Skip to main content
Top
Published in: BMC Public Health 1/2014

Open Access 01-12-2014 | Research article

Diabetes mellitus in North West Ethiopia: a community based study

Authors: Solomon Mekonnen Abebe, Yemane Berhane, Alemayehu Worku, Abebayehu Assefa

Published in: BMC Public Health | Issue 1/2014

Login to get access

Abstract

Background

Diabetes mellitus is recognized as one of the emerging public health problems in developing countries. However, its magnitude has not been studied at community levels, making the provision of appropriate services difficult in such countries. Hence, this study aimed to compare the magnitude and associated risks of diabetes mellitus among urban and rural adults in northwest Ethiopia.

Methods

A cross-sectional population based survey was performed using the WHO STEPwise method on adults aged 35 years and above. A multistage cluster random sampling strategy was used to select study participants from urban and rural locations. Fasting blood glucose levels were determined using peripheral blood samples by finger puncture. Prevalence was computed with a 95% confidence interval for each residential area. Selected risk factors were assessed using logistic regression.

Results

The prevalence of diabetes mellitus among adults aged 35 years and above was 5.1% [95% CI: 3.8, 6.4] for urban and 2.1% [95% CI: 1.2, 2.9] for rural dwellers. The majority (69%) of the identified diabetic cases were not diagnosed prior to the survey. The highest proportion (82.6%) of the undiagnosed cases was noted among the rural population and 63% among the urban population. Family history of diabetes (AOR = 5.05; 2.43, 10.51), older age (AOR = 4.86; 1.99, 11.9) and physical inactivity (AOR = 1.92; 1.06, 3.45) were significantly associated with diabetes mellitus among the urban population. Alcohol consumption (AOR = 0 .24, 0 .06, 0.99) was inversely associated with diabetes mellitus in rural areas.

