ABSTRACT
OBJECTIVES: This study aimed to determine the risk factors for diabetes mellitus (DM) in the eastern part of the Democratic Republic of Congo. METHODOLOGY: Multilevel sampling identified 200 households (444 adults aged ≥ 20 years) from 20 neighbourhoods in the city of Bukavu, and 90 households (255 adults aged ≥ 20 years) from 10 villages in the Kaziba (South Kivu) chiefdom (the South Kivu VITARAA study). DM was defined as a personal history of the disorder or a casual glycaemia greater or equal to 200 mg/dL. Standardization according to age and sample readjustment based on the urban-rural distribution of the population was applied accordance with the typical Congolese population. The probability of DM was assessed by multiple logistic regressions. RESULTS: Total prevalence of DM was 3.5%. DM was significantly more prevalent in urban areas (age-standardized prevalence: 4.0%) than in rural areas (1.7%). City-dwelling DM patients were characterized by higher rates of indices of abdominal obesity (P < 0.05) whereas, in rural areas, no patients were obese. In the study group as a whole, only 25.0% of diabetic patients were obese. On multivariate analyses, only age [adjusted OR (95% CI): 4.79 (1.60-14.25); P = 0.004] was independently associated with the prevalence of DM, while the effect of obesity was not significant [2.64 (0.99-7.02); P = 0.051]. CONCLUSION: Age and living in an urban environment appeared to be major determinants of DM in South Kivu. Also, obesity prevalence was relatively low in these diabetic patients, confirming the peculiar, relatively lean, phenotype of type 2 DM in indigenous sub-Saharan Africans.
Subject(s)
Aging , Blood Glucose/metabolism , Diabetes Mellitus, Type 2/epidemiology , Hypertension/epidemiology , Metabolic Syndrome/epidemiology , Obesity/epidemiology , Triglycerides/blood , Urban Population/statistics & numerical data , Adult , Age Distribution , Age Factors , Aged , Aging/blood , Congo/epidemiology , Diabetes Mellitus, Type 2/blood , Diabetes Mellitus, Type 2/physiopathology , Fasting , Female , Genetic Predisposition to Disease , Glucose Tolerance Test , Humans , Hypertension/blood , Hypertension/physiopathology , Logistic Models , Male , Metabolic Syndrome/blood , Metabolic Syndrome/physiopathology , Middle Aged , Obesity/blood , Obesity/physiopathology , Phenotype , Prevalence , Risk Factors , Rural Population , Thinness/epidemiology , Young AdultABSTRACT
La situation actuelle de la tuberculose a Kinshasa est fort preoccupante. L'accroissement du nombre de cas s'inscrit probablement dans un contexte multifactoriel. Tout en ayant une couverture sanitaire suffisante; Kinshasa ne depiste pas encore; ou ne declare pas; tous ses tuberculeux et la prise en charge des cas diagnostiques butte contre le cout eleve du traitement et ou l'insuffisance de preparation du personnel du terrain. Il y a la une interpellation qui risque d'exposer une fraction plus importante de la collectivite a la maladie
