Glycaemic control among patients with type 2 diabetes followed in a rural African primary care setting — A reality check in the Democratic Republic of Congo

Blum, Johannes; Chaney, Matthew; Mudji, Junior; Mfungwa, Jean-aimé Kibala; Rice, Timothy; Labhardt, Niklaus Daniel

doi:10.1016/j.pcd.2019.08.002

Cited by 11 publications

(25 citation statements)

References 27 publications

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“…In respectively two studies, low monthly income [ 18 , 87 ], absence of health insurance [ 47 , 58 ], and being a farmer [ 25 , 48 ] were associated with poor glycaemic control. In respectively one study, living in urban areas [ 49 ], and a high frequency of seeking traditional medicine practitioners [ 30 ] were associated with poor glycaemic control. Residing less than 100 kms from a health facility [ 25 ], residing in Guinea compared to residing in Cameroon [ 32 ], self-reporting a positive perception of family support [ 68 ], and the frequency of participating in religious activities [ 31 ] were associated with good glycaemic control in respectively one study.…”

Section: Resultsmentioning

confidence: 99%

“…Concerning body mass index (BMI), all categories, such as being underweight [ 60 ], having a normal BMI [ 46 ], or being overweight/obese [ 18 , 34 , 87 ] have been significantly associated with poor glycaemic control. Central obesity was associated with poor glycaemic control in four studies [ 16 , 30 , 52 , 56 ]. In respectively one study, the presence of anaemia [ 17 ], non-alcoholic fatty liver disease [ 19 ], vitamin B12 deficiency [ 20 ], metabolic syndrome [ 28 ], cognitive impairment [ 32 ], congestive cardiac failure [ 46 ], HIV infection [ 46 ], thyroid autoimmunity [ 74 ], and hypogonadism [ 45 ] had a significant association with poor glycaemic control.…”

Section: Resultsmentioning

confidence: 99%

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Glycaemic control among type 2 diabetes patients in sub-Saharan Africa from 2012 to 2022: a systematic review and meta-analysis

Lubaki

Omole

Francis

2022

Diabetol Metab Syndr

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Background There is an increased burden of diabetes globally including in sub-Saharan Africa. The literature shows that glycaemic control among type 2 diabetes patients is poor in most countries in sub-Saharan Africa. Understanding the factors influencing glycaemic control in this region is therefore important to develop interventions to optimize glycaemic control. We carried out a systematic review to determine the prevalence and factors associated with glycaemic control in sub-Saharan Africa to inform the development of a glycaemic control framework in the Democratic Republic of the Congo. Methods We searched five databases (African Index Medicus, Africa-Wide Information, Global Health, PubMed, and Web of Science) using the following search terms: type-2 diabetes, glycaemic control, and sub-Saharan Africa. Only peer-reviewed articles from January 2012 to May 2022 were eligible for this review. Two reviewers, independently, selected articles, assessed their methodological quality using Joanna Briggs checklists, and extracted data. A meta-analysis was performed to estimate the prevalence of glycaemic control. Factors associated with glycaemic control were presented as a narrative synthesis due to heterogeneity as assessed by the I2. Results A total of 74 studies, involving 21,133 participants were included in the review. The pooled prevalence of good glycaemic control was 30% (95% CI:27.6–32.9). The glycaemic control prevalence ranged from 10–60%. Younger and older age, gender, lower income, absence of health insurance, low level of education, place of residence, family history of diabetes, longer duration of diabetes, pill burden, treatment regimen, side effects, use of statins or antihypertensives, alcohol consumption, smoking, presence of comorbidities/complications, and poor management were associated with poor glycaemic control. On the other hand, positive perceived family support, adequate coping strategies, high diabetes health literacy, dietary adherence, exercise practice, attendance to follow-up, and medication adherence were associated with good glycaemic control. Conclusion Suboptimal glycaemic control is pervasive among patients with type-2 diabetes in sub-Saharan Africa and poses a significant public health challenge. While urgent interventions are required to optimize glycaemic control in this region, these should consider sociodemographic, lifestyle, clinical, and treatment-related factors. This systematic review and meta-analysis protocol is registered in PROSPERO under CRD 42021237941.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Glycaemic control among type 2 diabetes patients in sub-Saharan Africa from 2012 to 2022: a systematic review and meta-analysis

Lubaki

Omole

Francis

2022

Diabetol Metab Syndr

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“…The hospital comprises a total of 479 beds and serves a health zone with a population of more than 300,000 people, as well as patients from neighboring health zones. 11 The hospital is located in Kwilu Province, in the Vanga health zone. This is 530 km east of Kinshasa, 35 km from Bulungu hospital, and 60 km from Djuma hospital.…”

Section: Methodsmentioning

confidence: 99%

Seroprevalence of Viral Hepatitis B and C and Knowledge of the Hepatitis B Virus among Pregnant Women Attending Prenatal Care in the Democratic Republic of Congo