Conclusion

The prevalence of diabetes mellitus is considerably high among the urban compared to the rural population. Diabetes is largely undiagnosed and untreated, especially in rural settings. Appropriate actions need to be taken to provide access to early diagnosis and treatment in order to reduce associated complications.
Appendix
Available only for authorised users
Literature
1.
go back to reference Zaoui S, Biemont C, Meguenni K: Epidemiology of diabetes in urban and rural regions of Tlemcen (Western Algeria). Sante. 2007, 17 (1): 15-21.PubMed Zaoui S, Biemont C, Meguenni K: Epidemiology of diabetes in urban and rural regions of Tlemcen (Western Algeria). Sante. 2007, 17 (1): 15-21.PubMed
2.
go back to reference Shaw JE, Sicree RA, Zimmet PZ: Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes Res Clin Pract. 2010, 87 (1): 4-14. 10.1016/j.diabres.2009.10.007.CrossRefPubMed Shaw JE, Sicree RA, Zimmet PZ: Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes Res Clin Pract. 2010, 87 (1): 4-14. 10.1016/j.diabres.2009.10.007.CrossRefPubMed
3.
go back to reference Whiting DR, Guariguata L, Weil C, Shaw J: IDF diabetes atlas: global estimates of the prevalence of diabetes for 2011 and 2030. Diabetes Res Clin Pract. 2011, 94 (3): 311-321. 10.1016/j.diabres.2011.10.029.CrossRefPubMed Whiting DR, Guariguata L, Weil C, Shaw J: IDF diabetes atlas: global estimates of the prevalence of diabetes for 2011 and 2030. Diabetes Res Clin Pract. 2011, 94 (3): 311-321. 10.1016/j.diabres.2011.10.029.CrossRefPubMed
4.
go back to reference Gning SB, Thiam M, Fall F, Ba-Fall K, Mbaye PS, Fourcade L: Diabetes mellitus in sub-Saharan Africa: epidemiological aspects and management issues. Med Trop (Mars). 2007, 67 (6): 607-611. Gning SB, Thiam M, Fall F, Ba-Fall K, Mbaye PS, Fourcade L: Diabetes mellitus in sub-Saharan Africa: epidemiological aspects and management issues. Med Trop (Mars). 2007, 67 (6): 607-611.
5.
go back to reference Nshisso LD, Reese A, Gelaye B, Lemma S, Berhane Y, Williams MA: Prevalence of hypertension and diabetes among Ethiopian adults. Diabetes Metab Syndr. 2012, 6 (1): 36-41. 10.1016/j.dsx.2012.05.005.CrossRefPubMedPubMedCentral Nshisso LD, Reese A, Gelaye B, Lemma S, Berhane Y, Williams MA: Prevalence of hypertension and diabetes among Ethiopian adults. Diabetes Metab Syndr. 2012, 6 (1): 36-41. 10.1016/j.dsx.2012.05.005.CrossRefPubMedPubMedCentral
6.
go back to reference Leena A, Ahmad MaJPC MD: Type 2 diabetes prevention: a review. ADA Clin Diabetes. 2010, 28 (2): 53-59. 10.2337/diaclin.28.2.53.CrossRef Leena A, Ahmad MaJPC MD: Type 2 diabetes prevention: a review. ADA Clin Diabetes. 2010, 28 (2): 53-59. 10.2337/diaclin.28.2.53.CrossRef
7.
go back to reference Seyoum B: Impotence in Ethiopian diabetic men. East Afr Med J. 1998, 75 (4): 208-210.PubMed Seyoum B: Impotence in Ethiopian diabetic men. East Afr Med J. 1998, 75 (4): 208-210.PubMed
8.
go back to reference Worku D, Hamza L, Woldemichael K: Patterns of diabetic complications at jimma university specialized hospital, southwest ethiopia. Ethiop J Health Sci. 2010, 20 (1): 33-39.PubMedPubMedCentral Worku D, Hamza L, Woldemichael K: Patterns of diabetic complications at jimma university specialized hospital, southwest ethiopia. Ethiop J Health Sci. 2010, 20 (1): 33-39.PubMedPubMedCentral
9.
go back to reference Mengesha B, Abdulkadir J: Heritability of diabetes mellitus in Ethiopian diabetics. East Afr Med J. 1997, 74 (1): 37-40.PubMed Mengesha B, Abdulkadir J: Heritability of diabetes mellitus in Ethiopian diabetics. East Afr Med J. 1997, 74 (1): 37-40.PubMed
10.
go back to reference Cowie CC, Rust KF, Byrd-Holt DD, Eberhardt MS, Flegal KM, Engelgau MM, Saydah SH, Williams DE, Geiss LS, Gregg EW: Prevalence of diabetes and impaired fasting glucose in adults in the U.S. population: National Health And Nutrition Examination Survey 1999–2002. Diabetes Care. 2006, 29 (6): 1263-1268. 10.2337/dc06-0062.CrossRefPubMed Cowie CC, Rust KF, Byrd-Holt DD, Eberhardt MS, Flegal KM, Engelgau MM, Saydah SH, Williams DE, Geiss LS, Gregg EW: Prevalence of diabetes and impaired fasting glucose in adults in the U.S. population: National Health And Nutrition Examination Survey 1999–2002. Diabetes Care. 2006, 29 (6): 1263-1268. 10.2337/dc06-0062.CrossRefPubMed
12.
