Conference abstract

Factors associated with intermediate outcomes of diabetes care among clients attending facilities in two rural districts in Eastern Uganda

Pan African Medical Journal - Conference Proceedings. 2017:3(58).24 Dec 2017.
doi: 10.11604/pamj-cp.2017.3.58.189

Contact the corresponding author
Keywords: Diabetes mellitus, rural setting, diabetes control
Oral presentation

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

&Corresponding author
Catherine Birabwa, Makerere University School of Public Health, Kampala, Uganda

Abstract

Introduction: 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.

Methods: 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 was used 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 the predictors of the outcomes. Ethical approval was given by Higher Degree Research and Ethics Committee-School of Public Health.

Results: 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 = 3.3 (95%CI 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)].

Conclusion: 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.