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To identify adverse outcomes and factors associated with diabetes mellitus among children and youths in East Africa.
This review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
No date restrictions were applied to searches of the Ovid MEDLINE, Embase, PubMed, CINAHL, Scopus, Web of Science, Cochrane Library databases and Google Scholar. The review identified and included literature published between 2007 and 2024.
Independent reviewers conducted study selection, data extraction, and quality assessment. Data were organised in Microsoft Excel, detailing study characteristics, demographics, exposures, and outcomes. Narrative synthesis summarised the data, while meta-analysis yielded pooled proportions.
From 3797 publications, 30 studies involving 6109 children and youths with type 1 diabetes were included. Findings revealed that between 39.3% and 99% did not achieve target glycaemic levels. Diabetic ketoacidosis at diagnosis ranged from 35.8% to 78.7%. Pooled estimates indicated mortality in 6.47%, nephropathy in 15.66%, and retinopathy in 27.49% of the cases. Other complications included decreased health-related quality of life, lipodystrophy, psychiatric disorders, and stunting.
This review highlights the need for context-specific, personalised diabetes care for children and youths in East Africa. It underscores the need for healthcare professionals, particularly nurse diabetes educators, to provide personalised, holistic care and education. Policies that strengthen health systems, expand health insurance, and improve access to care are critical priorities to improve outcomes for these populations.
This study provides new information on diabetes-related complications and management challenges among children and youths in East Africa. Findings flag the urgent need for integrated care, standardised diagnostic criteria, and improved access to resources, with implications for healthcare providers, policymakers, and researchers to enhance health outcomes and quality of life.
This study did not include patient or public involvement in its design, conduct, or reporting.
With little known about the impact of acculturation on cardiovascular disease (CVD) self-care among immigrants, this study examined acculturation among Chinese immigrants and investigated its association with CVD self-care behaviours in this population.
A cross-sectional study was conducted, employing multiple acculturation indices and the Self-Care of Coronary Heart Disease Inventory to collect data from Chinese immigrants with CVD via Chinese Community Centres, social media and cardiac clinics. Descriptive statistics and multiple linear regression analyses were employed. The study adhered to the STROBE guidelines.
Altogether 260 participants were recruited; 47.7% were female; the mean age was 71.8 years, the mean age at migration was 55.1 years and their mean duration of residence in Australia was 16.7 years; 41.2% could not speak English. Participants reported low acculturation levels via the Suinn Lew Asian Self-Identity Acculturation scale (mean score 1.8), but perceived high self-efficacy in coping with acculturation stressors relating to their health management (mean score 33.6). Their attitudes scored as slight agreement with Traditional Chinese Medicine (TCM) beliefs (mean score 3.4). Proxy acculturation measures revealed lower levels of acculturation associated with better CVD self-care behaviours. Higher perceived self-efficacy in coping with acculturation stress was linked with better CVD self-care maintenance and monitoring and better self-care management was observed among participants holding a stronger belief in TCM.
The acculturation of Chinese Australian immigrants contributed to the explanation of the variance in their CVD self-care behaviours.
Comprehensive assessment of acculturation in patients with culturally and linguistically diverse backgrounds can help nurses identify those likely to demonstrate poor CVD self-care behaviours, and culturally specific, individually tailored interventions may support improved self-care.
Patients were involved as participants in this study for data collection.
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