title: Very low rates of screening for metabolic syndrome among patients with severe mental illness in Durban, South Africa.
abstract: BACKGROUND
  Sub Saharan African is experiencing the largest increase in the prevalence of type 2 diabetes mellitus and cardiovascular disease globally. Metabolic syndrome (MetS) is a cluster of risk factors for these conditions. There is a consistently higher prevalence of cardiometabolic disease among individuals with severe mental illness (SMI) compared to the general population worldwide. However, it is known from research in high income countries that screening for MetS in patients with SMI is low. The objective of this study was to document the extent of the expected low frequency of testing for all the components of the metabolic syndrome (MetS) in patients with SMI in a low middle income country.
  
  
  METHODS
  This was a cross sectional study, undertaken from January to June 2012 on out-patients with SMI who were treated with antipsychotic medication for at least 6 months. The study measured the proportion of participants who were tested for MetS in the previous year.
  
  
  RESULTS
  The study included 331 (M: F; 167:164) participants with a mean age of 35.2 ± 11.98 years. The majority (78.8%) were black South Africans. Only 2 subjects (0.6%) were screened for all five components of MetS. Regarding the individual components, 99%, 0.6%, 3.9% and 1.8% were screened for raised blood pressure, abdominal obesity, hyperglycaemia, hypertriglyceridaemia and decreased high density lipoprotein cholesterol respectively.
  
  
  CONCLUSIONS
  It is unacceptable that less than one percent of our participants were adequately screened for modifiable risk factors for type 2 diabetes mellitus and cardiovascular disease which are the most common causes of mortality among patients with SMI. These results highlight the need for translating guidelines into action in low and middle income countries.
authors.forename: Shamima
authors.initials: S
authors.lastname: Saloojee
authors.forename: Jonathan K
authors.initials: JK
authors.lastname: Burns
authors.forename: Ayesha A
authors.initials: AA
authors.lastname: Motala
mesh_terms: D000328:Adult; D000368:Aged; D014150:Antipsychotic Agents / Q000627:therapeutic use; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000453:epidemiology*; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D001523:Mental Disorders / Q000188:drug therapy / Q000453:epidemiology*; D024821:Metabolic Syndrome / Q000453:epidemiology*; D008875:Middle Aged; D010045:Outpatients; D015995:Prevalence; D012307:Risk Factors; D013019:South Africa / Q000453:epidemiology; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents
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