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Manyara AM, Mwaniki E, Gill JMR, Gray CM. Knowledge, perceptions and practices towards diabetes risk in sub-Saharan Africa: a mixed-methods scoping review. Public Health Nutr 2024; 27:e104. [PMID: 38533768 PMCID: PMC11010065 DOI: 10.1017/s1368980024000752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 03/03/2024] [Accepted: 03/19/2024] [Indexed: 03/28/2024]
Abstract
OBJECTIVE To synthesise current evidence on knowledge, perceptions and practices towards type 2 diabetes risk in sub-Saharan Africa. DESIGN Mixed-methods scoping review, which included 101 studies (seventy-three quantitative, twenty qualitative and eight mixed methods) from seven electronic databases. SETTING Sub-Saharan Africa, 2000-2023. PARTICIPANTS Men and women without diabetes with mean ages ranging from 20 to 63 years. RESULTS The majority of participants in most studies knew the three main diabetes modifiable risk factors - excess weight, unhealthy diet and physical inactivity. However, most people with excess weight in almost all studies underestimated their weight. Further, the self-described ideal body weight was between midpoint of normal weight and the upper limits of overweight in most quantitative studies and was described as not too skinny but not too fat in qualitative studies. In the majority of studies, participants reported low engagement in weight control, high regular sugar intake, and low regular fruit and vegetable intake but moderate to high engagement in physical activity. Barriers to reducing diabetes risk were social (e.g. societal perceptions promoting weight gain) and environmental (e.g. limited affordability of healthy foods, high accessibility of Western diets and lack of physical activity facilities). CONCLUSION There is a need for multicomponent type 2 diabetes prevention interventions that increase knowledge of identifying diabetes risk (e.g. what constitutes excess weight) and create social and physical environments that support healthy lifestyles (e.g. societal perceptions that promote healthy living, increased availability and affordability of healthy foods and physical activity facilities).
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Affiliation(s)
- Anthony Muchai Manyara
- School of Health and Wellbeing, University of
Glasgow, Glasgow, UK
- Department of Health Systems Management and Public Health,
Technical University of Kenya, Nairobi,
Kenya
- Global Health and Ageing Research Unit, Bristol Medical School,
University of Bristol, Bristol,
UK
| | - Elizabeth Mwaniki
- Department of Health Systems Management and Public Health,
Technical University of Kenya, Nairobi,
Kenya
| | - Jason MR Gill
- School of Cardiovascular and Metabolic Health, University of
Glasgow, Glasgow, UK
| | - Cindy M Gray
- School of Health and Wellbeing, University of
Glasgow, Glasgow, UK
- School of Social and Political Sciences, University of
Glasgow, Glasgow, UK
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Ferreira PL, Morais C, Pimenta R, Ribeiro I, Amorim I, Alves SM, Santiago L. Knowledge about type 2 diabetes: its impact for future management. Front Public Health 2024; 12:1328001. [PMID: 38525337 PMCID: PMC10957559 DOI: 10.3389/fpubh.2024.1328001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 01/29/2024] [Indexed: 03/26/2024] Open
Abstract
Diabetes can cause several long-term complications. Knowledge about this disease can play an important role in reducing diabetes-related complications. In addition, the lack of awareness leads to misconceptions, which joined with inadequate knowledge, are relevant barriers to proper diabetes management. In this study, we aimed to assess the diabetes knowledge of a type 2 diabetes (T2D) population and identify major knowledge gaps, in order to prevent complications and to increase quality of life. In a cross-sectional, observational study in a convenience sample, we identified individuals diagnosed with T2D attending ambulatory visits from five health settings, older than 18 years, with a time diagnosis of at least 1 year, and attending multidisciplinary visits for at least 3 months. To assess the knowledge of T2D individuals, we applied the Portuguese version of the Diabetes Knowledge Test. The sample included a total of 1,200 persons, of whom almost half were female. The age range of the participants varied from 24 to 94 years old, and the mean age was 65.6 ± 11.4 years. Most of the sample had a level of education under secondary and lived with someone. In our sample, 479 (39.9%) were insulin-treated. The percentage of correct answers was 51.8% for non-insulin vs. 58.7% for insulin treated (p < 0.05). There were three items with a percentage of correct answers lower than 15%; the item with the lower value of correct answers was the one related to the identification of signs of ketoacidosis with only 4.4% of correct answers, the errors presented a random pattern; the item related to the identification of which food should not be used to treat low blood glucose with 11.9%, where 56.9% of the sample's participants considered that one cup of skim milk would be the correct answer (53.1% in non-insulin patients and 62.6% in insulin treated patients; p < 0.001). The item regarding the knowledge of free food presented a 13.3% of correct answers (10.8% non-insulin group vs. 17.1% insulin group; p < 0.01). Two of the three items with lower value of correct answers were related to glycemic control and health status monitoring, the other was related to diet and food.
