Speaker
Description
Background
Diabetes prevalence is increasing, but the rate is faster in sub-Saharan Africa (SSA) than in other regions. It is a matter of concern among people living with HIV (PLWH) in SSA due to the long years of diabetogenic antiretroviral therapy (ART) and the epidemiological transition of chronic diseases in the region. For this reason, the current study sought to explore the burden of diabetes among PLWH and examine the predictors of undiagnosed diabetes mellitus (DM) among participants.
Methods
A hospital-based cross-sectional study design and systematic sampling were used to recruit 254 PLWH. Anthropometric measurements and lifestyle factors, including alcohol consumption, were done using the WHO STEPS protocol. Blood samples were also taken to determine the HbA1c level. Age-standardized prevalence of DM was determined using WHO weighted prevalence. Univariable and multivariable logistic regression models were used to determine the predictors of undiagnosed DM.
Results
The mean age of participants was 54.87 years (SD=7.06) and females were the majority, 73.1% (n=87). The crude prevalence of DM was 26.89% (95% CI, 19.17-35.79) of the study population, and 23.5% (95% CI: 16.3-32.1) were undiagnosed of the study population, while 20.2% (95% CI: 13.5-28.4) were pre-diabetics, and 1.7%, (95% CI: 0.2-6.0%) were uncontrolled. The DM detection rate was 12.5% and 50% controlled rates. Most of the participants who were DM were between 50 and 59 years and were females, 90.6% (n=29), had a normal BMI 43.7% (n=14), and 43.7% were obese (n=14). Adjusted for covariates (age, HbA1c, sex, hypertension, ART duration, income and alcohol consumption), in a multivariate model, for each decrease in income, there is 0.3% (OR=.997, 95% CI: .994-.999, P=.011) odds of undiagnosed DM. For every unit increase in BMI, there is 11.3% (OR = 1.113, 95% CI: 1.001-1.236, P = .047) increased odds of undiagnosed DM.
Conclusion: There were high rates of undiagnosed diabetes and pre-diabetes among PLWH. DM screening, care and prevention should be integrated with routine HIV care and non-drug intervention programs should be encouraged among participants with pre-diabetes to prevent their progression.