{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T06:12:23Z","timestamp":1791526343356,"version":"4.3.4"},"reference-count":55,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2022,6,2]],"date-time":"2022-06-02T00:00:00Z","timestamp":1654128000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosglobalpublichealth.org"],"crossmark-restriction":false},"short-container-title":["PLOS Glob Public Health"],"abstract":"<jats:p>Hospital and community based-studies had been conducted for Urinary Incontinence (UI) in Sub-Sahara Africa (SSA) countries. A significant limitation of these studies is likely under-estimation of the burden of UI in SSA. It is therefore, imperative that a well-structured systematic review and meta-analytical models in SSA are required to accurately and reliably estimate the burden of UI. Medline\/PubMed, Google Scholar, Africa Journal Online (AJOL) were searched to identified data on burden of UI studies in SSA. Two independent authors performed the initial screening of studies based on the details found in their titles and abstracts. The quality of the retrieved studies was assessed using the Newcastle-Ottawa Quality Assessment instrument. The pooled burden of UI was calculated using a weighted inverse variance random-effects model. A sub-group and meta-regression analyses were performed. Publication bias was checked by the funnel plot and Egger\u2019s test. Of the 25 studies included, 14 were hospital-based, 10 community- based, and 1 university-based studies involving an overall 17863 participants from SSA. The systematic review showed that the prevalence of UI ranged from 0.6% in Sierra Leone to 42.1% in Tanzania. The estimated pooled burden of UI across all studies was 21% [95% CI: 16%-26%, I<jats:sup>2<\/jats:sup> = 91.01%]. The estimated pooled prevalence of stress UI was 52% [95% CI: 42%-62%], urgency UI 21% [95% CI: 15%-26%], and mixed UI 27% [95% CI: 20%-35%]. The common significant independent factors were; parity, constipation, overweight\/obese, vaginal delivery, chronic cough, gestational age, and aging. One out of every five women in SSA suffers from UI. Parity, constipation, overweight\/obesity, vaginal delivery, chronic cough, gestational age, and age were the most important risk variables. As a result, interventions aimed at reducing the burden of UI in SSA women aged 15 to 100 years old in the context of identified determinants could have significant public health implications.<\/jats:p>","DOI":"10.1371\/journal.pgph.0000562","type":"journal-article","created":{"date-parts":[[2022,6,2]],"date-time":"2022-06-02T17:27:14Z","timestamp":1654190834000},"page":"e0000562","update-policy":"https:\/\/doi.org\/10.1371\/journal.pgph.corrections_policy","source":"Crossref","is-referenced-by-count":24,"title":["Estimated burden, and associated factors of Urinary Incontinence among Sub-Saharan African women aged 15\u2013100 years: A systematic review and meta-analysis"],"prefix":"10.1371","volume":"2","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5045-1104","authenticated-orcid":true,"given":"Martin","family":"Ackah","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louise","family":"Ameyaw","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed Gazali","family":"Salifu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cynthia","family":"OseiYeboah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abena","family":"Serwaa Ampomaa Agyemang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kow","family":"Acquaah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaa Boatema","family":"Koranteng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asabea","family":"Opare-Appiah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,6,2]]},"reference":[{"issue":"SUPPL. 