Association between urban–rural location and prevalence of type 2 diabetes and impaired fasting glucose in West Africa: a cross–sectional population–based epidemiological study

Association between urban–rural location and prevalence of type 2 diabetes and impaired fasting glucose in West Africa: a cross–sectional population–based epidemiological study

ObjectivesWe investigated the association between urban/rural location and both type 2 diabetes mellitus (T2DM) and pre-diabetes among populations of five West African countries.DesignCross-sectional studies, using the WHO Stepwise (STEPs) survey data.SettingNational representative data of both urba...

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Bibliographic Details
Published in:BMJ open Vol. 13; no. 9; p. e063318
Main Authors: Issaka, Ayuba, Stevenson, Christopher, Paradies, Yin, Houehanou, Yessito Corine N, Bosu, William K, Kiwallo, Jean Baptiste, Wesseh, Chea Sanford, Houinato, Dismand Stephan, Nazoum, Diarra J P, Cameron, Adrian J
Format: Journal Article
Language:English
Published: London BMJ Publishing Group LTD 21-09-2023
BMJ Publishing Group
Series:Original research
Subjects:
Alcohol
Blood pressure
Body mass index
Cardiovascular Medicine
Diabetes
Epidemiology
Fasting
Glucose
Marital status
Obesity
Population-based studies
Risk factors
Rural areas
Sensitivity analysis
Sociodemographics
Surveillance
Urban areas
Urbanization
Variables
Ghana
Burkina Faso
West Africa
Africa
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Summary:ObjectivesWe investigated the association between urban/rural location and both type 2 diabetes mellitus (T2DM) and pre-diabetes among populations of five West African countries.DesignCross-sectional studies, using the WHO Stepwise (STEPs) survey data.SettingNational representative data of both urban and rural areas from Benin, Burkina Faso, Ghana, Liberia and Mali.ParticipantsAdults comprising 15 468 participants (6774 men and 8746 women; 7663 urban and 7805 rural residents) aged between 25 and 64 years.ResultsThe age and sex-adjusted prevalence of T2DM was 6.2% for urban areas and 2.5% for rural areas. The prevalence of impaired fasting glucose (IFG) was 6.6% for urban areas, and 3.0% for rural areas. No differences by sex were observed. The crude relative risk (RR) and 95% CI of T2DM and IFG in urban compared with rural areas were 2.69 (1.85 to 3.91) and 2.37 (1.53 to 3.66), respectively. This reduced to RR: 2.03, 95% CI (1.34 to 3.08) and RR: 2.04, 95% CI (1.27 to 3.28), respectively, after adjusting for covariables.ConclusionThe prevalence of both T2DM and IFG was more than two times as high in urban areas compared with rural areas in West Africa. Behavioural risk factors are common among urban populations, with ongoing urbanisation expected to drive increases in the prevalence of T2DM. These results could guide planning for T2DM screening, preventive strategies and resource allocation in West Africa.
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ISSN:2044-6055
2044-6055
DOI:10.1136/bmjopen-2022-063318