Prevalence and clinical patterns of urolithiasis in sub-saharan Africa: a systematic review and meta-analysis of observational studies.

IF 2.2 4区 医学 Q2 UROLOGY & NEPHROLOGY
Altaseb Beyene Kassaw, Mekonnen Belete, Ebrahim Msaye Assefa, Amare Abera Tareke
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引用次数: 0

Abstract

Background and objective: Urolithiasis, the presence of stones in the urinary tract, has been linked to various clinical features and reported as a worldwide health concern. Its prevalence varies across different regions as well as populations. Several primary studies have been conducted in Sub-Saharan Africa on the situation. However, their reports are inconsistent. Hence, this review aimed to assess the pooled magnitude of urolithiasis and its clinical patterns among hospital-visiting patients in sub-Saharan Africa.

Methods: Online databases such as PubMed, Hinari, the African Journals online database, and Google Scholar were used to comprehensively search articles published until June 28, 2023, about the prevalence and clinical patterns of urolithiasis in Sub-Saharan Africa. All the included studies were conducted at hospital setting. The retrieved data was exported to STATA version 16 for final analysis. A random-effect meta-analysis model was computed to estimate the pooled results. The heterogeneity of the studies was assessed using I2 and Cochran's Q. Publication bias was examined by observation using funnel plots and statistically by Egger's tests. Subgroup analysis was performed based on the country where the studies have been conducted.

Result: A total of 26 articles (11 reported both prevalence and clinical pattern, 5 reported only prevalence, and 10 reported only clinical patterns of urolithiasis) were included in the final systematic review and meta-analysis. The pooled prevalence of urolithiasis among hospital-visiting patients was 9.4% (95% CL = 4.9-14%), with significant heterogeneity. Most of the urolithiasis was located in the kidney, with an estimated pooled proportion of 4.6% (95% CI = 2.7, 6.5), followed by bladder stone-2.0% (95% CI = 0.7, 3.4), ureteral stone-1.8% (95% CI = 0.7, 2.9), and urethral stone-0.2% (95% CI = 0.00, 0.05). The subgroup analysis showed the highest prevalence of urolithiasis was found in Mauritian, 28.1% (95%CI 24.5, 31.7), followed by Ethiopia 18.1%, and the lowest was in Eritrea, 1.0%. A sensitivity analysis using the random-effects model found no influential study on the pooled prevalence of urolithiasis. Evidence of significant publication bias was observed and trim-fill analysis was conducted for adjustment. Accordingly, two missing studies were identified, and after adjustment, the combined prevalence of urolithiasis was estimated to be 10.7%. The study also found that urolithiasis prevalence per gender was 6.3% in males and 2.9% in females. The most common clinical presentation of urolithiasis was flank pain at 58.4% (95% CL=, 45.9, 70.8), followed by low back pain at 45.9% (95% CL=, 23.1, 68.8), and nausea/vomiting at 29.9% (95% CI: 1 1.1, 48.8).

Conclusion: The prevalence of urolithiasis in Sub-Sahara African Countries is increasing even though a remarkable regional variation was observed, with higher predominance in males than females. Common clinical presentations of urolithiasis were flank pain, low back pain, and nausea/vomiting.

撒哈拉以南非洲地区尿路结石的发病率和临床模式:观察性研究的系统回顾和荟萃分析。
背景和目的:尿路结石是指尿路中存在结石,它与各种临床特征有关,是一个全球关注的健康问题。不同地区和人群的发病率各不相同。在撒哈拉以南非洲地区,已就这一情况开展了多项初步研究。然而,它们的报告并不一致。因此,本综述旨在评估撒哈拉以南非洲地区医院就诊患者中尿路结石的总体发病率及其临床模式:方法:使用 PubMed、Hinari、非洲期刊在线数据库和谷歌学术等在线数据库,全面检索截至 2023 年 6 月 28 日发表的有关撒哈拉以南非洲地区尿路结石发病率和临床模式的文章。所有纳入的研究均在医院环境中进行。检索到的数据被导出到 STATA 16 版本中进行最终分析。计算随机效应荟萃分析模型以估算汇总结果。研究的异质性采用 I2 和 Cochran's Q 进行评估。发表偏倚采用漏斗图观察和 Egger's 检验进行统计分析。根据进行研究的国家进行了分组分析:共有 26 篇文章(11 篇同时报告了尿石症的患病率和临床模式,5 篇仅报告了患病率,10 篇仅报告了临床模式)被纳入最终的系统综述和荟萃分析。在医院就诊的患者中,尿路结石的合计患病率为 9.4%(95% CL = 4.9-14%),存在显著的异质性。大多数尿路结石位于肾脏,估计总比例为 4.6% (95% CI = 2.7, 6.5),其次是膀胱结石-2.0% (95% CI = 0.7, 3.4)、输尿管结石-1.8% (95% CI = 0.7, 2.9)和尿道结石-0.2% (95% CI = 0.00, 0.05)。亚组分析显示,毛里求斯的尿路结石发病率最高,为 28.1%(95%CI 24.5,31.7),其次是埃塞俄比亚的 18.1%,最低的是厄立特里亚的 1.0%。使用随机效应模型进行的敏感性分析发现,没有研究对尿路结石的合计患病率产生影响。有证据表明存在明显的发表偏倚,因此进行了修剪填充分析以进行调整。因此,发现了两项缺失的研究,经过调整后,尿路结石的综合患病率估计为 10.7%。研究还发现,不同性别的尿路结石发病率分别为:男性 6.3%,女性 2.9%。尿路结石最常见的临床表现是侧腹疼痛,占 58.4%(95% CL=,45.9,70.8),其次是腰痛,占 45.9%(95% CL=,23.1,68.8),恶心/呕吐占 29.9%(95% CI:1 1.1,48.8):结论:撒哈拉以南非洲国家的尿路结石发病率正在上升,但地区差异显著,男性发病率高于女性。尿路结石的常见临床表现为侧腹疼痛、腰痛和恶心/呕吐。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
BMC Nephrology
BMC Nephrology UROLOGY & NEPHROLOGY-
CiteScore
4.30
自引率
0.00%
发文量
375
审稿时长
3-8 weeks
期刊介绍: BMC Nephrology is an open access journal publishing original peer-reviewed research articles in all aspects of the prevention, diagnosis and management of kidney and associated disorders, as well as related molecular genetics, pathophysiology, and epidemiology.
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