Tarekegne Fitsum Eyayu, Padyab Mojgan, Schröders Julia, Stewart Williams Jennifer
Mailman School of Public Health, Centre for International Programs, Columbia University, Addis Ababa, Ethiopia.
Centre for Demographic and Ageing Research (CEDAR), Umeå University, Umea, Sweden.
BMJ Open Diabetes Res Care. 2018 Feb 2;6(1):e000449. doi: 10.1136/bmjdrc-2017-000449. eCollection 2018.
The objective is to identify and describe the sociodemographic and behavioral characteristics of adults, aged 50 years and over, who self-reported having been diagnosed and treated for diabetes mellitus (DM) in Ghana and South Africa.
This is a cross-sectional study based on the WHO Study on global AGEing and adult health (SAGE) wave 1. Information on sociodemographic factors, health states, risk factors and chronic conditions is captured from questionnaires administered in face-to-face interviews. Self-reported diagnosed and treated DM is confirmed through a 'yes' response to questions regarding having previously been diagnosed with DM, and having taken insulin or other blood sugar lowering medicines. Crude and adjusted logistic regressions test associations between candidate variables and DM status. Analyses include survey sampling weights. The variance inflation factor statistic tested for multicollinearity.
In this nationally representative sample of adults aged 50 years and over in Ghana, after adjusting for the effects of sex, residence, work status, body mass index, waist-hip and waist-height ratios, smoking, alcohol, fruit and vegetable intake and household wealth, WHO-SAGE survey respondents who were older, married, had higher education, very high-risk waist circumference measurements and did not undertake high physical activity, were significantly more likely to report diagnosed and treated DM. In South Africa, respondents who were older, lived in urban areas and had high-risk waist circumference measurements were significantly more likely to report diagnosed and treated DM.
Countries in sub-Saharan Africa are challenged by unprecedented ageing populations and transition from communicable to non-communicable diseases such as DM. Information on those who are already diagnosed and treated needs to be combined with estimates of those who are prediabetic or, as yet, undiagnosed. Multisectoral approaches that include socioculturally appropriate strategies are needed to address diverse populations in SSA countries.
旨在识别并描述加纳和南非50岁及以上自我报告已被诊断患有糖尿病（DM）并接受治疗的成年人的社会人口学和行为特征。
这是一项基于世界卫生组织全球老龄化与成人健康研究（SAGE）第一轮的横断面研究。通过面对面访谈中发放的问卷收集社会人口学因素、健康状况、风险因素和慢性病方面的信息。通过对先前是否被诊断患有糖尿病以及是否服用过胰岛素或其他降糖药物的问题回答“是”来确认自我报告的已诊断和治疗的糖尿病。采用粗逻辑回归和调整逻辑回归检验候选变量与糖尿病状态之间的关联。分析包括调查抽样权重。使用方差膨胀因子统计量检验多重共线性。
在加纳这个具有全国代表性的50岁及以上成年人样本中，在调整了性别、居住状况、工作状态、体重指数、腰臀比和腰高比、吸烟、饮酒、水果和蔬菜摄入量以及家庭财富的影响后，年龄较大、已婚、受过高等教育、腰围测量处于极高风险且未进行大量体育活动的世界卫生组织全球老龄化与成人健康研究调查受访者，报告已诊断和治疗糖尿病的可能性显著更高。在南非，年龄较大、居住在城市地区且腰围测量处于高风险的受访者报告已诊断和治疗糖尿病的可能性显著更高。
撒哈拉以南非洲国家面临着前所未有的人口老龄化以及从传染病向糖尿病等非传染病转变的挑战。已被诊断和治疗者的信息需要与糖尿病前期或尚未被诊断者的估计数相结合。需要采取包括社会文化适宜策略在内的多部门方法来应对撒哈拉以南非洲国家的不同人群。
