Knowledge, Awareness, and Health-Seeking Behavior Regarding Polycystic Ovary Syndrome in Sub-Saharan Africa: A Systematic Review and Meta-Analysis Incorporating Novel Community Data from Tanzania

Abstract

Polycystic Ovary Syndrome (PCOS) is a prevalent endocrine disorder with significant reproductive and cardiometabolic implications. Although global awareness is growing, data from Sub-Saharan Africa (SSA) remain fragmented. This study aims to systematically review and meta-analyze PCOS awareness in SSA, integrating novel community-based data from Dar-es-Salaam, Tanzania. Following PRISMA guidelines, a systematic search was conducted across PubMed, Scopus, and African Journals Online (AJOL) through May 2026. Primary community- and clinical-based studies assessing PCOS awareness, knowledge, and information sources in SSA were included. Novel cross-sectional data from Dar-es-Salaam (N=405 women of reproductive age) were pooled with identified regional studies. A random-effects meta-analysis was used to calculate pooled proportions for awareness and knowledge domains. Seven studies (including the novel Dar-es-Salaam cohort, N=405; Ethiopian healthcare providers, N=210; and Tanzanian fertility cohorts) met the inclusion criteria. The pooled prevalence of basic PCOS awareness among SSA women was 48.2% (95% CI: 39.1–57.4, I²=78%). Awareness of overt reproductive symptoms was moderate (pooled irregular menstruation recognition: 71.5%), whereas knowledge of long-term metabolic complications was critically low (pooled awareness of Type 2 Diabetes risk: 41.3%). Social media emerged as a primary yet unregulated information source (39.3% daily use in the Tanzanian cohort), whereas healthcare providers accounted for only 14.3% of initial information dissemination. There is a profound disconnect between the clinical burden of PCOS and community awareness in SSA. Awareness is largely superficial, focusing on reproductive symptoms while overlooking critical cardiometabolic risks. Urgent, culturally adapted, multi-channel health literacy interventions are required.