Abstract / Summary
Precision medicine approaches involving biomarkers and genomic technologies are increasingly being explored in bipolar disorder research globally. However, evidence from Africa remains fragmented. This systematic review aimed to synthesize available evidence on biomarkers, genetic information, and precision medicine applications in bipolar disorder across African populations. The review followed a published protocol registered on PROSPERO (ID: CRD420251174509) and adhered to PRISMA guidelines. The PsycInfo, PubMed, Scopus, Web of Science and CINAHL databases were searched. Screening and study selection were performed independently by two reviewers. Data extraction focused on study characteristics, biomarkers/genetic information assessed, technologies used, outcomes measured and reported associations. 3531 records were identified, and 14 studies met the inclusion criteria. Most studies were conducted in North Africa, specifically, Tunisia ( n = 7) and Egypt ( n = 2), with fewer studies from sub-Saharan Africa, namely South Africa ( n = 4) and Ethiopia ( n = 1). Eight studies investigated biochemical biomarkers, while six focused on genetic information. Most studies used prospective case-control design ( n = 10), while four studies used other prospective designs. BD patients sample size ranged from 5 to 109. Commonly studied biomarkers included inflammatory markers (C-reactive protein), oxidative stress markers (glutathione, thiols, malondialdehyde, advanced oxidation protein products), and metabolic markers (homocysteine and oxysterols). Genetic studies primarily assessed candidate gene polymorphisms involving BDNF , CACNA1C , DRD1 , DRD2 , AKT1 , and GSK3B . Biomarkers and genetic variants were mainly associated with BD diagnosis, disease susceptibility, condition severity, lithium treatment response, and treatment-related adverse effects. We found that, research remains geographically concentrated, methodologically heterogeneous, and limited in terms of genetic coverage. Studies largely focused on diagnostic applications, with limited evidence on prognosis, and longitudinal treatment monitoring. Expanding biomarker and genomic research to cover scientific and methodological gaps and improving regional representation are essential for advancing precision psychiatry on the continent.