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In resource-limited countries where the challenge of diabetes management is especially severe, there has been a recent call for the inclusion of traditional healers in the fight against diabetes. In response, some researchers have highlighted the dangers of incorporating traditional healers while others, have presented them as a potential asset to the health care system if well trained and guided. We report here on a pilot intervention to include traditional healers in the health promotion and prevention efforts for diabetes in Cameroon, as part of the Cameroon Burden of Diabetes (CAMBoD) project. We trained 106 healers in a range of topics and practices relating to diabetes prevention and care. Eight months later we carried out a field evaluation of 36 of them using in-depth semi-structured interviews and direct observation methods to find out if they remembered and applied the learning from the training. Most healers recalled and were applying some of the lessons learnt, including referral of patients for blood glucose tests at biomedical health facilities, desisting from scarifying patients with diabetes, and educating their patients, peers and other people in their communities about diabetes. Healers were enthusiastic about collaboration with the diabetes control program, though some wanted additional responsibilities. We conclude that healers could learn prevention strategies of diabetes relatively rapidly and collaborate in health promotion.

BackgroundThe prevalence of diabetes is increasing worldwide, particularly in low and middle income countries, where treatment and control are often unavailable and inaccessible. Information on risk factors at local and regional levels is of utmost importance for tailored prevention programmes to curb the rise in diabetes.The current study was undertaken to investigate the prevalence of Impaired Fasting Glucose (IFG)/Type 2 Diabetes (T2D) and its risk factors in the adult population in Biyem-Assi-Yaoundé, Cameroon.MethodsInformation on cardiovascular risk factors using the WHO STEPwise approach was obtained for 1623 men and women aged 25 years and older of the CAMBoD Project in Biyem-Assi, Yaoundé, Cameroon. T2D was defined as fasting capillary glucose (FCG) ≥ 7.0 mmol/l and/or being on diabetes medication, IFG/T2D as FCG ≥ 6.1 mmol/l and/or being on diabetes medication. Descriptive statistics and multivariate logistic regression analyses were used to describe prevalence of IFG/T2D, prevalence of risk factors for IFG/T2D and to investigate the association of risk factors with prevalence of IFG/T2D.ResultsPrevalence of T2D and of IFG/T2D was 3.3% and 5.7%. Prevalence of hypertension, obesity and abdominal obesity (elevated waist circumference) was 26.6%, 28.4% and 34.9%, respectively. Age and abdominal obesity were significantly associated with IFG/T2D in multivariate logistic regression.ConclusionFor successful primary prevention of T2D in the general population in Cameroon tailored efforts to address obesity, particularly abdominal obesity, and associated life-style factors are warranted.

BackgroundData on Non-Communicable Diseases (NCDs) among indigenous populations are needed for interventions to improve health care. We conducted a survey in 2013 among rural indigenous Mbororo, Fulbe and other ethnic groups to determine the distribution of risk factors of NCDs in Cameroon.MethodsWe selected seven targets of NCD risk factors: tobacco use, alcohol use, diet (salt/sugar intake, vegetable/fruit consumption), raised blood pressure, raised blood glucose, physical inactivity and weight measures. The WHO STEPwise approach was used to collect data from 1921 consenting participants aged ≥20 years. Prevalence of NCD risk factors was summarised by descriptive statistics.ResultsUnderweight was widespread, Mbororo (50.8%) and Fulbe (37.2%). Increase in prevalence of six risk factors was observed among the Fulbe when compared to Mbororo. Participants aged 20–39 years had low levels of physical activity, poor diet and higher levels of alcohol consumption (except Mbororo) and those aged ≥40 years had higher prevalence of diabetes, hypertension, current smoking and overweight/obesity. Men and women differed in current smoking, occasional/daily alcohol consumption, pre-hypertension and hypertension, continuous walking for at least ten minutes, and weight measures for Fulbe and Mbororo, p < 0.05.ConclusionDistribution of NCD risk factors was high among settled Fulani (Fulbe) when compared to indigenous nomadic Fulani (Mbororo). Change from nomadic to settled life might be accompanied by higher prevalence of NCDs. This data should be used to develop intervention programmes to curb the rising burden of NCDs in rural indigenous and non-indigenous populations.

BackgroundHypertension is a public health problem and the main contributor to cardiovascular mortality and morbidity. Little is known about hypertension among the minority, diverse and socially disadvantaged 23–24 million Fulani/Peul populations dispersed in West, Central and East Africa, undergoing a transition from traditional to transitional and modern lifestyle.This study describes age and gender variations in blood pressure and drivers of hypertension among rural Fulani population of Cameroon.MethodsWe analysed population-based cross-sectional data collected in 2013 by standard methods from 1337 Fulani/Peul aged ≥ 20 years. Hypertension was defined as systolic blood pressure (SBP) ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg or current use of anti-hypertensive medication. We elucidated the occurrence and drivers of hypertension by chi-square test, Student’s t test and univariate and multivariable logistic regression models.ResultsThe prevalence of hypertension was 31.1% (men 36.5% and women 28.7%). Systolic and diastolic blood pressure increased with age. Older women suffered more from grades 1, 2 and 3 hypertension than older men. Old age, divorced/separated, never attended school, current/former smoker, family history (FH) of hypertension, diabetic, underweight and substantially increased risk from waist circumference were independently associated with hypertension. Insomnia and had 8–12 children were the only drivers of hypertension among men.ConclusionPrevalence of hypertension was high. Awareness and control were low. Hypertension prevalence increased with age and was more prevalent among men than women. Older women experienced severe hypertension more than older men. Culturally embedded interventions are warranted to curb the high burden of hypertension among the Fulani.Electronic supplementary materialThe online version of this article (10.1186/s41043-017-0112-2) contains supplementary material, which is available to authorized users.