Burden of urolithiasis in Chad: epidemiological, diagnostic, and management trends

Abstract

Introduction: Urolithiasis is a common condition with a steadily increasing global prevalence. Its epidemiology varies across regions, influenced by multiple factors, and it represents a major public health problem due to its severe complications, impact on quality of life, and high economic burden. In sub-Saharan Africa, available data remain limited and likely underestimated, although the disease seems to occur more frequently. Hence, a better understanding of the urolithiasis burden and its determinants is essential to guide prevention and management strategies. This study aims to assess the situation in Chad by reviewing available data.

Methods: Study selection, in accordance with PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines, was based on searches in PubMed, Google Scholar, AJOL (African Journals Online), and manual screening without time restriction. Included studies addressed urolithiasis in Chad and were published in English or French, with standardised data extraction (population, diagnosis, and treatment). Data extraction was validated by two independent reviewers. Analyses were conducted according to data homogeneity, combining qualitative and quantitative approaches.

Results: An initial search identified 406 studies, from which 26 duplicates were removed. After applying the inclusion criteria, four articles published between 2015 and 2023 were included in the final qualitative synthesis. The mean urolithiasis prevalence was estimated at 4.6%. Overall, the review included 590 patients, with a mean age of 5.5–36 years and a male predominance (7.3:1 sex ratio). Dysuria was the main presenting complaint, while urinary tract infection was reported in 44.4% of patients. Plain radiography and ultrasound were the primary diagnostic modalities. Most stones were located in the lower urinary tract (n = 496, 84.5%), and all interventions employed open surgery. Postoperative complications (wound suppuration and vesicocutaneous fistula) were reported across all studies, with rates varying among authors. One study reported a mean hospital stay of 18 days.

Conclusion: Urolithiasis in Chad predominantly affects young individuals, including children, with limited diagnostic resources and primarily invasive treatment. The high frequency of complications highlights the need to improve management. Further research is essential to optimise care and reduce the urolithiasis burden.