Background : Despite the rising prevalence of diabetes in Nigeria and sub-Saharan Africa , few studies have assessed the prevalence of prediabetes and diabetes in people with low socioeconomic status or urban slums. Methods: Using the WHO STEP-wise approach to surveillance of noncommunicable diseases, we estimated the prevalence of diabetes and prediabetes among adults 20 years and older living in two urban slums in Enugu south east Nigeria. Diabetes was defined as previous history of diabetes, use of hypoglycemic agents and fasting blood glucose within the diabetes range on two occasions during the survey period. Study duration was 5 months. Results: Out o f the 811 individuals invited to the clinic, 605 (74.6%) participants had their fasting blood glucose measured based on the study protocol. The prevalence of diabetes and prediabetes in the population was 11.7% (95% CI; 9.2 - 14.3) and 7.6% (95% CI; 5.0 - 9.7) respectively. About 54.9% were newly detected and 28.1% of them had normal control. The prevalence of diabetes peaked at 55 - 64 years. The odds ratio for diabetes was significantly higher in participants ≥ 45 years (1.033, 95% CI; 1.208 - 3.420), participants with hypertension (0.442, 95% CI; 0.257 - 0.762) and stroke (1.638, 95% CI; 0.459 - 5.848). Conclusion: There is a relatively high prevalence of diabetes among adults in two urban slums in Enugu. Public health educational measures promoting prevention and early detection of diabetes should be encouraged. Efforts should be made to educate the populace on the need for early detection and treatment.
Mbanya, J.C., Motala, A.A., Sobngwi, E., Assah, F.K. and Enoru, S.T. (2010) Diabetes in Sub-Saharan Africa. The Lancet, 375, 2254-2266. https://doi.org/10.1016/S0140-6736(10)60550-8
IDF Diabetes Atlas. (2013) Sixth Edition, International Diabetes Federation. http://www.idf.org/diabetesatlas
Noncommunicable Diseases Country Profiles. (2011) World Health Organization.
Shaw, J.E., Sicree, R.A. and Zimmet, P.Z. (2009) Global Estimates of the Prevalence of Diabetes for 2010 and 2030. Diabetes Research in Clinical Practice, 87, 2009-2014.
Hall, V., Thomson, W.T., Henriksen, O. and Lohse, N. (2011) Diabetes in Sub-Saharan Africa 1999-2011: Epidemiology and Public Health Implications. A Systematic Review. BMC Public Health, 11, 564. https://doi.org/10.1186/1471-2458-11-564 http://www.biomedcentral.com/1471-2458/11/564
Chinenye, S. and Young, E. (2011) State of Diabetes Care in Nigeria: A Review. Nigeria Health Journal, 11, 101-109.
Bos, M. and Agyemang, C. (2013) Prevalence and Complications of Diabetes Mellitus in Northern Africa, a Systematic Review. BMC Public Health, 13, 387. https://doi.org/10.1186/1471-2458-13-387
Ejike, C.E.C.C., Uka, N.K. and Nwachukwu, S.O. (2015) Diabetes and Prediabetes in Adult Nigerians: Prevalence, and Correlations of Blood Glucose Concentrations with Measures of Obesity. African Journal of Biochemistry Research, 9, 55-60.
Akinjinmi, A.A., Adeyooye, O.A., Akingbade, O.A. and Okerentugba, P.O. (2014) Prevalence of Diabetes Mellitus in Abeokuta, Ogun State. Resarcher, 6, 73-75.
