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- ItemRestrictedPrevalence of type 2 diabetes, risk factors and complications at Queen Elizabeth Central Hospital(Kamuzu University of Health Sciences, 2022-08-17) Duncan, BerthaEXECUTIVE SUMMARY Type 2 diabetes, by far the most common type of diabetes, is on the rise globally at an alarming rate. It is rapidly escalating into a significant global public health catastrophe that poses a threat to the economies of all countries, particularly poor countries like Malawi. It was discovered to affect 382 million (7.7%) people in 2013 and is expected to reach 483 million (8.3%) by 2030. According to current forecasts, the total number of cases in the world could quadruple in the next two decades, resulting in a corresponding increase in the disease's human, social, and economic consequences. According to the Internal Diabetes Federal (IDF) data, poor and middle income nations account for almost 70% of current cases of type 2 diabetes. TYPE OF STUDY This will be a cross-sectional descriptive and analytical study aimed at estimating the prevalence of type 2 diabetes mellitus and its risk factors and their association with diabetes complications PROBLEM Prevalence of type 2 diabetes mellitus, risk factors and complications at Queen Elizabeth Central Hospital. OBJECTIVES I. Broad Objective To investigate the prevalence of type 2 diabetes mellitus, risk factors and the associated complications. II. Specific Objectives To determine the prevalence of type 2 diabetes mellitus To investigate the association between risk factors and type 2 diabetes mellitus To evaluate the number of people who report type 2 diabetes mellitus related complications. METHOLOGY This will be a cross-sectional study which will be conducted at QECH, diabetes clinic. Qualitative data will be collected using a questionnaire form a sample of 81 participants above 45 years old (because most diseases become prominent 10-15 years after diagnosis. Therefore, recruiting participants above 45 years of age will assist in the analysis of the complications.) EXPECTED FINDINGS The prevalence of Type 2 diabetes mellitus is expected to be high because of ageing (insulin resistance increases with ageing) and other related factors like occupational and environmental factors. There will be more diabetes related complications in people who have lived with diabetes for a longer period of time. DISSEMINATION The results will be disseminated through a presentation to the medical laboratory science (MLS) department. A copy of results will also be submitted to the college of medicine and research ethics committee (COMREC) for review and to the COM library for access by other scholars. A copy of dissertation will be submitted to the QECH diabetes clinic to keep them updated of the current prevalence of risk factors and their associated complications. Further dissemination will be done through local and international seminars and conferences. The results will also be published in an accredited peer reviewed journal.
- ItemRestrictedPrevalence of type 2 diabetes, risk factors and complications at Queen Elizabeth Central Hospita(Kamuzu University of Health Sciences, 2022-08-17) Duncan, Bertha; Mpando, MacdonaldExecutive summary: Type 2 diabetes, by far the most common type of diabetes, is on the rise globally at an alarming rate. It is rapidly escalating into a significant global public health catastrophe that poses a threat to the economies of all countries, particularly poor countries like Malawi. It was discovered to affect 382 million (7.7%) people in 2013 and is expected to reach 483 million (8.3%) by 2030. According to current forecasts, the total number of cases in the world could quadruple in the next two decades, resulting in a corresponding increase in the disease's human, social, and economic consequences. According to the Internal Diabetes Federal (IDF) data, poor and middle income nations account for almost 70% of current cases of type 2 diabetes. Type of study: This will be a cross-sectional descriptive and analytical study aimed at estimating the prevalence of type 2 diabetes mellitus and its risk factors and their association with diabetes complications Problem: Prevalence of type 2 diabetes mellitus, risk factors and complications at Queen Elizabeth Central Hospital. Objectives: Broad Objective To investigate the prevalence of type 2 diabetes mellitus, risk factors and the associated complications. Specific Objectives To determine the prevalence of type 2 diabetes mellitus To investigate the association between risk factors and type 2 diabetes mellitus To evaluate the number of people who report type 2 diabetes mellitus related complications. Methodology: This will be a cross-sectional study which will be conducted at QECH, diabetes clinic. Qualitative data will be collected using a questionnaire form a sample of 81 participants above 45 years old (because most diseases become prominent 10-15 years after diagnosis. Therefore, recruiting participants above 45 years of age will assist in the analysis of the complications.) Expected findings: The prevalence of Type 2 diabetes mellitus is expected to be high because of ageing (insulin resistance increases with ageing) and other related factors like occupational and environmental factors. There will be more diabetes related complications in people who have lived with diabetes for a longer period of time. Dissemination: The results will be disseminated through a presentation to the medical laboratory science (MLS) department. A copy of results will also be submitted to the college of medicine and research ethics committee (COMREC) for review and to the COM library for access by other scholars. A copy of dissertation will be submitted to the QECH diabetes clinic to keep them updated of the current prevalence of risk factors and their associated complications. Further dissemination will be done through local and international seminars and conferences. The results will also be published in an accredited peer reviewed journal.
