A community-based study on prevalence and correlates of erectile dysfunction among Kinondoni District Residents, Dar Es Salaam, Tanzania

Abstract

BackgroundGlobally, erectile dysfunction burden (ED) is rising appreciably and it is projected to affect about 332 million men by the year 2025. This rise is attributable to the rising incidence of conditions associated with ED including obesity, diabetes, hypertension, coronary artery disease and depression. We conducted this community-based screening to elucidate on the prevalence of ED and its associated factors among men residing in an urban community in Tanzania.MethodsWe conducted a cross-sectional community-based study and interviewed 441 men aged at least 18 years. Diabetes and hypertension were defined as per the International Diabetes Federation (IDF) and the 7th Report of the Joint National Committee (JNC 7) respectively. The 5-item version of the International Index of Erectile Function (IIEF-5) Scale was used to assess for erectile dysfunction. Multivariate logistic regression analyses were performed to explore the factors associated with ED.ResultsThe mean age was 47.1 years, 57.6 % had excess body weight, 8.2 % had diabetes and 61.5 % had high blood pressure. Overall, 24 % (106/441) of men in this study had some form of ED. Participants with age ≥55, positive smoking history, obesity, diabetes and hypertension displayed highest rates of ED in their respective subgroups. However, age ≥40 and diabetes were ultimately the strongest factors for ED after multivariate logistic regression analyses, (OR 5.0, 95 % CI 2.2–11.2, p < 0.001 and OR 5.3, 95 % CI 2.2–12.7, p < 0.001 respectively).ConclusionErectile dysfunction affects about a quarter of adult men living in Kinondoni district. Old age, obesity, smoking, hypertension and diabetes have the potential to increase the odds of ED up-to 5 times. In view of this, men with diabetes and hypertension should be offered screening services and treatment of ED as an integral component in their management.

The global prevalence of erectile dysfunction: a review

“…Age as a risk factor for ED was universal across all studies. A linear relationship between increasing ED prevalence and increasing age was also seen in all studies, regardless of the ED assessment method used [5,9,[13][14][15][16][18][19][20][21][22][23][24][25][26]29,[31][32][33][34]38,[41][42][43][44][45]48]. Physiological ageing processes mediating vascular changes in the penis have been implicated; however, cardiovascular comorbidities, such as diabetes and HTN, appear to expedite and exacerbate the process [67].…”

“…Table 1 [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] shows the prevalence of ED assessed by the IIEF, IIEF-5 or IIEF variants. The overall global prevalence was 13.1-71.2% [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27]. The prevalence by continent was as follows: North America, 20.7% [17]; Europe, 16.8-65.4% [22,23,26,27]; Oceania, 40.3-42% [13,16]; Asia, 13.1-71.2% [14,18,19,21,24,25]; and Africa, 24-58.9% [15,20].…”

“…Genetic, environmental, and lifestyle factors are likely to be involved. The main risk factors associated with ED include: age; comorbidities (diabetes, CVD, obesity, prostate cancer, and depression and 592 © 2019 The Authors BJU International © 2019 BJU International anxiety treatment); lifestyle factors, such as heavy alcohol consumption and smoking, were also positively associated with ED [17,19,20,22,28]. Single, separated or divorced men are also at increased risk, as well as men who are unemployed or of low socio-economic status [16,17].…”

Sexual Dysfunction and Hypogonadism in Men With Diabetes

“…Recent studies have reported that alteration of the cyclic guanosine monophosphate (cGMP)/nitric oxide (NO) pathway among men with diabetes with impaired vascular relaxation is related to endothelial dysfunction (16)(17)(18). Among men with diabetes, risk factors include increasing age, duration of diabetes, poor glycemic control, cigarette smoking, hypertension, dyslipidemia, androgen-deficiency states (19) and cardiovascular disease (CVD) (6,11,12,(20)(21)(22)(23)(24).…”

“…In addition, studies indicate that 40% of men with diabetes greater than 60 years of age have complete ED (7-15).Recent studies have reported that alteration of the cyclic guanosine monophosphate (cGMP)/nitric oxide (NO) pathway among men with diabetes with impaired vascular relaxation is related to endothelial dysfunction (16-18). Among men with diabetes, risk factors include increasing age, duration of diabetes, poor glycemic control, cigarette smoking, hypertension, dyslipidemia, androgen-deficiency states (19) and cardiovascular disease (CVD) (6,11,12,(20)(21)(22)(23)(24).ED as a marker of potential cardiovascular (CV) events has been reported by numerous investigators (25-34). In fact, ED has been shown to be significantly associated with all-cause mortality and CV events (35)(36)(37).…”