Prevalence, Risk Factors, and Complications of Diabetes in the Kilimanjaro Region: A Population-Based Study from Tanzania.

Autor: Stanifer JW; Division of Nephrology, Department of Medicine, Duke University, Durham, North Carolina, United States of America.; Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America.; Duke Clinical Research Institute, Duke University, Durham, North Carolina, United States of America., Cleland CR; Eye Department, Kilimanjaro Christian Medical Centre, Moshi, Tanzania., Makuka GJ; Kilimanjaro Christian Medical University College, Moshi, Tanzania., Egger JR; Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America., Maro V; Kilimanjaro Christian Medical University College, Moshi, Tanzania., Maro H; Eye Department, Kilimanjaro Christian Medical Centre, Moshi, Tanzania., Karia F; Kilimanjaro Christian Medical University College, Moshi, Tanzania., Patel UD; Division of Nephrology, Department of Medicine, Duke University, Durham, North Carolina, United States of America.; Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America.; Duke Clinical Research Institute, Duke University, Durham, North Carolina, United States of America., Burton MJ; International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, United Kingdom.; Moorfields Eye Hospital, London, United Kingdom., Philippin H; Eye Department, Kilimanjaro Christian Medical Centre, Moshi, Tanzania.; International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, United Kingdom.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2016 Oct 06; Vol. 11 (10), pp. e0164428. Date of Electronic Publication: 2016 Oct 06 (Print Publication: 2016).
DOI: 10.1371/journal.pone.0164428
Abstrakt: Background: In sub-Saharan Africa, diabetes is a growing burden, yet little is known about its prevalence, risk factors, and complications. To address these gaps and help inform public health efforts aimed at prevention and treatment, we conducted a community-based study assessing diabetes epidemiology.
Methods and Findings: We conducted a stratified, cluster-designed, serial cross-sectional household study from 2014-2015 in the Kilimanjaro Region, Tanzania. We used a three-stage cluster probability sampling method to randomly select individuals. To estimate prevalence, we screened individuals for glucose impairment, including diabetes, using hemoglobin A1C. We also screened for hypertension and obesity, and to assess for potential complications, individuals with diabetes were assessed for retinopathy, neuropathy, and nephropathy. We enrolled 481 adults from 346 urban and rural households. The prevalence of glucose impairment was 21.7% (95% CI 15.2-29.8), which included diabetes (5.7%; 95% CI 3.37-9.47) and glucose impairment with increased risk for diabetes (16.0%; 95% CI 10.2-24.0). Overweight or obesity status had an independent prevalence risk ratio for glucose impairment (2.16; 95% CI 1.39-3.36). Diabetes awareness was low (35.6%), and few individuals with diabetes were receiving biomedical treatment (33.3%). Diabetes-associated complications were common (50.2%; 95% CI 33.7-66.7), including renal (12.0%; 95% CI 4.7-27.3), ophthalmic (49.6%; 95% CI 28.6-70.7), and neurological (28.8%; 95% CI 8.0-65.1) abnormalities.
Conclusions: In a northern region of Tanzania, diabetes is an under-recognized health condition, despite the fact that many people either have diabetes or are at increased risk for developing diabetes. Most individuals were undiagnosed or untreated, and the prevalence of diabetes-associated complications was high. Public health efforts in this region will need to focus on reducing modifiable risk factors, which appear to include obesity, as well as early detection that includes increasing awareness. These findings highlight a growing urgency of diabetes prevention in this region as well as the need for treatment, including management of complications.
Competing Interests: The authors have declared that no competing interests exist.
Databáze: MEDLINE
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