- ItemRestrictedType 2 Diabetes Treatment Guidelines in Malawi: A Cross Section Survey for Type 2 Diabetes Remission(Kamuzu University of Health Sciences, 2022-03-08) Mpinganjira, Obed; Chisenga, BisayiStudy type: This is a cross-sectional study, intending to investigate the management of type 2 diabetes in Malawi. The problem: Worldwide, prevalence of non-communicable diseases (NCDs) is increasing and this includes diabetes mellitus. Some studies have indicated that type 2 diabetes is a chronic problem which requires strict adherence to its pharmacological intervention. However, most developing countries have a narrow choice of pharmacological drugs due to limited availability of most suitable drugs. This might lead to complications such as nephropathy and retinopathy, and even lower limb amputations. This indicates the need for regulated management of diabetes mellitus including periodical reviews of treatment options. Aim and Objectives: The main aim is to identify the gaps that exist in management of type 2 diabetes mellitus in Malawi. The specific objectives include describing the drugs used for diabetes type 2 treatment at diabetic clinic at QECH, to determine the commonly used measures for the management of type 2 diabetes, assessing how diabetes type 2 patients monitor their blood glucose and identifying the challenges faced by type 2 diabetes patients in managing their condition. Methodology: This is a qualitative cross section study that will look at the gaps which exist in management of diabetes mellitus type 2 in Malawi in relation to recommendations by international organizations. We will explore the case management of diabetes type 2 at diabetic clinic at QECH using questionnaire and case narrative management. The findings will be analyzed in relation to the recommendations provided by international organizations such as WHO and NHS. We aim to obtain the international recommendations for type 2 diabetes management by searching google scholar and gov.com websites. Expected Findings and Dissemination: Generated data will be analyzed and shared with Pharmacy department and other interested parties such as COMREC and QECH hospital. If resources enable us, we will publish the findings in a peer-reviewed journal.
