Systematic Review of Prevalence of Endometriosis among Indigenous Africans

Introduction: Although the prevalence of endometriosis is to a certain extentdocumented in women living in high resource countries, its prevalence inblack Africa is unknown. Since the current view is that endometriosis hardlyaffects indigenous Africans, we aim to provide a systematic review of prevalenceof endometriosis among the indigenous Africans. Objective: To determinethe prevalence and clinical presentation of endometriosis in the indigenousAfrican women. Methodology: A systematic literature search was carriedout for relevant articles on all citations on PubMed, based on the keywords “Endometriosis” and “Africa”. An additional search was done on Africanjournal Online. Outcome Measures: The primary outcome measure wasthe prevalence of endometriosis among indigenous Africans. Results: Out of58 identified paper’s, only 4 were eligible for the systematic review. The prevalenceof endometriosis was 4.3% (Osefo et al. [1] and 8.2% (Ekwempu et al. [2]) in the laparotomy and hysterectomy specimen respectively. In the paperby Fawole et al. [3], where endometriosis was diagnosed on the basis of laparoscopicvisualization alone without histological confirmation, the prevalencewas 48.1%. Somigliana et al. [4] estimated endometriosis to be 0.2% based onclinical history, clinical examination and imaging, without surgical procedureto confirm this estimation. Due to differences in study populations, methodologyand diagnostic criteria, it was not possible to have pooled prevalence ofendometriosis. Conclusion: Although existing evidence suggests that theprevalence of endometriosis in indigenous Africans is 0.2% - 48.1%, the studyanalyzed had limitations. Prospective multi-centered studies with laparoscopicdiagnosis and histological confirmation of endometriosis are required toestablish the prevalence of endometriosis among the general population in theindigenous Africans. Endometriosis in Africa needs to receive more researchattention. This paper is expected to stimulate and sensitize the clinicians andresearchers in Africa about this condition.