Secular Trends in Admissions and Mortality Rates from Diabetes Mellitus in the Central Belt of Ghana: A 31-Year Review
Diabetes Mellitus is currently a leading cause of morbidity and mortality throughout the world, particularly in sub-Saharan Africa where a significant proportion of diabetes cases are now found. Longitudinal profiling of in-patient admissions and mortality trends from diabetes provide useful insight...
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| Published in: | PloS one Vol. 11; no. 11; p. e0165905 |
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| Main Authors: | , , , , , |
| Format: | Journal Article |
| Language: | English |
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22-11-2016
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| Abstract | Diabetes Mellitus is currently a leading cause of morbidity and mortality throughout the world, particularly in sub-Saharan Africa where a significant proportion of diabetes cases are now found. Longitudinal profiling of in-patient admissions and mortality trends from diabetes provide useful insights into the magnitude of the burden of diabetes, serve as a sentinel on the state of out-patient diabetes care and provide effective tools for planning, delivering and evaluating the health care needs relating to the disease in sub-Saharan Africa.
To evaluate the 31-year trend in diabetic admissions and mortality rates in central Ghana.
This is a retrospective analysis of data on diabetes admissions and deaths at a tertiary referral hospital in central Ghana between 1983 and 2014. Rates of diabetes admissions or deaths were expressed as diabetes admissions or deaths divided by the total number of admissions or deaths respectively. Yearly crude fatality rates for diabetes were calculated. Trends were analysed for in patient diabetes admissions and mortality for the period. Predictors of diabetes mortality were determined using multiple logistic regression.
A total of 11,414 diabetes patients were admitted over the period with a female predominance; female:male ratio of 1.3:1.0. Over the study period, diabetes admission rates increased significantly from 2.36 per 1000 admissions in 1983 to 14.94 per 1000 admissions in 2014 (p<0.0001for linear trend), representing a 633% rise over the 31-year period. In-patient diabetes fatality rates increased from 7.6 per 1000 deaths in 1983 to 30 per 1000 deaths in 2012. The average 28-day mortality rate was 18.5%. The median age of patients increased significantly over the period. So was the proportion of females admitted over the years. Predictors of in-patient mortality were increasing age- aOR of 1.23 (CI: 1.15-1.32) for age > 80 years compared with < 20 years, admissions in 2000s compared to 1980s-aOR of 1.56 (1.21-2.01), male gender-aOR of 1.45 (1.19-1.61), the presence of glycemic complications such as ketoacidosis- aOR-2.67(CI: 2.21-3.21), hyperosmolar hyperglycemic states- aOR 1.52 (1.33-1.73) symptomatic hypoglycemia- aOR 1.64 (1.24-2.17) and presence of end organ complications including peripheral neuropathic ulcers- aOR 1.31 (1.12-1.56), nephropathy- aOR -1.11 (1.03-1.23), cerebrovascular disease-aOR-1.52 (1.32-1.98), coronary artery disease- aOR-3.21 (1.91-5.15) and peripheral artery disease- aOR-1.15 (1.12-1.21) were associated with increased risk of death compared with normoglycemic diabetic admissions and admissions without end organ complications respectively.
