The burden of non-communicable diseases among people living with HIV in Sub-Saharan Africa : a systematic review and meta-analysis

Abstract

BACKGROUND : Non-communicable diseases (NCDs) are increasing among people living with HIV (PLHIV), especially in Sub-Saharan Africa (SSA). We determined the prevalence of NCDs and NCD risk factors among PLHIV in SSA to inform health policy makers. METHODS : We conducted a systematic review and meta-analysis on the prevalence of NCDs and risk factors among PLHIV in SSA. We comprehensively searched PubMed/MEDLINE, Scopus, and EBSCOhost (CINAHL) electronic databases for sources published from 2010 to July 2023. We applied the random effects meta-analysis model to pool the results using STATA. The systematic review protocol was registered on PROSPERO (registration number: CRD42021258769). FINDINGS : We included 188 studies from 21 countries in this meta-analysis. Our findings indicate pooled prevalence estimates for hypertension (20.1% [95% CI:17.5–22.7]), depression (30.4% [25.3–35.4]), diabetes (5.4% [4.4–6.4]), cervical cancer (1.5% [0.1–2.9]), chronic respiratory diseases (7.1% [4.0–10.3]), overweight/obesity (32.2% [29.7–34.7]), hypercholesterolemia (21.3% [16.6–26.0]), metabolic syndrome (23.9% [19.5–28.7]), alcohol consumption (21.3% [17.9–24.6]), and smoking (6.4% [5.2–7.7]). INTERPRETATION : People living with HIV have a high prevalence of NCDs and their risk factors including hypertension, depression, overweight/obesity, hypercholesterolemia, metabolic syndrome and alcohol consumption. We recommend strengthening of health systems to allow for improved integration of NCDs and HIV services in public health facilities in SSA. NCD risk factors such as obesity, hypercholesterolemia, and alcohol consumption can be addressed through health promotion campaigns. There is a need for further research on the burden of NCDs among PLHIV in most of SSA.