Abstract
To ascertain the prevalence of diabetes mellitus from history and biochemical estimation so as to attest the WHO Rule of halves in a lean population. A population based national survey on diabetes mellitus was carried out in 2009. History and fingerpicks blood analysis were examined according to recommended procedures of the WHO STEPwise approach and the WHO recommended automated machine to compare the two modalities of estimating diabetes prevalence. Over 6000 people with a response rate of 95 % and a prevalence of raised blood glucose of 5.0 %. The prevalence from history of raised blood sugar was 2.2 %. Less than half (47 %) of the persons with high blood glucose were aware of their status with less than half on treatment. Of those on treatment less than half (30 %) were well controlled. Prevalence of raised fasting blood glucose was more than double that estimated from history, with less than half of the people aware of their status and of those on treatment nearly half are under good control. The underestimation of the disease through history supports the WHO rule of halves and calls for the use of biochemical tests when estimating prevalence of diabetes in the general population or at least doubling the rate from history alone.
Highlights
Diabetes mellitus, which was insignificant in its prevalence in early 1900 (Cook 1901) and was further estimated to be insignificant till the 1960s, is rapidly increasing
Once the questionnaire was adapted it was tested before the actual data collection process, the questionnaire was uploaded into Personal Digital Assistants (PDAs) to be used by the data collectors as e-questionnaire
Tigrigna ethnic group showed the highest prevalence of raised fasting blood glucose (5.5 %), followed by Tigre (2.3 %) while the remaining seven ethnic groups combined was slightly higher (2.8 %) than that of Tigre ethnic group alone (Table 2)
Summary
Diabetes mellitus, which was insignificant in its prevalence in early 1900 (Cook 1901) and was further estimated to be insignificant till the 1960s, is rapidly increasing. In 2010, 12.1 million people were estimated to be living with diabetes in Sub-Saharan Africa and this was extrapolated to increase to 23.9 million by 2030 (Sicre et al 2009). The prevalence rates range from 2.5–8 % in the rural and urban communities of West Africa and. Various studies on trends of diabetes mellitus in the African region demonstrate that there is a dramatic increase in the prevalence affecting both rural and urban communities as well as men and women as in Cameroun whereby type 2 diabetes increased tenfold between 1994 and 2003 (Hanley 2007; Mufunda et al 2006; Hall et al 2011; Usman et al 2006)
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