Diabetes admission and mortality rates have increased significantly over the past three decades in central Ghana. More intensive education on the risk factors for diabetes, acute diabetes care as well as instituting hospital guidelines for diabetes control and reduction of modifiable risk factors for diabetes are urgently needed to reduce the poor case fatality associated with diabetes in resource-limited settings. |
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| AbstractList | Introduction Diabetes Mellitus is currently a leading cause of morbidity and mortality throughout the world, particularly in sub-Saharan Africa where a significant proportion of diabetes cases are now found. Longitudinal profiling of in-patient admissions and mortality trends from diabetes provide useful insights into the magnitude of the burden of diabetes, serve as a sentinel on the state of out-patient diabetes care and provide effective tools for planning, delivering and evaluating the health care needs relating to the disease in sub-Saharan Africa. Objective To evaluate the 31-year trend in diabetic admissions and mortality rates in central Ghana. Methods This is a retrospective analysis of data on diabetes admissions and deaths at a tertiary referral hospital in central Ghana between 1983 and 2014. Rates of diabetes admissions or deaths were expressed as diabetes admissions or deaths divided by the total number of admissions or deaths respectively. Yearly crude fatality rates for diabetes were calculated. Trends were analysed for in patient diabetes admissions and mortality for the period. Predictors of diabetes mortality were determined using multiple logistic regression. Results A total of 11,414 diabetes patients were admitted over the period with a female predominance; female:male ratio of 1.3:1.0. Over the study period, diabetes admission rates increased significantly from 2.36 per 1000 admissions in 1983 to 14.94 per 1000 admissions in 2014 (p 80 years compared with < 20 years, admissions in 2000s compared to 1980s-aOR of 1.56 (1.21-2.01), male gender-aOR of 1.45 (1.19-1.61), the presence of glycemic complications such as ketoacidosis- aOR-2.67(CI: 2.21-3.21), hyperosmolar hyperglycemic states- aOR 1.52 (1.33-1.73) symptomatic hypoglycemia- aOR 1.64 (1.24-2.17) and presence of end organ complications including peripheral neuropathic ulcers- aOR 1.31 (1.12-1.56), nephropathy- aOR -1.11 (1.03-1.23), cerebrovascular disease-aOR-1.52 (1.32-1.98), coronary artery disease- aOR-3.21 (1.91-5.15) and peripheral artery disease- aOR-1.15 (1.12-1.21) were associated with increased risk of death compared with normoglycemic diabetic admissions and admissions without end organ complications respectively. Conclusion Diabetes admission and mortality rates have increased significantly over the past three decades in central Ghana. More intensive education on the risk factors for diabetes, acute diabetes care as well as instituting hospital guidelines for diabetes control and reduction of modifiable risk factors for diabetes are urgently needed to reduce the poor case fatality associated with diabetes in resource-limited settings. Diabetes Mellitus is currently a leading cause of morbidity and mortality throughout the world, particularly in sub-Saharan Africa where a significant proportion of diabetes cases are now found. Longitudinal profiling of in-patient admissions and mortality trends from diabetes provide useful insights into the magnitude of the burden of diabetes, serve as a sentinel on the state of out-patient diabetes care and provide effective tools for planning, delivering and evaluating the health care needs relating to the disease in sub-Saharan Africa.To evaluate the 31-year trend in diabetic admissions and mortality rates in central Ghana.This is a retrospective analysis of data on diabetes admissions and deaths at a tertiary referral hospital in central Ghana between 1983 and 2014. Rates of diabetes admissions or deaths were expressed as diabetes admissions or deaths divided by the total number of admissions or deaths respectively. Yearly crude fatality rates for diabetes were calculated. Trends were analysed for in patient diabetes admissions and mortality for the period. Predictors of diabetes mortality were determined using multiple logistic regression.A total of 11,414 diabetes patients were admitted over the period with a female predominance; female:male ratio of 1.3:1.0. Over the study period, diabetes admission rates increased significantly from 2.36 per 1000 admissions in 1983 to 14.94 per 1000 admissions in 2014 (p<0.0001for linear trend), representing a 633% rise over the 31-year period. In-patient