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  • Sociodemographic and behavioral characteristics associated with self-reported diagnosed diabetes mellitus in adults aged 50+ years in Ghana and South Africa: results from the WHO-SAGE wave 1

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Epidemiology/Health Services Research
Sociodemographic and behavioral characteristics associated with self-reported diagnosed diabetes mellitus in adults aged 50+ years in Ghana and South Africa: results from the WHO-SAGE wave 1
  1. Fitsum Eyayu Tarekegne1,
  2. Mojgan Padyab2,3,
  3. Julia Schröders4,
  4. Jennifer Stewart Williams4,5
  1. 1 Mailman School of Public Health, Centre for International Programs, Columbia University, Addis Ababa, Ethiopia
  2. 2 Centre for Demographic and Ageing Research (CEDAR), Umeå University, Umea, Sweden
  3. 3 Department of Social Work, Umea University, Umea, Sweden
  4. 4 Unit of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Faculty of Medicine, Umeå University, Umea, Sweden
  5. 5 Research Centre for Generational Health and Ageing, University of Newcastle, Callaghan, Australia
  1. Correspondence to Dr Fitsum Eyayu Tarekegne; fiteya{at}yahoo.com

Abstract

Objective The objective is to identify and describe the sociodemographic and behavioral characteristics of adults, aged 50 years and over, who self-reported having been diagnosed and treated for diabetes mellitus (DM) in Ghana and South Africa.

Research design and methods This is a cross-sectional study based on the WHO Study on global AGEing and adult health (SAGE) wave 1. Information on sociodemographic factors, health states, risk factors and chronic conditions is captured from questionnaires administered in face-to-face interviews. Self-reported diagnosed and treated DM is confirmed through a ‘yes’ response to questions regarding1 having previously been diagnosed with DM, and2 having taken insulin or other blood sugar lowering medicines. Crude and adjusted logistic regressions test associations between candidate variables and DM status. Analyses include survey sampling weights. The variance inflation factor statistic tested for multicollinearity.

Results In this nationally representative sample of adults aged 50 years and over in Ghana, after adjusting for the effects of sex, residence, work status, body mass index, waist-hip and waist-height ratios, smoking, alcohol, fruit and vegetable intake and household wealth, WHO-SAGE survey respondents who were older, married, had higher education, very high-risk waist circumference measurements and did not undertake high physical activity, were significantly more likely to report diagnosed and treated DM. In South Africa, respondents who were older, lived in urban areas and had high-risk waist circumference measurements were significantly more likely to report diagnosed and treated DM.

Conclusions Countries in sub-Saharan Africa are challenged by unprecedented ageing populations and transition from communicable to non-communicable diseases such as DM. Information on those who are already diagnosed and treated needs to be combined with estimates of those who are prediabetic or, as yet, undiagnosed. Multisectoral approaches that include socioculturally appropriate strategies are needed to address diverse populations in SSA countries.

  • Africans
  • ageing
  • socioeconomic determinants
  • health risk behaviors

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjdrc-2017-000449

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    Footnotes

    • Contributors FET made substantial contribution to the conception of the study, analysed the data and wrote the first draft. MP together with FET designed the study. MP provided methodological advice, helped in manuscript preparation and revised the manuscript critically. JS assisted in the interpretation of data and participated in drafting of the manuscript and revising it critically. JSW provided overall direction, advice and guidance throughout the manuscript development, reviewed and edited work in progress, and provided critical intellectual and scientific input at all stages. JSW led the response to reviewers and wrote the final draft which was approved by all the authors.

    • Funding At the time of writing of the first draft, FET was a Swedish Institute/SI/scholarship holder for the MPH programme at Umea University. The scholarship provider had no role in study design, data collection, analysis, decision to publish or preparation of the manuscript.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Ethics approval The SAGE study was approved by the Ethics Review Committee, WHO, Geneva, Switzerland and the individual ethics committees in each of the SAGE countries.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement The anonymised data sets are in the public domain: http://apps.who.int/healthinfo/systems/surveydata/index.php/catalog/central. SAGE is committed to the public release of study instruments, protocols and meta data and micro data: access is provided upon completion of the Users Agreement available through WHO’s SAGE website: www.who.int/healthinfo/systems/sage. The questionnaires and other materials can be found at: http://www.who.int/healthinfo/sage/cohorts/en/index2.html.