Prevalence of diabetes and impaired glucose tolerance in rural Tanzania.

The prevalence of diabetes mellitus and impaired glucose tolerance (IGT) was assessed by use of WHO diagnostic criteria in 6299 Africans aged 15 years and above living in six villages in Tanzania. 0.87% (1.1% male, 0.68% female) had diabetes and 7.8% (6.9% male, 7.7% female) had IGT. Prevalence rates were 1.1% and 8.4%, respectively, when age-adjusted to the USA population. Only 7 (13.5%) of the 53 individuals with diabetes had been known to have the disorder; 34 (74%) of the other 46 were symptom-free. Mean age was 54 (SD 20) for diabetic subjects and 37 (17) years for the whole population. Diabetes and IGT rates did not differ significantly between villages despite geographical, socioeconomic, and dietary differences. Diabetes rates increased modestly with age and body mass index (BMI). Fasting blood glucose (FBG) levels did not rise significantly with age but correlated positively with systolic blood pressure (BP) and negatively with haemoglobin concentration (Hb) and BMI. The 2 hour post-glucose load blood glucose values correlated positively with age, sex, and systolic BP and negatively with Hb. Diabetes is less prevalent in rural Africa than in developed countries, even when age has been corrected for. This difference is probably related to body weight, diet, and exercise.

Pituitary tumours and blindness: continuation of the pre-Harvey-Cushing era in developing countries.

Of the 11 patients with pituitary or suprasellar tumours seen at Muhimbili Medical Centre, Dar es Salaam, from January, 1980, until July, 1982, 6 (54.5%) were totally blind, 3 (27.3%) were blind in one eye and had severe visual impairment in the other, and 2 (18.2%) had marked visual field abnormalities but normal visual acuity in one eye. Blindness in most of these patients highlights the absence of neurosurgical services in many developing countries. In addition there is little prospect of countries like Tanzania establishing neurosurgical services in the foreseeable future. The only help for patients with neurosurgical problems is from referral overseas. This, however, is possible for only a limited number because of costs, unless neurosurgical units in developed countries offer their services at nominal cost. Such an offer would not only benefit patients who would otherwise die but would also help to further the interests of neurosurgery in the helper country.

Biochemical studies in Tanzanian patients with ataxic tropical neuropathy.

Data on thiocyanate and vitamin B(12) concentrations in plasma from Tanzanian patients with ataxic tropical neuropathy are presented and support the hypothesis that, as in Nigeria, the condition may result from chronic exposure to cyanide or cyanogens from a diet including large amounts of cassava.