Prevalence of erectile dysfunction patients with diabetes mellitus and its association with body mass index and glycated hemoglobin in Africa: a systematic review and meta-analysis

Abstract

Background: Mortality and morbidity in patients with diabetes mellitus (DM) is attributed to both the micro vascular and macro vascular complications. Variation among primary studies was seen on the prevalence of erectile dysfunction in Africa. Therefore this study was aimed to estimate the pooled prevalence of erectile dysfunction patients with diabetes mellitus and its association with body mass index and glycated hemoglobin in Africa. Methods: PubMed Web of Science Cochrane library Scopus Psyinfo Africa online journal and Google Scholar were searched. A funnel plot and Egger s regression test were used to see publication bias. I squared statistic was used to check heterogeneity of studies. DerSimonian and Laird random effects model was applied to estimate the pooled effect size. The subgroup and Meta regression analysis were conducted by country sample size and year of publication. Sensitivity analysis was deployed to see the effect of single study on the overall estimation. STATA version 14 statistical software was used for meta analysis. Result: A total of 20 studies with 5 177 study participants were included to estimate the pooled prevalence. The pooled prevalence of erectile dysfunction patients with diabetes mellitus was 61.62% (95% CI: 48.35, 74.9). BMI greater than or equal to 30kg/m2 (AOR = 1.26; 95% CI: 0.73, 2.16) and glycated hemoglobin greater than or equal to 7%(AOR = 0.93; 95% CI: 0.5, 5.9) were identified factors though not statistically significant associated with erectile dysfunction. Conclusions: The prevalence of erectile dysfunction in Africa remains high. Therefore, situation based interventions and country context specific preventive strategies could be developed to reduce the magnitude of erectile dysfunction among patients with diabetes mellitus. Keywords erectile dysfunction impotence sexual dysfunction diabetes mellitus Africa