diabetes fatality rates increased from 7.6 per 1000 deaths in 1983 to 30 per 1000 deaths in 2012. The average 28-day mortality rate was 18.5%. The median age of patients increased significantly over the period. So was the proportion of females admitted over the years. Predictors of in-patient mortality were increasing age- aOR of 1.23 (CI: 1.15-1.32) for age > 80 years compared with < 20 years, admissions in 2000s compared to 1980s-aOR of 1.56 (1.21-2.01), male gender-aOR of 1.45 (1.19-1.61), the presence of glycemic complications such as ketoacidosis- aOR-2.67(CI: 2.21-3.21), hyperosmolar hyperglycemic states- aOR 1.52 (1.33-1.73) symptomatic hypoglycemia- aOR 1.64 (1.24-2.17) and presence of end organ complications including peripheral neuropathic ulcers- aOR 1.31 (1.12-1.56), nephropathy- aOR -1.11 (1.03-1.23), cerebrovascular disease-aOR-1.52 (1.32-1.98), coronary artery disease- aOR-3.21 (1.91-5.15) and peripheral artery disease- aOR-1.15 (1.12-1.21) were associated with increased risk of death compared with normoglycemic diabetic admissions and admissions without end organ complications respectively.Diabetes admission and mortality rates have increased significantly over the past three decades in central Ghana. More intensive education on the risk factors for diabetes, acute diabetes care as well as instituting hospital guidelines for diabetes control and reduction of modifiable risk factors for diabetes are urgently needed to reduce the poor case fatality associated with diabetes in resource-limited settings. INTRODUCTIONDiabetes Mellitus is currently a leading cause of morbidity and mortality throughout the world, particularly in sub-Saharan Africa where a significant proportion of diabetes cases are now found. Longitudinal profiling of in-patient admissions and mortality trends from diabetes provide useful insights into the magnitude of the burden of diabetes, serve as a sentinel on the state of out-patient diabetes care and provide effective tools for planning, delivering and evaluating the health care needs relating to the disease in sub-Saharan Africa.OBJECTIVETo evaluate the 31-year trend in diabetic admissions and mortality rates in central Ghana.METHODSThis is a retrospective analysis of data on diabetes admissions and deaths at a tertiary referral hospital in central Ghana between 1983 and 2014. Rates of diabetes admissions or deaths were expressed as diabetes admissions or deaths divided by the total number of admissions or deaths respectively. Yearly crude fatality rates for diabetes were calculated. Trends were analysed for in patient diabetes admissions and mortality for the period. Predictors of diabetes mortality were determined using multiple logistic regression.RESULTSA total of 11,414 diabetes patients were admitted over the period with a female predominance; female:male ratio of 1.3:1.0. Over the study period, diabetes admission rates increased significantly from 2.36 per 1000 admissions in 1983 to 14.94 per 1000 admissions in 2014 (p<0.0001for linear trend), representing a 633% rise over the 31-year period. In-patient diabetes fatality rates increased from 7.6 per 1000 deaths in 1983 to 30 per 1000 deaths in 2012. The average 28-day mortality rate was 18.5%. The median age of patients increased significantly over the period. So was the proportion of females admitted over the years. Predictors of in-patient mortality were increasing age- aOR of 1.23 (CI: 1.15-1.32) for age > 80 years compared with < 20 years, admissions in 2000s compared to 1980s-aOR of 1.56 (1.21-2.01), male gender-aOR of 1.45 (1.19-1.61), the presence of glycemic complications such as ketoacidosis- aOR-2.67(CI: 2.21-3.21), hyperosmolar hyperglycemic states- aOR 1.52 (1.33-1.73) symptomatic hypoglycemia- aOR 1.64 (1.24-2.17) and presence of end organ complications including peripheral neuropathic ulcers- aOR 1.31 (1.12-1.56), nephropathy- aOR -1.11 (1.03-1.23), cerebrovascular disease-aOR-1.52 (1.32-1.98), coronary artery disease- aOR-3.21 (1.91-5.15) and peripheral artery disease- aOR-1.15 (1.12-1.21) were associated with increased risk of death compared with normoglycemic diabetic admissions and admissions without end organ complications respectively.CONCLUSIONDiabetes admission and mortality rates have increased significantly over the past three decades in central Ghana. More intensive education on the risk factors for diabetes, acute diabetes care as well as instituting hospital guidelines for diabetes control and reduction of modifiable risk factors for diabetes are urgently needed to reduce the poor case fatality associated with diabetes in resource-limited settings. Diabetes Mellitus is currently