go back to reference Tadesse T, Getachew A, Admassu M, Kebede Y, Awoke T, Melese T, Amsalu S, Alemu S, Andargie G, Wassie B, et al: Demographic and health survey at Dabat District in Northwest, Ethiopia report of the 2008 baseline survey. Ethiopian J Health Biomed Sci. 2011, 4: 1-4. Tadesse T, Getachew A, Admassu M, Kebede Y, Awoke T, Melese T, Amsalu S, Alemu S, Andargie G, Wassie B, et al: Demographic and health survey at Dabat District in Northwest, Ethiopia report of the 2008 baseline survey. Ethiopian J Health Biomed Sci. 2011, 4: 1-4.
13.
go back to reference Muluneh AT, Haileamlak A, Tessema F, Alemseged F, Woldemichael K, Asefa M, Mamo Y, Tamiru S, Abebe G, Deribew A, et al: Population based survey of chronic non-communicable diseases at gilgel gibe field research center, southwest Ethiopia. Ethiop J Health Sci. 2012, 22 (S): 7-18.PubMedPubMedCentral Muluneh AT, Haileamlak A, Tessema F, Alemseged F, Woldemichael K, Asefa M, Mamo Y, Tamiru S, Abebe G, Deribew A, et al: Population based survey of chronic non-communicable diseases at gilgel gibe field research center, southwest Ethiopia. Ethiop J Health Sci. 2012, 22 (S): 7-18.PubMedPubMedCentral
14.
go back to reference Luboshitzky R, Atar S, Qupti G, Tamir A, Dgani Y, Flatau E: Prevalence of diabetes mellitus and glucose intolerance in adult Ethiopian immigrants. Harefuah. 1995, 128 (7): 406-408. 464PubMed Luboshitzky R, Atar S, Qupti G, Tamir A, Dgani Y, Flatau E: Prevalence of diabetes mellitus and glucose intolerance in adult Ethiopian immigrants. Harefuah. 1995, 128 (7): 406-408. 464PubMed
15.
go back to reference Longo-Mbenza B, Ngoma DV, Nahimana D, Mayuku DM, Fuele SM, Ekwanzala F, Beya C: Screen detection and the WHO stepwise approach to the prevalence and risk factors of arterial hypertension in Kinshasa. Eur J Cardiovasc Prev Rehabil. 2008, 15 (5): 503-508. 10.1097/HJR.0b013e3282f21640.CrossRefPubMed Longo-Mbenza B, Ngoma DV, Nahimana D, Mayuku DM, Fuele SM, Ekwanzala F, Beya C: Screen detection and the WHO stepwise approach to the prevalence and risk factors of arterial hypertension in Kinshasa. Eur J Cardiovasc Prev Rehabil. 2008, 15 (5): 503-508. 10.1097/HJR.0b013e3282f21640.CrossRefPubMed
16.
go back to reference Jaakkot Uomilehto AI, Johan GE: Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med Med. 2001, 344 (18): 1343-1349. 10.1056/NEJM200105033441801.CrossRef Jaakkot Uomilehto AI, Johan GE: Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med Med. 2001, 344 (18): 1343-1349. 10.1056/NEJM200105033441801.CrossRef
17.
go back to reference Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, Jones DW, Materson BJ, Oparil S, Wright JT, et al: Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension. 2003, 42 (6): 1206-1252. 10.1161/01.HYP.0000107251.49515.c2.CrossRefPubMed Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, Jones DW, Materson BJ, Oparil S, Wright JT, et al: Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension. 2003, 42 (6): 1206-1252. 10.1161/01.HYP.0000107251.49515.c2.CrossRefPubMed
18.
go back to reference Grundy SM, Brewer HB, Cleeman JI, Smith SC, Lenfant C: Definition of metabolic syndrome: Report of the National Heart, Lung, and Blood Institute/American Heart Association conference on scientific issues related to definition. Circulation. 2004, 109 (3): 433-438. 10.1161/01.CIR.0000111245.75752.C6.CrossRefPubMed Grundy SM, Brewer HB, Cleeman JI, Smith SC, Lenfant C: Definition of metabolic syndrome: Report of the National Heart, Lung, and Blood Institute/American Heart Association conference on scientific issues related to definition. Circulation. 2004, 109 (3): 433-438. 10.1161/01.CIR.0000111245.75752.C6.CrossRefPubMed
19.
go back to reference Lau DC, Douketis JD, Morrison KM, Hramiak IM, Sharma AM, Ur E: Canadian clinical practice guidelines on the management and prevention of obesity in adults and children [summary]. CMAJ 2007. 2006, 176 (8): S1-S13. Lau DC, Douketis JD, Morrison KM, Hramiak IM, Sharma AM, Ur E: Canadian clinical practice guidelines on the management and prevention of obesity in adults and children [summary]. CMAJ 2007. 2006, 176 (8): S1-S13.
20.