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Affiliation(s)
- Pedro L. Ferreira
- Centre for Health Studies and Research of the University of Coimbra, Portugal (CEISUC), Coimbra, Portugal
- Faculty of Economics, University of Coimbra, Portugal (FEUC), Coimbra, Portugal
| | - Carminda Morais
- Centre for Health Studies and Research of the University of Coimbra, Portugal (CEISUC), Coimbra, Portugal
- Superior School of Health of the Polytechnical Institute of Viana do Castelo (ESS-IPVC), Viana do Castelo, Portugal
| | - Rui Pimenta
- Centre for Health Studies and Research of the University of Coimbra, Portugal (CEISUC), Coimbra, Portugal
- School of Health, Polytechnic of Porto (ESS|P.PORTO), Porto, Portugal
| | - Inês Ribeiro
- Centre for Health Studies and Research of the University of Coimbra, Portugal (CEISUC), Coimbra, Portugal
| | - Isabel Amorim
- Centre for Health Studies and Research of the University of Coimbra, Portugal (CEISUC), Coimbra, Portugal
- Superior School of Health of the Polytechnical Institute of Viana do Castelo (ESS-IPVC), Viana do Castelo, Portugal
| | - Sandra Maria Alves
- Centre for Health Studies and Research of the University of Coimbra, Portugal (CEISUC), Coimbra, Portugal
- School of Health, Polytechnic of Porto (ESS|P.PORTO), Porto, Portugal
| | - Luiz Santiago
- Centre for Health Studies and Research of the University of Coimbra, Portugal (CEISUC), Coimbra, Portugal
- Faculty of Medicine, University of Coimbra, Portugal (FMUC), Coimbra, Portugal
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Diallo AI, Dieng CM, Tine JAD, Bassoum O, Diongue FB, Ba MF, Ndiaye I, Ndiaye M, Faye A, Seck I. Factors associated with diabetes knowledge, attitudes and practices among people aged 18 and over in the commune of Niakhene in Senegal. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002265. [PMID: 38451973 PMCID: PMC10919690 DOI: 10.1371/journal.pgph.0002265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 02/11/2024] [Indexed: 03/09/2024]
Abstract
More than 422 million people worldwide have diabetes in 2016, and 1.6 million deaths are attributed to diabetes each year. Knowledge of preventive measures would enable the adjustment of preventive policies. Hence this study on knowledge and practices in rural Senegal. This was a cross-sectional, descriptive and analytical survey of subjects aged at least 18 and living in the commune of Niakhene, carried out in October 2020. A systematic random sample, stratified by sex and age group, was used. The questionnaire was based on the STEPS 2015 tool and a review of the literature. In addition to personal characteristics, the questionnaire was used to measure knowledge of symptoms, complications, risk factors, attitude to the disease and screening practices. Descriptive and analytical analyses were performed using R 4.0.2 software. A total of 300 subjects were surveyed. The average age was 35.3 years (+/-16.9), and 52.3% were women. Knowledge (62.7%) was associated with higher education (ORaj2.46{1.16-3.44}), awareness by healthcare staff (ORaj2.88{1.60-5.34}), and a family history of diabetes (ORaj3.09{1.06-11.3}). The positive attitude (53%) was associated with male sex (ORaj1.98{2.07-7.52}), awareness via audio-visual information sources (ORaj3.87{2.07-7.52}), community awareness (ORaj 3.87{2.07-7.52}), existence of a family history of hypertension and knowledge of diabetes (ORaj3.34{2.5-7.69}). Screening was carried out in 34.3% of patients. The associated risk factors were male sex (ORaj 1.95{1.12-3.34}), higher education (ORaj2.49{1.12-559}) and positive attitudes to diabetes (ORaj1.83{1.04-3.26}). One of the most effective interventions against this disease is the adoption of preventive measures which involve early detection and strengthening communication for more effective prevention.
