were as follows: age, sex, body mass index, sample size, type and duration of diabetes, and point prevalence of PDN. PDN point prevalence was calculated as event rate (i.e., proportion out of 1) and used to produce the overall prevalence in the region using comprehensive meta-analysis software. Results: The searches identified 1657 records. The full texts of 16 records were retrieved following removal of 600 duplicates and exclusions of 1045 abstracts. Five studies were eligible for review following screening of full-text reports. Four of the five reports described surveys of PDN conducted in one country: Saudi Arabia (1 report), Turkey (2 reports), and Algeria (1 report). One report described surveys conducted in Egypt, Lebanon, Jordan, and the Gulf States. The Douleur Neuropathique 4 (DN4) questionnaire was used in seven of the surveys and the Leeds Assessment of Neuropathic Symptoms and Signs pain scale in one survey. The prevalence of PDN was 65.3% for Saudi Arabia, 14% and 23% for Turkey, and 45% for Algeria. The prevalence of PDN was 53.7% in a study that combined estimates from Egypt, Lebanon, Jordan, and Gulf States. Overall, the prevalence of PDN in people with diabetes was 43.2% (95% confidence interval = 30.1%–57.2%, 8 surveys, 7898 participants, 3761 women). Conclusions: The prevalence of PDN in people with diabetes from the MENA region was 43.2% (7898 participants) and higher than estimates from other regions of the world such as the United Kingdom (22%–35%) and the United States of America (11%–25%).


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