Ayele Behailu Hawulte, Roba Hirbo Shore, Beyene Addisu Shunu, Mengesha Melkamu Merid
School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.
Department of Epidemiology and Biostatistics Unit, College of Health and Medical Sciences, School of Public Health, Haramaya University, Harar, Ethiopia.
SAGE Open Med. 2020 Nov 20;8:2050312120975235. doi: 10.1177/2050312120975235. eCollection 2020.
Globally, 8.8% of adults were estimated to have diabetes mellitus, with the low-and middle-income countries sharing the largest burden. However, the research evidence for targeted interventions is lacking in sub-Saharan Africa, particularly in Ethiopia. Therefore, this study aimed to assess the prevalence of diabetes mellitus, disaggregated by the epidemiology of diabetes mellitus morbidity and associated factors among adults in Dire Dawa town, Eastern Ethiopia.
Data from a total of 872 randomly sampled adults aged 25-64 years were obtained for analysis using the World Health Organization STEPwise approach to non-communicable disease risk factors surveillance instruments. We estimated the prevalence of diabetes mellitus disaggregated by the previous diabetes mellitus diagnosis status and by the current blood sugar level control status. The bivariable and multivariable binary logistic regression model was used to identify correlates of diabetes mellitus, along with STATA version 14.2 for data management and analysis. All statistical tests were declared significant at p-value < 0.05.
14.9% (95% confidence interval: 12.1, 17.4) of adults aged 25-64 years had diabetes mellitus in the study sample with 58.5% (95% confidence interval: 49.7, 66.7) on diabetes mellitus medication. Among adults currently taking diabetes mellitus medications, 30.3% (95% confidence interval: 19.8, 45.6) had uncontrolled diabetes mellitus. The magnitude of previously undiagnosed diabetes mellitus was 6.2% (95% confidence interval: 4.8, 8.0) in the study sample and 41.5% (95% confidence interval: 33.3, 50.3) among the diabetics. The odds of diabetes mellitus were higher among adults over the age of 55 years (adjusted odds ratio = 2.1, 95% confidence interval: 1.2, 3.6), currently married adults (adjusted odds ratio = 2.3, 95% confidence interval: 1.2, 4.4), and overweight adults (adjusted odds ratio = 1.6, 95% confidence interval: 1.1, 2.1). Adults with primary education (adjusted odds ratio = 0.4, 95% confidence interval: 0.2, 0.8) and no formal education (adjusted odds ratio = 0.5, 95% confidence interval: 0.2, 0.9) had lower odds of diabetes mellitus.
The prevalence of diabetes mellitus among adults was high in Dire Dawa, with a third of the diabetics having poor control of their blood sugar levels and, nearly four in ten were previously undiagnosed. Adults who were overweight, currently married, and those over 55 years need to be targeted for regular diabetes health checkups and community-based screening. Also, a mechanism should be instituted to track a patient's adherence to medications and promote diabetes self-care management.
据估计，全球8.8%的成年人患有糖尿病，低收入和中等收入国家负担最重。然而，撒哈拉以南非洲地区，尤其是埃塞俄比亚，缺乏针对性干预措施的研究证据。因此，本研究旨在评估埃塞俄比亚东部迪雷达瓦镇成年人中糖尿病的患病率，并按糖尿病发病流行病学和相关因素进行分类。
使用世界卫生组织非传染性疾病风险因素监测工具的逐步方法，对872名年龄在25至64岁之间的随机抽样成年人的数据进行分析。我们根据先前的糖尿病诊断状况和当前的血糖水平控制状况，估计了糖尿病的患病率。采用双变量和多变量二元逻辑回归模型确定糖尿病的相关因素，并使用STATA 14.2版本进行数据管理和分析。所有统计检验的p值<0.05时被判定为显著。
在研究样本中，25至64岁的成年人中有14.9%（95%置信区间：12.1，17.4）患有糖尿病，其中58.5%（95%置信区间：49.7，66.7）正在服用糖尿病药物。在目前正在服用糖尿病药物的成年人中，30.3%（95%置信区间：19.8，45.6）的糖尿病未得到控制。在研究样本中，先前未被诊断出的糖尿病患病率为6.2%（95%置信区间：4.8，8.0），在糖尿病患者中为41.5%（95%置信区间：33.3，50.3）。55岁以上的成年人（调整后的优势比=2.1，95%置信区间：1.2，3.6）、目前已婚的成年人（调整后的优势比=2.3，95%置信区间：1.2，4.4）和超重成年人（调整后的优势比=1.6，95%置信区间：1.1，2.1）患糖尿病的几率更高。接受小学教育的成年人（调整后的优势比=0.4，95%置信区间：0.2，0.8）和未接受正规教育的成年人（调整后的优势比=0.5，95%置信区间：0.2，0.9）患糖尿病的几率较低。
迪雷达瓦成年人中糖尿病患病率较高，三分之一的糖尿病患者血糖控制不佳，近十分之四的患者先前未被诊断出。超重、目前已婚以及55岁以上的成年人需要作为定期糖尿病健康检查和社区筛查的目标人群。此外，应建立一种机制来跟踪患者对药物的依从性，并促进糖尿病自我护理管理。