Mudji

Madinga

Horsmans

2021

The American Journal of Tropical Medicine and Hygiene

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Viral hepatitis B (HBV) and C (HCV) can significantly influence maternal and child health. Although HIV infection, malaria, and syphilis in pregnant women are likely to be systematically screened for and managed according to national guidelines in the Democratic Republic of Congo, there is no plan for HBV and HCV. Furthermore, there is no documentation regarding pregnant women's knowledge about HBV and HCV. This situation has motivated the researchers to undertake the current study, which was designed to estimate the seroprevalence of HBV and HCV. We have also assessed knowledge of the HBV infection among pregnant women who consulted for antenatal care for the first time at Vanga Evangelical Hospital in Vanga. A cross-sectional study was conducted with 457 pregnant women who attended antenatal care. Sociodemographic, obstetric, and previous medico-surgical data, as well as information related to women's HBV knowledge, were collected using a questionnaire. Rapid tests were used to detect HBV surface antigen and HCV antibodies. Most pregnant women were aged 20-24 years. Only 6.8% of respondents had knowledge of HBV, and the main source of this knowledge was health facilities (4.6%). Only 0.7% reported having been tested, whereas 98.5% said that they had not been offered a test. Overall, 18 (3.9%) participants were HBV positive and 22 (4.8%) were positive for HCV. There is limited knowledge about HBV and HCV among pregnant women in rural Vanga. All pregnant women should be screened during antenatal care, and a well-implemented program of management is needed.

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“…Concerning the body mass index (BMI), all the categories as being underweight [61], having a normal BMI [47], or being overweight/obese [18,34,87] have been associated signi cantly with poor glycaemic control. Central obesity was associated with poor glycaemic control in four studies [16, 30,52,56].…”

Section: Clinical Factorsmentioning

confidence: 99%

Prevalence and Factors Associated with Type 2 Diabetes Control in Sub-Saharan Africa: A Systematic Review and Meta-analysis

Lubaki

Omole

Francis

2022

Preprint

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Background There is an increased burden of diabetes globally including in sub-Saharan Africa. The literature shows that the control of type-2 diabetes is generally poor in most countries in sub-Saharan Africa. Gaining an understanding of the factors influencing glycaemic control in this region is therefore important to develop interventions to optimize glycaemic control. We carried out a systematic review to determine the prevalence and factors associated with glycaemic control in sub-Saharan Africa to inform the development of a glycaemic control framework in the Democratic Republic of the Congo. MethodsWe searched five databases (African Index Medicus, Africa-Wide Information, Global Health, PubMed, and Web of Science) using the following search terms: type-2 diabetes, glycaemic control, and sub-Saharan Africa. Only peer-reviewed articles from January 2012 to May 2022 were eligible for this review. Two reviewers, independently, selected articles, assessed their methodological quality using Joanna Briggs checklists, and extracted data. A meta-analysis was performed to estimate the prevalence of glycaemic control. Factors associated with glycaemic control were presented as a narrative synthesis due to heterogeneity as assessed by the I2. ResultsA total of 74 studies, involving 21,133 participants were included in the review. The pooled prevalence of glycaemic control was 30%. The highest glycaemic control reported was 60%. The factors significantly associated with glycaemic control were categorized into six groups: sociodemographic (younger and older age, gender, lower income, absence of health insurance, low level of education, place of residence, family support, coping strategies), lifestyle (dietary adherence, practice of exercise, smoking, alcohol consumption), clinical (family history of diabetes, longer duration of diabetes, presence of comorbidities/complications), adherence (attendance to follow-up, medication adherence), treatment modalities (pill burden, treatment regimen, use of statins or anti-hypertensives, education about diabetes, definition of glycaemic goals), and glycaemic control optimization interventions.ConclusionSub-optimal glycaemic control is pervasive among patients with type-2 diabetes in sub-Saharan Africa and poses a significant public health challenge. While urgent interventions are required to optimize glycaemic control in this region, these should be taken account of sociodemographic, lifestyle, clinical and treatment-related factors. This systematic review and meta-analysis protocol is registered in PROSPERO under CRD 42021237941.

show abstract

Glycaemic control among patients with type 2 diabetes followed in a rural African primary care setting — A reality check in the Democratic Republic of Congo

Cited by 11 publications

References 27 publications

Glycaemic control among type 2 diabetes patients in sub-Saharan Africa from 2012 to 2022: a systematic review and meta-analysis

Glycaemic control among type 2 diabetes patients in sub-Saharan Africa from 2012 to 2022: a systematic review and meta-analysis

Seroprevalence of Viral Hepatitis B and C and Knowledge of the Hepatitis B Virus among Pregnant Women Attending Prenatal Care in the Democratic Republic of Congo

Prevalence and Factors Associated with Type 2 Diabetes Control in Sub-Saharan Africa: A Systematic Review and Meta-analysis

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