Meta-Analysis of the Prevalence of Diabetic Foot Ulcer in Bangladesh

Diabetic foot ulcer is a serious and common complication of diabetes mellitus, and is a leading cause of hospitalization, lower-limb amputation, and reduced quality of life. Bangladesh has a large and growing diabetes population with limited access to specialized foot care, while current studies reflect a wide variance regarding the reported prevalence of diabetic foot ulcer, largely due to differences in study settings, populations, and ulcer definitions. A comprehensive and unrestricted electronic search shall be conducted on prominent sources for health science evidence synthesis, such as PubMed/MEDLINE, EMBASE, Web of Science, Scopus, and Google Scholar. The result will be limited to publications in the English peer-reviewed literature that involve observational studies on the prevalence of diabetic foot ulcer among diabetic patients in Bangladesh. Two team members shall independently assess studies for inclusion, extract data, and assess methodological quality using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for studies on prevalence. A random effects meta-analysis shall be performed to calculate the pooled prevalence along with 95% confidence intervals, while heterogeneity shall be explored via subgroup analyses or sensitivity analyses, as appropriate. The systematic review and meta-analysis will provide a pooled estimate of the prevalence of diabetic foot ulcer among patients with diabetes in Bangladesh. Through this approach, there will be a focus on raising awareness about the burden of this preventable complication. Also, there will be a focus on understanding the origins of heterogeneity between studies, including differences in study settings, populations, and ulcer definitions. The overall expected outcome of the proposed study will be used to provide guidance on strategies aimed at foot-care education, early screening, and prevention of amputation among diabetic patients in Bangladesh. The protocol has been developed following guidelines set by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Protocols (PRISMA-P) and PRISMA-S Statement guidelines regarding the reporting of literature searches in systematic reviews. The protocol has been prospectively registered with the Open Science Framework (OSF).