Prevalence and correlates of pre-diabetes and diabetes among a national population based sample of adults in Zambia: Results of the first national STEPS survey in 2017

Abstract

Background: This investigation aimed to estimate the prevalence and its correlates of pre-diabetes and diabetes among 18-69 year-old persons in Zambia.Method: Nationally representative cross-sectional data were analysed from 3,608 18-69 year old persons (31 years median age) that participated in the “2017 Zambia STEPS survey,” with complete blood glucose measurement.Results: Results indicate that 8.8% of 18-69 year-olds had pre-diabetes and 7.2% diabetes. In adjusted multinomial logistic regression analysis, older age, rural residence, central obesity (or overweight or obesity), hypertension, raised total cholesterol and physical inactivity were associated with pre-diabetes and/or diabetes. In addition, in unadjusted analysis, female sex, lower education, alcohol family problem and alcohol dependence were associated with pre-diabetes and/or diabetes. Only 8.4% of the study sample reported that they ever had their blood glucose examined by a health care professional. Having had blood glucose measured was higher among women (9.6%) than men (7.2%) but not significantly (P=0.08). Residents in urban areas (11.8%) had significantly more often ever their blood glucose measured than residents in rural areas (5.4%) (P<0.001). Among study participants with diabetes, 22.3% were aware, 9.4% were currently taking treatment and 17.1% had controlled their diabetes (<7.0 mmol/L).Conclusion: Almost one in ten participants had pre-diabetes and diabetes and several associated variables were detected which can aid in designing intervention strategies.