title: Use of medical services and medicines attributable to type 2 diabetes care in Yaoundé, Cameroon: a cross-sectional study.
abstract: The increasing numbers of people with type 2 diabetes (T2D) is a global concern and especially in sub-Saharan Africa, where diabetes must compete for resources with communicable diseases. Diabetes intensifies health care utilisation and leads to an increase in medical care costs. However, In Cameroon like in most developing countries, data on the impact of diabetes on the medical health system are scarce. We aimed to analyse the use of medical services and medicines attributable to T2D care in Yaoundé, Cameroon.
  
  
  
  We conducted a cross-sectional study comparing the use of medical services and medicines on 500 people with T2D attending the diabetic outpatient units of three hospitals in Yaoundé and 500 people without diabetes matched for age, sex and residence. We performed multivariate logistic and quantile regressions to assess the effect of diabetes on the use of medical services and medicines and the presence of other chronic health problems. Models were adjusted for age, educational level, marital status, occupation and family income.
  
  
  
  Overall, the rate of use of health services was found to be greater in people with T2D than those without diabetes. People with T2D had greater odds of having an outpatient visit to any clinician (OR 97.1 [95% CI: 41.6-226.2]), to be hospitalised (OR 11.9 [95% CI: 1.6-87.9]), to take at least one medicine (OR 83.1 [37.1-185.8]) compared with people without diabetes. We also observed an association between diabetes and some chronic diseases/diabetes complications including hypertension (OR 9.2 [95% CI: 5.0-16.9]), cardiovascular diseases (OR 1.9 [95% CI: 0.8-4.9]), peripheral neuropathy (OR 6.2 [95% CI: 3.4-11.2]), and erectile dysfunction (OR 5.8 [95% CI: 2.7-12.1]).
  
  
  
  This study showed that the presence of diabetes is associated with an increased use of health care services and medicines as well as with some chronic diseases/diabetes complications.
authors.affiliation: Department of Public Health, Faculty of Medicine and Biomedical sciences, The University of Yaoundé I, Yaoundé, Cameroon. mapatassou@yahoo.fr.
authors.forename: Clarisse
authors.identifier: 0000-0002-0709-1449
authors.initials: C
authors.lastname: Mapa-Tassou
authors.affiliation: University of Paris 13, Sorbonne Paris Cité - UREN (Unité de Recherche en Epidémiologie Nutritionnelle), U557 Inserm; U1125 Inra; Cnam; CRNH IdF, F-93017, Bobigny, France.
authors.forename: Leopold K
authors.initials: LK
authors.lastname: Fezeu
authors.affiliation: Department of Public Health, Faculty of Medicine and Biomedical sciences, The University of Yaoundé I, Yaoundé, Cameroon.
authors.forename: Zakariaou
authors.initials: Z
authors.lastname: Njoumemi
authors.affiliation: Diabetes Research and Training Centre and Division of Endocrinology, Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, USA.
authors.forename: Eric
authors.initials: E
authors.lastname: Lontchi-Yimagou
authors.affiliation: Department of Internal Medicine and specialties, Faculty of Medicine and Biomedical sciences, The University of Yaoundé I, Yaoundé, Cameroon.
authors.forename: Eugène
authors.initials: E
authors.lastname: Sobngwi
authors.affiliation: Department of Internal Medicine and specialties, Faculty of Medicine and Biomedical sciences, The University of Yaoundé I, Yaoundé, Cameroon.
authors.forename: Jean Claude
authors.initials: JC
authors.lastname: Mbanya
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000706:statistics & numerical data; D002163:Cameroon; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D003906:Developing Countries; D048909:Diabetes Complications / Q000150:complications / Q000628:therapy*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000628:therapy*; D003925:Diabetic Angiopathies / Q000150:complications / Q000628:therapy; D005260:Female; D017048:Health Care Costs; D006296:Health Services / Q000706:statistics & numerical data; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000628:therapy; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007182:Income; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data
chemical_list: D007004:Hypoglycemic Agents
keywords: Africa; Cameroon; Complications; Medical services; Medicines; Type 2 diabetes