title: Diabetes in Mozambique: prevalence, management and healthcare challenges.
abstract: OBJECTIVE
  The growing trend towards and deficient management of diabetes in Africa are important public-health challenges requiring surveillance. For this reason, this study aimed to assess the prevalence and awareness of diabetes in urban and rural Mozambique, and to describe its management.
  
  
  METHODS
  In 2005, a representative sample of the national Mozambican adult population (n=2343) was evaluated, according to the STEPwise approach to chronic disease risk factor surveillance (STEPS). Twelve-hour fasting blood glucose (FBG) was measured, using fingertip capillary whole blood, to estimate the prevalence of impaired fasting glucose (IFG; FBG ≥5.6 mmol/L and less than 6.1 mmol/L) and diabetes (FBG ≥6.1 mmol/L, or treatment with insulin and/or oral blood glucose-lowering drugs). Patients' awareness and management of diabetes were assessed by questionnaire.
  
  
  RESULTS
  The prevalence of diabetes and IFG was 2.9% [95% confidence interval (95%CI): 1.8-4.0] and 2.5% (95%CI: 1.3-3.7), respectively. Diabetes was more frequent among urban dwellers (OR=2.92, 95%CI: 1.45-5.86), mostly due to urban-rural differences in age, education, body mass index (BMI) and waist circumference (adjusted OR=2.27, 95%CI: 0.83-6.26). In all, 13% of those with diabetes were aware of their condition, 10.9% had undergone glycaemia determination during the previous year, and 9% were being treated with oral blood glucose-lowering drugs and 3% with insulin.
  
  
  CONCLUSIONS
  Diabetes prevalence is low in Mozambique, but most diabetic patients were neither aware of their condition nor being treated pharmacologically, thus posing serious challenges to the provision of adequate care in an already disadvantageous context.
authors.affiliation: Department of Non-Communicable Diseases, Mozambique Ministry of Health, Maputo, Mozambique.
authors.forename: C
authors.initials: C
authors.lastname: Silva-Matos
authors.forename: A
authors.initials: A
authors.lastname: Gomes
authors.forename: A
authors.initials: A
authors.lastname: Azevedo
authors.forename: A
authors.initials: A
authors.lastname: Damasceno
authors.forename: A
authors.initials: A
authors.lastname: Prista
authors.forename: N
authors.initials: N
authors.lastname: Lunet
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000097:blood / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D005951:Glucose Tolerance Test; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000453:epidemiology; D008297:Male; D016488:Medicine, African Traditional; D008875:Middle Aged; D009073:Mozambique / Q000453:epidemiology; D012307:Risk Factors
chemical_list: D001786:Blood Glucose