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
Yin Paradies,
Christopher Stevenson,
William K Bosu,
Chea Sanford Wesseh,
Adrian J Cameron,
Ayuba Issaka,
Yessito Corine N Houehanou,
Jean Baptiste Kiwallo,
Dismand Stephan Houinato,
Diarra J P Nazoum
Affiliations
Yin Paradies
Alfred Deakin Institute for Citizenship and Globalisation, Faculty of Arts and Education, Deakin University, Geelong, Victoria, Australia
Christopher Stevenson
School of Health and Social Development, Global Obesity Centre (GLOBE), Institute for Health Transformation (IHT), Faculty of Health, Deakin University, Geelong, Victoria, Australia
William K Bosu
Department of Public Health and Research, West African Health Organisation, Bobo-Dioulasso, Haut-Bassin, Burkina Faso
Chea Sanford Wesseh
Republic of Liberia Ministry of Health, Congo Town, Monrovia, Montserrado, Liberia
Adrian J Cameron
School of Health and Social Development, Global Obesity Centre (GLOBE), Institute for Health Transformation (IHT), Faculty of Health, Deakin University, Geelong, Victoria, Australia
Ayuba Issaka
School of Health and Social Development, Global Obesity Centre (GLOBE), Institute for Health Transformation (IHT), Faculty of Health, Deakin University, Geelong, Victoria, Australia
Yessito Corine N Houehanou
National School of Senior Technicians Training in Public Health and Epidemiological Surveillance, University of Parakou, Parakou, Borgou, Benin
Jean Baptiste Kiwallo
Directorate of Population Health Protection (DPSP) of Burkina Faso, Ministry of Health, Ouagadougou, Burkina Faso
Dismand Stephan Houinato
Laboratory of Epidemiology of Chronic and Neurological Diseases (LEMACEN), Faculty of Health Sciences, University of Abomey Calavi, Cotonou, Benin
Diarra J P Nazoum
Non-Communicable Diseases and National Directorate of Health, Ministry of Health and Public Hygiene, Bamako, Mali
Objectives We investigated the association between urban/rural location and both type 2 diabetes mellitus (T2DM) and pre-diabetes among populations of five West African countries.Design Cross-sectional studies, using the WHO Stepwise (STEPs) survey data.Setting National representative data of both urban and rural areas from Benin, Burkina Faso, Ghana, Liberia and Mali.Participants Adults comprising 15 468 participants (6774 men and 8746 women; 7663 urban and 7805 rural residents) aged between 25 and 64 years.Results The 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.Conclusion The 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.
