Diabetes Mellitus Among Adults in Herat, Afghanistan: A Cross-Sectional Study

Khwaja Mir Islam Saeed

Abstract


Introduction: Diabetes is reaching epidemic levels in Afghanistan. This study identifies the risk factors associated with diabetes in Herat City, Afghanistan, and explores the prevalence of previously undiagnosed diabetes.

Methods: A cross-sectional study was conducted using multistage cluster sampling by adopting the World Health Organization’s (WHO) STEPwise approach to Surveillance (STEPS). We enrolled 1129 participants aged 25-70 years between May and June of 2015 (47.4% males, 52.6% females). A structured questionnaire was used for data collection of demographic, socioeconomic, and behavioral factors. Investigators collected anthropometric measurements and blood samples from study participants. A multivariable logistic regression model was used to identify factors associated with diabetes prevalence.

Results: We found that the prevalence of diabetes in Herat City was 9.9% (9.8% in males and 10.1% in females). Of the 1129 respondents, only 3.3% were previously diagnosed with diabetes or were under treatment, whereas 6.6% of respondents were previously undiagnosed. The multivariable analyses showed that age, frequency of rice consumption, type of cooking oil, and systolic blood pressure were associated with diabetes. 

Conclusions: This is one of the first studies to discuss the high prevalence of undiagnosed diabetes in Herat, Afghanistan. This study found several modifiable factors that were associated with diabetes in Herat, Afghanistan. Future reduction of disease burden should focus on these factors in the development of the most optimal diabetes prevention programs.


Keywords


Risk Factors; Diabetes; Chronic Disease; Afghanistan

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References


Global Report on Diabetes. WHO Press: World Health Organization; 2016.

IDF Atlas. Brussels, Belgium: International Diabetes Federation; 2015.

American Diabetes Association. Clinical Practice Recommendations 2003. Diabetes Care. 2003;26 (suppl 1).

WHO Mortality Database. http://www.who.int/mediacentre/factsheets/fs310/en/. Accessed 29 July 2017.

NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in diabetes since 1980: a pooled analysis of 751 population-based studies with 4.4 million participants. Lancet (London, England). 2016;387(10027):1513-1530.

Al Khalaf MM, Eid MM, Najjar HA, Alhajry KM, Doi SA, Thalib L. Screening for diabetes in Kuwait and evaluation of risk scores. Eastern Mediterranean health journal = La revue de sante de la Mediterranee orientale = al-Majallah al-sihhiyah li-sharq al-mutawassit. 2010;16(7):725-731.

Al-Moosa S, Allin S, Jemiai N, Al-Lawati J, Mossialos E. Diabetes and urbanization in the Omani population: an analysis of national survey data. Population health metrics. 2006;4:5.

Esteghamati A, Gouya MM, Abbasi M, et al. Prevalence of diabetes and impaired fasting glucose in the adult population of Iran: National Survey of Risk Factors for Non-Communicable Diseases of Iran. Diabetes Care. 2008;31(1):96-98.

Gu D, Reynolds K, Duan X, et al. Prevalence of diabetes and impaired fasting glucose in the Chinese adult population: International Collaborative Study of Cardiovascular Disease in Asia (InterASIA). Diabetologia. 2003;46(9):1190-1198.

Shera AS, Basit A, Fawwad A, et al. Pakistan National Diabetes Survey: prevalence of glucose intolerance and associated factors in the Punjab Province of Pakistan. Primary care diabetes. 2010;4(2):79-83.

Afghan Public Health Institute at the Ministry of Public Health - APHI/MoPH CSO-CA, ICF Macro, Indian Institute of Health Management Research - IIHMR, and World Health Organization Regional Office for the Eastern Mediterranean - WHO/EMRO. Afghanistan Mortality Survey 2010. Calverton, Maryland, USA: APHI/MoPH, CSO, ICF Macro, IIHMR and WHO/EMRO; 2011.

