title: Prevalence and determinants of diabetic polyneuropathy in a sub-Saharan African referral hospital.
abstract: BACKGROUND
  Diabetic peripheral neuropathy is the commonest complication of diabetes mellitus, and a major cause of limb amputations. In general however, the magnitude of diabetic neuropathy in sub-Saharan Africans with diabetes has been less reliably quantified. We assessed the prevalence and determinants of diabetic polyneuropathy in hospital settings in Cameroon.
  
  
  METHODS
  We conducted a cross-sectional survey at the Douala Laquintinie Hospital, which is one of the main reference hospital in the economic capital of Cameroon (3 million populations). Participants included all patients with type 1 (T1DM) or type 2 (T2DM) diabetes who reported to the hospital regardless of the reason, during a 5-month recruitment period. Polyneuropathy was defined as diabetic in a patient with a Diabetic Neuropathy Examination score of >3/16 and/or a monofilament score of <5/9.
  
  
  RESULTS
  A total of 306 patients were recruited, including 196 women (64%) and 294 (96%) with T2DM. The mean (standard deviation) values were 59.8 (11.2) years for age and 8.4 (8.2) years for diabetes duration. Clinical signs of polyneuropathy were present in 102 (crude prevalence rate: 33.3%) patients. The polyneuropathy was symptomatic in 79/102 (77.4%) patients. Determinants of polyneuropathy were urban residence (p=0.02), infection with hepatitis C virus (p=0.002), infection with HIV (p=0.012) and presence of albuminuria (p=0.0001).
  
  
  CONCLUSIONS
  About one in three patients with diabetes reporting to the hospital in our setting has prevalent diabetes related polyneuropathy. This emphasizes the importance of routine implementation of therapeutic education and other measures to limit the complications.
authors.affiliation: Faculty of Medicine and Biomedical Sciences, University of Yaounde 1, Cameroon; Neurology Department, Douala Laquintinie Hospital, Cameroon. Electronic address: kuate.callixte@gmail.com.
authors.forename: C
authors.initials: C
authors.lastname: Kuate-Tegueu
authors.affiliation: Department of Internal Medicine, Douala General Hospital, Cameroon.
authors.forename: E
authors.initials: E
authors.lastname: Temfack
authors.affiliation: Neurology Department, Douala Laquintinie Hospital, Cameroon.
authors.forename: S
authors.initials: S
authors.lastname: Ngankou
authors.affiliation: Neurology Department, Douala Laquintinie Hospital, Cameroon; Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Cameroon.
authors.forename: J
authors.initials: J
authors.lastname: Doumbe
authors.affiliation: Faculty of Medicine and Biomedical Sciences, University of Yaounde 1, Cameroon.
authors.forename: V P
authors.initials: VP
authors.lastname: Djientcheu
authors.affiliation: South African Medical Research Council & University of Cape Town.
authors.forename: A P
authors.initials: AP
authors.lastname: Kengne
mesh_terms: D000368:Aged; D002163:Cameroon / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003929:Diabetic Neuropathies / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012044:Regression Analysis
keywords: Africa; Cameroon; Diabetes mellitus; Diabetic neuropathy; Painful diabetic neuropathy; Polyneuropathy; Prevalence; Risk factors