Feleke Sefineh Fenta, Dessie Anteneh Mengist, Getachew Zenebe Daniel, Bizuneh Fasikaw Kebede, Kidie Atitegeb Abera, Yayeh Berihun Mulu, Ayal Birtukan Gizachew, Tesfa Natnael Amare
Department of Public Health, College of Health Sciences, Woldia University, Woldia, Ethiopia.
Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.
PLoS One. 2025 Jan 23;20(1):e0309097. doi: 10.1371/journal.pone.0309097. eCollection 2025.
Multiple studies across Ethiopia have investigated the occurrence of DKA, showing significant variations and conflicting findings. This systematic review and meta-analysis seek to consolidate the overall prevalence of diabetic ketoacidosis and its associated factors in the Ethiopian context.
The study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P) guidelines. Data was collected from PubMed/MEDLINE, Science direct, Google Scholar, and gray literature sources. Microsoft Excel was used for data extraction and summary, while the analysis was performed with R software version 4.3.2. The overall pooled prevalence of diabetic ketoacidosis and its components was estimated using a random effects model. Publication bias was assessed both graphically, using funnel plots, and statistically, with tests such as Egger's regression test. Subgroup analysis were carried out to minimize random variations in the estimates from the primary studies.
The pooled estimated prevalence of diabetic ketoacidosis among diabetic patients in Ethiopia was 46% (95% CI; 36, 57; I2 = 100%, P≤0.001). Medication discontinuations (AOR = 1.30, 95 CI 1.20, 1.64), presence of comorbidity (AOR = 1.53, 95 CI 1.10, 2.20) and presence of infection (AOR = 1.62, 95 CI 1.31, 1.98) had an association with diabetic ketoacidosis among diabetic patients.
Medication discontinuations, comorbidity, and infection are individual contributors to diabetic ketoacidosis in diabetic patients. Implementing initiatives to enhance medication adherence and establish comprehensive diabetes management programs covering glycemic control, comorbidities, and infection management can effectively address these factors.
埃塞俄比亚各地的多项研究调查了糖尿病酮症酸中毒（DKA）的发生率，结果显示存在显著差异且相互矛盾。本系统评价和荟萃分析旨在汇总埃塞俄比亚背景下糖尿病酮症酸中毒的总体患病率及其相关因素。
本研究遵循系统评价和荟萃分析方案的首选报告项目（PRISMA-P）指南。数据从PubMed/MEDLINE、科学Direct、谷歌学术和灰色文献来源收集。使用Microsoft Excel进行数据提取和汇总，而分析则使用R软件版本4.3.2进行。使用随机效应模型估计糖尿病酮症酸中毒及其组成部分的总体合并患病率。使用漏斗图以图形方式评估发表偏倚，并使用Egger回归检验等统计方法进行评估。进行亚组分析以尽量减少主要研究估计值中的随机变异。
埃塞俄比亚糖尿病患者中糖尿病酮症酸中毒的合并估计患病率为46%（95%CI；36，57；I2 = 100%，P≤0.001）。药物中断（AOR = 1.30，95 CI 1.20，1.64）、合并症的存在（AOR = 1.53，95 CI 1.10，2.20）和感染的存在（AOR = 1.62，95 CI 1.31，1.98）与糖尿病患者的糖尿病酮症酸中毒有关。
药物中断、合并症和感染是糖尿病患者发生糖尿病酮症酸中毒的个体因素。实施提高药物依从性的举措，并建立涵盖血糖控制、合并症和感染管理的综合糖尿病管理计划，可以有效解决这些因素。