go back to reference Abubakari ARLW, Jones MC, Kirk A, Agyemang C, Bhopal RS: Prevalence and time trends in diabetes and physical inactivity among adult West African populations: the epidemic has arrived. Public Health. 2009, 123 (9): 602-614. 10.1016/j.puhe.2009.07.009.CrossRefPubMed Abubakari ARLW, Jones MC, Kirk A, Agyemang C, Bhopal RS: Prevalence and time trends in diabetes and physical inactivity among adult West African populations: the epidemic has arrived. Public Health. 2009, 123 (9): 602-614. 10.1016/j.puhe.2009.07.009.CrossRefPubMed
21.
go back to reference Peer N, Steyn K, Lombard C, Lambert EV, Vythilingum B, Levitt NS: Rising diabetes prevalence among urban-dwelling black South Africans. PloS One. 2012, 7 (9): e43336-10.1371/journal.pone.0043336.CrossRefPubMedPubMedCentral Peer N, Steyn K, Lombard C, Lambert EV, Vythilingum B, Levitt NS: Rising diabetes prevalence among urban-dwelling black South Africans. PloS One. 2012, 7 (9): e43336-10.1371/journal.pone.0043336.CrossRefPubMedPubMedCentral
22.
go back to reference Ramachandran A, Mary S, Yamuna A, Murugesan N, Snehalatha C: High prevalence of diabetes and cardiovascular risk factors associated with urbanization in India. Diabetes Care. 2008, 31 (5): 893-898. 10.2337/dc07-1207.CrossRefPubMed Ramachandran A, Mary S, Yamuna A, Murugesan N, Snehalatha C: High prevalence of diabetes and cardiovascular risk factors associated with urbanization in India. Diabetes Care. 2008, 31 (5): 893-898. 10.2337/dc07-1207.CrossRefPubMed
23.
go back to reference Mbanya JC, Motala AA, Sobngwi E, Assah FK, Enoru ST: Diabetes in sub-Saharan Africa. Lancet. 2010, 375 (9733): 2254-2266. 10.1016/S0140-6736(10)60550-8.CrossRefPubMed Mbanya JC, Motala AA, Sobngwi E, Assah FK, Enoru ST: Diabetes in sub-Saharan Africa. Lancet. 2010, 375 (9733): 2254-2266. 10.1016/S0140-6736(10)60550-8.CrossRefPubMed
24.
go back to reference LR K: IDF and WHO initiatives to put diabetes on the health agenda in Africa. Diabetes Voice. 2004, 49 (2): LR K: IDF and WHO initiatives to put diabetes on the health agenda in Africa. Diabetes Voice. 2004, 49 (2):
25.
go back to reference Hjelm K, Mufunda E: Zimbabwean diabetics’ beliefs about health and illness: an interview study. BMC Int Health Hum Rights. 2010, 10: 7-10.1186/1472-698X-10-7.CrossRefPubMedPubMedCentral Hjelm K, Mufunda E: Zimbabwean diabetics’ beliefs about health and illness: an interview study. BMC Int Health Hum Rights. 2010, 10: 7-10.1186/1472-698X-10-7.CrossRefPubMedPubMedCentral
26.
go back to reference Consultation WI: Definition and Diagnosis of Diabetes Mellitus and Intermediate Hyperglycemia. 2006, Geneva, Switzerland: WHO Document Production Services Consultation WI: Definition and Diagnosis of Diabetes Mellitus and Intermediate Hyperglycemia. 2006, Geneva, Switzerland: WHO Document Production Services
27.
go back to reference Adelson N: The embodiment of inequity: health disparities in aboriginal Canada. Can J Public Health. 2005, 96 (Suppl 2): S45-61.PubMed Adelson N: The embodiment of inequity: health disparities in aboriginal Canada. Can J Public Health. 2005, 96 (Suppl 2): S45-61.PubMed
28.
go back to reference Garcia-Palmieri MR, Costas R, Cruz-Vidal M, Cortes-Alicea M, Colon AA, Feliberti M, Ayala AM, Patterne D, Sobrino R, Torres R, et al: Risk factors and prevalence of coronary heart disease in Puerta Rico. Circulation. 1970, 42 (3): 541-549. 10.1161/01.CIR.42.3.541.CrossRefPubMed Garcia-Palmieri MR, Costas R, Cruz-Vidal M, Cortes-Alicea M, Colon AA, Feliberti M, Ayala AM, Patterne D, Sobrino R, Torres R, et al: Risk factors and prevalence of coronary heart disease in Puerta Rico. Circulation. 1970, 42 (3): 541-549. 10.1161/01.CIR.42.3.541.CrossRefPubMed
29.
go back to reference Zein CO, Levy C, Basu A, Zein NN: Chronic hepatitis C and type II diabetes mellitus: a prospective cross-sectional study. Am J Gastroenterol. 2005, 100 (1): 48-55. 10.1111/j.1572-0241.2005.40429.x.CrossRefPubMed Zein CO, Levy C, Basu A, Zein NN: Chronic hepatitis C and type II diabetes mellitus: a prospective cross-sectional study. Am J Gastroenterol. 2005, 100 (1): 48-55. 10.1111/j.1572-0241.2005.40429.x.CrossRefPubMed
30.
