Abstract
Background:Africa is experiencing a rapid increase in morbidity and mortality related to diabetes mellitus (DM). Contemporary data are needed to guide efforts to improve prevention and treatment for microvascular complications in children and adolescents in Africa. This study was conducted to assess prevalence of diabetic microvascular complications in northwestern Tanzania, including nephropathy, retinopathy, and neuropathy, as well as associated risk factors.Objectives:1) To determine the prevalence of microvascular complications and the overlap of nephropathy, retinopathy and neuropathy and 2) to determine factors associated with the development of microvascular complications.Methods:This cross-sectional study included 155 children and adolescents with DM consecutively attending all three health centers providing diabetes care for children in the Mwanza region of Tanzania. Participants were examined for microvascular complications and possible risk factors.Results:Fifty-one of 155 participants (age: 5–19 years) had diabetic nephropathy (32.9%), 16 had diabetic retinopathy (10.3%), and 21 had diabetic neuropathy (13.6%). Risk factors for development of a microvascular complication included age, duration of DM, and poor glycemic control. Of the participants, 107 had poor levels of glycemic control (69%) with HbA1C levels >10%.Conclusion:The prevalence of microvascular complications, especially that of nephropathy, was disturbingly high. Risk factors for microvascular complications were similar to other studies from Africa and included poor glycemic control, older age, and longer duration of DM. Innovative, locally appropriate systems for optimizing glycemic control are urgently needed.
Highlights
Africa is experiencing a rapid increase in morbidity and mortality related to diabetes mellitus (DM)
The number of individuals living with diabetes mellitus (DM) in Sub-Saharan Africa (SSA) is expected to grow from 12.1 million in 2010 to 34.2 million by 2040, the largest percentage increase in DM of any region in the world [2]
Study enrollment A total of 170 diabetic children and adolescents with DM attending the designated health facilities were screened for entry into the study
Summary
Africa is experiencing a rapid increase in morbidity and mortality related to diabetes mellitus (DM). This study was conducted to assess prevalence of diabetic microvascular complications in northwestern Tanzania, including nephropathy, retinopathy, and neuropathy, as well as associated risk factors. Objectives: 1) To determine the prevalence of microvascular complications and the overlap of nephropathy, retinopathy and neuropathy and 2) to determine factors associated with the development of microvascular complications. Risk factors for development of a microvascular complication included age, duration of DM, and poor glycemic control. Risk factors for microvascular complications were similar to other studies from Africa and included poor glycemic control, older age, and longer duration of DM. Africa is experiencing a rapid increase in morbidity and mortality related to diabetes mellitus (DM) [1]. One study estimated that children in rural Mozambique with DM live on average just 7.2 months after diagnosis [9]
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