Daniel Bekele Ketema^1*, Cheru Tesema Leshargie¹, Getiye Dejenu Kibret¹, Moges Agazhe Assemie¹, Alehegn Aderaw ³, Animut Alebel², Getachew Mullu Kassa¹

¹ Department of Public Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia,

² Department of Nursing, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia

³Department of Nutrition and Food Science, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia

Abstract

Background: Diabetes Mellitus (DM) is increasingly become a serious global public health concern  in developed and developing countries including Ethiopia . It imposes significant burden of care on the individual, health care professionals and health system. As the result, immense need of self-care behaviors in multiple domains like food choices, physical activity, foot care, and blood glucose monitoring is required. However, there is no national study on diabetic self-care practices in Ethiopia. This meta-analysis, therefore, aims to estimate the pooled level of self-care practice among individuals living with diabetes mellitus in Ethiopia.

Methods: The systematic review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guideline. We systematically searched the databases: PubMed /MEDLINE, CINAHL, EMBASE, Google Scholar, Hinari, and Science Direct databases for studies conducted in Ethiopia about self-care practice of diabetes patients. We have included all cross-sectional studies written in English-language, scored in the range of “good quality” on the Newcastle Ottawa Scale (NOS), and were published until August 20,2019. Studies were excluded if a standardized approach was not used to measure main outcomes. Data were analyzed using STATA^TM version 14.1. software, and the pooled prevalence with 95% confidence intervals (CI) findings were presented using forest plots. We used Higgins and Egger’s test to identify any heterogeneity and publication bias. Primary estimates were pooled using a random effect meta-analysis.

Results: We included 35 studies (with 11,103 participants) in this meta-analysis. The overall pooled prevalence (PP) of good diabetes self-care behavior among diabetic patients was 49 % (95% CI 43%, 56%). When categorized by the major domains of diabetes self-care, the pooled estimate of dietary practice was 50% (95 CI: 42%, 58%), for self- monitoring of blood glucose was 27 % (95%CI: 19 %, 36%), for recommended physical activity was 49% (95% CI: 38 %, 59 %), and for diabetic foot-care was 58 % (95% CI: 41 %, 74 %).

Conclusion: More than half of diabetic patients in Ethiopia had poor diabetes self-care practice. High percentage of diabetic patients also had poor dietary practice, self- monitoring of blood glucose, physical activity, and diabetic foot care. Therefore, intervention programs should focus on improving the knowledge level of diabetic patients to improve the self-care practice of diabetic patients.

Key words: Diabetes, self-care, blood glucose monitoring, systematic review, meta-analysis