A population-based survey of prevalence of diabetes and correlates in an urban slum community in Nairobi, Kenya
A population-based survey of prevalence of diabetes and correlates in an urban slum community in Nairobi, Kenya
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DOI：
10.1186/1471-2458-13-371
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发表时间：
2013-04-20
影响因子：
4.5
通讯作者：
Mutai, Kenneth K.
中科院分区：
文献类型：
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作者：
Ayah, Richard;Joshi, Mark D.;Mutai, Kenneth K.
背景：非洲城市贫民窟人口的增长速度继续快于国家人口。普遍缺乏以这部分人口的非传染性疾病为重点的卫生战略。我们确定了糖尿病和相关的心血管疾病（CVD）的危险因素相关的基贝拉，内罗毕最大的slum.Methods：我们进行了一项以人口为基础的家庭调查，利用整群抽样的概率成比例的大小。采用随机游走法选择住户，招募18岁及以上同意的居民。使用WHO STEPS工具。获得随机毛细血管血糖（RCBS）;已知患有糖尿病的人和RCBS >11.1的受试者抽取8小时空腹血糖（FBS）。糖尿病被定义为RCBS>= 11.1 mmol/l和FBS>= 7.0 mmol/l，或先前诊断或接受糖尿病药物治疗。结果：在2061名入组者中，50.9%为男性，平均年龄为33.4岁，87%至少受过小学教育。只有10.6%的人曾经测量过血糖。年龄校正的糖尿病患病率为5.3%（95% CI 4.2-6.4），患病率随年龄增加而增加，在45-54岁年龄组达到峰值10.5%（95% CI 6.8-14.3%）。糖尿病（DM）的相关因素是：13.1%吸烟，74.9%饮酒，75.7%高水平的体力活动，16.3%肥胖和29%超重，女性的比例更高。在糖尿病患者中，肥胖、腰围增加和高血压的几率分别是非糖尿病患者的三倍、两倍和三倍。糖尿病受试者的心血管危险因素高，反映了整个样本，但他们有一个显着更高的使用tobacco.Conclusions：这个以前未研究的城市贫民窟有一个高患病率的DM，但低筛查率。关键的相关因素包括吸烟和大量饮酒。然而，也有报告说，体力活动水平很高。研究结果对NCD的预防和护理具有重要意义。对于这一迅速增长的年轻城市贫民窟人口，决策者需要将注意力集中在不仅应对传染性疾病而且应对非传染性疾病的战略上。
Background: Urban slum populations in Africa continue to grow faster than national populations. Health strategies that focus on non-communicable diseases (NCD) in this segment of the population are generally lacking. We determined the prevalence of diabetes and associated cardiovascular disease (CVD) risk factors correlates in Kibera, Nairobi's largest slum.Methods: We conducted a population-based household survey utilising cluster sampling with probability proportional to size. Households were selected using a random walk method and consenting residents aged 18 years and above were recruited. The WHO STEPS instrument was administered. A random capillary blood sugar (RCBS) was obtained; known persons with diabetes and subjects with a RCBS >11.1 had an 8 hours fasting blood sugar (FBS) drawn. Diabetes was defined as a RCBS of >= 11.1 mmol/l and a FBS of >= 7.0 mmol/l, or a prior diagnosis or receiving diabetes drug treatment.Results: Out of 2061 enrolled; 50.9% were males, mean age was 33.4 years and 87% had a minimum of primary education. Only 10.6% had ever had a blood sugar measurement. Age adjusted prevalence of diabetes was 5.3% (95% CI 4.2-6.4) and prevalence increased with age peaking at 10.5% (95% CI 6.8-14.3%) in the 45-54 year age category. Diabetes mellitus (DM) correlates were: 13.1% smoking, 74.9% alcohol consumption, 75.7% high level of physical activity; 16.3% obese and 29% overweight with higher rates in women. Among persons with diabetes the odds of obesity, elevated waist circumference and hypertension were three, two and three fold respectively compared to those without diabetes. Cardiovascular risk factors among subjects with diabetes were high and mirrored that of the entire sample; however they had a significantly higher use of tobacco.Conclusions: This previously unstudied urban slum has a high prevalence of DM yet low screening rates. Key correlates include cigarette smoking and high alcohol consumption. However high levels of physical activity were also reported. Findings have important implications for NCD prevention and care. For this rapidly growing youthful urban slum population policy makers need to focus their attention on strategies that address not just communicable diseases but non communicable diseases as well.