Diabetes in the Western Cape: an eight-year profile

N. Sahadew, S. Pillay, V. Singaram
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引用次数: 1

Abstract

Background: The need for greater information on the burden of diabetes has never been more significant than at present, especially when considering the association between diabetes and the severity of COVID-19. Statistics South Africa has identified diabetes mellitus (DM) as the leading cause of death in the Western Cape (WC) province, South Africa. Aims: This study aimed to analyse diabetes-related data collected on patient visits, screening frequency, age proportion and distribution of new patients at primary health levels in the WC public healthcare sector. Methods: An eight-year (2012–2019) audit was conducted of all diabetes-related public health data routinely collected using the WC District Health Information System (DHIS). The data were analysed using Excel® 2016. Time-series and cross-sectional analyses were made possible using pivot tables to gain insight into data trends and incidence rates. Results: This study found that the eight-year crude incidence rate for diabetes increased by 2% between 2012 and 2019. In addition, the incidence rate of diabetes increased by an average of 21% when private institutions were excluded. The recorded number of patients diagnosed with type 1 DM (T1DM) decreased annually between 2013 and 2017 (796 vs. 217, respectively). This decreasing trend could be due to the late onset of T1DM in patients from the African continent or possible data misinterpretation and inadequate training at a primary collection level. The cumulative number of patients screened for diabetes within the WC public health sector (2016–2019) depicts a compound annual growth rate of 16%. A strong positive correlation (p = 0.98) was found between patients screened and the frequency of patients newly diagnosed with DM. The majority (64%) of clinical visits by patients registered with a confirmed diagnosis of diabetes were seen in the metropolitan municipality of ‘The City of Cape Town’. Conclusions: The incidence of DM in the WC province, as in South Africa and globally, is increasing. Intensified screening translates into improved ‘pick-up’ rates and decreases the overall prevalence of undiagnosed DM with its complications. The findings of this study have implications for the development of public healthcare policies and guidelines. Personnel training and resources are suggested to improve the quality of the clinical data and strengthen the DHIS.
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西开普省的糖尿病:八年概况
背景:目前比以往任何时候都更需要更多关于糖尿病负担的信息,特别是考虑到糖尿病与COVID-19严重程度之间的关联。南非统计局已经确定糖尿病(DM)是南非西开普省(WC)的主要死亡原因。目的:本研究旨在分析在WC公共卫生部门收集的患者就诊、筛查频率、年龄比例和初级卫生水平新患者分布的糖尿病相关数据。方法:对使用WC区卫生信息系统(DHIS)常规收集的所有与糖尿病相关的公共卫生数据进行了为期8年(2012-2019)的审计。使用Excel®2016对数据进行分析。使用数据透视表可以进行时间序列和横断面分析,以深入了解数据趋势和发病率。结果:本研究发现,2012年至2019年期间,糖尿病的8年粗发病率增加了2%。此外,如果不包括私立医院,糖尿病的发病率平均增加了21%。2013年至2017年,诊断为1型糖尿病(T1DM)的记录患者数量每年下降(分别为796例和217例)。这种下降趋势可能是由于来自非洲大陆的T1DM患者发病较晚,或可能的数据误解和初级收集水平的培训不足。2016-2019年,世界卫生组织公共卫生部门糖尿病筛查患者累计人数的复合年增长率为16%。筛查的患者与新诊断为糖尿病患者的频率之间存在很强的正相关(p = 0.98)。大多数(64%)登记为糖尿病确诊患者的临床就诊发生在开普敦市。结论:在WC省,与南非和全球一样,糖尿病的发病率正在上升。加强筛查可提高“拾取”率,并降低未确诊糖尿病及其并发症的总体患病率。本研究结果对公共卫生政策和指导方针的制定具有启示意义。建议开展人员培训和资源建设,提高临床资料质量,加强DHIS。
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