Prevalence and risk factors for hypertension and diabetes among those screened in a refugee settlement in Uganda
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Date
2021
Journal Title
Journal ISSN
Volume Title
Publisher
Conflict and Health
Abstract
Diabetes and hypertension are increasingly prevalent in low and middle income countries, but they
are not well documented in refugee settlements in these settings. We sought to estimate the prevalence and
associated characteristics of diabetes and hypertension among adults presenting for clinic-based HIV testing in
Nakivale Refugee Settlement in Uganda.
Methods: HIV-negative adults presenting to outpatient clinics for HIV testing at three health centers in Nakivale
Refugee Settlement were enrolled from January 2019 through January 2020. Multi-lingual research assistants
administered questionnaires aloud to ascertain medical history and sociodemographic information. The research
assistants used standardized procedures to measure participants’ blood pressure to detect hypertension (systolic
blood pressure ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg), and conduct a point-of-care blood glucose
test for diabetes (random blood glucose ≥11.1 mmol/L with self-reported frequent urination or thirst, or fasting
blood glucose ≥7.0 mmol/L regardless of symptoms), as per Uganda Ministry of Health guidelines. We used χ-
square or Fisher’s exact test to test for differences in disease prevalence by refugee status and log-binomial or
Poisson regression models to estimate associations of immigration status and country of origin, respectively, with
hypertension and diabetes while controlling for age, sex, education level, and body mass index.
Results: Among 2127 participants, 1379 (65%) were refugees or asylum seekers and 748 (35%) were Ugandan
nationals. Overall, 32 participants met criteria for diabetes (1.5%, 95% CI 1.1–2.1%) and the period prevalence was
2.3% (95% CI 1.7–3.0). There were 1067 (50%, 95% CI 48.0–52.2%) who met the criteria for pre-hypertension and 189
(9%, 95% CI 7.7–10.1%) for hypertension. These proportions did not vary by immigration status or country of origin
in univariate tests or multivariable regression models. Conclusions: Hypertension was common and diabetes was uncommon among those screened in a Ugandan
refugee settlement. Routine blood pressure screening should be considered in this setting. Additional research
could develop diabetes screening criteria to help identify at risk individuals in this limited resource setting.
Description
Keywords
Hypertension, Diabetes, Refugee, Health screening
Citation
Kubiak, R. W., Sveum, E. M., Faustin, Z., Muwonge, T., Zaidi, H. A., Kambugu, A., ... & O’Laughlin, K. N. (2021). Prevalence and risk factors for hypertension and diabetes among those screened in a refugee settlement in Uganda. Conflict and Health, 15, 1-8. https://doi.org/10.1186/s13031-021-00388-z