Epidemiology of prediabetes and diabetes in Namibia, Africa: a multilevel analysis.

BACKGROUND

Diabetes is a leading cause of progressive morbidity and early mortality worldwide. Little is known on the burden of diabetes and pre-diabetes in Namibia, a Sub-Saharan African (SSA) country that is undergoing a demographic transition.

METHODS

We estimated the prevalence and correlates of diabetes (defined as fasting [capillary] blood glucose [FBG] >126 mg/dL) and prediabetes (defined by World Health Organization [WHO] and American Diabetes Association [ADA] criteria [FBG 110-125 mg/dL and 100-125 mg/dL, respectively]) in a random sample of 3278 participants aged 35-64 from the 2013 Namibia Demographic and Health Survey.

RESULTS

The prevalence of diabetes was 5.1% (95% Confidence Interval [CI]: 4.2-6.2), with no evidence of gender differences (p=0.45). The prevalence of prediabetes was 6.8% (5.8-8.0) and 20.1% (18.4-21.9) using WHO and ADA criteria, respectively. Male sex, older age, higher body mass index (BMI) and occupation independently increased the odds of diabetes in Namibia, while higher BMI was associated with the higher odds of prediabetes and residing in household categorized as middle wealth index were associated with lower odds of prediabetes (Adjusted odds ratio [aOR] = 0.71; 95% Credible Interval [CrI] = 0.46-0.99). There was significant clustering of prediabetes and diabetes at the community-level.

CONCLUSIONS

One in five adult Namibians has prediabetes by ADA criteria. Resources should be invested at the community level to promote efforts to prevent progression of this disease and its complications. This article is protected by copyright. All rights reserved.