a leading cause of morbidity and mortality throughout the world, particularly in sub-Saharan Africa where a significant proportion of diabetes cases are now found. Longitudinal profiling of in-patient admissions and mortality trends from diabetes provide useful insights into the magnitude of the burden of diabetes, serve as a sentinel on the state of out-patient diabetes care and provide effective tools for planning, delivering and evaluating the health care needs relating to the disease in sub-Saharan Africa. To evaluate the 31-year trend in diabetic admissions and mortality rates in central Ghana. This is a retrospective analysis of data on diabetes admissions and deaths at a tertiary referral hospital in central Ghana between 1983 and 2014. Rates of diabetes admissions or deaths were expressed as diabetes admissions or deaths divided by the total number of admissions or deaths respectively. Yearly crude fatality rates for diabetes were calculated. Trends were analysed for in patient diabetes admissions and mortality for the period. Predictors of diabetes mortality were determined using multiple logistic regression. A total of 11,414 diabetes patients were admitted over the period with a female predominance; female:male ratio of 1.3:1.0. Over the study period, diabetes admission rates increased significantly from 2.36 per 1000 admissions in 1983 to 14.94 per 1000 admissions in 2014 (p 80 years compared with < 20 years, admissions in 2000s compared to 1980s-aOR of 1.56 (1.21-2.01), male gender-aOR of 1.45 (1.19-1.61), the presence of glycemic complications such as ketoacidosis- aOR-2.67(CI: 2.21-3.21), hyperosmolar hyperglycemic states- aOR 1.52 (1.33-1.73) symptomatic hypoglycemia- aOR 1.64 (1.24-2.17) and presence of end organ complications including peripheral neuropathic ulcers- aOR 1.31 (1.12-1.56), nephropathy- aOR -1.11 (1.03-1.23), cerebrovascular disease-aOR-1.52 (1.32-1.98), coronary artery disease- aOR-3.21 (1.91-5.15) and peripheral artery disease- aOR-1.15 (1.12-1.21) were associated with increased risk of death compared with normoglycemic diabetic admissions and admissions without end organ complications respectively. Diabetes admission and mortality rates have increased significantly over the past three decades in central Ghana. More intensive education on the risk factors for diabetes, acute diabetes care as well as instituting hospital guidelines for diabetes control and reduction of modifiable risk factors for diabetes are urgently needed to reduce the poor case fatality associated with diabetes in resource-limited settings. Introduction Diabetes Mellitus is currently a leading cause of morbidity and mortality throughout the world, particularly in sub-Saharan Africa where a significant proportion of diabetes cases are now found. Longitudinal profiling of in-patient admissions and mortality trends from diabetes provide useful insights into the magnitude of the burden of diabetes, serve as a sentinel on the state of out-patient diabetes care and provide effective tools for planning, delivering and evaluating the health care needs relating to the disease in sub-Saharan Africa. Objective To evaluate the 31-year trend in diabetic admissions and mortality rates in central Ghana. Methods This is a retrospective analysis of data on diabetes admissions and deaths at a tertiary referral hospital in central Ghana between 1983 and 2014. Rates of diabetes admissions or deaths were expressed as diabetes admissions or deaths divided by the total number of admissions or deaths respectively. Yearly crude fatality rates for diabetes were calculated. Trends were analysed for in patient diabetes admissions and mortality for the period. Predictors of diabetes mortality were determined using multiple logistic regression. Results A total of 11,414 diabetes patients were admitted over the period with a female predominance; female:male ratio of 1.3:1.0. Over the study period, diabetes admission rates increased significantly from 2.36 per 1000 admissions in 1983 to 14.94 per 1000 admissions in 2014 (p<0.0001for linear trend), representing a 633% rise over the 31-year period. In-patient diabetes fatality rates increased from 7.6 per 1000 deaths in 1983 to 30 per 1000 deaths in 2012. The average 28-day mortality rate was 18.5%. The median age of patients increased significantly over the period. So was the proportion of females admitted over the years. Predictors of in-patient mortality were increasing age- aOR of 1.23 (CI: 1.15-1.32) for age > 80 years compared with < 20 years, admissions in 2000s compared to 1980s-aOR of 1.56 (1.21-2.01), male gender-aOR of 1.45 (1.19-1.61), the presence of glycemic