دورية أكاديمية
أعرض في EDS

Diabetes care cascade and associated factors in 10 700 middle-aged adults in four sub-Saharan African countries: a cross-sectional study.

التفاصيل البيبلوغرافية
العنوان: Diabetes care cascade and associated factors in 10 700 middle-aged adults in four sub-Saharan African countries: a cross-sectional study.
المؤلفون: Wade AN; MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, University of the Witwatersrand Johannesburg Faculty of Health Sciences, Johannesburg, South Africa Alisha.wade@wits.ac.za., Maposa I; Division of Epidemiology and Biostatistics, University of the Witwatersrand Johannesburg Faculty of Health Sciences, Johannesburg, South Africa., Agongo G; Navrongo Health Research Centre, Navrongo, Ghana.; Department of Biochemistry and Forensic Sciences, School of Chemical and Biochemical Sciences, C. K. Tedam University of Technology and Applied Sciences, Navrongo, Ghana., Asiki G; Health and Systems for Health Unit, African Population and Health Research Center, Nairobi, Kenya., Boua P; Clinical Research Unit of Nanoro, Institut de Recherche en Sciences de la Sante, Ouagadougou, Burkina Faso., Choma SSR; Department of Pathology and Medical Sciences, DIMAMO Population Health Research Centre, University of Limpopo, Sovenga, South Africa., Gómez-Olivé FX; MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, University of the Witwatersrand Johannesburg Faculty of Health Sciences, Johannesburg, South Africa., Maimela E; Department of Public Health, University of Limpopo, Sovenga, South Africa., Micklesfield LK; South African Medical Research Council/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa., Mohamed SF; Health and Systems for Health Unit, African Population and Health Research Center, Nairobi, Kenya., Nonterah EA; Navrongo Health Research Centre, Navrongo, Ghana., Norris SA; South African Medical Research Council/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.; Global Health Research Institute, School of Health and Human Development, University of Southampton, Southampton, UK., Sorgho H; Clinical Research Unit of Nanoro, Institut de Recherche en Sciences de la Sante, Ouagadougou, Burkina Faso., Ramsay M; Sydney Brenner Institute for Molecular Bioscience, University of the Witwatersrand Johannesburg Faculty of Health Sciences, Johannesburg, South Africa., Crowther NJ; Department of Chemical Pathology, National Health Laboratory Service, University of the Witwatersrand Johannesburg Faculty of Health Sciences, Johannesburg, South Africa.
مؤلفون مشاركون: AWIGen and the H3Africa Consortium
المصدر: BMJ open [BMJ Open] 2023 Apr 27; Vol. 13 (4), pp. e069193. Date of Electronic Publication: 2023 Apr 27.
نوع المنشور: Journal Article; Research Support, N.I.H., Extramural
اللغة: English
بيانات الدورية: Publisher: BMJ Publishing Group Ltd Country of Publication: England NLM ID: 101552874 Publication Model: Electronic Cited Medium: Internet ISSN: 2044-6055 (Electronic) Linking ISSN: 20446055 NLM ISO Abbreviation: BMJ Open Subsets: MEDLINE
أسماء مطبوعة: Original Publication: [London] : BMJ Publishing Group Ltd, 2011-
مواضيع طبية MeSH: Diabetes Mellitus*/epidemiology , Diabetes Mellitus*/therapy , Hypertension*/epidemiology, Middle Aged ; Adult ; Humans ; Cross-Sectional Studies ; Blood Glucose ; Africa South of the Sahara/epidemiology ; Prevalence
مستخلص: Objectives: We investigated progression through the care cascade and associated factors for people with diabetes in sub-Saharan Africa to identify attrition stages that may be most appropriate for targeted intervention.
Design: Cross-sectional study.
Setting: Community-based study in four sub-Saharan African countries.
Participants: 10 700 individuals, aged 40-60 years.
Primary and Secondary Outcome Measures: The primary outcome measure was the diabetes cascade of care defined as the age-adjusted diabetes prevalence (self-report of diabetes, fasting plasma glucose (FPG) ≥7 mmol/L or random plasma glucose ≥11.1 mmol/L) and proportions of those who reported awareness of having diabetes, ever having received treatment for diabetes and those who achieved glycaemic control (FPG <7.2 mmol/L). Secondary outcome measures were factors associated with having diabetes and being aware of the diagnosis.
Results: Diabetes prevalence was 5.5% (95% CI 4.4% to 6.5%). Approximately half of those with diabetes were aware (54%; 95% CI 50% to 58%); 73% (95% CI 67% to 79%) of aware individuals reported ever having received treatment. However, only 38% (95% CI 30% to 46%) of those ever having received treatment were adequately controlled. Increasing age (OR 1.1; 95% CI 1.0 to 1.1), urban residence (OR 2.3; 95% CI 1.6 to 3.5), hypertension (OR 1.9; 95% CI 1.5 to 2.4), family history of diabetes (OR 3.9; 95% CI 3.0 to 5.1) and measures of central adiposity were associated with higher odds of having diabetes. Increasing age (OR 1.1; 95% CI 1.0 to 1.1), semi-rural residence (OR 2.5; 95% CI 1.1 to 5.7), secondary education (OR 2.4; 95% CI 1.2 to 4.9), hypertension (OR 1.6; 95% CI 1.0 to 2.4) and known HIV positivity (OR 2.3; 95% CI 1.2 to 4.4) were associated with greater likelihood of awareness of having diabetes.
Conclusions: There is attrition at each stage of the diabetes care cascade in sub-Saharan Africa. Public health strategies should target improving diagnosis in high-risk individuals and intensifying therapy in individuals treated for diabetes.
Competing Interests: Competing interests: ANW declares an honorarium received from Sanofi for serving as a panel member at an educational event on thyroid cancer. SAN declares participation in a data safety monitoring board of a Phase IV open-label trial to assess bone mineral density in a cohort of African women on Depo-Provera and tenofovir disoproxil fumarate switched to tenofovir alafenamide fumarate based antiretroviral therapy and Council membership in the International Society of Developmental Origins of Health and Disease.
(© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
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معلومات مُعتمدة: K43 TW010698 United States TW FIC NIH HHS; U54 HG006938 United States HG NHGRI NIH HHS
فهرسة مساهمة: Keywords: General diabetes; International health services; PUBLIC HEALTH
المشرفين على المادة: 0 (Blood Glucose)
تواريخ الأحداث: Date Created: 20230427 Date Completed: 20230501 Latest Revision: 20230504
رمز التحديث: 20240628
مُعرف محوري في PubMed: PMC10151877
DOI: 10.1136/bmjopen-2022-069193
PMID: 37105688
قاعدة البيانات: MEDLINE
الوصف
تدمد:2044-6055
DOI:10.1136/bmjopen-2022-069193