Research Article: Association between urban–rural location and prevalence of type 2 diabetes and impaired fasting glucose in West Africa: a cross–sectional population–based epidemiological study
Abstract:
Objectives We investigated the association between urban/rural location and both type 2 diabetes mellitus (T2DM) and pre-diabetes among populations of five West African countries. Design Cross-sectional studies, using the WHO Stepwise (STEPs) survey data. Setting National representative data of both urban and rural areas from Benin, Burkina Faso, Ghana, Liberia and Mali. Participants Adults comprising 15?468 participants (6774 men and 8746?women; 7663 urban and 7805 rural residents) aged between 25 and 64 years. Results The age and sex-adjusted prevalence of T2DM was 6.2% for urban areas and 2.5% for rural areas. The prevalence of impaired fasting glucose (IFG) was 6.6% for urban areas, and 3.0% for rural areas. No differences by sex were observed. The crude relative risk (RR) and 95%?CI of T2DM and IFG in urban compared with rural areas were 2.69 (1.85 to 3.91) and 2.37 (1.53 to 3.66), respectively. This reduced to RR: 2.03, 95%?CI (1.34 to 3.08) and RR: 2.04, 95%?CI (1.27 to 3.28), respectively, after adjusting for covariables. Conclusion The prevalence of both T2DM and IFG was more than two times as high in urban areas compared with rural areas in West Africa. Behavioural risk factors are common among urban populations, with ongoing urbanisation expected to drive increases in the prevalence of T2DM. These results could guide planning for T2DM screening, preventive strategies and resource allocation in West Africa.
Introduction:
Type 2 diabetes mellitus (T2DM) has emerged as a significant public health burden in Africa and is expected to reach pandemic levels by 2045. 1 2 The International Diabetes Federation (IDF) estimates that T2DM will increase by 134% in sub-Saharan Africa (SSA) from 2021 to 2045 compared with a 46% increase in the rest of the world. 2 The global burden of disease study suggests that between 1990 and 2017, total disability-adjusted life years (DALYs) lost due to non-communicable disease (NCDs), including T2DM, in SSA…
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