Do adult patients with diabetes mellitus living in rural part of Ethiopia and having poor social support have disproportionately poor self-care practice? A systematic review and meta-analysis

• Published in: Primary care diabetes 2021-08, Vol.15 (4), p.642-652
• Main Authors: Yehualashet, Fikadu Ambaw, Tegegne, Eleni Tesfaye, Ayele, Amare Demsie, Takele, Wubet Worku
• Format: Article
• Language: English
• Subjects: Determinants; Diabetes mellitus and Ethiopia; Diabetic self-care practice; Systematic review and meta-analysis
• ISSN: 1751-9918; 1878-0210
• DOI: 10.1016/j.pcd.2021.02.010

•Well over half of adult patients with diabetes Mellitus apply self-care practice.•Patients living in rural Ethiopia and those who have no social support poorly practice self-care.•Patients having co-morbidity poorly apply self-care practice. This systematic review and meta-analysis is aimed at determining the pooled national percentage of diabetic self-care practice and its determinants among adult diabetic patients in Ethiopian. Different electronic databases including PubMed/Medline and search engines such as Google scholar were used to retrieve published studies. The Joanna Briggs Institute quality appraisal checklists were used to appraise the quality of studies. Data were extracted using excel spreadsheets and analyses were done by STATA 14. Heterogeneity among studies was diagnosed using the I2 test. The DerSimonian and Laird random-effects model was employed for substantial heterogeneity (I2 > 50%). The pooled estimate of diabetic self-care and odds ratio was reported based on the 95% CI. A total of 3861 studies were identified, of which only 19 studies have reached the final qualitative synthesis and quantitative analysis. Well over half of the Ethiopian diabetic patients have good self-care 54.04% (47.07–61.01, I2 = 97.3, P < 0.001). Subgroup analysis by region showed that the highest pooled estimate was observed in Southern Nations Nationalities and Peoples 81.96% (71.85–92.04), I2 = 89.1, p < 0.002), whereas the lowest was from the Harari region 44.53% (32.16–56.89%) I2 = 94%, p < 0.001). Being knowledgeable about diabetes Mellitus 2.69 (1.62, 4.46; I2 = 99%, p < 0.001), having good social support 2.25 (1.49–3.39; I2 = 99%, p = 0.00), owning private glucometer 3.04(1.64, 5.65; I2 = 97.4, P < 0.001), and being urban residents 3.26 (2.24, 4.74; I2 = 96.3%, P < 0.001) promote diabetic victims to apply self-care practice. Despite the life-threatening complications of diabetes Mellitus, the percentage of patients applying self-care has remained low in Ethiopia, depicting the high proportion of diabetic patients are prone to develop long and short-term sequelae of diabetes Mellitus. Therefore, improving the client’s awareness about the disease and counseling clients about the significance of social support are believed to be possible strategies to improve self-care practice and policymakers are strongly recommended to combat complications to attain sustainable development goal 3.4 Aims to reduce premature death. The protocol has been registered under