TYPE 2 DIABETES MELLITUS IN THE ARUMERU DISTRICT OF NORTHERN TANZANIA: EVALUATION OF THE PREVALENCE AND ASSOCIATED RISK FACTORS IN RURAL COMMUNITIES
Miller, Benjamin J.
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Purpose: Describe the prevalence of diabetes in rural northern Tanzania and the association between biometric markers and lifestyle indicators with diabetes, hypertension, and obesity.Background: Diabetes in sub-Sahara Africa is expected to increase by 161% in the next 15 years. Estimates suggest the prevalence of diabetes is 4.8% in east Africa and 1.4% in rural Tanzania. The cost of health care is high when compared to average household income. Understanding prevalence rates as well as increased risk factors will help develop preventative interventions. Methods: Cross-sectional observational study was used to estimate the indirect the age-adjusted prevalence rates of pre-diabetes and diabetes in rural Tanzania. Data regarding socioeconomic status (SES), past medical history, behavioral lifestyle factors, and anthropometric measurements described the association and odds ratio for the development of impaired glucose metabolism (IGM), hypertension (HTN) and excessive adiposity.Findings: The age adjusted rates for pre-diabetes and T2DM are 2.55% (95% CI [0.06; 0.1]) and 2.81% (95% CI [0.07; 0.12]), respectively. Impaired glucose metabolism (IGM) was associated with excessive adiposity (p=.003) and hypertension (p=.001). Advancing age was significantly associated with IGM (p=.004), HTN (p=.001) and excess adiposity (p<.001). Higher glucose levels were associated with an increased risk of developing hypertension (p=.001) and excessive adiposity (p=.006). Factors associated with excess adiposity included advancing age, female gender (p<.001) and wooden or concrete household flooring (p=.001). When regressed, higher frequency of sweet drink consumption was associated with higher fasting plasma glucose levels (p=.012). Significance: The prevalence of pre-diabetes and diabetes has been established in the rural AruMeru district Tanzania. Socioeconomic development increased the risk of developing hypertension, diabetes, and adiposity. Understanding the prevalence rates for diabetes and factors with IGM will guide in the planning intervention strategies and health policy.