TITLE:
Systematic Review of Prevalence of Endometriosis among Indigenous Africans
AUTHORS:
Gichuhi J. Wanyoike, Rafique Parkar, Ndegwa S. Wanjiru
KEYWORDS:
Endometriosis, Indigenous African, Prevalence, Laparoscopy
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.7 No.8,
August
2,
2017
ABSTRACT: Introduction: Although the prevalence of endometriosis is to a certain extent
documented in women living in high resource countries, its prevalence in
black Africa is unknown. Since the current view is that endometriosis hardly
affects indigenous Africans, we aim to provide a systematic review of prevalence
of endometriosis among the indigenous Africans. Objective: To determine
the prevalence and clinical presentation of endometriosis in the indigenous
African women. Methodology: A systematic literature search was carried
out for relevant articles on all citations on PubMed, based on the key
words “Endometriosis” and “Africa”. An additional search was done on African
journal Online. Outcome Measures: The primary outcome measure was
the prevalence of endometriosis among indigenous Africans. Results: Out of
58 identified paper’s, only 4 were eligible for the systematic review. The prevalence
of endometriosis was 4.3% (Osefo et al. [1] and 8.2% (Ekwempu et al. [2]) in the laparotomy and hysterectomy specimen respectively. In the paper
by Fawole et al. [3], where endometriosis was diagnosed on the basis of laparoscopic
visualization alone without histological confirmation, the prevalence
was 48.1%. Somigliana et al. [4] estimated endometriosis to be 0.2% based on
clinical history, clinical examination and imaging, without surgical procedure
to confirm this estimation. Due to differences in study populations, methodology
and diagnostic criteria, it was not possible to have pooled prevalence of
endometriosis. Conclusion: Although existing evidence suggests that the
prevalence of endometriosis in indigenous Africans is 0.2% - 48.1%, the study
analyzed had limitations. Prospective multi-centered studies with laparoscopic
diagnosis and histological confirmation of endometriosis are required to
establish the prevalence of endometriosis among the general population in the
indigenous Africans. Endometriosis in Africa needs to receive more research
attention. This paper is expected to stimulate and sensitize the clinicians and
researchers in Africa about this condition.