complications such as ketoacidosis- aOR-2.67(CI: 2.21-3.21), hyperosmolar hyperglycemic states- aOR 1.52 (1.33-1.73) symptomatic hypoglycemia- aOR 1.64 (1.24-2.17) and presence of end organ complications including peripheral neuropathic ulcers- aOR 1.31 (1.12-1.56), nephropathy- aOR -1.11 (1.03-1.23), cerebrovascular disease-aOR-1.52 (1.32-1.98), coronary artery disease- aOR-3.21 (1.91-5.15) and peripheral artery disease- aOR-1.15 (1.12-1.21) were associated with increased risk of death compared with normoglycemic diabetic admissions and admissions without end organ complications respectively. Conclusion Diabetes admission and mortality rates have increased significantly over the past three decades in central Ghana. More intensive education on the risk factors for diabetes, acute diabetes care as well as instituting hospital guidelines for diabetes control and reduction of modifiable risk factors for diabetes are urgently needed to reduce the poor case fatality associated with diabetes in resource-limited settings. Introduction Diabetes Mellitus is currently a leading cause of morbidity and mortality throughout the world, particularly in sub-Saharan Africa where a significant proportion of diabetes cases are now found. Longitudinal profiling of in-patient admissions and mortality trends from diabetes provide useful insights into the magnitude of the burden of diabetes, serve as a sentinel on the state of out-patient diabetes care and provide effective tools for planning, delivering and evaluating the health care needs relating to the disease in sub-Saharan Africa. Objective To evaluate the 31-year trend in diabetic admissions and mortality rates in central Ghana. Methods This is a retrospective analysis of data on diabetes admissions and deaths at a tertiary referral hospital in central Ghana between 1983 and 2014. Rates of diabetes admissions or deaths were expressed as diabetes admissions or deaths divided by the total number of admissions or deaths respectively. Yearly crude fatality rates for diabetes were calculated. Trends were analysed for in patient diabetes admissions and mortality for the period. Predictors of diabetes mortality were determined using multiple logistic regression. Results A total of 11,414 diabetes patients were admitted over the period with a female predominance; female:male ratio of 1.3:1.0. Over the study period, diabetes admission rates increased significantly from 2.36 per 1000 admissions in 1983 to 14.94 per 1000 admissions in 2014 (p<0.0001for linear trend), representing a 633% rise over the 31-year period. In-patient diabetes fatality rates increased from 7.6 per 1000 deaths in 1983 to 30 per 1000 deaths in 2012. The average 28-day mortality rate was 18.5%. The median age of patients increased significantly over the period. So was the proportion of females admitted over the years. Predictors of in-patient mortality were increasing age- aOR of 1.23 (CI: 1.15–1.32) for age > 80 years compared with < 20 years, admissions in 2000s compared to 1980s-aOR of 1.56 (1.21–2.01), male gender-aOR of 1.45 (1.19–1.61), the presence of glycemic complications such as ketoacidosis- aOR-2.67(CI: 2.21–3.21), hyperosmolar hyperglycemic states- aOR 1.52 (1.33–1.73) symptomatic hypoglycemia- aOR 1.64 (1.24–2.17) and presence of end organ complications including peripheral neuropathic ulcers- aOR 1.31 (1.12–1.56), nephropathy- aOR -1.11 (1.03–1.23), cerebrovascular disease—aOR-1.52 (1.32–1.98), coronary artery disease- aOR-3.21 (1.91–5.15) and peripheral artery disease- aOR-1.15 (1.12–1.21) were associated with increased risk of death compared with normoglycemic diabetic admissions and admissions without end organ complications respectively. Conclusion Diabetes admission and mortality rates have increased significantly over the past three decades in central Ghana. More intensive education on the risk factors for diabetes, acute diabetes care as well as instituting hospital guidelines for diabetes control and reduction of modifiable risk factors for diabetes are urgently needed to reduce the poor case fatality associated with diabetes in resource-limited settings. Diabetes Mellitus is currently a leading cause of morbidity and mortality throughout the world, particularly in sub-Saharan Africa where a significant proportion of diabetes cases are now found. Longitudinal profiling of in-patient admissions and mortality trends from diabetes provide useful insights into the magnitude of the burden of diabetes, serve as a sentinel on the state of out-patient diabetes care and provide effective tools for planning, delivering and evaluating the health care needs relating to the disease in sub-Saharan