Original articleAge and living in an urban environment are major determinants of diabetes among South Kivu Congolese adultsL’âge et le milieu urbain sont des déterminants majeurs du diabète sucré chez l’adulte congolais du Sud-Kivu
Introduction
Diabetes mellitus (DM) represents a worldwide public-health problem, and its prevalence is relentlessly increasing. From 1985 to 2000, the global prevalence of diabetic patients rose from 30 to 157 million, while the projections for 2030 estimate that this number will reach 366 million [1]. The majority of cases represent type 2 diabetes mellitus (T2DM). Each year, DM is responsible for more than one million deaths worldwide [2]. The major complications associated with chronic hyperglycaemia and T2DM co-morbidities (such as hypertension and dyslipidaemia) include micro- and macroangiopathy, with diabetic eye disease, diabetic nephropathy, coronary heart disease, stroke and lower-limb non-traumatic amputation responsible for the bulk of diabetes-related morbidity [3].
With an increased rate estimated at 170% compared with a 41% prevalence of DM in the developed countries, developing countries such as the Democratic Republic of Congo (DRC) are poised to face a surge in T2DM prevalence following the increasingly reported anticipated changes in lifestyle in these populations, especially in urban situations [1], [4], [5].
As for the DRC, the World Health Organization (WHO) estimates a prevalence of DM of less than 3% [1], citing studies undertaken in Tanzania [6], a country with some similarities to the DRC. However, investigations carried out of adult populations in the Kinshasa studies, which were mostly urban-based, put the prevalence of T2DM between 7% and 16% [7], [8], and the African WHO Regional Office now classifies the DRC among those countries in which the DM prevalence is between 7% and 10% [4].
Generalizing such results to the whole of the DRC, however, could prove hazardous, given the wide socioeconomic and lifestyle disparities in a population that is still overwhelmingly (57%) rural [9].
That is why the present study has focused on evaluating, within another DRC region, the urban vs rural differences and their relationship to risk factors of DM.
Section snippets
Study participants and sampling
The Visite de tension artérielle et du risque associé en Afrique (VITARAA; evaluation of arterial blood pressure and its associated risk in Africa) was conducted in Cameroon and in the DRC in 2008. The present report presents the results obtained in the region of South Kivu in the eastern part of the DRC [10].
In this region, multilevel sampling yielded the identification of 290 potential households, of which 200 were selected from 20 neighbourhoods (322 streets) in the city of Bukavu (with an
Results
The study participants’ general characteristics are shown in Table 1. Of the 669 subjects in the investigation, 424 lived in urban areas vs 245 in rural areas. Mean age, BMI, AC, systolic blood pressure (SBP), diastolic blood pressure (DBP) and glycaemia were 42.5 ± 18.1 years, 23.7 ± 4.4 kg/m2, 82.3 ± 11.8 cm, 130.5 ± 21.1 mmHg, 82.9 ± 13.0 mmHg and 103.5 ± 46.8 mg/dL, respectively.
Discussion
The present investigation's main findings were that DM is prevalent in the eastern part of the DRC (3.5%), and significantly more prevalent in urban (age-standardized prevalence: 4.0%) than in rural (1.7%) populations. Urban-dwelling patients were characterized by higher rates of indices of abdominal obesity (P < 0.05) whereas, in rural areas, there was no statistically significant difference in indices of abdominal obesity among those with and without DM (P > 0.05). Age was, however, a major
Disclosure of interest
The authors declare that they have no conflicts of interest concerning this article.
Acknowledgements
The authors thank A.F. Akamba, M.D., R. Baderha Ngabo, M.D., B.M. Balola, M.D., Z.C. Baseme, M.D., K.A. Mukendi, M.D., C.F. Murhula, M.D., B.M. Murhesa, M.D., M.L. Mutimbwa, M.D., S.J. Neze, M.D., M.R. Ntumwa, M.M. Shakangana, M.D., M.H. Watukalusu, M.D. and K.G. Yenga, M.D. for their enthusiastic participation in data collection, and the NGO Leuven Development Cooperation in Central Africa for funding the surveys in South Kivu.
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