Epidemiology of monoclonal gammopathies in sub-saharan Africa: a systematic review and meta-analysis of MGUS and multiple myeloma
1
Nuffield Centre for International Health and Development, University of Leeds, Leeds, United Kingdom
2
Department of CardioNephrology, Cardiac Renal & Vascular Associates, Jackson Mississippi, United States
3
Mersey and West lancashire NHS Trust, Blackpool, United Kingdom
4
Ladoke Akintola University of Technology, Ogbomosho, Nigeria
5
Noble's Hospital, Douglas, Isle of Man
6
Faculty of Health and Sports Sciences, Ege University, Izmir, Turkey
7
University College Hospital, Ibadan, Nigeria
8
Rostov State Medical University, Rostov-on-don, Russian Federation
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
INTRODUCTION:
monoclonal gammopathy of undetermined significance (MGUS) and multiple myeloma (MM) occur more frequently in black populations, particularly African Americans. however, despite Sub-Saharan Africa (SSA) being home to the largest black population globally, epidemiological data on MGUS and MM in the region remain limited. This gap restricts understanding of disease burden, survival outcomes, and context-specific clinical complications.
METHODS:
a systematic review and meta-analysis of published studies from ssa was conducted to estimate the pooled prevalence of MGUS and MM, assess regional variations, evaluate survival outcomes, and quantify key clinical complications including HIV-associated MM, renal failure, anaemia and hypercalcaemia. Eligible studies were screened, extracted and synthesised using random-effects models.
RESULTS:
forty five studies met the inclusion criteria, including eight on MGUS and thirty-seven on mm MM. The pooled prevalence of MGUS in SSA was 3.1 per cent (95 per cent CI 0.8–12.0), while MM prevalence was 7.8 per cent (95 per cent CI 5.6–10.4). MM burden was highest in central Africa and lowest in West Africa, while MGUS prevalence was highest in southern Africa. the pooled mean survival for MM was 34.7 months. one-year and five-year overall survival rates were 46.0 per cent and 20.7 per cent, respectively. HIV substantially modified outcomes: the pooled prevalence of mm among people living with HIV was 7.2 per cent (95 per cent CI 1.9–24.2), and mean survival was markedly shorter in HIV-positive patients (9.9 months) compared with HIV-negative patients (36.7 months). Renal failure was common, affecting 30.1 per cent (95 per cent CI 23.5–37.6) of patients at diagnosis.
CONCLUSIONS:
MGUS and MM impose a substantial and under-recognised burden in SSA, with survival outcomes far poorer than global averages. High rates of late presentation, limited diagnostic capacity, absence of screening and restricted access to effective therapies likely contribute to these disparities. Strengthening diagnostic infrastructure, improving early detection and expanding treatment access are urgently needed to advance equity in myeloma care across SSA.
monoclonal gammopathy of undetermined significance (MGUS) and multiple myeloma (MM) occur more frequently in black populations, particularly African Americans. however, despite Sub-Saharan Africa (SSA) being home to the largest black population globally, epidemiological data on MGUS and MM in the region remain limited. This gap restricts understanding of disease burden, survival outcomes, and context-specific clinical complications.
METHODS:
a systematic review and meta-analysis of published studies from ssa was conducted to estimate the pooled prevalence of MGUS and MM, assess regional variations, evaluate survival outcomes, and quantify key clinical complications including HIV-associated MM, renal failure, anaemia and hypercalcaemia. Eligible studies were screened, extracted and synthesised using random-effects models.
RESULTS:
forty five studies met the inclusion criteria, including eight on MGUS and thirty-seven on mm MM. The pooled prevalence of MGUS in SSA was 3.1 per cent (95 per cent CI 0.8–12.0), while MM prevalence was 7.8 per cent (95 per cent CI 5.6–10.4). MM burden was highest in central Africa and lowest in West Africa, while MGUS prevalence was highest in southern Africa. the pooled mean survival for MM was 34.7 months. one-year and five-year overall survival rates were 46.0 per cent and 20.7 per cent, respectively. HIV substantially modified outcomes: the pooled prevalence of mm among people living with HIV was 7.2 per cent (95 per cent CI 1.9–24.2), and mean survival was markedly shorter in HIV-positive patients (9.9 months) compared with HIV-negative patients (36.7 months). Renal failure was common, affecting 30.1 per cent (95 per cent CI 23.5–37.6) of patients at diagnosis.
CONCLUSIONS:
MGUS and MM impose a substantial and under-recognised burden in SSA, with survival outcomes far poorer than global averages. High rates of late presentation, limited diagnostic capacity, absence of screening and restricted access to effective therapies likely contribute to these disparities. Strengthening diagnostic infrastructure, improving early detection and expanding treatment access are urgently needed to advance equity in myeloma care across SSA.
| eISSN: | 2654-1459 |
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