- ItemRestrictedFactors affecting glycemic control in patients attending peadiatric diabetic clinic at QECH(Kamuzu University of Health Sciences, 2022-02-09) Mwasapi, Ireen; Mtonga, Chisomo; Mthyoka, Tamala; Mubisa, Hannah1.0 Executive summary This is a quantitative cross-sectional study aimed at analyzing factors affecting glycemic control in patients attending pediatric diabetic clinic at Queen Elizabeth Central Hospital. The study will analyze factors affecting glycemic control and determine the proportion of patients with poor glycemic control. Patients will also be assessed for possible complications. Participants will be selected using convenient sampling method. Data will be collected using questionnaires and managed using Microsoft excel. Results will be presented at research dissemination at the end of research block at College of Medicine. The results will help improve management of diabetes patients and to prevent complications and other comorbidities. 2.0 Background Diabetes is a chronic non communicable disease which occurs when the pancreas produces insufficient insulin or when the body cannot effectively use the available insulin. Type 1 diabetes mellitus is an autoimmune disease which results from cellular mediated destruction of beta cells of the pancreas characterized by deficient insulin production. Type 1 diabetes mellitus (T1DM) is one of the most common chronic conditions in children, and it represents a global public health challenge There is an association between poor glycemic control and study level of patients, healthy eating habits and diabetes duration. Patients who have had diabetes for a longer duration betteglycemic control as compared to new onset diabetics(1).Additionally, there is poor glycemic control in African children especially adolescents. About 4% of children above 12 years of age have reasonable control compared to 78% of children less than 12 years(2). Body mass index, guardian education level and insulin type are some also factors associated with poor glycemic control(3). Furthermore, metabolic control is poor in type 1 diabetics population with overall poor adherence. Other factors associated with poor control were include older age, a caregiver other than the mother and poor adherence to Blood glucose monitoring(4). However, some studies have been done to find out ways of ensuring good glycemic control. Diabetic youth education camps have a positive impact on glycemic control(5).Additionally, diabetic education significantly reduces the risk of severe hypoglycemia, though better glycemic control cannot always be achieved(6). Poor glycemic control is associated with many acute complications. There is a high proportion of severe hypoglycemia and Diabetic Ketoacidosis (DKA) among patients attending diabetic clinic. There is also significant relationship between Diabetic Ketoacidosis (DKA) and mode of storage of insulin, most of the participants use the traditional storage method that is a clay pot with sand and water kept at the coolest place in their home. 97.56% of the participants had poor control of Type 1 diabetes mellitus with a mean HbA1c 0f 13.22%(7). Furthermore, inadequate knowledge on; diabetes complications; management of hyperglycemia; appropriate self-monitoring of blood glucose; differences in signs and symptoms of hyperglycemia and hypoglycemia and provision of psychological support contributes to poor glycemic control(8).
- ItemRestrictedAssessing the burden of Diabetes Mellitus (DM) and risk factors among Blantyre city based Non-Governmental Organisation (NGO) drivers(Kamuzu University of Health Sciences, 2020-06-05) Mtila, YusufType of Study The study is a cross-sectional study that will adopt the World Health Organization (WHO) STEPS survey design for NCD risk factors assessment with particular interest on Diabetes. Problem The prevalence of Diabetes Mellitus (DM) in Malawi was determined at 5.6% among adults aged 25-64 years by national wide STEPS survey in 2009. Sedentary life style which is a characteristic of driving population has been associated with increasing prevalence of Diabetes Mellitus. Studies on determinants and distribution of DM among different groups of driving populations including taxi drivers, bus drivers and truck drivers have been conducted. The results from the studies have informed effective programming on DM response interventions amongst the target populations. Currently epidemiology of DM among Non-Governmental Organization drivers in particularly is not known and documented. Knowledge on prevalence of DM and their associated risk factors among NGO drivers in Blantyre city will inform evidence-based interventions that specifically respond to diabetes burden among them. Objectives The main objective of the study is to assess the prevalence and risk factors of Diabetes Mellitus among NGO drivers in Blantyre city. Specific objectives include: Assess prevalence of lifestyle and behavior risk factors, Medical/ physiological risk factors and prevalence of DM among NGO drivers. Methodology A sample of 91 NGO drivers from Blantyre city will be interviewed, assessed on behavior, physical and biomedical risk factors. Two enumerators and two certified providers will be temporally employed to facilitate data collection process. The enumerators will be interviewing NGO drivers on background information, behavior risk factors using a questionnaire. The interviewees together with their partly filled questionnaires will next be directed to providers (Nurse/Clinician) for presence of DM, physical and biomedical factors assessment. All interviews will be recorded, entered into STATA 16 and hard copies filed in a file cabinet. Data will be processed and analyzed using STATA. Expected Findings It is expected that there will be significant associations between behavior, physical, physiological risk factors to prevalence of DM in Blantyre city-based NGO drivers. Dissemination of Findings Findings from the study will be shared with relevant authorities in Blantyre city council, CONGOMA, Ministry of Health and COMREC to reflect on the recommendations of the study. It is expected that findings from the study will be used by Malawi government for reference on development of comprehensive national NCDI /Diabetes policy.