Dyslipidaemia in Africa—comment on a recent systematic review
Authors: Robert Newton
Journal: The Lancet Global Health (2018)

The publication of the systematic review by Jean Jacques Noubiap and colleagues1Noubiap JJ Bigna JJ Nansseu JR et al.Prevalence of dyslipidaemia among adults in Africa: a systematic review and meta-analysis.Lancet Glob Health. 2018; 6: e998-e1007Summary Full Text Full Text PDF PubMed Scopus (70) Google Scholar in The Lancet Global Health highlights two important issues. The first issue is the trend to systematically review data according to well established formula, but in the absence of a thorough understanding of the field and expertise. Many systematic reviews are produced by professional reviewers with little topic-specific knowledge. In Noubiap and colleagues'1Noubiap JJ Bigna JJ Nansseu JR et al.Prevalence of dyslipidaemia among adults in Africa: a systematic review and meta-analysis.Lancet Glob Health. 2018; 6: e998-e1007Summary Full Text Full Text PDF PubMed Scopus (70) Google Scholar systematic review, data are presented including three studies from Uganda; however, these three articles cover the same study, although the focus of each article was different. The second issue is the desire to summarise Africa. Currently, the UN recognises 54 countries on what is the second largest (and arguably the most diverse) continent in the world, both in terms of land area and population. With such wide heterogeneity of results across the studies included in Noubiap and colleagues'1Noubiap JJ Bigna JJ Nansseu JR et al.Prevalence of dyslipidaemia among adults in Africa: a systematic review and meta-analysis.Lancet Glob Health. 2018; 6: e998-e1007Summary Full Text Full Text PDF PubMed Scopus (70) Google Scholar review, a summary estimate should not have been calculated. There is little value in saying that the prevalence of low HDL in Africa is 41%, when the range is from 2% to 96% (the lowest and highest prevalence estimates were from studies conducted in the same country). Systematic reviews can be valuable, but they can also be misleading. I declare no competing interests. Prevalence of dyslipidaemia among adults in Africa: a systematic review and meta-analysisThe prevalence of dyslipidaemia is high in the general adult population in Africa. Ongoing efforts to reduce cardiovascular diseases in Africa should integrate effective detection and treatment of dyslipidaemia. Full-Text PDF Open AccessDyslipidaemia in Africa—comment on a recent systematic review – Authors' replyWe thank Robert Newton for his Correspondence, which has provided us with the opportunity to correct an oversight. We agree that our review1 mistakenly included three articles from the same study done in Uganda.3–4 After further cross-checking of the 181 studies initially included in the review, we identified two additional duplicates.5–8 We conducted new analyses including only data reported in the articles with highest sample size among the duplicates identified (table). The pooled prevalence of dyslipidaemia in the general population from population-based studies was 25·5% (95% CI 20·0–31·4; corrected from 23·6%, 18·4–29·6) for elevated concentrations of total cholesterol with a cutoff of at least 5·2 mmol/L, 37·4% (29·4–45·7; corrected from 41·1%; 33·0–49·2) for low concentrations of HDL cholesterol with a cutoff of less than 1·0 mmol/L, 28.6% (15·8–43·5; corrected from 25·7%, 16·2–36·6) for elevated concentrations of LDL cholesterol with a cutoff of at least 3·3 mmol/L, and 17·0% (11·9–22·7; corrected from 16·5%, 11·8–21·6) for elevated concentrations of triglycerides with a cutoff of at least 1·7 mmol/L (table). Full-Text PDF Open Access