ArticleBMJ open2023
Diabetes care cascade and associated factors in 10 700 middle-aged adults in four sub-Saharan African countries: a cross-sectional study.
Article in BMJ open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Global, regional, and national cascades of diabetes care, 2000-23: a systematic review and modelling analysis using findings from the Global Burden of Disease Study.The lancet. Diabetes & endocrinology · 2025Pooled it
- Article
- Burden of Diagnosed Diabetes among People With and Without HIV in Uganda: a Cross-Sectional Analysis of the Rakai Community Cohort Study.Research square · 2026Article
- Article
- Genome-wide association study identifying novel risk variants associated with glycaemic traits in the continental African AWI-Gen cohort.Diabetologia · 2025Article
- Sex-disaggregated data along the gendered health pathways: A review and analysis of global data on hypertension, diabetes, HIV, and AIDS.PLoS medicine · 2025Review
- Incident type 2 diabetes and its risk factors in men and women aged 40-60 years from four sub-Saharan African countries: results from the AWI-Gen study.The Lancet. Global health · 2025Article
- Cohort Profile: Africa Wits-INDEPTH partnership for Genomic studies (AWI-Gen) in four sub-Saharan African countries.International journal of epidemiology · 2024Article
- A cascade of care for diabetes in people living with HIV in a tertiary care center in Mexico City.HIV research & clinical practice · 2024Article
- Hypertension and diabetes control: faith-based centres offer a promise for expanding screening services and linkage to care in Ghana.BMC primary care · 2024Article
- Recognition of language barriers in comprehending non-communicable disease management among rural elderly people in the DIMAMO surveillance area: a case of AWI-Gen participants.BMC public health · 2024Article
- A qualitative study to understand the barriers and enablers of access to diabetic screening services in Nigeria.International journal of community medicine and public health · 2024Article
- Hypertension knowledge, attitudes and perceptions among adults in the Navrongo Health and Demographic Surveillance Site: a mixed methods analysis.BMC primary care · 2024Article
- Extended cost-effectiveness analysis of interventions to improve uptake of diabetes services in South Africa.Health policy and planning · 2024Article
- Number of People with Type 2 Diabetes Mellitus in 2035 and 2050: A Modelling Study in 188 Countries.Current diabetes reviews · 2024Article
- Psychological distress, coping methods and self-care among people with diabetes mellitus in Ibadan.Nigerian medical journal : journal of the Nigeria Medical AssociationReview
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Authors and funding
16 authors.
Funding
Abstract
objectivesWe investigated progression through the care cascade and associated factors for people with diabetes in sub-Saharan Africa to identify attrition stages that may be most appropriate for targeted intervention.
designCross-sectional study.
settingCommunity-based study in four sub-Saharan African countries.
participants10 700 individuals, aged 40-60 years. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome measure was the diabetes cascade of care defined as the age-adjusted diabetes prevalence (self-report of diabetes, fasting plasma glucose (FPG) ≥7 mmol/L or random plasma glucose ≥11.1 mmol/L) and proportions of those who reported awareness of having diabetes, ever having received treatment for diabetes and those who achieved glycaemic control (FPG <7.2 mmol/L). Secondary outcome measures were factors associated with having diabetes and being aware of the diagnosis.
resultsDiabetes prevalence was 5.5% (95% CI 4.4% to 6.5%). Approximately half of those with diabetes were aware (54%; 95% CI 50% to 58%); 73% (95% CI 67% to 79%) of aware individuals reported ever having received treatment. However, only 38% (95% CI 30% to 46%) of those ever having received treatment were adequately controlled. Increasing age (OR 1.1; 95% CI 1.0 to 1.1), urban residence (OR 2.3; 95% CI 1.6 to 3.5), hypertension (OR 1.9; 95% CI 1.5 to 2.4), family history of diabetes (OR 3.9; 95% CI 3.0 to 5.1) and measures of central adiposity were associated with higher odds of having diabetes. Increasing age (OR 1.1; 95% CI 1.0 to 1.1), semi-rural residence (OR 2.5; 95% CI 1.1 to 5.7), secondary education (OR 2.4; 95% CI 1.2 to 4.9), hypertension (OR 1.6; 95% CI 1.0 to 2.4) and known HIV positivity (OR 2.3; 95% CI 1.2 to 4.4) were associated with greater likelihood of awareness of having diabetes.
conclusionsThere is attrition at each stage of the diabetes care cascade in sub-Saharan Africa. Public health strategies should target improving diagnosis in high-risk individuals and intensifying therapy in individuals treated for diabetes.
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