Epidemiology of diabetic retinopathy and maculopathy in Africa: a systematic review.

AIM: To summarize findings from studies reporting the prevalence and incidence of diabetic retinopathy and diabetic maculopathy in African countries in light of the rising prevalence of diabetes mellitus. METHODS: Using a predefined search strategy, we systematically searched MEDLINE, EMBASE, Science Citation index and Conference Proceedings Citation index, African Index Medicus and the grey literature database 'OpenSIGLE' for studies published between January 1990 and February 2011. Included studies reported prevalence or incidence of diabetic retinopathy or diabetic maculopathy of subjects with diabetes resident in African countries. RESULTS: Sixty-two studies from 21 countries were included: three population-based surveys; two cohort studies; five case-control studies; 32 diabetes clinic-based, nine eye clinic-based and 11 other hospital-based surveys. Included studies varied considerably in terms of patient selection, method of assessing the eye and retinopathy classification. In population-based studies, the reported prevalence range in patients with diabetes for diabetic retinopathy was 30.2 to 31.6%, proliferative diabetic retinopathy 0.9 to 1.3%, and any maculopathy 1.2 to 4.5%. In diabetes clinic-based surveys, the reported prevalence range for diabetic retinopathy was 7.0 to 62.4%, proliferative diabetic retinopathy 0 to 6.9%, and any maculopathy 1.2 to 31.1%. No obvious association between prevalence and income level of the country was detected. CONCLUSIONS: Large, community-based cross-sectional and cohort studies are needed to investigate rates and determinants of prevalence of diabetic retinopathy, incidence and progression in Africa. Consensus is needed on the most appropriate methods of identification and classification of retinopathy for research and clinical practice. Estimates of prevalence of diabetic retinopathy, proliferative diabetic retinopathy and maculopathy are comparable with recent European and American studies

The links between Generalized Joint Laxity and the incidence, prevalence and severity of limb injuries related to physical exercise: a systematic literature review

© 2018, © 2018 Informa UK Limited, trading as Taylor & Francis Group. Background: Generalized Joint Laxity (GJL) is a significant risk factor for lower limb injury incidence and prevalence in sporting populations. However, the links with upper limb injury and injury severity in a wider population of people undertaking physical exercise have not been systematically reviewed to date. Objectives: The primary aim was to determine the links between GJL and the incidence, prevalence and severity of upper and lower limb injuries related to physical exercise. Secondary aims were to identify the quality of the existing research evidence and gaps within the literature that may warrant future research. Methods: Relevant literature was identified using online databases (SportDiscus, Medline, CINAHL and EMBASE OVID) and snowballing. Research papers with a primary aim of identifying a link between GJL and upper and lower limb injury incidence, prevalence and/or severity were included. The population of interest was those undertaking physical exercise, not limited to sport. Included papers were critically appraised and a narrative synthesis conducted. Results: A total of 274 studies were identified. Following application of the inclusion and exclusion criteria, nine papers were selected for critical appraisal that investigated the link between GJL and the incidence, prevalence and/or severity of limb injuries. The link between GJL and lower limb injury incidence and prevalence was supported across numerous types of physical exercise. However, the links between GJL and upper limb injury, and injury severity was inconclusive. Conclusions: GJL is associated with increased lower limb injury incidence and prevalence. Future research should investigate the links between GJL, upper limb injury and injury severity