Department of Biomedical Science, College of Medicine and Health Science, Wollo University, P.O. Box 1145, Dessie, Ethiopia.
BMC Nephrol. 2024 Oct 8;25(1):334. doi: 10.1186/s12882-024-03780-y.
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.
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 I 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.
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).
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.
尿路结石（尿路中有结石）与各种临床特征有关，被认为是全球关注的健康问题。其患病率因地区和人群的不同而有所差异。在撒哈拉以南非洲地区已经进行了一些初级研究来探讨这个问题。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住院患者尿路结石的总体患病率及其临床模式。
使用在线数据库，如 PubMed、Hinari、非洲期刊在线数据库和 Google Scholar，全面搜索截至 2023 年 6 月 28 日发表的关于撒哈拉以南非洲尿路结石患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 版本 16 进行最终分析。使用随机效应荟萃分析模型来估计汇总结果。使用 I ²和 Cochran's Q 评估研究的异质性。使用漏斗图和 Egger 检验观察性地和统计学地检查发表偏倚。根据研究开展的国家进行亚组分析。
共有 26 篇文章（11 篇报告了患病率和临床模式，5 篇仅报告了患病率，10 篇仅报告了尿路结石的临床模式）被纳入最终的系统评价和荟萃分析。在住院患者中，尿路结石的总体患病率为 9.4%（95%置信区间 4.9-14%），存在显著的异质性。大多数尿路结石位于肾脏，估计的总体比例为 4.6%（95%置信区间 2.7, 6.5），其次是膀胱结石-2.0%（95%置信区间 0.7, 3.4）、输尿管结石-1.8%（95%置信区间 0.7, 2.9）和尿道结石-0.2%（95%置信区间 0.00, 0.05）。亚组分析显示，毛里求斯的尿路结石患病率最高，为 28.1%（95%CI 24.5, 31.7），其次是埃塞俄比亚 18.1%，而厄立特里亚最低，为 1.0%。使用随机效应模型进行敏感性分析发现，没有研究对尿路结石的总体患病率有影响。观察到显著的发表偏倚证据，并进行了修剪填充分析进行调整。因此，确定了两项缺失的研究，调整后，尿路结石的合并患病率估计为 10.7%。该研究还发现，尿路结石的患病率在男性中为 6.3%，在女性中为 2.9%。尿路结石最常见的临床表现是腰痛，占 58.4%（95%置信区间 45.9, 70.8），其次是腰痛，占 45.9%（95%置信区间 23.1, 68.8），恶心/呕吐占 29.9%（95%CI 1 1.1, 48.8）。
尽管观察到显著的地区差异，但撒哈拉以南非洲国家尿路结石的患病率正在增加，且男性患病率高于女性。尿路结石的常见临床表现是腰痛、腰痛和恶心/呕吐。