Africa. To evaluate the 31-year trend in diabetic admissions and mortality rates in central Ghana. This is a retrospective analysis of data on diabetes admissions and deaths at a tertiary referral hospital in central Ghana between 1983 and 2014. Rates of diabetes admissions or deaths were expressed as diabetes admissions or deaths divided by the total number of admissions or deaths respectively. Yearly crude fatality rates for diabetes were calculated. Trends were analysed for in patient diabetes admissions and mortality for the period. Predictors of diabetes mortality were determined using multiple logistic regression. A total of 11,414 diabetes patients were admitted over the period with a female predominance; female:male ratio of 1.3:1.0. Over the study period, diabetes admission rates increased significantly from 2.36 per 1000 admissions in 1983 to 14.94 per 1000 admissions in 2014 (p<0.0001for linear trend), representing a 633% rise over the 31-year period. In-patient diabetes fatality rates increased from 7.6 per 1000 deaths in 1983 to 30 per 1000 deaths in 2012. The average 28-day mortality rate was 18.5%. The median age of patients increased significantly over the period. So was the proportion of females admitted over the years. Predictors of in-patient mortality were increasing age- aOR of 1.23 (CI: 1.15-1.32) for age > 80 years compared with < 20 years, admissions in 2000s compared to 1980s-aOR of 1.56 (1.21-2.01), male gender-aOR of 1.45 (1.19-1.61), the presence of glycemic complications such as ketoacidosis- aOR-2.67(CI: 2.21-3.21), hyperosmolar hyperglycemic states- aOR 1.52 (1.33-1.73) symptomatic hypoglycemia- aOR 1.64 (1.24-2.17) and presence of end organ complications including peripheral neuropathic ulcers- aOR 1.31 (1.12-1.56), nephropathy- aOR -1.11 (1.03-1.23), cerebrovascular disease-aOR-1.52 (1.32-1.98), coronary artery disease- aOR-3.21 (1.91-5.15) and peripheral artery disease- aOR-1.15 (1.12-1.21) were associated with increased risk of death compared with normoglycemic diabetic admissions and admissions without end organ complications respectively. Diabetes admission and mortality rates have increased significantly over the past three decades in central Ghana. More intensive education on the risk factors for diabetes, acute diabetes care as well as instituting hospital guidelines for diabetes control and reduction of modifiable risk factors for diabetes are urgently needed to reduce the poor case fatality associated with diabetes in resource-limited settings. |
| Audience | Academic |
| Author | Eghan, Benjamin Acheamfour-Akowuah, Emmanuel Sarfo, Fred Stephen Sarfo-Kantanka, Osei Oparebea Ansah, Eunice Ayisi-Boateng, Nana Kwame |
| AuthorAffiliation | Yokohama City University, JAPAN 1 Directorate of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana 2 Department of Medicine, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana 3 University Health Services, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana |
| AuthorAffiliation_xml | – name: 2 Department of Medicine, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana – name: 3 University Health Services, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana – name: 1 Directorate of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana – name: Yokohama City University, JAPAN |
| Author_xml | – sequence: 1 givenname: Osei surname: Sarfo-Kantanka fullname: Sarfo-Kantanka, Osei organization: Directorate of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana – sequence: 2 givenname: Fred Stephen surname: Sarfo fullname: Sarfo, Fred Stephen organization: Department of Medicine, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana – sequence: 3 givenname: Eunice surname: Oparebea Ansah fullname: Oparebea Ansah, Eunice organization: Directorate of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana – sequence: 4 givenname: Benjamin surname: Eghan fullname: Eghan, Benjamin organization: Department of Medicine, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana – sequence: 5 givenname: Nana Kwame surname: Ayisi-Boateng fullname: Ayisi-Boateng, Nana Kwame organization: University Health Services, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana – sequence: 6 givenname: Emmanuel surname: Acheamfour-Akowuah fullname: Acheamfour-Akowuah, Emmanuel organization: Directorate of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/27875539$$D View this record in MEDLINE/PubMed |
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| ContentType | Journal Article |
| Copyright | COPYRIGHT 2016 Public Library of Science 2016 Sarfo-Kantanka et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. 2016 Sarfo-Kantanka et al 2016 Sarfo-Kantanka et al |
