Indirect and direct effects of factors associated with diabetes amongst the rural black population in the Dikgale Health and Demographic Surveillance System, South Africa

Abstract

Background: Diabetes is an enormous, growing clinical and public health problem, which together with hypertension contributes significantly to the high risk of cardiovascular diseases (CVDs) globally.Aim: To examine the indirect and direct effects of risk factors simultaneously as a network of multiple pathways leading to diabetes in the rurally based adult population (aged 15+) using a household survey.Methods: This investigation was based on a predictive model using a cross-sectional community-based study to identify the direct and indirect effects of diabetes risk factors in the Dikgale Health and Demographic Surveillance System (HDSS) consisting of 15 villages, with 7200 households and a total population of approximately 36 000. Fasting blood glucose and total cholesterol were measured using ILAB 300 with the following cut-off values: high fasting blood glucose 7 mmol/L and triglycerides 1.70 mmol/L.Results: A total of 1407 individuals were interviewed, of whom 1281 had their blood pressure (BP) measured. The conceptual model was validated by the goodness-of-fit indexes (comparative fit index [CFI] = 1.00, Tucker Lewis index [TLI] = 1.041, root mean square error of approximation [RMSEA] = 0.001). Hypertension had the strongest direct effect of 0.0918 on diabetes, followed by age (0.0039) and high waist circumference (−0.0023). Hypertension also mediates the effects that high waist circumference (0.0005) and triglycerides (0.0060) have on diabetes status.Conclusion: The results in this study confirm the conceptual model considered in the risk factors for diabetes and suggest that hypertension, age and high waist circumference are the key variables directly affecting the diabetes status in the South African rural black population. The direct effect of triglycerides on diabetes suggests mediation by some measured factor(s).

Retrospective Analysis of the Outcome of Hospitalized COVID-19 Patients with Coexisting Metabolic Syndrome and HIV Using Multinomial Logistic Regression

“…The country also reports a high prevalence of diabetes, with a high proportion (38%) of people with undiagnosed diabetes [21]. A recent population-based study reported a prevalence of diabetes of 28% [22]. Excess waist circumference and subcutaneous abdominal fat are metabolic comorbidities that contribute to the burden of NCDs in South Africa, and the prevalence of overweight/obesity ranges between 56-68% [23,24].…”

Exploring Roles of Stakeholders in Combating Substance Abuse in the DIMAMO Surveillance Site, South Africa

“…In this population, the prevalence of substance abuse was identified to be a challenge, with 86% smokers and 83% abusing alcohol. 19 This study was conducted as part of the South African Population Research Infrastructure Network (SAPRIN), an initiative hosted by the South African Medical Research Council and receives long-term from the National Department of Science and Innovation.…”

“…Prior studies conducted in the Dikgale area recently showed a high prevalence of alcohol use (83%) and smoking (86%) in the Dikgale community. 19 Anyanwu et al 14 study has shown that the prevalence of substance abuse among adolescents or youth is characterized by increased adventurous tendencies and peer influences, where they start with substances like cigarettes and alcohol and gradually progress to other substances to the degree that they depend on these substances.…”

“… 18 Substance abuse can be hard to combat, especially in rural areas due to limited resources for prevention, treatment, and recovery. In a recent study done by Mphekgwana et al, 19 the DIMAMO population group, the prevalence of substance abuse was found to be high with alcohol use being (83%) and smoking (86%). The fight against substance abuse can be effective with the involvement of different community stakeholders and the proper allocation of required resources such as awareness campaigns.…”

“… 4 According to the South African Government, 20 awareness campaigns such as the Anti-Substance Abuse Program of Action are perfect examples of primary prevention strategies that build a community free of Alcohol and Drug Abuse. Although Mphekgwana et al 19 noted a high prevalence of substance abuse, very little was done to intervene in the substance abuse in the Dikgale Community. In 2022, the DIMAMO surveillance unit organized a substance abuse awareness campaign with key stakeholders to educate the Dikgale community about the risk associated with substance and available services to combat substance abuse.…”