Diabetes-related-distress and its relationship with glycaemic control among type 2 diabetes mellitus patients attending a specialty clinic in Lagos, Nigeria

Diabetes Mellitus (DM) is a chronic metabolic disease with various complications throughout its course. The presence of emotional burden in diabetes disease, which is referred to as diabetes-related distress (DRD) is common among such patients and may affect their response to treatment. Objectives: To assess the relationship of diabetes-related distress and glycaemic control among patients with Type 2 Diabetes mellitus. Methods: This hospital-based cross-sectional study was conducted at the Family Medicine Department of LASUTH, Ikeja, Lagos. A total of 317 patients with Type 2 Diabetes mellitus were systematically recruited. The data were collected over a four-month period. Important clinical information including clinical characteristics and diabetes-related distress using the diabetes distress scale (DDS-17) was collected. Glycosylated haemoglobin (HbA1c) was also assessed. Results: The degrees of DRD were as follows: 54.9% (None/little), 40.1% (moderate) and 5.0% (severe). The mean HbA1c estimate for all participants was 7.83±1.8%. Among the 317 study participants, 67.2% had poor glycaemic control while 32.8% had good glycaemic control. There was a statistically significant association between DRD and glycaemic control (p< 0.001). Likewise, the various domains of DRD had statistically significant associations with glycaemic control with the exception of physician-related domain. Participants with better glycaemic control reported lower levels of DRD than participants with poorer glycaemic control. Conclusion: There is a high level of diabetes-related distress patients with diabetes mellitus. Good glycaemic control is important in improving or preventing DRD. Therefore, T2DM patients should be screened for DRD during their treatment.

Monitoring and evaluation of Integrated Disease Surveillance and Response in selected districts in Tanzania

Integrated Disease Surveillance and Response (IDSR) is a strategy developed by the World Health Organization. Regional Office for Africa in 1998. The Ministry of Health; Tanzania has adopted this strategy for strengthening communicable diseases surveillance in the country. In order to improve the effectiveness of the implementation of IDSRmonitoring and evaluating the performance of the surveillance system; identifying areas that require strengthening and taking action is important. This paper presents the findings of baseline data collection for the period October - December 2003 in 12 districts representing eight regions of Tanzania. The districts involved were Mbulu; Babati; odoma Rural; Mpwapwa; Igunga; Tabora Urban; Mwanza Urban; Muleba; Nkasi; Sumbawanga Rural; Tunduru and Masasi. Results are grouped into three key areas: surveillance reporting; use of surveillance data and management of the IDSR system. In general; reporting systems are weak; both in terms of receiving all reports from all acilities in a timely manner; and in managing those reports at the district level. Routine analysis of surveillance data is not being done at facility or district levels; and districts do not monitor the performance of their surveillance system. There was also good communication and coordination with other sectors in terms of sharing information and resources. It is important that districts' capacity on IDSR is strengthened to enable them monitor and evaluate their own performance using established indicators