| Copyright_xml | – notice: COPYRIGHT 2016 Public Library of Science – notice: 2016 Sarfo-Kantanka et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. – notice: 2016 Sarfo-Kantanka et al 2016 Sarfo-Kantanka et al |
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| DOI | 10.1371/journal.pone.0165905 |
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| DocumentTitleAlternate | Trends in Admission and Mortality in Central Ghana: A 31-Year Review |
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| Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Competing Interests: The authors have declared that no competing interest exists. Conceptualization: OSK FSS EOA. Data curation: OSK FSS EAA EOA BE NKAB. Formal analysis: OSK FSS EAA EOA BE NKAB. Investigation: OSK FSS EAA NKAB. Methodology: OSK FSS BE. Project administration: FSS BE. Resources: OSK FSS EAA EOA BE NKAB. Software: BE EAA. Visualization: OSK FSS EAA EOA. Writing – original draft: OSK FSS EAA EOA BE NKAB. Writing – review & editing: OSK FSS EAA EOA BE NKAB. |
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| References_xml | – volume: 87 start-page: 879 issue: 1 year: 2010 ident: ref19 article-title: Epidemiological Transition and the double burden of disease in Accra, Ghana publication-title: J Urban Health doi: 10.1007/s11524-010-9492-y contributor: fullname: S Agyei-Mensah – volume: 4 start-page: 90 issue: 3 year: 1993 ident: ref13 article-title: Diabetes in Ghana: a morbidity and mortality analysis publication-title: International Diabetes Digest contributor: fullname: KOM Adubofour – volume: 18 start-page: 505 year: 2008 ident: ref28 article-title: Prevalence, detection, management and control of hypertension among Ghanaian civil servants publication-title: Ethn Disease contributor: fullname: J Addo – volume: 3 start-page: 75 year: 1964 ident: ref8 article-title: A diabetes case finding survey in Ho, Ghana publication-title: Ghana Med J contributor: fullname: SRA Dosu – volume: 10 start-page: 282 year: 1993 ident: ref34 article-title: Persistent mortality in diabetes ketoacidosis publication-title: Diabet Med doi: 10.1111/j.1464-5491.1993.tb00060.x contributor: fullname: A Basu – volume: 41 start-page: 231 year: 2011 ident: ref17 article-title: Trend of diabetes admissions in Tikur Ambessa and St Paul University teaching Hospital from January 2005 to December 2009, Addis Ababa, Ethiopia publication-title: Ethiop Med J contributor: fullname: A Adem – volume: 15 start-page: 683 issue: 6 year: 2008 ident: ref29 article-title: Prevalence and pattern of hypertension in a semi urban community in Nigeria publication-title: Eur J Cardiovasc Prev Rehabil doi: 10.1097/HJR.0b013e32830edc32 contributor: fullname: RA Adedotin – volume: 41 start-page: 999 year: 1988 ident: ref16 article-title: Sentinel health surveillance in diabetes. deaths among persons under age 45 with diabetes publication-title: J Clin Epidemiol doi: 10.1016/0895-4356(88)90039-X contributor: fullname: D Bild – volume: 6 start-page: 5 year: 2010 ident: ref10 article-title: Tackling Africa’s Global Chronic disease burden: from the local to the Global publication-title: Globalisation and Health doi: 10.1186/1744-8603-6-5 contributor: fullname: A Aikins – ident: ref25 – volume: 56 start-page: 197 issue: 3 year: 2002 ident: ref9 article-title: Diabetes in Ghana: a community based prevalence study in Greater Accra publication-title: Diabetes Res Clin Pract doi: 10.1016/S0168-8227(01)00374-6 contributor: fullname: AG Amoah – volume: 375 start-page: 2254 issue: 9733 year: 2010 ident: ref4 article-title: Diabetes in sub-Saharan Africa publication-title: Lancet doi: 10.1016/S0140-6736(10)60550-8 contributor: fullname: JC Mbanya – volume: 46 start-page: 69 year: 2012 ident: ref20 article-title: A comprehensive review of the policy and programmatic response to chronic non-communicable disease in Ghana publication-title: Ghana Med J contributor: fullname: WK Bosu – volume: 27 start-page: 1047 issue: 5 year: 2004 ident: ref5 article-title: Global Prevalence of Diabetes. Estimates for the year 2000 and projections for 2030 publication-title: Diabetes Care doi: 10.2337/diacare.27.5.1047 contributor: fullname: S Wild – volume: 112 start-page: 3592 year: 2005 ident: ref6 article-title: Cardiovascular complications of diabetes mellitus in sub-Saharan Africa contributor: fullname: PA Kengne – start-page: 83 year: 1997 ident: ref14 article-title: Diabetes in Africa contributor: fullname: KOM Adubofour – volume: 32 start-page: 464 issue: 3 year: 2014 ident: ref23 article-title: Hypertension and overweight/obesity in