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Affiliation(s)
- Amadou Ibra Diallo
- Department of Preventive Medicine and Public Health Faculty of Medicine, Pharmacy and Odontology (FMPO), Cheikh Anta Diop University (UCAD), Dakar, Senegal
- Health and Development Institute (ISED), Cheikh Anta Diop University (UCAD), Dakar, Senegal
| | - Cheikh Mbacke Dieng
- Faculty of Medicine, Pharmacy and Odontology, Cheikh Anta Diop University (UCAD), Dakar, Senegal
| | - Jean Augustin Diegane Tine
- Department of Preventive Medicine and Public Health Faculty of Medicine, Pharmacy and Odontology (FMPO), Cheikh Anta Diop University (UCAD), Dakar, Senegal
- Health and Development Institute (ISED), Cheikh Anta Diop University (UCAD), Dakar, Senegal
| | - Oumar Bassoum
- Department of Preventive Medicine and Public Health Faculty of Medicine, Pharmacy and Odontology (FMPO), Cheikh Anta Diop University (UCAD), Dakar, Senegal
- Health and Development Institute (ISED), Cheikh Anta Diop University (UCAD), Dakar, Senegal
| | - Fatoumata Binetou Diongue
- Department of Preventive Medicine and Public Health Faculty of Medicine, Pharmacy and Odontology (FMPO), Cheikh Anta Diop University (UCAD), Dakar, Senegal
- Health and Development Institute (ISED), Cheikh Anta Diop University (UCAD), Dakar, Senegal
| | - Mouhamadou Faly Ba
- Health and Development Institute (ISED), Cheikh Anta Diop University (UCAD), Dakar, Senegal
| | - Ibrahima Ndiaye
- Department of Preventive Medicine and Public Health Faculty of Medicine, Pharmacy and Odontology (FMPO), Cheikh Anta Diop University (UCAD), Dakar, Senegal
| | - Mbayang Ndiaye
- Department of Preventive Medicine and Public Health Faculty of Medicine, Pharmacy and Odontology (FMPO), Cheikh Anta Diop University (UCAD), Dakar, Senegal
| | - Adama Faye
- Department of Preventive Medicine and Public Health Faculty of Medicine, Pharmacy and Odontology (FMPO), Cheikh Anta Diop University (UCAD), Dakar, Senegal
- Health and Development Institute (ISED), Cheikh Anta Diop University (UCAD), Dakar, Senegal
| | - Ibrahima Seck
- Department of Preventive Medicine and Public Health Faculty of Medicine, Pharmacy and Odontology (FMPO), Cheikh Anta Diop University (UCAD), Dakar, Senegal
- Health and Development Institute (ISED), Cheikh Anta Diop University (UCAD), Dakar, Senegal
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Airikkala E, Laaksonen M, Halkoaho A, Kaunonen M. Perception of inherited risk in type 2 diabetes: a systematic review. Front Public Health 2023; 11:1293874. [PMID: 38155883 PMCID: PMC10752975 DOI: 10.3389/fpubh.2023.1293874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 11/30/2023] [Indexed: 12/30/2023] Open
Abstract
Introduction A family history is impacting the individual's risk perception. The objective of this systematic review was to describe inherited risk perceptions of type 2 diabetes from the citizen's viewpoint. The aim was to summarize and increase understanding so that the increased knowledge could be used effectively in type 2 diabetes risk communication in health care. Methods We conducted a systematic review using CINAHL, Medline, and Scopus databases for hereditary, risk, perception, and diabetes related concepts, within the date range of 1.1.2017 to 2.8.2022. Eligible articles were English, peer-reviewed, and addressed the research question: how is hereditary risk of type 2 diabetes perceived? Returns were viewed independently by two authors, and evaluated using the appraisal criteria of the Joanna Briggs Institute. A thematic analysis was used for the synthesis of the data, yielding three themes describing perceptions of inherited risk in type 2 diabetes. Results A total of 32 articles were included, of which 23 were quantitative, 5 qualitative, and 4 were mixed-methods studies. The extracted themes were (1) Identifying heredity as a risk factor, (2) Diversity of hereditary risk, and (3) Perception of the magnitude of personal risk. Discussion The perception towards hereditary risk can vary from a desire to actively make a lifestyle change, to the view that diabetes is inevitable regardless of lifestyle. A positive family history increases the risk perception of type 2 diabetes, but the perceived magnitude of the risk may vary from person to person. The findings have the potential to be applied in healthcare's risk communication.
