Factors associated with intermediate outcomes of diabetes care among clients attending facilities in two rural districts in Eastern Uganda
Catherine Birabwa1,&, Roy Mayega1, Francis Bwambale1
1Makerere University School of Public Health, Kampala, Uganda
Catherine Birabwa, Makerere University School of Public Health, Kampala, Uganda
diabetes mellitus is one of the major non-communicable diseases in Uganda. Optimal glucose and blood pressure control are recommended interventions for diabetes control especially in resource-limited settings; to reduce risk of complications and death among clients. This study determined factors associated with outcomes of diabetes care among clients attending facilities in a rural setting in Uganda.
a cross-sectional study was conducted among 377 diabetes clients aged 18
years and above with known diabetes for at least 1 year. These were consecutively
sampled from 6 facilities. A pre-tested interviewer-administered questionnaire
to collect data on 3 intermediate outcomes of diabetes care, process-related
and client-related factors. The outcomes were: glucose control (RBS 11.1mmol/L;
FPG 6.5mmol/L), blood pressure control (130/80mmHg) and chronic complications.
Data was entered and analyzed using Epi Data (v3.1) and STATA (v12) respectively.
Prevalence of selected outcomes was summarized as a proportion and binary
logistic regression using stepwise forward selection was performed to determine
of the outcomes. Ethical approval was given by Higher Degree Research and
Ethics Committee-School of Public Health.
the mean age of participants was 49.04 years (SD = 11.7) and majority (62.1%)
were female. Over four-fifths (87.5%) had elevated fasting while less than
a half (43.2%) had elevated random glucose levels. Slightly more than half
(50.7%) had poorly controlled BP and 84.4% reported to have at least one
complication. Glucose control was associated with being on insulin therapy
aOR = 0.3 (95%CI
0.16-0.49); blood pressure control with being younger than 40 years aOR =
1.37-7.89) and having any comorbidity aOR = 0.2 (95%CI 0.13-0.41)]; and having
complications with being younger than 40 years aOR = 0.2 (95%CI 0.04-0.68),
having any comorbidities aOR = 3.1 (95%CI 1.36-7.13), being on insulin therapy
aOR = 3.5
(95%CI 1.13-10.66), paying for any service aOR = 6.7 (95%CI 2.76-16.09) and
not working aOR = 0.2 (95%CI 0.08-0.63)].
intermediate diabetes outcomes are poorly controlled in most clients in this
rural setting. Being aged < 40 years was associated with better outcomes while
having co-morbidities and being on insulin therapy were associated with poor
outcomes. Training of health workers, provision of guidelines for standard care
and ensuring availability of appropriate medicines may contribute to better
client management and better outcomes.
1st Ghana Field Epidemiology and Laboratory Training Programme Scientific conference (Accra)
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