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Title: | Secular Trends in Admissions and Mortality Rates from Diabetes Mellitus in the Central Belt of Ghana: A 31-Year Review |
Authors: | Sarfo-Kantanka, Osei Sarfo, Fred Stephen Ansah, Eunice Oparebea Eghan, Benjamin Ayisi-Boateng, Nana Kwame Acheamfour-Akowuah, Emmanuel |
Issue Date: | 2019 |
Publisher: | Plos one |
Citation: | Sarfo-Kantanka O, Sarfo FS, Oparebea Ansah E, Eghan B, Ayisi-Boateng NK, Acheamfour- Akowuah E (2016) Secular Trends in Admissions and Mortality Rates from Diabetes Mellitus in the Central Belt of Ghana: A 31-Year Review. PLoS ONE 11(11): e0165905. doi:10.1371/journal. pone.0165905 |
Abstract: | Introduction
Diabetes Mellitus is currently a leading cause of morbidity and mortality throughout the
world, particularly in sub-Saharan Africa where a significant proportion of diabetes cases
are now found. Longitudinal profiling of in-patient admissions and mortality trends from
diabetes provide useful insights into the magnitude of the burden of diabetes, serve as a
sentinel on the state of out-patient diabetes care and provide effective tools for planning,
delivering and evaluating the health care needs relating to the disease in sub-Saharan
Africa.
Objective
To evaluate the 31-year trend in diabetic admissions and mortality rates in central Ghana.
Methods
This is a retrospective analysis of data on diabetes admissions and deaths at a tertiary referral
hospital in central Ghana between 1983 and 2014. Rates of diabetes admissions or
deaths were expressed as diabetes admissions or deaths divided by the total number of
admissions or deaths respectively. Yearly crude fatality rates for diabetes were calculated.
Trends were analysed for in patient diabetes admissions and mortality for the period. Predictors
of diabetes mortality were determined using multiple logistic regression.
Results
A total of 11,414 diabetes patients were admitted over the period with a female predominance;
female:male ratio of 1.3:1.0. Over the study period, diabetes admission rates
increased significantly from 2.36 per 1000 admissions in 1983 to 14.94 per 1000 admissions
in 2014 (p<0.0001for linear trend), representing a 633% rise over the 31-year period. Inpatient
diabetes fatality rates increased from 7.6 per 1000 deaths in 1983 to 30 per 1000
deaths in 2012. The average 28-day mortality rate was 18.5%. The median age of patients increased significantly over the period. So was the proportion
of females admitted over the years. Predictors of in-patient mortality were increasing ageaOR
of 1.23 (CI: 1.15±1.32) for age > 80 years compared with < 20 years, admissions in
2000s compared to 1980s-aOR of 1.56 (1.21±2.01), male gender-aOR of 1.45 (1.19±1.61),
the presence of glycemic complications such as ketoacidosis- aOR-2.67(CI: 2.21±3.21),
hyperosmolar hyperglycemic states- aOR 1.52 (1.33±1.73) symptomatic hypoglycemiaaOR
1.64 (1.24±2.17) and presence of end organ complications including peripheral neuropathic
ulcers- aOR 1.31 (1.12±1.56), nephropathy- aOR -1.11 (1.03±1.23), cerebrovascular
diseaseÐaOR-1.52 (1.32±1.98), coronary artery disease- aOR-3.21 (1.91±5.15) and
peripheral artery disease- aOR-1.15 (1.12±1.21) were associated with increased risk of
death compared with normoglycemic diabetic admissions and admissions without end
organ complications respectively.
Conclusion
Diabetes admission and mortality rates have increased significantly over the past three
decades in central Ghana. More intensive education on the risk factors for diabetes, acute
diabetes care as well as instituting hospital guidelines for diabetes control and reduction of
modifiable risk factors for diabetes are urgently needed to reduce the poor case fatality
associated with diabetes in resource-limited settings. |
Description: | An article published by Sarfo-Kantanka O, Sarfo FS, Oparebea
Ansah E, Eghan B, Ayisi-Boateng NK, Acheamfour-
Akowuah E (2016) Secular Trends in Admissions
and Mortality Rates from Diabetes Mellitus in the
Central Belt of Ghana: A 31-Year Review. PLoS
ONE 11(11): e0165905. doi:10.1371/journal.
pone.0165905 |
URI: | http://hdl.handle.net/123456789/13424 |
Appears in Collections: | College of Health Sciences
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