Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE credits
Objective: The aim of the study is to evaluate the prevalence of diabetes among individuals 50 years and above in the two Sub-Saharan African countries, Ghana and South Africa and to identify socio-demographic, life style and physical risk factors associated with diabetes in the two countries.Methods: This study used a cross sectional study method using the WHO SAGE Wave 1 data which is a part of the longitudinal multi-country study. The data was collected from individuals 50 years and above during the time period between 2007 and 2008 in the two sub-Saharan African countries, Ghana and South Africa. Those who have diabetes & are on treatment based on self-report were considered as having diabetes for this study. The independent variables were socio-demographic, lifestyle and physical characteristics. The response rate of participation in Ghana was 80% and that of South Africa was 77%. Completed interview response was 99% in Ghana and 96% in South Africa. Stata 13 software was used to analyze the data. Country specific weighted estimates were used in every analysis. Descriptive statistics were used to analyze the characteristics of the study population and weighted prevalence. Bivariate and multivariable logistic regression model were used to assess the association between the independent variables and diabetes.Results: The weighted prevalence of diabetes among individuals 50 years and above in Ghana was 2.86% and in South Africa 7.64%. In the bivariate logistic regression model, in both countries: Age, place of residence, educational status, work history, wealth, BMI, WC, and physical activity were associated with diabetes. In addition, WHtR in Ghana and Sex & Alcohol history in South Africa were associated with diabetes in the bivariate logistic regression model. After adjusting for sex, age group, place of residence, marital status, work history, educational status, wealth, BMI, WC , WHR, WHtR, smoking history, alcohol history, physical activity and fruit & vegetable intake, only Age group 70-79 (AOR= 2.49, 95% CI: 1.32-4.68), Place of residence (AOR=0.54, 95% CI: 0.31-0.96), and WC Very high risk (AOR=2.71, 95% CI: 1.12-6.56) remained significantly associated with diabetes in the South African study population while Age group 60-69 (AOR= 2.89, 95% CI: 1.56-5.36) 70-79 (AOR=2.05, 95% CI: 1.03-4.09), Marital status (AOR=1.78, 95% CI: 1.03-3.07), Educational status- those who completed high school (AOR=2.35, 95% CI: 1.14-4.86) those who completed college/university (AOR=4.21, 95% CI: 1.62-10.8), WC Very high risk (AOR=2.21, 95% CI: 1.002-4.9) and Moderate Physical activity (AOR=1.87, 95% CI: 1.03-3.41) remained significantly associated with diabetes in the Ghanaian study population.Conclusion: This study found the prevalence of diabetes among individuals aged 50 years and above as 2.9% in Ghana and 7.6% in South Africa. In the present study, factors like age, place of residence, marital status, educational status, waist circumference and physical activities are the main predictors of diabetes among individuals aged 50 years and above in the two sub-Saharan African countries. Health Policies should address and revise the nutrition and physical activity programs together with the social determinant factors to halt the burden of non-communicable diseases like diabetes among old age people.
2015. , 34 p.