Metabolic syndrome among people with mental illness in sub Saharan Africa: Female gender as a factor. A Systematic review and meta-analysis.

Background: The prevalence of metabolic syndrome among psychiatric patients in developing nations is mounting alarmingly and it is a reason for decreased life expectancy and quality of life of people with mental illness. Although great discrepant epidemiological studies have been carried out in Sub Saharan African countries, there has no systematic review and meta-analysis conducted. Therefore, summarized evidence has a paramount importance for policy makers and health planning. This study aims to estimate the prevalence of metabolic syndrome and to examine the effect of gender on metabolic syndrome among people with mental illness in sub Saharan Africa.

Method: Systematic literature search was performed using PubMed, CINAHL, Web of science, Global health electronic databases. In addition, gray literatures were retrieved from Google and Google scholar. Two authors independently extracted all the necessary data using a format prepared in Microsoft Excel. Data analysis was done using STATA Version 14 (software). The heterogeneity of the studies was assessed using Itest.Random-effects model was used to estimate pooled prevalence of MetS and its odds ratio. Publication bias was checked using Funnel plot and Egger's test.

Result: 1306 studies were reviewed and nine studies fulfilling the inclusion criteria were selected for the meta-analysis. The meta-analysis of nine studies that included 1896 participants found a prevalence rate of metabolic syndrome which was performed based on assessment criteria; JIS criteria prevalence 21.11% (95% CI: 17.93-24.29), IDF criteria 23.77% (95% CI: 15.41-32.12) and NCEP ATP-III criteria 21.63% (95% CI: 16.30-26.96). Female gender (AOR = 3.00; 95% CI: 1.98-4.55) was found to have a significant association with metabolic syndrome.

Conclusion: The prevalence of metabolic syndrome among people with mental illness in sub Saharan Africa is high in various assessment criteria. The likelihood is significantly increased in females than males. Metabolic syndrome increases by three folds among females with mental illness as compared to their counterparts.