Ghanaians and Nigerians living in West Africa and industrialized countries: a systematic review publication-title: J Hypertens doi: 10.1097/HJH.0000000000000061 contributor: fullname: Y Commodore-Mensah – volume: 14 start-page: 1285 year: 2011 ident: ref24 article-title: Sociodemographic correlates of obesity among Ghanaian women publication-title: Public Health Nutr doi: 10.1017/S1368980010002879 contributor: fullname: FA Dake – ident: ref15 – volume: 28 start-page: 604 year: 1998 ident: ref35 article-title: Diabetes Ketoacidosis in adults in an Auckland hospital publication-title: Aust NZ J Med contributor: fullname: W Bagg – volume: 87 start-page: 293 issue: 3 year: 2010 ident: ref12 article-title: Global health care expenditure on diabetes for 2010 and 2030 publication-title: Diabetes Research and Clinical Practice doi: 10.1016/j.diabres.2010.01.026 contributor: fullname: P Zhang – volume: 87 start-page: 4 issue: 1 year: 2010 ident: ref1 article-title: Global estimates of the prevalence of diabetes for 2010 and 2030 publication-title: Diabetes Research and Clinical Practice doi: 10.1016/j.diabres.2009.10.007 contributor: fullname: JE Shaw – volume: 97 start-page: 85 year: 1998 ident: ref33 article-title: Clinical profile in adult diabetes ketoacidosis patients in a tertiary medical referral centre in southern Taiwan publication-title: J Formes Med Assoction contributor: fullname: EH Yu – volume: 11 start-page: S58 issue: Suppl 1 year: 2014 ident: ref21 article-title: Results from Ghana’s 2014 Report Card on Physical Activity for Children and Youth publication-title: J Phys Act Health doi: 10.1123/jpah.2014-0171 contributor: fullname: R Ocansey – volume: 123 start-page: 602 year: 2009 ident: ref22 article-title: Prevalence and time trends in diabetes and physical inactivity among adult West African populations: the epidemic has arrived publication-title: Public Health doi: 10.1016/j.puhe.2009.07.009 contributor: fullname: AR Abubakari – volume: 46 start-page: 14 year: 2012 ident: ref26 article-title: Lipid Disorders in Hospital Attendants in Kumasi, Ghana publication-title: Ghana Med J contributor: fullname: FB Micah – volume: 99 start-page: 150 year: 2007 ident: ref27 article-title: Health of urban Ghanaian women as identified by the Women's Health Study of Accra publication-title: Int J Gynaecol Obstet doi: 10.1016/j.ijgo.2007.05.024 contributor: fullname: AG Hill – volume: 103 start-page: 137 issue: 2 year: 2014 ident: ref2 article-title: Global estimates of diabetes prevalence for 2013 and projections for 2035 publication-title: Diabetes Research and Clinical Practice doi: 10.1016/j.diabres.2013.11.002 contributor: fullname: L Guariguata – year: 2005 ident: ref11 article-title: A vital investment – volume: 11 start-page: 564 year: 2011 ident: ref3 article-title: Diabetes in Sub-Saharan Africa 1999–2011: Epidemiology and public health implications. A systemic review publication-title: BMC Public Health doi: 10.1186/1471-2458-11-564 contributor: fullname: V Hall – ident: ref18 – volume: 10 start-page: 644 issue: 8 year: 2008 ident: ref30 article-title: Barriers to optimal hypertension control publication-title: J Clin Hypertens(Greenwich) doi: 10.1111/j.1751-7176.2008.08329.x contributor: fullname: G Ogedegbe – volume: 23 start-page: 696 issue: 9 year: 2007 ident: ref7 article-title: Migration and its impact on adiposity and type 2 diabetes publication-title: Nutrition doi: 10.1016/j.nut.2007.06.008 contributor: fullname: A Misra – ident: ref31 – volume: 22 start-page: 466 year: 2005 ident: ref32 article-title: Clinical characteristics of Diabetes Ketoacidosis in Korea over the past two decades publication-title: Diabet Med doi: 10.1111/j.1464-5491.2005.01450.x contributor: fullname: SH Ko |
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| Snippet | Diabetes Mellitus is currently a leading cause of morbidity and mortality throughout the world, particularly in sub-Saharan Africa where a significant... Introduction Diabetes Mellitus is currently a leading cause of morbidity and mortality throughout the world, particularly in sub-Saharan Africa where a... INTRODUCTIONDiabetes Mellitus is currently a leading cause of morbidity and mortality throughout the world, particularly in sub-Saharan Africa where a... Introduction Diabetes Mellitus is currently a leading cause of morbidity and mortality throughout the world, particularly in sub-Saharan Africa where a... |
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| Title | Secular Trends in Admissions and Mortality Rates from Diabetes Mellitus in the Central Belt of Ghana: A 31-Year Review |
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