1","key":"pgph.0000562.ref001","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/j.1464-410X.2006.06299.x","article-title":"The global burden of female pelvic floor disorders","volume":"98","author":"K Kenton","year":"2006","journal-title":"BJU Int"},{"issue":"1","key":"pgph.0000562.ref002","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12905-020-01039-w","article-title":"Burden of pelvic organ prolapse in Ethiopia: A systematic review and meta-analysis.","volume":"20","author":"G Gedefaw","year":"2020","journal-title":"BMC Womens Health"},{"issue":"1","key":"pgph.0000562.ref003","doi-asserted-by":"crossref","first-page":"1311","DOI":"10.1001\/jama.300.11.1311","article-title":"Prevalence of Symptomatic Pelvic Floor Disorders in US Women","volume":"23","author":"I. 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Assessing the quality of studies in meta-analyses: Advantages and limitations of the Newcastle Ottawa Sca.","volume":"2","author":"Claudio Luchini","year":"2012","journal-title":"World J Psychiatry"},{"issue":"11","key":"pgph.0000562.ref024","doi-asserted-by":"crossref","first-page":"1539","DOI":"10.1002\/sim.1186","article-title":"Quantifying heterogeneity in a meta-analysis.","volume":"21","author":"JPT Higgins","year":"2002","journal-title":"Stat Med"},{"issue":"3","key":"pgph.0000562.ref025","first-page":"251","article-title":"NIH Public Access","volume":"109","author":"CB Bowling","year":"2010","journal-title":"Int J Gynaecol Obs"},{"issue":"4","key":"pgph.0000562.ref026","first-page":"6","article-title":"Prevalence and Risk Factors of Urinary Incontinence among Adult Rwandan Women","volume":"61","author":"LQ Gashugi P","year":"2005","journal-title":"SA J Physiother"},{"issue":"2","key":"pgph.0000562.ref027","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1016\/j.ijgo.2014.03.017","article-title":"Estimating the prevalence of urinary and fecal incontinence in a nationally representative survey in Sierra Leone Hiten.","volume":"126","author":"Hiten D. 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Ojengbede, Imran O. Morhason-Bello, B. O. A., & Kolade, N. S. O. and C. O. (2010). urinary incontinence among 5000 black women community survey. BJU International, 1793\u20131800. https:\/\/doi.org\/10.1111\/j.1464-410X.2010.09758.x","DOI":"10.1111\/j.1464-410X.2010.09758.x"},{"key":"pgph.0000562.ref035","first-page":"1","article-title":"Prevalence and risk factors for urinary incontinence in pregnancy in Ikere-Ekiti, Nigeria","author":"TO Okunola","year":"2018","journal-title":"Neurourol Urodyn"},{"issue":"1","key":"pgph.0000562.ref036","doi-asserted-by":"crossref","first-page":"35","DOI":"10.14302\/issn.2381-862X.jwrh-18-2074","article-title":"Prevalence of Non-Fistulous Urinary Incontinence among Nonparturient Women in A Tertiary Hospital","volume":"2","author":"OO Bello","year":"2018","journal-title":"J woman\u2019s Reprod Heal"},{"key":"pgph.0000562.ref037","first-page":"45","article-title":"The Prevalence of Urinary Incontinence and its Impact on Quality of Life among the University Female Staff in South Africa","author":"L MM Skaal","year":"2011","journal-title":"SA J Physiother"},{"key":"pgph.0000562.ref038","first-page":"29","article-title":"Prevalence of urinary incontinence in a sample of women living in Benin city, Prevalence of urinary incontinence in a sample of women living in Benin city, Nigeria","volume":"1","author":"SF Usifoh","year":"2012","journal-title":"J Med Res Pr"},{"key":"pgph.0000562.ref039","article-title":"Urinary Incontinence in Women aged 40 and Older: Its Prevalence, Risk Factors, and Effect on Quality of Life","author":"SG Y Ya\u011fmur","year":"2021","journal-title":"Niger J Clin Pract"},{"issue":"5","key":"pgph.0000562.ref040","doi-asserted-by":"crossref","first-page":"989","DOI":"10.18203\/2394-6040.ijcmph20160976","article-title":"Prevalence, quality of life assessment of urinary incontinence using a validated tool (ICIQ-UI SF) and bothersomeness of symptoms among rural community\u202f: dwelling women in Southwest, Nigeria","volume":"3","author":"OO Abiola","year":"2016","journal-title":"Int J Community Med Public Heal"},{"issue":"1","key":"pgph.0000562.ref041","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1016\/j.ejogrb.2010.02.008","article-title":"European Journal of Obstetrics & Gynecology and Reproductive Biology Suffering in silence\u202f: pregnant women \u2018 s experience of urinary incontinence in","volume":"150","author":"SE Adaji","year":"2010","journal-title":"Eur J Obstet Gynecol"},{"key":"pgph.0000562.ref042","article-title":"The physical finding of stress urinary incontinence among African women in Ghana.","author":"RMK Adanu","year":"2005","journal-title":"Int Urogynecol J."