Shaw JE, Sicree RA, Zimmet PZ. Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes research and clinical practice. 2010;87(1):4-14.

Saeed KMI, Asghar RJ, Sahak MN, Ansari J. Prevalence and risk factors associated with diabetes mellitus among Kabul citizens—Afghanistan, 2012. International Journal of Diabetes in Developing Countries. 2015;35(3):297-303.

Mir Islam SK. Prevalence and Predictors of Diabetes Mellitus in Jalalabad City, Afghanistan-2013. Iranian Journal of Diabetes and Obesity. 2014;6(1):1-8.

Saeed KMI, Rasooly M. Prevalence of Risk Factors for Non-Communicable Diseases (NCD) Using WHO STEP-Wise Approach in Herat City Afghanistan. IOSR Journal of Pharmacy. 2016;6(10):34-40.

Saeed KMI. Prevalence of Diabetes and its Risk Factors in Urban Setting of Kandahar City, Afghanistan-2015. IOSR Journal of Pharmacy. 2016;6(11):53-60.

Bonita R, Winkelmann R, Douglas KA, de Courten M. The WHO Stepwise Approach to Surveillance (Steps) of Non-Communicable Disease Risk Factors. In: McQueen DV, Puska P, eds. Global Behavioral Risk Factor Surveillance. Boston, MA: Springer US; 2003:9-22.

Central Statistics of Afghanistan (CSO). Population: Estimated Settled Population by Civil Division, Urban, Rural and Sex-2015-16. http://www.cso.gov.af/en/page/demography-and-socile-statistics/demograph-statistics/3897111. Accessed 29 July 2017.

Diabetes. Fact Sheet no. 312. 2015; http://www.who.int/mediacentre/factsheets/fs312/en/. Accessed 29 July 2017.

Obesity: preventing and managing the global epidemic. Geneva: World Health Organization; 2000.

The IDF consensus worldwide definitions of the metabolic syndrome. 2006; https://www.idf.org/e-library/consensus-statements/60-idfconsensus-worldwide-definitionof-the-metabolic-syndrome. Accessed 29 July 2017.

Whitworth JA. 2003 World Health Organization (WHO)/International Society of Hypertension (ISH) statement on management of hypertension. Journal of hypertension. 2003;21(11):1983-1992.

Aekplakorn W, Abbott-Klafter J, Premgamone A, et al. Prevalence and management of diabetes and associated risk factors by regions of Thailand: Third National Health Examination Survey 2004. Diabetes Care. 2007;30(8):2007-2012.

Zafar J, Bhatti F, Akhtar N, et al. Prevalence and risk factors for diabetes mellitus in a selected urban population of a city in Punjab. JPMA The Journal of the Pakistan Medical Association. 2011;61(1):40-47.

Ning F, Pang ZC, Dong YH, et al. Risk factors associated with the dramatic increase in the prevalence of diabetes in the adult Chinese population in Qingdao, China. Diabetic medicine : a journal of the British Diabetic Association. 2009;26(9):855-863.

Khawaldeh A. Hyperlipidemia in Non-Insulin-Dependent Diabetes Mellitus. Bahrain Medical Bulletin. 1999;21(4).

Seftel AD, Sun P, Swindle R. The prevalence of hypertension, hyperlipidemia, diabetes mellitus and depression in men with erectile dysfunction. The Journal of urology. 2004;171(6 Pt 1):2341-2345.

Asgari F, Agajani H, Haghazali M, Heidarian H. Non-communicable diseases risk factors surveillance in Iran. Iranian Journal of Public Health. 2009;38(Suppl 1):119-122.

Bener A, Zirie M, Janahi IM, Al-Hamaq AO, Musallam M, Wareham NJ. Prevalence of diagnosed and undiagnosed diabetes mellitus and its risk factors in a population-based study of Qatar. Diabetes research and clinical practice. 2009;84(1):99-106.




DOI: https://doi.org/10.5195/cajgh.2017.271

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