Prevalence, type and associated factors of anemia among patients with cancer in Sub Saharan Africa, systematic review and meta-analysis

Abstract

<title>Abstract</title> Background Anemia is a condition that develops when there is no sufficient healthy red blood cell, which is characterized either by a reduction in hemoglobin, red blood cells or hematocrit count below normal levels. This systematic review and meta-analysis aimed to assess the prevalence of anemia in Sub Saharan Africa. Methods A comprehensive search of electronic databases, including PubMed, Scopus, Web of Science, African Journals Online and Google Scholar was conducted. Cochrane I² statistics and Eggers test with funnel plot were done to check heterogeneity and publication bias, respectively. Results In this review, 33 studies with 11652 study participants were included. The overall pooled prevalence of anemia among patients with cancer in Sub Saharan Africa was 33.874% (33.176, 34.573). The subgroup analysis by publication year revealed that the prevalence of anemia was highest among studies conducted before 2020 (48.407(29.658, 67.155)). Similarly, sub-group analysis by country revealed that the prevalence of anemia was highest in Uganda (89.927(87.0, 92.851)). Presence of metastasis (OR: 4.683 (95%CI, 1.57, 13.961)), 0.027), advanced stage of cancer (OR: 4.743 (95%CI; 1.1, 20.7)), 0.038, being under weight (OR: 2.392 (95%CI, 1.396, 4.098), 0.04) and poor Eastern Cooperative Oncology Group performance status (OR: 1.818 (95% CI, 6.1-54.237), 0.03) were significantly associated with anemia. Conclusion The pooled prevalence of anemia among patients with cancer was high. Moreover, advanced stage of cancer, presence of metastasis, being under weight and Eastern Cooperative Oncology Group Performance status were the most common risk factors.