Mayega, R.W., Guwatudde, D., Makumbi, F., Nakwagala, F.N., Peterson, S., Tomson, G. and Ostenson, C. (2013) Diabetes and Pre-Diabetes among Persons Aged 35 to 60 Years in Eastern Uganda: Prevalence and Associated Factors. PLoS ONE, 8, e72554. https://doi.org/10.1371/journal.pone.0072554
Rabi, D.M., Edwards, A.L., Southern, A.D., Svenson, L.W., Sargious, P.M., Norton, P., Larsen, E.T. and Ghali, W.T. (2006) Association of Socio-Economic Status with Diabetes Prevalence and Utilization of Diabetes Care Services. BMC Health Services Research, 6, 124. https://doi.org/10.1186/1472-6963-6-124
Krishnan, S., Cozier, Y.C., Rosenburg, L. and Palmer, J. (2010) Socioeconomic Status and Incidence of Type 2 Diabetes: Results from the Black Women’s Health Study. American Journal of Epidemiology, 171, 564-570. https://doi.org/10.1093/aje/kwp443
Saydah, S. and Lochner, K. (2010) Socioeconomic Status and Risk of Diabetes-Related Mortality in the U.S. Public Health Reports, 125, 377-388. https://doi.org/10.1177/003335491012500306
Dall, T.M., Narayan, K.M.V., Gillespie, K.B., Gallo, P.D., Blanchard, T.D., Solcan, M., O’Grady, M. and Quick, W.W. (2014) Detecting Type 2 Diabetes and Prediabetes among Asymptomatic Adults in the United States: Modeling American Diabetes Association versus US Preventive Services Task Force Diabetes Screening Guidelines. Population Health Metrics, 12, 12. https://doi.org/10.1186/1478-7954-12-12
Forouhi, N.G., Luan, J., Hennings, S. and Wareham, N.J. (2007) Incidence of Type 2 Diabetes in England and Its Association with Baseline Impaired Fasting Glucose: The Ely Study 1990-2000. Diabetic Medicine, 24, 200-207. https://doi.org/10.1111/j.1464-5491.2007.02068.x
Balde, N.M., Diallo, I., Balde, M.D., Barry, I.S., Kaba, L., Diallo, M.M., Kake, A., Bah, D., Barry, M.M., Sangare-Bah, B. and Maugendre, D. (2007) Diabetes and Impaired Fasting Glucose in Rural and Urban Populations in Futa Jallon (Guinea): Prevalence and Associated Risk Factors. Diabetes & Metabolism, 33, 114-120. https://doi.org/10.1016/j.diabet.2006.10.001
Christensen, D.L., Friis, H., Mwaniki, D.L., Kilonzo, B., Tetens, I., Boit, M.K., Omondi, B., Kaduka, L. and Borch-Johnson, K. (2009) Prevalence of Glucose Intolerance and Associated Risk Factors in Rural and Urban Populations of Different Ethnic Groups in Kenya. Diabetes Research Clinical Practice, 84, 303-310. https://doi.org/10.1016/j.diabres.2009.03.007
Malek, R., Balatech, F., Laouamri, S., Hamdi-Cherif, M., Touabli, A., Bendib, W., Nechadi, A., Mekideche, F.Z. and Hanat, S. (2001) Prevalence of Type 2 Diabetes Mellitus and Glucose Intolerance in the Setif Area (Algeria). Diabetes and Metabolism, 27, 164-171.
Blakely, T., Hales, S. and Woodward, A. (2004) Poverty: Assessing the Distribution of Health Risks by Socioeconomic Position at National and Local Levels. World Health Organization, Geneva.
WHO (2005) WHO STEP Wise Approach to Chronic Disease Risk Factor Surveillance (STEPS). WHO, Geneva, Switzerland.
O’Brien, E., Asmar, R., Beilin, L., Imai, Y., Mancia, G., Mengden, T., Meyers, M., Palatini, P., Parati, G., Pickering, T., Redon, J., Staessen, J., Stergiou, G. and Verdecchia, P. (2005) On Behalf of the European Society of Hypertension Working Group on Blood Pressure Monitoring. Practice Guidelines of the European Society of Hypertension for Clinic, Ambulatory and Self Blood Pressure Measurement. Journal of Hypertension, 23, 697-701. https://doi.org/10.1097/01.hjh.0000163132.84890.c4
World Health Organization (2000) Obesity: Preventing and Managing the Global Epidemic.
Powers, A.C. (2005) Diabetes Mellitus. In: Kasper, D.L., Fauci, A.S., Longo, D.L., Braunwald, E., Hauser, S.L. and Jameson, J.L., Eds., Harrison’s Principles of Internal Medicine, 16th Edition, McGraw-Hill, New York, 2152-2180.
World Health Organization. (2018) Global Status Report on Alcohol and Health 2018.
Yamane, T. (1967) Statistics: An Introductory Analysis. 2nd Edition, Harper and Row, New York.
Ahmad, O.B., Boschi-Pinto, C., Lopez, A.D., Murray, C.J.L., Lozano, R. and Inoue, M. (2001) Age Standardization of Rates: A New WHO Standard. World Health Organization.
