Pooled prevalence of symptomatic dry eye and its associated factors among adults in Africa: (2016–2025) systematic review and meta-analysis study

Dry eye disease poses a significant global public health concern, with notable implications for populations in Africa. Individuals affected by this condition experience symptoms such as ocular discomfort, dryness, burning, irritation, reflex tearing, and visual disturbances. Despite numerous studies investigating the prevalence and risk factors of symptomatic dry eye across African populations, findings remain inconsistent and fragmented, lacking a comprehensive synthesis of its overall burden and determinants within the region. To address this gap, the present systematic review and meta-analysis aims to estimate the pooled prevalence of symptomatic dry eye and to elucidate its principal associated factors across Africa.

We conducted a comprehensive literature search across multiple databases, including PubMed, Google Scholar, EMBASE, Scopus, and the Cochrane Library, as well as by reviewing references from relevant articles following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The methodological quality was evaluated using the Joanna Briggs Institute critical appraisal checklist. Publication bias was assessed using both Funnel Plot visualization and Egger’s regression test. Heterogeneity was quantified using Higgins’ I² statistics. Subgroup and sensitivity analyses were performed, and a random-effects model was applied to estimate the pooled prevalence of symptomatic dry eye. All statistical analyses were performed with STATA version 17.

A systematic review of 5,044 studies published from 2016 to 2025 identified 12 eligible for meta-analysis. The pooled prevalence of symptomatic dry eye among African adults was 61.29% (95% CI: 51.41–71.17). Subgroup analyses revealed the highest prevalence in South Africa (92%; 95% CI: 87.66–96.34), in community settings (76.08%; 95% CI: 62.66–89.51), and among studies conducted from 2016 to 2021 (67.99%; 95% CI: 54.23–81.75). The lowest prevalence was reported in Ethiopia (43.64%; 95% CI: 36.94–50.34). Significant associated factors included visual display use for more than 5 h (OR: 3.95; 95% CI: 2.20–7.10), diabetes duration of 11 years or more (OR: 2.85; 95% CI: 2.04–3.97), poor glycemic control (OR: 2.57; 95% CI: 1.91–3.47), allergic conjunctivitis (OR: 2.79; 95% CI: 1.66–4.70), and ophthalmic drop use (OR: 3.05; 95% CI: 1.53–6.11).

PROSPERO CRD420251043328.