Authors: Ibrahim Alkassoum Salifou, Abdel Nacer Amoukou Issaka, Djongolé Hassane Moussa, Amadou Bouba Traore Hassane, Zeinabou Tondi Moussa, Abdou Atté Bachir, Djibrilla Baoua Bonkano, Oumar Ousmane, Roukayatou Karimou Issaka, Ibrahim Mamane Laminou
Abstract
Chronic diseases are rising in sub-Saharan Africa (SSA), where diagnosis is often delayed. Therapeutic patient education (TPE) is a low-cost strategy, but its effect on preventing complications in this region remains poorly established. This narrative review, guided by the SANRA scale, synthesizes published evidence on the role of TPE in preventing complications of adult chronic diseases in SSA. A targeted search was run on 19 September 2026 through a web search engine (27 queries), with selection by a single reviewer and a thematic synthesis without formal risk-of-bias assessment. Diabetes accounts for most of the evidence, but findings diverge: one meta-analysis of randomized trials reports a mean HbA1c reduction of 0.57 percentage points, a 2025 meta-analysis (19 trials) a moderate and heterogeneous effect, and another 2025 meta-analysis (18 trials) a non-significant effect. In hypertension, team-based interventions led by non-physician providers lower systolic blood pressure by 3.91 mmHg on average, with low certainty of evidence. Nurse-led, peer-led and community health worker programmes appear promising, but the effect of education is hard to separate from that of follow-up and treatment; mobile health has not shown conclusive benefit, and community support in HIV yields mixed results. No TPE data were identified for sickle cell disease or chronic kidney disease, and clinical complications are rarely assessed. TPE can improve intermediate outcomes, but the size and consistency of the effect vary, and evidence that it prevents complications remains indirect; no trial was identified in Niger.
Keywords: patient education; self-management; chronic disease; sub-Saharan Africa; diabetes complications; hypertension; community health workers