Prevalence of Dry Eye Disease in Africa: A Systematic Review and Meta-analysis

SIGNIFICANCE Dry eye disease is a significant public health problem globally. The magnitude of the dry eye disease problem in Africa is, however, unknown. This study provides important and lacking information on dry eye disease in Africa. PURPOSE This study aimed to estimate the prevalence of dry eye disease in Africa. METHODS A systematic online literature search was conducted for articles on dry eye disease in Africa. Meta-analysis was conducted to estimate the prevalence of dry eye disease in Africa and meta-regression to explore the association between dry eye and sex, age, study population, country of study, and type of study. RESULTS The overall prevalence estimate of dry eye disease in Africa was 42.0% (95% confidence interval [CI], 30.7 to 53.8%). The prevalence rates of dry eye disease in male and female individuals were 42.1% (95% CI, 28.5 to 56.3%) and 44.4% (95% CI, 30.2 to 59.0%), respectively; in South Africa, Ghana, Nigeria, and Egypt, the rates were 54.9% (95% CI, 39.0 to 70.4%), 38.3% (95% CI,17.7 to 61.4%), 41.4% (95% CI, 20.1 to 64.5%), and 34.9% (95% CI, 13.2 to 60.6%) respectively; and in school, hospital, and population-based studies, the rates were 51.6% (95% CI, 40.6 to 62.6%), 38.7% (95% CI, 21.9 to 57.0%), and 37.4% (95% CI, 27.4 to 48.0%). respectively. The prevalence rates of dry eye disease were 36.9% (95% CI, 26.7 to 51.1%) in a "normal" population and 44.2% (95% CI, 18.0 to 67.9%) in a population with known risk conditions. There were no associations between dry eye disease prevalence and sex (P = .88), type of study (P = .42), country of study (P = .33), study population (P = .59), and the diagnostic criteria used (P = .36). CONCLUSIONS There seems to be a significant dry eye disease burden in Africa. This may pose an important public health problem that requires immediate attention and action. More epidemiological studies in Africa are needed to fully understand this problem to inform policy decisions.