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Affiliation(s)
- Elisa Airikkala
- Faculty of Social Sciences, Health Sciences, Tampere University, Tampere, Finland
- School of Social Services and Health Care, Tampere University of Applied Sciences, Tampere, Finland
| | - Mari Laaksonen
- Faculty of Social Sciences, Health Sciences, Tampere University, Tampere, Finland
- School of Social Services and Health Care, Tampere University of Applied Sciences, Tampere, Finland
| | - Arja Halkoaho
- Applied Research Center, Tampere University of Applied Sciences, Tampere, Finland
| | - Marja Kaunonen
- Faculty of Social Sciences, Health Sciences, Tampere University, Tampere, Finland
- Wellbeing Services County of Pirkanmaa, Tampere, Finland
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Luambano C, Mwinuka B, Ibrahim RP, Kacholi G. Knowledge about diabetes mellitus and its associated factors among diabetic outpatients at Muhimbili National Hospital in Tanzania. Pan Afr Med J 2023; 45:3. [PMID: 37346920 PMCID: PMC10280699 DOI: 10.11604/pamj.2023.45.3.33143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 04/02/2023] [Indexed: 06/23/2023] Open
Abstract
Diabetes mellitus is emerging as one of the major public health threats that contributed to 2% of all deaths in Tanzania in 2016. Although adequate knowledge related to diabetes mellitus is associated with early case detection, prevention, and minimization of health complications and socioeconomic-related consequences, there is less evidence about the adequacy of the community´s knowledge of diabetes in Tanzania. This study aimed to determine knowledge about diabetes mellitus and its associated factors among diabetic outpatients. A cross-sectional study was conducted among 220 diabetic outpatients aged 18 years and above at Muhimbili national hospital in Tanzania between February and April 2017. Data were collected using a structured pretested questionnaire and were entered into Microsoft Excel and exported to SPSS Version 20 for analysis. Bivariate and multivariate logistic regression was used to determine the predictive variables. The significance of independent variables was declared at a 95% confidence level and p-value < 0.05. A total of 137 (64.01%) of the participants had adequate knowledge about diabetes mellitus. The majority (86.9% and 85.1%) reported having adequate knowledge of complications of diabetes and treatment options for diabetes respectively. The least level of knowledge reported was on signs and symptoms (48.6%) and type of diabetes (32.7%). The majority (54%) cited health facilities as the most common sources of information related to diabetes. Both bivariate and multivariate logistic regression analyses showed that there was a statistical association between knowledge related to diabetes and the level of education of study participants. The overall level of knowledge of participants about diabetes mellitus was adequate, with a low level of knowledge related to signs and symptoms of diabetes, and type of diabetes. Health facilities were the most common sources of information related to diabetes. Policy and decision-makers and health care providers should take collective action to improve community knowledge about diabetes. Health education related to diabetes should be integrated into the educational curriculum at all levels in Tanzania, which would massively increase awareness of diabetes.
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Affiliation(s)
- Christine Luambano
- Department of Health Systems Management, School of Public Administration and Management, Mzumbe University, Morogoro, Tanzania
| | - Bertha Mwinuka
- Department of Health Systems Management, School of Public Administration and Management, Mzumbe University, Morogoro, Tanzania
- Centre of Excellence in Health Monitoring and Evaluation, Mzumbe University, Morogoro, Tanzania
| | - Rogate Phinias Ibrahim
- Department of Health Systems Management, School of Public Administration and Management, Mzumbe University, Morogoro, Tanzania
- Centre of Excellence in Health Monitoring and Evaluation, Mzumbe University, Morogoro, Tanzania
| | - Godfrey Kacholi
- Department of Health Systems Management, School of Public Administration and Management, Mzumbe University, Morogoro, Tanzania
- Centre of Excellence in Health Monitoring and Evaluation, Mzumbe University, Morogoro, Tanzania
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Knowledge of diabetes among Gambian adults: evidence from a nation-wide survey. BMC Cardiovasc Disord 2022; 22:145. [PMID: 35366807 PMCID: PMC8976999 DOI: 10.1186/s12872-022-02591-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 03/28/2022] [Indexed: 11/24/2022] Open
Abstract
Background Diabetes is increasingly becoming a public health problem in developing countries like The Gambia. Prevention of diabetes and appropriate management of the disease largely depends on correct knowledge of the risk factors and signs and symptoms of the condition. However, studies that have assessed knowledge of diabetes at population level are limited. We examined the knowledge of diabetes risk factors, and signs and symptoms among Gambian adults. Methods The 2019–2020 Gambia demographic and health survey data was used to analyze 4, 436 men and 6, 186 women. Knowledge of diabetes was assessed two-fold: (1) diabetes risk factors and (2) diabetes signs and symptoms. Several sociodemographic factors were considered for analysis. A generalized estimating equation model was fitted to test the association between the selected sociodemographic factors and diabetes knowledge. Results Among the men, 7.6% and 3.1% had knowledge about diabetes risk factors, and signs and symptoms, respectively. Approximately 3.1% and 1.2% of the women included in the analysis had knowledge of diabetes risk factors, and signs and symptoms, respectively. Men who were aged ≥ 35 years were more likely to have knowledge regarding diabetes risk factors (adjusted odds ratio (AOR) = 1.90, 95% confidence interval (CI) = 1.12–3.22), and signs and symptoms (AOR = 2.59, 95% CI = 1.08–6.17). Having access to media was associated with increased odds of having knowledge regarding diabetes risk factors (AOR = 1.61, 95% CI = 1.09–2.37) and signs and symptoms (AOR = 2.04, 95% CI = 1.07–3.88) among men. Among other factors, educational level was positively associated with having diabetes knowledge among both men and women. Heterogeneities regarding diabetes knowledge were observed among different regions and areas of residence. Conclusion There is a need to improve awareness regarding diabetes in The Gambia as low knowledge has been observed. Programs aimed to improve diabetes knowledge should consider regional and area of residence variations in their designs. The use of mass media and strengthening the education sector in The Gambia may be of importance in raising diabetes knowledge among Gambian adults.
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