go back to reference Rouabhia S, Malek R, Bounecer H, Dekaken A, Bendali Amor F, Sadelaoud M, Benouar A: Prevalence of type 2 diabetes in Algerian patients with hepatitis C virus infection. World J Gastroenterol. 2010, 16 (27): 3427-3431. 10.3748/wjg.v16.i27.3427.CrossRefPubMedPubMedCentral Rouabhia S, Malek R, Bounecer H, Dekaken A, Bendali Amor F, Sadelaoud M, Benouar A: Prevalence of type 2 diabetes in Algerian patients with hepatitis C virus infection. World J Gastroenterol. 2010, 16 (27): 3427-3431. 10.3748/wjg.v16.i27.3427.CrossRefPubMedPubMedCentral
31.
go back to reference Danquah I, Bedu-Addo G, Terpe KJ, Micah F, Amoako YA, Awuku YA, Dietz E, van der Giet M, Spranger J, Mockenhaupt FP: Diabetes mellitus type 2 in urban Ghana: characteristics and associated factors. BMC Public Health. 2012, 12: 210-10.1186/1471-2458-12-210.CrossRefPubMedPubMedCentral Danquah I, Bedu-Addo G, Terpe KJ, Micah F, Amoako YA, Awuku YA, Dietz E, van der Giet M, Spranger J, Mockenhaupt FP: Diabetes mellitus type 2 in urban Ghana: characteristics and associated factors. BMC Public Health. 2012, 12: 210-10.1186/1471-2458-12-210.CrossRefPubMedPubMedCentral
32.
go back to reference Ferrannini E, Gastaldelli A, Iozzo P: Pathophysiology of prediabetes. Med Clin North Am. 2011, 95 (2): 327-339. 10.1016/j.mcna.2010.11.005. vii-viiiCrossRefPubMed Ferrannini E, Gastaldelli A, Iozzo P: Pathophysiology of prediabetes. Med Clin North Am. 2011, 95 (2): 327-339. 10.1016/j.mcna.2010.11.005. vii-viiiCrossRefPubMed
33.
go back to reference van Dam RM: The epidemiology of lifestyle and risk for type 2 diabetes. Eur J Epidemiol. 2003, 18 (12): 1115-1125.CrossRefPubMed van Dam RM: The epidemiology of lifestyle and risk for type 2 diabetes. Eur J Epidemiol. 2003, 18 (12): 1115-1125.CrossRefPubMed
34.
go back to reference Norris SL, Zhang X, Avenell A, Gregg E, Schmid CH, Lau J: Long-term non-pharmacological weight loss interventions for adults with prediabetes. Cochrane Database Syst Rev. 2005, 2: CD005270 Norris SL, Zhang X, Avenell A, Gregg E, Schmid CH, Lau J: Long-term non-pharmacological weight loss interventions for adults with prediabetes. Cochrane Database Syst Rev. 2005, 2: CD005270
35.
go back to reference Jeon CY, Lokken RP, Hu FB, van Dam RM: Physical activity of moderate intensity and risk of type 2 diabetes: a systematic review. Diabetes Care. 2007, 30 (3): 744-752. 10.2337/dc06-1842.CrossRefPubMed Jeon CY, Lokken RP, Hu FB, van Dam RM: Physical activity of moderate intensity and risk of type 2 diabetes: a systematic review. Diabetes Care. 2007, 30 (3): 744-752. 10.2337/dc06-1842.CrossRefPubMed
36.
go back to reference Goodyear LJ, Kahn BB: Exercise, glucose transport, and insulin sensitivity. Annu Rev Med. 1998, 49: 235-261. 10.1146/annurev.med.49.1.235.CrossRefPubMed Goodyear LJ, Kahn BB: Exercise, glucose transport, and insulin sensitivity. Annu Rev Med. 1998, 49: 235-261. 10.1146/annurev.med.49.1.235.CrossRefPubMed
37.
go back to reference Howard AA, Arnsten JH, Gourevitch MN: Effect of alcohol consumption on diabetes mellitus: a systematic review. Ann Intern Med. 2004, 140 (3): 211-219. 10.7326/0003-4819-140-6-200403160-00011.CrossRefPubMed Howard AA, Arnsten JH, Gourevitch MN: Effect of alcohol consumption on diabetes mellitus: a systematic review. Ann Intern Med. 2004, 140 (3): 211-219. 10.7326/0003-4819-140-6-200403160-00011.CrossRefPubMed
38.
go back to reference van de Wiel A: Diabetes mellitus and alcohol. Diabetes Metab Res Rev. 2004, 20 (4): 263-267. 10.1002/dmrr.492.CrossRefPubMed van de Wiel A: Diabetes mellitus and alcohol. Diabetes Metab Res Rev. 2004, 20 (4): 263-267. 10.1002/dmrr.492.CrossRefPubMed
39.
go back to reference Baliunas DO, Taylor BJ, Irving H, Roerecke M, Patra J, Mohapatra S, Rehm J: Alcohol as a risk factor for type 2 diabetes: a systematic review and meta-analysis. Diabetes Care. 2009, 32 (11): 2123-2132. 10.2337/dc09-0227.CrossRefPubMedPubMedCentral Baliunas DO, Taylor BJ, Irving H, Roerecke M, Patra J, Mohapatra S, Rehm J: Alcohol as a risk factor for type 2 diabetes: a systematic review and meta-analysis. Diabetes Care. 2009, 32 (11): 2123-2132. 10.2337/dc09-0227.CrossRefPubMedPubMedCentral
Metadata
Title
Diabetes mellitus in North West Ethiopia: a community based study
Authors
Solomon Mekonnen Abebe
Yemane Berhane
Alemayehu Worku
Abebayehu Assefa
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2014
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-14-97

Other articles of this Issue 1/2014

BMC Public Health 1/2014 Go to the issue