(2006) Federal Republic of Nigeria 2006 Population and Housing Census. Population Distribution by Age and Sex (State and Local Government Area). National Population Commission, Abuja, Nigeria.
MOH (2005) National Survey: Zimbabwe Non-Communicable Disease Risk Factors (ZiNCoDs). Preliminary Report. Ministry of Health and Child Welfare, Zimbabwe.
Ben Romdhane, H., Ben Ali, S., Aissi, W., Traissac, P., Aounallah-Skhiri, H., Bougatef, S., Marie, B., Delpeuchm, F. and Achour N. (2014) Prevalence of Diabetes in Northern African Countries: The Case of Tunisia. BMC Public Health, 14, 86. https://doi.org/10.1186/1471-2458-14-86
Guize, L., Jaffiol, C., Gueniot, M., Bringer, J., Tramoni, M., Thomas, F., Pannier, B., Bean, K. and Jego, B. (2008) Diabetes and Socioeconomic Deprivation: A Study in a Large French Population. Bulletin de l’Academienationale de Medicine, 192, 1707-1723.
Sims, M., Diez Roux, A.V., Boykin, S., Sarpong, D., Gebreab, S.Y., Wyatt, S.B., Hickson, D., Payton, M., Ekunwe, L. and Taylor, H.A. (2011) The Socioeconomic Gradient of Diabetes Prevalence, Awareness, Treatment, and Control among African Americans in the Jackson Heart Study. Annals of Epidemiology, 21, 892-898. https://doi.org/10.1016/j.annepidem.2011.05.006
Sobngwi, E., Mbanya, J.C., Unwin, N.C., Kengne, A.P., Fezeu, L., Minkoulou, E.M., Aspray, T.J. and Alberti, K.G. (2002) Physical Activity and Its Relationship with Obesity, Hypertension and Diabetes in Urban and Rural Cameroon. International Journal of Obesity, 26, 1009-1016. https://doi.org/10.1038/sj.ijo.0802008
Mathenge, W., Foster, A. and Kuper, H. (2010) Urbanization, Ethnicity and Cardiovascular Risk in a Population in Transition in Nakuru, Kenya: A Population-Based Survey. BMC Public Health, 10, 569. https://doi.org/10.1186/1471-2458-10-569
Uche, O.E. (2017) Factors Affecting Health Seeking Behaviour among Rural Dwellers in Nigeria and Its Implication on Rural Livelihood. European Journal of Social Sciences Studies, 2, 2. https://www.oapub.org/soc/
Nathan, D.M., Davidson, M.B., De Fronzo, R.A., Heine, R.J., Henry, R.R., Pratley, R. and Zinman, B. (2007) American Diabetes Association. Impaired Fasting Glucose and Impaired Glucose Tolerance: Implications for Care. Diabetes Care, 30, 753-759. https://doi.org/10.2337/dc07-9920
Larson, H., Lindgarde, F., Berglund, G. and Ahren, B. (2004) Prediction of Diabetes Using ADA or WHO Criteria in Postmenopausal Women: A 10 Year Follow-Up Study. Diabetologia, 43, 1224-1228.
Ezeala-Adikaibe, B.A., Orjioke, C., Ekenze, O.S., Ijoma, U., Onodugo, O., Okudo, G., Okwara, C., Chime, P., Mbadiwe, N., Eddy, A., Onyekonwu, C., Onyebueke, G., Ulasi, I. and Mbah, A.U. (2015) Population-Based Prevalence of High Blood Pressure among Adults in an Urban Slum in Enugu, South East Nigeria. Journal of Human Hypertension, 30, 285-291. https://doi.org/10.1038/jhh.2015.49
Ulasi, I.I., Ijoma, C.K., Onwubere, B.J., Arodiwe, E., Onodugo, O. and Okafor, C. (2011) High Prevalence and Low Awareness of Hypertension in a Market Population in Enugu, Nigeria. International Journal of Hypertension, 2011, Article ID: 869675.
Okafor, C.I., Gezawa, I.D., Sabir, A.A., Raimi, T.H. and Enang, O. (2014) Obesity, Overweight, and Underweight among Urban Nigerians. Nigerian Journal of Clinical Practice, 17, 743-749. https://doi.org/10.4103/1119-3077.144389