},{"key":"pgph.0000562.ref043","article-title":"Urinary incontinence\u202f: prevalence, pattern, and opportunistic screening in Ile-Ife, Nigeria.","author":"OO Badejoko","year":"2015","journal-title":"Int Urogynecol J"},{"key":"pgph.0000562.ref044","doi-asserted-by":"crossref","first-page":"1","DOI":"10.4236\/ss.2021.121001","article-title":"Risk Factors for Urinary Incontinence after Obstetric Vesicovaginal Fistula Closure in.","volume":"12","author":"FB Balde","year":"2021","journal-title":"Surg Sci"},{"key":"pgph.0000562.ref045","first-page":"2","article-title":"Urinary incontinence among pregnant women, following antenatal care at University of Gondar Hospital, North West Ethiopia","volume":"16","author":"A Bekele","year":"2016","journal-title":"BMC Pregnancy Childbirth [Internet]"},{"key":"pgph.0000562.ref046","article-title":"Prevalence and associated factors of urinary incontinence in women living in China\u202f: a literature review.","author":"K Xue","year":"2020","journal-title":"BMC Urol [Internet]"},{"key":"pgph.0000562.ref047","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12877-021-02135-8","article-title":"Prevalence and factors related to urinary incontinence in older adults women worldwide\u202f: a comprehensive systematic review and meta-analysis of observational studies","volume":"21","author":"S Batmani","year":"2021","journal-title":"BMC Geriatr"},{"key":"pgph.0000562.ref048","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1001\/archinte.165.5.537","article-title":"Urinary Incontinence in US Women","volume":"165","author":"JL Melville","year":"2005","journal-title":"Arch Intern Med"},{"key":"pgph.0000562.ref049","first-page":"1","article-title":"Women \u2018 s autonomy in healthcare decision- making and healthcare seeking behaviour for childhood illness in Ghana\u202f: Analysis of data from the 2014 Ghana Demographic and Health Survey","author":"E Budu","year":"2020","journal-title":"PLoS One [Internet]"},{"key":"pgph.0000562.ref050","article-title":"Association between parity and the risk for urinary incontinence in women.","volume":"97","author":"H Zhou","year":"2018","journal-title":"Medicine (Baltimore)"},{"key":"pgph.0000562.ref051","article-title":"Urinary incontinence in women","volume":"349","author":"LN Wood","year":"2014","journal-title":"BMJ"},{"key":"pgph.0000562.ref052","doi-asserted-by":"crossref","DOI":"10.1155\/2017\/2138073","article-title":"Female Functional Constipation Is Associated with Overactive Bladder Symptoms and Urinary Incontinence","volume":"2017","author":"T Maeda","year":"2017","journal-title":"Biomed Res Int"},{"key":"pgph.0000562.ref053","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1016\/j.neulet.2008.06.063","article-title":"Neuroscience Letters Colorectal distension enforce acute urinary bladder distension-induced hepatic vasoconstriction in the rat","volume":"443","author":"S Chen","year":"2008","journal-title":"Neurosci Lett"},{"key":"pgph.0000562.ref054","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1016\/S0002-9378(11)91418-5","article-title":"Obesity and lower urinary tract function in women\u202f: Effect of surgically induced weight loss","author":"RC Bump","year":"1992","journal-title":"Am J Obs Gynecol"},{"key":"pgph.0000562.ref055","first-page":"3","article-title":"Obesity and Urinary Incontinence: Epidemiology and Clinical Research Update","volume":"182","author":"Leslee L. 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